{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:16:51Z","timestamp":1788445011604,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Pediatrics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Developmental delay (DD) is a major public health concern in Sub-Saharan Africa (SSA). This systematic review and meta-analysis estimated the pooled prevalence of DD and identified associated factors among children in SSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational studies were identified from PubMed, Google Scholar, CINAHL, Scopus, Cochrane Library, Web of Science, and African Journals Online. Data were analyzed using STATA version 16 with a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pooled prevalence was\n                      <jats:bold>33.00%<\/jats:bold>\n                      (95% CI: 22.00\u201344.00). Subgroup analysis showed the highest prevalence in South Africa (\n                      <jats:bold>37.00%; 95% CI: 10.00\u201373.00<\/jats:bold>\n                      ). Maternal education (AOR = 0.41; 95% CI: 0.24\u20130.72), child age (AOR = 0.43; 95% CI: 0.23\u20130.81), maternal age (AOR = 0.24; 95% CI: 0.10\u20130.57), and nutritional status (AOR = 3.59; 95% CI: 1.08\u201311.92) were significantly associated with DD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pooled prevalence of DD in Sub-Saharan Africa is high. Maternal education, child age, maternal age, and nutritional status were key factors associated with DD. Strengthening early screening, improving maternal education, and promoting optimal child nutrition are essential to reduce the burden of developmental delay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/30502225261485776","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:39:57Z","timestamp":1788187197000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Associated Factors of Developmental Delay Among Under-five Children in Sub-saharan African Countries: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-862X","authenticated-orcid":false,"given":"Angefa","family":"Ayele","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Armaur Hansen Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belayneh Jejaw","family":"Abate","sequence":"additional","affiliation":[{"name":"University of Gondar Comprehensive Specialized Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliyas Addisu","family":"Taye","sequence":"additional","affiliation":[{"name":"University of Gondar Comprehensive Specialized Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Endalew Minwuye","family":"Andargie","sequence":"additional","affiliation":[{"name":"Debre Berhan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halima Ayalew","family":"Kebede","sequence":"additional","affiliation":[{"name":"Woldia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen Brhan","family":"Alemaw","sequence":"additional","affiliation":[{"name":"Woldia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofiya Ayalew","family":"Kebede","sequence":"additional","affiliation":[{"name":"Wollo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashenafi Solomon","family":"Weldeyohanis","sequence":"additional","affiliation":[{"name":"Medical Teams International"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adem Tsegaw","family":"Zegeye","sequence":"additional","affiliation":[{"name":"University of Gondar Comprehensive Specialized Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6977-2672","authenticated-orcid":false,"given":"Alo","family":"Edin","sequence":"additional","affiliation":[{"name":"Institute of Health"},{"name":"Bule Hora University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31389-7"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60032-4"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30266-2"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002034"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1301524"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S369408"},{"key":"e_1_3_6_8_2","volume-title":"Early childhood development and developmental difficulties in low- and middle-income countries","author":"WHO","year":"2012","unstructured":"WHO. 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