A Multi-National Cross-Sectional Exploration of Rehabilitation Services for Children and Young People Following Brain Injury in Low and Middle Income Countries

Authors

• Mark A Linden
• Leigh Schrieff-Brown
• Linda Ewing-Cobbs
• R A Leonard
• Rajendra Prasad
• Juan Carlos Arango-Lasprilla
• Sandra Strazzer
• Lucia Braga
• Consuelo Reyes Payeras
• Kim C Davis
• Lisa Kalungwana-Mambwe
• Flavia Dorrego
• Mathilde Chevignard

Language

English

Publication Date

11-3-2025

Journal

BMC Public Health

DOI

10.1186/s12889-025-24933-0

PMID

41184922

PMCID

PMC12581435

PubMedCentral® Posted Date

11-3-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Brain injury (BI) is the largest cause of mortality and morbidity among children and can lead to significant cognitive, social, emotional and behavioural deficits. There has been an absence of research examining the availability of rehabilitation services for affected children and young people in low and middle income countries (LMICs). This study therefore investigated current rehabilitation provision in LMICs for children and young people with BI.

Methods: An online survey was developed which collected data on funding support for rehabilitation, causes of BI and access to services. The survey was distributed to healthcare professionals known to members of the research team. Participants were asked to forward the survey to other professionals in their networks. Representation was sought from as many LMICs as possible. Data were analysed using descriptive statistics (e.g. percentages) and the Kruskal Wallis test to explore differences between Official Development Assistance (ODA) status (least developed, lower middle and upper middle) on access to services.

Results: A total of 179 participants from 32 LMICs responded to the survey. Healthcare professionals from the least developed countries reported charities as the main source of funding to support rehabilitation, while those from upper middle income regions were most often funded by governments. According to healthcare professionals, the greatest cause of BI in LMICs was hypoxia. The Kruskal Wallis test comparing ODA status showed statistically significant differences in access to services for occupational (P = .005), speech and language (P = .038) and aquatic therapies (P < .001), cognitive (p < .001) and vocational rehabilitation (P = .008), and community based inclusive development programmes (P = .009).

Conclusions: There is a lack of equity in accessibility of rehabilitation services for children and young people with BI in LMICs, with some services being non-existent in lower income countries. Improvements to obstetric services, screening and management of infectious diseases are needed to reduce rates of hypoxic injuries and injury prevention programmes are needed to reduce traumatic injury. Centralised, government funding is required to develop services to improve life chances for these children.

Keywords

Humans, Cross-Sectional Studies, Child, Adolescent, Developing Countries, Brain Injuries, Female, Male, Health Services Accessibility, Surveys and Questionnaires, Child, Preschool, Survey, Cross-sectional, Low and middle income countries, Service provision, Rehabilitation, Children and young people, Brain injury, Health

Published Open-Access

yes

Recommended Citation

Linden, Mark A; Schrieff-Brown, Leigh; Ewing-Cobbs, Linda; et al., "A Multi-National Cross-Sectional Exploration of Rehabilitation Services for Children and Young People Following Brain Injury in Low and Middle Income Countries" (2025). Faculty, Staff and Student Publications. 4158.
https://digitalcommons.library.tmc.edu/uthmed_docs/4158