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Supporting Ultra Poor People with Rehabilitation and Therapy among families of children with Cerebral Palsy in rural Bangladesh (SUPPORT CP): Protocol of a randomised controlled trial

Author

Listed:
  • Mahmudul Hassan Al Imam
  • Israt Jahan
  • Mohammad Muhit
  • Manik Chandra Das
  • Rosalie Power
  • Arifuzzaman Khan
  • Delwar Akbar
  • Nadia Badawi
  • Gulam Khandaker

Abstract

Introduction: Poverty is a key contributor to delayed diagnosis and limited access to early intervention and rehabilitation for children with cerebral palsy (CP) in rural Bangladesh. 97% of families of children with CP live below the poverty line in Bangladesh. Therefore, in low-and middle-income countries (LMICs), efforts to improve outcomes for children with CP (including health-related quality of life, motor function, communication, and nutritional attainments) should also include measures to improve family economic and social capital. We propose a randomised controlled trial (RCT) to evaluate the effectiveness of an integrated microfinance/livelihood and community-based rehabilitation (IMCBR) program for ultra-poor families of children with CP in rural Bangladesh. Material and methods: This will be a cluster RCT comparing three arms: (a) integrated microfinance/livelihood and community-based rehabilitation (IMCBR); (b) community-based rehabilitation (CBR) alone; and (c) care-as-usual (i.e. no intervention). Seven clusters will be recruited within each arm. Each cluster will consist of 10 child-caregiver dyads totalling 21 clusters with 210 dyads. Parents recruited in the IMCBR arm will take part in a microfinance/livelihood program and Parent Training Module (PTM), their children with CP will take part in a Goal Directed Training (GDT) program. The programs will be facilitated by specially trained Community Rehabilitation Officers. The CBR arm includes the same PTM and GDT interventions excluding the microfinance/livelihood program. The care-as-usual arm will be provided with information about early intervention and rehabilitation. The assessors will be blinded to group allocation. The duration of the intervention will be 12 months; outcomes will be measured at baseline, 6 months, 12 months, and 18 months. Conclusion: This will be the first RCT of an integrated microfinance/livelihood and CBR program for children with CP in LMIC settings. Evidence from the study could transform approaches to improving wellbeing of children with CP and their ultra-poor families.

Suggested Citation

  • Mahmudul Hassan Al Imam & Israt Jahan & Mohammad Muhit & Manik Chandra Das & Rosalie Power & Arifuzzaman Khan & Delwar Akbar & Nadia Badawi & Gulam Khandaker, 2021. "Supporting Ultra Poor People with Rehabilitation and Therapy among families of children with Cerebral Palsy in rural Bangladesh (SUPPORT CP): Protocol of a randomised controlled trial," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-16, December.
    • Handle: RePEc:plo:pone00:0261148
    DOI: 10.1371/journal.pone.0261148
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    References listed on IDEAS

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    1. Rosalie Power & Mohammad Muhit & Eamin Heanoy & Tasneem Karim & Nadia Badawi & Rahena Akhter & Gulam Khandaker, 2019. "Health-related quality of life and mental health of adolescents with cerebral palsy in rural Bangladesh," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-17, June.
    2. Heckman, James J. & Kautz, Tim, 2012. "Hard evidence on soft skills," Labour Economics, Elsevier, vol. 19(4), pages 451-464.
    3. Debashis Sarker, 2015. "Inclusion of disabled people in microfinance institutions: Where does Bangladesh stand?," International Journal of Innovation and Economic Development, Inovatus Services Ltd., vol. 1(1), pages 67-79, April.
    4. Gautam Rao, 2019. "Familiarity Does Not Breed Contempt: Generosity, Discrimination, and Diversity in Delhi Schools," American Economic Review, American Economic Association, vol. 109(3), pages 774-809, March.
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