The prevalence of neurological impairments (NI) and disability may have been changing over the past three decades, but the overall burden and rehabilitation for older children are unknown in resource-scarce countries. Using data from epidemiolocal studies conducted between 2000 and 2020, I investigated changes over time in the prevalence and risk factors, premature mortality, and healthcare for older children with NI in a defined rural area along the Kenyan coast. I used empirical and literature estimates to model disability-adjusted life-years (DALYs) for the ages 5-14 years. The overall prevalence decreased from 61 per 1000 (95% confidence interval [CI] 48.0-74.0 in 2001 to 44.7 per 1000 (95%CI 40.9-48.6) in 2015 (p