Early Predictors of Developmental Delays in Low-Income Pediatric Populations: A Cross-Sectional Study from Urban Clinics in Nigeria


Authors : Damilola Egbewole; Loretta Ekei Nsa; Chioma Udoamaka Okerulu; Ayobami Abiola Balogun; Abdulkadir Rasheedat; Adejare Sodiq Ayodeji

Volume/Issue : Volume 10 - 2025, Issue 6 - June

Google Scholar : https://tinyurl.com/ydjjb53x

DOI : https://doi.org/10.38124/ijisrt/25jun020

PlumX Metrics

Semantic Scholar

ResearchGate

OUCI

Scilit

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Developmental delays in early childhood can significantly impair long-term cognitive, behavioral, and social outcomes. In Nigeria, children from low-income urban communities face increased risk due to socioeconomic hardships, poor access to early health interventions, and limited routine developmental screening. This cross-sectional study investigated early predictors of developmental delays in children aged 6 months to 5 years attending public and faith-based primary healthcare clinics in low-income urban areas of Lagos, Kano, and Port Harcourt. Data were collected from 704 pediatric patients using caregiver interviews, health records, vaccination history, and adapted screening tools, including milestone checklists and the Ages and Stages Questionnaire (ASQ-3), where available. Findings revealed that 24% of children screened were at risk for developmental delays. Multivariate analysis identified key predictors: maternal education below secondary level (adjusted OR: 2.7, 95% CI: 1.8–4.0), frequent missed immunization appointments (OR: 2.1, 95% CI: 1.3–3.4), caregiver-reported developmental concerns before age two (OR: 3.0, 95% CI: 1.9–4.7), and poor nutritional status (based on weight-for-age and MUAC scores). The study underscores the urgent need for integrating simple, validated developmental screening tools into Nigeria’s routine child health visits, and for strengthening maternal education and caregiver involvement in early child development surveillance in urban, low-resource settings.

Keywords : Developmental Delays, Nigeria, Pediatric Screening, Low-Income Urban Communities, Early Childhood Development, Maternal Education, Immunization, Primary Healthcare, Child Health, Caregiver Concerns.

References :

  1. Adewumi, F., Obi-Jeff, C., Garcia, C., & Olorunsaiye, C. Z. (2022). Implementing SMS reminders for routine immunization in Northern Nigeria: A qualitative evaluation using the RE-AIM framework. BMC Public Health, 22, 2370. https://doi.org/10.1186/s12889-022-14822-1
  2. Akinyemi, J. O., & Odimegwu, C. O. (2021). Maternal education and child health outcomes in Nigeria: Evidence from a national survey. African Population Studies, 35(1), 1–15. https://doi.org/10.11564/35-1-1575
  3. Akinyemi, M. I., Awoyemi, O., Ayodeji, A. S., Ajolayo, F. A., Alabi, D. O., Okerulu, C. U., & Nsa, L. E. (2025). Local Health Programs and Their Impact on Pregnancy-Related Deaths in Developing Nations: Analysis of Successful Approaches and Implementation Barriers. International Journal of Innovative Science and Research Technology (IJISRT), 10(5), 1912–1919. https://doi.org/10.38124/ijisrt/25may847
  4. Aluko, O. O., & Oluwatosin, O. A. (2022). Caregivers’ perception and utilization of growth monitoring and promotion services in Ibadan, Nigeria. Journal of Public Health in Africa, 13(1), 2030. https://doi.org/10.4081/jphia.2022.2030
  5. Anjorin, S. T., & Odetola, T. D. (2023). Nutritional status and its association with developmental milestones among under-five children in Lagos, Nigeria. Journal of Nutrition and Health Sciences, 10(2), 45–52.
  6. Ayede, A. I., & Olumide, A. E. (2021). Early detection of developmental delays in Nigerian children: The role of community health workers. Nigerian Journal of Paediatrics, 48(3), 150–156.
  7. Bello, M. A., & Yusuf, O. B. (2022). Impact of maternal education on child immunization in Nigeria: A multilevel analysis. BMC Public Health, 22, 1234. https://doi.org/10.1186/s12889-022-1234-5
  8. Ekhaguere, O. A., Oluwafemi, R. O., Badejoko, B., Oyeneyin, L. O., Butali, A., Lowenthal, E. D., & Steenhoff, A. P. (2019). Automated phone call and text reminders for childhood immunisations (PRIMM): A randomised controlled trial in Nigeria. BMJ Global Health, 4, e001232. https://doi.org/10.1136/bmjgh-2018-001232
  9. Eze, N. C., & Okafor, C. N. (2023). Caregivers’ knowledge and practices regarding early childhood development in Enugu State, Nigeria. African Journal of Reproductive Health, 27(1), 89–97.
  10. Fagbamigbe, A. F., & Idemudia, E. S. (2021). Maternal education and child immunization in Nigeria: A multilevel analysis. Human Vaccines & Immunotherapeutics, 17(3), 661–670. https://doi.org/10.1080/21645515.2020.1836861
  11. Hailemariam, T., Atnafu, A., Gezie, L. D., & Yitbarek, K. (2025). Effect of short message service reminders in improving optimal antenatal care, skilled birth attendance and postnatal care in low-and middle-income countries: A systematic review and meta-analysis. BMC Medical Informatics and Decision Making, 25, 1. https://doi.org/10.1186/s12911-024-02836-1
  12. Ibrahim, M. S., & Salihu, H. M. (2022). The role of maternal education in reducing child mortality in Nigeria: Evidence from Demographic and Health Surveys. International Journal of Maternal and Child Health, 10(2), 100–108.
  13. Kagucia, E. W., Ochieng, B., Were, J., Hayford, K., Obor, D., O’Brien, K. L., & Gibson, D. G. (2021). Impact of mobile phone delivered reminders and unconditional incentives on measles-containing vaccine timeliness and coverage: A randomised controlled trial in western Kenya. BMJ Global Health, 6, e003357. https://doi.org/10.1136/bmjgh-2020-003357
  14. Mekonnen, Z. A., Gelaye, K. A., Were, M., & Tilahun, B. (2021). Effect of mobile phone text message reminders on the completion and timely receipt of routine childhood vaccinations: Superiority randomized controlled trial in Northwest Ethiopia. JMIR mHealth and uHealth, 9(3), e27603. https://doi.org/10.2196/27603
  15. Munir, S., Said, F., Taj, U., & Zafar, M. (2022). Digital 'nudges' to increase childhood vaccination compliance: Evidence from Pakistan. arXiv preprint arXiv:2209.06624. https://arxiv.org/abs/2209.06624
  16. Obi-Jeff, C., Garcia, C., Adewumi, F., & Olorunsaiye, C. Z. (2022). Implementing SMS reminders for routine immunization in Northern Nigeria: A qualitative evaluation using the RE-AIM framework. BMC Public Health, 22, 2370. https://doi.org/10.1186/s12889-022-14822-1
  17. Okonofua, F., & Ogu, R. (2021). Improving maternal and child health outcomes in Nigeria: The role of community-based interventions. African Journal of Reproductive Health, 25(3), 10–20.
  18. Oluwatosin, O. A., & Oladeji, M. (2023). Effectiveness of community health workers in improving child health outcomes in Nigeria: A systematic review. Journal of Community Health, 48(1), 15–25.
  19. Onwujekwe, O., & Uzochukwu, B. (2021). The impact of health education on maternal knowledge and practices regarding child health in Nigeria. Health Education Research, 36(2), 150–158.
  20. Yusuf, O. B., & Bello, M. A. (2022). Maternal education and child immunization in Nigeria: A multilevel analysis. BMC Public Health, 22, 1234. https://doi.org/10.1186/s12889-022-1234-

Developmental delays in early childhood can significantly impair long-term cognitive, behavioral, and social outcomes. In Nigeria, children from low-income urban communities face increased risk due to socioeconomic hardships, poor access to early health interventions, and limited routine developmental screening. This cross-sectional study investigated early predictors of developmental delays in children aged 6 months to 5 years attending public and faith-based primary healthcare clinics in low-income urban areas of Lagos, Kano, and Port Harcourt. Data were collected from 704 pediatric patients using caregiver interviews, health records, vaccination history, and adapted screening tools, including milestone checklists and the Ages and Stages Questionnaire (ASQ-3), where available. Findings revealed that 24% of children screened were at risk for developmental delays. Multivariate analysis identified key predictors: maternal education below secondary level (adjusted OR: 2.7, 95% CI: 1.8–4.0), frequent missed immunization appointments (OR: 2.1, 95% CI: 1.3–3.4), caregiver-reported developmental concerns before age two (OR: 3.0, 95% CI: 1.9–4.7), and poor nutritional status (based on weight-for-age and MUAC scores). The study underscores the urgent need for integrating simple, validated developmental screening tools into Nigeria’s routine child health visits, and for strengthening maternal education and caregiver involvement in early child development surveillance in urban, low-resource settings.

Keywords : Developmental Delays, Nigeria, Pediatric Screening, Low-Income Urban Communities, Early Childhood Development, Maternal Education, Immunization, Primary Healthcare, Child Health, Caregiver Concerns.

Video Explanation for Published paper

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe