Implementation of Home-Based Rehabilitation for Children With Cerebral Palsy in Douala, Cameroon: Perspectives of Caregivers and Rehabilitation Technicians

Introduction Despite the known benefits of home-based rehabilitation (HBR) for children with cerebral palsy (CP), its implementation remains limited in most low-resource settings. Objective This study aimed to explore the perspectives of caregivers (CGs) and rehabilitation technicians (RTs) on HBR for children with CP. Specifically, the study assessed their experiences, challenges, and suggestions for the effective implementation of HBR for children with CP. Methods A phenomenological qualitative study design was used to explore the experiences, challenges, and suggestions of CGs and RTs regarding HBR and to identify strategies for its effective implementation. Participants were enrolled from the rehabilitation programme at Mboppi Baptist Hospital Douala, Cameroon. We conducted 24 interviews: 16 face-to-face and eight by mobile phone. The data were analysed using reflexive thematic analysis, which yielded six themes: Theme 1, CG perceptions of HBR; Theme 2, RT perceptions of HBR; Theme 3, challenges faced by CGs in implementing HBR for children with CP; Theme 4, challenges faced by RTs in implementing HBR; Theme 5, strategies needed by CGs for effective HBR; and Theme 6, strategies proposed by RTs to enhance HBR. Results The key findings highlighted challenges, such as limited resources and inadequate training, that hindered the effective implementation of HBR. RTs reported systemic and logistical challenges, such as a limited rehabilitation workforce, inadequate transportation, insufficient institutional support, and skills gaps, particularly in applying the step approach to HBR. CGs faced challenges such as limited knowledge and skills, difficulty adapting rehabilitation tasks, inconsistent support from RTs, irregular home visits by RTs, and family rejection. Continuous training, CG support, and the increased availability of skilled RTs were the main suggestions for improving HBR for children with CP. Conclusion The study underscores the need for structured HBR interventions, CG education, an expanded rehabilitation workforce, and policy improvements to enhance service accessibility while prioritising a family-centred approach. These findings will inform healthcare planning and optimise rehabilitation for children with CP in Cameroon and similar settings.