Living with spinal cord injury in the community of Bangladesh: a comprehensive analysis using the ICF framework.

Abstract

To describe limitations in functioning (activities and participation) and environmental and personal factors that are associated with functioning using the ICF framework among persons living with spinal cord injury in the community of Bangladesh. Cross-sectional study, Bangladesh arm of the International Spinal Cord Injury (InSCI) Community Survey (2023-2024). 789 individuals with spinal cord injury. Face-to-face interview through culturally adapted InSCI questionnaires. Generalized linear models were used to determine the associated factors. Participants were predominantly male (73%), aged 18-40 years (51%), and from rural areas (63%). More than one-third had tetraplegia (34%). Tetraplegic participants reported greater limitations across all ICF domains compared with paraplegics (all p <  0.01). Determinants of poorer outcomes included male sex, younger age, low education, rural residence, and severe injury of all ICF domains. Individuals with spinal cord injury in Bangladesh face severe restrictions in functioning and participation, shaped by sociodemographic and clinical factors. These findings echo global evidence from other InSCI countries and LMIC studies, highlighting systemic barriers common to resource-constrained settings. Addressing these disparities through accessible rehabilitation, policy reforms, and cross-national knowledge exchange is critical to advancing equitable spinal cord injury care worldwide.