African Journal of Disability最新文献

Background: In light of the increasing diversity within school populations globally, a pressing need arises for nations to prioritise the enhancement of teachers' competencies in implementing inclusive education, recognising the central role teacher education programmes play in addressing this imperative. Teacher education programmes centred on inclusion not only respond to this global priority but also wield influence on teachers' attitudes, self-efficacy and stress levels when engaging with diverse learners.

Objectives: The study presents an analysis of the effectiveness of a teacher education programme in Ethiopia in developing teachers' competencies for inclusion.

Method: Using a sequential explanatory mixed-methods research design, involving 159 teachers, data were collected through questionnaires (n = 152) and individual interviews (n = 7). Quantitative data were analysed using SPSS, and qualitative data underwent thematic analysis. This approach ensures a nuanced examination of the research question with precision and depth.

Results: Findings highlight challenges in the Ethiopian teacher education system, revealing a significant lack of provision of sufficient knowledge to empower teachers to understand inclusion. The inadequacy extends to the influence on teachers' attitudes towards inclusion, as well as the insufficient exposure to practical, hands-on experiences essential for addressing diverse learning needs.

Conclusion: The challenges faced by teacher training in Ethiopia, evident in its struggle to align with global standards for supporting teachers in implementing inclusive education, necessitate urgent and substantial reforms.

Contribution: Addressing the gaps in understanding inclusion, fostering positive attitudes and enhancing practical experiences necessitating a comprehensive overhaul of teacher education curricula and practices.

Background: Parents of Deaf or hard-of-hearing (DHH) children are faced with a plethora of overwhelming decisions concerning their children, particularly during the early stages of development. Among these decisions are those concerning assistive devices and the modes of communication for their child.

Objectives: The aim of this study was to explore the perceptions of parents of DHH children towards the various modes of communication for their children within the South African context.

Method: The study adopted a Q-methodology research design. Participants rated statements according to what they least and most agree with and then answered follow-up questions concerning the statements. Participants were also invited to participate in a live, one-on-one, semi-structured interview with the researcher. Data were analysed through both qualitative and quantitative statistics. Thematic analysis was adopted to analyse the qualitative data, while factor analysis through Ken-Q analysis was used for quantitative data.

Results: Although 66% of participants thought that sign language allows DHH children to communicate more freely, 88% agreed that a DHH child should always learn to speak if they can. In terms of decision-making, 88% reported the issue of stigma or marginalisation and 88% cited the lack of Deaf schools as barriers in their decision-making.

Conclusion: The study's findings provide valuable insights into the complex interplay of factors influencing communication mode decisions for DHH children in South Africa.

Contribution: These insights are crucial for developing inclusive and effective communication strategies that consider individual needs, societal norms and access to support services.

Background: Caring for children with disabilities in Tanzania involves significant challenges, including stigma, limited support and mental health risks. A cultural collective for caretakers of children with disabilities enrolled at a primary school was established to address these issues.

Objectives: The study aims to explore the experiences of caregivers who started a cultural collective and to assess its impact on their lives in the short term.

Method: This study used a community-based participatory research (CBPR) approach with a sequential mixed-methods design. Data were collected over a period of 8 weeks, while the participants in this study established a collective in Dar es Salaam. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using Braun and Clarke's method for thematic analysis.

Results: As assessed by a validated and normed questionnaire, Patient Health Questionnaire-9 (PHQ-9), 63% of the caregivers showed signs of depression before starting work in the collective. Economic needs, education and the desire for support were the primary motivations for joining. Starting the collective improved social support, fostered agency and began to enhance caregivers' financial conditions.

Conclusion: The collective addressed caregivers' needs for economic improvement, social support and mental support, and the experience was vitalising for the caretakers.

Contribution: This study deepens our understanding of holistic interventions for children with disabilities and their families in urban Africa. It offers valuable insights into a crucial stage of developing contextually relevant interventions for vulnerable, poverty-stricken populations. It provides a model that can be adapted for similar interventions in comparable contexts.

Background: Play is integral to optimal childhood development. Occupational therapists often use play to improve play skills. However, when it comes to learners with autism spectrum disorder (ASD) in South Africa, there is limited research regarding play-based interventions that address the underlying motivators of play, namely, social play and playfulness.

Objectives: In this study, the authors present a rationale for the development of a protocol for a study aiming to measure the impact of the Playbox Africa Intervention. This is a play-based occupational therapy intervention with the aim of enhancing the playfulness, social play and occupational performance of South African children with ASD.

Method: The study will utilise a within-subject, repeated measures design and will be implemented over 16 weeks with 8-10 learners (aged 3-8 years) with ASD attending a developmental-centre environment in Johannesburg, South Africa. The playfulness and social play of the learners will be assessed using the Test of Playfulness (ToP). The modified Canadian Occupational Performance Measure (M-COPM) will be used to measure occupational performance factors.

Results: Given that this protocol outlines an intervention that has not yet been implemented, there are no results to report on.

Conclusion: The development of this protocol could encourage the adaption of existing play-based protocols, for children with ASD, perhaps within different settings or varying support needs.

Contribution: Additionally, it could lay the foundation for future clinical trials and culturally relevant play-based interventions to be developed in the South African special needs context.

Background: Cerebral palsy affects children's movement and posture because of damage to the brain's development. Care assistants in healthcare facilities provide care to children. Caring for the children is overwhelming, hence support is required. Such support is absent, causing frustration among care assistants, which leads to poor quality care for children.

Objectives: To explore and describe the experiences of care assistants of children admitted with cerebral palsy in healthcare facilities of the Gauteng province, and to develop a support programme for care assistants.

Method: A qualitative, exploratory, descriptive, and contextual research design was used. Participants were selected from healthcare facilities in Gauteng province. Semi-structured interviews were used to collect data. Content data analysis was used to analyse data. The results were used to develop a support programme for care assistants.

Results: Three themes emerged, namely, a lack of training opportunities, a lack of resources, and a lack of support. The results were used to develop a support programme, using the three steps of the Donabedian model for care: structure, process and outcome.

Conclusion: Care assistants are not given training opportunities, work with limited resources and are not supported, hence the development of a support programme. If effectively utilised, the programme can lead to staff satisfaction and improvement of quality care for children.

Contribution: The study enabled managers in healthcare facilities to see the need for policy and the need for support strategies for care assistants. A support programme was further developed.

Background: Children with disabilities encounter obstacles attaining basic education. Significantly, previous studies on South Africa have shown that up to 70% of the children with disabilities are out of school. Despite efforts to support inclusive education through White Paper 6 policy, the deployment of resources and transformation of the education sector has been a slower process.

Objectives: The main objective of the article is to explore the challenges of basic education faced by children with disabilities in South Africa.

Method: The study was conducted during the COVID-19 pandemic using a qualitative research methodology. The data were collected using key informant interviews through online media platforms. The data analysis was conducted using computer-aided software in the form of ATLAS.ti 8.

Results: This study established several challenges faced by special needs schools, especially in the rural areas. These include a limited number of special needs schools, scholar transport, enrolment, lack of psychosocial and expert support, sanitation and infrastructure and the impact of COVID-19 pandemic on children with disabilities.

Conclusion: The article concludes that even though White Paper 6 focusses on Special Needs Education in South Africa, there remains poor policy implementation to ensure inclusivity for learners with disabilities.

Contribution: The research provides an understanding of the challenges faced by children with disabilities to assist policy makers with recommendations and areas of concern to improve policy implementation of the White Paper 6 in South Africa.

Background: People with disability are a vulnerable population and are at a high risk of acquiring human immunodeficiency virus (HIV) infection.

Objectives: We investigated the association between severity of disability and not having knowledge of any HIV prevention method among adults in Uganda.

Method: Between January 2015 and December 2015, data were collected within a general population in Uganda, on six domains of disability based on the Washington Group Short Set on Functioning. In addition, routine data on socio-demographic factors and other HIV-related data were collected among adults aged 16 years and above. A continuum of functioning was developed: without disability, mild, moderate and severe. Bivariate and multivariate associations of disability and not knowing any HIV prevention method were fitted using logistic regression models.

Results: A total of 3331 adults (60.4% female) were included. Of these, 14.5% (n = 482) were classified as having either moderate or severe disability, and this proportion exponentially increased with age (p < 0.001). Overall, 4.2% (n = 140) reported not knowing any HIV prevention method, with a slightly higher proportion among females than males (3.1% in males, 4.9% in females). Compared to people with no disability, those with moderate or severe disability were 5 times more unlikely to know any HIV prevention methods (adjusted odds ratio = 5.45, 95% confidence interval = 3.25-9.13, p < 0.001). Additionally, the combined effect of moderate and severe disability and none/incomplete primary education increased the likelihood of not knowing HIV prevention methods over and beyond their separate effects (p < 0.001).

Conclusion: Effective HIV prevention strategies must integrate best practices that target people with disabilities.

Contribution: These findings contribute to the evidence of the lack of HIV prevention knowledge among people with disabilities in general populations.

Background: COVID-19 had an impact on all sections of society, including people with disabilities.

Objectives: The authors aimed to explore the needs and experiences of people with disabilities in Zambia during the COVID-19 pandemic.

Method: In this hermeneutic phenomenological study, we used a semi-structured interview guide to collect data from a purposive and snowball sample of 40 people with disabilities and their caregivers. The participants were from 11 districts in 6 provinces in Zambia. The in-depth interviews were done between July 2022 and November 2022. Data were managed in NVivo and analysed using reflexive thematic analysis.

Results: The three themes included: (1) awareness and experience of public health measures on COVID-19 among people with disabilities; (2) experience of othering and stigmatisation as people with disability during the COVID-19 pandemic and (3) experience of COVID-19 symptoms and having COVID-19 among people with disabilities.

Conclusion: Interventions were largely unresponsive to the needs of people with disabilities, exacerbating the risk of exposure to infection. In future, adaptations like emergency risk communication in braille, audio and sign language interpretation in adapted communication formats should be made. Further studies are needed to quantify the gaps in access to health, explore policies and strategies to improve health outcomes for people with disabilities in LMICs like Zambia.

Contribution: The findings may contribute to the development and enhancement of policies and interventions responsive to the needs of people with disabilities in future pandemics in the Zambian context.

Background: Diabetes mellitus (DM) is a global health concern that has greatly affected South Africa. The gap in the current management of DM has resulted in complications such as lower extremity amputations (LEAs) and death. Eastern Cape province reflects this struggle, with disparities in access to healthcare and poor health outcomes. Understanding survival rates and associated factors between the urban Livingstone Hospital and the rural Nelson Mandela Academic Hospital can improve health interventions and outcomes.

Objectives: This study compared the survival rate of patients in urban areas and those in rural areas.

Method: This retrospective cohort study was conducted in an urban and a rural hospital by reviewing existing medical records of diabetic patients who underwent an LEA between 2016 and 2019.

Results: The retrospective cohort study examined 439 diabetic-related LEA cases. This study found that residing in rural areas significantly decreased the risk of mortality by 62% compared with living in the urban areas. Factors such as haemoglobin A1c (HbA1c) levels, nephropathy, cardiovascular disease, human immunodeficiency virus (HIV), other comorbidities and level of amputation significantly influenced survival probabilities.

Conclusion: Survival analysis indicated a significant difference in the 3-year survival probabilities of the two groups, favouring rural residency (p = 0.001). The biggest cause for concern between the two regions was uncontrolled blood glucose levels as this resulted in high mortality rates.

Contribution: Insights from this study have shown that introducing podiatry and orthotics at primary healthcare (PHC) could improve foot care and reduce diabetic-related LEAs and mortality.