Only 2% of Arab children who go to a Family Health Center (“Tipat Halab”) in East Jerusalem, have begun a process of child development evaluation, compared to 10-15% among the general population, according to a Jerusalem Institute for Policy Research study.
The study, conducted as part of a program operated by the Jerusalem municipality in family health centers with the aim of narrowing gaps and increasing the rate of evaluated children in the eastern part of the city, surveyed the challenges and stumbling blocks in the process that the child and parents must undergo – from raising initial concerns of developmental issues, to referral to a pediatrician who would then refer them to a child development center. Pediatricians and family practitioners in East Jerusalem are employed by concessionaires and not directly by the HMOs. They typically lack training in child development and do not perform routine child development examinations on children who come to see them; as such, referrals to child development centers for developmental evaluation are nearly always to the western part of the city. Beyond the transportation challenges in traveling to the western part of the city, it was reported that cultural accessibility and availability of Arabic translation at these centers is limited; finally, the evaluation summary and treatment recommendations are written almost exclusively in Hebrew and are submitted to the concessionaire clinic and not directly to the parents.
The parent survey conducted as part of the study included about 1,380 parents. The study found that there is a concern for developmental difficulties among 8% of the children, while only 2% have begun an evaluation process; an evaluation was actually conducted for 0.6% of the children. Furthermore, among those 8% of children suspected of having developmental difficulties, only 35% of them obtained a written referral for evaluation. An encouraging statistic – 88% of the children who did undergo evaluation, did begin treatment. These findings reflect a complex process, requiring parents to cope with many challenges and stumbling blocks. This is particularly so among those whose lives are already quite complex, and who have a low level of awareness of child development; narrowing the gaps in evaluating and treating child development issues is thus particularly difficult.