Perceived barriers and opportunities to the continuous distribution of ivermectin in the Cameroon primary health care system: an exploratory study of major stakeholders.

Early childhood (0–5 years) represents a critical period for development, during which rapid changes occur across motor, cognitive, social, and emotional domains [, , ]. Motor development plays a central and foundational role in this process, as it not only reflects the maturation of neuromuscular systems but also actively drives children’s engagement with their physical and social environments []. Importantly, motor development both influences and is influenced by cognitive, social, and emotional domains, emerging from dynamic interactions between the individual and multiple environmental systems, including family, school, and broader sociocultural contexts [, ]. Understanding how these factors interact to shape motor development in early childhood is essential for identifying potential risks and promoting optimal development across multiple domains []. Building on this perspective, child development results from interactions between individual characteristics and multiple environmental systems []. Thus, child development is shaped not only by biological factors but also by the quality and diversity of movement-related opportunities available within children’s immediate contexts (e.g., family, school) and broader socioeconomic and cultural environments [, ]. These opportunities are particularly relevant for motor development, as repeated engagement in movement experiences supports skill acquisition and refinement. Further, from a bioecological perspective, proximal processes, such as children’s everyday interactions with people, objects, and spaces in the microsystems where they participate (e.g. at home [, ] or in daycare centers [, ], represent key mechanisms through witch development occurs []. However, despite this theoretical understanding, there is still limited evidence on how these contextual opportunities shape motor development in early childhood. Conversely, biological and perinatal risk factors, such as prematurity [, ] and low birthweight [, ], can compromise development. Contextual risks, including poverty [, , , , ], limited access to health services [], lack of school enrollment [], and restricted access to adequate physical space for movement [, ], also negatively influence development, often with long-term consequences [, ]. When these constraints co-occur, their effects accumulate across developmental systems, increasing the likelihood of atypical motor development trajectories [, ].