RIGHTS principles for early intervention: right care at the right time for every infant, child and family in low and middle-income countries

Vollständiger Abstract

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Background Early intervention programmes for infants and young children at developmental risk are implemented inconsistently and inequitably worldwide. Variation in access, surveillance, referral, follow-up and service quality means that children and families may receive very different opportunities depending on where they live, system capacity and resources, laws, policy and local pathways. Practical, evidence-informed guidance is needed to translate ‘what should be done’ into ‘how to implement it’ across diverse settings. Methods This conceptual, practice-oriented article used a narrative review and an evidence-informed iterative framework-development process. Sources included global frameworks, clinical guidelines and evidence syntheses, randomised and longitudinal studies relevant to low and middle-income contexts and implementation science frameworks. Results We propose six Reach, Identify early, align Goals, Help families deliver, Track and improve and ensure Sustainability (RIGHTS) principles for early intervention programmes: (1) Reach underserved infants, children and families through proactive, equity-oriented and outreach-capable models; (2) Identify developmental risk early through standardised, feasible pathways with clear timepoints, tools, thresholds and referral circuits; (3) align Goals with family priorities, functioning and everyday routines through shared decision-making; (4) Help families deliver intervention using coaching, routines-based strategies and realistic doses of practice; (5) Track and improve systems through standards, service indicators, family experience measures and continuous learning cycles; and (6) ensure Sustainability by institutionalising governance, financing, workforce capacity and policy alignment for durable impact. Conclusions Early intervention programmes should be designed to connect timely identification with family-centred, functionally meaningful and feasible support. Embedding standardisation, equity, caregiver partnership and data-informed improvement into service design may reduce unwarranted variation and strengthen continuity of care. Priority research areas include implementation-effectiveness studies, equity impacts, minimum data sets and the cost-effectiveness of scalable and sustainable early intervention programmes.