Hossain M1, Islam S2, Rahman A3, Herbert R4, Muldoon S5, Taylor V6, Harvey L1
1The University of Sydney, John Walsh Centre for Rehabilitation Research, Sydney, Australia, 2Centre for the Rehabilitation of the Paralysed, Physiotherapy, Savar, Bangladesh, 3Centre for the Rehabilitation of the Paralysed, Physiotherapy, Dhaka, Bangladesh, 4Neuroscience Research Australia (NeuRA), Neuroscience, Sydney, Australia, 5Livability, Enniskillen, Co Fermanagh, Netherlands, 6Centre for the Rehabilitation of the Paralysed, Administration, Dhaka, Bangladesh
Background: Spinal cord injuries (SCI) are common in Bangladesh and other low-and middle-income countries. We know from anecdotal evidence that they have major implications on the individuals affected and their families. However, we have very little accurate data from representative samples.
Purpose: The purpose of the study was to determine the effect of spinal cord injuries on families in a large and representative sample of people from Bangladesh with recent SCI.
Methods: Data were collected as part of a large 5-year clinical trial (the CIVIC trial). The participants were people with recent SCI who were wheelchair dependent and about to be discharged from a large SCI hospital in Bangladesh. At the time of discharge, they were interviewed to determine their families' financial and employment situations prior to their injuries. These data were used to model the implications of participants' SCI on the financial situation of their families after injury.
Results: A consecutive series of 410 people with SCI about to be discharged from hospital were recruited. 90% of them were young males and 64% of the participants had limited or no ability to read the local language. Nearly all of them lived in extended families with a total of 1,802 adults and children directly or indirectly affected by participants' SCI. Importantly, 72% of participants were the main income earners for their households prior to injury. The median income per family member was US$37 per month (IQR, $24 to $60). In 50% of participants, this income was required to support 3 or more adults and 3 or more children. Prior to the injury, participants' income was sufficient to keep 60% of family members above the extreme poverty line (monthly median income per household member US$37, IQR $24 to $60). After injury, with the loss of the person's income, 82% of family members fell below the extreme poverty line (monthly median income per household member US$1, IQR, $0 to $24).
Conclusion(s): Spinal cord injuries in low-and middle-income countries have profound implications for individuals and their extended family members because those most often injured are young, poor, illiterate men who are the main income earners for their extended families. Spinal cord injuries throws injured people and their families into poverty.
Implications: The results of this study highlight the devastating effects of SCI on families. These data are important for enabling healthcare professionals to lobby governments and healthcare providers to provide better support for people with SCI and their families in low-and middle-income countries. The results from this study also indicate the need to focus attention on getting people with SCI back into employment, and directing attention to providing vocational training to the wives of young men affected by SCI in low-and middle-income countries.
Keywords: Baseline demographic, Randomised Control Trial, Poverty
Funding acknowledgements: National Health and Medical Research Council,(NHMRC), Australia.
Purpose: The purpose of the study was to determine the effect of spinal cord injuries on families in a large and representative sample of people from Bangladesh with recent SCI.
Methods: Data were collected as part of a large 5-year clinical trial (the CIVIC trial). The participants were people with recent SCI who were wheelchair dependent and about to be discharged from a large SCI hospital in Bangladesh. At the time of discharge, they were interviewed to determine their families' financial and employment situations prior to their injuries. These data were used to model the implications of participants' SCI on the financial situation of their families after injury.
Results: A consecutive series of 410 people with SCI about to be discharged from hospital were recruited. 90% of them were young males and 64% of the participants had limited or no ability to read the local language. Nearly all of them lived in extended families with a total of 1,802 adults and children directly or indirectly affected by participants' SCI. Importantly, 72% of participants were the main income earners for their households prior to injury. The median income per family member was US$37 per month (IQR, $24 to $60). In 50% of participants, this income was required to support 3 or more adults and 3 or more children. Prior to the injury, participants' income was sufficient to keep 60% of family members above the extreme poverty line (monthly median income per household member US$37, IQR $24 to $60). After injury, with the loss of the person's income, 82% of family members fell below the extreme poverty line (monthly median income per household member US$1, IQR, $0 to $24).
Conclusion(s): Spinal cord injuries in low-and middle-income countries have profound implications for individuals and their extended family members because those most often injured are young, poor, illiterate men who are the main income earners for their extended families. Spinal cord injuries throws injured people and their families into poverty.
Implications: The results of this study highlight the devastating effects of SCI on families. These data are important for enabling healthcare professionals to lobby governments and healthcare providers to provide better support for people with SCI and their families in low-and middle-income countries. The results from this study also indicate the need to focus attention on getting people with SCI back into employment, and directing attention to providing vocational training to the wives of young men affected by SCI in low-and middle-income countries.
Keywords: Baseline demographic, Randomised Control Trial, Poverty
Funding acknowledgements: National Health and Medical Research Council,(NHMRC), Australia.
Topic: Neurology: spinal cord injury; Disability & rehabilitation; Service delivery/emerging roles
Ethics approval required: Yes
Institution: The University of Sydney, Australia and CRP, Bangladesh
Ethics committee: The University of Sydney, Australia and CRP-R&E
Ethics number: 2015/041 and 0401-126
All authors, affiliations and abstracts have been published as submitted.
