Provision of rehabilitation services for children with disabilities living in low- and middle-income countries: a scoping review.

BACKGROUND: Childhood disability is a growing global health priority. The purpose of this scoping review was to identify and summarize rehabilitation interventions used to support children with disabilities in low- and middle-income countries.
METHODS: This scoping review involved a systematic search of electronic databases using a combination of subject headings and/or keywords related to child disability, rehabilitation, and low- and middle-income countries. Charting involved an iterative process whereby the full text of articles meeting the inclusion criteria were abstracted using a charting form. Data were charted according to pre-selected and emerging characteristics deemed relevant to the scoping review's purpose.
RESULTS: Eighty-one articles were included in the final analysis. Forty-three articles explored the use of screening and/or diagnostic tools in identifying children with disabilities in low and middle income countries, and 38 articles evaluated rehabilitation services for these children.
CONCLUSIONS: A number of rehabilitation strategies are available that have the potential to improve the identification of and outcomes for children with disabilities in low and middle income countries. Future research ought to advance the development, implementation, and evaluation of training programs for non-rehabilitation specialists (e.g., doctors, nurses, and teachers), non-specialist community members (e.g., community health workers), and caregivers in the area of rehabilitation, and evaluate the effectiveness of rehabilitation interventions in improving participatory outcomes and quality of life for children with disabilities. Implications for Rehabilitation Additional research is needed to understand the influence of rehabilitation on personal factors (e.g., self-efficacy and quality of life) and participation for children with disabilities. There is limited availability of experienced rehabilitation service providers, especially in rural areas, warranting additional research into the development and evaluation of non-specialist training programs, and the integration of rehabilitation concepts across health workforce education programs. Researchers from low and middle income countries appear to be underrepresented in published rehabilitation research, indicating a need to further promote the inclusion of this group through community-based participatory research.