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Family planning for women and girls with disabilities

FRASER, Erika
CORBY, Nick
January 2019

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Individual, environmental, attitudinal and institutional factors affecting access to and uptake of family planning for women and girls with disabilities in low and middle income countries are explored through a rapid literature review. Evidence of good practice concerning increasing full free and informed contraceptive choice is also examined.

 

Disability Inclusion Helpdesk Report. Pilot 2

Investigating barriers teachers face in the implementation of inclusive education in high schools in Gege branch, Swaziland

ZWANE, Sifiso L.
MALALE, Matome M.
2018

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Background: The kingdom of Swaziland is a signatory to policies on universal education that ensure high quality basic education for all. Education for All is a commitment to provide equal opportunities for all children and the youth as provided for in the country’s constitution of 2005. The tone for the introduction of inclusive education in Swaziland was inevitably set by the new constitution of 2005. Since then several policies have been produced by the government, all aimed at providing equal education opportunities to all children in the country. These policies include the Swaziland National Children’s Policy (2009), Poverty Reduction Strategy and Action Plan (2006) and Draft Inclusive Education Policy (2008). The Education for All Policy (2010) is the policy that upon implementation became a stimulus for the introduction of inclusive education into mainstream schools; as a result, all teachers in the country’s schools were expected to be competent enough to teach learners with a wide range of educational needs. However, in-service teachers received inadequate staff development and training ahead of the implementation of inclusive education and a majority of teachers were not professionally developed for inclusive education, as pre-service students at tertiary training level.

 

Objectives: This study investigated barriers in the implementation of inclusive education at high schools in the Gege branch, Swaziland, with a view to finding lasting solutions to inform research and government policy.

 

Method: This research is a qualitative interpretive case study based on selected schools in the Gege branch of schools. Data was obtained through semi-structured research interviews and document analysis. It was processed and analysed through data coding, unitising, categorising and emergence of themes, which became the findings of the study.

 

Results: Lack of facilities in the governments’ schools and teachers’ incompetence in identifying learners facing learning challenges in their classrooms are some barriers to inclusivity.

 

Conclusion: The study concludes that there is a need for the Ministry of Education and Training to craft an inclusive curriculum in line with the inclusive policy in order to cater for the diverse educational needs of all learners in mainstream schools. It is thought that instituting a vibrant in-service and pre-service teacher training programme by the Ministry of Education and Training will increase teachers’ capacity to a level where teaching in inclusive classrooms does not negatively affect their competence.

Challenges of inclusion: a qualitative study exploring barriers and pathways to inclusion of persons with mental disabilities in technical and vocational education and training programmes in East Africa

EBUENYI, Ikenna
ROTTENBURG, Esther
BUNDERS-AELEN, Joske
REGEER, Barbara
November 2018

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Barriers and pathways to the inclusion of persons with mental and intellectual disabilities in technical and vocational education and training (TVET) programmes in four East African countries (Ethiopia, Kenya, Rwanda, and Uganda) were explored, in order to pave the way to greater inclusion. An explorative, qualitative study including 10 in-depth interviews and a group discussion was conducted with coordinators of different programmes.

 

Disability and Rehabilitation, 42:4, 536-544

https://doi.org/10.1080/09638288.2018.1503729

Barriers and Facilitators for Wheelchair Users in Bangladesh: A Participatory Action Research Project

ALDERSEY, Heather
QUADIR, Mohammad Morshedul
AKTER, Soniya
MOZUMDER, Rabiul Hossain
NAZNEEN, Nayma
NURI, Reshma Parvin
2018

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Purpose: People who use wheelchairs face a range of physical, social, and economic barriers to regular participation in their communities. These barriers may be more acute in countries such as Bangladesh which are affected by poverty and often lack the physical infrastructure or resources necessary to create inclusive or accessible environments. This research aimed to identify: (a) the barriers and facilitators to accessibility faced by wheelchair users in Bangladesh; (b) how these barriers affect the inclusion of wheelchair users in Bangladeshi society; and (c) what could be done to improve accessibility and inclusion for wheelchair users in Bangladesh.

 

Methods:  This participatory action research (PAR) project used Photovoice and semi-structured interviews to identify barriers and facilitators to accessibility for people who use wheelchairs in Bangladesh.

 

Results: Participants mentioned a number of barriers in public spaces, such as roads, missing or inadequate ramps, inaccessible restrooms, and negative attitudes. There were also participants who had made their home environments more accessible with accommodations such as ramps, arrangement of space, and low countertops/work spaces. Women wheelchair users seemed to face greater barriers to access, as compared to men, in a range of community spaces and activities. Participants’ recommendations for improvement targeted government stakeholders and included greater focus on road infrastructure, particularly during flooding in the rainy season, and modifications to the public transportation system.

 

Conclusion: A key goal of the study was to identify barriers and facilitators, and use the information gathered to promote social change on the ground. Future research and action should encourage more people to get involved in removing barriers for people with disabilities, in Bangladesh as well as globally

Lived Experience of Psychosocial Disability and Social Inclusion: A Participatory Photovoice Study in Rural India and Nepal

FERNANDES, Helen Lea
CANTRILL, Stephanie
SHRESTHA, Ram, Lal
RAJ, Rachel, Belda
ALLCHIN, Becca
KAMAL, Raj
BUTCHER, Nicole
GRILLS, Nathan
2018

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Purpose: This study aimed to investigate the experiences of people living with a psychosocial disability in rural India and Nepal, and to highlight key barriers and enablers for inclusion.

 

Method: Participatory action research approaches and Photovoice methodology were employed to investigate the lived experience of 32 participants in rural India and Nepal. There were 12 participants and 4 caregivers of people with psychosocial disability from each of the two countries. Semi-structured interviews with study participants were transcribed and analysed thematically to answer the study question.

 

Results: The findings revealed themes related to various supports, meaningful engagement in activity, and community awareness. Among these categories were both enabling and impeding factors to inclusion, the presence or absence of which was typically associated with improvements or worsening of symptoms respectively.

 

Conclusions and Implications: This study underscores the need for integrated community-based approaches that are multisectoral, inclusive of family, and strengthen community responses. Photovoice was also shown to be a feasible research methodology for providing insights into the lived experience of people with psychosocial disability and for fostering their empowerment

Understanding barriers, enablers, and long-term adherence to a health behavior intervention in people with multiple sclerosis

BARNARD, Emma
BROWN, Chelsea R
WEILAND, Tracey J
JELINEK, George A
MARCK, Claudia H
October 2018

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Background: The optimal management strategy for multiple sclerosis (MS), and many other chronic diseases, likely involves health behavior modification. Multimodal behavioral interventions may be most effective, but little is known about long-term adherence in people with MS.

 

Methods: This qualitative study assessed barriers and enablers to long-term adherence by people with MS who self-selected for a 5-day health behavior intervention 3–5 years prior. Thirteen women and five men participated in semi-structured phone interviews, which were transcribed and thematically analyzed.

 

Results: The experience was described as useful for information gathering, decision making, and practical strategies regarding health behaviors. The majority still followed supplementation and dietary recommendations most of the time, although consuming non-recommended food while eating out was common. Support at home, ability and enjoyment in food preparation, and ability to resist unhealthy foods were both barriers and enablers. Adherence to “time-consuming” exercise and meditation recommendations were less common and episodic. Many reported competing interests on time from work and family; and barriers including injuries and symptoms, weather, financial or geographical barriers, and lack of person-centred support and motivation. Increased fitness and mobility, weight loss, and a sense of accomplishment and control were advantages and motivators. Practical and attitudinal strategies employed included planning, tailoring activities to ability and preference, and self-monitoring.

 

Conclusion: While most people attempted to engage with all components of the intervention initially, only some still engaged with all components, and none to the recommended levels. These data can inform future quantitative studies and health behavior interventions.

Disability in South Sudan. K4D Helpdesk Report

ROHWERDER, Brigitte
March 2018

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Decades of conflict in South Sudan, pre and post-independence in 2011, poverty and poor access to services have increased the rate of disability and rendered people with disabilities more marginalised and excluded as a result of the numerous attitudinal, environmental, and institutional barriers they face, and the lack of concerted efforts to include them. This rapid review identifies the available evidence on the experiences of people with disabilities living in South Sudan.

Dyslexic learners’ experiences with their peers and teachers in special and mainstream primary schools in North-West Province

LESEYANE, Monicca
MANDENDE, Peter
MAKGATO, Mary
CEKISO, Madoda
2018

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Background: Inclusive education requires that the framework within which education is delivered should be broad enough to accommodate equally the needs and circumstances of every learner in the society. This includes learners with disabilities like dyslexia who have been excluded from the formal education system. This article reports the findings of a qualitative study that explored and described the dyslexic learners’ experiences with their peers and teachers in special and public schools in North-West Province of South Africa.


Methods: The study adopted a qualitative methodology and used a phenomenology research design. The sample was purposively selected and comprised nine dyslexic learners. All the learners were in public schools previously and were later moved to a special school after being diagnosed as dyslexic. The participants were aged 9–12 years. The researchers conducted one-on-one interviews with the participants and content-analysed the data.


Findings: The findings revealed that in public schools the dyslexic learners were exposed to ill-treatment by other learners who despised, ridiculed, bullied and undermined them. The findings further revealed that teachers in public schools were not patient with dyslexic learners, did not give them extra attention and that some teachers used negative comments that embarrassed them.


Conclusion: The article spells out the barriers experienced by dyslexic learners in public schools and also recommends training of teachers so that they know how to deal with dyslexic learners, thereby eliminating the barriers. The study further recommended awareness campaigns among the student body about dyslexia.

Barriers to Healthcare Services for People with Disabilities in Developing Countries: A Literature Review

BAART, Judith
TAAKA, Florence
2018

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Purpose: This literature review aimed to identify the main barriers in access to mainstream healthcare services for people with disabilities.

 

Method: Online databases were searched for relevant articles published after 2006.  Preference was given to articles pertaining to developing countries. On the basis of pre-determined inclusion and exclusion criteria, 16 articles were selected for the review. Barriers noted in the articles were grouped thematically.

 

Results: There appeared to be 7 main barriers - 4 related to the demand side i.e., pertaining to the individual seeking healthcare services, and 3 barriers on the supply side i.e., pertaining to healthcare provision. These are: 1) Lack of information; 2) Additional costs of healthcare; 3) Limited mobility; and, on the demand side, 4) Stigmatisation; while on the supply side, 5) Staff attitude; 6) Communication barriers; and, 7) Inaccessible facilities.

 

Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the individuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.

Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit

MACLACHLAN, Malcolm
BANES, David
BELL, Diane
BORG, Johan
DONNELLY, Brian
FEMBEK, Michael
GHOSH, Ritu
GOWRAN, Rosemary Joan
HANNAY, Emma
HISCOCK, Diana
HOOGERWERF, Evert-Jan
HOWE, Tracey
KOHLER, Friedbert
LAYTON, Natasha
LONG, Siobhán
MANNAN, Hasheem
MJI, Gubela
ONGOLO, Thomas Odera
PERRY, Katherine
PETTERSSON, Cecilia
POWER, Jessica
RAMOS, Vinicius Delgado
SLEPIČKOVÁ, Lenka
SMITH, Emma M
TAY-TEO, Kiu
GEISER, Priscille
HOOKS, Hilary
2018

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Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization’s Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable.

Disability inclusive elections in Africa: a systematic review of published and unpublished literature

VIRENDRAKUMAR, Bhavisha
JOLLEY, Emma
BADU, Eric
SCHMIDT, Elena
2018

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The United Nations Convention on the Rights of Persons with Disabilities underscores the equal right of persons with disabilities to participate in political life. However, in Africa they are often unable to exercise their right to vote. This study sought to systematically review available evidence on inclusive elections in Africa. Findings showed that although most African countries ratified disability-focused legislation and proclaimed equal opportunities, the implementation of the legislation varies across the continent. Barriers to political participation can occur at any electoral stage and can be broadly categorised into three groups: lack of education and financial resources; stigma and negative social attitudes; and inaccessible physical infrastructure.

An intersection in population control: welfare reform and indigenous people with a partial capacity to work in the Australian northern territory

St GUILLAUME, Louise
THILL, Cate
2018

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In Australia, in the last decade, there have been significant policy changes to income support payments for people with a disability and Indigenous people. These policy reforms intersect in the experience of Indigenous people with a partial capacity to work in the Northern Territory who are subject to compulsory income management if classified as long-term welfare payment recipients. This intersection is overlooked in existing research and government policy. In this article, we apply intersectionality and Southern disability theory as frameworks to analyse how Indigenous people with a partial capacity to work (PCW) in the Northern Territory are governed under compulsory income management. Whilst the program is theoretically race and ability neutral, in practice it targets specific categories of people because it fails to address the structural and cultural barriers experienced by Indigenous people with a disability and reinscribes disabling and colonising technologies of population control.

 

Disability and the Global South, 2018, Vol.5, No. 2

Disability in Somalia

ROHWERDER, Brigitte
January 2018

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People with disabilities have been identified as a particularly marginalised and at risk group within Somali society as a result of the numerous attitudinal, environmental, and institutional barriers they face, and the lack of concerted efforts to include them . This rapid review identifies available evidence on the experiences of people with disabilities living in Somalia. It was found that there are still numerous evidence gaps in relation to the experiences of people with disabilities living in Somalia.

The nation’s body: disability and deviance in the writings of Adolf Hitler

BENGTSSON, Staffan
2018

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This article takes its starting point in the Nazi ideology as it appears in the writings of Adolf Hitler, and discusses how disability and the body can be understood in the context of Mein Kampf. The article underlines how disability and bodily infirmities, alongside race, featured significantly in Hitler’s demagogic message. Although the overall image of disability was related to a sense of threat – and a culture gone wrong – Mein Kampf also contains a mixed interpretation of disability as a phenomenon, in which different and opposing disability narratives took part in the construction and the image of the body as a national property.

“I Guess that the Greatest Freedom … ”: A Phenomenology of Spaces and Severe Multiple Disabilities

EVENSEN, Kristin Vindhol
STANDAL, Øyvind Førland
2017

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This paper expresses wonder about how bodies in motion can lead towards an understanding of lived meaning in silent lifeworlds. In such lifeworlds, expressions are without words, pre-symbolic, and thus embodied. To address the wonder, phenomenological philosophy and phenomenological methodology were employed to frame an approach that acknowledges lives with disabilities as qualitatively different from, and yet not inferior to, nor less imbued with meaning than, lives without.

The paper focuses on spatiality as decisive in determining possibilities for persons to express their perspectives through a wide range of movements. Movements take place in the continuum between the spatiality of positions as objective bodily sensations and the spatiality of situations as embodied interactions with others and the world. Thus, in order to access the perspectives of students with severe and multiple disabilities, transitions between and movements within different spaces are examined.

Approaching an educational everyday life where students are restricted in the possibilities available to them for moving in and out of spaces, the study reported points to the importance of recognizing the relationship between subjective movements and the spaces enveloping them as what creates a spatiality that is meaningful to the subject. It is accordingly suggested that choosing which spaces to include in educational contexts are formative choices that express a view of humanity. The paper also emphasizes the importance of recognizing temporality as a pedagogical resource when detecting and acting upon students’ changing expressions.

Access to health care in an age of austerity: disabled people’s unmet needs in Greece

ROTAROU, Elena S
SAKELLARIOU, Dikaios
2017

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Since late 2009, Greece has been dealing with the effects of a debt crisis. The neoliberal principles embedded in the three structural adjustment programmes that the country accepted have required radical cuts in health care funding, which in turn have led to widening inequalities in health. This article focuses on access to health care for people with disabilities in Greece in the context of these structural adjustments. We investigate possible differences in unmet health care needs between people with and without disabilities, using de-identified cross-sectional data from the European Health Interview Survey. The sample included 5400 community- dwelling men and women aged 15 years and over. The results of the logistic regressions showed that people with disabilities report higher unmet health care needs, with cost, transportation, and long waiting lists being significant barriers; experience of all barriers was positively associated with low socio- economic status. These findings suggest that a section of the population who may have higher health care needs face greater barriers in accessing services. Austerity policies impact on access to health care in both direct and indirect ways, producing long-term disadvantage for disabled people. Social policies and comprehensive anti-discrimination legislation might help to address some of the barriers this population faces.

Forgotten, excluded or included? Students with disabilities: A case study at the University of Mauritius

PUDARUTH, Sameerchand
GUNPUTH, Rajendra P.
SINGH, Upasana G.
2017

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Background: Students with disabilities in the tertiary education sector are more than a just a phenomenon, they are a reality. In general, little attention is devoted to their needs despite the fact that they need more care and attention.


Objectives: This paper, through a case study at the University of Mauritius, sought to answer some pertinent questions regarding students with disabilities. Does the University of Mauritius have sufficient facilities to support these students? Are students aware of existing facilities? What additional structures need to be put in place so that students with any form of disability are neither victimised, nor their education undermined? Are there any local laws about students with disabilities in higher education?


Method: To answer these questions and others, an online questionnaire was sent to 500 students and the responses were then analysed and discussed. The response rate was 24.4% which showed that students were not reticent to participate in this study.


Results: Our survey revealed that most students were not aware of existing facilities and were often neglected in terms of supporting structures and resources. ICT facilities were found to be the best support that is provided at the University of Mauritius. The right legal framework for tertiary education was also missing.


Conclusion: Ideally, students with disabilities should have access to special facilities to facilitate their learning experiences at tertiary institutions. Awareness about existing facilities must also be raised in order to offer equal opportunities to them and to enable a seamless inclusion.

Challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: The case of Chitungwiza town

Tafadzwa RUGOHO,
France MAPHOSA
2017

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Background: Women with disabilities in Zimbabwe face numerous challenges in accessing sexual and reproductive health. Cultural belief still regards them as not sexually active. The government has also failed to promote policies that facilitate access to sexual and reproductive services by women with disabilities.


Objectives: The reseach objectives were to explore the challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe.


Method: The data were gathered using in-depth interviews with 23 purposively selected respondents. Thirteen women had physical disabilities, five were visually impaired, three were deaf and two were stammering. The respondents with physical disabilities were using wheelchairs, walking frames, prosthesis, crutches and caliper shoes. The participants’ ages ranged from 18 to 45 years. All interviews were transcribed and translated verbatim into English, and passages were extracted from the transcripts. Key themes and concepts were identified and coded to offer a rich framework for analysis, comparisons and presentation of the data.


Results: Negative perceptions of health personnel towards people with disabilities, disability-unfriendly infrastructure at health facilities and absence of trained personnel for people with disabilities (sign language) are some of the challenges involved.
Conclusion: The government, in partnership with other stakeholders, should address challenges faced by women with disabilities when accessing sexual and reproductive health services. Non-government, private hospitals and profit-making organisations should join hands with government in funding health requirements for women with disabilities.

Th e Search for Successful Inclusion

KARLSUDD, Peter Ingemar
2017

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Purpose: This study primarily aimed to find the factors which can facilitate or, alternatively, hinder inclusion efforts.

 

Method: Results from a number of student theses, which dealt with common issues in the area of inclusion of pupils with special needs, were brought together systematically. The method has been called area-delimited meta-study, where increased validity and generalisability are expected to strengthen development at the schools where the thesis work is carried out. A total of 18 thesis projects with a representation of 24 classrooms were included. The results of these projects have been categorised with the help of two models, positive and negative labelling, as well as inner and outer inclusion capital.

 

Results: The respondents in the various studies were quite positive towards inclusion. The teachers stated that inclusion offers a range of possibilities even if problems often occur during implementation. For efforts to succeed, personnel should internalise the values intrinsic to inclusion. Staff knowledge, perception and empathy are examples of the inner inclusion capital necessary to achieve the goal of inclusion. Courage, self-confidence and self-awareness are additional factors that are essential for success. Outer inclusion capital such as clear leadership and effective teamwork are conditions that promote inclusion.

 

Conclusion: Based on the results, it would be logical to invest in the positive labelling factors that are identified and at the same time work towards minimising the negative factors. The work can be further developed with area-delimited meta-studies, and future thesis projects could be initiated with a structure that is more participatory and action-oriented.

 

Limitations: One problem in evaluating the circumstances around inclusion is that the respondents' interpretation of the definition of the word inclusion may vary. Even the experience of how inclusion works can differ between the teachers involved in the study. Despite these difficulties, the overall results provide a robust picture of the problems and opportunities that fit within the area. Differences in teacher interpretation could also be an important element for the research.

Exploration of the academic lives of students with disabilities at South African universities: Lecturers’ perspectives

MUTANGA, Oliver
WALKER, Melanie
2017

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Background: A decade has passed since South Africa signed and ratified the Convention on the Rights of Persons with Disabilities, a human rights treaty that protects the rights and dignity of people with disabilities. However, not much have changed for students with disabilities.


Objectives: The aim of this study was to explore lecturers’ experiences with, and perspectives on, disability as well as with students with disabilities. It was hoped that this would contribute to the ongoing policy debates about diversity, inclusion and support for students with disabilities at universities.


Methods: In an effort to understand the lives of students with disabilities better, a study which included students with disabilities, lecturers and disability supporting staff was conducted at two South African universities – University of the Free State and University of Venda. The paper takes a snapshot view of four lecturers and their perceptions of the lives of students with disabilities at their respective universities.


Results and Conclusion: Although most disability literature report students with disabilities blaming lecturers for their failure to advance their needs, this paper highlights that the education system needs to be supportive to lecturers for the inclusive agenda to be realised. An argument is made for a more comprehensive approach towards a national disability policy in higher education involving many stakeholders. Without a broader understanding of disability, it will be difficult to engage with the complex ways in which inequalities emerge and are sustained.

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