Perceptions of disability among mothers of children with disability in Bangladesh: Implications for rehabilitation service delivery

Abstract

Background. Eighty-five percent of children with disabilities (CWD) live in developing countries, and <5% receive rehabilitation services.

Purpose. To describe perceptions of disability among mothers of CWD in Bangladesh, and to explore how these perceptions influence the care sought for their CWD.

Methods. Descriptive qualitative research methods were employed. Eleven semi-structured interviews were conducted with mothers of CWD receiving services at a large pediatric rehabilitation facility in Bangladesh. Interviews were recorded and transcribed, and data were coded and analyzed to identify themes.

Results. Three primary categories of themes emerged: (1) mothers' perceptions of disability; (2) perceptions of treatment; and (3) expectations for the future of their CWD. The findings suggest that the family members, healthcare providers, and the rehabilitation setting have a considerable influence on mothers' perceptions. Study participants had adopted a biomedical understanding of disability and treatment, but reported that family elders continued to believe strongly in traditional explanations creating conflict regarding appropriate treatment approaches. Participants suggested that education and peer support networks provided in the rehabilitation setting played (or could play) a critical role in addressing these conflicts.

Conclusion. Understanding mothers' perceptions of disability and treatment, and the myriad of factors that influence those perceptions, provides valuable knowledge to assist in planning and delivery of family centered rehabilitation services for CWD. Rehabilitation has a central role to play in assisting mothers' understanding of the nature of their children's disabilities and how they can be managed. Ultimately, such an understanding may translate into improved social and educational opportunities for CWD.

Keywords:

• Bangladesh
• children
• mothers

Acknowledgments

The authors acknowledge Centre for the Rehabilitation of the Paralysed [www.crp-bangladesh.org], Sohrab Hossain, and Sharmin Hasnat who served as interpreter for this study. They also acknowledge Danielle Rolfe and Dr. Stephanie Nixon for their assistance in the initial phases of research, as well as the International Health Division of the Canadian Physiotherapy Association for their financial support.