Abstract
BACKGROUND: Neonatal brachial plexus injury (NBPI) refers to weakness or flaccid paralysis of the upper extremity, which is diagnosed at birth or shortly after birth. This occurs because of the overstretching of one or more cervical and thoracic nerve roots (C5-T1). Globally, the incidence of NBPI ranges from 0.38 to 5.1 per 1,000 live births, with a higher prevalence in low- and middle-income countries. This study aimed to assess the profile and rehabilitation approaches used for children with NBPI in selected Rwandan hospitals. METHODS: A cross-sectional analytical design was used to evaluate NBPI management in two district hospitals. Systematic sampling was applied, with data collected through a capture sheet and a modified version of the Brachial Plexus Outcome Measure (BPOM) questionnaire. Data were analyzed via STATA to generate frequencies, cross-tabulations, and logistic regression. RESULTS: Approximately 30% of the children achieved independent use of their affected limb after rehabilitation, 60% achieved moderate improvement, and 10% achieved no recovery. The key factors associated with recovery included maternal education, marital status, wealth index, timing of treatment initiation, severity of the injury, duration of rehabilitation, and treatment frequency. CONCLUSION AND RECOMMENDATIONS: Early diagnosis and timely referral are crucial for better outcomes. Emphasis should be placed on educating parents about therapy adherence and expanding access to specialized care. Policymakers should address socioeconomic barriers by subsidizing treatment and enhancing insurance coverage. Increasing treatment frequency and offering flexible scheduling or telehealth services may improve adherence and recovery rates.