SUpporting People in extreme POverty with Rehabilitation and Therapy (SUPPORT CP): A trial among families of children with cerebral palsy in Bangladesh

Mahmudul Hassan Al Imam; Israt Jahan; Manik Chandra Das; Sk Md Kamrul Bashar; Arifuzzaman Khan; Mohammad Muhit; Rosalie Power; Delwar Akbar; Nadia Badawi; Gulam Khandaker

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

Dev Med Child Neurol. 2023 Jun;65(6):773-782. doi: 10.1111/dmcn.15445. Epub 2022 Nov 6.

Authors

Mahmudul Hassan Al Imam^{1

2

3

4}, Israt Jahan^{1

2

3}, Manik Chandra Das^{1

2}, Sk Md Kamrul Bashar^{1

2}, Arifuzzaman Khan^{1

2

4

5}, Mohammad Muhit^{1

2}, Rosalie Power^{2

6}, Delwar Akbar⁷, Nadia Badawi^{8

9}, Gulam Khandaker^{3

4

8}

Affiliations

¹ CSF Global, Dhaka, Bangladesh.
² Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh.
³ School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.
⁴ Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia.
⁵ School of Public Health, The University of Queensland, Brisbane, Australia.
⁶ Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia.
⁷ School of Business and Law, Central Queensland University, Rockhampton, Queensland, Australia.
⁸ Grace Centre for Newborn Intensive Care, Sydney Children's Hospital Network, The University of Sydney, Sydney, Australia.
⁹ Cerebral Palsy Alliance Research Institute, The University of Sydney, Sydney, Australia.

PMID: 36335570
DOI: 10.1111/dmcn.15445

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.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Bangladesh
COVID-19*
Cerebral Palsy*
Child
Humans
Pandemics
Poverty
Quality of Life