African Journal of Disability最新文献

Background: The African Network for Evidence-to-Action in Disability (AfriNEAD) is a leading role player in Africa promoting evidence-informed policies and practices for disability inclusion on the continent. This article presents findings of a desktop review that explored trends of disability research in the AfriNEAD affiliated countries.

Objectives: The review explored trends of research that has been published by members of the disability research community who are contributing to AfriNEAD Conferences.

Method: A Google scholar search was conducted using names of researchers who presented articles at the first six AfriNEAD Conferences, recording peer-reviewed journal publications by each author according to the eight AfriNEAD research focus areas. This was followed by a hand search of all articles published in the African Journal of Disability from AfriNEAD affiliated countries.

Results: There is an exponential increase in the number of peer reviewed journal publications from AfriNEAD affiliated countries over the last two decades. Collaborations are common among authors within the same African country. International collaborations are common among authors from Africa with authors from the Global North.

Conclusion: African researchers need to network and collaborate more across Africa, to promote disability research in countries where research is scarce and to focus more on research areas that are not receiving attention.

Contribution: The desktop exploration is a first step for AfriNEAD to get a baseline understanding of published disability research in the countries affiliated to the network. Further research is required to understand these trends and to provide evidence necessary to address the identified gaps.

Background: Recently, attention has been paid to how rehabilitation not only provides medical treatment and instrumental skills but also impacts psychological well-being and identity. We all have psychological structures that discipline the self, enforcing norms internalised during early life and exacting judgments when we fail to 'make the grade'. In cases of congenital disabilities, rehabilitation interventions may span many years, involving strict programmes of therapy, exercise and self-discipline. These regimes may align with internalised rules in harmful ways, as striving for functional improvements takes on a moral dimension, affecting psychological health and empowered disability identities.

Objectives: This study explores rehabilitation by examining the experiences of adults with congenital disabilities, who have undergone childhood medical and rehabilitative interventions.

Method: This study was based on the experience of a psychoanalytic psychotherapist working with adults with disability, and presents composite case material to illustrate how interactions with medical authority figures, such as rehabilitation professionals, can have a formative influence on self-identity and entitlement to inclusion.

Results: The findings vividly reflected how 'medical socialisation' created meanings of disability that were enacted and repeated well into adulthood.

Conclusion: The discipline of rehabilitation still has much to do in examining its value-laden assumptions and practices, and how these may shape the internal and relational worlds of people with disability.

Contribution: This article contributes to the debate in critical rehabilitation studies, focussing on the issue of constructions of disability which may be communicated to people with disability, with implications for self-advocacy and the growth of the disability movement.

Background: Obuntu Bulamu is a Ugandan intervention promoting inclusive education for children with disabilities. This culturally appropriate approach, based on the Ubuntu philosophy, utilises peer-to-peer support activities for children, parents and teachers.

Objectives: To effectively measure the intervention's impact on disability inclusion, the study aimed to select, adapt and test classroom observation instruments suitable for the Ugandan context.

Method: Three structured classroom observation tools were selected and piloted in 10 primary schools in Wakiso District: The Classroom Observation Checklist (CoC), the Teacher-Pupil Observation Tool (T-POT) and the Interaction Engagement Scale (IES). These tools were adapted to ensure cultural relevance and applicability within Ugandan school settings.

Results: Factors like class size, teaching methods, cultural relevance, language and ease of use influenced the suitability of the selected tool. The CoC emerged as a more effective tool with a strong internal consistency (Cronbach's alpha of 0.80) for capturing inclusiveness and peer-to-peer support in the classroom compared to the T-POT and IES.

Conclusion: The study findings emphasise the significance of adapting and testing tools in specific cultural contexts and low-income country settings and considering culturally contextual factors like class size, teaching methods, language complexity and ease of use when measuring disability inclusion in primary schools.

Contribution: The selection of a classroom observation tool for the Obuntu Bulamu randomised control trial contributed to African disability knowledge and practices designed on and for the continent.

Background: The greatest challenge for persons with disabilities is that of securing and maintaining employment, because of the limitations associated with being visually impaired.

Objectives: This study aims to explore the employment challenges of securing and maintaining employment faced by persons with visual impairments.

Method: A qualitative research approach with an exploratory research design was employed. A non-probability sampling method using the snowball sampling technique was adopted. A semi-structured interview was conducted with a total of n = 9 participants, and the data were analysed using the thematic analysis method.

Results: The findings indicate that persons with visual impairment continue to face adverse challenges, especially in the quest of securing employment. Discrimination, isolation, rejection and lack of recognition are key issues that continue to persist in their life experiences, from the tertiary to post-tertiary level.

Conclusion: Persons with visual impairment need continued support from various stakeholders as far as employment opportunities are concerned. There is a need to sensitise stakeholders, at all levels, on the challenges encountered by persons with visual impairment in their employment journey for effective inclusion and diversity management.

Contribution: The findings can aid in the development of an all-round model of support and optimal functioning for persons with visual impairment from grassroots level to post-tertiary education and in workplaces.

Background: Population-based data show high proportions of severe cases of cerebral palsy (CP) in resource-poor regions such as sub-Saharan Africa, where most children have potentially preventable risk factors (factors that may increase the likelihood of CP occurrence but can be mitigated through medical interventions).

Objectives: This study aimed to describe the demographic and clinical profile of children living with CP accessing services at Tygerberg Hospital over a period of 10 years (2010-2020), identify the potential gaps in care (proportion of individuals in a country requiring but not receiving suboptimal or inadequate care), and comparison with a similar study at the same centre two decades ago.

Method: This 10-year retrospective study investigated causes and morbidities in children with CP, attending a central hospital in the Western Cape, South Africa.

Results: A total of 613 children with CP were identified. Perinatal causes were predominant, especially in 57.7% (n = 354) of the cohort: perinatal asphyxia (41.1%) and preterm birth (16.6%). Postnatal causes constituted 15.2% (n = 93), which included tuberculous meningitis (3.6%) and bacterial meningitis (3.6%). The most common complications were intellectual impairment (61.8%; n = 379); epilepsy (30.8%; n = 189) and visual impairment (54.7%; n = 234). A third of the cohort had severe CP, classified as Gross Motor Function Classification System IV and V (38%).

Conclusion: Most of the previously documented main drivers of CP are still present and the implementation of healthcare prevention strategies remains inadequate.

Contribution: This study provides longitudinal evidence to confirm that CP in a South African setting is associated with a high burden of potentially preventable causes.

Background: Increasing functional limitations and disabilities have raised the need for comprehensive rehabilitation services at the primary healthcare (PHC) level, particularly in low- and middle-income countries. To support the integration of these services into PHC in South Africa, assessing outcomes from the service users' perspectives is essential.

Objectives: This study examined service users' views on their PHC rehabilitation outcomes in a Metropolitan District of Gauteng, South Africa. The aim was to understand perceived changes in activity limitations and participation restrictions following the rehabilitation intervention.

Method: A quantitative survey design, including self-rating measurements and structured interviews, was employed. Thirty-eight rehabilitation service users from eight clinics and community health centres were purposively sampled. Participants rated their pre- and post-rehabilitation levels of difficulty in activity limitations and participation restrictions, with open-ended questions providing additional insights. Data analysis used descriptive statistics, quantitative content analysis, and non-parametric tests.

Results: Significant improvements in mobility, self-perception, and quality of life were reported by both adult and child service users. Caregivers of child service users also noted positive experiences (p = 0.019) in community, social, and civic life.

Conclusion: This study highlights the perceived positive changes experienced by PHC rehabilitation service users in addressing functional limitations and disabilities. It underscores the effectiveness of integrated rehabilitation service delivery in improving user outcomes.

Contribution: The findings offer valuable insights into how rehabilitation interventions enhance functional abilities, social participation, and overall well-being. By focusing on activity limitations and participation restrictions from service users' perspectives, this study supports the priority of providing person-centred rehabilitation services at the PHC level.

Background: Disability inclusive youth research, involving youth with disabilities in the design, implementation and dissemination of study data, is still limited in Africa.

Objectives: To describe and reflect on the experiences of involving youth with disabilities in an exploratory research study, focused on disability-inclusive education and employment in 7 African countries.

Method: 12 youths with different impairments, aged 18 to 35, were employed as researchers in Ethiopia, Ghana, Kenya, Nigeria, Rwanda, Senegal and Uganda. Youth researchers contributed to the data collection and analysis of interviews with 210 youth with disabilities. 24 youth advisors with disabilities formed two youth advisory groups (YAG) of 12 advisors each in the regional hub countries Ghana and Uganda. The YAGs met 4 times during the project and contributed to the study design, data collection, data analysis and dissemination activities. In addition, 4 workshops were held with the Ugandan YAG to develop a participatory film.

Results: Together with the youth participants, we reflected on the experiences of involving youth with disabilities and conducting research with, by and on youth with disabilities. We highlighted ethics and safeguarding, recruitment and representation, exploring experiences and data quality, participatory dissemination, accessibility, capacity building and networking as key areas of consideration and benefit in this project.

Conclusion: Participatory research with youth with disabilities is feasible, enriching, and key to inclusive research that informs education and employment policy and practices.

Contribution: Lessons learned from youth involvement in a disability inclusive research programme, focused on education and employment in 7 African countries.

Background: This paper presents researchers' experiences using participatory, inclusive research methodologies to explore aspects of inclusive education, with children with disabilities, parents, and teachers in Nigeria and Kenya.

Objectives: The objective is to describe working with children and adults with disabilities, as research collaborators, alongside local INGO staff and OPD partners.

Method: In Kenya we worked with 9 peer researchers with disabilities to run focus groups and interviews with children with disabilities, parents and teachers about inclusive pre-school education. In Nigeria we ran participatory workshops with children with disabilities, and their parents discussing what makes school and community settings inclusive, to inform the design of a Wellbeing and Inclusion checklist. The studies were based in pilot primary schools and Early Childhood Development and Education (ECDE or pre-school) classes in Nigeria and Kenya respectively. The data produced were recordings and notes from focus group discussions, interviews and activities and reflections from the peer researchers. Data analysis was an inclusive participatory process of thematic analysis carried out in person and online.

Results: These innovative approaches demonstrate that with careful planning and support, both adults and children with disabilities can be involved very directly in research processes not just as participants but as researchers.

Conclusion: We argue that using participatory, disability-inclusive approaches helps to make the findings more nuanced and genuine and the data and outputs generated uniquely grounded in people's realities and perspectives.

Contribution: These methods can potentially inform the mainstreaming of a disability inclusion approach into international development debates and activities.

Background: The right to participate in political processes is fundamental to democratic governance, economic development and human rights.

Objectives: We assessed participation in political processes and also explored factors associated with voting at the most recent election for people with and without disabilities.

Method: We conducted cross-sectional survey in four cities in Senegal and three in Cameroon in 2021. Disability was assessed using the Washington Group Short Set of questions. Univariate and multiple regression analyses were conducted to identify the factors associated with voting at the most recent elections.

Results: Among 4180 participants in Cameroon and 4171 in Senegal, disability prevalence was 9.77% and 10.89%, respectively. More than half of the participants had voted at the most recent elections in both Cameroon (52.31%) and Senegal (58.27%). Participants with an interest in politics, having all the key documents or registered with a political party were more likely to have voted in both countries. Adjusting for socio-demographic characteristics, people with disabilities were less likely to have voted compared to those without disabilities in Cameroon (odds ratio [OR] = 0.58 [0.40, 0.84]) and in Senegal (OR = 0.36 [0.26, 0.44]).

Conclusion: There is an urgent need to address the socio-political and environmental factors that have been identified so as to close the disability gaps in voting and ensure equitable opportunities and levels of political participation between people with and without disabilities.

Contribution: This article contributes to the existing knowledge base on the political participation of people with and without disabilities in Cameroon and Senegal.

Background: Digital stories have been shown to be effective in sharing information. The Partnerships for Inclusive Research and Learning (PIRL) was a 4-year international participatory research project focussed on the digital divide in inclusive research.

Objectives: Members of PIRL share their experience of using digital storytelling to get key messages from the project to a wide range of people.

Method: Members of PIRL were invited to develop digital stories and create project-specific guidelines for digital story development. Seven people participated in workshops given by experts, read literature, watched digital stories and discussed how to create digital stories.

Results: The group created six digital stories, each one addressing a different aspect related to disability-inclusive research, with many having a focus on Africa and the creation of credible African evidence. The importance of assisting community members to think about and support research and evidence creation was one of the goals of the project. The videos provide an avenue to share insights about disability-inclusive development research. Group members stated that being part of the process significantly improved their understanding of translating evidence into formats that are more understandable.

Conclusion: Creating digital stories requires commitment, a significant amount of time, access to digital tools, and financial resources. Working collaboratively on this project was not only meaningful but also encouraged positive working relationships and fostered critical thinking.

Contribution: This article contributes to a better understanding of ways in which digital storytelling can be used in knowledge-sharing strategies to promote disability inclusion.