scholarly journals Predictors of Rehabilitation Service Utilisation among Children with Cerebral Palsy (CP) in Low- and Middle-Income Countries (LMIC): Findings from the Global LMIC CP Register

2021 ◽  
Vol 11 (7) ◽  
pp. 848
Author(s):  
Mahmudul Hassan Al Imam ◽  
Israt Jahan ◽  
Mohammad Muhit ◽  
Denny Hardianto ◽  
Francis Laryea ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Parental Education ◽  
Service Providers ◽  
Functional Limitation ◽  
Rehabilitation Service ◽  
Service Utilisation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Children With Cerebral Palsy ◽  
Low And Middle Income

Background: We assessed the rehabilitation status and predictors of rehabilitation service utilisation among children with cerebral palsy (CP) in selected low- and middle-income countries (LMICs). Methods: Data from the Global LMIC CP Register (GLM-CPR), a multi-country register of children with CP aged <18 years in selected countries, were used. Descriptive and inferential statistics (e.g., adjusted odds ratios) were reported. Results: Between January 2015 and December 2019, 3441 children were registered from Bangladesh (n = 2852), Indonesia (n = 130), Nepal (n = 182), and Ghana (n = 277). The proportion of children who never received rehabilitation was 49.8% (n = 1411) in Bangladesh, 45.8% (n = 82) in Nepal, 66.2% (n = 86) in Indonesia, and 26.7% (n = 74) in Ghana. The mean (Standard Deviation) age of commencing rehabilitation services was relatively delayed in Nepal (3.9 (3.1) year). Lack of awareness was the most frequently reported reason for not receiving rehabilitation in all four countries. Common predictors of not receiving rehabilitation were older age at assessment (i.e., age of children at the time of the data collection), low parental education and family income, mild functional limitation, and associated impairments (i.e., hearing and/or intellectual impairments). Additionally, gender of the children significantly influenced rehabilitation service utilisation in Bangladesh. Conclusions: Child’s age, functional limitation and associated impairments, and parental education and economic status influenced the rehabilitation utilisation among children with CP in LMICs. Policymakers and service providers could use these findings to increase access to rehabilitation and improve equity in rehabilitation service utilisation for better functional outcome of children with CP.

scholarly journals Epidemiology of Malnutrition among Children with Cerebral Palsy in Low- and Middle-Income Countries: Findings from the Global LMIC CP Register

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3676
Author(s):  
Israt Jahan ◽  
Mohammad Muhit ◽  
Denny Hardianto ◽  
Francis Laryea ◽  
Samuel Kofi Amponsah ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Nutritional Status ◽  
Nutrition Education ◽  
Maternal Education ◽  
Motor Impairment ◽  
Older Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Children With Cerebral Palsy ◽  
Low And Middle Income

Background: This study aimed to describe the epidemiology of malnutrition among children with cerebral palsy (CP) in low- and middle-income countries (LMICs). Methods: Data from children with confirmed CP aged <18 years registered into the Global LMIC CP Register (GLM CPR) from Bangladesh, Indonesia, Nepal, and Ghana were included. Anthropometric measurements were collected, and nutritional status was determined following the WHO guidelines. Descriptive statistics and adjusted logistic regression were used to describe the nutritional status and identify predictors of malnutrition. Results: Between January 2015 and December 2020, 3619 children with CP were registered into the GLM CPR (median age at assessment: 7.0 years, 39% female). Overall, 72–98% of children from Bangladesh, Indonesia, Nepal, and Ghana had at least one form of undernutrition. The adjusted analysis showed, older age, low maternal education, spastic tri/quadriplegia, and Gross Motor Functional Classification System (GMFCS) levels III–V were significant predictors of underweight and stunting among children with CP in Bangladesh. In Nepal, female children, GMFCS III–V had higher odds of underweight and stunting. In Ghana, low maternal education was significantly associated with underweight, whereas older age and the presence of associated impairments were the significant predictors of stunting among children with CP. Having a GMFCS of III–V increased the odds of being underweight among children in Indonesia; however, no predictors were identified for stunting, as nearly all children with CP registered from Indonesia were stunted. Conclusion: Most children with CP in GLM CPR had undernutrition. Maternal education and moderate-to-severe motor impairment (GMFCS III–V) were significant predictors. Practical nutrition education to mothers/caregivers and management guidelines according to the motor severity using local resources could improve the nutritional outcome of children with CP in LMICs.

scholarly journals Expert consensus for in-hospital neurorehabilitation during the COVID-19 pandemic in low- and middle-income countries

2021 ◽  
Vol 6 ◽  
pp. 130
Author(s):  
Dorcas B.C. Gandhi ◽  
Sureshkumar Kamalakannan ◽  
Manigandan Chockalingam ◽  
Ivy A. Sebastian ◽  
Gerard Urimubenshi ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Service Providers ◽  
Occupational Therapists ◽  
Service Organizations ◽  
Expert Consensus ◽  
Neurological Dysfunction ◽  
Rehabilitation Service ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: People with neurological dysfunction have been significantly affected by the ongoing coronavirus disease 2019 (COVID-19) crisis in receiving adequate and quality rehabilitation services. There are no clear guidelines or recommendations for rehabilitation providers in dealing with patients with neurological dysfunction during a pandemic situation especially in low- and middle-income countries. The objective of this paper was to develop consensus-based expert recommendations for in-hospital based neurorehabilitation during the COVID-19 pandemic for low- and middle-income countries based on available evidence.  Methods: A group of experts in neurorehabilitation consisting of neurologists, physiotherapists and occupational therapists were identified for the consensus groups. A scoping review was conducted to identify existing evidence and recommendations for neurorehabilitation during COVID-19. Specific statements with level 2b evidence from studies identified were developed. These statements were circulated to 13 experts for consensus. The statements that received ≥80% agreement were grouped in different themes and the recommendations were developed.  Results: 75 statements for expert consensus were generated. 72 statements received consensus from 13 experts. These statements were thematically grouped as recommendations for neurorehabilitation service providers, patients, formal and informal caregivers of affected individuals, rehabilitation service organizations, and administrators.  Conclusions: The development of this consensus statement is of fundamental significance to neurological rehabilitation service providers and people living with neurological disabilities. It is crucial that governments, health systems, clinicians and stakeholders involved in upholding the standard of neurorehabilitation practice in low- and middle-income countries consider conversion of the consensus statement to minimum standard requirements within the context of the pandemic as well as for the future.

Data on cerebral palsy in Vietnam will inform clinical practice and policy in low and middle-income countries

2021 ◽  
pp. 1-8
Author(s):  
Tasneem Karim ◽  
Rachael Dossetor ◽  
Nguyen Thi Huong Giang ◽  
Trinh Quang Dung ◽  
Tran Vinh Son ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Clinical Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Cost and cost-effectiveness analysis of treatment for child undernutrition in low- and middle-income countries: A systematic review

2020 ◽  
Vol 5 ◽  
pp. 62
Author(s):  
Rebecca G Njuguna ◽  
James A Berkley ◽  
Julie Jemutai
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Service Providers ◽  
Productivity Loss ◽  
Sub Saharan Africa ◽  
Economic Evaluations ◽  
Middle Income ◽  
Child Undernutrition ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Undernutrition remains highly prevalent in low- and middle-income countries, with sub-Saharan Africa and Southern Asia accounting for majority of the cases. Apart from the health and human capacity impacts on children affected by malnutrition, there are significant economic impacts to households and service providers. The aim of this study was to determine the current state of knowledge on costs and cost-effectiveness of child undernutrition treatment to households, health providers, organizations and governments in low and middle-income countries (LMICs). Methods:  We conducted a systematic review of peer-reviewed studies in LMICs up to September 2019. We searched online databases including PubMed-Medline, Embase, Popline, Econlit and Web of Science. We identified additional articles through bibliographic citation searches. Only articles including costs of child undernutrition treatment were included. Results: We identified a total of 6436 articles, and only 50 met the eligibility criteria. Most included studies adopted institutional/program (45%) and health provider (38%) perspectives. The studies varied in the interventions studied and costing methods used with treatment costs reported ranging between US$0.44 and US$1344 per child. The main cost drivers were personnel, therapeutic food and productivity loss. We also assessed the cost effectiveness of community-based management of malnutrition programs (CMAM). Cost per disability adjusted life year (DALY) averted for a CMAM program integrated into existing health services in Malawi was $42. Overall, cost per DALY averted for CMAM ranged between US$26 and US$53, which was much lower than facility-based management (US$1344). Conclusion: There is a need to assess the burden of direct and indirect costs of child undernutrition to households and communities in order to plan, identify cost-effective solutions and address issues of cost that may limit delivery, uptake and effectiveness. Standardized methods and reporting in economic evaluations would facilitate interpretation and provide a means for comparing costs and cost-effectiveness of interventions.

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