Sociotechnical Misalignments in Hospital AI System Implementation: Qualitative Case Study.

Early childhood is widely regarded as the most critical stage of development, forming the foundation for success and well–being throughout the lifespan [,]. Unfortunately, not every child has the opportunity to develop to their full potential; developmental disabilities are, in fact, the leading cause of childhood disability worldwide. In 2016, the Global Burden of Disease (GBD) study estimated that 52.9 million children globally (8.4%) were affected by one of six developmental disabilities: intellectual disability, attention–deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, hearing loss, or vision loss []. The majority of children with developmental disabilities reside in low–and middle–income countries (LMICs). Nigeria, the Democratic Republic of the Congo, and Ethiopia are among the top 10 African countries with the largest burden of pediatric developmental disabilities [–]. In response, the World Health Organization (WHO) and other global organizations have launched initiatives to improve early childhood development worldwide, including in Ethiopia []. Programs such as the Healthy Child Program (HCP), the Nurturing Care Program, and the Care for Child Development program have been implemented [,]. The programs acknowledge early identification of developmental problems is an essential first step toward ensuring that children receive the necessary interventions and support to promote optimal growth and development [,,]. While developmental delay is a significant public health issue, its identification through early evaluation remains suboptimal, even in high–income countries [,]. A multi–country review highlighting this variability showed that the uptake of developmental checks fluctuates significantly by age and region: in Australia, 67.5% of children received checks at 12 months, and 61% at 3.5 years; in New Zealand, 68% received all core contacts by 12 months, with 89% receiving checks at 4 years. Sweden reports 89%–95% coverage for language screening at 2.5 years, while Canada reports 54% at 18 months. In the United Kingdom, 87% coverage was achieved at 12 months, and 78% at 2.5 years [].