The High Cost of Survival: Exploring Financial Pressures in Medical Services and Daily Living for Persons with Spinal Cord Injury from two Selected Study Settings in Rwanda: A Qualitative study

Abstract

Background: Spinal cord injury causes lasting disability and financial hardship. Individuals in low- and middle-income settings like Rwanda face major barriers to affordable long-term services. Methodology: This study employed a qualitative phenomenological design to gain an in-depth understanding of participants’ lived experiences of financial pressures related to medical services and daily living. Purposive sampling was used to recruit participants, and following thematic saturation, the sample size was 12 participants. Data were gathered through in-depth interviews and analysed using thematic analysis. Results: The study generated two main themes and associated sub-themes. The first theme, financial pressures in daily living, captured the economic strain on family livelihoods, the high cost of daily living, and expensive transportation. The second theme, financial pressures in medical and related services, reflected the high cost of hospitalisation, assistive devices, and other medical services. Conclusion: These findings underscore the multifaceted financial challenges faced by people with spinal cord injury in Rwanda, both in daily living and in accessing medical services. The cumulative burden of unemployment, costly private transportation, limited insurance coverage, and unaffordable rehabilitation services highlights the urgent need for inclusive policies and financial support systems.