Early detection of disabilities in children is key to effective and inclusive early childhood development (ECD). Identification can lead to design of effective follow up and rehabilitation services so that further delays in the child’s development are prevented. Literature suggests there is a strong need to strengthen disability identification systems (conceptualisation, access and follow-up support systems) across countries and especially in poorer contexts.

The proposed study will conduct a systematic analysis of existing models of early detection and referral pathways for children with or at risk of disability, focusing on the primary and community health care system.

The aim is to understand the policy context, available structures and systems, enabling and constraining factors, and assess system effectiveness, and the lessons provided by the Tanzania case study on strengthening service delivery for early detection and referral of children with disabilities more widely.

This will contribute to understanding the policies, systems and processes in place for identification and referral for children with disabilities. The lessons generated will be useful for other similar contexts and contribute to global evidence on early detection systems for children with disability and how they can be better integrated into national service delivery systems.

The study has the following objectives:

• To conduct a systematic analysis to map and assess existing models of early detection and referral pathways for children with or at risk of disabilities in mainland Tanzania, focusing on the primary and community health care system (key entry points for early years)
• To understand the strengths and weaknesses of the existing systems
• To generate evidence on how these systems could be strengthened in Tanzania and other similar settings

• Qualitative methods
• Participatory methods