African Journal of Disability最新文献

Background: Vicious cycles of disability and poverty isolate disabled women, making it difficult for them to meet their own and their family's human needs. Their exclusion and deprivations may be bridged through inclusive development processes. The article presents an Afro-centric approach to inclusive development that speaks to experiences of disabled women who lived in informal settlements in the Cape Town metropole, South Africa that also has relevance for marginalised and oppressed communities in the Global North.

Objectives: To describe how human scale development (HSD) as a conceptual framework resonates with Ubuntu values and principles to enable individual and collective action spaces to overcome human poverties.

Method: Reflexivity was done to explicate and further conceptualise an Ubuntu approach to community-based inclusive development for disabled women.

Results: Analysis revealed the centrality of Ubuntu values in effecting social change through bi-directional shifts in self and collective identities, and a spirituality of disability. Themes included Disability as a burden (deprivation), and Disability as a gain (a potentiality). Five development opportunities emerged: enhanced self-identity; strengthened family life; sustained livelihood; community rehabilitation workers as brokers to facilitate access to health and social services; and information.

Conclusion: Ubuntu as an African philosophy draws on indigenous knowledge systems that provide an Afro-centric approach to inclusive development of disabled women. Ubuntu promotes a reflexive, person-centred and collective approach to human development at the micro-level.

Contribution: Harnessing the power of learning to listen deeply to each other's stories facilitates the interdependence and spirituality of Ubuntu to create supportive, inclusive development.

Background: Autism spectrum disorders (ASD) are an evolving concept in the neurodiversity community. There is a continuum of views ranging from biological to social models, of which the medical model views ASD as pathological rather than atypical. How people live with their diversity attributes may depend on how they understand their own diversity attribute.

Objectives: This study explored self-perceptions of young people with mild-to-moderate ASD within their cultural context.

Method: Participants included an equal number of males and females with mild-to-moderate ASD (five each). They participated in two focus group discussions on self-perceptions of life situations in young people with ASD and whether they are considered as neurodiversity or pathology paradigms. Data analysis was done using the thematic content analysis approach.

Results: Participants viewed ASD as: (1) a human neurological variation, (2) were not disordered, (3) had sense of friendship and belonging, and (4) had natural and normal social emotional development.

Conclusion: Young people with ASD perceive ASD from a neurodiversity approach. A neurodiversity approach to ASD is primarily a social justice movement aiming to end what proponents see as the default pathologisation of neurodivergence and promoting the acceptance and accommodation of human neurodiversity.

Contribution: This study enhances understanding of self-perceptions among young people with ASD in Zimbabwe, revealing challenges and strengths unique to their experiences. It may inform educators and policymakers, promoting inclusive practices and tailored interventions, ultimately fostering empowerment, acceptance, and improved quality of life for young people within this community.

Background: Women with disabilities are at disproportionate risk for adverse pregnancy outcomes partly because of the limited information on their pregnancy histories. However, deaf women are faced with communication challenges, sexuality, menstrual health as well as pregnancy and its care, which remain a contemporary phenomenon. Still, little is known about the lived experiences of deaf women and girls.

Objectives: The aim of this study was to examine the maternal health experiences of deaf women and girls, identify the challenges that influence their antenatal, childbirth and postnatal outcomes and improve access.

Method: The study used qualitative research of an intrinsic case study design utilising semi-structured interviews and focus group discussions with 50 deaf women and girls who are deaf or hard of hearing in Mbale district and 13 key informants from state and non-state entities. Documentary analysis was also utilised to examine government documents on this topic.

Results: Findings revealed that 100% of deaf women and girls lack antenatal services tailored to their linguistic needs and communication barriers, which provide no opportunities for better medical provider-patient communication.

Conclusion: Despite Uganda's legal frameworks on maternal health rights (MHRs), deaf women and girls' linguistic needs are yet to be incorporated into the Ugandan health sector. Current healthcare provisions do not always meet their needs during maternal services. Therefore, visible and constructive policies are necessary to steer deaf MHRs and services.

Contribution: Deaf epistemology should be integrated into policy, research spaces and practice for effective and evidence-based policies needed to guide Sexual and Reproductive Health services among deaf women and girls.

Background: Prosthetic rehabilitation modifies functional limitations and psychological challenges caused by amputations, as it helps to restore mobility and body image. A physical rehabilitation centre in Juba, South Sudan, has been providing prosthetic rehabilitation since 2009 in this conflict torn part of the world.

Objectives: To determine the quality of life (QoL) of persons with unilateral transfemoral or transtibial amputations who have received prosthetic rehabilitation in Juba, South Sudan.

Method: A cross-sectional survey was conducted with 40 participants, identified through consecutive sampling. Data were collected through face-to-face interviews using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF)questionnaire. Descriptive analysis was conducted, and relationships between QoL and participants' demographic and medical information were explored through the t-test and analysis of variance (normally distributed data) and the Mann-Whitney U and Kruskal-Wallace tests (skewed data).

Results: Mean domain scores were physical (74.28%), psychological (72.59%), social (71.40%) and environmental (58.81%). Overall QoL and overall health satisfaction had mean scores of 4.1/5 and 3.975/5. Marital status (0.049) and occupation (0.022) played a significant role in psychological QoL. No other demographic or medical variable had a significant effect on overall or domain QoL scores. Women were significantly more satisfied with their health than men (0.046).

Conclusion: Overall, participants had high QoL scores. This might be because of prosthetic rehabilitation. Lower scores in the environmental domain might be because of poverty and the continuous danger of armed conflict.

Contribution: Even when using basic components, prosthetic rehabilitation can significantly improve QoL after lower limb amputation.

Background: Job satisfaction among people with disabilities (PWDs) is a significant concern because of its impact on productivity, job retention and well-being in the workplace.

Objectives: This study aimed to assess the job satisfaction of employees with disabilities in Ethiopia and to identify key factors influencing job satisfaction.

Method: A cross-sectional survey was conducted with 784 Ethiopian government employees with various disabilities. All interviews were conducted in 2021.The survey was designed to collect key socio-demographic information, and factors related to job satisfaction.

Results: The majority of respondents had motor difficulties (59%), followed by visual impairments (36.7%). The mean age was 33 years, and 67% were male. Over half of the study participants were first-degree holders, and 80.6% had experienced integrated education. The mean time to secure a job was 15.41 months, with over 18% unemployed for 6-12 months. Job dissatisfaction was influenced by factors such as low salary, gender, service years and lack of personal assistance. Vision impairment correlated with higher dissatisfaction. Overall, around 32.5% reported satisfaction in their job, 44.1% were neutral and 23.4% were dissatisfied. Dissatisfaction rose to 29% when measured using supplementary questions.

Conclusion: The study was the first to examine factors leading to job satisfaction of employees with disabilities in the Ethiopian public sector. Recommendations include social policy adjustments for better working conditions, considering central factors associated with dissatisfaction. The government should explore measures such as employment quotas or wage supplementation to address disparities and ensure reasonable accommodation. Inclusive research methods will assist in leading change.

Contribution: This research contributes nuanced insights into the factors affecting job satisfaction and its complexities among employees with disabilities in the Ethiopian context, emphasising the need for ongoing research to improve worker support structures and inclusive practices in job acquisition and employment.

Background: Ample evidence suggests that primary caregivers of children with cerebral palsy experience barriers relating to their caregiving role; however, these caregivers also reported encountering factors that facilitate their caregiving experience.

Objectives: This article aimed to explore factors that facilitate and support caregivers of children living with cerebral palsy in rural South Africa.

Method: An exploratory qualitative research design was employed. Purposive convenience and snowball sampling were used to select 10 primary caregivers of children living with cerebral palsy between the ages of 3 years and 18 years. A semi-structured interview was used to collect data. Data were analysed using thematic analysis.

Results: This research identified several factors for facilitating and supporting caregivers of children living with cerebral palsy. These include social support, caregivers' ability to understand and accept their children's disability, mental health support and caregivers' access to resources.

Conclusion: The study found that caregivers looking after children living with cerebral palsy in rural communities have access to certain support systems that aid their caregiving experiences; however, such systems of support need to be strengthened and sustained to reduce the burden of care.

Contribution: This article highlights the facilitators and supportive factors of caring for children living with cerebral palsy in rural communities of South Africa to inform stakeholders on possible intervention strategies for maternal mental health in the context of raising a child with limiting disabilities.

Background: Political rights are crucial for all individuals, especially marginalised groups such as people with disabilities (PWDs). The Constitution of Zimbabwe specifically reserves two seats in the Senate for PWDs. While this is commendable, the current political climate in Zimbabwe does not sufficiently address PWDs' political inclusion, necessitating further action.

Objectives: This study aimed to firstly describe diverging definitions of disability and highlight that persons with visual and hearing impairments are excluded from the media, thus affecting their political engagement. Secondly, to build upon this assertion and elucidate the necessity of enhancing media access for PWDs to improve their political engagement.

Method: A qualitative document-based methodology was utilised.

Results: People with visual and hearing impairments face considerable barriers in accessing media content during and following electoral processes, effectively constraining their political participation.

Conclusion: Political parties should ensure the inclusion of sign language interpreters during election campaigns and provide their manifestos in Braille to enhance media accessibility by people with visual and hearing impairments. Additionally, the integration of sign language and Braille into educational curricula may foster more effective political engagement through various media channels for PWDs. Furthermore, training journalists in sign language and Braille may improve their communication for people with visual and hearing impairments.

Contribution: This study reveals significant challenges encountered by PWDs in accessing media, which exposes barriers to their political participation. To address these obstacles to accessing media, practical solutions are proposed that may improve the representation of PWDs in political roles.

Background: Developmental disabilities (DDs) involve impairments affecting children's abilities, impacting development and necessitating specialised care. Many caregivers face challenges caring for these children, lacking access to supportive healthcare interventions. Addressing this issue aligns with United Nations (UN) goals for ensuring access to quality services for children with disabilities and their caregivers.

Objectives: This study aimed to systematically review and synthesise evidence on healthcare interventions enhancing caregiver capabilities for children with DDs, identifying intervention types, components and effectiveness.

Method: Our systematic review analysed peer-reviewed English-language studies from 2014 to 2024, focusing on interventions for caregivers of children with DDs. The review investigated healthcare interventions designed to enhance caregiver capabilities across diverse cultural contexts, examining international research to understand strategies supporting caregivers of children with DDs.

Results: We found significant improvements in caregiver well-being through five interventions. Parent education reduces stress and improves parenting. Peer support decreased isolation while counselling enhanced family functioning. Condition-specific interventions increased intervention adherence among minorities. Combined interventions showed strong positive effects, especially when tailored. Comprehensive programmes greatly improved caregiver quality of life. Further research is needed for underserved communities and culturally adaptive interventions.

Conclusion: Our review indicates potential positive parental impacts with limited evidence. Small samples warrant future research using larger studies, emphasising rigorous methods, cultural adaptation and diverse community representation.

Contribution: Our review identifies promising intervention types and highlights the need for further research to optimise caregiver support and promote access to quality services.

Introduction: Spinal cord injuries (SCIs), while relatively rare, profoundly alter the lives of those affected. Among the diverse causes of SCI, traumatic sporting injuries represent 8.7% of newly reported cases. Despite the life-altering consequences of SCI, physical activity (PA) can mitigate some of these impacts.

Patient presentation: This case study highlights the long-term benefits of sustained PA and its crucial role in fostering a cascade of positive outcomes post-SCI. We present the case of an elite South African athlete, 'Jim', who sustained a complete SCI at the C6 level at the age of 16 in 2012 following a fall during dismount in a gymnastics competition. Jim's rehabilitation journey began shortly after the injury, encompassing formal inpatient care, alternative therapies and ultimately a return to competitive sports. By 2015, Jim resumed athletic activities, beginning with shot put and discus before transitioning to wheelchair racing, which became a pivotal aspect of his recovery.

Management and outcome: The case emphasises how sustained PA led to Jim's significant physical and mental improvements, such as weight loss, enhanced self-esteem, increased mobility and greater independence in daily living. Moreover, sport provided Jim with a renewed sense of purpose and direction.

Conclusion: This case underscores the importance of creating ongoing opportunities for individuals with SCI to continue their recovery long after discharge from inpatient rehabilitation.

Contribution: This case study illustrates how sustained PA contributed to a cascade of positive outcomes in Jim's recovery following SCI, offering valuable insights from his lived experience.

Background: The World Health Organization (WHO) published 'Standards for Prosthetics and Orthotics' to improve these services globally. Research that compares services to the standards assists in developing a baseline against which future development can be measured and identifies areas needing improvement.

Objectives: This article aims to describe prosthetic services in Namibia and compare them to the 60 WHO standards.

Method: A mixed-methods exploratory design was employed. Qualitative data were collected through semi-structured interviews with purposively selected participants, including managers (n = 2), service providers (n = 9) and users (n = 16). The data were analysed using content analysis. In the quantitative phase, cross-sectional surveys were administered to managers (n = 2), service providers (n = 10) and users (n = 120). The data were analysed descriptively. Qualitative and quantitative data were triangulated to determine Namibia's adherence to the standards.

Results: The triangulated data showed adherence to 14 standards, partial adherence to 24 and non-adherence to 22 standards. As per the standards' requirements, the government directed the provision of prosthetic services, and a range of prosthetic products was provided free of charge at all levels of care. Funding challenges, no national prosthetics committee, and no databases as well as lacklustre support of providers' careers and professional development, indicated areas of non-adherence.

Conclusion: A systems-based approach, utilising a people-centred conceptual framework, can aid Namibia and similar countries in implementing the standards.

Contribution: This study is the first to provide information on implementing WHO prosthetic standards in an African setting.