SUpporting People in extreme POverty with Rehabilitation and Therapy (SUPPORT CP): A trial among families of children with cerebral palsy in Bangladesh
- PMID: 36335570
- DOI: 10.1111/dmcn.15445
SUpporting People in extreme POverty with Rehabilitation and Therapy (SUPPORT CP): A trial among families of children with cerebral palsy in Bangladesh
Abstract
Aim: To test the efficacy of an integrated microfinance/livelihood and community-based rehabilitation (IMCBR) programme in improving health-related quality of life (HRQoL) and motor function of children with cerebral palsy (CP) and gain in social capital to their ultra-poor families in rural Bangladesh.
Method: This was an open-label cluster randomized control trial. Children with CP aged 5 years or under were randomly allocated to three arms; Arm A: IMCBR; Arm B: community-based rehabilitation (CBR); and Arm C: care-as-usual. The CBR was modified with phone follow-up followed by home-based CBR at 2.5 months post-enrolment because of the COVID-19 pandemic. Intention-to-treat analysis was performed.
Results: Twenty-four clusters constituting 251 children-primary caregivers' dyads were assigned to three arms (Arm A = 80; Arm B = 82; Arm C = 89). Between baseline and endline, the percentage mean change in the physical functioning domain of HRQoL was highest in Arm A (30.0%) with a significant mean difference between Arm A and Arm B (p = 0.015). Improvement in the mean social capital score was significantly higher in Arm A compared to Arm C (p < 0.001).
Interpretation: The findings suggest that IMCBR could improve the HRQoL of children with CP and the social capital of their ultra-poor families. Long-term follow-up of the trial participants and future exploration of such interventions are essential. The integrated livelihood and CBR programme holds potential to improve health and well-being of children with CP and their ultra-poor families.
What this paper adds: Half of the families who received livelihoods were impacted by a cold-wave, suggesting the need for a more disaster-resilient livelihood asset. The integration of livelihood with community-based rehabilitation programme helps to improve health-related quality of life of children with cerebral palsy and the social capital of their ultra-poor families.
© 2022 Mac Keith Press.
Comment in
-
Improvement in social capital and health of children with cerebral palsy: Evidence from resource-poor settings.Dev Med Child Neurol. 2023 Jun;65(6):727-728. doi: 10.1111/dmcn.15566. Epub 2023 Mar 5. Dev Med Child Neurol. 2023. PMID: 36872462 No abstract available.
References
REFERENCES
-
- Trabacca A, Vespino T, Di Liddo A, Russo L. Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care. J Multidiscip Healthc 2016; 9: 455-62.
-
- Al Imam MH, Jahan I, Das MC, Muhit M, Smithers-Sheedy H, McIntyre S, et al. Rehabilitation status of children with cerebral palsy in Bangladesh: Findings from the Bangladesh Cerebral Palsy Register. PLoS One 2021; 16: e0250640.
-
- Al Imam MH, Jahan I, Das MC, Muhit M, Akbar A, Badawi N, et al. Situation analysis of rehabilitation services for persons with disabilities in Bangladesh: identifying service gaps and scopes for improvement. Disabil Rehabil 2022 Sep;44(19):5571-5584.
-
- Khandaker G, Muhit M, Karim T, Smithers-Sheedy H, Novak I, Jones C, et al. Epidemiology of cerebral palsy in Bangladesh: a population-based surveillance study. Dev Med Child Neurol 2019; 61: 601-9.
-
- Gwatkin DR. The need for equity-oriented health sector reforms. Int J Epidemiol 2001; 30: 720-3.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous