Navigating the Care Landscape for Spinal Cord Injury: A Sociological Insight

Abstract

background: Spinal Cord Injury (SCI) is a major global public health concern, with a disproportionate burden in low- and middle-income countries (LMICs), particularly in Africa. In Nigeria, most research has emphasized clinical and rehabilitative outcomes, with limited attention to sociocultural aspects of SCI care. This study examined how people living with SCI and their caregivers navigate the healthcare landscape, and the sociocultural factors shaping their choices and experiences.

Methods: This hospital-based, cross-sectional study was conducted between February 2018 and February 2019 at the University College Hospital, Ibadan, using a mixed-methods design. Data were collected through surveys with 108 informal caregivers, in-depth interviews with 30 SCI patients and caregivers, and 6 key informant interviews with traditional healers. Quantitative data were analyzed using univariate and bivariate statistics, while qualitative data was analyzed thematically.

Results: Biomedical care was the most common initial response to SCI, driven by its acute presentation and availability of specialized services. Many participants later concurrently or sequentially utilized alternative care, including traditional bone setting (25.9%) and spiritual healing (71.3%). Medical tourism was reported in a few cases, and decision-making was heavily influenced by family, friends, and spiritual advisors. Despite skepticism, some caregivers reported psychological and cultural value in alternative therapies. No significant associations were found between caregivers’ socio-demographic characteristics and alternative care use.

Conclusion: Healthcare-seeking for SCI in Nigeria reflects a complex blend of biomedical, traditional, and spiritual practices. Integrating culturally sensitive, community-based rehabilitation strategies with evidence-based care is critical for improving outcomes and ensuring continuity of care in LMICs.