African Journal of Disability最新文献

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: Technical Vocational Education and Training (TVET) in South Africa is often viewed as the 'Cinderella' of higher education, with many matriculating students choosing mainstream universities instead. This preference stems from stigma and misconceptions that label TVET students - often from poorer working-class backgrounds - as less intelligent than their university peers. The lived experiences of students with physical and learning disabilities in these institutions are particularly underexplored.

Objectives: This study aimed to illuminate the experiences of students with disabilities at five TVET colleges in Gauteng, South Africa.

Method: Using a phenomenological approach, the study conducted story exercises and individual interviews with a convenience sample of 40 students with disabilities.

Results: The findings reveal that TVET education predominantly serves black students from marginalised backgrounds, with students with disabilities facing significant barriers in accessing both the curriculum and the physical environments of the colleges. Despite numerous challenges, a resilient narrative emerged among these students, rooted in African traditional values.

Conclusion: This article contributes to knowledge on disability inclusion in higher education by showcasing the challenges and resilience of students with disabilities in South Africa's TVET system.

Contribution: The study employed innovative methodologies, such as picture stories, to co-create knowledge with students living with disabilities.

Background: Spina bifida is a congenital neural tube defect, where there is incomplete formation of the spinal cord and vertebrae, resulting in abnormal development of the neural tube. This affects bladder function and urinary incontinence. Clean Intermittent Catheterization (CIC) is used to manage bladder and bowel management.

Objectives: This study aims to scope evidence on the facilitators and barriers to usage and practice of CIC in children with spina bifida in low-income countries.

Method: We searched databases including PubMed, Web of Science and SCOPUS, and screened articles for inclusion following the PRISMA-ScR guidelines. The search terms included 'Spina Bifida ([continence management] AND [clean intermittent catheterisation]) AND ([barriers to Clean Intermittent Catheterisation] OR [Low Income Countries]) OR (myelomeningocele)'. Full-text assessment for eligibility excluded 202 articles. Twenty-two articles were reviewed and twelve full-text articles were excluded because of limited content. Ten articles published in English between 2004 and 2023 were selected for review.

Results: Barriers in practicing CIC include pain and discomfort in catheter insertion, stigma and fears; inaccessibility of public toilets, unavailability of appropriate catheters, difficulty in positioning, limited quality of teaching and challenges with accessing supplies. Facilitators include starting CIC in infancy, follow-up by healthcare providers, support from family and community members, quality of training, continuous practice of CIC, utilisation of lubricants, reuse of catheters and other low-cost materials.

Conclusion: Our review summarises facilitators and barriers to CIC and provides recommendations for further research, which includes the involvement of family members and community-based rehabilitation workers.

Contribution: This article contributes to a better understanding of CIC use in low-income countries.

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.