Thesis highlights need for early interventions in Sub-Saharan Africa's children at risk of developmental delays
Anna-Theresia Ekman recently achieved a significant milestone by successfully defending her doctoral thesis, which examines developmental risks among children in sub-Saharan Africa. Through extensive field studies in five countries, she shows that many children are at risk of not reaching age-appropriate developmental milestones – particularly in environments marked by poverty and undernutrition.
Children with disabilities have often been excluded from mainstream developmental efforts due to a lack of data on their prevalence and risk factors, especially in low- and middle-income countries like those in Sub-Saharan Africa. To address this data gap, the UNICEF Multiple Indicator Cluster Surveys introduced the child functioning module in 2017, which measures functional difficulties and identifies children at risk of disability.
Anna-Theresia Ekman’s thesis comprises four sub-studies, each of them contributing to the overall aim: to better understand the characteristics of childhood disability and how to increase early child development services, with focus on an underserved region.
Anna-Theresia Ekman’s thesis comprises four sub-studies, each of them contributing to the overall aim: to better understand the characteristics of childhood disability and how to increase early child development services, with focus on an underserved region.
In her initial study, Ekman utilized data from Sierra Leone to determine the number of children at risk of disability, and to identify the risk and resilience factors through the child functioning module.
The second study explored whether children at risk of disability have increased odds of common childhood infections. It also examined their healthcare-seeking behavior.
"These studies reaffirmed increased health and development risks among children with functional difficulties and highlight the importance of identifying these children early in order to provide support," says Ekman.
In the third study, the prevalence of children at risk of developmental delays or disabilities was estimated in Sierra Leone, Comoros, Nigeria, Benin, and Eswatini. The findings revealed particularly high prevalence in Eswatini, with boys and younger children generally facing greater risks. These risks were strongly linked to undernutrition and socioeconomic vulnerability.
The fourth study explored how child health stakeholders in Uganda perceive preventive child health services. Through in-depth interviews and focus group discussions, a clear need emerged for developing integrated, sustainable, and reliable health services. Early identification of children at higher risk of health problems was highlighted as a key priority.
"Well-child visits have the potential to improve outcomes for children, especially those at risk of developmental delays and disabilities. For such an endeavour to be successful it is vital that the project is well anchored within existing health systems. A collaborative, co-design approach – combined with strong local leadership – will ensure relevant stakeholders are actively engaged in expanding well-child visits within the region," Ekman concludes.
Anna-Theresia Ekman’s doctoral thesis contributes important knowledge about child health and development in low-income countries and underscores the importance of early interventions – especially in communities where resources are limited but needs are great.