Policy Brief on Cerebral Palsy


The proposed Disability Policy amendment is specifically to recognise Children with Cerebral Palsy and to establish a physiotherapy centre. The principles underpinning this recognition should be those of article 23 & 31 of the UN Convention on the Rights of the Child. To support this policy there is a need to establish a new Physiotherapy Centre for Children with Cerebral Palsy in Chawama Township.

  1. Statement of the Problem

 Children with Cerebral Palsy in Chawama Township do not have adequate physiotherapy exercises. Before detailing the problem, I would like to briefly discuss what Cerebral Palsy is. Cerebral Palsy is condition not a  disease and it is caused among other things lack of oxygen to the brain at birth or just after birth.   CP affects the child’s ability to move and maintain balance and symmetric posture.  The CP condition is permanent and usually it does not get worse, especially when there is regular exercises.  The condition is ably described in the following diagram:



The problems which I want to address involve the children with CP and the problems include the following.

  • Chawama Township has an estimated number of 100,000 Households and only one government clinic, the Chawama clinic which is always congested.
  • Although a survey has not been taken, there more than 1,000 children with Cerebral Palsy in Chawama Township.
  • About 1,000 children with Cerebral Palsy (CP) attend physiotherapy exercises at Chawama Clinic.
  • The Children are usually brought to the clinic by mothers- Fathers are usual not available.
  • Each child attends the physiotherapy once in a month and this not good for their condition.
  • The Physiotherapy days for children with CP are restricted to Tuesdays and Thursdays only.
  • The Physiotherapy center is usually overcrowded and it is open to other clients such as stroke patients and other disabilities.

The Children with Cerebral Palsy are subjected to attend physiotherapy exercises together with other people at the Clinic.  This is not conducive atmosphere for the Children  with CP.  The  picture below shows a child with disabilities with other poeple doing exercises.


The mixing of children with disabilities with others in a physiotherapy centre is not good.  There is a need to have an exclusive centre for children with CP.

2.  Analysis of the Problem

Physiotherapy is very important for children with Cerebral Palsy (CP) and to allow these children use a common user facility in Chawama facility is not appropriate.  Children with CP require special attention because they require regular physiotherapy execrices on daily basis.  The forthcoming Disability Policy amendment should specifically recognise Children with CP.  The principles underpinning this recognition should be those of articles 23 and 31 of the United Nations Convention on the Rights of the Child ( Webb, R, 2003, Public Policy for Children with Disabilities).  To support this policy there is a need to establish a new physiotherapy centre for children with CP in Chawama Township.

3. Alternative Strategies

 The alternative strategies include two options but not limited to these two options.

  • Allocation of more time to the Children with CP at the physiotherapy centre of Chawama Clinic. This option will utilise the existing physiotherapy center and it will require more time and other resources allocated to Children with CP.  AT present the Children with CP are allocated two days in a week but this should be increased to 5 days a week.

The disadvantages of this option is that Chawama Clinic is congested and children with CP are a small component of a larger group of clients who use this facility.  The physiotherapy centre deals with other clients such as:

  •  Persons who are recovering from car accidents
  • Stroke patients
  • Other disabilities such as spine bifida and others.


This option may not work because the clinic is already congested and the centre is open to everyone.


  • The second alternative strategy is to extend the existing physiotherapy centre at Chawama Clinic. The extended wing should be dedicated  to Children with CP.  This option is feasible and may be of lower cost than establishing anew centre for Children with CP.  However, it may be difficult to find space for the extension of the existing centre.  Furthermore, extension programme of the clinic may not have physiotherapy centre as a priority because they are other competing needs for labour ward extension, children’s ward extension and many others.


  1. SWOT Analysis and Risk Analysis


Mothers usually take the children to physiotherapy exercises.  These mothers take time off from their buy schedules of doing some business of livelihood to go and wait for long hours to have a 30 minute exercise for their child with CP.  Usually, the mothers take half a day sometimes more than half a day in order to have a turn for for this physical exercise for their child with CP.


The existing physiotherapy centre is not adequate and a proposal to construct a new physiotherapy centre is shown using the Strengths, Weakness, Opportunities and Threats (SWOT) Analysis given below:


Table 1: SWOT Analysis for Establish a Physiotherapy Centre


Strengths: Majority of the mothers will support the setting up a new Physiotherapy Centre

Physiotherapies will be will to work at the centre

Other care givers will support the centre.

Equipment for the centre will be easily acquired


Opportunities: Link with other campaigns locally.

Link with other campaigns internationally

More resources will come to the centre

Other activities will come up, Traffic control initiative, green garden initiative and opening of a restaurant

Weaknesses: Inadequate resources to set up the centre.

Few fathers will participate in the initiative

Threats: Some key stakeholders will not be interested in the initiative

Some key stakeholder will start other initiatives which will be competing with the project.


5. Friends-Neutrals-Enemies Analysis

The project of establishing a new physiotherapy centre is further subjected to a friends-neutrals-enemies Analysis.  This analysis is given below:

 Table 2: Friends-Neutral-Enemies Analysis

Friends Neutral Enemies
Policy Formulation
Ministry of Health, National, Provincial, District &  the Chawama clinic No one will be neutral Ministry of Finance. The will not consider it as a priority.
Policy Implementation
Ministry of Health, National, Provincial, District &  the Chawama clinic No one will be neutral Ministry of Finance. They will not consider it as a priority.

  1. Risk Analysis

The project of establishing a new physiotherapy centre is furthermore subjected to Risk Analysis as follows:

Table 3: Risk Analysis for Establishing a Physiotherapy Centre


Probability 4


Contingency planning, Immediate Action:

To bring the more fathers on board.

Avoid at all cost

Avoid other key: stakeholder to start other initiatives



Signal &Tolerate: Inadequate resources to start the centre Reduce Frequency, Reduce Disruption

Ensure the participation of the ministry of Health officials at clinic & HQ level

1 2      3        4



·         1=Low Probability

·         2=Low Probability

·         3=Medium Probability

·         4=High Probability

·         1=Low Impact

·         2=Low Impact

·         3=Medium Impact

·         4=High Impact

7. Conclusion

This policy brief highlights the problem of inadequate physiotherapy facilities at Chawama Clinic.  The physiotherapy centre carters for many clients including children with Cerebral Palsy.  This inadequacy of the physiotherapy centre calls for recognition of children with cerebral palsy in the Disability Policy.  The recognition of Children with CP calls for sepcial attention for these children because they require regular exercises.  To support this amendment to the policy, there is a need to establish a physiotherapy centre in Chawama Township for Children with CP.

The alternative strategies include allocation more time to children with CP at the existing centre.  However, this not feasible because of the congestion at the clinic and they needs for centre go beyond the children with CP.  There are other clients such as car accident victims and stroke patients.   The other alternative is to extend the centre and the extended wing would be exclusively for children with CP.  This again may not be feasible at the clinic because extensions works for the clinic may go to other priority needs of the clinic such as labour ward and children’s ward.

A centre exclusively for children with CP is the ideal situation for these children with special needs as can be seen in this picture below.




The best alternative is for the establishment of a new physiotherapy centre exclusively for children with CP.  This policy brief has given the justifications for the establishing of the physiotherapy centre.




CARDI, 2010.  10 Guidelines for writing Policy Recommendations.

LGPSRI, 2010.  Writing Effective Public Policy Papers.

Glover, D, 2002.  “What Makes a Good Policy Paper”? Ten Examples.

NCO, 2003.  Ready,Steady,Play A National Play Policy.

Webb,R.2003, Public Policy for Children with Disabilities.







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