Abstract:
Introduction: Cerebral palsy is the commonest cause of physical disability in children
worldwide, including Sri Lanka. Use of health services by children with disabilities can
be far from optimal, specially among disadvantaged groups. Many factors affect use ok
health care by these children, influencing their long term health. Objectives: To describe
patterns and correlates of health care utilization by children with cerebral palsy attending
a tertiary care setting. Materials and methods: This study was conducted among 375
children with a diagnosis of cerebral palsy, attending Teaching Hospital, Karapitiya, Galle.
An interviewer-administered questionnaire was used to collect data from their principal
caregivers. Univariate analysis was used to assess the correlates of health care utilization,
followed by logistic regression analysis. Results: Of the 375 children, 89.9% received some
form of regular health care, 8.0% received care irregularly, while 2.1% never received any
formal therapy. Commonest type of care received was physiotherapy (97.9%), followed
by drug therapy (53.3%), speech therapy (48.3%) and occupational therapy (9.9%). In
addition, approximately 11% used alternative therapy such as Ayurveda or Acupuncture.
Poor health care utilization was associated with older age of child (pco.ooi), younger age
of caregiver (p<0.05), low education of caregiver (p<o.oi), high family income (pco.os),
nuclear family type (pco.oi), longer distance to treatment facility (p<o.ooi) and longer
duration of treatment (p<0.001). All above variables except caregiver age and duration of
treatment were predictive of health service use in multivariate analysis. Conclusions:
Use of health services is inadequate among children with cerebral palsy in areas such as
speech and occupational therapy; probably due to lack of trained therapists and/or poor
parental awareness. Organizing community-based rehabilitation services and building
parental awareness may ensure a wider and regular use of services, while training/
recruitment of more therapists in required fields will further enhance optimal care.
