Abstract
ABSTRACT
Background
Cerebral palsy (CP) disproportionately affects children in low‐ and middle‐income countries, where stigma and discrimination lead to marginalization and reduced participation. To design culturally appropriate community‐based health promotion strategies that can address these challenges, the role of community stakeholders is crucial, yet unstudied in rural sub‐Saharan Africa. This study aimed to explore stakeholders’ perceptions, beliefs and attitudes towards children with CP and their caregivers in rural Malawi.
Methods
A qualitative study using semistructured focus group discussions was conducted with 68 stakeholders across five villages in Mangochi District, Malawi, from November 2022 to January 2023. Participants included traditional leaders, religious leaders, teachers, health surveillance assistants, traditional healers and community volunteers. Thematic analysis identified key themes regarding knowledge, perceptions, community participation and future needs.
Results
The following four major themes emerged: (1) limited knowledge about CP causes and treatment, with CP often attributed to infectious diseases, witchcraft or pregnancy complications; (2) perception of difficulties and their impact on the children and their caregivers; with financial constraints being named most and problems accessing education; (3) community participation and response; were stigma was identified as primary barrier to health promotion and community participation; and (4) future facilitators to improve quality of life including strong stakeholder willingness to support integrated care approaches.
Conclusions
Community stakeholders demonstrated positive attitudes towards children with CP and willingness to support inclusive care programmes, despite limited disease‐specific knowledge. Findings suggest that community‐based health promotion interventions addressing knowledge gaps, reducing stigma and strengthening referral pathways could significantly improve outcomes for children with CP and their families in low‐resource settings.