Caregiver’s perspectives on facilitators and barriers of active participation in cerebral palsy rehabilitation in North West Nigeria: a qualitative study

Abstract

Background Cerebral Palsy (CP) refers to the permanent disorders involving postural and movement control as a result of injury to the developing brain. As a result of impairment in postural and movement control, children with CP usually have problems in carrying out activities of daily living (ADL). This makes them dependent on help from their caregivers. Thus, for effective rehabilitation of children with CP, active participation of their caregivers is important. This study seeks to explore the facilitators and barriers of active participation of caregivers in the rehabilitation of children with CP in Kano, Nigeria. Methods The study design used was qualitative in-depth interview. The participants were caregivers of children with CP at Hasiya Bayero Paediatric Specialists Hospital, Kano. The caregivers were interviewed face-to-face, and their responses were audio-recorded with a tape recorder, supplemented with note taking. The data generated was analyzed using constant comparative analysis. Results Forty young caregivers (mean age, 27.17 ± 4.46 years) participated in the study. They expressed encouragement from the therapist managing the child, family support, empathy, improvement in the conditions of other children with CP, cooperation of the child during home programs family support and improvement in the child’s condition as factors that facilitate their active participation in the rehabilitation of the children. However, they mentioned occupation, financial resources and the number of children the caregiver has are the barriers to their active participation in the rehabilitation of the children. Conclusions Both the facilitators and barriers of active participation of caregivers in the rehabilitation of children with CP need to be recognized in order to help caregivers reinforce or overcome them respectively. In addition, economically sustainable and accessible rehabilitation services are needed for all children with CP. Similarly, sharing caregiving rehabilitation tasks amongst family members could facilitate caregiver active participation.

Aktueller Stand und Herausforderungen der neurologischen Rehabilitation in Nigeria

“…In Nigeria gibt es zwar inzwischen das Nationale Krankenversicherungssystem (NHIS), das zur Finanzierung von Gesundheitsleistungen beiträgt [19], dieses System deckt jedoch viele Leistungen, insbesondere die Rehabilitation, nicht ab. Daher müssen die Patienten und ihre Familien die meisten Gesundheitsleistungen aus eigener Tasche bezahlen.…”

“…So gibt es derzeit Arbeiten zur sensomotorischen [11][12][13][14] und autonomen Funktion [15] sowie zur kognitiven [16,17] Rehabilitation. Weitere Bereiche sind Zerebralparese [18][19][20], Epilepsie [21] und Covid-19 [22,23]. Zu den verwendeten Techniken gehören Hirnstimulation [16], periphere Stimulation [15,24,25] und manuelle körperliche Übungen [11][12][13][14].…”

Establishing childhood disability clinics may help reduce the prevalence of disability among children in Africa: A viewpoint

“…This can serve as a form of empowerment to their caregivers to become advocates, and can help them get the courage to assist the child with disability to be as independent as they can in carrying out their ADL (21). This is because active engagement of caregivers in the care of their children with disabilities may help improve outcomes (30).…”