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Knowledge of, beliefs about and attitudes to disability: implications for health professionals

MASASA, T
IRWIN-CARRUTHERS, S
FAURE, M
2014

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Background: South Africa is a multicultural, multiracial and multilingual nation with many different values, traditions and cultural practices. Different belief systems may give rise to different attitudes and practices relating to disability, which may impact on rehabilitation. The purpose of this study was to investigate the knowledge, attitudes and beliefs relating to disability in three broad cultural groups in the Western Cape.

 

Method: Sixty primary caregivers were interviewed by using a knowledge, attitude and belief (KAB) survey in a structured interview format. Probability and non-probability (systematic and purposive) sampling were used. The study used both quantitative and qualitative methods.

 

Results: While caregivers from coloured and white communities generally had become acquainted with disability from an early age, caregivers in black communities often only learnt about disability following the birth of a disabled child. All caregivers had only a rather rudimentary knowledge of the causes of disability, but held positive attitudes towards people with disabilities and their integration into society. The qualitative data showed some differences in beliefs between the three groups in relation to the causes of disability and the need for rehabilitation. The data also revealed negative experiences across the groups in relation to education and the availability of transport, particularly amongst caregivers from black and coloured communities.

 

Conclusions: Health professionals need to understand the culture, values, beliefs and expectations of their clients when providing rehabilitation services within a community-based model. There appears to be a need for improved disability awareness in schools and amongst transport service providers.

Report on the implementation of the UN convention on the rights of persons with disabilities (CRPD) by the European Union

THE EUROPEAN UNION
June 2014

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This report covers the period of the entry into force of the Convention on the Rights of Persons with Disabilities (CRPD) for the European Union (EU)  in January 2011 to December 2013. It begins with a brief introduction to the institutions of the EU, and some key legal and structural information. The report then focuses on the key articles of the CRPD (articles 1 to 33) and provides details on the EU's strategy towards implementation, including discussion of the measures taken, and information on the relevant EU legislation. This report would be particularly useful to anyone interested in understanding how the EU has implemented the CRPD so far

Commission Staff Working Document

Brussels, 5.6.2014 , SWD(2014) 182 final

Universal health coverage for inclusive and sustainable development. A synthesis of 11 country case studies.

MAEDA, Akiko
ARAUJO, Edson
CASHIN, Cheryl
HARRIS, Joseph
IKEGAMI, Naoki
REICH, Michael R.
et al
2014

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Universal health coverage (UHC) for inclusive and sustainable development synthesises the experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The UHC policies for each country are examined around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The path to UHC is specific to each country, but countries can benefit from experiences of others and avoid potential risks

Development process in Africa: Poverty, politics and indigenous knowledge

EIDE, Arne H
KHUPE, Watson
MANNAN, Hasheem
2014

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Background: Persons with disability run the danger of not profiting from the development process due to exclusion from basic services and opportunities. Still, the knowledge base on exclusion mechanisms is relatively weak and there is a danger that important aspects are not addressed as they are hidden behind established understandings that are not critically scrutinised.

 

Objectives: The main purpose of this article was to highlight critical thoughts on prevailing knowledge of the relationship between disability and poverty, the policy base for addressing the rights of persons with disability, and culture as a key component in continued discrimination.

 

Method: This article aimed at integrating three papers on the above topics presented at the 2011 African Network for Evidence-to-Action on Disability (AfriNEAD) Symposium. The researchers have therefore thoroughly examined and questioned the relationship between disability and poverty, the influence of policy on action, and the role of culture in reproducing injustice.

 

Results: The article firstly claims that there are limitations in current data collection practice with regards to analysing the relationship between poverty and disability. Secondly, ambitions regarding inclusion of persons with disability in policy processes as well as in implementation of policies are not necessarily implemented in an optimal way. Thirdly, negative aspects of culture in discrimination and bad treatment of disabled need to be highlighted to balance the discussion on disability and culture.

 

Conclusion: A critical view of prevailing understandings of disability and development is key to producing the knowledge necessary to eradicate poverty amongst persons with disability and other vulnerable groups. Not only do we need research that is actually designed to reveal the mechanisms behind the disability–poverty relationship, we need research that is less tied up with broad political agreements that is not necessarily reflecting the realities at ground level.

Research & humanities in medical education (RHiME)

DHALIWAL, Upreet
et al
March 2014

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Research and Humanities in Medical Education (RHiME) is an open access, peer-reviewed online journal with the vision to blend humanities with the sciences in medical education. It aims to encourage contributions from and discussion between teachers and students, doctors and patients, the sick and their care-providers, and between health policy makers and policy users

Mapping report of physical rehabilitation services in Afghanistan, Bangladesh, Odisha (India) and Sri Lanka

AXELSSON, Charlotte
2014

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This report presents a mapping (situational analysis) of the physical rehabilitation sector in the three countries and the Odisha state in India completed as part of Handicap International’s three year regional program in South Asia “Towards Disability Inclusive Development through a Strengthened Rehabilitation Sector in South Asia”. The aim of this mapping is improve the availability of information on the physical rehabilitation sector and to have an overview of the needs and unmet needs for physical rehabilitation

A guide for community health workers supporting children with disabilities

ADAMS, Mel
et al
2014

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"This resource is to be used as a guide for Community Health Workers (CHWs) to support parents in promoting the development and independence of their child with neurodevelopmental disabilities...In line with current thinking, this resource places the emphasis on promoting activity and participation in a child’s daily life activities rather than therapies that try to fix ‘the problem’ (Skelton and Rosenbaum, 2010). As such, this manual provides ideas on how to support the child during activities of daily living – taking particular account of their physical and communication abilities and needs – and does not include hands-on rehabilitation techniques that focus on specific impairments. It does however provide guidance on overall management and prevention of further disability. The materials in this manual can be used as the basis for a programme of intervention that progresses through two stages"

Note: As indicated when clicking on the resource link below, the manual is available once contact details are entered or alternatively user can contact mel@maits.org.uk to receive a free pdf copy of this resource

The Convention on the Rights of Persons with Disabilities Training Guide : Professional Training Series No. 19

UNITED NATIONS HUMAN RIGHTS OFFICE OF THE HIGH COMISSIONER
2014

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These eight training modules are meant to “inform and empower those who are involved in ratifying, implementing and monitoring the two instruments. While the Training Guide is mainly targeted at facilitators of training courses on the Convention and its Optional Protocol, it acknowledges that each and every one of us has a role to play. I recommend wide dissemination of the training package, and its use by all those who want to embark upon the essential journey towards greater awareness and effective implementation of the rights of persons with disabilities and, ultimately, the building of an inclusive society for all.”

Disability and the League of Nations: the Crippled Child’s Bill of Rights and a call for an International Bureau of Information, 1931

GROCE, Nora
2013

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In Disability Studies the evolution of conceptual models is often portrayed as linear, with a nineteenth-century charity model shifting to the medical model that dominated disability discourse in the twentieth century. This is then assumed to be largely unchallenged until the 1970s, when an emergent Disability Rights Movement re-framed issues into the social model, from which evolved a rights-based model. This paper documents two early efforts to address disability issues submitted to the League of Nations: the Crippled Child’s Bill of Rights in 1931 and a ‘Memorial’ requesting the establishment of an International Bureau of Information on Crippled Children in 1929. Neither submission achieved its stated goals, yet both reflect early attempts to place disability within wider social contexts.

Perceptions about Barriers to Sexual and Reproductive Health Information and Services among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: This study aimed to provide insights into factors that influence the acquisition, accessibility, and utilisation of Sexual and Reproductive Health (SRH) information and services by deaf people who communicate using Ghanaian Sign Language (GSL).

 

Method: The study explored deaf people’s perceptions about barriers to SRH information and services in Ghana. There were 26 participants in 3 focus groups: 10 executives of Ghana National Association of the Deaf (GNAD), 7 deaf adult males and 9 deaf adult females. A key informant, who had experience in working with deaf people, was also interviewed. Review of documents and observations helped to clarify data gathered from the focus groups.

 

Results: Study findings indicated that when accessing SRH information and services in Ghana, deaf people encounter numerous barriers such as problems with communication, ignorance about deafness, negative attitudes, and services that are not customised to their needs.

 

Conclusion: If it is to succeed, any SRH programme for the deaf community must make the eradication of communication barriers a priority, since communication is fundamental to all challenges that deaf people encounter.

Effect of an Experiential Dysphagia Workshop on Caregivers’ Knowledge, Confidence, Anxiety and Behaviour During Mealtimes

HETTIARACHCHI, S
KITNASAMY, G
2013

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Purpose: Children with cerebral palsy who have associated feeding difficulties are at risk of aspiration and poor nutrition. This study aimed to measure the changes in knowledge, confidence, anxiety and behaviour among 25 Sri Lankan mothers with responsibility for feeding children diagnosed with cerebral palsy, after they attended an experiential workshop.

 

Method: Data collection was done through pre- and post-workshop questionnaires, observations and semi-structured interviews.

 

Results: There was a significant improvement in reported levels of knowledge and confidence and a decrease in the caregivers’ level of anxiety during mealtimes. The qualitative data analysis indicated changes in participant knowledge, particularly about the signs of aspiration and positioning during mealtimes. Observations showed better adherence to recommendations on communication, bolus size and utensils.

 

Conclusion: The findings support the utility of experiential training for caregivers, to ensure that children with cerebral palsy are fed safely.

The ICT opportunity for a disability-inclusive development framework

INTERNATIONAL TELECOMMUNICATIONS UNION
September 2013

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This report "contributes to a better understanding of the extent to which information and communication technologies (ICTs) enable and accelerate the social and economic inclusion of persons with disabilities. It highlights that when ICTs are available, affordable and accessible, they significantly improve access to all aspects of society and development. It also lists challenges that are still to be addressed while outlining concrete actions to be undertaken by each group of stake holders - including national governments, the private sector, and civil and international organizations - and relevant indicators to monitor progress towards the achievement of a disability-inclusive development agenda"
Note: report is available in pdf and word formats, additional annexes can be downloaded from the link above

The ICT opportunity for a disability-inclusive development framework : executive summary

INTERNATIONAL TELECOMMUNICATIONS UNION
September 2013

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This report, "produced as a result of an extensive expert consultation organized from 20 May to 17 June 2013 in the context of the High Level Meeting on Disability and Development (HLMDD), aims to complement previous work on the use of ICT as an enabler of the social and economic inclusion of persons with disabilities by further exploring specific contributions that ICT can make in achieving a disability-inclusive development agenda"
Note: report is available in pdf and word formats; additional annexes and the full report can be downloaded from the link above

Inclusive disaster and emergency management for persons with disabilities : a review of needs, challenges, effective policies, and practices

RAJA, Deepti Samant
NARASIMHAN, Nirmita
2013

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This report provides an introduction into the needs of persons with disabilities in disasters and emergencies and reviews the challenges, effective policies and practices of inclusive disaster and emergency management.  It compiles international mandates and guidelines, strategies and practices for inclusive disaster management and gives an overview of the disaster and emergency management process and how persons with disabilities can be affected at each stage.  This report highlights the importance of information and communication technologies throughout the process and provides related case studies

Knowledge and use of contraceptive methods amongst deaf people in Ghana

MPRAH, Wisdom K
2013

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Background: Persons with disabilities in general face serious barriers to sexual and reproductive health (SRH) information and services due to institutional and attitudinal barriers. However, because deaf people have unique communication and linguistic needs, which are often misunderstood or ignored, they face greater barriers than other persons with disabilities. Whilst available data indicated that there is a wide gap between knowledge and usage of contraceptive amongst Ghanaians, little is known about the level of contraceptive knowledge and usage amongst deaf people.

 

Objectives: The objective of the study was to investigate the level of knowledge and use of contraceptive methods amongst deaf people in Ghana with the aim of understanding their contraceptive behaviour and to improve access.

 

Method: The study was a participatory SRH needs assessment utilising a two-phase, sequential, mixed methods design. The study included 179 participants, consisting of focus groups with seven executives of Ghana National Association of the Deaf (GNAD), 10 male deaf adults, and 9 deaf female adults. A total of 152 deaf people, made up of students, women, and men participated in a survey, whilst one hearing person served as a key informant.

 

Results: The findings of the study indicated that of the 13 methods shown in the survey, only three were known to about 70% of the adults and 60% of the students. Level of knowledge of the remaining nine methods was low.

 

Conclusion: Clear and effective policies are needed to guide the provision of SRH information and services for deaf people in Ghana.

Teachers for all : inclusive teaching for children with disabilities

LEWIS, Ingrid
BAGREE, Sunit
July 2013

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This paper provides detail about the context and scale of the challenges of the global shortage of inclusive teachers for children with disabilities. It then outlines five broad issues that need addressing if we are to prepare, recruit and support enough teachers, with appropriate skills, to educate every child, including those with disabilities

Training CBR Personnel in South Africa to contribute to the Empowerment of Persons with Disabilities

RULE, S
2013

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Purpose: Recent conceptualisations of community based rehabilitation include empowerment of persons with disabilities as a key activity. This article reports on a study which explored the training of mid-level CBR workers in South Africa, with a specific focus on the ability of the course participants to address the oppression and empowerment of persons with disabilities.

 

Method: Over a three-year period, one cycle of action research was conducted in a non-government organisation that conducts mid-level CBR training in South Africa. Data collection methods included in-depth interviews with staff, students and past graduates of the course, document analysis, participatory rural appraisal techniques and two focus group discussions with the students’ clients.

 

Results: Personnel, who had been trained in CBR before the year 2003, were found to have some difficulty in explaining the social model of disability and the oppression of persons with disabilities at a cultural and structural level. It was noted that after changes were implemented in the CBR course, the students had an orientation to working with, rather than for, persons with disabilities. They began to understand the complexities of empowerment and also engaged in social action to address the oppression of persons with disabilities.

 

Conclusions: The CBR Guidelines require a new skill-mix in mid-level CBR personnel. This study illustrates a possible training approach which can contribute to the development of these skills.

Exploring Knowledge and Attitudes towards HIV/AIDS among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.

 

Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.

 

Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.

 

Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.

Social Skills Training of Children with Learning Disability

BHAN, S
FAROOQUI, Z
2013

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Purpose: The ability to recognise emotions in oneself and in others is a fundamental prerequisite to function successfully in the social world. Emotion recognition deficit in people with learning disability may therefore be an important contributory factor to deficits in social skills and poor social adaptation. This study aimed to examine the level of emotional understanding in students with learning disabilities (LD).

 

Method: A pre-test, post-test equivalent groups design was adopted for this study. The focus was on identification of emotions through verbal and pictorial situations, and the appropriate expression of emotions. Training was provided to enhance the emotional understanding of students through the use of ‘I C ME’ module. The 6 emotions addressed in this study were anger, excitement, embarrassment, jealousy, love and anxiety. 30 children with LD, in the age group of 9-12 years, were selected for the study.

 

Results: It was seen that while children with LD had difficulty in the identification of an emotion, they found it more difficult to express the emotion in a socially appropriate way. The post-test results indicated that the training provided to the students significantly improved their emotional understanding.

 

Conclusions: The students learnt about the 6 emotions (anger, excitement, embarrassment, love, jealousy, and anxiety), the vocabulary associated with these emotions, and also the appropriate way to express, self-monitor and self-regulate each emotion.

 

Limitations: Intervention was done for only 6 emotions

Leprosy: Knowledge and Attitudes of Physiotherapists in Nigeria

AYANNIYI, O
DUNCAN, F O
ADENIYI, A F
2013

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Purpose: The objectives of this study were to investigate the knowledge and attitudes towards leprosy of physiotherapists in Nigeria.

 

Method: A cross-sectional survey of 330 physiotherapists, with minimum 1-year work experience in public hospitals in the 6 geo-political zones of Nigeria, was carried out. A pre-tested, self-administered questionnaire with open and close- ended questions was employed. Data obtained were analysed using descriptive and inferential statistics of Chi-square tests with Alpha level at 0.05.

 

Results: The respondents’ mean and range of years of job experience was 8.6 + 5.51 and 1 to 27 years respectively. Close to half (44.5%) of the physiotherapists had only a fair knowledge about leprosy and 165 (50%) had poor attitudes towards leprosy and persons with leprosy. There were significant associations between the schools of training and each level of knowledge (χ2 = 45.04; p = 0.0001) and attitudes of physiotherapists to leprosy and to persons who have suffered from leprosy (χ2 = 20.26; p = 0.009). There was, however, no significant association between years of job experience and each of knowledge (χ2 = 4.76; p = 0. 312), or attitudes of the physiotherapists to leprosy (χ2 = 4.55; p = 0.337).

 

Conclusions and Implications: It was concluded that a substantial number of physiotherapists in Nigeria had fair knowledge but poor attitudes towards leprosy. The institution of training appears to have an influence on their knowledge and attitudes. It is therefore recommended that educational and training programmes on leprosy should be organised and emphasised at the basic training institutions for physiotherapists.

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