What are structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy in low- and middle-income countries? A scoping review.
22 affiliations
- 1School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada.
- 2Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
- 3Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada.
- 4Populations and Public Health Research Program, ICES Western, London, ON, Canada.
- 5Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- 6Graduate Studies, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
- 7Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- 8Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
- 9Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
- 10Department of Gender Studies, Queen's University, Kingston, ON, Canada.
- 11Faculty of Health Sciences, Western University, London, ON, Canada.
- 12Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
- 13Faculty of Social Science and Humanities, Ontario Tech University, Oshawa, ON, Canada.
- 14Research, Innovation and Knowledge Mobilization, Grandview Children's Centre, Ajax, ON, Canada.
- 15Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada.
- 16Faculty of Graduate Studies, Ontario Tech University, Oshawa, ON, Canada.
- 17Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, Netherlands.
- 18Department of Pediatrics, Horacio Oduber Hospital, Oranjestad, Aruba.
- 19MGM Center of Human Movement Science, MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, India.
- 20Physiocare, PPF Olorien Commercial Complex, Arusha, Tanzania.
- 21Library Services, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
- 22Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Abstract
PurposeThis scoping review aimed to systematically map the experiences regarding structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy (CP) in low- and middle-income countries; and investigate whether experiences vary by social factors.MethodsWe conducted a scoping review that included qualitative or mixed methods studies (qualitative component) exploring structural barriers or facilitators to accessing habilitation/rehabilitation among children with CP. Structural barriers and facilitators included socioeconomic and political contexts, governance, policies, and cultural/societal values. Paired reviewers screened citations retrieved from databases and charted data, and we conducted a descriptive synthesis.ResultsWe identified 34 relevant studies. Based on one study in a low-income country focused on home-based programs, barriers included restrictive home environments and lack of understanding of CP, while facilitators involved the use of locally available resources. For lower- and upper-middle income countries (33 studies), structural barriers and facilitators to access were related to finances; location, transportation, inaccessibility, and unavailability of services; system infrastructure; lack of knowledge; and perceptions concerning CP. We identified structural barriers as stigma concerning CP in lower-middle income countries, and disruptions during natural emergencies in upper-middle income countries.ConclusionsIn middle-income countries, children with CP face many structural factors to accessing habilitation or rehabilitation, which intersect with social factors. Research is needed for low-income countries.
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BibTeX
@article{wong2026what,
title = {{What are structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy in low- and middle-income countries? A scoping review.}},
author = {Jessica J Wong and Pierre Côté and Lauren Ead and Simran Walia and Alanna Veitch and Nora Bakaa and Ashiga Surendiran and Cullen Ye and Jen Rinaldi and Taryn Eickmeier and Jamiu Busari and Rajani Mullerpatan and Remla Shirima and Kent Murnaghan and Heather M Shearer},
journal = {Journal of pediatric rehabilitation medicine},
year = {2026},
month = oct,
doi = {10.1177/18758894261501058},
url = {https://europepmc.org/article/MED/42905617},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - What are structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy in low- and middle-income countries? A scoping review.
AU - Jessica J Wong
AU - Pierre Côté
AU - Lauren Ead
AU - Simran Walia
AU - Alanna Veitch
AU - Nora Bakaa
AU - Ashiga Surendiran
AU - Cullen Ye
AU - Jen Rinaldi
AU - Taryn Eickmeier
AU - Jamiu Busari
AU - Rajani Mullerpatan
AU - Remla Shirima
AU - Kent Murnaghan
AU - Heather M Shearer
PY - 2026
DA - 2026/10/21
JO - Journal of pediatric rehabilitation medicine
DO - 10.1177/18758894261501058
UR - https://europepmc.org/article/MED/42905617
AB - PurposeThis scoping review aimed to systematically map the experiences regarding structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy (CP) in low- and middle-income countries; and investigate whether experiences vary by social factors.MethodsWe conducted a scoping review that included qualitative or mixed methods studies (qualitative component) exploring structural barriers or facilitators to accessing habilitation/rehabilitation among children with CP. Structural barriers and facilitators included socioeconomic and political contexts, governance, policies, and cultural/societal values. Paired reviewers screened citations retrieved from databases and charted data, and we conducted a descriptive synthesis.ResultsWe identified 34 relevant studies. Based on one study in a low-income country focused on home-based programs, barriers included restrictive home environments and lack of understanding of CP, while facilitators involved the use of locally available resources. For lower- and upper-middle income countries (33 studies), structural barriers and facilitators to access were related to finances; location, transportation, inaccessibility, and unavailability of services; system infrastructure; lack of knowledge; and perceptions concerning CP. We identified structural barriers as stigma concerning CP in lower-middle income countries, and disruptions during natural emergencies in upper-middle income countries.ConclusionsIn middle-income countries, children with CP face many structural factors to accessing habilitation or rehabilitation, which intersect with social factors. Research is needed for low-income countries.
SN - 1874-5393
SN - 1875-8894
ER -