Study transforms health services for children with cerebral palsy in Bangladesh
CQUniversity researchers have developed an innovative model to facilitate early intervention and rehabilitation services for children with cerebral palsy (CP) in rural Bangladesh.
With an estimated 50 million people affected by CP globally, the newly established ‘Sustainable Model of Early Intervention and Telerehabilitation for Children with CP' (SMART-CP) aims to create a positive impact in greater low-and-middle-income countries (LMIC), such as Bangladesh, where access to healthcare is limited.
The model was assessed in a randomised clinical trial funded by Cerebral Palsy Alliance Research Foundation and implemented by CSF Global (formerly the Child Sight Foundation) in Bangladesh, a key partner of CQU's international Global Low- and Middle-Income Country Cerebral Palsy Register (GLM CPR) program.
The SMART CP trial team included Dr Mahmudul Hassan Al Imam, Dr Israt Jahan, Dr Nuruzzaman Khan, Professor Delwar Akbar, Mr Shafiul Islam, Professor Mohammad Muhit, Professor Nadia Badawi and Professor Gulam Khandaker.
“CP is the leading cause of childhood disability, however the majority of children with CP living in LMICs do not receive timely diagnosis and intervention,” Prof Khandaker said.
“In Bangladesh half of all children with CP have never received rehabilitation services, and those who do typically begin at an average age of four years — well beyond the age when it's most effective.
“The country faces a severe shortage of rehabilitation professionals, with only one physiotherapist for every 106,383 people compared to 1:750 in Australia.
“Additionally, high out-of-pocket costs and long travel distances further compound these challenges."
Dr Al Imam explained that the SMART CP model integrates a telerehabilitation program and early intervention services with a network of community informants which includes teachers, health workers, religious leaders, and a peer support group of mothers of children with CP.
“SMART CP not only shortens travel distances and cuts costs for families but also increases the use of assistive devices," he said.
“It has made it possible for more children to receive timely diagnoses and interventions, showing promising results for broader applications in low resource settings worldwide."
Outcomes from the SMART CP randomised clinical trial were recently published in the prestigious JAMA Pediatrics (Impact Factor: 24.7), where the model was assessed in comparison to usual CP care in Bangladesh.
