Barriers and facilitators for work and social participation among individuals with spinal cord injury in Indonesia

Study design Qualitative study using in-depth interviews. Objectives To describe experienced barriers and facilitators for work and social participation among individuals with spinal cord injury (SCI). Setting Vocational rehabilitation (VR) center in Yogyakarta Province, Indonesia. Methods Semi-structured interviews were conducted with 12 participants (8 males, 4 females) aged 24-67 years. Five participants still underwent vocational rehabilitation, while seven participants lived in the community. Thematic analysis was used. Results None of the participants who worked before the injury returned to her/his previous occupation, most participants became self-employed. The frequency of participation in social activities decreased substantially. Barriers for work and social participation included health conditions and environmental barriers, including inaccessibility, stigma and discrimination and limited institutional support and services. Identified facilitators for work and social participation were perceived importance of work and social participation, adaptations to disability condition, and social support. Conclusion Barriers to engage in work and social activities for individuals with SCI in Indonesia are combination of physical limitations, lack of accessibility, stigma, and institutional barriers. The capacity of social networks such as family in facilitating participation should be strengthened during the VR processes. VR should provide marketing skills and link self-employed clients with the market, in collaboration with the private sector and industries. Immediate policy and programmatic action is needed to enable these individuals to enhance sustainable work and social participation.