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Objectives Nigeria has high rates of preterm births and unskilled deliveries, increasing risk of developmental delays and disabilities. Many affected children go undetected and lack access to early interventions. We aimed to enhance early detection and care through a strategy of developmental screening, referral, and caregiver support for families of children with delays or disabilities.Methods From February 2024 to August 2025, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), in partnership with RCPCH Global, Osun State Ministry of Health:Created child-friendly corners in 19 primary health centres.Trained of 292 health workers in early childhood development (ECD) and the Malawi Development Assessment Tool (MDAT).Integrated screening into immunisation clinics and established referral pathways.Supported a multidisciplinary (MDT) ECD centre at the tertiary hospital.Established caregiver support groups using the ‘Baby Ubuntu’ programme.Results 82% of health workers demonstrated improved ECD knowledge. The screening tool was considered simple, effective, and appropriate for resource-constrained settings. 8,100 children were screened, 98.7% showed no concerns, 0.7% presented developmental delays, and 0.6% required further assessment. 84% of children screened were <12 months. Caregiver satisfaction significantly improved regarding health worker ECD knowledge (97.4%, p=0.011) and services available (97.4%, p=0.007). Participation in support groups led to reported improvements in child development, caregiver confidence, and psychosocial wellbeing.Conclusions Integrating low-cost developmental screening into primary services is feasible in low-resource settings and enhances early identification of delays and disabilities. Establishing MDT services and peer-based caregiver programs can positively influence child outcomes and caregiver experiences.