Scielo RSS <![CDATA[African Journal of Disability (Online)]]> http://www.scielo.org.za/rss.php?pid=2226-722020220001&lang=en vol. 11 num. lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Disability-inclusive community development: A case of a community garden in Limpopo province in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100001&lng=en&nrm=iso&tlng=en BACKGROUND: Persons with disabilities living in rural areas are marginalised and excluded in most developmental initiatives in South Africa. They face many economic, political and social problems; hence, improving their quality of life is a daunting and challenging task which needs interventions from both the state and non-governmental stakeholders. OBJECTIVES: This study aimed to examine the role played by community gardens in rural Limpopo province in uplifting the lives of persons living with disabilities as well as their communities as a whole. Its main objectives were to assess the social and economic benefits they have provided to this group of people. METHOD: A qualitative research design was used for this study. Twenty-one participants were identified through purposive sampling. They were made up of people with disabilities, officials from Departments of Agriculture and Social Development. Face-to-face interviews were used to collect data which was analysed thematically. RESULTS: Key results were that community gardens have contributed to the economic and social well-being of persons with disabilities. They have assisted them with income to supplement their social grants. They also created jobs for their members and contributed to improved livelihoods of their families. CONCLUSION: The study demonstrated that people with disabilities are capable people who, if given the necessary support, can transform their livelihoods both socially and economically. The study recommends that a disability access audit be conducted to resolve the accessibility challenges of the garden. <![CDATA[<b>Difficulties in teaching Grade 3 learners with reading problems in full-service schools in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100002&lng=en&nrm=iso&tlng=en BACKGROUND: Many primary school learners in South Africa, including those in so-called full-service schools (FSSs), are reading below their grade level. OBJECTIVES: The authors of this article embarked on a study to find out what difficulties a group of Grade 3 teachers in full-service school faced to support their young custodians with reading problems. METHODS: The research followed a qualitative approach using semi-structured interviews and classroom observation. RESULTS: The data showed that the reading problems experienced by some Grade 3 learners can be attributed to the multiple levels of the education system. On the macro system as set out by Bronfenbrenner's ecological systems theory where the government and provincial departments operate, the first issue was the national department's progression policy which allows Grade 2 learners to progress to Grade 3 without the required reading competency. The second issue was a lack of enough readers and overcrowding in classrooms. Problems on the microsystem included aspects such as the language of learning and teaching; learners' reading skills and attitudes towards reading; teachers' lack of knowledge about diverse learning needs and parental support. CONCLUSION: It is envisaged that the study will contribute to an understanding of the teachers' difficulties in teaching reading so that the Grade 3 learners' reading problems especially those in FSSs could be dealt with through combined efforts of all the stakeholders in the education system. <![CDATA[<b>Promoting regional coherence and cohesion amidst multiple assistive technology initiatives in Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100003&lng=en&nrm=iso&tlng=en BACKGROUND: Appropriate provision of assistive technology services (ATS) and products are a global health issue and essential for achieving the Sustainable Development Goals (SDGs). The Sixth African Network for Evidence-to-Action on Disability (AfriNEAD) conference included a workshop on collaboration, cohesion and coherence in ATS delivery in Africa. OBJECTIVE: This article aimed to summarise the workshop proceedings and to provide some recommendations on how coherence and cohesion can be facilitated in assistive technology services in Africa. METHOD: A round table and small group discussions on assistive technology were facilitated in the virtual space of the AfriNEAD conference. Organisations and role players in ATS and products in Africa participated as keynote speakers, round table members and in small group discussions. RESULTS: There was consensus amongst participants that cohesive collaboration must be facilitated. They further agreed that users must be central to future action. There are local, national and regional initiatives, but none of these have grown into an African assistive technology platform. World Health Organization (WHO) Africa can bring partners together and facilitate creation, officialisation and operationalising of a continental assistive technology platform, through building on the existing initiatives. The AfriNEAD disability research country working groups can act as in-country coordinating bodies for ATS and afford a possibility of a structured approach to assistive technology research. CONCLUSION: It is time to break away from Western institutionalised biomedical ways of providing ATS in Africa. Africans must develop coherent, cohesive ATS driven by empowered users who build on Africa's strengths and addresses the continents' unique needs. <![CDATA[<b>Introducing the Including Disability in Education in Africa Research Unit at the University of Cape Town</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100004&lng=en&nrm=iso&tlng=en BACKGROUND: The Including Disability in Education in Africa (IDEA) Research Unit at the University of Cape Town in South Africa was established in 2020 and focused on carrying out research studies in the field of disability and education in Africa and beyond. OBJECTIVES: The objective of this article was to introduce the research unit and highlight its vision, mission and objectives. METHOD: A general review of the research unit. RESULTS: The IDEA Research Unit plays an important role in the research arena within South Africa and Africa when it comes to disability issues in education. CONCLUSION: More networking and collaboration should take place between the IDEA Research Unit and relevant stakeholders in the field of disability and education. <![CDATA[<b>Post stroke health-related quality of life, stroke severity and function: A longitudinal cohort study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100005&lng=en&nrm=iso&tlng=en BACKGROUND: Health related quality of life (HRQoL) is a determinant of physical, social and emotional well-being post-stroke. OBJECTIVES: This study aimed to correlate self-reported HRQoL with activities of daily living (ADL) and stroke severity. METHOD: A longitudinal observational study was conducted at a rehabilitation centre in the Western Cape, South Africa. Stroke inpatients were sampled over 6 months. The Euro-QoL Five Dimensions instrument (EQ5D-3L) for self-reported HRQoL, Barthel Index (BI) for function and independence in ADL, and modified Rankin Scale (mRS) for stroke severity were administered on admission and discharge. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25. RESULTS: Of the 54 potential participants, 49 met inclusion criteria and 41 completed reassessments (median age 48 years [interquartile range {IQR} 39-60]; median length of stay 53 days [IQR 46-60]). Most participants had infarctions (89.90%); with hypertension or diabetes risk factors (73.47% and 28.57%, respectively). The BI and mRS scores improved significantly (p < 0.001) with very strong correlation between scores (rs = -0.874, p < 0.001); indicating a trend of decreased stroke severity as function improved. The EQ5D Visual Analog Scale (VAS) scores (p < 0.001) and domains mobility, self-care, usual activities (p < 0.001) and pain/discomfort (p = 0.034) improved significantly. The anxiety/depression domain showed a non-significant change (p = 0.378). A weak negative significant correlation existed between EQ5D VAS and mRS scores (rs = -0.362; p = 0.02); indicating a trend that HRQoL was not improving to the degree stroke severity decreased. A weak positive significant correlation was seen between EQ5D VAS and BI scores (rs = 0.329; p = 0.036 CONCLUSION: Although an improvement was noted in HRQoL, EQ5D VAS scores tended not to improve as strongly, despite significant improvements in function and stroke severity. These findings demonstrate the need for psychological support and pain management interventions for adjustment post-stroke. <![CDATA[<b>Local knowledge in inclusive education policies in Africa: informing sustainable outcomes</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100006&lng=en&nrm=iso&tlng=en BACKGROUND: This article presents on the outcomes of a study that focused on an analysis of inclusive education (IE) policies in South Africa, Ghana and Uganda. Persons with disabilities live within communities and are raised by the values that apply within their communal context. Policymaking is intricately linked to policy implementation, and the inclusion of local knowledge strengthens policy influence, impacting on implementation processes. OBJECTIVES: This research study explored the definition and foci of inclusion, whether local knowledge is included and how it is represented within the national inclusive education policy in South Africa, Ghana and Uganda. This study reports on the outcomes of the second objective on inclusion of local knowledge. METHOD: A qualitative, critical, interpretative and constructivist approach was utilised for the study. Data were gathered through a desktop review and in-depth, individual interviews. RESULTS: There is inclusion of some local knowledge within the national policies; however, this is minimal and insufficient. Participants argue that even when it is included, it is often embedded or implied, that local knowledge should be made more prominent within inclusive education policies as local knowledge is a community resource that supports policy implementation. CONCLUSION: The inclusion of local community knowledge and ways of knowing within inclusive education policies is viewed as a critical and an integral aspect of policymaking. It will help to address the challenges of stigma and negative attitudes, promoting a continuity of knowledge that supports local values and well-being of children with disabilities and their communities. <![CDATA[<b>Perspectives of key stakeholders on educational experiences of children with autism spectrum disorders at the Kenyan Coast</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100007&lng=en&nrm=iso&tlng=en BACKGROUND: Little is known about the educational experiences of children diagnosed with autism spectrum disorders (ASDs) in the Kenyan Coastal context. OBJECTIVES: We examined the diagnostic and placement procedures used in education on the Kenyan coastal region. In addition, we investigated the education-related challenges faced by children with ASD. METHODS: We conducted focus group discussions and in-depth interviews with 21 participants, including teachers, clinicians and educational administrators. Data were analysed using an inductive thematic framework on qualitative data analysis software, NVIVO 10 RESULTS: The findings from this study indicate that there were no systematic approaches to diagnosing children as having ASD. Teachers reported experiencing many challenges, including a lack of specialised training, inadequate resources and difficulty in managing children with different functional abilities in one class. CONCLUSION: There is an urgent need for contextually relevant evidence-based identification, placement and management services to be put in place to meet the educational needs of children with ASD. <![CDATA[<b>Self-identified intervention priorities amongst women with road accident-acquired physical disabilities in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100008&lng=en&nrm=iso&tlng=en BACKGROUND: Acquiring a physical disability in adulthood necessitates a range of adjustments, with past research suggesting that some challenges encountered are unique to women. Moreover, several factors may complicate adjustment to an altered embodiment and difficulties in functioning after an accident, including insufficient rehabilitation and support services and problematic societal attitudes towards disability. In addition, women with disabilities are often excluded from health and social policy and programme development, an oversight that can result in support gaps. OBJECTIVES: This article presents the self-identified priority interventions of women with road accident-acquired physical disabilities in South Africa. METHODS: We conducted interviews with 18 women with road accident-acquired physical disabilities. The participants were recruited via snowball sampling. Interviews were conducted by experienced interviewers, who were home language speakers of the participants' preferred language of communication. The interview recordings were transcribed, translated, and coded by trained, independent researchers. RESULTS: Study participants identified three key areas of intervention requiring consideration in supportive intervention planning: the acute post-injury environment and healthcare infrastructure, transitional services and social inclusion interventions. These were identified as overlooked areas in which they required support to successfully adapt to limitations in functioning. CONCLUSION: To develop inclusive, accessible, and practical policy and programming for people with disabilities, exercises like those outlined in this research - eliciting intervention ideas from lived experience - should be conducted as they highlight actionable priorities for programming. <![CDATA[<b>Knowledge, perceptions and experiences of risk to sexual violence among adults with intellectual disabilities in Cape Town, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100009&lng=en&nrm=iso&tlng=en BACKGROUND: People with intellectual disabilities are at high risk to sexual violence, yet minimal research has been conducted in South Africa to understand this phenomenon, especially seeking perspectives of people with intellectual disabilities themselves. OBJECTIVES: This study aimed to explore and describe the knowledge and awareness of risk to sexual violence among adults with intellectual disabilities and to understand their perceptions and experiences of risk. METHOD: An exploratory qualitative approach was appropriate as there is lack of literature on this subject. Focus group discussions were used as the method of data collection. The method of conducting focus group discussions and data collection instruments were adapted to suit the communication and cognitive abilities of the adults. Twenty-seven adults participated in the study and they were divided into six groups of four to five participants in each group. RESULTS: The adults' responses revealed that they had some knowledge of risks to sexual violence, but they also had knowledge gaps and some erroneous knowledge and perceptions that could put them at high risk. The experiences they shared showed that the risk of sexual violence is high among women with intellectual disabilities. CONCLUSION: Further research is needed to inform a community approach which includes people with intellectual disabilities, their families, services providers and community members as an intervention to empower and protect people with intellectual disabilities from sexual violence. To achieve this, we recommend an ecological framework as a guiding tool in both the research processes and the implementation of the outcomes. <![CDATA[<b>Unreported and unaddressed: Students with disabilities experience of school violence in Zambia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100010&lng=en&nrm=iso&tlng=en BACKGROUND: Violence against school children is a prevalent global issue. Despite the high prevalence of school violence in Zambia, there is limited research on students with disabilities' experiences of school violence. OBJECTIVES: Guided by the socio-ecological model for bullying, the aim of this study was to understand students with disabilities' experiences of school violence in the Lusaka and Southern provinces of Zambia. METHODS: A qualitative descriptive study was conducted with 14 purposively sampled boys (n = 6) and girls (n = 8) with disabilities. Data were generated using semi-structured interviews and child-friendly methods. Child-friendly methods were co-constructed with Zambian youth with disabilities in order to ensure cultural appropriateness and included vignettes, cartoon captioning, photograph elicitation, drawings, and sentence starters. Qualitative data were analysed by thematic analysis. RESULTS: The themes illuminated that violence against students with disabilities occurs frequently but goes unaddressed. Moreover, students with disabilities were being blamed for causing the violence, and therefore, considered a risk to others. Participants reported that they turn to trusted teachers for support. CONCLUSION: This study illuminates the violence students with disabilities experience within the Zambian education system, with implications for school policies and programmes, peer education, and teacher training to create a safer education environment for students with disabilities. <![CDATA[<b>Special educators' intentions towards supporting practice of inclusive education for students with disabilities in secondary schools in Ghana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100011&lng=en&nrm=iso&tlng=en BACKGROUND: Although teacher training institutions have introduced courses in inclusive education to equip teachers with the necessary pedagogical skills to teach in diverse classrooms, it has been argued that the services of special educators are essential when it comes to teaching students with disabilities in regular classrooms. Unfortunately, there is scant literature on the views of special educators regarding the enactment of inclusive education in sub-Saharan African countries, such as Ghana OBJECTIVE: In an effort towards promoting inclusive education in Ghana, there has been deployment of special educators across Ghana to supervise the implementation of inclusive education in schools. The purpose of this study was to explore the intentions of special educators towards supporting teachers to teach students with disabilities in secondary schools METHOD: Ajzen's theory of planned behaviour guided the development of interview guide for data collection for this qualitative study. Twelve special educators were purposively selected and interviewed from five districts in Ghana RESULTS: The participants expressed their unpreparedness to work in secondary schools because of multiple factors, such as their job description, resistance from teachers, and inadequate teaching and learning materials CONCLUSION: This study concludes on the need for policymakers to reconsider the deployment of special educators to cluster of schools or geographical areas in order to supervise the education of children with disabilities <![CDATA[<b>Communication strategies used by adolescents with autism spectrum disorder and health professionals during treatment</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100012&lng=en&nrm=iso&tlng=en BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder, which affects social communicative capabilities. The research study has shown that ASD studies are focused on young children, excluding adolescents and adults: and it is understudied in the context of South Africa. OBJECTIVE: This study examined the interactional communication strategies of adolescents with ASD and health professionals during different treatment consultations to identify the interactional styles and communication strategies utilised by adolescents with ASD and their respective healthcare professionals in a variety of scenarios in order to generate management strategies for future healthcare professional communication training. METHOD: A multi-case study design with a qualitative research approach has been used. Four adolescents with a moderate form of ASD and four health practitioners were interviewed. Participants were chosen by purpose and snowball sampling. Semi-structured, open-ended interviews were used for health professionals to collect information on the various interaction types and communication methods used, as well as their interpretations of these methods. Conversely, adapted face-to-face interviews were used to collect similar knowledge from adolescents themselves. The findings were qualitatively analysed on a case-by-case and cross-case basis by thematic analysis techniques. RESULTS: The findings indicated that ASD adolescents have interaction types that influence intervention to various degrees. In comparison to motor therapies such as occupational therapy and physiotherapy, interaction types have a greater impact on psychiatry and psychology, which depend mainly on verbal communication. Intuitively, to promote contact with these teens, all health practitioners changed their own interaction styles. They used techniques of clarification and repair. The therapists shared the intention to learn a range of successful ways to strengthen future experiences with ASD between themselves and adolescents. CONCLUSION: The findings indicate that practitioners can benefit from altering their interaction styles, and that approaches for promoting successful interactions and in establishing rapport could be shared with other professionals in the future. <![CDATA[<b>Evaluating the awareness and knowledge of dyslexia among primary school teachers in Tshwane District, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100013&lng=en&nrm=iso&tlng=en BACKGROUND: Many developed countries have made rapid strides in addressing issues related to dyslexia but in the developing countries like South Africa, it has not received adequate attention. OBJECTIVES: The study therefore sought to evaluate awareness and knowledge of dyslexia among primary school teachers working in the government sector. METHODS: A phenomenological design was used and the study followed a mixed methods approach. The sample included 30 purposively selected primary school teachers. A questionnaire that consisted of true and false questions, closed-ended questions and open-ended questions was used to collect data. SPSS Version 22 and Excel Data Analyser 4 were used to analyse the quantitative data whereas the qualitative data was analysed thematically. RESULTS: The results indicated that the primary school teachers had a basic awareness and knowledge of dyslexia. Many of them were found to be using limited strategies in order to teach learners with dyslexia in their classrooms. CONCLUSION: Based on the findings, recommendations such as early diagnoses through testing, parental involvement, conducive learning environment and teachers' professional development regarding dyslexia were made. <![CDATA[<b>Working in the time of COVID-19: Rehabilitation clinicians' reflections of working in Gauteng's public healthcare during the pandemic</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100014&lng=en&nrm=iso&tlng=en BACKGROUND: When the coronavirus disease 2019 (COVID-19) pandemic manifested in South Africa, rehabilitation services were seriously affected. The consequences of these were wide-ranging: affecting service users, their families and caregivers, rehabilitation practices and practitioners as well as the integrity and sustainability of rehabilitation systems. OBJECTIVES: This study aimed to explore the nature and consequences of disruption caused by the pandemic, based on the experience of rehabilitation clinicians who were working in public healthcare facilities in Gauteng. METHODS: This was a phenomenology study that used critical reflection method. Trained and experienced in reflecting on barriers and enablers that affect their practices, a multidisciplinary group of rehabilitation clinicians captured their experience of working during the time of COVID-19. Data construction extended over 6 months during 2020. An inductive thematic analysis was performed using Taguette: an open-source qualitative data analysis tool. RESULTS: The main themes captured the disorder and confusion with its resultant impact on rehabilitation services and those offering these services that came about at the beginning of the pandemic. The importance of teamwork and leadership in rehabilitation also emerged as themes. Other themes related to having to approach work differently, working beyond professional scopes of practice and pandemic fatigue. CONCLUSION: The COVID-19 pandemic disrupted the way rehabilitation was being performed, creating an opportunity to reconceptualise, strengthen and improve rehabilitation services offered at public healthcare. The presence of effective leadership with clear communication, dependable multidisciplinary teams and clinicians with robust personal resources were strategies that supported rehabilitation clinicians whilst working during COVID-19. <![CDATA[<b>How education, training and development support the wellness of employees with disabilities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100015&lng=en&nrm=iso&tlng=en BACKGROUND: Existing wellness theories do not consider the unique needs of persons with disabilities. The lack of recognition of these needs in traditional wellness theories encouraged the researchers to develop a wellness framework for employees with disabilities (EWDs) to influence their wellness positively. OBJECTIVE: The aim of the study was to identify the wellness experiences of EWDs and explore how education, training and development can contribute towards the employees' wellness. METHOD: The qualitative study entailed semi-structured interviews with EWDs identified through snowball sampling. The study used the six-dimensional model of wellness that Bill Hettler developed in 1976 as a departure point to a holistic approach referring to social, intellectual, spiritual, physical, emotional and occupational wellness. The data collected was analysed through content analysis. RESULTS: The study found that EWDs experience various workplace challenges as limited or no changes have been made to accommodate their specific needs. This then has a negative influence on their wellness. Their wellness diminishes as they attempt to cope with circumstances rather than request assistance. They recognised development needs in all the wellness dimensions explored. Employers and other stakeholders, including customers, colleagues and the communities they serve, need development and capacity building on disability matters to ensure equal opportunities for EWDs. CONCLUSION: The study resulted in a Wellness framework for EWDs identifying the education, training and development needs that will contribute to their wellness. <![CDATA[<b>The lived experience of people with upper limb absence living in Uganda: A qualitative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100016&lng=en&nrm=iso&tlng=en BACKGROUND: The impact of upper limb absence on people's lived experiences is understudied, particularly in African countries, with implications for policy and service design. OBJECTIVES: The objective of this study was to explore the lived experiences of people with upper limb absence (PWULA) living in Uganda. METHOD: Informed by preliminary work, we designed a qualitative study employing semi-structured interviews to understand the experience of living with upper limb absence in Uganda. Seventeen adults with upper limb absence were individually interviewed and their interviews were analysed utilising thematic analysis. RESULTS: Seven themes illustrating the impact on the individual's life after amputation were identified and categorised into (1) living and adapting to life, (2) productivity and participation and (3) living within the wider environment. This study presents three main findings: (1) PWULA need psychological and occupational support services which are not available in Uganda, (2) PWULA want to work, but face multiple barriers to employment and has limited support, combined with the complex parenting and caring responsibilities, (3) the local Ugandan culture and social structures affect the everyday life of PWULA, both in positive and negative ways. CONCLUSION: This study provides information on the lived experiences of PWULA in Uganda which are lacking in the literature. People with upper limb absence face ableism and hardship underpinned by a lack of formal support structures and policies, which may in turn exacerbate the impact of upper limb absence on multiple facets of life. <![CDATA[<b>Monitoring disability inclusion: Setting a baseline for South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100017&lng=en&nrm=iso&tlng=en BACKGROUND: The progressive realisation of disability inclusion requires political will and commitment, and comprehensive monitoring is necessary to give a clear understanding of what needs to be addressed and to highlight the gaps and barriers to the achievement of social inclusion of people with disabilities. OBJECTIVES: This article uses an existing dataset to present a baseline assessment of inclusion for men and women with no, mild or moderate disability severity and with no or moderate affect difficulties in South Africa. METHODS: An existing dataset, capturing individual-level data for 8499 individuals, collected in 2019 across South Africa was analysed. Variables were utilised to represent aspects of nine domains of disability inclusion, and outcomes were compared using chi-squared tests (with Bonferroni adjustments) for groups categorised by disability severity and gender, and for affect severity and gender. RESULTS: Overall, inclusion levels declined with increasing disability severity, and there were fewer differences in inclusion levels between those with and without affect difficulties than for those with functioning difficulties (as measured using the Washington Group on Disability Statistics' Short Set of six questions on functioning. CONCLUSIONS: The article concludes by discussing several approaches to using the data to design policy responses, each of which results in a different range of domains that may initially be prioritised and targeted. <![CDATA[<b>A path toward disability-inclusive health in Zimbabwe Part 1: A qualitative study on access to healthcare</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100018&lng=en&nrm=iso&tlng=en BACKGROUND: On average, people with disabilities have greater healthcare needs, yet face a range of barriers in accessing care. OBJECTIVES: Our objectives were to explore the experiences of people with disabilities in accessing care and identify opportunities for the health system to be designed for inclusion in Zimbabwe. METHODS: In-depth qualitative interviews were conducted between May and June 2021 with 24 people with disabilities (identified through purposive sampling) and with 10 key informants from local and national health authorities (identified through expert recommendations). Interviews explored the experience of accessing healthcare prior to the coronavirus disease 2019 (COVID-19) pandemic. Interviews were transcribed, coded and thematically analysed. We used the disability-inclusive health 'Missing Billion' framework to map and inform barriers to inclusive healthcare and disparities in outcomes faced by people with disabilities. RESULTS: People with disabilities experienced difficulties accessing health services in Zimbabwe prior to COVID-19. These experiences were shaped by health literacy, self-stigma and affordability of services, which limited demand. Supply of health services was constrained by the perceived poor capacity of health workers to treat people with disabilities and discrimination. Inclusion was facilitated by clinic staff support of people with disabilities' access to medication through referral to mission hospitals and private clinics, and the lobbying of organisations of people with disabilities. CONCLUSION: Strategies to promote disability inclusion in healthcare include meaningfully engaging people with disabilities, investing in organisations of people with disabilities, protecting funding for disability inclusion, collecting and analysing disability-disaggregated data and strengthening a twin-track approach to health service provision. <![CDATA[<b>A path toward disability-inclusive health in Zimbabwe Part 2: A qualitative study on the national response to COVID-19</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100019&lng=en&nrm=iso&tlng=en BACKGROUND: People with disabilities are at higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes. Additionally, measures to mitigate COVID-19 transmission have impacted health service provision and access, which may particularly disadvantage people with disabilities OBJECTIVES: To explore the perspectives and experiences of people with disabilities in accessing health services in Zimbabwe during the pandemic, to identify perceived challenges and facilitators to inclusive health and key actions to improve accessibility METHODS: We used in-depth interviews with 24 people with disabilities (identified through purposive sampling) and with 10 key informants (from expert recommendation) to explore the impact of COVID-19 on access to health care. Interviews were transcribed, coded and thematically analysed. We used the disability-inclusive health 'Missing Billion' framework to map and inform barriers to inclusive health care during COVID-19 and disparities in outcomes faced by people with disabilities RESULTS: People with disabilities demonstrated good awareness of COVID-19 mitigation strategies, but faced difficulties accessing COVID-19 information and health services. Challenges to the implementation of COVID-19 guidelines related to a person's functional impairment and financial ability to do so. A key supply-side constraint was the perceived de-prioritisation of rehabilitation services. Further restrictions on access to health services and rehabilitation decreased an individual's functional ability and exacerbated pre-existing conditions CONCLUSION: The immediate health and financial impacts of the COVID-19 pandemic on people with disabilities in Zimbabwe were severe. Government departments should include people with disabilities in all communications and activities related to the pandemic through a twin-track approach, meaning inclusion in mainstream activities and targeting with specific interventions where necessary <![CDATA[<b>The Chaeli Campaign Journal Club: Strengthening evidence-based practice and contributing to practice-based evidence in under-resourced South African communities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202022000100020&lng=en&nrm=iso&tlng=en BACKGROUND: The Chaeli Campaign is a Cape Town based non-profit organisation offering programmes largely for children and youth with disabilities in diverse under-resourced communities in South Africa. Their therapy team established a Health Professions Council of South Africa accredited interdisciplinary journal club in January 2012, with the aim to improve the team's service to the community. OBJECTIVES: Our first objective was to make our practice more evidence-based through reading systematically and critically in our field. Our second objective was to write up and share some of our practices to contribute to the generation of practice-based evidence. METHOD: First-person action research was applied. The core group of participants over time comprised two occupational therapists, one physiotherapist, two speech therapists, two teachers and four community development workers. Nine iterative cycles of planning, action, review and revised planning have been implemented on an annual basis in this non-formal, long-term action research project. RESULTS: For over nine and a half years we have pre-read, discussed and completed evaluation questionnaires on 54 peer-reviewed journal articles, conducted 12 conference presentations and published three articles in accredited journals. Participants reported a broadened understanding of issues around disability, more reflective, contextually and culturally appropriate practice and improved interdisciplinary teamwork. CONCLUSION: The Chaeli Campaign journal club has built the capacity of therapists, teachers and community development workers to find, read, evaluate and use research evidence to improve their practice. It has also given participants the opportunity to ethically research, present and write up their grass roots interventions, thus contributing to locally applicable practise-based evidence. It is hoped that the sharing of our experience will assist and encourage other teams to start interdisciplinary journal clubs as a step towards facilitating two-way knowledge translation from evidence to practice and from practice to evidence.