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Repair strategies for assistive technology in low resource settings

OLDFREY, Ben
HOLLOWAY, Cathy
WALKER, Julian
McCORMACK, STEVEN
DEERE, Bernadette
KENNEY, Laurence
SSEKITOLEKO, Robert
ACKERS, Helen
MIODOWNIK, Mark
July 2023

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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 

Experiences of lower limb prosthesis users in Kenya: a qualitative study to understand motivation to use and satisfaction with prosthetic outcomes

MATTICK, Kate
OLDFREY, Ben
DONOVAN-HALL, Maggie
MAGOMERE, Grace
GAKUNGA, Joseph
HOLLOWAY, Catherine
December 2022

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An estimated 1.5 million people undergo limb amputation each year [1]. Low- and middle-income countries (LMICs) are projected to have a rapid increase in people living with an amputation in the coming years due to prevalence of non-communicable disease, trauma and conflict. This paper explores the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting.

This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied.

 

Disability and Rehabilitation Volume 45, 2023 - Issue 26

https://doi.org/10.1080/09638288.2022.2152875

Evaluating the use of a thermoplastic socket in Kenya: A pilot study

BARBARESCHI, Giulia
TEERLINK, Wesley
NJUGUNA, Josepg Gakunga
MUSUNGU, Purity
KIRINO, Mary Dama
HOLLOWAY, Catherine
October 2022

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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

Inclusive Design and Accessibility of the Built Environment in Nairobi, Kenya

PATRICK, M
MULDOWNEY, A
KILIMANJARO BLIND TRUST AFRICA
TANUI, G
BUKACHI, V
CAMPBELL CLAUSE, J
McKINNON, I
October 2022

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

This case study, funded through UK aid AT2030 programme, explores the current situation of inclusive and accessible environments for people with disabilities living in Nairobi. The research findings detailed in this report describe the current challenges and opportunities for embedding inclusive design in Nairobi’s future, providing priority recommendations and forward-thinking next steps.

The research took place in three phases between July 2021 and January 2022, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk research and interviews, phase 2 captured the lived experience of people with disabilities utilising interviews, photo diaries and co-design activities. Phase 3 then synthesised findings, running multiple workshops to create actions towards inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life, poverty, transport, housing, sanitation, public spaces and recreational activities. Quotes from participants are interwoven into this report, and strengthen the concluding actions towards inclusion.

 

Mainstreaming disability inclusive employment in international development

Mary Wickenden
Philip Mader
Stephen Thompson
Jackie Shaw
July 2022

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People with disabilities are under-represented in the global workforce, and this problem is often particularly acute inthe‘global south’. This is an editorial to a special issue that seeks to provide new perspectives on why this is the case. We deliberately wanted to place this collection in the Journal of International Development as a core development publication, rather than in a disability specific one, because we think it is important to ‘mainstream’ disability within development so that the international community can develop an increased understanding and awareness of disability dilemmas. The challenges faced by disabled people need to be tackled as part of all development thinking and programming.

Capability-sensitive principles for assistive technology to support young graduates with disabilities in Bangladesh and Kenya into employment

MORRIS, Lisa-Dione
ALGHAIB, Ola Abu
NORTHRIDGE, James
July 2022

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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

Barriers to inclusive employment for self-advocates and families

BIALIK, Kimber
MHIRI, Manel
June 2022

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This article is about the barriers to inclusive employment that people with intellectual disabilities and families face in Kenya, Uganda, Nigeria, and Bangladesh.

Through the Inclusion Works Project, we worked with our members in Kenya, Uganda, Nigeria, and Bangladesh to talk with self-advocates and family members about employment.

We had 3 consultation meetings with self-advocates and 3 consultation meetings with families – we talked to 54 self-advocates and 45 family members about access to inclusive employment in their countries.

Some of the barriers that they told us about were discrimination from employers, lack of access to education, unfair pay, issues with safety and security at work, and being pressured to choose self-employment.

This article explains some of the issues accessing inclusive employment that people with intellectual disabilities and their families told us they face in low- and middle-income countries.

The article also gives recommendations for how organisations doing work on inclusive employment can work towards addressing some of these barriers and being more inclusive.

 

 Journal of International Development, Volume 34, Issue 5

From disability budget commitments to budget execution in Kenya: Matching disability approved allocations to actual spending and performance

Development Initiatives
May 2022

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This paper builds on previous analyses conducted by DI on disability budgeting. In this paper, we match budget commitments to implementation; first by mapping the extent to which disability-relevant budget implementation information is accessible, then by analysing financial and non-financial performance in Kenya over the financial years 2016/17 to 2020/21. We have analysed disability budget implementation in five counties (Baringo, Bungoma, Busia, Kakamega, and Vihiga) and two national sectors (Education and Social Protection).

Unemployment in women with psychosocial disabilities during the COVID-19 pandemic: Lessons from Tana River County, Kenya

IBUENYI, Ikenna D.
GITONGA, Isaiah
TELE, Albert
SUYRINA, Elena
February 2022

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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

Social protection for disability in Kenya and Uganda - synthesis report

Development Initiatives
January 2022

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In 2021, Development Initiatives analysed how existing social protection programmes benefit persons with disabilities in Uganda and Kenya and associated challenges. The two country reports synthesised in this report interrogate policy frameworks, existing social protection schemes and institutional setups, and track public investment towards disability-specific and mainstream social protection programmes. 

Social protection for disability inclusion in Kenya

Development Initiatives
December 2021

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Disability and poverty are inextricably linked, with lifelong consequences for persons with disabilities and their families. Investing in a disability-inclusive social protection system, therefore, is critical for addressing the diverse risks, inequalities, disability-related costs and barriers that limit the participation of persons with disabilities in their communities.

This analysis provides an in-depth assessment of the progress that the national government of Kenya has made to establish disability-inclusive social protection programmes. It reviews the policy/legal framework and the institutional arrangements for social protection in Kenya. It also reviews public investments in disability-specific and mainstream social protection programmes based on a budget tracking exercise covering five financial years (FY) between 2017/18 and 2021/22.

Lives turned upside down in COVID-19 times: exploring disabled people's experiences in 5 low-and-middle income countries using narrative interviews

WICKENDEN, Mary
SHAW, Jackie
THOMPSON, Stephen
ROHWERDER, Brigitte
2021

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This article explores COVID-19 related experiences of disabled people in Bangladesh, Kenya, Nigeria, Nepal and Uganda. Narrative interviews generated storied responses, focussing on respondents' priorities, which enabled us to hear what was most significant for them and their families. 143 interviews were conducted online or by phone by 7 local researchers (3 disabled), with appropriate inclusive support. Nearly everyone was interviewed twice to capture the progression of impacts over time. The data was analysed thematically through a virtual participatory approach. An overarching 'subjective' theme of feelings experienced by the participants was labelled 'destabilisation, disorientation and uncertainty'. We also identified 'concrete' or material impacts. People experienced various dilemmas such as choosing between securing food and keeping safe, and tensions between receiving support and feeling increased vulnerability or dependence, with interplay between the emotions of fear, loss and hope. We found both the concept of liminality and grief models productive in understanding the progression of participants' experiences. Disabled people reported the same feelings, difficulties and impacts as others, reported in other literature, but often their pre-existing disadvantages have been exacerbated by the pandemic, including poverty, gender and impairment related stresses and discrimination, inaccessible services or relief, and exclusion from government initiatives.

A disability inclusive response to COVID-19 - four lessons learned about including people with disabilities in humanitarian aid

MORRIS, Lisa
ELLIOTT, Chris
PIERI, Susan
September 2021

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Inclusive Futures played a crucial role in supporting some of the most marginalised people with disabilities in Bangladesh, Kenya, Nepal, Nigeria, and Tanzania during the COVID-19 pandemic. This paper summarises what we learned and it can be used to include people with disabilities in future programming, particularly in contexts at risk of crisis.

Labour Market Assessment: Kenya 2021 refresh

INCLUSIVE FUTURES
BROWN, SIMON
OBOSI, Shikuku
August 2021

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This Labour Market Assessment for Kenya is a refresh of the initial assessments done in 2019 for the Inclusion Works programme. The assessment adopts a Markets for Poor (M4P) approach to mapping demand for and supply of labour, supporting functions and regulatory frameworks; recognising that labour markets conditions will have evolved since 2019, especially in light of COVID-19. The perspectives of jobseekers, employers, and organisations of persons with disabilities (OPDs) are also included in this analysis. The report provides insights into market changes and recommendations to enable Inclusion Works programming to adapt and be more effective in their interventions.

How much do counties in Kenya invest in disability inclusion? A synthesis report

DEVELOPMENT INITIATIVES
July 2021

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This synthesis report summarise the major findings from those five briefings, and provide context and supplementary information. It first discusses the disability prevalence rates at national and county level, and reasons for the discrepancies between the last two censuses. It then examines policy, governance and institutional set up for inclusions of persons with disabilities. Then it presents the major findings from the five budget-tracking exercises. The report ends with general conclusions and recommendations.

“This Time of Corona Has Been Hard”: People with Disabilities’ Experiences of the COVID-19 Pandemic in Kenya

ROHWERDER, Brigitte
NJUNGI, Josephine
WICKENDEN, Mary
THOMPSON, Stephen
SHAW, Jackie
June 2021

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The COVID-19 pandemic is deepening pre-existing inequalities. Emerging research suggests that people with disabilities across the world have experienced various rights violations and been disproportionality affected by the health, economic and social impacts of the COVID-19 pandemic and the responses to it. The aim of this research was to explore how people with disabilities, who often are excluded from research, have experienced the evolving COVID-19 pandemic in Kenya. To better understand how it has affected jobseekers with disabilities, in-depth qualitative research was conducted in Kenya as part of the Inclusion Works programme.

Empowering Kenyan women and girls with disabilities in managing menstrual health

UNITED NATIONS POPULATION FUND (UNFPA)
June 2021

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The partnership of UNFPA with This-Ability Trust, an organization that advances disability rights and inclusion by working with groups, to improve access to sexual and reproductive health information and services for women and girls with disabilities is reported. The partnership, which has reached 12,000 people in eight counties, also educates both recipients and caregivers on menstrual health management when distributing dignity kits with washable sanitary pads. The report highlights Mombasa-based Ms. Wanjiru who runs a group for persons with disabilities that includes a programme on sexuality for young women, whose families and caregivers are often uncomfortable discussing menstrual hygiene

Vihiga county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing tracks the inclusivity of Vihiga county budgets from financial years (FY) 2016–17 to 2020–21 towards persons with disabilities. It begins with an overview of disability prevalence in the county, then looks at county investments in disability inclusion. It concludes by looking at the critical financial gaps in the disability sector and providing actionable recommendations to be taken up by both the county government and disabled persons organisations (DPOs).

Trans Nzoia county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This is part of a series of briefings that track the disability inclusivity of county budgets. In this briefing, we present the inclusivity of Trans Nzoia County budgets towards persons with disabilities between financial years (FY) 2016–17 and 2020–21. It should be noted that this briefing has utilised data from only three FYs, as opposed to five as planned, due to the unavailability of budget data. The three FYs with available budget data are FY2017–18, FY2018–19 and FY2020–21. For the two FYs without budget data, we have used projections from the previous years.

Kakamega county disability-inclusive budget tracking

DEVELOPMENT INITIATIVES
June 2021

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This briefing tracks the inclusivity of Kakamega county budgets towards persons with disabilities from financial year (FY) 2016–17 to 2020–21. It begins with an overview of disability prevalence in the county, and then looks at county investments on disability inclusion. It concludes by looking at the critical financial gaps in the disability sector and providing actionable recommendations to be taken up by both the county government and persons with disabilities.

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