Online Reporter
Peter Matika [email protected]
FATHERS are emerging as the missing link in the rehabilitation of children with disabilities, with a Bulawayo physiotherapist’s doctoral study showing that involving fathers and siblings can significantly improve children’s developmental outcomes while easing the burden on mothers.
The four-year study by paediatric physiotherapist Dr Precious Madzimbe, who recently graduated with a PhD from the University of Cape Town (UCT), found that fathers and siblings were rarely involved in home rehabilitation programmes, with participation remaining below 20 percent.
However, the research found that children whose rehabilitation involved both parents performed better than those whose programmes were administered by mothers alone, while those supported by mothers, fathers and siblings recorded the strongest developmental trajectories.
Dr Madzimbe, who works in Bulawayo, said his research was inspired by what he repeatedly observed at rehabilitation clinics, where mothers commonly accompanied children with conditions such as cerebral palsy while fathers were largely absent.
“So many times we see mothers bringing children to the clinic. Fathers are invisible. They rarely come and they seem not to be well involved in the care of their children. And so are siblings. They are rarely involved,” he said.
His doctoral research, titled “Father and sibling participation in home rehabilitation programmes for children with neuro-developmental delay in an African context”, sought to establish why fathers and siblings were not participating in rehabilitation and the effect of their involvement on children and their families.
The research comprised four studies, including a review of existing literature, interviews with rehabilitation professionals, research involving fathers and a longitudinal study tracking children and their families.
Dr Madzimbe said the findings challenged the assumption that fathers were simply unwilling to participate.
Instead, many fathers interviewed expressed a desire to be involved but faced practical barriers, particularly demanding work schedules and difficulties securing time off to accompany their children to medical and rehabilitation appointments.
The children were divided into groups according to who participated in administering their home rehabilitation programmes — mothers alone; mothers and fathers; and mothers, fathers and siblings.
Dr Madzimbe said the results showed a clear difference in developmental trajectories depending on the level of family participation.
Children whose rehabilitation involved both parents performed better than those whose programmes were administered by mothers alone, while children whose mothers, fathers and siblings participated together recorded the strongest developmental outcomes.
The wider involvement of family members also had benefits for mothers’ mental wellbeing by reducing the burden associated with caring for children with disabilities.
“The study finally concluded that including fathers and siblings has a positive trajectory in the reaction of children with disabilities,” Dr Madzimbe said.
He said the findings had significant implications for Zimbabwe, where the responsibility for caring for children with disabilities often falls heavily on mothers and other female relatives.
Dr Madzimbe said rehabilitation services should therefore move from a model centred mainly on mothers and children towards a family-centred approach that deliberately brings fathers and siblings into the rehabilitation process.
The approach is already being encouraged at hospitals where he works, including Mpilo Central Hospital, where clinicians are being encouraged to involve fathers from a child’s first appointment.
Dr Madzimbe said siblings also needed to be included, as they could experience emotional strain when they did not understand their brother or sister’s condition.
“Sometimes they don’t understand what is troubling their sibling; what’s their diagnosis; what’s their condition. So, emotionally, they get drained, because they are not actually involved,” he said.
The findings, Dr Madzimbe said, should inform both policy and clinical practice, particularly in designing rehabilitation services that accommodate the realities of working parents.
His study also suggests that improving father participation may require health institutions to deliberately create opportunities for fathers to take part rather than assuming that their absence reflects a lack of interest.
The research was conducted while Dr Madzimbe continued working as a clinician and involved the use of the Bayley Scales of Infant and Toddler Development to assess children across five developmental domains.
He is now seeking to extend the research through postdoctoral studies focusing specifically on siblings and examining how caring for a child with a disability affects their mental health and quality of life.
Dr Madzimbe said his ultimate goal is to transform rehabilitation from a responsibility largely carried by mothers into a collective family effort.
“Including fathers and siblings has a positive impact on the developmental trajectory of children with disabilities,” he said.
