Scielo RSS <![CDATA[African Journal of Disability (Online)]]> http://www.scielo.org.za/rss.php?pid=2226-722020210001&lang=en vol. 10 num. lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Altered cervical posture kinematics imposed by heavy school backpack loading: A literature synopsis (2009-2019)</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100001&lng=en&nrm=iso&tlng=en BACKGROUND: Habitual school backpack carriage causes neuro-musculoskeletal vertebral, shoulder and hand pain; deviated posture compromised cardiopulmonary function and proprioception. OBJECTIVE: Present a novel literature summary of the influence of backpack carriage associated with deviated cervical posture and compromised pulmonary function. METHOD: An electronic literature appraisal adopting the Preferred Reporting Items for Systematic Reviews, using Google Scholar, Science Direct, EMBASE, AMED, OVID, PubMed and Sabinet search engines, was instituted during 2009-2019. Key search words: schoolbag, backpack, carriage, cervical posture and children. The quality of the studies was assessed using the Downs and Black Appraisal Scale. RESULTS: 583 records were initially identified which was reduced to 14 experimental and observational studies. A total of 1061 participants were included across the 14 studies, with an average age of 11.5 ± 1.3 years, body mass of 37.8 ± 6.6 kilograms (kg), height of 1.41 ± 0.05 meters (m), backpack mass of 5.2 ± 0.9 kg and percentage backpack mass to child's body mass of 13.75%. The studies mean rating according to the Downs and Black Appraisal Scale was 76.3%. The average craniovertebral angle (CVA) was 53.9° ± 14.6° whilst standing without carrying a backpack was reduced to 50.4° ± 16.4° when loaded (p < 0.05). Backpack loads carried varied from 5% - 30% of the participant's body mass that produced a mean CVA decline of 3.5°. CONCLUSION: Backpack carriage alters cervical posture, resulting in smaller CVA and compromised pulmonary function. There is no consensus of the precise backpack mass that initiates postural changes. Girls' posture begin changes when carrying lighter backpacks as compared to boys of the same age strata. <![CDATA[<b>Using selected behaviour modification practices to enhance reinforcement of reading abilities among dyslexic learners in Kenya</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100002&lng=en&nrm=iso&tlng=en BACKGROUND: Dyslexic learners have difficulties in accurate and fluent word recognition and poor spelling and decoding abilities. OBJECTIVE: The present study investigated the use of selected behaviour modification practices to enhance reinforcement of reading abilities amongst dyslexic learners in primary schools in Kenya. METHODS: The Solomon four research design was adopted. A sample size of 229 dyslexic learners in four selected schools was obtained using purposive sampling technique. The tools used were the Bangor Dyslexia Test and a short reading comprehension test. Internal validity of the constructs was tested using the Kaiser-Meyer-Oklin measure of sampling adequacy (KMO Index) and the Bartlett's test of sphericity. The reliability of the questionnaires was ascertained using Cronbach's alpha and internal consistencies of 0.673-0.807 were reported RESULTS: The findings reported a statistical significant difference between pre-test and post-test scores of the experiment group 1, t (48) = -15.059, p < 0.01, implying that a significant effect was found in the use of behaviour modification strategies in improving learner English language reading skills. The regression model explained 54.7% (R² = 0.547) of the variability in the level of English language reading abilities amongst primary school learners with dyslexia. CONCLUSION: The study concludes that coaching behaviour modification practice had the highest influence on English language reading abilities as compared to prompting, shaping and modelling practices. The study recommended training of teachers on the use of behaviour modification practices to improve dyslexic learners' reading ability. <![CDATA[<b>Cognitive behaviour therapy-based early intervention and prevention programme for anxiety in South African children with visual impairments</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100003&lng=en&nrm=iso&tlng=en BACKGROUND: Anxiety is the most common psychological difficulty reported by youth worldwide and may also be a significant problem for children with visual impairments. Cognitive behaviour therapy (CBT) interventions have proven to be successful in treating childhood anxiety; however, mostly these are not suitable for children with visual impairments, as the materials used are not sufficiently accessible to this population. OBJECTIVES: The present study was motivated by the dearth of research on this topic and aimed to examine the effects of a specifically tailored, group-based, universally delivered, CBT intervention for anxiety in children with visual impairments and to examine the influence of three predictor variables (i.e. age, gender and level of visual impairment) on prevention effects. METHOD: A randomised wait-list control group design with pre-, post- and follow-up intervention measures was employed. The final sample of 52 children (aged 9-14) with varying degrees of visual impairment received the anxiety intervention. Participants were followed over a course of 10 months during which their anxiety symptoms were assessed quantitatively at four time points (T1-T4). RESULTS: The results indicated that the anxiety intervention did not significantly decrease symptoms of anxiety within the intervention groups. However, the intervention appeared beneficial for girls, younger children and legally blind participants. CONCLUSION: This study demonstrated how CBT interventions can be adapted for use in children with visual impairments. Results obtained provide a foundation upon which future updated anxiety intervention programmes can be built, meeting the need for further research in this area. <![CDATA[<b>Perspectives on access and usage of assistive technology by people with intellectual disabilities in the Western Cape province of South Africa: Where to from here?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100004&lng=en&nrm=iso&tlng=en BACKGROUND: Whilst assistive technology (AT) can play an important role to improve quality of life, health inequity regarding access to appropriate AT for people with intellectual disabilities (ID) is still very much present especially in low resource countries OBJECTIVES: This study focused on exploring factors that influence access to and continued use of AT by people with ID in the Western Cape province of South Africa and to suggest potential implications of these findings and actions required to promote access to AT METHOD: A qualitative approach was used to explore the experiences of people with ID and providers of AT. Face-to-face interviews with 20 adults with mild to profound ID, and 17 providers of AT were conducted and the data were analysed thematically RESULTS: People with ID within the study setting faced many challenges when trying to access AT and for those who managed to acquire AT, its continued usage was influenced by both personal characteristics of the user and environmental factors. Important factors that influence AT access and use for people with ID found in this study were (1) attitudes from the community, (2) knowledge and awareness to identify AT need and (3) AT training and instructions to support the user and care network CONCLUSION: With the perspectives of both the providers and users of AT, this study identified priority factors, which could be addressed to improve AT access and use for people with ID in the Western Cape province <![CDATA[<b>Sexual and reproductive health services utilisation amongst in-school young people with disabilities in Ghana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100005&lng=en&nrm=iso&tlng=en BACKGROUND: Sexual and reproductive health (SRH) of young people including those with disabilities is a major public health concern globally. However, available evidence on their use of sexual and reproductive health services (SRHS) is inconsistent. OBJECTIVE: This study investigated utilisation of SRHS amongst the in-school young people with disabilities (YPWDs) in Ghana using the healthcare utilisation model. METHODS: Guided by the cross-sectional study design, a questionnaire was used to obtain data from 2114 blind and deaf pupils or students in the age group 10-24 years, sampled from 15 purposively selected special schools for the deaf and the blind in Ghana. RESULTS: About seven out of every 10 respondents had ever utilised SRHS. The proportion was higher amongst the males (67.8%) compared with the females (62.8%). Young persons with disabilities in the coastal (OR = 0.03, 95% CI = 0.01-0.22) and middle (OR = 0.06, 95% CI = 0.01-0.44) zones were less likely to have ever utilised SRHS compared with those in the northern ecological zone. The blind pupils or students were more likely to have ever utilised SRHS than the deaf (OR = 1.45, 95% CI = 1.26-3.11. CONCLUSIONS: Generally, SRHS utilisation amongst the in-school YPWDs in Ghana is high but significantly associated with some predisposing, need and enabling or disabling factors. This underscores the need for policymakers to consider in-school YPWDs as a heterogeneous group in the design and implementation of SRHS programmes. The Ghana Education Service in collaboration with the Ghana Health Service should adopt appropriate pragmatic measures and targeted interventions in the special schools to address the SRH needs of the pupils or students. <![CDATA[<b>Barriers and facilitators to participation for children and adolescents with disabilities in low- and middle-income countries - A scoping review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100006&lng=en&nrm=iso&tlng=en BACKGROUND: Research has shown that all children and adolescents have the right to participate in their everyday life. However, little is known about what impacts the participation of children and adolescents with disabilities living in low-and middle-income countries OBJECTIVE: The present study undertakes a scoping review of research to synthesise the current literature about barriers and facilitators to participation in everyday life for children and adolescents with disabilities living in low- and middle-income countries METHOD: A scoping review was conducted. The databases Psyc INFO, MEDLINE, CINAHL, Pubmed, ERIC and African Wide information were searched for studies published between 2001 and April 2018. Data was analysed using deductive content analysis. The barriers and facilitators to participation were categorised into personal factors, social factors, environmental factors, and policy and programme factors RESULT: In the end, 17 articles were included for data extraction as they mentioned barriers and facilitators to participation for children and adolescents with disabilities. Most of the reviewed studies reported on barriers to participation. Only one of the studies was performed in a country classified as a low-income country; all other studies were performed in middle-income countries. The results indicate that some factors, especially social factors, could be perceived as both facilitators and barriers to participation CONCLUSION: There is a lack of studies describing barriers and facilitators in low- and middle- income countries. Barriers and facilitators in proximity to the child and family are most frequently described in the literature <![CDATA[<b>Malawian mothers' experiences of raising children living with albinism: A qualitative descriptive study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100007&lng=en&nrm=iso&tlng=en BACKGROUND: Albinism in humans is characterised by a reduced amount of pigment (melanin) present in the skin, hair follicles and the eye; approximately 7000-10 000 Malawians of all ages are affected. Children with these features face extreme forms of human rights abuses, even death. OBJECTIVES: This study aims to describe Malawian mothers' experiences, perceptions and understanding of raising children with albinism (CWA). METHODS: The study was conducted in 2018 using a qualitative descriptive design, with purposive sampling and voluntary participation. Mothers, 18 years and older, who had given birth to a CWA and who attended the dermatology clinic of a local public hospital participated. An interview guide used during standardised, open-ended interviews was translated from English to Chichewa using forward and backward translation. Interviews were conducted in Chichewa, audio recorded, transcribed and forward and back translated from English to Chichewa. Thematic data analysis was employed. RESULTS: The mean age of participants (N = 10) was 33 years; two had albinism. Emerging themes confirmed the existence of myths and stereotypes regarding albinism but from the mothers' perspectives. : (1) some experiences of emotional pain, initially, but also love and acceptance of their children, despite adverse reactions of others; (2) their experiences of stigmatisation of their children and themselves, and of intended harm to their children, and (3) their own lack of knowledge and understanding of albinism. CONCLUSION: In our limited study, mothers' self-reported experiences of raising CWA in Malawi highlight the need for educational programmes on albinism at national level, particularly for families with a CWA, health professionals and educators. <![CDATA[<b>'Satan is holding your tongue back': Stuttering as moral failure</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100008&lng=en&nrm=iso&tlng=en BACKGROUND: The last decade has seen researchers and speech-language pathologists employ and advocate for a disability studies approach in the study of the lived experiences of people who stutter and in the design of interventions and treatment approaches for such individuals. Joshua St. Pierre, one of the few theorists to explore stuttering as a disability, mentions as a key issue the liminal nature of people who stutter when describing their disabling experiences. OBJECTIVES: This article aimed to build on the work of St. Pierre, exploring the liminal nature of people who stutter. METHOD: Drawing on my personal experiences of stuttering as a coloured South African man, I illuminated the liminal nature of stuttering. RESULTS: This analytic autoethnography demonstrates how the interpretation of stuttering as the outcome of moral failure leads to the discrimination and oppression of people who stutter by able-bodied individuals as well as individuals who stutter. CONCLUSION: As long as stuttering is interpreted as the outcome of moral failure, the stigma and oppression, as well as the disablism experience by people who stutter, will continue to be concealed and left unaddressed. <![CDATA[<b>Structural validity and internal consistency of Picture My Participation: A measure for children with disability</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100009&lng=en&nrm=iso&tlng=en BACKGROUND: Picture My Participation (PMP) intended to measure participation, defined as attendance and involvement in everyday situations, of children with disabilities, particularly in low- and middle-income settings OBJECTIVES: To explore structural validity of PMP by identifying possible subcomponents in the attendance scale and examining internal consistency of the total score and each subcomponent METHOD: A picture-supported interview was conducted with 182 children, 7-18 years, with and without intellectual disability (ID). Frequency of attendance in 20 activities was rated on a four-point Likert scale (never, seldom, sometimes and always RESULTS: An exploratory principal component analysis extracted four subcomponents: (1) organised activities, (2) social activities and taking care of others, (3) family life activities and 4) personal care and development activities. Internal consistency for the total scale (alpha = 0.85) and the first two subcomponents (alpha = 0.72 and 0.75) was acceptable. The two last subcomponents alpha values were 0.57 and 0.49 CONCLUSION: The four possible subcomponents of PMP can be used to provide information about possible domains in which participation and participation restrictions exist. This study provided further psychometric evidence about PMP as a measure of participation. The stability and the utility of these subcomponents needed further exploration <![CDATA[<b>Family disability, poverty and parenting stress: Analysis of a cross-sectional study in Kenya</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100010&lng=en&nrm=iso&tlng=en BACKGROUND: Households with a disabled member, be they a caregiver or a child, are poorer than households not affected by disability. Poverty, caregiving as a person with a disability and being the caregiver of a child with a disability can lead to increased parenting stress OBJECTIVES: The objective of this study was to examine whether parenting stress experienced by caregivers in a household with a disabled member is greater when the disabled member is the caregiver, or the child, and how much of these respective relationships is explained by poverty. METHOD: We collected cross-sectional data using a demographic survey, the Washington Group Questions on adult disability, the 10 Questions on child disability and the Parenting Stress Index-Short Form, from 465 caregivers enrolled in a non-governmental child development programme in Kenya. RESULTS: Households with a disabled member were poorer than households without a disabled member. Parenting stress of disabled caregivers was higher than parenting stress of non-disabled caregivers; however, this relationship disappeared when socio-economic status was controlled for. Caregivers of disabled children were more stressed than caregivers of non-disabled children, and this effect was not explained by differences in socio-economic status. CONCLUSION: Our findings highlight the importance of developing a comprehensive understanding of the stressors facing households with a disabled member, particularly if that member is a child, so that supportive interventions can adequately cater to the needs of caregivers, and their children, in the context of poverty. <![CDATA[<b>African families' and caregivers' experiences of raising a child with intellectual disability: A narrative synthesis of qualitative studies</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100011&lng=en&nrm=iso&tlng=en BACKGROUND: The prevalence of intellectual disability was high in Africa, particularly amongst low socio-economic communities. Despite this, there was limited literature on primary caregivers and parents of people with intellectual disabilities regarding their experience raising an individual with the condition, especially within the African context. OBJECTIVES: The aim of the current systematic review was to investigate experiences of caregivers and parents of children with intellectual disability in Africa. METHOD: We used strict eligibility criteria to identify suitable studies. We identified Medical Subject Headings (MeSH) terms and other keyword terms and, after conducting searches in electronic databases, identified articles that met the inclusion criteria for articles published between 1975 and the end of 2019. RESULTS: 164 articles were assessed for eligibility. Nine studies met the review's criteria. Six major themes emerged: understanding of intellectual disability (ID), worries about the future, burden of care, lack of services, coping strategies and stigma and discrimination CONCLUSION: Caregivers of children with intellectual disability in Africa faced substantial challenges. Current findings suggested that there was the need for both formal and alternative healthcare workers to work together towards an understanding and management of intellectual disability in Africa. <![CDATA[<b>Creating inclusive Performing Arts practices for development of youth with disabilities: A critical ethnographic study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100012&lng=en&nrm=iso&tlng=en BACKGROUND: Youth with disabilities are a marginalised group in society. This marginalisation traps them and prevents their full participation in social and economic development. OBJECTIVE: This study sought to understand how exposure to the Performing Arts facilitates the inclusion of youth with disabilities. METHODS: The study adopted a qualitative research approach, utilising critical ethnography. Primary data consisted of three focus group discussions with youth with disabilities, and an in-depth interview with a performer with disability. Thematic data analysis was conducted RESULTS: Four themes emerged. Theme 1, Blown away, shares the experiences of youth who attended Artscape Theatre. Theme 2, I can do it, you can do it, describes their career aspirations. Theme 3, Embracing hope, identifies the social and life skills learned through visited Artscape. Theme 4, Long way to go, presents the factors that influence the participation of youth with disabilities in the Performing Arts. While their experiences are diverse, and their impairments are unique, contact with the Performing Arts supported social and economic inclusion, and triggered empowerment of youth with disabilities. Insufficient accessible and available transportation is the most notable barrier to accessing development opportunities. CONCLUSION: Exposure to the Performing Arts provides important skills development and social opportunities for disabled youth. It is up to the 'keepers' of the Performing Arts - those in administration and management - to realign the Performing Arts in a way that can best benefit everyone. <![CDATA[<b>Voices of children with intellectual disabilities on participation in daily activities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100013&lng=en&nrm=iso&tlng=en BACKGROUND: Participation in daily activities is expressed as a human right. Full participation of children with disabilities in daily activities creates optimal opportunities for learning and development. Previous studies have focused primarily on proxy ratings of participation of children with intellectual disabilities in daily activities. However, little is known about how the children rate barriers and facilitators to their participation in everyday activities. OBJECTIVES: To identify barriers to and facilitators for everyday activities as experienced by children with intellectual disabilities from low- and middle-income countries and high-income countries. The research questions were as follows: 'what barriers to participation do children with disabilities experience in everyday activities?' and 'what facilitators to participation do children with disabilities experience in everyday activities?' METHOD: A qualitative content analyses was used in this study, and individual interviews were conducted with 49 children with intellectual disabilities. The interviews were performed using pictures. The children also selected the most important activities and described in their own words the facilitators and barriers relevant to being able to perform the activities. RESULTS: The most important activities were organised leisure activities, formal learning at school, taking care of other family members and family mealtimes. Self-reported barriers identified were personal functioning, social exclusion and lack of resources. The identified facilitators included satisfaction, personal capability, being included and having access to resources. CONCLUSION: These findings provide important knowledge about the factors to consider in the development of interventions, aimed at improving the participation of children with intellectual disabilities. <![CDATA[<b>'The world is not only for hearing people - It's for all people': The experiences of women who are deaf or hard of hearing in accessing healthcare services in Johannesburg, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100014&lng=en&nrm=iso&tlng=en BACKGROUND: Despite legal and adopted frameworks purporting access to healthcare and rehabilitation services, which are both a human right and key to developmental issues, women who are deaf and/or hard of hearing (HoH) are still excluded and experience barriers when accessing healthcare services. Largely, this is attributed to communication barriers between healthcare professionals and women who are deaf and/or HoH. There have been limited research studies carried out on women with invisible disabilities, such as deafness, especially amongst African women. OBJECTIVES: This study sought to gain insights into the communication experiences of women who are deaf or HoH when accessing public healthcare services in hospitals in Johannesburg. METHODS: A qualitative research study employing semi-structured interviews with 10 African women who are deaf and/or HoH residing in Johannesburg, South Africa and attending government healthcare facilities was conducted. Participants were purposively selected. Data were analysed using thematic analysis. RESULTS: Data revealed the following themes: communication barriers resulting in compromised quality of care and infringement on participants' right to confidentiality; accommodation that is not accommodative and negative attitudes of healthcare professionals CONCLUSION: The findings of this study confirm the alienating, exclusion, marginalisation, discrimination, invisibility, lack of independence and autonomy of women who are deaf and/or HoH when accessing healthcare services. Therefore, this study argues for a need for the conscientisation of healthcare professionals on communication needs of persons who are deaf and/or HoH. This has implications for the implementation of training programmes that will address communication, reasonable accommodation and attitudes of healthcare professionals. <![CDATA[<b>Transitioning to a life with disability in rural South Africa: A qualitative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100015&lng=en&nrm=iso&tlng=en BACKGROUND: Adjustment to the onset of disability has complex reverberations relating to both socially engendered disadvantage and the realities of functional limitation. Pre-existing ways of understanding disability can meaningfully shape this experience. OBJECTIVE: This study aimed to provide an exploratory understanding of the experience of becoming disabled in a low-income, under-served, rural South African community. In particular, it was interested in how people with disabilities constructed their struggle within the conceptual split between disadvantage caused by 'malfunctioning' bodies (a 'medical model' view) and that caused by social organisation (a 'social model' view. METHODS: Seven people between the ages of 39 and 47 who had acquired a physical disability within the last 4 years were recruited in a rural area of Limpopo province, South Africa. Semi-structured face-to-face interviews were conducted, and the resulting data were thematically analysed. The authors were positioned as both 'insiders' and 'outsiders' to the participants and sought to use this orientation to best understand and stay faithful to participants' views while simultaneously applying participant's experiences to conceptual knowledge in disability studies. RESULTS: Four themes emerged: (1) emotional impact of onset of disability, (2) being introduced to disablist prejudice, (3) being required to take on a 'disabled' identity and (4) socio-economic implications of becoming disabled. The findings reflected a complex set of adverse experiences in the lives of the participants, spanning disadvantages based on embodied, cultural, relational and environmental factors, which were superimposed on existing, generalised poverty in their local communities. Participants made sense of their predicament in multiple, evolving ways. CONCLUSION: This study contributes to the understanding of the complex predicaments, and sense-making, of persons who have acquired a disability in a rural, impoverished Global South environment. <![CDATA[<b>Impact of prostheses on quality of life and functional status of transfemoral amputees in Tanzania</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100016&lng=en&nrm=iso&tlng=en BACKGROUND: The rise of diabetes and traumatic injury has increased limb loss-related morbidity in low- and middle-income countries (LMICs). Despite this, the majority of amputees in LMICs have no access to prosthetic devices, and the magnitude of prosthesis impact on quality of life (QOL ) and function has not been quantified. OBJECTIVES: Quantify the impact of prostheses on QOL and function in Tanzanian transfemoral amputees. METHOD: A prospective cohort study was conducted. Transfemoral amputees at Muhimbili Orthopaedic Institute were assessed twice before and three times after prosthetic fitting using EuroQol-5D-3L (EQ-5D-3L), Prosthetic Limb Users Survey of Mobility (PLUS-M), 2-minute walk test (2MWT) and Physiologic Cost Index (PCI). Data were analysed for change over time. Subgroup analysis was performed for amputation aetiology (vascular or non-vascular) and prosthesis use RESULTS: Amongst 30 patients, EQ-5D, PLUS-M and 2MWT improved after prosthesis provision (p < 0.001). EuroQol-5D increased from 0.48 to 0.85 at 1 year (p < 0.001). EuroQol-5D and 2MWT were higher in non-vascular subgroup (p < 0.030). At 1-year, 84% of non-vascular and 44% of vascular subgroups reported using their prosthesis (p = 0.068). CONCLUSION: Prosthesis provision to transfemoral amputees in an LMIC improved QOL and function. This benefit was greater for non-vascular amputation aetiologies. Quality of life and function returned to pre-prosthesis levels with discontinued use of prosthesis. <![CDATA[<b>Education of students with intellectual disabilities at Technical Vocational Education and Training institutions in Botswana: Inclusion or exclusion?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100017&lng=en&nrm=iso&tlng=en BACKGROUND: Despite a commitment to achieving inclusion for all by the Botswana government, the enrolment of students with disabilities in Botswana's Technical and Vocational Education and Training (TVET) institutions is still fraught with confusion as reflected by its practice and implementation. Exclusionary rather than inclusive practices remain prevalent. OBJECTIVE: This study explores students with mild intellectual disabilities' experiences of inclusion or exclusion in TVET institutions using key concepts of the Capability Approach. METHOD: A phenomenological interpretive qualitative design was adopted. One government, technical vocational institution, offering programmes for students with disabilities in Botswana was conveniently selected. Fourteen students were purposefully selected from this institution based on the criterion that they were students with mild intellectual disabilities. Individual interviews served as the data collection method to enable participants to voice their experiences of inclusion or exclusion at the TVET institution. Thematic content analysis was utilised to analyse the data. RESULTS: It was found that whilst students with mild intellectual disabilities are offered an opportunity to enrol at TVET institutions, they are faced with social and epistemological exclusion, deliberate marginalisation, labelling and emotional abuses CONCLUSION: These negative experiences hinder students' achievement by limiting their capabilities. <![CDATA[<b>Family functioning and stroke: Family members' perspectives</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100018&lng=en&nrm=iso&tlng=en BACKGROUND: Stroke survivors often experience permanent or temporal physical and psychological stroke impairments. As a result, stroke survivors are often discharged to recover in their home environments and are cared for mostly by family members. Additionally, caregiving roles are often assumed without any formal training or preparation whatsoever. This can transform the family's functional patterns due to adjustments that are made to accommodate the caregiving needs. OBJECTIVES: To explore the experiences and influence of stroke on families and on family functioning. METHOD: Explorative descriptive qualitative research design through the use of in-depth interviews were employed as the means of data collection. The sample size was eight (8) family members and was guided by the saturation point. Data was thematically analysed RESULTS: Four themes emerged from the analysis: 1) reduced interactions with family members due to communication barriers, 2) the influence of stroke on family relationships, 3) emotional engagement in caring for a family member with a stroke and 4) financial implications of stroke on family functioning. This study found that stroke can influence the family functioning negatively as family members may be forced to change their functional patterns. However, some family members reported positive experiences, they developed a supportive structure to accommodate the new life of the stroke survivor. CONCLUSION: Using the McMaster's model of family functioning, this study found that stroke is a threat to the six dimensions of family functioning: 1) problem-solving, 2) communication, 3) roles, 4) affective responsiveness, 5) affective involvement, and 6) behaviour control.. <![CDATA[<b>African families' and caregivers' experiences of raising a child with intellectual disability: A narrative synthesis of qualitative studies</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100019&lng=en&nrm=iso&tlng=en BACKGROUND: The prevalence of intellectual disability was high in Africa, particularly amongst low socio-economic communities. Despite this, there was limited literature on primary caregivers and parents of people with intellectual disabilities regarding their experience raising an individual with the condition, especially within the African context OBJECTIVES: The aim of the current systematic review was to investigate experiences of caregivers and parents of children with intellectual disability in Africa METHOD: We used strict eligibility criteria to identify suitable studies. We identified Medical Subject Headings (MeSH) terms and other keyword terms and, after conducting searches in electronic databases, identified articles that met the inclusion criteria for articles published between 1975 and the end of 2019 RESULTS: 164 articles were assessed for eligibility. Nine studies met the review's criteria. Six major themes emerged: understanding of intellectual disability (ID), worries about the future, burden of care, lack of services, coping strategies and stigma and discrimination CONCLUSION: Caregivers of children with intellectual disability in Africa faced substantial challenges. Current findings suggested that there was the need for both formal and alternative healthcare workers to work together towards an understanding and management of intellectual disability in Africa <![CDATA[<b>Barriers to and facilitators of employment of persons with disabilities in low- and middle-income countries: A scoping review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100020&lng=en&nrm=iso&tlng=en BACKGROUND: Unemployment rates for persons with disabilities in low- and middle-income countries (LMICs) are high. This is despite the call to action by the United Nations Convention on the Rights of Persons with Disabilities and Sustainable Development Goals aimed at improving the economic well-being of the marginalised. To improve the employment outcomes of persons with disabilities in these countries, factors that facilitate and hinder employment should be explored. OBJECTIVES: This study explored barriers to and facilitators of employment for persons with disabilities in LMICs through a scoping review. METHODS: A search strategy included a systematic search of nine databases using specific keywords. The International Classification of Functioning, Disability and Health (ICF) framework was used as a conceptual framework and barriers and facilitators were reported according to the domains of the ICF. Articles published between 2008 and 2020 were reviewed using a predefined criteria. RESULTS: Thirty-two studies were identified in the review. Factors were identified in all domains of the ICF: (1) body function and body structure (12; 39%); (2) activities and participation (13; 42%); (3) personal factors (23; 74%); (4) environmental factors (27; 84% CONCLUSION: Factors that hinder and facilitate the participation of persons with disabilities in LMICs were mainly found in the environment, with personal factors also influencing participation. The presence of negative attitudes and lack of services mainly in health and transport were major factors within the environment whilst personals factors included the lack of educational qualifications and skills. These results indicate the importance of consideration of contextual factors when developing intervention strategies aimed at facilitating the employment of persons with disabilities in LMICs. <![CDATA[<b>Erratum: The life stories and experiences of the children admitted to the Institute for Imbecile Children from 1895 to 1913</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2226-72202021000100021&lng=en&nrm=iso&tlng=en BACKGROUND: Unemployment rates for persons with disabilities in low- and middle-income countries (LMICs) are high. This is despite the call to action by the United Nations Convention on the Rights of Persons with Disabilities and Sustainable Development Goals aimed at improving the economic well-being of the marginalised. To improve the employment outcomes of persons with disabilities in these countries, factors that facilitate and hinder employment should be explored. OBJECTIVES: This study explored barriers to and facilitators of employment for persons with disabilities in LMICs through a scoping review. METHODS: A search strategy included a systematic search of nine databases using specific keywords. The International Classification of Functioning, Disability and Health (ICF) framework was used as a conceptual framework and barriers and facilitators were reported according to the domains of the ICF. Articles published between 2008 and 2020 were reviewed using a predefined criteria. RESULTS: Thirty-two studies were identified in the review. Factors were identified in all domains of the ICF: (1) body function and body structure (12; 39%); (2) activities and participation (13; 42%); (3) personal factors (23; 74%); (4) environmental factors (27; 84% CONCLUSION: Factors that hinder and facilitate the participation of persons with disabilities in LMICs were mainly found in the environment, with personal factors also influencing participation. The presence of negative attitudes and lack of services mainly in health and transport were major factors within the environment whilst personals factors included the lack of educational qualifications and skills. These results indicate the importance of consideration of contextual factors when developing intervention strategies aimed at facilitating the employment of persons with disabilities in LMICs.