Policy to Practice: What Works to Meet the Needs of Families of Children with Disabilities in Bangladesh
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Introduction and objectives: Research on the needs of families of children with disabilities (CWDs) is sparse, particularly in low and middle-income countries such as Bangladesh. Further, little is known about factors that deter families from accessing government support. To address this gap, this multiphase study aimed to determine the extent to which the government offers support to meet the needs of CWDs and their families within disability policy; to explore the extent to which family members of CWDs have knowledge and access to government supports; to understand the experiences of family members of CWDs in accessing government supports; and to understand the perspective of service providers in implementing government support programs. Method: To achieve these aims, I conducted a policy analysis using the 18 core concepts of disability policy (Phase I), a cross-sectional survey with 393 family members of CWDs (Phase II), a qualitative descriptive study with 27 family members of CWDs (Phase III), and a qualitative descriptive study with 21 service providers (Phase IV). Results: Family members and service providers’ experiences together with the policy analysis revealed that the government of Bangladesh has made several commitments “on paper” to provide necessary support to meet the needs of families of CWDs. However, “in practice” families have limited access to government support due to obstacles including family members’ limited knowledge about government support, limited availability of support (e.g., lack of disability allowance and shortage of rehabilitation professionals), fragmented nature of support coupled with inaccessible physical environments, stigma, favoritism and perceived low quality of service. iii Conclusion: The results suggest that the government of Bangladesh, including practitioners need to educate families about available government support for CWDs. Additionally, practitioners should go beyond their clinical practice to that of an advocacy role and lobby with government to invest more resources to increase support for CWDs. Policymakers in Bangladesh need to strengthen monitoring and evaluation to minimize inequity in the implementation of disability specific programs. It is also important to address environmental barriers such as accessible infrastructure and public transportation. Finally, the Bangladeshi government should strive for greater coordination across all disability services.