Breaking barriers to rehabilitation for children with disabilities in low‐ and middle‐income countries: A call for multifaceted, context‐specific action

Low- and middle-income countries (LMICs) are home to the youngest and fastest-growing population globally. By 2050, these countries are expected to be among the top contributors to global population growth. However, LMICs also bear 95% of the global burden of childhood disabilities, including cerebral palsy (CP), that often stems from preventable causes. These public health concerns are juxtaposed with the realities of widespread poverty and limited access to healthcare services.1 The recent publication by Drew et al. offers an important glimpse into the lived experiences of primary caregivers of children with disabilities, thereby providing some insight into the daily challenges these families face as they strive to access neurorehabilitation services within the resource-constrained contexts of LMICs.2 By amplifying the voices of those directly impacted, this study reveals some of the context-specific, often overlooked barriers that hinder access to essential services. These insights are a reminder that policy and interventions must reflect the on-the-ground challenges faced by children living with disabilities and their families. The impact of intertwined financial and logistical hurdles confronting families with children living with disabilities in LMICs has also been highlighted by Drew et al. For some families dwelling in geographically inaccessible areas, the promise of rehabilitation services remains out of reach. As such, some of these children (especially those in rural settings) may never access any form of rehabilitation services, thereby exacerbating the cycle of isolation and unmet health needs.3 Drew et al. also mention the essential role of peer support. Empowering primary caregivers through shared experiences and collective resilience in navigating rehabilitation challenges is fundamental. In many LMICs, mothers of children with disabilities often stand alone as advocates, facing stigma sometimes from within the families and extending to the wider community. Therefore, equipping primary caregivers with practical knowledge and skills to nurture their children at home, alongside fostering connections with peer support groups, can catalyse transformative change for both the primary caregivers and their children. Addressing the entrenched obstacles and guaranteeing equitable access to rehabilitation services for all children with CP in LMICs necessitates a multifaceted, context-specific strategy that hinges on the collaborative involvement of multiple stakeholders. This approach must be tailored to the unique sociocultural, economic, and healthcare context of these settings, integrating insights from families, local communities, healthcare providers, policymakers, researchers, and international partners. LMICs can dismantle systemic barriers and ensure rehabilitation services are accessible to all. First, by conducting focused implementation science research studies with individuals with lived experiences that can identify and recommend context-specific solutions.4 Second, the integration of rehabilitation services into national health priorities that ensure equitable access as a component of universal health coverage. Third, decentralizing services and implementing community-based rehabilitation models that leverage from the already existing networks of community healthcare workers may substantially cut down the costs incurred by families, usually from travel expenses to access services.5 Finally, local leaders' engagement to drive awareness campaigns in the communities could significantly increase rehabilitation uptake, provide strong support systems for families, as well as reduce stigma. Through these strategies, LMICs can holistically address financial, logistical, social, and systemic hurdles, making rehabilitation services not only widely available but also tailored to meet the individual needs of children with disabilities and their families. Not required.