Accessibility of occupational therapy treatment for at-risk children in low- to middle-income countries: A scoping review

Background: Barriers to occupational therapy (OT) treatment in low- to middle-income countries (LMICs) are not well documented, posing challenges for ensuring treatment accessibility. Objectives: This study focuses on at-risk children aged 0–17 years in LMICs, a vulnerable population facing unique and often overlooked barriers to accessing OT treatment. Given that low-income countries account for 85% of the world’s population, it is imperative to ensure that vulnerable children living in these regions receive adequate attention and resources to support their development and well-being. Method: This study explored the barriers to the accessibility of OT treatment for at-risk children in LMICs. Following the JBI Manual for Evidence Synthesis – 2024 edition, a search of CINAHL, PubMed, Scopus, PsycINFO and Web of Science yielded eight eligible studies. Records were screened first by title and abstract, and then by full text. All included studies were published within the last 10 years with a focus on at-risk children and/or adolescents who received OT treatment in LMICs. Results: A shortage of trained professionals is presented as the most common barrier limiting access to OT. Other barriers included limited government funding, lack of resources that impeded the delivery of treatment, social stigma and cultural attitudes, and lack of knowledge and awareness about OT. Conclusion: Further research is required to explore ways to address these barriers to improve access to OT services. Contribution: Identified barriers can facilitate actions to increase accessibility to OT interventions for at-risk children in LMICs, with the goal of improved health outcomes and greater social inclusion.