African Journal of Disability - latest Issue
Volume 5, Issue 1, 2016
Preparation of students with disabilities to graduate into professions in the South African context of higher learning : obstacles and opportunities : original researchSource: African Journal of Disability 5, pp 1 –8 (2016) http://dx.doi.org/10.4102/ajod.v5i1.150More Less
Background: Persons with disabilities continue to be excluded from professions in South Africa despite legislation on non-discrimination and equity.
Objectives: We sought to identify both the opportunities and obstacles that students with disabilities face in professional degrees.
Method: Selected texts from the South African and international literature were analysed and synthesised.
Results: Students with disabilities are afforded opportunities to graduate into professions through the current climate of transformation, inclusion and disability policies, various support structures and funding. These opportunities are mitigated by obstacles at both the higher education site and at the workplace. At university, they may experience difficulties in accessing the curriculum, disability units may be limited in the support they can offer, policies may not be implemented, funding is found to be inadequate and the built environment may be inaccessible. Fieldwork poses additional obstacles in terms of public transport which is not accessible to students with disabilities; a lack of higher education support extended to the field sites, and buildings not designed for access by people with disabilities. At both sites, students are impacted by negative attitudes and continued assumptions that disability results from individual deficit, rather than exclusionary practices and pressures.
Conclusion: It is in the uniqueness of professional preparation, with its high demands of both theory and practice that poses particular obstacles for students with disabilities. We argue for the development of self-advocacy for students with disabilities, ongoing institutional and societal transformation and further research into the experiences of students with disabilities studying for professional degrees.
Use of consumer wireless devices by South Africans with severe communication disability : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.202More Less
Background: Advancements in wireless technology (e.g. cell phones and tablets) have opened new communication opportunities and environments for individuals with severe communication disabilities. The advancement of these technologies poses challenges to ensuring that these individuals enjoy equal access to this increasingly essential technology. However, a paucity of research exists.
Objectives: To describe the nature and frequency with which South African adults with severe communication disabilities have access to and use wireless devices, as well as the types of activities for which wireless devices are used.
Method: Survey research was conducted with 30 individuals who use augmentative and alternative communication (AAC) technology using the Survey of User Needs Questionnaire developed in the United States, and localized to the South African context.
Results: All participants, despite their limited education, unemployment and low economic status, owned and/or used mainstream wireless devices. Slightly more than half of the participants (53.3%) needed adaptations to their wireless devices. Advantages of using wireless devices were highlighted, including connecting with others (through using text messaging, social networking, making plans with others, sharing photos and videos with friends), for leisure activities (e.g. listening to music, watching videos, playing games), and for safety purposes (e.g. to navigate when lost, using the device when in trouble and needing immediate assistance).
Conclusion: These wireless devices offer substantial benefits and opportunities to individuals with disabilities who rely on AAC in terms of independence, social participation, education and safety/security. However, they still do not enjoy equal opportunity to access and use wireless devices relative to the non-disabled population.
Early detection of communication delays with the PEDS tools in at-risk South African infants : original researchSource: African Journal of Disability 5, pp 1 –5 (2016) http://dx.doi.org/10.4102/ajod.v5i1.223More Less
Background : Prevalence of communication delays or disorders is increasing, possibly because of various environmental risk factors. Selection and implementation of effective screening tools are important to detect at-risk infants as early as possible. This study aimed to evaluate the accuracy of the Parents' Evaluation of Developmental Status (PEDS), PEDS-Developmental Milestones and PEDS tools to detect communication delays in infants (6-12 months) in a South African primary healthcare context.
Method : A comparative study design evaluated the accuracy of the PEDS tools to detect communication delays, using an internationally accepted diagnostic assessment tool, the Rossetti Infant-Toddler Language Scale (RITLS). A convenience sample of 201 infants was selected at primary healthcare clinics.
Results : Expressive and receptive language sensitivity scores were low across all three screens (ranging between 14% and 44%). The PEDS tools had high sensitivity (71%) and specificity (73%) ratings for the receptive and expressive language and socio-emotional domain in combination.
Conclusion : In the sample population, the PEDS tools did not accurately detect receptive and expressive language delays; however, communication delays in general were identified. Future research determining accuracy of the PEDS, PEDS-Developmental Milestones and PEDS tools for children aged 2-5 years in detecting communication delays should be prioritised.
Source: African Journal of Disability 5, pp 1 –10 (2016) http://dx.doi.org/10.4102/ajod.v5i1.225More Less
Background : Children with disabilities in Sub-Saharan Africa depend for a large part of their functioning on their parent or caregiver. This study explores parental stress and support of parents of children with spina bifida in Uganda.
Objectives : The study aimed to explore perceived stress and support of parents of children with spina bifida living in Uganda and the factors that influence them.
Methods : A total of 134 parents were interviewed. Focus group discussions were held with four parent support groups in four different regions within the country. The Vineland Adaptive Behaviour Scales, Daily Functioning Subscales and Parental Stress Index Short Form (PSI/SF) were administered to measure the child's daily functioning level and parental stress levels.
Results : Parental stress was high in our study population with over half of the parents having a > 90% percentile score on the PSI/SF. Stress outcomes were related to the ability to walk (Spearman's correlation coefficient [ρ] = -0.245), continence (ρ = -0.182), use of clean intermittent catheterisation (ρ = -0.181) and bowel management (ρ = -0.213), receiving rehabilitative care (ρ = -0.211), household income (ρ = -0.178), geographical region (ρ = -0.203) and having support from another parent in taking care of the child (ρ = -0.234). Linear regression showed parental stress was mostly explained by the child's inability to walk (β = -0.248), practicing bowel management (β = -0.468) and having another adult to provide support in caring for the child (β = -0.228). Parents in northern Uganda had significantly higher scores compared to parents in other regions (Parental Distress, F = 5.467*; Parent-Child Dysfunctional Interaction, F = 8.815**; Difficult Child score, F = 10.489**).
Conclusion : Parents of children with spina bifida experience high levels of stress. To reduce this stress, rehabilitation services should focus on improving mobility. Advocacy to reduce stigmatisation and peer support networks also need to be strengthened and developed.
Source: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.231More Less
Background : Clinical assessment of hypotonia is challenging due to the subjective nature of the initial clinical evaluation. This poses dilemmas for practitioners in gaining accuracy, given that the presentation of hypotonia can be either a non-threatening or malevolent sign. The research question posed was how clinical assessment can be improved, given the current contentions expressed in the scientific literature.
Objectives : This paper describes the development and critique of a clinical algorithm to aid the assessment of hypotonia.
Methods : An initial exploratory sequential phase, consisting of a systematic review, a survey amongst clinicians and a Delphi process, assisted in the development of the algorithm, which is presented within the framework of the International Classification of Functioning, Disability and Health. The ensuing critique followed a qualitative emergent-systematic focus group design with a purposive sample of 59 clinicians. Data were analysed using semantical content analysis and are presented thematically with analytical considerations.
Results : This study culminated in the development of an evidence-based clinical algorithm for practice. The qualitative critique of the algorithm considered aspects such as inadequacies, misconceptions and omissions; strengths; clinical use; resource implications; and recommendations.
Conclusions : The first prototype and critique of a clinical algorithm to assist the clinical assessment of hypotonia in children has been described. Barriers highlighted include aspects related to knowledge gaps of clinicians, issues around user-friendliness and formatting concerns. Strengths identified by the critique included aspects related to the evidence-based nature of the criteria within the algorithm, the suitability of the algorithm in being merged or extending current practice, the potential of the algorithm in aiding more accurate decision-making, the suitability of the algorithm across age groups and the logical flow. These findings provide a starting point towards ascertaining the clinical utility of the algorithm as an essential step towards evidence-based praxis.
Patient perspectives about the healthcare of chronic musculoskeletal pain : three patient cases : original researchSource: African Journal of Disability 5, pp 1 –7 (2016) http://dx.doi.org/10.4102/ajod.v5i1.216More Less
Background : Consideration of the patient's perspective in healthcare is important because it may inform holistic and contextually relevant management strategies.
Objectives : The purpose of this study was to explore patients' experiences and perspectives about their chronic musculoskeletal (CMSK) pain and its management in the private healthcare sector in South Africa. This work was done as a pilot study to test, adapt and finalize an interview schedule.
Methods : A descriptive, qualitative study was conducted. The sampling was purposive. Three patients with CMSK pain were recruited to participate in in-depth individual interviews. The interviews were recorded and transcribed ensuring confidentiality. Inductive, thematic content analyses of the transcripts were undertaken. Initial codes were assigned and a code book developed, which was applied to the transcripts to develop categories and themes.
Results : Four themes emerged from the data: (1) the participants sought understanding about the pain's origin and the reason for pain persistence; (2) pain impacted their lives in multiple ways; (3) the participants depended on healthcare providers (HCP) for guidance and support; and (4) they had the option of acceptance of chronic pain.
Conclusion : The participants' knowledge about their health condition had important implications as it influenced their perspectives on pain and its management. The pain presented the participants with several challenges, which included developing an understanding about pain and coping with the impact of pain in their lives. HCPs were perceived to play an important role in empowering or disempowering the participants.
Impact of structured wheelchair services on satisfaction and function of wheelchair users in Zimbabwe : original researchSource: African Journal of Disability 5, pp 1 –11 (2016) http://dx.doi.org/10.4102/ajod.v5i1.222More Less
Background : Providing wheelchairs without comprehensive support services might be detrimental to user satisfaction and function.
Objectives : This paper compares wheelchair user satisfaction and function before and after implementation of comprehensive wheelchair services, based on the World Health Organization guidelines on wheelchair service provision in less resourced settings, in Zimbabwe.
Method : A pre- and post-test study with a qualitative component was done. Quantitative data were collected with the Quebec User Evaluation of Satisfaction with Assistive Technology for adults and children and the 'Functioning Every day with a Wheelchair Questionnaire'. Data were collected from 55 consecutively sampled wheelchair users, who received a new wheelchair in the study period. Qualitative data were collected through two audio recorded focus groups and two case studies and are presented through narrative examples.
Results : The proportion of adult users who were satisfied significantly increased for all wheelchair and service delivery aspects (p = 0.001 - 0.008), except follow-up (p = 0.128). The same was true for children's post-test ratings on all variables assessed (p = 0.001 - 0.04), except training in the use of the device (p = 0.052). The biggest improvement in satisfaction figures were for comfort needs (44.3%), indoor mobility (43.2%), outdoor mobility (37.2%), safe and efficient, independent operation (33.5%) and transport (31.4%). The qualitative data illustrated user satisfaction with wheelchair features and services.
Conclusion : The wheelchair service programme resulted in significant positive changes in user satisfaction with the wheelchair, wheelchair services and function. It is recommended that the Zimbabwean government and partner organisations continue to support and develop wheelchair services along these guidelines.
Graduates' perceptions of prosthetic and orthotic education and clinical practice in Tanzania and Malawi : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.142More Less
Background : Maintaining and improving the quality of prosthetics and orthotics education at the Tanzania Training Centre for Orthopaedic Technologists is essential for the provision of appropriate prosthetics and orthotics services in African countries.
Objectives : To describe how Tanzanian and Malawian graduates' of the Diploma in Orthopaedic Technology perceive their education and how it could be improved or supplemented to facilitate clinical practice of graduates.
Methods : Nineteen graduates from the diploma course in orthopaedic technology were interviewed and phenomenographic analysis was applied to the data.
Results : Seven descriptive categories emerged, namely varied awareness of the profession before starting education, well-equipped teaching facilities, aspects lacking in the learning context, need for changes in the curriculum, enabling people to walk is motivating, obstacles in working conditions and the need for continuous professional development. All participants perceived possible improvements to the content and learning environment.
Conclusions : Prosthetic and orthotic education can be better provided by modifying the content of the diploma programme by dedicating more time to the clinical management of different patient groups and applied biomechanics as well as reducing the programme content focusing on technical aspects of prosthetic and orthotic practice. Graduates were not prepared for the rural working conditions and the graduates desired continued training.
Understanding how carers cope in a complexchildhood disability in Turkana, Kenya :humanitarian setting : original researchSource: African Journal of Disability 5, pp 1 –8 (2016) http://dx.doi.org/10.4102/ajod.v5i1.277More Less
Background: Although the consequences of disability are magnified in humanitarian contexts, research into the difficulties of caring for children with a disability in such settings has received limited attention.
Methods: Based on in-depth interviews with 31 families, key informants and focus group discussions in Turkana, Kenya, this article explores the lives of families caring for children with a range of impairments (hearing, vision, physical and intellectual) in a complex humanitarian context characterised by drought, flooding, armed conflict, poverty and historical marginalisation.
Results: The challenging environmental and social conditions of Turkana magnified not only the impact of impairment on children, but also the burden of care-giving. The remoteness of Turkana, along with the paucity and fragmentation of health, rehabilitation and social services, posed major challenges and created opportunity costs for families. Disability-related stigma isolated mothers of children with disabilities, especially, increasing their burden of care and further limiting their access to services and humanitarian programmes. In a context where social systems are already stressed, the combination of these factors compounded the vulnerabilities faced by children with disabilities and their families.
Conclusion: The needs of children with disabilities and their carers in Turkana are not being met by either community social support systems or humanitarian aid programmes. There is an urgent need to mainstream disability into Turkana services and programmes.
The validation of an educational database for children with profound intellectual disabilities : original researchSource: African Journal of Disability 5, pp 1 –11 (2016) http://dx.doi.org/10.4102/ajod.v5i1.237More Less
Background: The Western Cape Forum for Intellectual Disability took the South African Government to court in 2010 on its failure to implement the right to education for Children with Severe and Profound Intellectual Disability. Subsequently, multidisciplinary teams were appointed by the Western Cape Education Department to deliver services to the Special Care Centres (SCCs). Initially, minimal information was available on this population.
Objectives: The purpose is to document the process of developing and validating a database for the collection of routine data.
Method: A descriptive analytical study design was used. A sample of convenience was drawn from individuals under the age of 18 years, enrolled in SCCs in the Western Cape. The team who entered and analysed the data reached consensus regarding the utility and feasibility of each item.
Results: Data were collected on 134 children. The omission of certain items from the database was identified. Some information was not reliable or readily available. Of the instruments identified to assess function, the classification systems were found to be reliable and useful, as were the performance scales. The WeeFIM, on the other hand, was lengthy and expensive, and was therefore discarded.
Discussion and conclusions: A list of items to be included was identified. Apart from an individual profile, it can be useful for service planning and monitoring, if incorporated into the central information system used to monitor the performance of all children. Without such inclusion, this most vulnerable population, despite court ruling, will not have their right to education adequately addressed.
Students with hearing impairment at a South African university : self-identity and disclosure : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.229More Less
Background: A growing number of students with hearing loss are being granted access to higher education in South Africa due to the adoption of inclusive educational policies. However, available statistics indicate that participation by students with hearing impairments in higher education remains low and research suggests that support provisioning for those who do gain access is inadequate.
Objectives: This article aims to illustrate that the assumed self-identity of students with hearing impairment influences their choice to disclose their disability. The choice not to disclose their hearing loss prevents them from accessing the necessary reasonable accommodations and this in turn may affect their eventual educational success.
Method: Reported here is a qualitative descriptive case study at a South African university. Purposive sampling methods were employed. Data were gathered from in-depth interviews with seven students with hearing impairment ranging from moderate to profound, using spoken language. Constructivist grounded theory was used as an approach to the process of generating and transforming the data, as well as the construction of theory.
Findings: All the student participants identified as having a hearing rather than a D/deaf identity cultural paradigm and viewed themselves as 'normal'. Linked to this was their unwillingness to disclose their hearing impairment and thus access support.
Conclusion: It is crucially important for academic, support and administrative staff to be aware of both the assumed 'hearing' identity and therefore subsequent non-disclosure practices of students with a hearing impairment using the oral method of communication. Universities need to put measures in place to encourage students to voluntarily disclose their hearing impairment in order to provide more targeted teaching and learning support. This could lead to improved educational outcomes for students.
Communication rehabilitation in sub-Saharan Africa : a workforce profile of speech and language therapists : original researchSource: African Journal of Disability 5, pp 1 –13 (2016) http://dx.doi.org/10.4102/ajod.v5i1.227More Less
Background: There is an urgent global need to strengthen rehabilitation services for people with disabilities. In sub-Saharan Africa, rehabilitation services for people with communication disabilities continue to be underdeveloped. A first step in strengthening services for people with a communication disabilities is to understand the composition and conditions of the current workforce.
Objectives: This research describes a sample of the speech and language therapists (SLTs) working in SSA (excluding South Africa). This study explores the characteristics of this workforce, including their demographics, education, experience and geographical stability.
Method: A mixed-methods survey was used to collect data from SLTs within Anglophone countries of SSA. Completed surveys were received from 33 respondents working in 44 jobs across nine countries. Analysis included descriptive and non-parametric inferential statistics.This study reports on a subset of descriptive and quantitative data from the wider survey.
Results: A background profile of SLTs across the region is presented. Results indicated that the workforce of SLTs comprised a mix of local and international SLTs, with university-level education. Local SLTs were educated both within and outside of Africa, with more recent graduates trained in Africa. These data reflected the local emergence of speech and language therapy training in SSA.
Conclusion: This sample comprised a mix of African and international SLTs, with indications of growing localisation of the workforce. Workforce localisation offers potential advantages of linguistic diversity and stability. Challenges including workforce support and developing culturally and contextually relevant SLT practices are discussed.
Source: African Journal of Disability 5, pp 1 –8 (2016) http://dx.doi.org/10.4102/ajod.v5i1.254More Less
Background: Rehabilitation personnel need to be sensitive to the cultural aspects that constitute the environment of a disabled child's family life.
Objectives: The aim of this study was to gain insight on how families experience parenting of disabled children and how the families experience the support provided by the rehabilitation system in Malawi.
Method: An anthropological field study combining interviews and observations was conducted in a rural district of Malawi in 2011. Permission was granted to follow four families, and this study presents the stories of two families, whose children have severe disabilities. We used phenomenological and narrative analyses to make sense of the stories.
Results: The findings indicate that families with disabled children invest time and emphasise care for their disabled children. They feel enriched by their experience despite challenging situations with little support from the rehabilitation services. High standards of care demonstrating positive and moral attitudes have earned these families respect in their communities. Storytelling has created an opportunity for the families to understand and interpret their challenging situation with inherent contextual meaning.
Conclusion: This study shows that families with disabled children draw on cultural and structural strengths that rehabilitation professionals should be aware of in their support to mothers and other caregivers of children with disabilities.
An adult learning perspective on disability and microfinance : the case of Katureebe : original researchSource: African Journal of Disability 5, pp 1 –10 (2016) http://dx.doi.org/10.4102/ajod.v5i1.215More Less
Background: Despite Uganda's progress in promoting affirmative action for persons with disabilities and its strategy of using microfinance to fight poverty, access to microfinance services by persons with disabilities is still problematic due to barriers, characterised by discrepancies between policies and practices. Regarding education, the affirmative action in favour of learners with disabilities has not translated into actual learning opportunities due to personal and environmental barriers.
Objectives: The study on which this article is based investigated the non-formal and informal adult learning practices regarding microfinance that persons with disabilities engaged in. This article seeks to illuminate the barriers that a person with a visual impairment encountered while learning about and engaging with microfinance and the strategies that he developed to overcome them.
Methods: This was a case study, framed within the social model of disability and critical research paradigm. Data were collected through in-depth interviews of a person with visual impairment and observations of the environment in which adult learning and engagement with Savings and Credit Cooperative Organisations (SACCOs) occurred.
Results: Findings indicate that the person with a visual disability faced barriers to learning about microfinance services. He experienced barriers in an integrated manner and developed strategies to overcome these barriers. The barriers and strategies are theorised using the social model of disability.
Conclusion: The case of a person with visual impairment suggests that persons with disabilities face multiple barriers regarding microfinance, including social, psychological and educational. However, his own agency and attitudes were also of importance as they influenced his learning. Viewing these barriers as blockades can lead to non-participation in learning and engagement with microfinance whereas viewing them as surmountable hurdles can potentially motivate participants to succeed in learning about and engaging with microfinance.
Perceived burden of care and reported coping strategies and needs for family caregivers of people with mental disorders in Zimbabwe : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.209More Less
Background: Mental health service resources are inadequate in low-income countries, and families are frequently expected to provide care for their relative with a mental disorder. However, research on the consequences of care-giving has been limited in low-income countries, including Zimbabwe.
Objective: The study explored the perceived impact of mental illness, reported coping strategies and reported needs of the family members of persons diagnosed with bipolar affective disorder or schizophrenia attending a psychiatric hospital in Harare, Zimbabwe.
Methods: A purposive sample of 31 family members participated in in-depth interviews and focus group discussions using standardised study guides. Participants were also screened for common mental disorders (CMDs) using the 14-item Shona Symptom Questionnaire.Qualitative data were analysed thematically using NVivo 8 qualitative data analysis software. Statistical Package for Social Sciences (SPSS version 16) was used for descriptive quantitative data analysis.
Results: Caregivers experienced physical, psychological, emotional, social and financial burdens associated with care-giving. They used both emotion-focused and problem-focused coping strategies, depending on the ill family members' behaviours. Seeking spiritual assistance emerged as their most common way of coping. Twenty-one (68%) of the caregivers were at risk of CMDs (including three participants who were suicidal) and were referred to a psychiatrist for further management. Caregivers required support from healthcare professionals to help them cope better.
Conclusion: Caregivers of patients attending psychiatry hospitals in Zimbabwe carry a substantial and frequently unrecognised burden of caring for a family member with a mental disorder. Better support is needed from health professionals and social services to help them cope better. Further research is required to quantitatively measure caregiver burden and evaluate potential interventions in Zimbabwe.
The effect of therapeutic horseback riding on heart rate variability of children with disabilities : original researchSource: African Journal of Disability 5, pp 1 –8 (2016) http://dx.doi.org/10.4102/ajod.v5i1.248More Less
Background: Heart rate variability (HRV) is the oscillation in the interval between consecutive heart beats, resulting from dynamic interplay between multiple physiologic mechanisms that regulate instantaneous heart rate. Short-term heart rate regulation is governed by sympathetic and parasympathetic neural activity and therefore HRV examination can be used as a noninvasive estimate of the functioning of the autonomic nervous system (ANS).
Aim: To determine the effects of therapeutic horseback riding (THR) intervention on the HRV of children with disabilities. The objective was to examine if THR intervention improves the HRV of children, hence improving the parasympathetic activity that is associated with a calm and relaxed state.
Methods: This is a quasi-experimental design. Heart rate variability components were measured over six intervention sessions of THR. Heart rate variability measures were recorded from 29 participants with various disabilities, and was assessed in both time and frequency domains.
Results: Over the six THR sessions, the time domain showed an increase in HRV for pre-THR indicating improved vagal activation, whereas frequency domain showed both increased sympathetic activity and increased parasympathetic activation during THR based on different components of frequency domain.
Conclusion: Therapeutic horseback riding intervention of six sessions demonstrated a change in HRV of children with disabilities. However, the changes obtained were not significant to make conclusive measures as to whether sympathetic or parasympathetic activity is predominantly increased after the six sessions. Further research involving more than six sessions of THR is required to yield more significant changes.
Attitudes of health service providers : the perspective of people with disabilities in the Kumasi Metropolis of Ghana : original researchSource: African Journal of Disability 5, pp 1 –8 (2016) http://dx.doi.org/10.4102/ajod.v5i1.181More Less
Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities). This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis.
Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics.
Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39).
Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.
Slipping and holding minds : a psychosocial analysis of maternal subjectivity in relation to childhood disability : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.266More Less
Background: This paper elucidates a methodological approach to interview text that tries to acknowledge the psychosocial nature of disability and thereby ensuring that empirical work in disability studies complements theoretical arguments already developed.
Objectives: The aim of this study is to outline a psychosocial conceptualisation of maternal subjectivity in relation to childhood disability and to apply this conceptualisation as an analytic tool to segments of an interview with a mother of a child with physical and developmental disabilities.
Method: Drawing on psychoanalysis and attachment literature alongside critical social psychology we take readers through the analysis of an interview extract with a particular mother. Through a fine grained analysis, we demonstrate the value of attending to the affective processes in and around the text rooted in the particular intersubjective exchange ('here and how') of the interview and the particular socio-historical context ('there and then') in which the mother, child and researcher are located.
Findings: The reading draws attention to discourses that position this particular mother and her children in particular ways while also pointing to investments in these discourses such that these discourses are not purely social but play affective functions.
Conclusion: This paper demonstrates the value of using multiple lenses to read the text, seeking to understand what is going on from within each lens (discursive/social, interpersonal, intrapsychic), while also seeking to disrupt this understanding as we take up the position of a different lens. This approach enables us to hold onto the complexity and locatedness of maternal subjectivity for mothers of children with disabilities.
Enhancing the public sector's capacity for inclusive economic participation of disabled youth in rural communities : original researchSource: African Journal of Disability 5, pp 1 –9 (2016) http://dx.doi.org/10.4102/ajod.v5i1.189More Less
Background: The capacity of service providers in the public sector to deliver inclusive services is essential to implement strategies that will allow the full participation of disabled youth in development opportunities in the rural context.
Objectives: This article sets out to describe the capacity of service providers in facilitating the participation of disabled youth in economic development opportunities.
Method: An instrumental, embedded single case study informed the research design. The sample consisted of five disabled youth, four family members and six service providers. Data was gathered through in depth individual interviews and focus group discussions. Data analysis was done inductively and thematically. In the discussion, the interpretation usedorganisational capacity elements as a framework.
Results: The findings indicate a perception of disability as a multifaceted and challenging issue with different orientations to service delivery, based on the understanding of the impairment and disability. There is a strong focus on impairment and negative attitudes.
Discussion: An asset-building approach could facilitate awareness of the capacities of disabled youth and thus shift negative attitudes to enabling attitudes. The vague strategies for youth and women reflect an organisational attitude that seems non-committal to its core agenda of inclusive development, which would ensure equal opportunities for participation by disabled youth.
Conclusion: An appreciative process of facilitating a deeper understanding of the needs of disabled youth would assist service providers to reconceptualise disability within an expansive framework of equal opportunities and active citizenship.
Source: African Journal of Disability 5, pp 1 –6 (2016) http://dx.doi.org/10.4102/ajod.v5i1.192More Less
Background: There is not a lot in the literature on disability in Nigeria concerning the role that religion, culture and beliefs play in sustaining discriminatory practices against persons with disabilities.
Objectives: Many of these practices are exclusionary in nature and unfair. They are either embedded in or sustained by religion, culture and beliefs about disability and persons with disabilities.
Methods: Drawing on various resources and research on disability, this paper looks at these practices in respect of these sustaining factors. Some of the discriminatory practices that constitute the main focus of the paper are the trafficking and killing of people with mental illness, oculocutaneous albinism and angular kyphosis, raping of women with mental illness and the employment of children with disabilities for alms-begging.
Results: The examination of these practices lends some significant weight and substance to the social model of disability, which construes disability in the context of oppression and the failure of social environments and structures to adjust to the needs and aspirations of people with disabilities.
Conclusion: Given the unfairness and wrongness of these practices they ought to be deplored. Moreover, the Nigerian government needs to push through legislation that targets cultural and religious practices which are discriminatory against persons with disabilities as well as undertake effective and appropriate measures aimed at protecting and advancing the interests of persons with disabilities.