“…In low-income settings, families of children with DD tend to receive little or no formal support and are financially strained by healthcare costs and the inability to work due to caring responsibilities ( Colombi & Ghaziuddin, 2017 ; Global Research on Developmental Disabilities Collaborators, 2018 ). Similar challenges have been reported across sub-Saharan Africa ( Ambikile & Outwater, 2012 ; Dambi et al, 2015 ; Gona et al, 2016 ; Schlebusch & Dada, 2018 ; Tilahun et al, 2016 ) often with detrimental effects on the quality of life of children with DD and their families ( Ambikile & Outwater, 2012 ; Schlebusch et al, 2017 ), aggravated by stigma and lack of support by community members, healthcare workers and education professionals ( Ajuwon & Brown, 2012 ; Bakare et al, 2009 ; Gona et al, 2016 ; Tekola et al, 2016 ; Tilahun et al, 2016 ). The inadequacy or absence of specialist child mental healthcare has been noted in several African countries, including Uganda, Ethiopia, Kenya, Ghana, Zambia and to some extent South Africa ( Akol et al, 2015 ; Getanda et al, 2017 ; Kleintjes et al, 2010 ; Tekola et al, 2020 ; Tilahun et al, 2016 ; Van Schalkwyk et al, 2016 ).…”