Factors Associated with Access to Physical and Functional Rehabilitation Services Among Children with Disabilities in Selected District Hospitals in Rwanda, 2026

Approximately 15% of the global population live with physical disabilities, with 80% from low-income countries. In Rwandan, current data show that there are an estimated 8012 children with disabilities. This study aimed to determine factors influencing accessibility of physical and functional rehabilitation services for children with disabilities at Byumba L2TH, Kibuye RH and Ruhengeri L2TH, Rwanda respectively. This cross-sectional mixed-methods study had caretakers of the children with disabilities as target population with sample size of 419. Quantitative, and qualitative data were collected through face-to-face interviews using closed ended questionnaire and KIIs, respectively. Descriptive and inferential statistics analysis, in SPSS v31, and thematic analysis in NVivo v15 software. From results, 28.4% (95% CI: 24.2-32.9) of children adhered to prescribed rehabilitation services. Different enabling factors had significant implications, children from high income families had 4.63 times odds of access than ones from low-income families (AOR = 4.626, 95% CI [2.101-10.187], p < 0.001), traveling 0-5 km distance increased the odds of access compared with high than 5 km by 4.44 times (AOR = 4.447, 95% CI [2.346-8.432], p < 0.001), compared with high transport costs, lower costs increase the access by 6.53 times (AOR = 6.527, 95% CI [3.692-11.538], p < 0.001), affordability of services had 2.67 odds of increase the access (AOR = 4.371, 95% CI [2.462-7.761], p < 0.001). The availability of rehabilitation services was universally accessible (100%), while prosthetic and occupational therapy were severely limited (33.3%). For perceived needs, caretakers emphasized financial support, provision of assistive devices, stigma reduction, improved service delivery, and awareness campaigns. This study suggests the strengthening of community-based rehabilitation, integrating services into primary health care, ensuring affordability, and addressing stigma are essential.