Barriers to Developmental Assessment in Ethiopia: Qualitative Insights

The PLOS One qualitative study by Gebeyehu et al. (published August 10, 2026) finds that developmental assessment in Ethiopia is constrained by limited political priority, weak infrastructure, undertrained staff, cultural stigma, and parental cost barriers (PLOS One).

• 20 key informant interviews were conducted between August 2023 and January 2024, including 14 healthcare professionals and 6 parents, as reported in the PLOS One study published on August 10, 2026.
• As of July 2024 the Gamo Zone population was estimated at 2, 391, 628 with about 368, 310 children under five, context supplied by Gebeyehu et al. in PLOS One.
• Prior local data cited in the study show only 28.6% of providers assessed milestones in Addis Ababa in 2021 and just 3.7% used a standardized screening tool, according to the study authors referencing Tesfay (2021).
• Facility-level barriers in the PLOS One study include crowded vaccination rooms, missing IMNCI manuals, and staff seeing up to 50 patients per day, which limits time for observational assessments.

Answer: a descriptive qualitative study in the Gamo Zone explored why developmental assessment is not routine and what obstructs access, using semi-structured interviews between August 2023 and January 2024, as reported in PLOS One (published August 10, 2026).

According to Gebeyehu et al. in PLOS One, the researchers purposively sampled 20 key informants including one zonal MCH focal person, MCH officers, pediatricians, nurses, general practitioners, and six parents, then transcribed and thematically analyzed audio-recorded interviews using ATLAS.ti 7.

According to the PLOS One study, the team mapped emergent themes to the Consolidated Framework for Implementation Research (CFIR) to organize barriers across outer setting, inner setting, characteristics of individuals, and intervention characteristics.

Answer: implementers must address policy, capacity, workforce, and community barriers together to make developmental assessment routine, according to Gebeyehu et al. in PLOS One (published August 10, 2026).

According to the PLOS One study, low political priority and limited dedicated funding reduce the availability of screening tools and training, so researchers should pair implementation research with local advocacy and costing exercises to generate actionable evidence for policymakers.

According to the PLOS One findings, crowded OPDs and lack of private space block observational assessments, therefore implementers should pilot low-cost spatial reconfigurations like 'developmental monitoring corners' co-located with EPI and nutrition services.

According to Gebeyehu et al., provider knowledge gaps and heavy workloads mean training must be short, practical, and paired with supportive supervision and referral pathways; evaluation should measure fidelity, provider confidence, and referral completion rates.

The PLOS One study by Gebeyehu et al. (published August 10, 2026) shows that making developmental assessment routine in Ethiopia requires coordinated policy attention, low-cost infrastructure fixes, targeted training, and community engagement (PLOS One).

Researchers and implementers should use CFIR-aligned indicators and pragmatic pilots that pair facility reconfiguration with brief competency-based training, then measure fidelity and access.

For teams doing qualitative implementation research, Evidano can speed transcription, translate multilingual interviews, produce CFIR-mapped thematic analyses, and generate visualizations that make findings directly actionable; see Evidano features.

Next steps: reproduce the Gamo Zone interview protocol, collect baseline facility audits, and run a rapid pilot of 'developmental monitoring corners' linked to EPI clinics while measuring uptake and referral completion.

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