Navigating cultural context barrier faced by children with cerebral palsy: parent’s perspective

Abstract

Background: Although cerebral palsy (CP) is medically well defined, the lived experiences of affected children and their families in low and middle-income countries such as Bangladesh are strongly influenced by cultural beliefs, stigma, and limited resources. CP is frequently attributed to fate, divine punishment, or past sins, contributing to blame, shame, and social exclusion. These misconceptions often delay professional care and restrict access to rehabilitation services, while financial hardship and low awareness further limit long-term support. Aim: To explore cultural beliefs and contextual barriers faced by families of children with CP in Bangladesh and to examine how these factors influence caregiving practices and access to treatment and rehabilitation. Methods: A qualitative phenomenological design was adopted. Nineteen primary caregivers of children diagnosed with CP were recruited through purposive sampling. Data were collected via three focus group discussions conducted at the Centre for the Rehabilitation of the Paralysed (CRP), Savar, Bangladesh. Discussions lasted 30–35 minutes and were analyzed using Braun and Clarke’s thematic analysis framework. Results: Four major themes emerged: (1) misconceptions and knowledge gaps regarding CP; (2) cultural and religious influences on healthcare decision-making; (3) family and social dynamics shaping caregiving practices; and (4) structural and functional barriers to care and participation. Key subthemes included misunderstandings about CP causes and prognosis, reliance on spiritual or traditional treatments, influence of elders in decision-making, gendered caregiving responsibilities, social stigma, financial constraints, environmental inaccessibility, and limitations in daily participation. Conclusion: Cultural beliefs, stigma, family pressure, and socioeconomic barriers significantly affect access to care and participation for children with CP in Bangladesh, increasing caregiver burden particularly for mothers. Culturally responsive rehabilitation strategies, caregiver education, and community awareness initiatives are essential to reduce misconceptions, promote early intervention, and strengthen family centered care. Further research across diverse regions is recommended to inform inclusive service development. Keywords: Cerebral palsy; cultural beliefs; healthcare barriers; stigma; caregivers; Bangladesh; rehabilitation; social inclusion.