People with spinal cord injury in Morocco: results from the very first systematic data collection

Abstract

Purpose

To report on the methodology, participant characteristics, and associations of four most frequent environmental barriers with health conditions, general health and quality of life (QoL) in the very first systematic data collection in people with spinal cord injury (SCI) in Morocco.

Materials and methods

We obtained data from 385 participants of the cross-sectional Moroccan SCI community survey (MorSCI). We used descriptive statistics to describe participant characteristics and regression models to investigate associations of the five most frequently reported environmental barriers with health conditions (secondary conditions, pain intensity, mental health), general health and QoL.

Results

The most frequently reported environmental barriers were “lack of public services” (92.5%), “financial strain” (93.0%), restricted access to “public transportation” (85.5%), “public places” (83.9%) and “private places” (84.7%). People who perceived those factors as barriers also reported more secondary conditions, higher pain intensity, lower mental health, lower general health, and lower QoL.

Conclusions

This study on Moroccans with SCI found that environmental barriers detract from health and QoL. Given that environmental barriers are potentially modifiable, policy interventions present powerful tools to reduce barriers and potentially increase health and QoL in this vulnerable population.

IMPLICATIONS FOR REHABILITATION

• Public policy on the construction of transportation and public places is important to make the physical environment accessible for wheelchair users to support their participation in society.

• The provision of adequate rehabilitation services and specialized post-acute rehabilitation units for people with SCI in Morocco is urgently needed, not only to contribute to health and QoL but also to contribute to their abilities to overcome environmental barriers.

• Adequate state services including universal health coverage and access to rehabilitation services and assistive devices or adapted tools must be a priority on the policy level to facilitate activities of daily living and reduce barriers.

• Improving the skills and knowledge of health professionals in SCI rehabilitation and guide policy makers to promote patient education and self-advocacy in the meantime, may help reduce the gap between needs of people with SCI and available support.

Keywords:

• Spinal cord injury
• Morocco
• health
• quality of life
• environmental barriers
• disability

Acknowledgments

We thank all people with spinal cord injury participating in this first community survey and their families. Thank you to the following organizations, which have contributed to carrying out this survey: Mohammed VI National Center for the Disabled, Moroccan association for the promotion of rehabilitation sciences and disability prevention and WHO office in Morocco. We also thank the following individuals, who have also contributed to carrying out this research project: Members of the MorSCI research team and collaborating centers, member of the national study group and stakeholders and members of the InSCI Steering Committee.

Disclosure statement

No potential conflict of interest was reported by the author(s).