Barriers to rehabilitation treatment among poliomyelitis infected patients in Karachi, Pakistan: a mix methods study

Objective To identify the potential barriers to polio rehabilitation treatment in patients of Karachi, Pakistan. Methodology A mix methods study was conducted in the city of Karachi, Pakistan for 4 months and gathered data from polio survivors and physical therapists involved in rehabilitation treatment of polio patients. The study had a quantitative part supplemented by a questionnaire and a qualitative part in which in-depth interviews were conducted. The study was approved by the Ethical Committee of Research Review Board, Clifton Hospital and Board of Advance Study and Research (BASR) of Hamdard University, Madinatul Hikmah, Karachi, Pakistan. Results A total of 102 physical therapists and 120 polio survivors consented to participate. The mean age of the physical therapists was 36.1 years (SD 6.4), majority was male (77.5%) and with work experience of over 10 years (44.1%). The mean age of the polio survivors was 30.6 years (SD 8.4). Majority had low monthly family income i.e. PKR 15000 (US$ 147.38). Major barrier perceived by physical therapists was financial constraint (41.2%). Pushtun ethnicity (34.3%) was also perceived as a major barrier. Major and minor barriers perceived by polio survivors were financial constraint (95%) and treatment attendance (68.3%) respectively. Conclusion Poliomyelitis is an infectious disease of poverty. Our study highlighted low family income of the polio survivors. Since most of the patients in the country have to bear medical cost directly, Pakistan’s polio rehabilitation program is hindered by financial issues for most part. The health care authorities must formulate a strategy to assist patients financially in attending rehabilitation treatment program.