Developmental Concerns, Parental Perceptions and Missed Opportunities from Different Levels of Health Centers in a Middle-Income Country

Objective To evaluate the concerns the parents have with the development of their children and related conditions and investigate how often these concerns are addressed at all levels of the healthcare system. Determining parental perceptions of these issues and highlighting missed opportunities is valuable for improving healthcare services. Methods A total of 451 parents attending a medical appointment for their children in outpatient clinics at tertiary, secondary and primary health centers were administered a questionnaire comprised of 45 questions pertaining to their concerns regarding the development of their children and related conditions, including sociodemographic characteristics, practices supporting child development, information resources and personal opinions, such as whether they had sufficient information. Results The parents of 130 children (28.8%) reported at least one developmental concern. Less than half of the concerned parents had visited a health center for these concerns. The area of greatest concern was language development, but the concerns differed based on setting. Among the related factors, having insufficient information ( p = 0.000, OR: 0.375, CI: 0.24–0.58) and not playing with the child ( p = 0.029, OR: 0.563, CI: 0.33–0.94) increased the risk of having developmental concerns. Only 15.5% of children were followed up in a developmental and behavioral manner. Conclusions The authors observed many concerns and missed opportunities to address them at all levels of health centers. Family physicians were more effective at eliciting these issues than pediatricians. These issues need to be addressed in the health system with consideration of its complexity and integrated culture.