Published in PLOS One on 2026-08-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Selamawit Gebeyehu, Monique Mommers, Sultan Hussen, Mark Spigt
Source: PLOS One • DOI 10.1371/journal.pone.0355686
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Developmental delays in early childhood present significant long–term challenges, making early developmental assessment crucial for effective intervention. Despite this, such assessments are not routinely implemented within routine healthcare services in Ethiopia. This study examines the barriers and facilitators affecting both the provision and accessibility of developmental assessments by exploring the experiences of health professionals and parents of under–five children.
A descriptive qualitative study was conducted in the Gamo Zone, South Ethiopia, between August 2023 and January 2024. Twenty semi‑structured Key Informant Interviews (KII) were undertaken with purposively selected key informants, including one zonal maternal and child health (MCH) focal person, two MCH officers, two MCH coordinators, two pediatricians, three pediatric nurses, four general practitioners, and six parents of children under five years of age. All interviews were audio‑recorded, transcribed verbatim, and analyzed using ATLAS.ti 7. A thematic analysis approach was applied to identify barriers and facilitators influencing the provision and accessibility of child developmental assessments.
Health professionals reported challenges that hindered the delivery of effective developmental assessments, including poor infrastructure, limited government commitment, funding shortages, and insufficient knowledge and technical skills regarding developmental delays and assessment procedures. Conversely, the structured layout of the existing health‑care system and an established referral pathway were reported as operational facilitators to support the provision of these services. Parents described barriers to accessing developmental assessments, including low socioeconomic status, prevailing community beliefs, societal attitudes, and stigma toward children with developmental delays. Encouragingly, broad community trust in and acceptance of routine child health programs emerged as an important facilitator that improved access to developmental assessment services.
Improving the integration of developmental assessment into Ethiopia’s routine child health services requires addressing both system‑level shortcomings and the social realities that shape families’ access to care. A practical, implementation‑focused approach, one that strengthens frontline capacity, reinforces existing health‑system structures, and builds on community trust, offers the most promising path forward. With coordinated commitment, developmental assessment can shift from a neglected service to a reliable and sustainable part of pediatric care.
Introduction
Early childhood is widely regarded as the most critical stage of development, forming the foundation for success and well–being throughout the lifespan [1,2]. Unfortunately, not every child has the opportunity to develop to their full potential; developmental disabilities are, in fact, the leading cause of childhood disability worldwide. In 2016, the Global Burden of Disease (GBD) study estimated that 52.9 million children globally (8.4%) were affected by one of six developmental disabilities: intellectual disability, attention–deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, hearing loss, or vision loss [3]. The majority of children with developmental disabilities reside in low–and middle–income countries (LMICs). Nigeria, the Democratic Republic of the Congo, and Ethiopia are among the top 10 African countries with the largest burden of pediatric developmental disabilities [2–8].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Selamawit Gebeyehu, Monique Mommers, Sultan Hussen, Mark Spigt. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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