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Management of cerebral palsy in low- and middle-income countries

Edward Kija1, Tracy Tushabe Namata2, Robert Sebunya3

  • 1Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.

Seminars in Pediatric Neurology
|October 11, 2025
PubMed

Insights

Cerebral Palsy (CP), a leading childhood disability, is often caused by preventable HIE in low-income countries. Improving CP care requires local guidelines, awareness, and healthcare system reforms for better outcomes.

Area of Science:

  • Global Health
  • Pediatric Neurology
  • Disability Studies

Background:

  • Cerebral Palsy (CP) is the most common cause of childhood disability worldwide, disproportionately affecting low and middle-income countries (LMIC).
  • Hypoxic-ischemic encephalopathy (HIE), resulting from preventable perinatal issues, is the primary cause of CP in LMIC, with spastic quadriplegia being the most prevalent subtype.
  • Limited awareness, social stigma, and inadequate diagnostic/screening capabilities for comorbidities hinder early intervention and optimal management of CP in LMIC.

Purpose of the Study:

  • To highlight the challenges in managing Cerebral Palsy (CP) in low and middle-income countries (LMIC).
  • To emphasize the need for evidence-based local guidelines and improved healthcare systems for CP management.
  • To advocate for enhanced awareness, early diagnosis, and appropriate referral pathways for children with CP in LMIC.

Main Methods:

  • This study is a review of the current challenges and needs for Cerebral Palsy (CP) management in LMIC.
  • It synthesizes information on the prevalence, causes, subtypes, and management barriers of CP in these regions.
  • The analysis focuses on the requirements for healthcare system reforms, policy changes, and community engagement.

Main Results:

  • Spastic quadriplegic CP is the most common subtype in LMIC, often stemming from preventable HIE.
  • Access to specialized expertise and advanced surgical interventions (e.g., intrathecal baclofen, selective dorsal rhizotomy) is severely limited due to cost and personnel shortages.
  • Inadequate screening and diagnosis of comorbidities further complicate CP management.

Conclusions:

  • Effective management of CP in LMIC necessitates the development of evidence-based local guidelines to inform healthcare investments.
  • Concerted efforts involving healthcare system reforms, policy adjustments, community engagement, and increased awareness are crucial for improving CP care.
  • Implementing locally generated, evidence-based interventions is essential to enhance the quality of life for children with CP and their families in LMIC.

Keywords:
Cerebral palsyChild neurologyMultidisciplinary interventionsResource limited settings

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