African Journal of Disability最新文献

{"title":"Leaving no one behind: Disability and HIV prevention, knowledge among adults in a population cohort in Uganda.","authors":"Joseph O Mugisha, Ronald Makanga, Beatrice W Kimono, Ivan Kasamba","doi":"10.4102/ajod.v13i0.1497","DOIUrl":"10.4102/ajod.v13i0.1497","url":null,"abstract":"<p><strong>Background: </strong>People with disability are a vulnerable population and are at a high risk of acquiring human immunodeficiency virus (HIV) infection.</p><p><strong>Objectives: </strong>We investigated the association between severity of disability and not having knowledge of any HIV prevention method among adults in Uganda.</p><p><strong>Method: </strong>Between January 2015 and December 2015, data were collected within a general population in Uganda, on six domains of disability based on the Washington Group Short Set on Functioning. In addition, routine data on socio-demographic factors and other HIV-related data were collected among adults aged 16 years and above. A continuum of functioning was developed: without disability, mild, moderate and severe. Bivariate and multivariate associations of disability and not knowing any HIV prevention method were fitted using logistic regression models.</p><p><strong>Results: </strong>A total of 3331 adults (60.4% female) were included. Of these, 14.5% (<i>n</i> = 482) were classified as having either moderate or severe disability, and this proportion exponentially increased with age (<i>p</i> < 0.001). Overall, 4.2% (<i>n</i> = 140) reported not knowing any HIV prevention method, with a slightly higher proportion among females than males (3.1% in males, 4.9% in females). Compared to people with no disability, those with moderate or severe disability were 5 times more unlikely to know any HIV prevention methods (adjusted odds ratio = 5.45, 95% confidence interval = 3.25-9.13, <i>p</i> < 0.001). Additionally, the combined effect of moderate and severe disability and none/incomplete primary education increased the likelihood of not knowing HIV prevention methods over and beyond their separate effects (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Effective HIV prevention strategies must integrate best practices that target people with disabilities.</p><p><strong>Contribution: </strong>These findings contribute to the evidence of the lack of HIV prevention knowledge among people with disabilities in general populations.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1497"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards evidence-informed action in promoting disability inclusion in Africa.","authors":"Michelle Botha, Callista K Kahonde","doi":"10.4102/ajod.v13i0.1590","DOIUrl":"10.4102/ajod.v13i0.1590","url":null,"abstract":"","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1590"},"PeriodicalIF":1.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of students with disabilities in technical vocational education and training colleges.","authors":"Precious Muzite, Velisiwe Gasa","doi":"10.4102/ajod.v13i0.1477","DOIUrl":"10.4102/ajod.v13i0.1477","url":null,"abstract":"<p><strong>Background: </strong>Technical Vocational Education and Training (TVET) in South Africa is often viewed as the 'Cinderella' of higher education, with many matriculating students choosing mainstream universities instead. This preference stems from stigma and misconceptions that label TVET students - often from poorer working-class backgrounds - as less intelligent than their university peers. The lived experiences of students with physical and learning disabilities in these institutions are particularly underexplored.</p><p><strong>Objectives: </strong>This study aimed to illuminate the experiences of students with disabilities at five TVET colleges in Gauteng, South Africa.</p><p><strong>Method: </strong>Using a phenomenological approach, the study conducted story exercises and individual interviews with a convenience sample of 40 students with disabilities.</p><p><strong>Results: </strong>The findings reveal that TVET education predominantly serves black students from marginalised backgrounds, with students with disabilities facing significant barriers in accessing both the curriculum and the physical environments of the colleges. Despite numerous challenges, a resilient narrative emerged among these students, rooted in African traditional values.</p><p><strong>Conclusion: </strong>This article contributes to knowledge on disability inclusion in higher education by showcasing the challenges and resilience of students with disabilities in South Africa's TVET system.</p><p><strong>Contribution: </strong>The study employed innovative methodologies, such as picture stories, to co-create knowledge with students living with disabilities.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1477"},"PeriodicalIF":1.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice of clean intermittent catheterisation in children with spina bifida: A scoping review.","authors":"Denis Nono, Andrew S Ssemata, Femke Bannink Mbazzi, Janet Seeley","doi":"10.4102/ajod.v13i0.1473","DOIUrl":"10.4102/ajod.v13i0.1473","url":null,"abstract":"<p><strong>Background: </strong>Spina bifida is a congenital neural tube defect, where there is incomplete formation of the spinal cord and vertebrae, resulting in abnormal development of the neural tube. This affects bladder function and urinary incontinence. Clean Intermittent Catheterization (CIC) is used to manage bladder and bowel management.</p><p><strong>Objectives: </strong>This study aims to scope evidence on the facilitators and barriers to usage and practice of CIC in children with spina bifida in low-income countries.</p><p><strong>Method: </strong>We searched databases including PubMed, Web of Science and SCOPUS, and screened articles for inclusion following the PRISMA-ScR guidelines. The search terms included 'Spina Bifida ([continence management] AND [clean intermittent catheterisation]) AND ([barriers to Clean Intermittent Catheterisation] OR [Low Income Countries]) OR (myelomeningocele)'. Full-text assessment for eligibility excluded 202 articles. Twenty-two articles were reviewed and twelve full-text articles were excluded because of limited content. Ten articles published in English between 2004 and 2023 were selected for review.</p><p><strong>Results: </strong>Barriers in practicing CIC include pain and discomfort in catheter insertion, stigma and fears; inaccessibility of public toilets, unavailability of appropriate catheters, difficulty in positioning, limited quality of teaching and challenges with accessing supplies. Facilitators include starting CIC in infancy, follow-up by healthcare providers, support from family and community members, quality of training, continuous practice of CIC, utilisation of lubricants, reuse of catheters and other low-cost materials.</p><p><strong>Conclusion: </strong>Our review summarises facilitators and barriers to CIC and provides recommendations for further research, which includes the involvement of family members and community-based rehabilitation workers.</p><p><strong>Contribution: </strong>This article contributes to a better understanding of CIC use in low-income countries.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1473"},"PeriodicalIF":1.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At risk but not adequately included: People with disabilities' experience of COVID-19 in Zambia.","authors":"Queen E Seketi, J Anitha Menon, Charles Michelo, Lena Morgon Banks, Virginia Bond","doi":"10.4102/ajod.v13i0.1448","DOIUrl":"10.4102/ajod.v13i0.1448","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 had an impact on all sections of society, including people with disabilities.</p><p><strong>Objectives: </strong>The authors aimed to explore the needs and experiences of people with disabilities in Zambia during the COVID-19 pandemic.</p><p><strong>Method: </strong>In this hermeneutic phenomenological study, we used a semi-structured interview guide to collect data from a purposive and snowball sample of 40 people with disabilities and their caregivers. The participants were from 11 districts in 6 provinces in Zambia. The in-depth interviews were done between July 2022 and November 2022. Data were managed in NVivo and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>The three themes included: (1) awareness and experience of public health measures on COVID-19 among people with disabilities; (2) experience of othering and stigmatisation as people with disability during the COVID-19 pandemic and (3) experience of COVID-19 symptoms and having COVID-19 among people with disabilities.</p><p><strong>Conclusion: </strong>Interventions were largely unresponsive to the needs of people with disabilities, exacerbating the risk of exposure to infection. In future, adaptations like emergency risk communication in braille, audio and sign language interpretation in adapted communication formats should be made. Further studies are needed to quantify the gaps in access to health, explore policies and strategies to improve health outcomes for people with disabilities in LMICs like Zambia.</p><p><strong>Contribution: </strong>The findings may contribute to the development and enhancement of policies and interventions responsive to the needs of people with disabilities in future pandemics in the Zambian context.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1448"},"PeriodicalIF":1.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival rate of diabetic-related lower extremity amputees in hospitals in the Eastern Cape.","authors":"Aviwe S Mgibantaka, Alfred Musekiwa, Moleen Zunza","doi":"10.4102/ajod.v13i0.1503","DOIUrl":"10.4102/ajod.v13i0.1503","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a global health concern that has greatly affected South Africa. The gap in the current management of DM has resulted in complications such as lower extremity amputations (LEAs) and death. Eastern Cape province reflects this struggle, with disparities in access to healthcare and poor health outcomes. Understanding survival rates and associated factors between the urban Livingstone Hospital and the rural Nelson Mandela Academic Hospital can improve health interventions and outcomes.</p><p><strong>Objectives: </strong>This study compared the survival rate of patients in urban areas and those in rural areas.</p><p><strong>Method: </strong>This retrospective cohort study was conducted in an urban and a rural hospital by reviewing existing medical records of diabetic patients who underwent an LEA between 2016 and 2019.</p><p><strong>Results: </strong>The retrospective cohort study examined 439 diabetic-related LEA cases. This study found that residing in rural areas significantly decreased the risk of mortality by 62% compared with living in the urban areas. Factors such as haemoglobin A1c (HbA1c) levels, nephropathy, cardiovascular disease, human immunodeficiency virus (HIV), other comorbidities and level of amputation significantly influenced survival probabilities.</p><p><strong>Conclusion: </strong>Survival analysis indicated a significant difference in the 3-year survival probabilities of the two groups, favouring rural residency (<i>p</i> = 0.001). The biggest cause for concern between the two regions was uncontrolled blood glucose levels as this resulted in high mortality rates.</p><p><strong>Contribution: </strong>Insights from this study have shown that introducing podiatry and orthotics at primary healthcare (PHC) could improve foot care and reduce diabetic-related LEAs and mortality.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1503"},"PeriodicalIF":1.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hear our voices: The perceptions and experiences of women who are Deaf on gender-based violence.","authors":"Ronel Davids, Maria van Staden","doi":"10.4102/ajod.v13i0.1490","DOIUrl":"10.4102/ajod.v13i0.1490","url":null,"abstract":"<p><strong>Background: </strong>While all women are at risk of gender-based violence (GBV), it is essential to acknowledge that women are not a homogenous group and that women who are Deaf may experience GBV differently. This study aimed to answer the question: What are the perceptions and experiences of GBV among women who are Deaf?</p><p><strong>Objectives: </strong>The study's objectives were to explore and describe these women's understanding of GBV terminology, their perceptions of GBV and challenges regarding support strategies in place to respond to their unique circumstances.</p><p><strong>Method: </strong>A qualitative study with four workshops was conducted with 60 participants. The data collected were analysed using thematic analysis.</p><p><strong>Results: </strong>The results yielded three themes that intrinsically spoke to women's understanding of GBV terminology, perception of GBV and challenges accessing support. The results highlight that women who are Deaf are at a greater risk of GBV. Participants emphasised the importance of exploring the perceptions of GBV among men who are Deaf. Findings also indicated women's challenges when seeking support.</p><p><strong>Conclusion: </strong>The findings underscore the necessity of offering specific assistance to Deaf women facing GBV. Based on the study findings, it can be concluded that those providing support in GBV matters should receive specialised training in GBV, including Deaf culture and South African sign language.</p><p><strong>Contribution: </strong>The study findings contribute to the field of disability and the development of effective GBV strategies and programmes that are inclusive of women who are Deaf within a South African context.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1490"},"PeriodicalIF":1.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative process evaluation of a disability-inclusive ultra-poor graduation programme in Uganda.","authors":"Anthony Mugeere, Tom Shakespeare, Mark T Carew","doi":"10.4102/ajod.v13i0.1487","DOIUrl":"10.4102/ajod.v13i0.1487","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of evidence regarding what works to help persons with disabilities escape the trap of poverty. To address extreme poverty among the general population, poverty graduation approaches have gained popularity. These programmes combine direct livelihood assistance (e.g. provision of assets) with wider support given to individuals (e.g. skill development). However, these interventions have rarely been adapted to be disability-inclusive.</p><p><strong>Objectives: </strong>The present research is a qualitative process evaluation of a disability-inclusive poverty graduation intervention, implemented in Uganda from 2020 to 2022. The study focusses on contextual influences on the intervention and mechanisms of impact according to the perspectives of implementers and intervention recipients, with a complementary analysis of structures and resources used to deliver the intervention derived from a desk-based review of programme reports.</p><p><strong>Method: </strong>In all, 15 implementers and 23 persons with disabilities who received the intervention were interviewed using semi-structured interviews. Interview data underwent framework analysis.</p><p><strong>Results: </strong>National infection prevention measures and loss of intervention funding associated with coronavirus disease 2019 (COVID-19) were identified as contextual influences on the intervention. Respondents highlighted increases in social empowerment and positive changes in societal attitudes to disability as routes through which the intervention had a positive impact. However, instances of jealousy from community members not receiving the intervention were also an unintended consequence.</p><p><strong>Conclusion: </strong>Results are discussed in terms of practical implications for delivering similar interventions in other contexts.</p><p><strong>Contribution: </strong>This study contributes new knowledge about the key factors that influenced the effectiveness of a disability-inclusive poverty graduation intervention.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1487"},"PeriodicalIF":1.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability research in African Network for Evidence-to-Action in Disability affiliated countries.","authors":"Callista K Kahonde, Gubela Mji","doi":"10.4102/ajod.v13i0.1517","DOIUrl":"10.4102/ajod.v13i0.1517","url":null,"abstract":"<p><strong>Background: </strong>The African Network for Evidence-to-Action in Disability (AfriNEAD) is a leading role player in Africa promoting evidence-informed policies and practices for disability inclusion on the continent. This article presents findings of a desktop review that explored trends of disability research in the AfriNEAD affiliated countries.</p><p><strong>Objectives: </strong>The review explored trends of research that has been published by members of the disability research community who are contributing to AfriNEAD Conferences.</p><p><strong>Method: </strong>A Google scholar search was conducted using names of researchers who presented articles at the first six AfriNEAD Conferences, recording peer-reviewed journal publications by each author according to the eight AfriNEAD research focus areas. This was followed by a hand search of all articles published in the <i>African Journal of Disability</i> from AfriNEAD affiliated countries.</p><p><strong>Results: </strong>There is an exponential increase in the number of peer reviewed journal publications from AfriNEAD affiliated countries over the last two decades. Collaborations are common among authors within the same African country. International collaborations are common among authors from Africa with authors from the Global North.</p><p><strong>Conclusion: </strong>African researchers need to network and collaborate more across Africa, to promote disability research in countries where research is scarce and to focus more on research areas that are not receiving attention.</p><p><strong>Contribution: </strong>The desktop exploration is a first step for AfriNEAD to get a baseline understanding of published disability research in the countries affiliated to the network. Further research is required to understand these trends and to provide evidence necessary to address the identified gaps.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1517"},"PeriodicalIF":1.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation, the disciplining of the body, and disability identity: Reflections from psychotherapy with disabled people.","authors":"Brian P Watermeyer","doi":"10.4102/ajod.v13i0.1505","DOIUrl":"10.4102/ajod.v13i0.1505","url":null,"abstract":"<p><strong>Background: </strong>Recently, attention has been paid to how rehabilitation not only provides medical treatment and instrumental skills but also impacts psychological well-being and identity. We all have psychological structures that discipline the self, enforcing norms internalised during early life and exacting judgments when we fail to 'make the grade'. In cases of congenital disabilities, rehabilitation interventions may span many years, involving strict programmes of therapy, exercise and self-discipline. These regimes may align with internalised rules in harmful ways, as striving for functional improvements takes on a moral dimension, affecting psychological health and empowered disability identities.</p><p><strong>Objectives: </strong>This study explores rehabilitation by examining the experiences of adults with congenital disabilities, who have undergone childhood medical and rehabilitative interventions.</p><p><strong>Method: </strong>This study was based on the experience of a psychoanalytic psychotherapist working with adults with disability, and presents composite case material to illustrate how interactions with medical authority figures, such as rehabilitation professionals, can have a formative influence on self-identity and entitlement to inclusion.</p><p><strong>Results: </strong>The findings vividly reflected how 'medical socialisation' created meanings of disability that were enacted and repeated well into adulthood.</p><p><strong>Conclusion: </strong>The discipline of rehabilitation still has much to do in examining its value-laden assumptions and practices, and how these may shape the internal and relational worlds of people with disability.</p><p><strong>Contribution: </strong>This article contributes to the debate in critical rehabilitation studies, focussing on the issue of constructions of disability which may be communicated to people with disability, with implications for self-advocacy and the growth of the disability movement.</p>","PeriodicalId":45606,"journal":{"name":"African Journal of Disability","volume":"13 ","pages":"1505"},"PeriodicalIF":1.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}