The Sustainability of Self-Help Groups for Caregivers of Children With Disabilities in Kilifi, Kenya: The Changing Context of the COVID-19 Pandemic

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development Pub Date : 2025-04-12 DOI:10.1111/cch.70079

K. Bunning, J. K. Gona, S. W. Wanjala, S. Hartley

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Abstract

Background

Self-help groups offer an approach to empowering the lives of caregivers and their children with disabilities in settings of limited resources and support. A study was conducted over a 5-year period (2018–23) to assess the sustainability of 11 self-help groups in Kilifi, Kenya, during which there was the COVID-19 pandemic.

Methods

An integrated framework of action research and mixed methods was carried out over three stages. Stage 1: pre-pandemic, three self-help groups participated in focus group discussions. Template analysis structured around the five pillars of the WHO community-based rehabilitation matrix (CBR: health, education, livelihood, social, empowerment) was carried out. Stage 2: inter-pandemic, a bespoke questionnaire was administered to monitor each group. Descriptive statistics were reported (Questions 1–6) and the CBR template was applied to free-field responses (Questions 7–8). Stage 3: post-pandemic, a quality of life (QoL) questionnaire was administered to 21 caregivers of children with disabilities and a control group of 11 parents of typically developing children in the same geographical area and 8 caregivers pre- and post-pandemic. Descriptive statistics were applied.

Results

Pre-pandemic, there was food security, medicine availability, school attendance, social connections and livelihood. Group plans involved livelihood and social inclusion developments. However, member commitment, community attitudes and environmental conditions were ongoing challenges. Inter-pandemic, some socially distanced group meetings focus on COVID-19 prevention, livelihood and social support. Livelihood activities were affected variously with reported difficulties including food insecurity, school closures and reduced meeting frequency. Post-pandemic comparison between caregivers and a control group revealed overall significantly higher caregiver QoL scores. Pre- to post-pandemic evaluations demonstrated overall significantly improved caregiver QoL.

Conclusions

Despite the changing context brought by the COVID-19 pandemic, the self-help groups appear to have afforded some protection against the worst psychosocial and economic effects and helped to sustain the caregivers.

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查看原文本刊更多论文

肯尼亚基利菲残疾儿童照顾者自助团体的可持续性：COVID-19大流行的变化背景

背景：在资源和支持有限的情况下，自助小组提供了一种增强照顾者及其残疾儿童生活能力的方法。一项为期5年（2018-23年）的研究评估了肯尼亚基利菲11个自助团体的可持续性，在此期间发生了COVID-19大流行。方法采用综合行动研究框架和混合方法，分三个阶段进行。第一阶段：大流行前，三个自助小组参加了焦点小组讨论。围绕卫生组织社区康复矩阵（CBR：健康、教育、生计、社会、赋权）的五个支柱进行了模板分析。第2阶段：大流行期间，对每一组进行定制问卷监测。报告描述性统计（问题1-6），并将CBR模板应用于自由场回答（问题7-8）。第3阶段：大流行后，对21名残疾儿童的照料者和11名来自同一地理区域的正常发育儿童的父母以及大流行前后的8名照料者组成的对照组进行了生活质量问卷调查。采用描述性统计。结果疫情前，粮食安全、药品可及性、学校出勤率、社会关系和生计状况良好。团体计划涉及生计和社会融合发展。然而，成员的承诺，社区的态度和环境条件是持续的挑战。大流行期间，一些社交距离小组会议侧重于COVID-19预防、生计和社会支持。生计活动受到不同程度的影响，据报出现粮食不安全、学校关闭和会议频率减少等困难。大流行后护理人员和对照组之间的比较显示，护理人员的生活质量得分总体上显着提高。大流行前后的评估显示，护理人员的生活质量总体上显著改善。尽管2019冠状病毒病大流行带来了环境变化，但自助团体似乎提供了一些保护，免受最严重的社会心理和经济影响，并帮助维持照顾者。

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来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.