{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T18:34:02Z","timestamp":1792953242966,"version":"4.5.0"},"reference-count":62,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pediatric Rehabilitation Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This scoping review aimed to systematically map the experiences regarding structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy (CP) in low- and middle-income countries; and investigate whether experiences vary by social factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a scoping review that included qualitative or mixed methods studies (qualitative component) exploring structural barriers or facilitators to accessing habilitation\/rehabilitation among children with CP. Structural barriers and facilitators included socioeconomic and political contexts, governance, policies, and cultural\/societal values. Paired reviewers screened citations retrieved from databases and charted data, and we conducted a descriptive synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 34 relevant studies. Based on one study in a low-income country focused on home-based programs, barriers included restrictive home environments and lack of understanding of CP, while facilitators involved the use of locally available resources. For lower- and upper-middle income countries (33 studies), structural barriers and facilitators to access were related to finances; location, transportation, inaccessibility, and unavailability of services; system infrastructure; lack of knowledge; and perceptions concerning CP. We identified structural barriers as stigma concerning CP in lower-middle income countries, and disruptions during natural emergencies in upper-middle income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In middle-income countries, children with CP face many structural factors to accessing habilitation or rehabilitation, which intersect with social factors. Research is needed for low-income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18758894261501058","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:19:47Z","timestamp":1792603187000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["What are structural barriers and facilitators to accessing habilitation or rehabilitation among children with cerebral palsy in low- and middle-income countries? A scoping review"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5593-0238","authenticated-orcid":false,"given":"Jessica J.","family":"Wong","sequence":"first","affiliation":[{"name":"Western University"},{"name":"Western University"},{"name":"Ontario Tech University"},{"name":"ICES Western"},{"name":"University of Toronto"},{"name":"Canadian Memorial Chiropractic College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"C\u00f4t\u00e9","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"University of Toronto"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Ead","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"Canadian Memorial Chiropractic College"},{"name":"Canadian Memorial Chiropractic College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Walia","sequence":"additional","affiliation":[{"name":"Ontario Tech University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna","family":"Veitch","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"Queen\u2019s University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Bakaa","sequence":"additional","affiliation":[{"name":"Western University"},{"name":"Ontario Tech University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashiga","family":"Surendiran","sequence":"additional","affiliation":[{"name":"Western University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cullen","family":"Ye","sequence":"additional","affiliation":[{"name":"Western University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"Ontario Tech University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taryn","family":"Eickmeier","sequence":"additional","affiliation":[{"name":"Grandview Children\u2019s Centre"},{"name":"Ontario Tech University"},{"name":"Ontario Tech University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8616-5564","authenticated-orcid":false,"given":"Jamiu","family":"Busari","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"Maastricht University"},{"name":"Department of Pediatrics, Horacio Oduber Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajani","family":"Mullerpatan","sequence":"additional","affiliation":[{"name":"MGM Center of Human Movement Science, MGM School of Physiotherapy, MGM Institute of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remla","family":"Shirima","sequence":"additional","affiliation":[{"name":"PPF Olorien Commercial Complex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Murnaghan","sequence":"additional","affiliation":[{"name":"Canadian Memorial Chiropractic College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather M.","family":"Shearer","sequence":"additional","affiliation":[{"name":"Ontario Tech University"},{"name":"Canadian Memorial Chiropractic College"},{"name":"Holland Bloorview Kids Rehabilitation Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"United Nations. Convention on the Rights of Persons with Disabilities: Article 26 - Habilitation and Rehabilitation. Available at. https:\/\/www.un.org\/development\/desa\/disabilities\/convention-on-the-rights-of-persons-with-disabilities\/article-26-habilitation-and-rehabilitation.html (2008) accessed Jan 13 2023."},{"key":"e_1_3_7_3_2","unstructured":"World Health Organization (WHO). Rehabilitation 2030 Initiative. 2017. Available at. https:\/\/www.who.int\/initiatives\/rehabilitation-2030 (accessed Jan 6 2022)."},{"key":"e_1_3_7_4_2","unstructured":"United Nations. Convention on the Rights of Persons with Disabilities. Available at. https:\/\/www.un.org\/development\/desa\/disabilities\/convention-on-the-rights-of-persons-with-disabilities\/convention-on-the-rights-of-persons-with-disabilities-2.html (2008) accessed Jan 13 2023."},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32340-0"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2014.956814"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15243"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/17483107.2017.1373307"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/0963828021000007941"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12706"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012551"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.15346"},{"key":"e_1_3_7_13_2","unstructured":"World Health Organization. Rehabilitation. 2021. Available at. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/rehabilitation (accessed June 1 2021)."},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05487-w"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1359105314523305"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEP.0000000000000459"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001331"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S229535"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16245145"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.2010.01170.x"},{"key":"e_1_3_7_21_2","first-page":"2072","article-title":"Psychosocial experiences of mothers caring for children with cerebral palsy in the eThekwini district","volume":"28","author":"Seroke S","year":"2023","unstructured":"Seroke S, Mkhize SW. Psychosocial experiences of mothers caring for children with cerebral palsy in the eThekwini district. Health SA 2023; 28: 2072. https:\/\/doi.org\/10.4102\/hsag.v28i0.2072","journal-title":"Health SA"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000155"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-20-12"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_3_7_26_2","volume-title":"Convention on the Rights of the Child","author":"United Nations","year":"1989","unstructured":"United Nations. Convention on the Rights of the Child, 1989. Available at: https:\/\/www.ohchr.org\/en\/instruments-mechanisms\/instruments\/convention-rights-child (accessed Jan 16, 2024)."},{"key":"e_1_3_7_27_2","unstructured":"National Institute of Neurological Disorders and Stroke. Cerebral palsy: what is cerebral palsy?. Available at. https:\/\/www.ninds.nih.gov\/health-information\/disorders\/cerebral-palsy (2023) accessed Mar 27 2024."},{"key":"e_1_3_7_28_2","first-page":"8","article-title":"A report: the definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum P","year":"2007","unstructured":"Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8\u201314.","journal-title":"Dev Med Child Neurol Suppl"},{"key":"e_1_3_7_29_2","unstructured":"World Health Organization. International Classification of Functioning Disability and Health (ICF). Available at. https:\/\/www.who.int\/standards\/classifications\/international-classification-of-functioning-disability-and-health (2001) accessed Jan 10 2023."},{"key":"e_1_3_7_30_2","unstructured":"Solar O Irwin A. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice)."},{"key":"e_1_3_7_31_2","volume-title":"The World by Income and Region","author":"The World Bank","year":"2024","unstructured":"The World Bank. The World by Income and Region, 2024. Available at: https:\/\/datatopics.worldbank.org\/world-development-indicators\/the-world-by-income-and-region.html (accessed Aug 1, 2024."},{"key":"e_1_3_7_32_2","unstructured":"Cochrane Equity. PROGRESS-Plus. 2023. Available at. https:\/\/methods.cochrane.org\/equity\/projects\/evidence-equity\/progress-plus (accessed March 31 2023)."},{"key":"e_1_3_7_33_2","unstructured":"Canadian Institutes of Health Research (CIHR). Gender-Based Analysis Plus (GBA+) at CIHR. Available at. https:\/\/cihr-irsc.gc.ca\/e\/50968.html (2022) accessed Jan 15 2023."},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.01.021"},{"key":"e_1_3_7_35_2","unstructured":"CanChild. Gross Motor Function Classification System \u2013 Expanded & Revised. Available at. https:\/\/canchild.ca\/resources\/42-gmfcs-e-r\/ (2025) accessed Sept 29 2025."},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0282328"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/17450128.2023.2224975"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2024-002617"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-014-0016-3"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2023.07.019"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1177\/0308022614562793"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1080\/20473869.2019.1573572"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258650"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.47985\/dcidj.513"},{"issue":"1","key":"e_1_3_7_45_2","first-page":"e1","article-title":"A chasm: Consequences of poor collaboration between health and education in paediatric cerebral palsy care in Johannesburg","volume":"68","author":"Lydall M","year":"2021","unstructured":"Lydall M, Gerber B. A chasm: Consequences of poor collaboration between health and education in paediatric cerebral palsy care in Johannesburg. S Afr J Commun Disord 2021; 68(1): e1\u2013e8. https:\/\/doi.org\/10.4102\/sajcd.v68i1.817","journal-title":"S Afr J Commun Disord"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.1080\/0145935X.2019.1594757"},{"key":"e_1_3_7_47_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2022-001807"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/769619"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12624"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12490"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12929"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.17159\/2310-3833\/2021\/vol51n3a9"},{"key":"e_1_3_7_53_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajp.v71i1.274"},{"key":"e_1_3_7_54_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12618"},{"key":"e_1_3_7_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2016.03.002"},{"key":"e_1_3_7_56_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1356383"},{"key":"e_1_3_7_57_2","volume-title":"Caregivers' Burden of Caring for Children with Cerebral Palsy in Lagos, Nigeria","author":"Akuma LC","year":"2021","unstructured":"Akuma LC. Caregivers' Burden of Caring for Children with Cerebral Palsy in Lagos, Nigeria. University of Pretoria, 2021."},{"key":"e_1_3_7_58_2","doi-asserted-by":"publisher","DOI":"10.47985\/dcidj.392"},{"key":"e_1_3_7_59_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-3011-0"},{"key":"e_1_3_7_60_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19010475"},{"key":"e_1_3_7_61_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1411982"},{"key":"e_1_3_7_62_2","unstructured":"World Health Organization (WHO). Global report on health equity for persons with disabilities. Available at. https:\/\/www.who.int\/publications\/i\/item\/9789240063600 (2022) accessed Oct 1 2025."},{"key":"e_1_3_7_63_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1422036"}],"container-title":["Journal of Pediatric Rehabilitation Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18758894261501058","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/18758894261501058","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18758894261501058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T17:59:42Z","timestamp":1792951182000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/18758894261501058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":62,"alternative-id":["10.1177\/18758894261501058"],"URL":"https:\/\/doi.org\/10.1177\/18758894261501058","relation":{},"ISSN":["1874-5393","1875-8894"],"issn-type":[{"value":"1874-5393","type":"print"},{"value":"1875-8894","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"article-number":"18758894261501058"}}