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Estimates of the birth prevalence of clubfoot in low and middle income settings range from 0.5 to 2 per 1000 births. However, there is currently no estimate of global birth prevalence of clubfoot.

A systematic review of studies was carried out reporting the birth prevalence of clubfoot across all countries and regions worldwide in the last 10 years. Africa Wide Information, EMBASE, CINAHL, Global Health, LILACS and Medline databases were searched for relevant studies from January 1st 2012 to February 9th 2023. Pooled prevalence estimates were calculated using the inverse variance method, and a random effects model was applied to account for heterogeneity between studies.

eClinicalMedicine,  Vol 63 September, 2023

DOI:https://doi.org/10.1016/j.eclinm.2023.102178

Purpose: To  investigate the  practices of  repair that  exist for  users of  mobility assistive products in  low resource settings, as  well  as  the  psychosocial impact that  the  repair, or  non-repair, of  these devices has on users’ lives.

Materials and Methods: This article collates data on repair practices and the responses from participants on  the  topic of  repair from studies conducted by  the  authors across four  different low  resource settings in  Kenya, Uganda, Sierra Leone, and  Indonesia. This  data was  then analyzed to  identify the  common themes found across geographies

DISABILITY AND REHABILITATION: ASSISTIVE TECHNOLOGY

https://doi.org/10.1080/17483107.2023.2236142 

With the increased attention to disability as a vulnerability criterion in the Sustainable Development Goals, international organizations and NGOs within the international development sector have started to pay explicit attention to persons with disabilities, including the collection of data on persons with disabilities. The Washington Group Short Set of Questions, which focuses on functional limitations, has been gaining popularity as an assessment tool for disability. This set of questions reflects a categorization of disability that does not necessarily correspond with subjective disability assessments, such as the yes/no question (“do you have a disability?”) which many development actors have used in their assessment tools when they collect disability data This study compares the subjective and the functional limitations assessment tools for disability to answer the question: do they identify the same individuals as persons with disabilities? Based on a survey carried out amongst persons with disabilities in Cambodia, we included both the Washington Group Short Set and a subjective question asking respondents to self-identify their disability type. We find that, although all respondents self-identified as disabled, not all respondents would be considered disabled according to the Washington Group Short Set of questions. In addition, there is little overlap between specific disability types according to a subjective classification method and the domains of functioning measured through the Washington Group methodology. Our findings affirm that categorization as abled or disabled depends on the tool used. This is important, as the assessment approach chosen by those collecting disability data can shape the design choices of policies and programs, and determine who benefits.

Functional limitations become more prevalent as populations age, emphasising an increasingly urgent need for assistive technology (AT). Critical to meeting this need trajectory is understanding AT access in older ages. Yet few publications examine this from a longitudinal perspective.

This review aims to identify and collate what data exist globally, seeking all population-based cohorts and repeated cross-sectional surveys through the Maelstrom Research Catalogue (searched May 10, 2022) and the Disability Data Report (published 2022), respectively. Datasets incorporating functional limitations modules and question(s) dedicated to AT, with a wave of data collection since 2009, were included.

International Journal of Population Data Science; 2023

Vol. 8 No. 1 (2023): IJPDS Standard Issue
 https://doi.org/10.23889/ijpds.v8i1.1901

Many people with amputations who live in low-resourced settings struggle to access the workshops where qualified prosthetists provide appropriate care. Novel technologies such as the thermoplastic Confidence Socket are emerging, which could help facilitate easier access to prosthetic services. The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket. This is a longitudinal repeated-measures design study.

Prosthet Orthot Int. 2022 Oct; 46(5): 532–537.

Published online 2022 Mar 25. doi: 10.1097/PXR.0000000000000130

Owing to increased inclusion of young people with disabilities into the private sector in Bangladesh and Kenya, there is an urgent need to find alternative ways to support young graduates with a disability in the workplace with assistive technology solutions. The aim of the paper is to identify barriers for private workplace sectors to use assistive technology to support young graduates seeking, maintaining and retaining employment. This qualitative study adopted the research onion design of Saunders et al. Data were collected usinginterviews and focus group discussions and analysed using thematic analysis. The findings reveal that barriers are linked to seven key person-centred capability themes: the dream, external factors, internal factors, assistive technology vision,strategic design priorities and gaps and assistive actions.

Journal of International Development, Volume 34, No. 5

The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and oftenreactive nature of non-governmental organisation (NGO ) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.

Journal of International Development, Volume 34, Issue 5

https://doi.org/10.1002/jid.3678

Background: The COVID-19 pandemic caused significant challenges to education globally, as schools were closed, and alternative means had to be sought to enable students to continue with their studies. In the resource-constrained setting of Bangladesh, the pandemic impacted on the education of 37 million children (UNICEF 2021), of whom children with disabilities have been amongst the most severely affected. Already disadvantaged compared to children without disabilities in terms of access to education, the pandemic and the challenges of accessing remote learning have deepened inequalities between children with disabilities and their able-bodied peers. This study was undertaken as part of DID Task Order 13 Bangladesh, the goal of which is for girls and boys with disabilities to have equal access to quality education and support. Interventions are based in the two districts of Narsingdi and Siranjganj and the subdistricts of Narsingdi Sadar, Tarash and Sirajganj Sadar. The aim of this research was to explore the experiences of children with disabilities, their parents and teachers in respect of access to learning opportunities during school closures and beyond. Its findings inform the interventions of the project, specifically the support required for individual learners with disabilities and their families as well as for the schools where they are enrolled. Method: This qualitative study was carried out in the three sub-districts of Bangladesh mentioned above and based in schools denoted for project intervention. Children with disabilities were purposively selected from school records to represent a range of ages, grades, type of disability and different sexes. Screening was conducted using the UNICEF Child Functioning Module (CFM). Data was collected between October 2021 and February 2022 and included in-depth interviews with 22 children with disabilities, 23 caregivers and six teachers, as well as through household and school observations. Findings: Based on the CFM, 91% of the children interviewed have difficulties in more
than one functional domain, with the most common being difficulties in controlling behaviour, learning and communication. The study found the CFM to be more sensitive to identification of functional difficulties than the teachers’ assessments. Through the interviews, a range of challenges were raised regarding continuation of learning during the pandemic. Almost all the children mentioned that they missed their schools, and particularly their friends. Caregivers expressed concern about their children being out of touch with their studies, acknowledging that schools provide an environment that helps students learn. When movements were restricted, and children could not go to
coaching classes or be with their friends, some children displayed regressive behaviour such as increased agitation because of the social isolation. One of the most common supports that facilitated learning during school closures was the appointment of private tutors. In addition, family members helped their children study at home. Where teachers were able to visit children and provide structure and support for home learning (in the form of assignments), this significantly contributed to children’s motivation to continue with their education. While the caregivers tried to support their children as far as possible, several factors impacted negatively on learning viz. lack of motivation of children to continue with their studies, inadequate support from teachers and financial constraints undermining the ability of families to cover the costs of education. Especially challenging was the lack of access to technological support and limited time and skills of parents to support their children with disabilities, in addition to their household responsibilities and other children to look after. Although caregivers talked about the lack of support from teachers, the teachers, on the other hand, mentioned that they were not fully equipped with knowledge and skills to appropriately support learners with disabilities. In some instances, children with disabilities were kept behind a grade for not passing their class assessments or were allowed to progress to the next grade without achieving the required competencies. Observations of homes revealed that almost all of the children with disabilities interviewed were living in low-income households, with overcrowding, outside washrooms, minimal furniture and no conducive study areas. Some houses had mud flooring and tin rooves, posing multiple safety and physical barriers for children with disabilities. School visits enabled identification of inaccessible infrastructure, including access roads, entrances and washrooms. Although all of the schools visited had ramps, none of these were fully usable and none had rails. As schools reopen, interviewees identified various strategies that would contribute to encouraging learners with disabilities to return to school and participate effectively in learning. These include specific focus on learners with disabilities by teachers in order to
provide targeted support; ending discrimination against those who do not perform well academically; and differentiation of the curriculum and assessments for learners with intellectual disabilities. These interventions, together with ensuring accessible school infrastructure, will contribute to creating a more enabling environment for learners with disabilities.
Recommendations: The COVID-19 pandemic has further deepened vulnerability of low income families and exclusion of children with disabilities from education. In order to address the potential widening gap that could be created by a surge of dropouts following school closures, various interventions need to be prioritized. These include building on the strategies of resilience already developed by families to support learning of their children; and enhancing parents’ confidence in providing support themselves. In addition,linkages between home and school need to be strengthened and appropriate learning resources made available to children at home, taking cognizance of the inaccessibility of
technology and remote programmes for children with disabilities (both in terms of devices and connectivity). It is essential that teachers’ role in supporting learning at home for children with disabilities be strengthened; and that teachers are equipped with skills to cater for disability and diversity among learners. This needs to be accompanied by removal of barriers in the built environments of schools and their surrounds.

In low-income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID-19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context-sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio-economic empowerment and inclusion.

Journal of International Development, volume 34, issue 5

https://doi.org/10.1002/jid.3638