Barriers and enablers to return to work after stroke in Maputo, Mozambique: A qualitative study

Stroke frequently results in reduced work participation or permanent withdrawal from work. In low- and middle-income countries like Mozambique, return to work is influenced by limited rehabilitation services, socioeconomic challenges and workplace factors. Little is known about stroke survivors' experiences of these barriers and enablers in Mozambique.

To explore stroke survivors' perceptions of barriers and enablers influencing return to work in Maputo, Mozambique.

A qualitative, exploratory, descriptive study was conducted using semi-structured face-to-face interviews with 18 purposively selected stroke survivors attending outpatient rehabilitation services at Maputo Central Hospital. Interviews explored participants' experiences of returning to work after stroke and were audio-recorded, transcribed and analysed using thematic content analysis. Findings were interpreted using the International Classification of Functioning, Disability and Health (ICF).

Findings were organised according to the ICF framework. Barriers to return to work included impairments in body functions and structures (motor deficits, fatigue and cognitive difficulties), limitations in activities, restrictions in work participation and environmental factors such as limited vocational rehabilitation, inaccessible transport, workplace discrimination and inadequate employer support. Key enablers included functional gains through rehabilitation, family and social support, workplace accommodations and strong personal motivation to resume employment.

Return to work after stroke is a multidimensional process shaped by interaction between body functions and structures, activities and participation, environmental and personal factors. Addressing these factors through comprehensive rehabilitation, vocational support, workplace accommodations and coordinated health and employment policies may improve sustainable work reintegration for stroke survivors in Mozambique.

This study highlights context-specific barriers and enablers to return to work after stroke in Mozambique, informing rehabilitation practice and disability-inclusive employment strategies.