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Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone

AENISHANSLIN, Justine
AMARA, Abu
MAGNUSSON, Lina
April 2020

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In order to explore the experiences of persons with physical disabilities accessing and using rehabilitation services in Sierra Leone, interviews with 38 individuals with differing physical disabilities were carried out in three locations across Sierra Leone (Freetown, Bo and Makeni).

The analysis resulted in six themes:  The initial and ongoing need for rehabilitation throughout life; Challenges with the cost of rehabilitation and transportation to reach rehabilitation services; Varied experiences with rehabilitation staff; Coming to terms with disability and facing stigma; The struggles without and opportunities with rehabilitation services; Limited knowledge and availability of rehabilitation services.

Addressing barriers to affordability, access, and availability of rehabilitation and addressing knowledge gaps, attitudinal barriers and stigma towards rehabilitation and persons with disability are discussed.

 

Disability and Rehabilitation, April 2020

DOI: 10.1080/09638288.2020.1755375

Disability and global health: Special issue of International Journal of Environmental Research and Public Health

KUPER, Hannah
POLAK, Sarah
Eds
2019

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Papers included in this special issue are:

 

DFID’s strategy for disability inclusive development 2018-23

December 2018

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The UK Department for International Development (DFID)'s vision is a world where all people with disabilities, women, men, girls and boys, in all stages of their lives, are engaged, empowered and able to exercise and enjoy their rights on an equal basis with others, contributing to poverty reduction, peace and stability. A world where no-one is left behind.

Over the next five years DFID will prioritise four strategic pillars for action: (i) inclusive education, (ii) social protection, (iii) economic empowerment, and (iv) humanitarian action. To complement this focus DFID are adopting three cross-cutting areas, vital to disability inclusion, which will be consistently and systematically addressed in all of their work: (v) tackling stigma and discrimination; (vi) empowering girls and women with disabilities; and (vii) access to appropriate assistive technology.

DFID have introduced a new set of standards for all DFID business units to meet. The standards require all country offices and departments to; review their leadership and culture, engage with people with disabilities, influence others, adapt programming and improve data and evidence.

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

Towards inclusion. A guide for organisations and practitioners

VAN EK, Vera
SCHOT, Sander
November 2017

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Inclusive development is about creating societies that value and enfranchise all marginalised groups. It is often not difficult to open up development projects to persons from these marginalised groups. But it does take time before organisations are willing and able to fully commit to inclusion.

Towards Inclusion aims to support organisations who wish to commit to an inclusive approach. It establishes the rationale for inclusion and provides technical advice and tools for putting theory into practice. It is intended to be used as a reference during organisational development, as well as a tool to support good practice in implementation.

If you are looking to support a (development) organisation in the process of becoming an inclusive organisation, then Towards Inclusion is for you

This guide consists of three parts. The first part guides the reader through the process of assessing whether or not the organization is ready to change towards becoming a more inclusive organization. The second part introduces the ACAP framework, which sets up a way of approaching inclusion via focus on the areas: Access, Communication, Attitude and Participation. It then demonstrates how the framework can be applied to projects and programmes. The third part provides guidelines for the people who will guide organizations through the process of change towards becoming inclusive of persons from marginalized groups

Childhood disability in Malaysia: a study of knowledge, attitudes and practices

MOORE, Katie
BEDFORD, Juliet
November 2017

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This study was carried out to assess the knowledge, attitudes and practices of society towards children with disabilities, the children themselves, and their peers in Malaysia. The study took place in Selangor, Kelantan, Sabah and Sarawak. There were 756 total respondents/participants including government ministries, community members, service providers, care givers and children and adolescents both with and without disabilities. 

Disability and HIV

UNAIDS
August 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care. Globally, it is estimated that 1 billion people (15% of the world’s population) have a disability. Of those aged over 15 years, approximately 110–190 million (2.2–3.8%) experience significant disabilities. Disability is increasing in prevalence due to ageing populations, trauma, accidents and the increase in chronic health conditions, including HIV. Persistent discrimination against and exclusion of people with disabilities, in particular women and girls with disabilities, increases their vulnerability, including their risk of HIV infection.
 

The right to live independently and be included in the community : Addressing barriers to independent living across the globe

ANGELOVNA-MLADENOVA, Lilia
June 2017

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"This reports looks at the main barriers to the realisation of disabled people’s right to live independently and be included in the community, which is set out in Article 19 of the UN Convention on the Rights of Persons with Disabilities (CRPD). They are grouped in seven broad areas: (1) misunderstanding and misuse of key terms, (2) negative attitudes and stigma, (3) lack of support for families, (4) prevalence of institutional services, (5) barriers related to community support services, (6) barriers in mainstream services and facilities, and (7) barriers, concerning other CRPD provisions, with effect on Article 19. A set of recommendations is also provided, outlining measures required to address these barriers"

Barriers in Using Assistive Devices among a Group of Community-dwelling Persons with Lower Limb Disabilities in Sri Lanka

WEERASINGHE, Inoka E
FONSEKA, P
DHARMARATNE, S D
JAYATILAKE, J A M S
GIELEN, A C
2015

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Purpose: Rehabilitation with assistive devices is of great benefit to people with limb disabilities, enabling them to lead independent and productive lives. While assistive devices improve the quality of life of persons with lower limb disabilities by facilitating activities of daily living, there are also many barriers to their use. This study aims to describe these barriers among community-dwelling persons with lower limb disabilitiesin central Sri Lanka.

 

Methods: A community survey was conductedmong adults between 18 and 59 years of age, to find persons with lower limb disabilities in Kandy Municipal Council area, in the central province of Sri Lanka. This was followed by purposive sampling to select a sub-sample of 12 individuals with unilateral lower limb disabilities for a qualitative study using in-depth interviews. Unilateral lower limb disabilities were identified using a clinical examination and World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). A qualitative thematic content analysis was used to evaluate the interview text.

 

Results: Participants described several barriers in using assistive devices, such as unaffordable assistive technology like wheelchairs and artificial limbs, unavailability of appropriate assistive technology, difficulties associated with repair and maintenance, and problems in accessibility. Limited knowledge of modern technology also restricted their choice of better devices. Psychological barriers and stigma in using assistive devices directly affected their social lives and day-to-day activities as well.

 

Conclusion and Implications: People with lower limb disabilities face multiple barriers in using assistive devices. These barriers need to be addressed by improving local infrastructure and accessibility facilities, public awareness and funding, and ensuring continuous supply and maintenance services.

Disability under occupation : at the congruence between conflict, religion, & society in Palestine

RASHID, Omar
January 2015

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A dissertation on the Palestinian experience of disability under Israeli territorial occupation. The following key research questions were considered under this dissertation. "First, to locate the perceptions of disability among the disabled in the occupied territories of Palestine, in light of their religious affiliation. Second, to investigate the realities of the disabled within Palestine; and third, to enquire as to whether there had been any differences in the perceptions of disabilities and the realities of those who were injured in conflict, and those who were born with impairment" These questions were answered through a hybrid-methods system of research, with a mix of qualitative and quantitative methods being used

 

Dissertation submitted in part fulfilment of the requirements for a Masters degree at the University of Birmingham

The user has given permission for the original dissertation document to be uploaded to be reproduced and made publicly available on the Source website

Evidence for the effectiveness of rehabilitation-in-the-community programmes

VELEMA, Johan P
EBENSO, Bassey
FUZIKAWA, Priscila L
March 2008

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"The present literature review identified 29 reports from 22 countries in Asia, Africa and Central America reporting on the outcomes of rehabilitation-in-the-community programmes in low and middle income countries published between 1987 and 2007. Interventions included home visits by trained community workers who taught disabled persons skills to carry out activities of daily living, encouraged disabled children to go to school, helped find employment or an income generating activity, often involving vocational training and/or micro-credit. Many programmes had a component of influencing community attitudes towards disabled persons. The information collected shows that such programmes were effective in that they increased independence, mobility and communication skills of disabled persons, helped parents of disabled children to cope better and increased the number of disabled children attending schools. Economic interventions effectively increased the income of disabled persons although they rarely made them financially independent. CBR activities result in social processes that change the way community members view persons with disabilities, increase their level of acceptance and social inclusion and mobilise resources to meet their needs"
Leprosy Review, Vol 79, Issue 1

Factors shaping attitudes towards physical disability and availability of rehabilitative support systems for disabled people in rural Kenya

MONK, Julie
WEE, Joy
2008

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This study examines the range of attitudes towards persons with physical disability in a rural community in western Kenya. It also evaluates the availability of services for persons with disabilities in the community. Qualitative data analysis of interview material led to the generation of a model describing the attitudes towards people with disabilities. Availability of services was explored through interview questions and document collection. Perceived cause of disability, perceived characteristics and activities of people with disabilities by the community and perceived role of society, appear to shape the attitudes towards people with disabilities in the community studied. The opinions within these categories contribute to enabling and disabling features of the environment in which people with disabilities live. It appears that services available are underused by disabled members of the community due to poor accessibility and financial barriers. The results yielded relatively enabling attitudes towards PWD. The responses suggest that this community may be ready to support increased participation by its members, possibly through a community based rehabilitation programme.

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

Disablist Britain : barriers to independent living for disabled people in 2006

MILLER, Paul
GILLINSON, Sarah
HUBER, Julia
January 2006

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This report draws on qualitative and quantitative evidence to portray the extent of institutional discrimination in services for health, rehabilitation, welfare, employment, built environment, media coverage and education. It also addresses societal stigma and its impact on disabled peoples lack of access to goods and services. This report would be useful for anyone with an interest in human rights and approaches to disability issues

Access to care : challenges [whole issue]

HEALTH AND DEVELOPMENT NETWORKS (HDN)
2004

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This report is intended as a tangible record of the 13th ICASA (International Conference on AIDS and STDs in Africa) conference: what was said, by whom and when. The report summarizes the highlights, beginning with the conference's history and moves on to themes and objectives. It presents the main issues emerging from the conference through the eyes of the rapporteur teams, key correspondents and selected participants. The focus then shifts to a brief description of the on-site newspaper Pamoja News and the skills building sessions, and finally, the rapporteurs' presentations. By documenting the proceedings of the 13th ICASA it is hoped that the momentum in collective struggle against HIV/AIDS will be maintained, through ongoing strategies of partnership, stakeholder collaboration, and cross and multi-sectoral approaches

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