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A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia

TAY, Ee Lin
WONG, Chee Piau
2018

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Purpose: Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.

 

Method: A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.

 

Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.

 

Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.

Cross-sectional Survey to Assess Prevalence of Disability and Access to Services in Albay Province, The Philippines

HODGE, Marcus
BOLINAS, Amable
JAUCIAN, Erlynn
BONEO, Rebecca
SCHAPIRA, Allan
VILLANUEVA, Mary Mediatrix V
2017

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Aim:  A cluster randomized cross-sectional survey to assess the prevalence of disability and access to support services was conducted in Albay Province, the Philippines in April 2016.

 

Method:  The population-based survey methodologies developed by the Washington Group of the United Nations Statistical Commission and UNICEF were utilized.  A sample of 70 barangays (the 3rd level administrative division in the Philippines) was selected as clusters, with probability proportional to size, and 30 households were selected randomly in each barangay to be surveyed.

 

Results:  The estimated prevalence of disability using the standard criteria of the Washington Group and UNICEF among children (2-17 years old) was 2.0% and for adults (≥18 years old) it was 6.5%.  The estimated prevalence of disability was higher in rural than in urban areas.  Deficiencies in the performance of existing services were identified; access by children with disabilities to support services was lowest in rural highland and rural plain barangays.

 

Conclusions: There was a large unmet demand for support services addressing the needs of persons with disabilities in Albay Province, especially in rural highland areas.  Persons with disabilities were disadvantaged in access to education and employment; many had not been educated in their basic rights.

 

Implications:  To identify, educate and fully support persons with disabilities, community-based rehabilitation (CBR), health and other rehabilitation services must communicate effectively with each other, their current work should be mapped and analysed, their comparative strengths identified, and their future work coordinated.  It is a priority to educate persons with disabilities and their families about their rights, and facilitate their access to support services; this requires increased investment in communication targeting persons with disabilities and the communities, especially rural.  Providers caring for persons with disabilities need to work in partnership to identify unreached persons with disabilities.  Prevalence surveys, with stronger focus on the profiles and performance of CBR and related services, would add to the evidence-base to improve the quality and coverage of services for persons with disabilities.

Prevalence of Physical Disability among Urban Community-dwelling Adults in Sri Lanka

Weerasinghe, Inoka E
Fonseka, P
Dharmaratne, S D
Jayatilake, J A M S
2015

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Purpose: Assessment of physical disability at the community level is essential for rehabilitation and supply of services. This study aimed to assess the prevalence of physical disability among adults in an urban community in Sri Lanka.

 

Methods: A descriptive cross-sectional study was conducted among 2460 adults (18 -59 years of age) who were selected using cluster sampling. Physical disability was measured using a Physical Impairment Examination Tool (PIET) and World Health Organisation Disability Assessment Schedule II (WHODAS II).

 

Results: Prevalence of physical disability was 4.2% (95% CI= 3.5-5.1). Physical disability was higher among people in the age group of 40-59 years (6.5%, n=64) than among those in the age group of 18-39 years (2.6%, n=39) (P<0.05). Physical disability was more prevalent among females (4.4%, 95% CI= 4.2-4.6) than males (2.6%, 95% CI: 2.4-2.8), and among Tamils (7.8%, 95% CI=5.1%- 10.5%) than Sinhalese (3.3%, 95% CI=2.4%- 4.1%). It was higher among those who were divorced/widowed (58.3%, 95% CI=30.4- 86.2) than among married people (3.6%, 95% CI=2.8- 4.4). The prevalence of physical disability was 7.1% (95% CI=4.6- 9.5) among people with primary education, 4.5% (95% CI=3.4- 5.6) among those with secondary education, and 1.8% (95% CI=0.8- 2.8) among those with tertiary education. It was higher among the unemployed (7.2%, 95% CI=5.7-8.7) than the employed (1.8%, 95% CI=1.1-2.5). Age, gender, ethnicity, marital status, education levels and employment status were significantly associated with physical disability. 

 

Conclusions: Though the prevalence of physical disability appears to be higher among Sri Lankan adults than among people in developed countries, it is less than among people in other South-East Asian countries. Associations with socio-demographic variables were consistent with other studies.

Barriers to Early Diagnosis, Intervention and Social Integration of Children with Developmental Disabilities: A Qualitative Study from Rural Villages and a Poor Urban Settlement of Bangalore, South India

GEORGE, C E
NORMAN, G
BENJAMIN, T E
MUKHERJEE, D
2014

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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.

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