The pooled prevalence of developmental delays and its association with malnutrition among children in East Africa: a systematic review and meta-analysis

Abstract

Developmental delays refer to a child’s slower progress in achieving one or more developmental milestones, such as gross motor, fine motor, cognitive, communication, and social function at the expected age. It continues to be a major childhood public health concern, particularly in developing countries. In East Africa, although primary studies have investigated developmental delays and their associated factors, variations have been observed across these studies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of developmental delays and identify their association with malnutrition among children in East Africa. We exhaustively searched PubMed, HINARI, Science Direct, PsycINFO, Google Scholar, and African Journals Online to identify articles. We checked the quality of primary studies using the Joanna Briggs Institute checklist. Heterogeneity among studies was checked using I-squared statistics. Funnel plot visual inspection and Egger’s test were used to identify publication bias. The pooled prevalence of developmental delays was estimated using the random-effect model. The overall pooled prevalence of developmental delays among children was 23.90% (95%CI: 15.43, 35.10). whereas, the pooled prevalence of delay in gross motor, fine motor, communication, problem-solving, and personal social skills was 11.45%, 10.59%, 10.86%, 12.07%, and 10.12%, respectively. Moreover, stunting (OR: 2.01, 95%CI: 1.51; 2.67), underweight (OR: 3.99, 95% CI: 2.93; 5.44), wasting (OR: 2.82, 95%CI: 1.69; 4.69), initiation of complementary feeding before six months of age (OR: 2.83, 95%CI: 1.73; 4.64), not receiving a diversified diet (OR: 2.29, 95%CI: 1.51; 3.50), and preterm birth were factors associated with a higher risk of developmental delays. In East Africa, the pooled prevalence of developmental delays among children is notably higher than reported in previous literature. The risk of developmental delays is higher among children who have experienced malnutrition (stunting, underweight, and wasting). Moreover, children who did not receive a diversified diet are at an increased risk of developmental delays. Therefore, governments of each country should develop and implement an integrated child developmental surveillance and screening strategy, particularly for high-risk children, to facilitate early intervention for children with abnormalities. Moreover, children experiencing malnutrition should receive appropriate developmental stimulation interventions to prevent developmental delays.

The authors' abstract, as published at the source. BMC Public Health, 2026 · DOI ↗