Background: The prevalence of cerebral palsy (CP) in countries in Africa is suggested to be higher than in Western countries. Research in Western resource-rich contexts has demonstrated the importance of environmental factors in the activities and participation of individuals with CP, as illustrated by the International Classification of Functioning, Disability and Health (ICF). Although the domains of the ICF are often acknowledged in research on CP in western contexts, the extent to which these domains have been explored in resource-limited areas is unknown. The current review aims to describe the nature of the current published literature on CP in African countries and how it aligns with the domains of the ICF. Methods: Key informants familiar with the literature on CP in Africa were consulted, and a literature search was conducted to identify articles on CP originating from countries in Africa. Identified articles were assessed to determine the ICF domains that align with the studies. Themes relating to each domain were identified. Results: Twenty-seven studies were included. The majority of studies were quantitative (70.3%) and focused on children or caregivers. Most studies included a body functions and structures component (70.4%), focusing on impairment rather than functioning. Activities and participation domains were addressed, but often focused solely on mobility. Environmental factors typically related to resources and policies and personal factors were often unexplored.
Conclusions:Research on CP in Africa tends to be grounded in a biomedical approach to disability and does not explicitly use the ICF as a guiding framework.Studies exploring body function and structures tend to be descriptive in nature, whereas activities and participation, and environmental and personal factors, represent modifiable factors that may be addressed with interventions. Knowledge translation activities that promote the ideas of the ICF in an African context should therefore be considered.
K E Y W O R D SAfrica, cerebral palsy, disability, ICF
The purpose of this special communication is to present ideas and thoughts from a symposium at the 75th Annual Meeting of the American Academy for Cerebral Palsy and Developmental Medicine. These included perspectives and lessons from 3 previously published review studies regarding cerebral palsy (CP) research in Brazil, India, and African countries, which explored the literature through the lens of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. Using this common lens, first we present the main findings of each of these articles, as well as the similarities and differences in CP research across these low-and middle-income countries (LMICs). Second, considering current evidence, lessons from other LMICs and based on our experiences, we raise recommendations of critical areas to be addressed such as ICF framework implementation and best evidence practice on CP, focusing on prevention, early diagnosis, and intervention
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