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Purpose: Children with developmental disabilities, if given skilled early intervention, have the potential to lead productive lives and can contribute to the social and economic development of their communities. This study explores the barriers to early diagnosis and intervention for children with developmental disabilities who live in rural and urban areas of Bangalore city, India.

Methods: The study was conducted in selected villages of Devanahalli Taluk in Bangalore Rural District, and in Devara Jeevanahalli (DJ Halli), a shanty town in Bangalore city. The qualitative study design consisted of in-depth interviews and focus group discussions (FGDs).Parents of children with developmental disabilities, doctors practising in the area and school teachers were interviewed using a purposive sampling framework. An inductive, data-driven thematic analysis was carried out.

Results: The physician-related barriers were identified as lack of skills and understanding of children with developmental disabilities, lack of knowledge and resources, lack of specialist back-up services, and communication difficulties with regard to conveying bad news to clients. Parent-related barriers were financial constraints, delay in accepting the diagnosis, and prevalent myths, beliefs and stigma pertaining to disability. The teachers viewed children with special needs as an additional responsibility, and were also apprehensive about the attitudes and interaction of other children at school with children with disabilities.

Background: A disability grant is the financial assistance given by the government to South African citizens and bona fide refugees who have debility that results in inability to work. Doctors in state hospitals and clinics are tasked with the duty of assessing applicants for this grant. Ideally, the assessment is done by an institutional committee consisting of a doctor, physiotherapist, social worker, occupational therapist and specialised nurses. However, this is not always the case because of a shortage of personnel, particularly in rural areas. A lack of clear guidelines for the assessment process has led to confusion and differences in the outcomes. This poses major problems for the doctors, as well as the applicants, who often are dependent on the grant for survival. The aim of this study was to explore the factors that influence doctors in the assessment of applicants for a disability grant.

Methods: A qualitative study using free attitude interviews was conducted amongst doctors involved in the assessment process in Limpopo province. Content analysis was used to identify themes from the interviews.

Results: The assessment process was not entirely objective and was influenced by subjective factors. These included the mood of the doctors, emotions such as anger and sympathy, and feelings of desperation. Perceptions by the doctors regarding abuse of the system, abuse of the grant, the inappropriateness of the task, lack of clear guidelines and the usefulness of the committees were important in decision making. The doctors’ personal life experiences were a major determinant of the outcome of the application.

Conclusion: The assessment of applicants for a disability grant is a subjective and emotional task. There is need for policy makers to appreciate the difficulties inherent in the current medicalised process. Demedicalisation of certain aspects of disability assessment and other social needs that doctors do not view as a purely clinical functions is necessary. In addition, there is a need for clear, uniform policy on and guidelines for the management of the grant, the role of the doctor has to be defined, healthcare practitioners must be trained in disability assessment, institutional committees should be established and intersectoral initiatives should be encouraged to address issues of poverty and dependence.

Background: Persons with disabilities in general face serious barriers to sexual and reproductive health (SRH) information and services due to institutional and attitudinal barriers. However, because deaf people have unique communication and linguistic needs, which are often misunderstood or ignored, they face greater barriers than other persons with disabilities. Whilst available data indicated that there is a wide gap between knowledge and usage of contraceptive amongst Ghanaians, little is known about the level of contraceptive knowledge and usage amongst deaf people.

Objectives: The objective of the study was to investigate the level of knowledge and use of contraceptive methods amongst deaf people in Ghana with the aim of understanding their contraceptive behaviour and to improve access.

Method: The study was a participatory SRH needs assessment utilising a two-phase, sequential, mixed methods design. The study included 179 participants, consisting of focus groups with seven executives of Ghana National Association of the Deaf (GNAD), 10 male deaf adults, and 9 deaf female adults. A total of 152 deaf people, made up of students, women, and men participated in a survey, whilst one hearing person served as a key informant.

Results: The findings of the study indicated that of the 13 methods shown in the survey, only three were known to about 70% of the adults and 60% of the students. Level of knowledge of the remaining nine methods was low.

Conclusion: Clear and effective policies are needed to guide the provision of SRH information and services for deaf people in Ghana.

Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.

Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.

Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.

Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.

Purpose: The objectives of this study were to investigate the knowledge and attitudes towards leprosy of physiotherapists in Nigeria.

Method: A cross-sectional survey of 330 physiotherapists, with minimum 1-year work experience in public hospitals in the 6 geo-political zones of Nigeria, was carried out. A pre-tested, self-administered questionnaire with open and close- ended questions was employed. Data obtained were analysed using descriptive and inferential statistics of Chi-square tests with Alpha level at 0.05.

Results: The respondents’ mean and range of years of job experience was 8.6 + 5.51 and 1 to 27 years respectively. Close to half (44.5%) of the physiotherapists had only a fair knowledge about leprosy and 165 (50%) had poor attitudes towards leprosy and persons with leprosy. There were significant associations between the schools of training and each level of knowledge (χ2 = 45.04; p = 0.0001) and attitudes of physiotherapists to leprosy and to persons who have suffered from leprosy (χ2 = 20.26; p = 0.009). There was, however, no significant association between years of job experience and each of knowledge (χ2 = 4.76; p = 0. 312), or attitudes of the physiotherapists to leprosy (χ2 = 4.55; p = 0.337).

Conclusions and Implications: It was concluded that a substantial number of physiotherapists in Nigeria had fair knowledge but poor attitudes towards leprosy. The institution of training appears to have an influence on their knowledge and attitudes. It is therefore recommended that educational and training programmes on leprosy should be organised and emphasised at the basic training institutions for physiotherapists.

Purpose: To identify factors influencing the sexual health of women with spinal cord injury (SCI) in Bangladesh.

Methods: This study used both qualitative and quantitative methods. The quantitative part used a case-control design. Cases were women with SCI and controls were age-matched women without SCI. Questionnaires were used to collect data concerning the sexual health status of women. Multivariate logistic regression was done to determine which factors had an independent effect on sexual health. In-depth interviews were held with a sub-group of women from both groups, and interview guides were used. The in-depth interview data was subjected to content analysis.

Results: In total, 92 questionnaires were given out and 30 in-depth interviews were conducted. A relationship was found between physical factors and sexual health, as pain, vaginal dryness and physical discomfort were mentioned more frequently among women with SCI. Environmental and emotional factors such as stigma, satisfaction of the husband and support from the husband and friends had an influence on the sexual health of the women with SCI, as well as the other group of women.

Conclusions: From interviews it became clear that most of the women with SCI were dissatisfied with their sexual health as compared to the women without SCI. However, environmental and emotional factors such as attitudes, support and stigma, rather than physical factors, were the most important influences on sexual health in both groups of women.

Purpose: Inclusion of children with disabilities in mainstream classrooms has become the focus of extensive research in education. It has both academic and social benefits for all students, such as providing opportunities for communication and social interaction. The evaluation of teachers’ attitudes towards inclusion appears to be a good method to determine the success of the programme. Although this has been widely researched in many countries, the available evidence is not consistent. This study was undertaken in the state of Andhra Pradesh in India, to measure and compare teachers’ attitudes towards the inclusion of children with hearing impairment in schools.

Method: A questionnaire developed by Giles and Tanner (1995) measuring three domains - (1) effective strategies for meeting the needs of all students, (2) the support for educational change in their district, and (3) inclusive education - was modified in keeping with cultural and geographical variations and used as the test tool. A hundred teachers of various Government and non-Government schools in 2 districts of Andhra Pradesh, India, participated in the study.

Results: Higher scores on domain 1 indicate that teachers feel effective strategies to benefit students with disabilities should be implemented in schools. The results also indicate that most teachers are agreeable to the inclusion of students with disabilities in their classrooms. Significant difference in attitudes was observed, based on the teachers’ qualifications, teaching experience, gender, level of teaching and management.

Conclusion: The study concludes that there is a need for intervention to foster more positive attitudes among teachers, if the implementation of inclusive education is to succeed. It also has implications for the framing of laws and policies for children with hearing impairments.

Persons with physical disabilities face many architectural and social barriers to community participation. This research employed the ‘Photovoice’ method. The aim was to gain insight into the daily lives of persons with physical disabilities, and to assess their needs in the Kumasi metropolis. Participants in this study were trained and instructed to photograph their everyday activities, so as to document their struggles and concerns, to promote critical dialogue and to reach policymakers. Results indicated a number of concerns, such as poor accessibility to public toilets, transport and buildings, as well as a need for attitudinal change and equal opportunities. Other needs which were raised by theparticipants included economic empowerment, marketable vocational training, accident prevention, affordable and quality rehabilitation, and the establishment of emergency shelters. It was concluded that the most pressing needs of persons with disabilities were related to overall social, employment and accessibility issues. Finally, the ‘Photovoice’ methodology offered a suitable, structured, and participatory way to assess the needs of persons with disabilities. It gave this marginalised group a voice through photographs, and formed an excellent way of disseminating the findings of this study to the stakeholders involved.

This article reports from a pilot project in Uganda where the aim is to enable persons with disabilities to have access to mainstream microfinance services. Several lessons have already been learned: 1) entrepreneurs with disabilities are an untapped market opportunity for Micro Finance Institutions (MFIs); 2) to influence MFIs it is important to understand their business model and team up with key actors from the industry; 3) persons with disabilities are often misinformed about MFIs' terms and services and don't know how to tap these opportunities. Gradually a change in attitudes in MFIs and Disabled Peoples Organizations (DPOs) is observed. All MFIs participating in the project now report an increase in the number of clients with disabilities served. This is happening without the use of any economic incentives.