Global Health Research Unit on Neurodevelopment and AutisM in South ASia Treatment and Evidence (NAMASTE)

Project Details


Research question

Evaluation of the implementation and effectiveness of a detection and intervention care pathway for neurodevelopmental disability and autism spectrum disorder in four contrasting health systems in South Asia.


Neuro psychiatric disorder accounts for 15 to 30% of the disability adjusted life years lost during the first three decades of life and poses new challenges for health systems.

South Asia has the highest prevalence of neurodevelopmental disability (NDD) of any nation and about 95% of autistic spectrum disorder (ASD) children live in low and middle income countries.

Over a decade of collaboration, we have undertaken the first detection study for NDD and ASD in India, and have adapted for South Asia an effective UK ASD intervention.

The resulting PASSPlus intervention, delivered by non-specialists, is the first of its kind with demonstrated effectiveness in published trials; supported by a digital training and supervision platform.

In parallel, colleagues in the World Health Organisation have developed CST, a group intervention for child developmental disability.

Aims and objectives

Building on this previous work, NAMASTE will test the implementation and effectiveness of a combined stepped detection and intervention pathway, identifying children with NDD or ASD and linking them to CST and/or PASSPlus ASD intervention.

We will test the components of this pathway within four health systems that differ markedly in their implementation settings, along with building their clinical and research capacity and investigating cost-effectiveness aspects of delivery.


Four workstreams:

•WS1 - tool and workforce development
•WS2 - detection pathway implementation
•WS3 - intervention implementation
•WS4 - community inclusion and participation

Detection and intervention evaluation measures will be adapted and evidence-based. We will evaluate:

i) the accceptability and effectiveness of digital training
ii) the feasibility and acceptability of detection and its validity against independent clinical assessment
iii) intervention effectiveness on family outcomes and child development, through a pre-post observational cohort design
iv) case studies and mixed methods evaluation of community and public engagement.

A combined analysis will evaluate the whole detection intervention system by site as a measure of programme success and implementation learning.


•Y1: establishment and start-up, community engagement, completion of WS1.
•Y2: detection pathway.
•Y3: intervention pathway.
•Y4: detection and intervention pathway completed.
•Y5: Analysis, write-up, dissemination and completion of postgraduate programmes. 

Dissemination and impact

The evaluation of the digitally-supported detection and care pathway in NAMASTE will be the first of its kind in LAMIC, disseminated professionally and in the community.

This GHRU will have built clinical and research capacity and have impact as a regional research and training hub in South Asia and potentially beyond, along a theory of change pathway towards universal health coverage for NDD and ASD in LAMIC.
Effective start/end date1/09/2231/08/27

Collaborative partners

  • The University of Manchester (lead)
  • Sangath (Joint applicant)
  • AutismCare Nepal Society (Collaborator)
  • Ministry of Health Sri Lanka (Collaborator)
  • Dimagi Software Innovations Pvt (Collaborator)
  • La Trobe University (Collaborator)
  • Harvard Medical School (Collaborator)
  • Pass Plus Competency Consultants (Sub-contractor)
  • Erica Salomone Consultancy (Person) (Sub-contractor)
  • King's College London (Collaborator)


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