Acceptability, feasibility and preliminary evaluation of the WHO caregiver skills training for children with developmental disabilities in rural and urban Kenya

Background Interventions to improve the developmental outcomes of children with developmental disabilities (DDs) in low-resourced settings such as Kenya are limited. The WHO caregiver skills training (CST) was developed to address social and communication needs of children with DDs through caregiver-mediated engagement strategies. This study investigated CST's acceptability, feasibility and evaluated its effect on behavioural, communication and quality of life outcomes for children with DDs and their caregivers in Kenya. Methods The settings were rural Kilifi and Korogocho informal settlement in Nairobi, Kenya. A sequential mixed-methods design consisting of three phases. First, CST materials translation to Swahili, stakeholder consultations and pretesting the adapted CST with caregivers. A pilot with 90 caregivers randomly assigned to the CST or non-CST arm followed. Postintervention discussions with caregivers explored CST's acceptability. Quantitative data were analysed using descriptive statistics and tests of associations. Qualitative data were analysed using thematic analysis. Results The adapted Swahili CST materials were found acceptable. Stakeholders reflected on the appropriateness, potential barriers and recommended approaches to improve CST. CST's perceived benefits were increased awareness of DDs and support resources, and stigma management. Overall, 86% of caregivers attended two-thirds of CST sessions, though non-attendance was mostly recorded in informal settings. CST's preliminary evaluation suggested improved scores on child and caregiver outcomes. Conclusion WHO CST is a € promising' intervention that needs adaptations and serves the needs of families of children with DDs in Kenya. Future studies evaluating CST's efficacy and feasibility for scale-up in health, education and community-based systems are needed.