Abstract:
Background: children with perinatal HIV exposure are at increased risk for neurodevelopmental (ND) delays, yet
little is known about ND screening implementation for this population.
Methods: This longitudinal study evaluated ND screening implementation at a health clinic in Kenya, from 9/2021 to
8/2023. children aged 18-36 months with perinatal HIV exposure were screened using a 12-item general ND tool.
Implementation outcomes—acceptability, feasibility, fidelity, and sustainability—were assessed through time-motion
observations, clinic records, and semi-structured interviews with caregivers and staff.
results: Of 507 eligible children, 405 (80%) were screened. screening rates were consistent over 24 months, with
average time reduced to under 5 min. facilitators included staff collaboration and caregiver support; barriers included
time constraints and child temperament.
conclusions: ND screening was acceptable, feasible, and sustainable. Policymakers should embed ND screening
within national child health programs, invest in workforce training and task-sharing models, strengthen referral and
follow-up systems, and ensure affordable access to services.
