Editorial: JRCRS. 2023; 11(03): 139-140
1- The Challenges of Providing Rehabilitation Services for Children with Cerebral Palsy in Pakistan
Qamar Mahmood
PhD Rehabilitation Sciences (Pak.) & Certified Bobath Instructor (Japan)
Certified Expert in Medical Rehabilitation (Japan)
HOD, Physiotherapy Department, National Institute of Rehabilitation Medicine, Islamabad &
Visiting faculty member, Riphah College of Rehabilitation Sciences, RIU, Islamabad
Correspondence:
Dr. Qamar Mahmood
Email: [email protected]
Cerebral palsy (CP) is a neurological disorder that affects movement, posture, and muscle coordination. It often manifests during early childhood and can have a profound impact on a child’s physical and cognitive development. In Pakistan, like many developing countries, providing comprehensive rehabilitation services for children with cerebral palsy is a complex and multifaceted challenge. Because cerebral palsy is a lifelong condition, but early intervention can help children with cerebral palsy reach their full potential. Therefore, this article delves into the difficulties faced by the Pakistani healthcare system in delivering effective rehabilitation services to these children.1
Limited Awareness and Stigma: One of the primary challenges in addressing cerebral palsy in Pakistan is the lack of awareness about the condition among both the general public and healthcare professionals. Misunderstandings and myths surrounding CP contribute to stigmatization, isolation, and discrimination of affected children and their families. Many families are unaware of the available resources and appropriate interventions, further hindering timely and effective care.2
Shortage of Skilled Healthcare Professionals: The shortage of skilled healthcare professionals, particularly those specializing in pediatric rehabilitation, is a significant hurdle. Rehabilitation for children with cerebral palsy requires a multidisciplinary approach involving pediatricians, physiotherapists, occupational therapists, speech therapists, and special education experts. However, there is a scarcity of such experts in Pakistan, resulting in limited access to proper care and therapy.3
Geographical Disparities: The distribution of healthcare resources in Pakistan is uneven, with urban areas having better access to medical facilities compared to rural regions. Children with cerebral palsy in remote or underserved areas face greater challenges in accessing rehabilitation services. The lack of infrastructure and transportation options compounds the difficulties for these families in reaching specialized facilities.
Financial Constraints: The cost of cerebral palsy treatment and rehabilitation can be burdensome for families, especially those from lower socio-economic backgrounds. Therapies, assistive devices, medications, and regular medical appointments all contribute to the financial strain. Rehabilitation services mostly are very expensive, and many families cannot afford to pay for them. This means that many children with cerebral palsy do not receive the treatment they need. The absence of comprehensive health insurance schemes covering rehabilitation exacerbates the issue, making it difficult for many families to provide adequate care for their children.4
Inadequate Infrastructure and Equipment: Rehabilitation services for children with cerebral palsy require specialized equipment and facilities. Unfortunately, the existing infrastructure often falls short in providing necessary resources. Accessible buildings, assistive devices, and therapy equipment are essential components of effective rehabilitation, but their availability remains limited, impeding progress in the treatment of affected children.
Lack of Collaboration and Coordination: Efficient management of cerebral palsy necessitates close collaboration between healthcare providers, educators, and caregivers. In Pakistan, the lack of coordinated efforts among these stakeholders hampers the holistic care of children with CP. There’s a need for better communication and partnerships among healthcare institutions, schools, and community organizations to ensure a comprehensive support system. Despite these challenges, there are a number of organizations in Pakistan that are working to provide rehabilitation services for children with cerebral palsy. These organizations are providing much-needed services, but they need more support.5
Cultural and Social Factors: Cultural norms and societal attitudes can impact the treatment and acceptance of children with cerebral palsy. Some families may opt for traditional remedies or avoid seeking medical assistance due to cultural beliefs. Addressing these factors requires culturally sensitive approaches that integrate traditional values with evidence-based medical practices.6
Conclusion
Providing effective rehabilitation services for children with cerebral palsy in Pakistan is a complex endeavor marked by numerous challenges. From awareness and stigma reduction to improving access to skilled healthcare professionals and creating a supportive environment, multiple facets of the issue need to be addressed. Collaborative efforts between the government, non-governmental organizations, healthcare professionals, and communities are essential to overcoming these challenges and ensuring a brighter future for children with cerebral palsy in Pakistan.7
References
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2. Husain MO, Zehra SS, Umer M, Kiran T, Husain M, Soomro M, et al. Stigma toward mental and physical illness: attitudes of healthcare professionals, healthcare students and the general public in Pakistan. BJPsych open. 2020;6(5):e81.
3. McCoy SW, Palisano R, Avery L, Jeffries L, Laforme Fiss A, Chiarello L, et al. Physical, occupational, and speech therapy for children with cerebral palsy. Developmental Medicine & Child Neurology. 2020;62(1):140-6.
4. Ismail A, Sk Abd Razak R, Suddin LS, Mahmud A, Kamaralzaman S, Yusri G. The economic burden and determinant factors of parents/caregivers of children with cerebral palsy in Malaysia: a mixed methods study. Int J Environ Res Public Health. 2022;19(1):475.
5. Vadivelan K, Sekar P, Sruthi SS, Gopichandran V. Burden of caregivers of children with cerebral palsy: an intersectional analysis of gender, poverty, stigma, and public policy. BMC public health. 2020;20:1-8.
6. Qayyum A, Lasi SZ, Rafique G. Perceptions of primary caregivers of children with disabilities in two communities from Sindh and Balochistan, Pakistan. Disability, CBR & Inclusive Development. 2013;24(1):130-42.
7. OpenAI. The Challenges of Providing Rehabilitation Services for Children with Cerebral Palsy in Pakistan. [August26, 2023]. Available from: [https://chat.openai.com]