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Asige E, Saloojee G, Andrews C, Namaganda LH, Kakooza-Mwesige A, Damiano DL, Forssberg H. Functioning and activity outcomes of the Akwenda Intervention Program for children and young adults with cerebral palsy in Uganda: A cluster-randomized trial. Dev Med Child Neurol 2024. [PMID: 38922854 DOI: 10.1111/dmcn.16007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/04/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
AIM To evaluate the efficacy of the Akwenda Intervention Program on motor, self-care, and social function of children and young people with cerebral palsy (CP). METHOD This was a cluster-randomized, controlled, single-blinded, intervention study of 100 participants with CP (2-23 years; 52 males) in rural eastern Uganda. Half were allocated to the intervention program, the remainder served as waitlist controls. Gross Motor Function Measure-66 (GMFM-66) and the Ugandan version of Pediatric Evaluation of Disability Inventory (PEDI-UG) were collected before group allocation and after intervention. General linear models and t-tests were used to compare changes within and between groups. Cohen's d estimated the effect size of group differences. Change scores were evaluated by age and mobility subgroups. RESULTS Significant group by time interactions were found for GMFM-66 (p =0.003) and PEDI-UG outcomes (p <0.001), except mobility, with the intervention group demonstrating greater changes. Both groups increased their scores on the GMFM-66 and child PEDI-UG, while only the intervention group had significant increases in caregiver assistance scores and across all age and mobility subgroups. Cohen's d showed large effect sizes (d >0.8) of differences for PEDI-UG outcomes except mobility. INTERPRETATION The Akwenda Intervention Program had a large positive impact on functioning and activity across age and mobility levels.
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Affiliation(s)
- Elizabeth Asige
- Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Gillian Saloojee
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Carin Andrews
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lukia H Namaganda
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Angelina Kakooza-Mwesige
- Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Diane L Damiano
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Stockholm, Sweden
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Banati P, Ross DA, Weobong B, Kapiga S, Weiss HA, Baltag V, Nzvere F, Glozah F, Nsanya MK, Greco G, Ferrand R, Doyle AM. Adolescent health and well-being check-up programme in three African cities (Y-Check): protocol for a multimethod, prospective, hybrid implementation-effectiveness study. BMJ Open 2024; 14:e077533. [PMID: 38908843 DOI: 10.1136/bmjopen-2023-077533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND During adolescence, behaviours are initiated that will have substantial impacts on the individual's short-term and long-term health and well-being. However, adolescents rarely have regular contact with health services, and available services are not always appropriate for their needs. We co-developed with adolescents a health and well-being check-up programme (Y-Check). This paper describes the methods to evaluate the feasibility, acceptability, short-term effects and cost-effectiveness of Y-Check in three African cities. METHOD This is a multi-country prospective intervention study, with a mixed-method process evaluation. The intervention involves screening, on-the-spot care and referral of adolescents through health and well-being check-up visits. In each city, 2000 adolescents will be recruited in schools or community venues. Adolescents will be followed-up at 4 months. The study will assess the effects of Y-Check on knowledge and behaviours, as well as clinical outcomes and costs. Process and economic evaluations will investigate acceptability, feasibility, uptake, fidelity and cost effectiveness. ETHICS AND DISSEMINATION Approval has been received from the WHO (WHO/ERC Protocol ID Number ERC.0003778); Ghana Health Service (Protocol ID Number GHS-ERC: 027/07/22), the United Republic of Tanzania National Institute for Medical Research (Clearance No. NIMR/HQ/R.8a/Vol.IX/4199), the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2766) and the LSHTM (Approval Numbers 26 395 and 28312). Consent and disclosure are addressed in the paper. Results will be published in three country-specific peer-reviewed journal publications, and one multicountry publication; and disseminated through videos, briefs and webinars. Data will be placed into an open access repository. Data will be deidentified and anonymised. TRIAL REGISTRATION NUMBER NCT06090006.
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Affiliation(s)
| | | | | | - Saidi Kapiga
- National Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Farirai Nzvere
- London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Mussa Kelvin Nsanya
- National Institute for Medical Research Mwanza Research Centre, Mwanza, United Republic of Tanzania
| | - Giulia Greco
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rashida Ferrand
- Biomedical Research and Training Institute, Harare, Zimbabwe
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Aoife Margaret Doyle
- London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
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Olusanya BO, Wright SM, Smythe T, Khetani MA, Moreno-Angarita M, Gulati S, Brinkman SA, Almasri NA, Figueiredo M, Giudici LB, Olorunmoteni O, Lynch P, Berman B, Williams AN, Olusanya JO, Wertlieb D, Davis AC, Hadders-Algra M, Gladstone MJ. Early childhood development strategy for the world's children with disabilities. Front Public Health 2024; 12:1390107. [PMID: 38962774 PMCID: PMC11220280 DOI: 10.3389/fpubh.2024.1390107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/28/2024] [Indexed: 07/05/2024] Open
Abstract
Early childhood is foundational for optimal and inclusive lifelong learning, health and well-being. Young children with disabilities face substantial risks of sub-optimal early childhood development (ECD), requiring targeted support to ensure equitable access to lifelong learning opportunities, especially in low- and middle-income countries. Although the Sustainable Development Goals, 2015-2030 (SDGs) emphasise inclusive education for children under 5 years with disabilities, there is no global strategy for achieving this goal since the launch of the SDGs. This paper explores a global ECD framework for children with disabilities based on a review of national ECD programmes from different world regions and relevant global ECD reports published since 2015. Available evidence suggests that any ECD strategy for young children with disabilities should consists of a twin-track approach, strong legislative support, guidelines for early intervention, family involvement, designated coordinating agencies, performance indicators, workforce recruitment and training, as well as explicit funding mechanisms and monitoring systems. This approach reinforces parental rights and liberty to choose appropriate support pathway for their children. We conclude that without a global disability-focussed ECD strategy that incorporates these key features under a dedicated global leadership, the SDGs vision and commitment for the world's children with disabilities are unlikely to be realised.
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Affiliation(s)
| | - Scott M. Wright
- Johns Hopkins Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Tracey Smythe
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Mary A. Khetani
- Department of Occupational Therapy, College of Applied Health Sciences of Illinois Chicago, Chicago, IL, United States
| | | | | | - Sally A. Brinkman
- Fraser Mustard Centre, Telethon Kids Institute, School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Nihad A. Almasri
- School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Marta Figueiredo
- European Network of Occupational Therapy in Higher Education, Escola Superior de Saúde do Alcoitão, Alcabideche, Portugal
| | - Lidia B. Giudici
- Latín American Association for Neonatal and Pediatric Follow-Up (ALSEPNEO), Buenos Aires, Argentina
| | | | - Paul Lynch
- School of Education, University of Glasgow, Glasgow, United Kingdom
| | - Brad Berman
- Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew N. Williams
- Virtual Academic Unit, Children’s Directorate, Northampton General Hospital, Northampton, United Kingdom
| | | | - Donald Wertlieb
- Eliot-Pearson Department of Child Development, Tufts University, Medford, MA, United States
| | | | - Mijna Hadders-Algra
- University Medical Centre Groningen, Department of Pediatrics, Division of Developmental Neurology, and Faculty of Theology and Religious Studies, University of Groningen, Groningen, Netherlands
| | - Melissa J. Gladstone
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
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Adugna MB, Ghahari S, Lysaght R. Disability stigma and the pursuit of inclusion among children with physical disabilities in northwest Ethiopia. Disabil Rehabil 2024:1-11. [PMID: 38832395 DOI: 10.1080/09638288.2024.2356016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/12/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Globally, many children with physical disabilities (CwPDs) are excluded from their education and social life, mainly due to stigma and its effects. However, information on disability stigma is scarce in low-and middle-income countries like Ethiopia. The purpose of this study, therefore, was to explore the lived experience of stigma from the perspective of CwPDs and their caregivers in northwest Ethiopia. METHODS The study incorporated a constructivist grounded theory approach. Data were gathered through observations, in-depth interviews, and key informant interviews. Inductive and iterative grounded theory techniques were used to code and categorize data through constant comparison. FINDINGS The study showed that CwPDs are bullied and talked about, subject to pity, socially excluded, and held in contempt at home, in their neighborhood, and at school. They live in fear and uncertainty and struggle with stigma. These factors affect their emotions, social relationships, and educational activities. CONCLUSIONS This study makes theoretical and practical contributions to understanding and addressing disability stigma and can help to introduce inclusive education policy, school practice, and disability advocacy. The study results highlight the need for disability awareness-raising programs, interventions for empowerment, and informing disability policy and practice.
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Affiliation(s)
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Ryan AK, Miller L, Rose TA, Johnston LM. Child-led goal setting and evaluation tools for children with a disability: A scoping review. Dev Med Child Neurol 2024. [PMID: 38760984 DOI: 10.1111/dmcn.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
AIM To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. METHOD Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. RESULTS Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. INTERPRETATION Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.
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Affiliation(s)
- Aisling K Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Chandy BR, Davey C, Oswald WE, Kaliappan SP, Aruldas K, Banks LM, Jasper S, Nagarajan G, Galagan S, Kennedy DS, Walson JL, Koshy B, Ajjampur SS, Kuper H. Prevalence of functional difficulty among school-aged children and effect on school enrolment in rural southern India: A cross-sectional analysis. RESEARCH SQUARE 2024:rs.3.rs-4154190. [PMID: 38746354 PMCID: PMC11092848 DOI: 10.21203/rs.3.rs-4154190/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Despite the large number of children in India, there is little information on the impact of children's disability on school enrolment, and how this differs by population. We estimated the prevalence of childhood disability in two sites in Tamil Nadu, southern India, and the effect of functional difficulty on school enrolment. We used a parent-reported survey containing the UNICEF-Washington Group questions to identify children aged 5 to 17 years with functional difficulty during a census conducted for an ongoing trial. We estimated pooled- and gender-specific prevalence of functional difficulty among 29,044 children. We fitted regression models to identify subgroups with higher rates of functional difficulty and the effect of functional difficulty on reported school enrolment. We estimated the modification of the effect of functional difficulty by age, gender, socioeconomic status, household education, and sub-site, on additive and multiplicative scales. We found of 29,044 children, 299 (1.0%) had any functional difficulty, equal among boys and girls. Being understood (0.5%) and walking (0.4%) were the most common difficulties. Functional difficulty was strongly associated with non-enrolment in school (Prevalence ratio [PR] 4.59, 95% CI: 3.87, 5.43) after adjusting for age, gender, and site. We show scale-dependent differences between age and socioeconomic groups in the effect of functional difficulty on enrolment. This study shows that at least one in a hundred children in this region have severe functional difficulties and nearly half of these children are not enrolled in school, highlighting the need for further efforts and evidence-based interventions to increase school enrolment among these groups.
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Adjei ES, Osei E, Edusei AK, Nakua EK. A systematic review of academic performance of Children with Disabilities (CWDs) in inclusive education schools in Low and Middle-Income Countries (LMICs). Heliyon 2024; 10:e25216. [PMID: 38322967 PMCID: PMC10844053 DOI: 10.1016/j.heliyon.2024.e25216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Globally it is estimated that about 150 million children are living with disabilities. Inclusive education inspires the participation of all students in the learning process in the same classroom. However, it is really difficult to find thorough, credible accounts of disabled children's access to education, enrolment, attendance, and results. This review evaluated academic performance, including access to school, enrolment, attendance, and results of Children with disabilities (CWD) in LMICs. In reporting this systematic review, the researchers followed the recommended Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting standards. The authors conducted searches using Science Direct, PubMed, Scopus, and Google Scholar electronic databases. The study's major findings indicate that CWDs in inclusive schools perform poorly academically compared to their non-disabled peers. Consequently, the researchers recommend more primary research to evaluate the academic performance of CWDs and the progress of inclusive education in LMICs.
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Affiliation(s)
- Evelyn Serwaa Adjei
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ernest Osei
- Department of Public Health, School of Public Health and Allied Sciences, Catholic University of Ghana, Sunyani, Ghana
| | - Anthony K. Edusei
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel K. Nakua
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mathabela B, Madiba S, Modjadji P. Exploring Barriers to Accessing Sexual and Reproductive Health Services among Adolescents and Young People with Physical Disabilities in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:199. [PMID: 38397689 PMCID: PMC10887722 DOI: 10.3390/ijerph21020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Despite South Africa having a progressive and liberal sexual and reproductive health (SRH) policy framework, adolescents and young people with disabilities (AYPWDs) are less likely to receive sexual and reproductive healthcare, being consequently predisposed to a long-term detrimental impact on their health. Our study explored the barriers to accessing sexual and reproductive health services (SRHSs) in clinics among AYPWDs in Mpumalanga, South Africa. We conducted a descriptive qualitative study with twenty-seven AYPWDs in four focus group discussions using semi-structured interviews, audiotaped and transcribed verbatim, and then applied a thematic analysis of the data. Employing a socio-ecological model, the findings show a poor socioeconomic status, lack of information on SRH, and the attitudes of AYPWDs as barriers at the individual level, hindering AYPWDs from accessing SRHSs in clinics. AYPWDs also faced difficulties to talk about SRH with parents, a lack of support to seek SRHSs, improper care from family/parents, and negative attitudes of friends, at the interpersonal level. They further expressed barriers at the community/societal level as negative attitudes of non-disabled community members and poor infrastructure for wheelchair use. At the organization level, their access to SRHSs was negatively affected by HCWs' maltreatment, described in the forms of negative attitudes, being judgmental using verbal abuse, discrimination, and bullying. Furthermore, AYPWDs described difficulties in communication with HCWs, as well as violating their confidentiality and misconceived ideas on their sexuality. Intensified efforts to strengthen public health strategies are needed to improve access to SRHSs by AYPWDs in South Africa, as well as enhancing the proficiency and communication skills of HCWs and educating AYPWDs, parents, and non-disabled community members on SRH.
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Affiliation(s)
- Bheki Mathabela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
| | - Sphiwe Madiba
- Faculty of Health Sciences, University of Limpopo, Polokwane 0700, South Africa;
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa;
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Johannesburg 1709, South Africa
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Philippin H, Morny EKA, Heinrich SP, Töws I, Maier PC, Guthoff RF, Qureshi BM, Reinhard T, Burton MJ, Finger RP. [Global ophthalmology : Update]. DIE OPHTHALMOLOGIE 2024; 121:157-170. [PMID: 38300260 DOI: 10.1007/s00347-023-01983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/02/2024]
Abstract
The aim of global ophthalmology is to maximize vision, ocular health and functional ability, thereby contributing to overall health and well-being, social inclusion and quality of life of every individual worldwide. Currently, an estimated 1.1 billion people live with visual impairment, 90% of which can be prevented or cured through largely cost-effective interventions. At the same time, 90% of people affected live in regions with insufficient eye health coverage. This challenge drove the World Health Organization (WHO) and a group of nongovernmental organizations to launch "VISION 2020: the Right to Sight", a global campaign which recently concluded after 20 years. The achievements, challenges and lessons learned were identified and incorporated into the current campaign "2030 IN SIGHT".
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Affiliation(s)
- Heiko Philippin
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland.
- International Centre for Eye Health, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HTUK, London, Vereinigtes Königreich.
- CBM Christoffel-Blindenmission Christian Blind Mission, Bensheim, Deutschland.
| | - Enyam K A Morny
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sven P Heinrich
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Ingrid Töws
- Institut für Evidenz in der Medizin, Universitätsklinikum und Medizinische Fakultät, Universität Freiburg, Freiburg i. Brsg., Deutschland
| | - Philip C Maier
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Rudolf F Guthoff
- Klinik und Poliklinik für Augenheilkunde, Universität Rostock, Rostock, Deutschland
| | - Babar M Qureshi
- CBM Christoffel-Blindenmission Christian Blind Mission, Cambridge, Vereinigtes Königreich
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
| | - Matthew J Burton
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstr. 5, 79106, Freiburg i. Brsg., Deutschland
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, Vereinigtes Königreich
| | - Robert P Finger
- Augenklinik, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim, Deutschland
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Loucaides EM, Zuurmond M, Nemerimana M, Kirk CM, Lassman R, Ndayisaba A, Smythe T, Baganizi E, Tann CJ. Livelihood support for caregivers of children with developmental disabilities: findings from a scoping review and stakeholder survey. Disabil Rehabil 2024; 46:293-308. [PMID: 36571438 DOI: 10.1080/09638288.2022.2160018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/13/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE Poverty amongst families with a child with disability adversely impacts child and family quality of life. We aimed to identify existing approaches to livelihood support for caregivers of children with developmental disabilities in low- and middle-income countries. METHODS This mixed-method study incorporated a scoping literature review and online stakeholder survey. We utilised the World Health Organization community-based rehabilitation (CBR) matrix as a guiding framework for knowledge synthesis and descriptively analysed the included articles and survey responses. RESULTS We included 11 peer-reviewed publications, 6 grey literature articles, and 49 survey responses from stakeholders working in 22 countries. Identified programmes reported direct and indirect strategies for livelihood support targeting multiple elements of the CBR matrix; particularly skills development, access to social protection measures, and self-employment; frequently in collaboration with specialist partners, and as one component of a wider intervention. Self-help groups were also common. No publications examined effectiveness of livelihood support approaches in mitigating poverty, with most describing observational studies at small scale. CONCLUSION Whilst stakeholders describe a variety of direct and indirect approaches to livelihood support for caregivers of children with disabilities, there is a lack of published literature on content, process, and impact to inform future programme development and delivery.
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Affiliation(s)
- Eva M Loucaides
- Centre for Maternal, Adolescent, Reproductive and Child Health (MARCH Centre), London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Zuurmond
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Mathieu Nemerimana
- Maternal and Child Health Programme, Partners in Health/Inshuti Mu Buzima (PIH/IMB), Kigali, Rwanda
| | - Catherine M Kirk
- Maternal and Child Health Programme, Partners in Health/Inshuti Mu Buzima (PIH/IMB), Kigali, Rwanda
| | | | - Albert Ndayisaba
- Maternal and Child Health Programme, Partners in Health/Inshuti Mu Buzima (PIH/IMB), Kigali, Rwanda
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Erick Baganizi
- Maternal and Child Health Programme, Partners in Health/Inshuti Mu Buzima (PIH/IMB), Kigali, Rwanda
| | - Cally J Tann
- Centre for Maternal, Adolescent, Reproductive and Child Health (MARCH Centre), London School of Hygiene & Tropical Medicine, London, UK
- Social Aspects of Care Programme, MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
- Neonatal Medicine, University College London Hospitals NHS Trust, London, UK
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11
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Charbonnet M, Sylvester L, Wang H, DeGrace BW. Provision of paediatric wheelchairs in low resource settings: a scoping review. Disabil Rehabil Assist Technol 2023; 18:1120-1138. [PMID: 34614386 DOI: 10.1080/17483107.2021.1986582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Inadequate wheelchair provision in children can lead to delays in growth and development, poorer health, and decreased participation. Wheelchair provision for children can be challenging, especially in low-resource settings, due to limited resources. Therefore, the purpose of the scoping review was to gain an understanding of the current state of paediatric wheelchair provision in low resource settings and identify factors, strategies, and gaps that can lead to more successful wheelchair provision. METHODS This scoping review used literature published after 2010, related to paediatric wheelchair provision in low resource settings. We searched online databases and grey literature and extracted data based on categories from the World Health Organisation Guidelines to wheelchair provision in low resource settings. RESULTS 34 articles were used to identify and analyse common themes and successful strategies related to wheelchair provision for children in low resource settings. Aspects of paediatric wheelchair provision were mentioned in the literature but were rarely the focus. End-user outcomes were the least represented category in the literature. CONCLUSION Based on the currently available evidence the overall state of a wheelchair for children is inadequate. Improvements in design and production, personnel capacity, and service delivery systems are recommended to promote best practices. The lack of child-focussed wheelchair provision and end-user involvement in the research process urgently needs to be addressed.Implications for RehabilitationIdentify best practiceIdentify gaps in knowledgeDetermine areas of need for future research.
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Affiliation(s)
- Monique Charbonnet
- Doctor of Science in Rehabilitation Program, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Lorraine Sylvester
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Hongwu Wang
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Beth W DeGrace
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
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Metwally AM, Aboulghate A, Elshaarawy GA, Abdallah AM, Abdel Raouf ER, El-Din EMS, Khadr Z, El-Saied MM, Elabd MA, Nassar MS, Abouelnaga MW, Ashaat EA, El-Sonbaty MM, Badawy HY, Dewdar EM, Salama SI, Abdelrahman M, Abdelmohsen AM, Eldeeb SE, Naga MM, Elshamy NH, Shaaban FA, ElRifay AS. Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study. BMC Psychiatry 2023; 23:689. [PMID: 37735643 PMCID: PMC10514965 DOI: 10.1186/s12888-023-05171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Child disability has significant implications on their well-being and healthcare systems. AIM This survey aimed to assess the magnitude of seven types of disability among Egyptian children aged 1 < 6 years and their socio-demographic, epidemiological, and perinatal predictors. METHODS A national population-based cross-sectional household survey targeting 21,316 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for identifying seven disability categories. RESULTS The percentage of children with at least one disability was 8.1% as follows: speech/communication (4.4%), Mobility/physical (2.5%), Seizures (2.2%), Comprehension (1.7%), Intellectual impairment (1.4%), Visual (0.3%) and Hearing (0.2%). Age was not found to affect the odds of disability except for visual disability (significantly increased with age (AOR = 1.4, 95% CI:1.1-1.7). Male sex also increased the odds of all disabilities except visual, hearing, and seizures. Convulsions after birth significantly increased the odds of disability as follows: hearing (AOR = 8.1, 95% CI: 2.2-30.5), intellectual impairment (AOR = 4.2, 95% CI: 2.5-6.9), and mobility/physical (AOR = 3.4, 95% CI: 2.3-5.0). Preterm delivery and being kept in an incubator for more than two days after birth increased the odds for visual disability (AOR = 3.7, 95% CI: 1.1-12.1 & AOR = 3.7, 95% CI: 1.7-7.9 respectively). Cyanosis increased the odds of seizures (AOR = 4.7, 95% CI: 2.2-10.3). Low birth weight also increased the odds for all disability domains except for visual and hearing. Maternal health problems during pregnancy increased the odds for all types of disability except hearing and seizures. Higher paternal education decreased the odds for all disabilities by at least 30% except for vision and hearing. CONCLUSION The study found a high prevalence of disability among Egyptian children aged 1-6 years. It identified a number of modifiable risk factors for disability. The practice of early screening for disability is encouraged to provide early interventions when needed.
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Affiliation(s)
- Ammal M. Metwally
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Ahmed Aboulghate
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Ghada A. Elshaarawy
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Ali M. Abdallah
- Quantitative Methods Department, Aswan University, Aswan, Egypt
| | - Ehab R. Abdel Raouf
- Child With Special Needs Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Ebtissam M. Salah El-Din
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Cairo, Egypt
- The Social Research Center, American University in Cairo, Cairo, Egypt
| | - Mostafa M. El-Saied
- Child With Special Needs Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Mona A. Elabd
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Maysa S. Nassar
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Marwa W. Abouelnaga
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Engy A. Ashaat
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Mohamed M. El-Sonbaty
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Hala Y. Badawy
- Prevention of Disability General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Eman M. Dewdar
- Prevention of Disability General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Somia I. Salama
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Mohamed Abdelrahman
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Aida M. Abdelmohsen
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Sherif E. Eldeeb
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Maie M. Naga
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Nada H. Elshamy
- Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), P.O. 12622, Giza, Dokki Egypt
| | - Fatma A. Shaaban
- Child With Special Needs Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
| | - Amira S. ElRifay
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre (Affiliation ID: 60014618), Cairo, Dokki Egypt
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Metwally AM, Aboulghate A, Elshaarawy GA, Abdallah AM, Abdel Raouf ER, El-Din EMS, Khadr Z, El-Saied MM, Elabd MA, Nassar MS, Abouelnaga MW, Ashaat EA, El-Sonbaty MM, Badawy HY, Dewdar EM, Salama SI, Abdelrahman M, Abdelmohsen AM, Eldeeb SE, Naga MM, Elshamy NH, Shaaban FA, ElRifay AS. Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study. BMC Psychiatry 2023; 23:689. [DOI: https:/doi.org/10.1186/s12888-023-05171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/08/2023] [Indexed: 10/31/2023] Open
Abstract
Abstract
Background
Child disability has significant implications on their well-being and healthcare systems. Aim: This survey aimed to assess the magnitude of seven types of disability among Egyptian children aged 1 < 6 years and their socio-demographic, epidemiological, and perinatal predictors.
Methods
A national population-based cross-sectional household survey targeting 21,316 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for identifying seven disability categories.
Results
The percentage of children with at least one disability was 8.1% as follows: speech/communication (4.4%), Mobility/physical (2.5%), Seizures (2.2%), Comprehension (1.7%), Intellectual impairment (1.4%), Visual (0.3%) and Hearing (0.2%). Age was not found to affect the odds of disability except for visual disability (significantly increased with age (AOR = 1.4, 95% CI:1.1–1.7). Male sex also increased the odds of all disabilities except visual, hearing, and seizures. Convulsions after birth significantly increased the odds of disability as follows: hearing (AOR = 8.1, 95% CI: 2.2–30.5), intellectual impairment (AOR = 4.2, 95% CI: 2.5–6.9), and mobility/physical (AOR = 3.4, 95% CI: 2.3–5.0). Preterm delivery and being kept in an incubator for more than two days after birth increased the odds for visual disability (AOR = 3.7, 95% CI: 1.1–12.1 & AOR = 3.7, 95% CI: 1.7–7.9 respectively). Cyanosis increased the odds of seizures (AOR = 4.7, 95% CI: 2.2–10.3). Low birth weight also increased the odds for all disability domains except for visual and hearing. Maternal health problems during pregnancy increased the odds for all types of disability except hearing and seizures. Higher paternal education decreased the odds for all disabilities by at least 30% except for vision and hearing.
Conclusion
The study found a high prevalence of disability among Egyptian children aged 1–6 years. It identified a number of modifiable risk factors for disability. The practice of early screening for disability is encouraged to provide early interventions when needed.
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Aruldas K, Banks LM, Nagarajan G, Roshan R, Johnson J, Musendo D, Arpudharangam I, Walson JL, Shakespeare T, Ajjampur SSR. "If he has education, there will not be any problem": Factors affecting access to education for children with disabilities in Tamil Nadu, India. PLoS One 2023; 18:e0290016. [PMID: 37585407 PMCID: PMC10431638 DOI: 10.1371/journal.pone.0290016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
This study explores factors affecting children with disabilities' enrolment and experience in school in Tamil Nadu, India. In-depth interviews were conducted with 40 caregivers and 20 children with disabilities. Children were purposively selected to maximise heterogeneity by gender, impairment type and enrolment status, using data from a previous survey. Overall, caregivers recognised the importance of school for their children's future livelihoods or at least as a means of socialisation. However, some questioned the value of school, particularly for children with intellectual or sensory impairments. Other barriers to school enrolment and regular attendance included poor availability and affordability of transport, safety concerns or school staffs' concerns about children's behaviour being disruptive. While in school, many children's learning was limited by the lack of teacher training and resources for inclusive education. Poor physical accessibility of schools, as well as negative or overly protective attitudes from teachers and peers, often limited children's social inclusion while in school. These findings carry implications for the implementation of inclusive education in India and elsewhere, as they indicate that despite legislative progress, significant gaps in attendance, learning and social inclusion remain for children with disabilities, which may not be captured in traditional metrics on education access.
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Affiliation(s)
- Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Lena Morgon Banks
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Guru Nagarajan
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reeba Roshan
- Department of Developmental Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jabaselvi Johnson
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - David Musendo
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Isaac Arpudharangam
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Judd L. Walson
- Departments of Global Health, Medicine, Pediatrics, and Epidemiology, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, University of Washington, Seattle, Washington, United States of America
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sitara S. R. Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Sapkota KP, Shibanuma A, Ong KIC, Kiriya J, Jimba M. Accommodation and disability-specific differences in nutritional status of children with disabilities in Kathmandu, Nepal: A cross-sectional study. BMC Public Health 2023; 23:315. [PMID: 36782145 PMCID: PMC9926754 DOI: 10.1186/s12889-023-14999-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Worldwide, more than 150 million children < 18 years live with disabilities. These children are more vulnerable to malnutrition regardless of institutional care that they receive, such as daycare or residential care. In Nepal, little is known about the status of malnutrition and factors associated with malnutrition among children with disabilities. This study was conducted to investigate the factors associated with malnutrition based on the types of disability and accommodation. METHODS This institution-based, cross-sectional study was conducted in 22 institutions in the Kathmandu Valley, Nepal. From these institutions, parents/guardians of all children with disabilities were recruited who were present there on the day of data collection. They were interviewed using a structured questionnaire. The questionnaire included questions on demographic characteristics, disability type and severity, accommodation place, feeding practices, and dietary patterns. The outcome variables, stunting, underweight, and obesity were measured using height-for-age, weight-for-age, and body mass index-for-age, respectively. A generalized linear model was used to investigate the factors associated with stunting and underweight, and multinomial logistic regression was used to identify the factors associated with overweight and obesity. RESULTS Among the 345 children with disabilities, 45% were stunted, 33% were underweight, 19% were thin, and 12% were overweight. Children with physical disabilities (relative risk ratio = 1.88, 95% confidence interval [CI] = 1.26-2.81) were more likely to be stunted than those with sensory disabilities. Children with autism (adjusted odds ratio [aOR] = 5.56, 95% CI: 1.23-25.23) and intellectual disabilities (aOR = 5.84, 95% CI: 1.59-21.51) were more likely to be overweight and obese than those with sensory disabilities. No evidence was found regarding an association between accommodation type and malnutrition. CONCLUSION Children with disabilities are vulnerable to malnutrition in several ways. Different types of disabilities are associated with different forms of malnutrition. Considering the types of disabilities, tailor-made approaches should be adopted to improve malnutrition status.
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Affiliation(s)
- Krishna Prasad Sapkota
- grid.26999.3d0000 0001 2151 536XDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Ken Ing Cherng Ong
- grid.26999.3d0000 0001 2151 536XDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- grid.26999.3d0000 0001 2151 536XDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- grid.26999.3d0000 0001 2151 536XDepartment of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Andrews C, Namaganda LH, Imms C, Eliasson AC, Asige E, Wanjala G, Kakooza-Mwesige A, Forssberg H. Participation of children and young people with cerebral palsy in activities of daily living in rural Uganda. Dev Med Child Neurol 2023; 65:274-284. [PMID: 35754006 PMCID: PMC10083931 DOI: 10.1111/dmcn.15323] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/23/2022] [Accepted: 05/19/2022] [Indexed: 01/04/2023]
Abstract
AIM To compare the participation attendance and involvement of children and young people with and without cerebral palsy (CP) in a low-resource area of Uganda. METHOD Eighty-two children and young people with CP aged 6 to 22 years (49 males, 33 females) and 81 age- and sex-matched peers without CP (6 to 22 years; 48 males, 33 females) participated in this population-based, cross-sectional study. Data on attendance and involvement in 20 home and community activities were obtained using Picture My Participation, an instrument intended to measure participation in children with disabilities, particularly in low- and middle-income countries. Non-parametric statistical methods were used to assess between-group differences. Effect size estimates were calculated. RESULTS Pooled attendance across all activities was lower in children and young people with CP than in children and young people without CP (p < 0.001) and for each activity item (p = 0.004 to p < 0.001). The effect sizes for each activity were 0.2 to 0.7. Between-group differences were larger for community activities than for home activities. Pooled involvement across all activities was less in the group with CP (p < 0.001) and for each activity (p = 0.014 to p < 0.001). The effect sizes for each activity were 0.2 to 0.5. Children and young people in Gross Motor Function Classification System (GMFCS) levels I and II had higher attendance (p < 0.001) and involvement (p = 0.023) than those in GMFCS levels III to V. INTERPRETATION Participation of young people living with CP in Uganda was restricted, especially for community activities. There is a need to identify context-specific participation barriers and develop strategies to overcome them. WHAT THIS PAPER ADDS Children and young people with cerebral palsy (CP) attended all activities less than their peers without CP. Differences in attendance were larger for community-based activities than home activities. When attending activities, children and young people with CP were less involved than their peers. Children and young people with milder impairments attended less frequently than their peers without CP. Children and young people with milder impairments attended more frequently than their peers with severe impairments.
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Affiliation(s)
- Carin Andrews
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Lukia Hamid Namaganda
- CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda.,Department of Epidemiology and Biostatistics, Makerere University, Kampala, Uganda
| | - Christine Imms
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Ann-Christin Eliasson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Neuropaediatric Unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Elizabeth Asige
- CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda.,Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Godfrey Wanjala
- CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda
| | - Angelina Kakooza-Mwesige
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda.,Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,CURIE Study Consortium, Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda.,Neuropaediatric Unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden
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The effect of a disability-targeted cash transfer program on universal health coverage and universal access to education: a nationwide cohort study of Chinese children and adolescents with disabilities. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 31:100635. [PMID: 36879791 PMCID: PMC9985013 DOI: 10.1016/j.lanwpc.2022.100635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022]
Abstract
Background To achieve improved outcomes for children and adolescents with disabilities, it is central to have universal health coverage (UHC) and universal access to education. This study investigates whether a disability-targeted cash transfer (CT) program is associated with improved access to healthcare and education for children and adolescents with disabilities. Methods We used nationwide survey data of two million children and adolescents living with disabilities, who aged 8-15 years when entering the cohort between January 1, 2015, and December 31, 2019. With a quasi-experimental study design, we compared the outcomes between CT beneficiaries who newly received CT benefits during the study period and non-beneficiaries who were disabled but never received CT using logistic regressions after propensity score matching with a 1:1 ratio. Outcomes of interest were utilization of rehabilitation services in the past year, medical treatment if the individual had illness in the past two weeks, school attendance if not in school at the start of the study, and reported financial hardship to access these services. Findings Of the total cohort, 368,595 children and adolescents fit the inclusion criteria, including 157,707 new CT beneficiaries and 210,888 non-beneficiaries. After matching, CT beneficiaries showed 2.27 (95% confidence interval [CI]: 2.23, 2.31) higher odds of utilizing rehabilitation services and 1.34 (95% CI: 1.23, 1.46) higher odds of getting medical treatment compared to non-beneficiaries. CT benefits were also significantly associated with less report of financial barrier to access rehabilitation services (odds ratio [OR]: 0.63, 95% CI: 0.60, 0.66) and medical treatment (OR: 0.66, 95% CI: 0.57, 0.78). Moreover, CT program was associated with higher odds of school attendance (OR: 1.99, 95% CI: 1.85, 2.15) and lower odds of reporting financial difficult to access education (OR: 0.41, 95% CI: 0.36, 0.47). Interpretation Our results suggest that the receipt of CT was associated with improved access to health and educational resources. This finding provides supporting evidence for the identification of efficient and feasible interventions to move toward UHC and universal education under the Sustainable Development Goals. Funding This research was supported by Sanming Project of Medicine in Shenzhen (NO.SZSM202111001), China National Natural Science Foundation (Grant/Award Number: 72274104, 71904099) and Tsinghua University Spring Breeze Fund (20213080028).
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Prevalence of Child Functional Difficulties and Its Associated Factors in Bangladesh: An Application of Count Regression Model. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6328522. [PMID: 36605102 PMCID: PMC9810413 DOI: 10.1155/2022/6328522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/29/2022]
Abstract
Children that are mentally and physically healthy have a higher quality of life and are better able to function in their daily lives. Therefore, this study is aimed at investigating associated factors causing functional difficulties in male and female children ages 5-17 years. This study used data from a nationally representative cross-sectional household survey named the Multiple Indicator Cluster Survey (MICS) Bangladesh 2019. A total of 58,746 children aged 5-17 were selected for the study, where 30,300 children were male, and 28,446 were female. To deal with overdispersed count data, the study used a negative binomial regression model to find the associated factors. The results show that 39.3% of the male children and 40.9% of the female children were from the age group of 10-14. Educated children had a lower risk of dysfunction. Among male children, women with a total number of children ever born of 4 or more were 1.21 times (incidence rate ratios (IRR) = 1.21) more likely to have a dysfunctional child. Children of dysfunctional mothers are more likely to be dysfunctional themselves. The incidence rate ratio for children functional difficulty among Muslim girls was 36 percent higher than non-Muslim girls in Bangladesh. When compared to the Barisal Division, female children in the Mymensingh Division had a 16% higher risk of functional problems. Based on the findings, the Bangladesh government and other development partners should initiate policies and programs to minimize the impact of functional dysfunction in children.
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Abdullahi A, Wong TWL, Ng SSM. Establishing childhood disability clinics may help reduce the prevalence of disability among children in Africa: A viewpoint. Front Public Health 2022; 10:1010437. [PMID: 36407982 PMCID: PMC9672508 DOI: 10.3389/fpubh.2022.1010437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Globally, there are about a billion people comprising of about 95 million children who experience disability. The number of people in Africa living with disability is about 80 million people; out of which 10%-15% are children of school age. The causes of disability among these children include epilepsy, vision loss, or hearing loss, cerebral palsy, poliomyelitis, tetanus, cerebrospinal meningitis and malaria. However, these causes of disability are preventable and can be managed with proper care. The aim of this article is to propose the establishment of childhood disability clinics in Africa in order to help prevent or reduce the incidence/ prevalence of disability among children. Some of the mandates of the clinics will be to carry out routine assessment of children for disability, to provide education on disability and strategies for disability prevention to parents and caregivers, to promptly prevent and manage disability or its causes. However, establishing these clinics requires shared commitment of all the stakeholders.
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Acharya Y, Yang D. Parental Disability and Children’s Educational, Labor Market and Marital Outcomes: Evidence from Nepal. Disabil Health J 2022; 16:101405. [PMID: 36496319 DOI: 10.1016/j.dhjo.2022.101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/24/2022] [Accepted: 11/13/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The extent to which parental disability affects children's educational, employment, and marital outcomes in low-income countries is poorly understood, limiting the countries' efforts to design and implement disability-inclusive policies. OBJECTIVE To assess the association between parental disability and children's education, employment, and marital outcomes in Nepal, and variations in these associations by sex. METHOD Using a nationally representative 15% sample of the 2011 census, we examine the relationship between parental disability and children's outcomes in a regression framework, controlling for potential confounders. We also test if the associations vary by the individual's sex. RESULTS Father's disability is not associated with any of the outcomes for boys except enrolment status. However, for girls, it is associated also with lower chances of being at the appropriate grade and higher chances of being employed. Mother's disability is associated with lower chances of being at the appropriate grade, lower educational attainment, higher chances of being employed, and earlier marriage for boys. For girls, it is associated only with lower chances of being at the appropriate grade and being employed. CONCLUSIONS Adverse effects of parental disability can last across generations in a low-income setting and can vary by the individual's sex. Further research is needed to ascertain causal pathways and intervening mechanisms.
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Affiliation(s)
- Yubraj Acharya
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA 16801, USA.
| | - Di Yang
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA 16801, USA
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21
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Coelho MLG, Campos TNC, Magalhães AG, Felix JB, Melo A, Tavares JS, Monteiro KS, Longo E. My child is growing and now? Exploring the environmental needs of children with congenital Zika syndrome according to their caregivers' perceptions. Health Expect 2022; 25:2828-2836. [DOI: 10.1111/hex.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/07/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Monique L. G. Coelho
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | - Taynah N. C. Campos
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | | | - Jean B. Felix
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | | | | | - Karolline S. Monteiro
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
| | - Egmar Longo
- Faculty of Health Science of Trairi Federal University of Rio Grande do Norte Santa Cruz Brazil
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22
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Morcov MV, Padure L, Morcov CG, Onose G. Further detailed objectification within comparative analysis of quality of life - based on some sociodemographic characteris-tics/parameters and related statistical analysis - between mothers of children with congenital versus acquired neuropathology. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract: This study aimed to determine whether there is a difference in quality of life between mothers of children with congenital neuropathology and, respectively, those with acquired neuropathology based on some sociodemographic characteristics/parameters, taking into account data from the specialized literature on the influence of sociodemographic characteristics/parameters on mothers with disabled children. 85 subjects (divided into two groups, congenital and acquired) were included in the study conducted at the National Clinical Centre of Neurorehabilitation for Children “Dr. N. Robanescu. To objectify – if existing – such differences, as mentioned above, we used the clinical, functional quantified evaluation instrument PedsQL- Family Impact Module (PedsQL-FIM). According to our data, there were statistically significant differences between groups for physical functioning, emotional functioning, communication, and worry. There were no statistically significant differences between the groups for daily activity, social functioning, cognitive functioning, and family relationships. We also found weak negative correlations between the following dimensions of PedsQL-FIM: emotional functioning, social functioning, and communication) and education for the former group; a weak positive correlation between worry and education, a weak negative correlation between emotional functioning and income level, and two moderate negative correlations between social functioning, daily activities, and income level for the latter group. We can conclude that the variable education had the most significant influence on the quality of life for mothers of children with congenital neuropathology, in contrast, the variable income level had the most significant influence on mothers of children with acquired neuropathology.
Keywords: sociodemographic characteristics, quality of life, disability
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Affiliation(s)
- Maria V. Morcov
- National Clinical Centre of Neurorehabilitation for Children “Dr. N. Robanescu”, 041408 Bucharest, Ro-mania
| | - Liliana Padure
- National Clinical Centre of Neurorehabilitation for Children “Dr. N. Robanescu”, 041408 Bucharest, Ro-mania
| | - Cristian G. Morcov
- National Clinical Centre of Neurorehabilitation for Children “Dr. N. Robanescu”, 041408 Bucharest, Ro-mania
| | - Gelu Onose
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
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23
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Acharya Y, Yang D. The effect of disability on educational, labor market, and marital outcomes in a low-income context. SSM Popul Health 2022; 19:101155. [PMID: 35813185 PMCID: PMC9260605 DOI: 10.1016/j.ssmph.2022.101155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/03/2022] Open
Abstract
There is limited evidence from low-income countries on the multifaceted effects of disability on an individual's wellbeing. Using a nationally representative sample of 2.8 million individuals, we documented the association between disability and educational, labor market, and marital outcomes in Nepal. We obtained plausibly causal estimates by comparing these outcomes for siblings living in the same household. Individuals with disability were at a severe disadvantage in almost all of the outcomes we evaluated. Compared to siblings without disability, siblings with disability were 16.5 percentage points less likely to be enrolled in school, 6.9 percentage points less likely to be at the appropriate grade level, and 21.4 percentage points less likely to be employed. Consistent with the prevalent discrimination against girls and stigma on disability, individuals with disability had difficulty getting married, and the adverse effects were more pronounced for girls than for boys. We examined the association between disability and educational, labor market, and marital outcomes in Nepal. Individuals with disability were at a severe disadvantage in almost all of the outcomes we evaluated. The adverse effects were more pronounced for girls than for boys.
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Urizar GG, Ramírez I, Caicedo BI, Mora C. Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2682-2702. [PMID: 34845739 PMCID: PMC9015286 DOI: 10.1002/jcop.22763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/03/2021] [Indexed: 05/15/2023]
Abstract
This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.
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Affiliation(s)
- Guido G. Urizar
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Ivonne Ramírez
- Instituto de Investigaciones en NeurodesarrolloUniversidad Mayor, Real y Pontificia de San Francisco Xavier de ChuquisacaSucreBolivia
| | - Brianna I. Caicedo
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
| | - Cindy Mora
- Department of PsychologyCalifornia State UniversityLong BeachCaliforniaUSA
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25
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Banks LM, Liu J, Kielland A, Tahirou AB, Harouna AKS, Mactaggart I, Dybdahl R, Mounkaila DF, Grønningsæter A. Childhood disability in rural Niger: a population-based assessment using the Key Informant Method. BMC Pediatr 2022; 22:170. [PMID: 35361177 PMCID: PMC8969242 DOI: 10.1186/s12887-022-03226-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Data on childhood disability is essential for planning health, education and other services. However, information is lacking in many low- and middle-income countries, including Niger. This study uses the Key Informant Method, an innovative and cost-effective strategy for generating population-based estimates of childhood disability, to estimate the prevalence and causes of moderate/severe impairments and disabling health conditions in children of school-going age (7–16 years) in the Kollo department of western Niger. Methods Community-based key informants were trained to identify children who were suspected of having the impairment types/health conditions included in this study. Children identified by key informants were visited by paediatricians and underwent an assessment for moderate/severe vision, hearing, physical and intellectual impairments, as well as epilepsy, albinism and emotional distress. Results Two thousand, five hundred sixty-one children were identified by key informants, of whom 2191 were visited by paediatricians (response rate = 85.6%). Overall, 597 children were determined to have an impairment/health condition, giving a prevalence of disability of 11.4 per 1000 children (10.6- 12.2). Intellectual impairment was most common (6.5 per 1000), followed by physical (4.9 per 1000) and hearing impairments (4.7 per 1000). Many children had never sought medical attention for their impairment/health condition, with health seeking ranging from 40.0% of children with visual impairment to 67.2% for children with physical impairments. Conclusion The Key Informant Method enabled the identification of a large number of children with disabling impairments and health conditions in rural Niger, many of whom have unmet needs for health and other services. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03226-0.
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Affiliation(s)
- Lena Morgon Banks
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.
| | | | | | - Ali Bako Tahirou
- Laboratoire d'Études Et de Recherche Sur Les Dynamiques Sociales Et Le Développement Local (LASDEL), Niamey, Niger
| | - Abdoul Karim Seydou Harouna
- Laboratoire d'Études Et de Recherche Sur Les Dynamiques Sociales Et Le Développement Local (LASDEL), Niamey, Niger
| | - Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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26
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Zhang JH, Ramke J, Jan C, Bascaran C, Mwangi N, Furtado JM, Yasmin S, Ogundo C, Yoshizaki M, Marques AP, Buchan J, Holland P, Ah Tong BAM, Evans JR, Congdon N, Webson A, Burton MJ. Advancing the Sustainable Development Goals through improving eye health: a scoping review. Lancet Planet Health 2022; 6:e270-e280. [PMID: 35219448 DOI: 10.1016/s2542-5196(21)00351-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
UN member states have committed to achieving the Sustainable Development Goals (SDGs) by 2030. This Review examines the published evidence on how improving eye health can contribute to advancing the SDGs (beyond SDG 3). We identified 29 studies that showed direct benefits from providing eye health services on SDGs related to one or more of poverty (SDGs 1, 2, and 8), education (SDG 4), equality (SDGs 5 and 10), and sustainable cities (SDG 11). The eye health services included cataract surgery, free cataract screening, provision of spectacles, trichiasis surgery, rehabilitation services, and rural community eye health volunteers. These findings provide a comprehensive perspective on the direct links between eye health services and advancing the SDGs. In addition, eye health services likely have indirect effects on multiple SDGs, mediated through one of the direct effects. Finally, there are additional plausible links to other SDGs, for which evidence has not yet been established.
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Affiliation(s)
- Justine H Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; Manchester Royal Eye Hospital, Manchester, UK.
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | | | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; Department of Clinical Medicine, Kenya Medical Training College, Nairobi, Kenya
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Cynthia Ogundo
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; Department of Ophthalmology, Mbagathi Hospital, Nairobi, Kenya
| | - Miho Yoshizaki
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - John Buchan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Holland
- International Agency for the Prevention of Blindness, London, UK
| | | | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; Centre for Public Health, Queen's University, Belfast, UK
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, UK; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Aubrey Webson
- Permanent Mission of Antigua and Barbuda to the United Nations, New York, NY, USA
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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27
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Okoli ML, Ogbu CE, Enyi CO, Okoli IC, Wilson RE, Kirby RS. Sociodemographic and socioeconomic correlates of learning disability in preterm children in the United States. BMC Public Health 2022; 22:212. [PMID: 35105328 PMCID: PMC8805283 DOI: 10.1186/s12889-022-12592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background In 2019, 1 in every 10 infants born in the United States was preterm. Prematurity has life-threatening consequences and causes a range of developmental disabilities, of which learning disability is a prevalent complication. Despite the availability of special services for children living with learning disability, gaps still exist in terms of access due to socioeconomic factors. The aim of this study is to evaluate socioeconomic and sociodemographic correlates of learning disability in preterm children. Methods This cross-sectional study used data from the 2016–2018 National Survey of Children’s Health. Weighted multivariable analyses were conducted to ascertain the association of sociodemographic and socioeconomic factors on learning disability among preterm children. The main outcome variable was the presence of learning disability. Results Among 9555 preterm children in our study population, 1167 (12%) had learning disability. Learning disability was significantly associated with health insurance, food situation, and poverty level after adjustment for other variables. Children currently insured had lower odds of having learning disability compared to those without health insurance (OR = 0.79, 95% C.I. = 0.70–0.91). Also, children living in households that cannot afford nutritious meals are more likely to have learning disability compared to those that can afford nutritious meals at home (OR = 1.55, 95% C.I. = 1.22–1.97). Conclusion These findings highlight the need for intervention efforts to target these children living with a learning disability to achieve the 2004 Individuals with Disabilities Education Act of promoting educational equality and empowerment of children living with a learning disability.
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Affiliation(s)
- Menkeoma Laura Okoli
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, USA.
| | - Chukwuemeka E Ogbu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, USA
| | - Chioma O Enyi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ibuchim C Okoli
- Department of Clinical sciences, All Saints University (SVG), Arnos Vale, Saint Vincent and the Grenadines
| | - Ronee E Wilson
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, USA
| | - Russell S Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, USA
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28
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Ngoie LB, Dybvik E, Hallan G, Gjertsen JE, Mkandawire N, Varela C, Young S. The unmet need for treatment of children with musculoskeletal impairment in Malawi. BMC Pediatr 2022; 22:67. [PMID: 35090430 PMCID: PMC8796456 DOI: 10.1186/s12887-022-03113-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022] Open
Abstract
Background More than a billion people globally are living with disability and the prevalence is likely to increase rapidly in the coming years in low- and middle-income countries (LMICs). The vast majority of those living with disability are children residing in LMICs. There is very little reliable data on the epidemiology of musculoskeletal impairments (MSIs) in children and even less is available for Malawi. Previous studies in Malawi on childhood disability and the impact of musculoskeletal impairment (MSI) on the lives of children have been done but on a small scale and have not used disability measurement tools designed for children. Therefore in this study, we aimed to estimate the MSI prevalence, causes, and the treatment need among children aged 16 years or less in Malawi. Methods This study was carried out as a national cross sectional survey. Clusters were selected across the whole country through probability proportional to size sampling with an urban/rural and demographic split that matched the national distribution of the population. Clusters were distributed around all 27-mainland districts of Malawi. Population of Malawi was 18.3 million from 2018 estimates, based on age categories we estimated that about 8.9 million were 16 years and younger. MSI diagnosis from our randomized sample was extrapolated to the population of Malawi, confidence limits was calculated using normal approximation. Results Of 3792 children aged 16 or less who were enumerated, 3648 (96.2%) were examined and 236 were confirmed to have MSI, giving a prevalence of MSI of 6.5% (CI 5.7–7.3). Extrapolated to the Malawian population this means as many as 576,000 (95% CI 505,000-647,000) children could be living with MSI in Malawi. Overall, 46% of MSIs were due to congenital causes, 34% were neurological in origin, 8.4% were due to trauma, 7.8% were acquired non-traumatic non-infective causes, and 3.4% were due to infection. We estimated a total number of 112,000 (80,000-145,000) children in need of Prostheses and Orthoses (P&O), 42,000 (22,000-61,000) in need of mobility aids (including 37,000 wheel chairs), 73,000 (47,000-99,000) in need of medication, 59,000 (35,000-82,000) in need of physical therapy, and 20,000 (6000-33,000) children in need of orthopaedic surgery. Low parents’ educational level was one factor associated with an increased risk of MSI. Conclusion This survey has uncovered a large burden of MSI among children aged 16 and under in Malawi. The burden of musculoskeletal impairment in Malawi is mostly unattended, revealing a need to scale up both P&O services, physical & occupational therapy, and surgical services in the country. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03113-8.
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Yanagisawa S, Swannimitr A, Singhala K, Rujkorakarn D, Aryamuang S, Hashimoto H, Sakamoto M. Needs assessment of caregivers of children with disabilities in resource-limited settings. J Rural Med 2022; 17:143-150. [PMID: 35847758 PMCID: PMC9263948 DOI: 10.2185/jrm.2021-062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/01/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aimed to identify and classify the needs of caregivers
of children with disabilities living in resource-limited settings and develop a framework
for need assessment. Participants and Methods: This study was conducted in the Maha Sarakham
Province, Thailand, with 15 caregivers caring for children with disabilities recruited
from hospitals, the Association for the Disabled, and primary health centers.
Semi-structured interviews were conducted in local dialects, recorded, transcribed,
converted into standard Thai, and then into English for thematic analysis. Meaning units
corresponding to caregivers’ needs were extracted, interpreted, coded, and hierarchically
organized into subcategories by comparing similarities and differences among the extracted
codes. The subcategories were further grouped and abstracted into categories, and then
domains of caregivers’ needs were formed. Results: Nineteen categories were identified across five domains of
caregivers’ needs: health and medical, welfare, educational, social, and informational.
Although basic medical treatment was covered, specific support, such as referral to a
specialist, rehabilitation, or psychological support, was limited. Financial support and
relief from the care burden are the main welfare needs. Educational needs were identified
to provide knowledge to children and to offer respite to their caregivers. Social needs
revealed ethical problems that arose because of strong rural community ties, making it
difficult to maintain privacy. Informational needs were intertwined with the other four
domains. In rural areas, where parents of children with disabilities migrate to cities to
find work, the special needs of grandparents who were primary caregivers of the children
needed to be addressed. Conclusion: This study provides a conceptual framework for comprehensive
needs assessment and policy development for caregivers of children with disabilities
living in resource-limited settings.
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Affiliation(s)
| | | | | | | | | | - Hidemi Hashimoto
- Faculty of Nursing, Doshisha Women’s College of Liberal Arts, Japan
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30
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Linder CL, Atijosan-Ayodele O, Chokotho L, Mulwafu W, Tataryn M, Polack S, Kuper H, Pandit H, Lavy C. Childhood musculoskeletal impairment in Malawi from traumatic and non-traumatic causes: a population- based assessment using the key informant method. BMC Musculoskelet Disord 2021; 22:1058. [PMID: 34933673 PMCID: PMC8693487 DOI: 10.1186/s12891-021-04942-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background Musculoskeletal impairment (MSI) in children is an under-recognised public health challenge. Although preventable, road injuries and other traumas continue to cause significant impairments to children worldwide. The study aimed to use the Key Informant Method (KIM) to assess prevalence and causes of MSI in children in two districts in Malawi, estimating the associated need for services provision, with a focus on traumatic aetiology. Methods The KIM was conducted in the districts of Thyolo (Southern Malawi) and Ntcheu (Central Malawi) in 2013. Five hundred key informants were trained to identify children who may have one of a range of MSI. The identified children were referred to a screening camp where they were examined by medical experts with standardised assessment protocols for diagnosing each form of impairment. Results 15,000 children were referred to screening camps. 7220 children were assessed (response rate 48%) for an impairment of whom 15.2% (1094) had an MSI. 13% of children developed MSI from trauma, while 54% had a neurological aetiology. For MSI of traumatic origin the most common body part affected was the elbow. Less than half of children with MSI (44.4%) were enrolled in school and none of these children attended schools with resources for disability. More than half of children with MSI (60%) had not received required services and 64% required further physical therapy. Conclusions The KIM method was used to identify a high prevalence of MSI among children in two districts of Malawi and estimates an unmet need for dedicated MSI services.
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Affiliation(s)
- Cortland L Linder
- Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1FR, UK
| | | | - Linda Chokotho
- Department of Surgery, College of Medicine, University of Malawi, Blantyre, Blantyre, Malawi.
| | - Wakisa Mulwafu
- Department of Surgery, College of Medicine, University of Malawi, Blantyre, Blantyre, Malawi
| | - Myroslava Tataryn
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | - Chris Lavy
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, Oxford University, Oxford, UK
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31
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Hunt X, Saran A, White H, Kuper H. PROTOCOL: Effectiveness of interventions for improving educational outcomes for people with disabilities in low- and middle-income countries: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1197. [PMID: 36950342 PMCID: PMC8988635 DOI: 10.1002/cl2.1197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The objectives of this review are to answer the following research questions: (1) What is the nature of the interventions used to support education for people with disabilities? (2) What is the size and quality of the evidence base of the effectiveness of interventions to improve educational outcomes for people with disabilities in low- and middle-income countries (LMICs)? (3) What works to improve educational outcomes for people with disabilities in LMICs? (4) Which interventions appear most effective for different types of disability? (5) What are the barriers and facilitators to improving of educational outcomes for people with disabilities? Is there evidence of cumulative effects-that certain interventions are effective when done in combination with others, but are less or ineffective when done alone?
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Affiliation(s)
- Xanthe Hunt
- Stellenbosch UniversityCape TownSouth Africa
| | | | | | - Hannah Kuper
- International Centre for Evidence on Disability, London School of Hygiene & Tropical MedicineLondonUK
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32
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Jagoe C, McDonald C, Rivas M, Groce N. Direct participation of people with communication disabilities in research on poverty and disabilities in low and middle income countries: A critical review. PLoS One 2021; 16:e0258575. [PMID: 34648588 PMCID: PMC8516265 DOI: 10.1371/journal.pone.0258575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 09/30/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION An estimated 1 billion people with disabilities live in low and middle income countries, a population that includes people with communication disabilities (PwCD). PwCD are a heterogenous group with a wide range of abilities who may be underrepresented in research due to the communication demands involved in research participation. METHODS A critical analysis of 145 studies from a previously published systematic review was undertaken with the aim of documenting the opportunities for direct participation of PwCD in research on poverty and disability in low- and middle- income countries. RESULTS The key finding was the high risk of underrepresentation of PwCD in research on poverty and disability in LMICs, despite low rates of explicit exclusion (n = 8; 5.5%). A total of 366 uses of data collection tools were analysed (255 unique tools). The majority of data collection tools had high communication demands (92.9%), including those measuring disability (88.6%) and those assessing poverty (100%). Only 22 studies (15.2%) specifically included PwCD. A subset of these studies (n = 14) presented disaggregated data in a way that allowed for analysis of outcomes for PwCD, suggesting a clear intersection between poverty and communication disability, with findings related to general poverty indicators, reduced access to education, low levels of employment, and additional expenditure. CONCLUSIONS The findings suggest a systematic underrepresentation of PwCD in research on poverty and disability with substantial implications for future policy and program planning, directly affecting the availability and provision of services and resources for this population. A failure to provide adequate opportunity for participation of PwCD in research risks leaving those with communication disabilities behind in the pursuit of global poverty eradication.
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Affiliation(s)
- Caroline Jagoe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Caitlin McDonald
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Minerva Rivas
- Institute of Ethics, History, and Humanities, University of Geneva, Geneva, Switzerland
| | - Nora Groce
- Institute of Epidemiology & Health Care, University College London, London, United Kingdom
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Influence of Prevalence of Psychoactive Substance Use in Mexican Municipalities on Early Childhood Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910027. [PMID: 34639329 PMCID: PMC8507637 DOI: 10.3390/ijerph181910027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
Children's early development is influenced by characteristics of the child, family, and environment, including exposure to substance abuse. The aim was to examine the association of early childhood development (ECD) with the prevalence of psychoactive substance use in Mexican municipalities. We obtained ECD data from the 2015 Survey of Boys, Girls, and Women (ENIM, for its Spanish acronym), measured with the ECD Index. The prevalence of psychoactive substance use was estimated at the municipal level, using the 2016 National Survey of Drug, Alcohol, and Tobacco Use (ENCODAT, for its Spanish acronym). Multilevel logistic models were fitted to evaluate the association between drug use and inadequacies in ECD overall and in four specific ECD domains: socio-emotional, literacy-numeric, learning, and physical. Inadequate ECD was directly associated with illegal drug use (OR = 1.10; 95% CI: 1.03, 1.17). For the specific ECD domains, inadequate socio-emotional development was directly associated with illegal drug use (OR = 1.08; 95% CI: 1.01, 1.15). These findings suggest that exposure to illegal drug use may influence ECD, and especially can lead to socio-emotional problems, although this cannot be considered the unanimous determinant of the problems presented. The implementation of evidence-based interventions to prevent drug abuse is necessary.
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Quinones S, Palermo TM, Lukongo TM, Luchemba P, Mitti R, Devries K, de Groot R, Khurshid A, Kuper H. Disability status and multi-dimensional personal well-being among adolescents in the Southern Highlands Region of Tanzania: results of a cross-sectional study. BMJ Open 2021; 11:e044077. [PMID: 34016661 PMCID: PMC8141426 DOI: 10.1136/bmjopen-2020-044077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Examine how disability status among adolescents is associated with the following domains of personal well-being: schooling, livelihoods, health, violence and psychosocial well-being. It is hypothesised that adolescents with a disability will have greater deficits in these areas of well-being compared with their healthier counterparts. DESIGN Cross-sectional data from 2018 were obtained from the second round of an on-going study of adolescents living in poor households in two regions of the Southern Highlands of Tanzania (Iringa and Mbeya). We use the Washington Group (WG) Short Set indicators to measure disability and undertook logistic and linear multivariate regressions to understand the association between disability and the outcomes of interest. PARTICIPANTS The sample included 2274 participants aged 15-20 years living in households participating in a government social protection programme targeted to households living in extreme poverty. RESULTS Overall, 310 participants (14%) were classified as having disabilities. Outcomes not associated with disability status included literacy, schooling, livelihoods and self-efficacy. Adolescents with disabilities were less likely to report good or very good health (adjusted OR (aOR)=0.39, 95% CI 0.29 to 0.52) and had increased odds of reporting depressive symptoms in (aOR=1.46, 95% CI 1.11 to 1.90), emotional violence (aOR=2.18, 95% CI 1.49 to 3.20) and physical violence (aOR=1.71, 95% CI 1.13 to 2.59), compared with those without disabilities. Reports of depression were higher among men, and violence was more prevalent among women. Patterns of association were generally similar between men and women, although the association of disability with markers of well-being reached statistical significance more often among men. CONCLUSION This study highlights areas where adolescents with disabilities are falling behind their peers in terms of personal well-being. These findings suggest that interventions may be needed to mainstream disability in programmes and policies aiming to improve well-being, mental health and violence prevention among adolescents. TRIAL REGISTRATION NUMBER Pan African Clinical Trial Registry (PACTR201804003008116).
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Affiliation(s)
- Sarah Quinones
- Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA
| | - Tia M Palermo
- Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA
| | - Tumpe Mnyawami Lukongo
- Research and Development Unit, Tanzania Social Action Fund, Dodoma, United Republic of Tanzania
| | - Paul Luchemba
- Monitoring and Evaluation Unit, Tanzania Social Action Fund, Dodoma, United Republic of Tanzania
| | | | - Karen Devries
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Hannah Kuper
- International Centre for Evidence in Disability, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Scherer N, Mactaggart I, Huggett C, Pheng P, Rahman MU, Biran A, Wilbur J. The Inclusion of Rights of People with Disabilities and Women and Girls in Water, Sanitation, and Hygiene Policy Documents and Programs of Bangladesh and Cambodia: Content Analysis Using EquiFrame. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105087. [PMID: 34064939 PMCID: PMC8151976 DOI: 10.3390/ijerph18105087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 01/09/2023]
Abstract
People with disabilities and as women and girls face barriers to accessing water, sanitation, and hygiene (WASH) services and facilities that fully meet their needs, especially in low- and middle-income countries. Women and girls with disabilities experience double discrimination. WASH policies should support and uphold the concepts of disability and gender inclusion, and they should also act as a guide to inform WASH programs and service delivery. Using a modified version of the EquiFrame content analysis tool, this study investigated the inclusion of 21 core concepts of human rights of people with disabilities and women and girls in 16 WASH policy documents and seven end-line program reports from Bangladesh and Cambodia. Included documents typically focused on issues of accessibility and neglected wider issues, including empowerment and support for caregivers. The rights of children and women with disabilities were scarcely focused on specifically, despite their individual needs, and there was a disconnect in the translation of certain rights from policy to practice. Qualitative research is needed with stakeholders in Bangladesh and Cambodia to investigate the inclusion and omission of core rights of people with disabilities, and women and girls, as well as the factors contributing to the translation of rights from policy to practice.
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Affiliation(s)
- Nathaniel Scherer
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (J.W.)
- Correspondence:
| | - Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (J.W.)
| | | | | | | | - Adam Biran
- Environmental Health Group, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Jane Wilbur
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (J.W.)
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Widyawati Y, Scholte RHJ, Kleemans T, Otten R. Positive parenting and its mediating role in the relationship between parental resilience and quality of life in children with developmental disabilities in Java Island, Indonesia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 112:103911. [PMID: 33631600 DOI: 10.1016/j.ridd.2021.103911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUNDS Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families. However, the extent of the effect of such consequences on quality of life is partially dependent on how parents address the situation. AIMS The study aimed to examine whether positive parenting mediates the link between parental resilience and quality of life of children with a developmental disability in Indonesia. METHODS AND PROCEDURES Data were derived from a three-wave longitudinal study on 497, 224 and 209 families in waves one, two and three, respectively. The study determined parental resilience by assessing the knowledge of parents about the characteristics of their child, perceived social support and positive perception of parenting. Quality of life consisted of five aspects: material well-being, communication and influence, socio-emotional well-being, development and activity. Positive parenting was assessed through observed levels of support, encouragement and praise. CONCLUSIONS AND IMPLICATIONS The results demonstrated that positive parenting mediated the impact of positive perception of parenting on quality of life. This finding implies that positive perception and positive parenting should be encouraged when families with children with developmental disabilities receive care or support.
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Affiliation(s)
- Yapina Widyawati
- Behavioural Science Institute, Radboud University, Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands.
| | - R H J Scholte
- Behavioural Science Institute, Radboud University, Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands
| | - Tijs Kleemans
- Behavioural Science Institute, Radboud University, Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands
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Economic Evaluation of Emotional and Personal Support in the Health Care of Women with Disabilities. Healthcare (Basel) 2021; 9:healthcare9040438. [PMID: 33917941 PMCID: PMC8068370 DOI: 10.3390/healthcare9040438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
It is generally accepted that people with disabilities make greater use of health services. Moreover, certain social circumstances alter the intensity of such use. This manuscript seeks to analyze the existing differences in the use of healthcare among women with and without disabilities, to study the impact of emotional and personal support (EPS) on such use and to assess the reduction of the economic cost that this factor entails. Data from the Spanish National Health Survey (SNHS-2017) and updated unit costs of health services have been used to estimate the differences in use attributable to disability and the economic impact of emotional and personal support. The empirical results show an association between disability and perceived EPS, the latter being less common among Spanish women with disabilities. In addition, within this group, EPS significantly influences the levels of use of health services. Finally, the net effect of a perceived EPS increase would translate into a reduction in the economic costs of health care for women with disabilities.
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Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomão SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, Faal HB. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health 2021; 9:e489-e551. [PMID: 33607016 PMCID: PMC7966694 DOI: 10.1016/s2214-109x(20)30488-5] [Citation(s) in RCA: 500] [Impact Index Per Article: 166.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Ana Patricia Marques
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rupert R A Bourne
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK; Department of Ophthalmology, Cambridge University Hospitals, Cambridge, UK
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | | | - Simon Arunga
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Department of Ophthalmology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Damodar Bachani
- John Snow India, New Delhi, India; Ministry of Health and Family Welfare, New Delhi, India
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Peek Vision, London, UK
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Tasanee Braithwaite
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; The Medical Eye Unit, St Thomas' Hospital, London, UK
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - John Cairns
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Chimgee Chuluunkhuu
- Orbis International, Ulaanbaatar, Mongolia; Mongolian Ophthalmology Society, Ulaanbaatar, Mongolia
| | | | | | - William H Dean
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Alastair K Denniston
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Ophthalmology Department, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Health Data Research UK, London, UK
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Paul M Emerson
- International Trachoma Initiative and Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kevin D Frick
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - David S Friedman
- Massachusetts Eye and Ear, Harvard Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - João M Furtado
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | | | - Reeta Gurung
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Esmael Habtamu
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Eyu-Ethiopia Eye Health Research, Training, and Service Centre, Bahirdar, Ethiopia
| | - Peter Holland
- International Agency for the Prevention of Blindness, London, UK
| | - Jost B Jonas
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas and Panda, Heidelberg, Germany; Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Pearse A Keane
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rohit C Khanna
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India; Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Peng Tee Khaw
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Fatima Kyari
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Van C Lansingh
- Instituto Mexicano de Oftalmologia, Queretaro, Mexico; Centro Mexicano de Salud Visual Preventiva, Mexico City, Mexico; Help Me See, New York, NY, USA
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Milka M Mafwiri
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Priya Morjaria
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Lizette Mowatt
- University Hospital of the West Indies, Kingston, Jamaica
| | - Debbie Muirhead
- The Fred Hollows Foundation, Melbourne, Australia; Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Gudlavalleti V S Murthy
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Indian Institute of Public Health, Hyderabad, India
| | - Nyawira Mwangi
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; Kenya Medical Training College, Nairobi, Kenya
| | - Daksha B Patel
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Bernadetha R Shilio
- Department of Curative Services, Ministry of Health Community Development, Gender, Elderly, and Children, Dodoma, Tanzania
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Bonnielin K Swenor
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hugh R Taylor
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Aubrey Webson
- Permanent Mission of Antigua and Barbuda to the United Nation, New York, NY, USA
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore; Duke-NUS Medical School, Singapore
| | - Richard Wormald
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK; National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | | | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Brien Holden Vision Institute, University of New South of Wales, Sydney, Australia
| | | | - Clare E Gilbert
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah B Faal
- Department of Ophthalmology, University of Calabar, Calabar, Nigeria; Africa Vision Research Institute, Durban, South Africa
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McDonald CL, Westcott-McCoy S, Weaver MR, Haagsma J, Kartin D. Global prevalence of traumatic non-fatal limb amputation. Prosthet Orthot Int 2021; 45:105-114. [PMID: 33274665 DOI: 10.1177/0309364620972258] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 10/12/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Reliable information on both global need for prosthetic services and the current prosthetist workforce is limited. Global burden of disease estimates can provide valuable insight into amputation prevalence due to traumatic causes and global prosthetists needed to treat traumatic amputations. OBJECTIVES This study was conducted to quantify and interpret patterns in global distribution and prevalence of traumatic limb amputation by cause, region, and age within the context of prosthetic rehabilitation, prosthetist need, and prosthetist education. STUDY DESIGN A secondary database descriptive study. METHODS Amputation prevalence and prevalence rate per 100,000 due to trauma were estimated using the 2017 global burden of disease results. Global burden of disease estimation utilizes a Bayesian metaregression and best available data to estimate the prevalence of diseases and injuries, such as amputation. RESULTS In 2017, 57.7 million people were living with limb amputation due to traumatic causes worldwide. Leading traumatic causes of limb amputation were falls (36.2%), road injuries (15.7%), other transportation injuries (11.2%), and mechanical forces (10.4%). The highest number of prevalent traumatic amputations was in East Asia and South Asia followed by Western Europe, North Africa, and the Middle East, high-income North America and Eastern Europe. Based on these prevalence estimates, approximately 75,850 prosthetists are needed globally to treat people with traumatic amputations. CONCLUSION Amputation prevalence estimates and patterns can inform prosthetic service provision, education and planning.
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Affiliation(s)
- Cody L McDonald
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sarah Westcott-McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Marcia R Weaver
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Deborah Kartin
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Saloojee G, Ekwan F, Andrews C, Damiano DL, Kakooza-Mwesige A, Forssberg H. Akwenda intervention programme for children and youth with cerebral palsy in a low-resource setting in sub-Saharan Africa: protocol for a quasi-randomised controlled study. BMJ Open 2021; 11:e047634. [PMID: 34006038 PMCID: PMC7942240 DOI: 10.1136/bmjopen-2020-047634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cerebral palsy (CP) is the most common childhood-onset motor disorder accompanied by associated impairments, placing a heavy burden on families and health systems. Most children with CP live in low/middle-income countries with little access to rehabilitation services. This study will evaluate the Akwenda CP programme, a multidimensional intervention designed for low-resource settings and aiming at improving: (1) participation, motor function and daily activities for children with CP; (2) quality of life, stress and knowledge for caregivers; and (3) knowledge and attitudes towards children with CP in the communities. METHODS This quasi-randomised controlled clinical study will recruit children and youth with CP aged 2-23 years in a rural area of Uganda. Children will be allocated to one of two groups with at least 44 children in each group. Groups will be matched for age, sex and motor impairment. The intervention arm will receive a comprehensive, multidimensional programme over a period of 11 months comprising (1) caregiver-led training workshops, (2) therapist-led practical group sessions, (3) provision of technical assistive devices, (4) goal-directed training and (5) community communication and advocacy. The other group will receive usual care. The outcome of the intervention will be assessed before and after the intervention and will be measured at three levels: (1) child, (2) caregiver and (3) community. Standard analysis methods for randomised controlled trial will be used to compare groups. Retention of effects will be examined at 12-month follow-up. ETHICS AND DISSEMINATION The study has been approved by the Uganda National Council for Science and Technology (SS 5173) and registered in accordance with WHO and ICMJE standards. Written informed consent will be obtained from caregivers. Results will be disseminated among participants and stakeholders through public engagement events, scientific reports and conference presentations. TRIAL REGISTRATION NUMBER Pan African Clinical Trials Registry (PACTR202011738099314) Pre-results.
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Affiliation(s)
| | - Francis Ekwan
- Department of Occupational Therapy, Mulago National Referral Hospital, Kampala, Uganda
| | - Carin Andrews
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Diane L Damiano
- Department of Rehabilitation Medicine, The National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | | | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Ani PN, Eze SN, Abugu PI. Socio-demographic factors and health status of adults with disability in Enugu Metropolis, Nigeria. Malawi Med J 2021; 33:37-47. [PMID: 34422232 PMCID: PMC8360292 DOI: 10.4314/mmj.v33i1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Disability is a major determinant of impaired health and nutritional status. This study aims to assess the health and nutritional status of adults with disability and their relationship with socio-demographic factors. Methods A descriptive cross-sectional study of 323 adults with disability in support-centers/schools of disability in Enugu Metropolis, Nigeria was conducted. The participants' socio-demographic factors, behavioural characteristics and 24-hour dietary recall were recorded. Blood pressure and anthropometric measurements of height, weight, waist and hip circumference were obtained. The height and weight measurements of non-ambulatory participants were estimated from knee height and mid-arm circumference. Biochemical analyses of blood samples were also performed. Multiple logistic regression was used to assess the effect of socio-demographic factors on health and nutritional status. Results The participants consisted of females (59.3%) within the age of 20 to 30 years (59.1%). The major area of difficulty was in physical mobility (51.1%) and this occurred mostly in females (26.9%). The participants' mean daily intakes of calorie, protein and fat were below the recommended dietary allowances. The participants were overweight (49.2%), obese (4.6%), hypertensive (29.7%) and diabetic (12.1%). Dyslipidemia (81.8%), anemia (63.6%) and zinc deficiency (51.1%) were highly prevalent among the study group. Gender difference was observed in alcohol consumption (p=0.000), smoking habit (p=0.001), waist circumference (WC)(p=0.000), waist-hip-ratio (WHR) (p=0.000), triglyceride (p=0.026) and haemoglobin concentration (p=0.007). Being boarder was a positive predictor of overweight/obesity (OR= 2.974, 95% CI=1.449-6.104), abnormal WHR (OR=2.893, 95% CI = 1.073-7.801) and hypertension (OR=8.381, 95% CI=1.598-13.959). Female gender was associated with abnormal WC (OR=7.219, 95% CI=3.116-14.228) and WHR (OR=3.590, 95% CI=2.095-6.150) whereas older age-group was associated with overweight/obesity (OR=1.908, 95% CI=1.137- 3.202). Being employed was a negative predictor of hypertension. Conclusion Overweight/obesity, anemia, zinc deficiency and dyslipidemia were highly prevalent among persons living with disability in Enugu Metropolis.
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Affiliation(s)
- Peace N Ani
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka
| | - Scholastica N Eze
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka
| | - Philomena I Abugu
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka
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Dey NEY, Dziwornu E, Frimpong-Manso K, Duah HO, Agbadi P. Correlates of child functional difficulties status in Ghana: A further analysis of the 2017/18 multiple indicator cluster survey. Heliyon 2020; 6:e05727. [PMID: 33364496 PMCID: PMC7750366 DOI: 10.1016/j.heliyon.2020.e05727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/06/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Functional difficulties have long-term implications for children's physical, cognitive, emotional, social, and academic growth and development. Although the subject of functional difficulties has received enough scholarly attention in the developed world, few studies have addressed the issue in Ghana. Therefore, the study aimed to regress child, maternal and household and geographical level factors associated with the functional difficulty of children in Ghana. METHOD We analysed the 2017/18 multiple indicator cluster survey dataset. The study sample consists of weighted cases of 21,871 children within the ages of 5-17 years. Summary statistics were produced for the study variables. Bivariate analyses were performed to select significant correlates for the multivariate analysis. We accounted for sample design and weight before using Poisson regression techniques to do the bivariate and multivariate analysis. RESULTS These factors were significantly associated with functional difficulties among 5-17 years old children in Ghana: not covered with health insurance, mothers who have a functional difficulty and those without information on their functional difficulty status, and children who dwelt in richer households compared to the richest households. Compared to the northern region, children from the remaining nine regions in Ghana were more likely to have had a child functional difficulty. CONCLUSION Given the results, the government of Ghana and other development partners should promote policies and programs to reduce the consequences of disability or functional difficulties in children by taking into consideration factors like mothers' functional difficulty, access to health insurance, and regional and economic disparities in Ghana.
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Affiliation(s)
| | - Emmanuel Dziwornu
- University of Health and Allied Sciences, Department of Psychological Medicine and Mental Health, School of Medicine, PMB 31, HO, Volta Region, Ghana
| | | | | | - Pascal Agbadi
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Schlebusch L, Huus K, Samuels A, Granlund M, Dada S. Participation of young people with disabilities and/or chronic conditions in low- and middle-income countries: a scoping review. Dev Med Child Neurol 2020; 62:1259-1265. [PMID: 32597506 DOI: 10.1111/dmcn.14609] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this scoping review was to describe and map the literature available on the participation of young people (0-21y) with disabilities and/or chronic conditions living in low- and middle-income countries (LMICs). METHOD A systematic search and selection process identified 78 publications. Descriptive data were extracted using a data-charting form, and studies were mapped using the family of participation-related constructs framework. RESULTS The findings demonstrated that, although the published evidence is steadily increasing, the participation research on this vulnerable population is still either absent or very scarce in the majority of LMICs, and very little is known about the participation of children with chronic health conditions. Most studies included in this review focused on attendance or 'being there'. INTERPRETATION Although attendance is an important aspect, more needs to be done to understand children's experiences or involvement while attending, thus capturing both dimensions of participation. WHAT THIS PAPER ADDS There is an increasing trend in research on participation patterns of children with disabilities in low- and middle-income countries. Most research focuses on children's attendance, or 'being there'. We know very little about children's involvement, or experience, while attending daily activities.
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Affiliation(s)
- Liezl Schlebusch
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Karina Huus
- CHILD Research Group, School of Health and Welfare, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden
| | - Alecia Samuels
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Mats Granlund
- CHILD Research Group, School of Health and Welfare, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
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Barton C, Buckley J, Samia P, Williams F, Taylor SR, Lindoewood R. The efficacy of appropriate paper-based technology for Kenyan children with cerebral palsy. Disabil Rehabil Assist Technol 2020; 17:927-937. [DOI: 10.1080/17483107.2020.1830442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Catherine Barton
- Physiotherapy Department, Powys Teaching Health Board, Brecon, Wales, UK
- Centre for Active Living, University Centre Shrewsbury (University of Chester), Chester, UK
| | - John Buckley
- Centre for Active Living, University Centre Shrewsbury (University of Chester), Chester, UK
| | - Pauline Samia
- Department of Paediatrics and Child Health, Aga Khan University, Nairobi, Kenya
| | - Fiona Williams
- Department of Geography and International Development, University of Chester, Chester, UK
| | - Suzan R. Taylor
- Centre for Active Living, University Centre Shrewsbury (University of Chester), Chester, UK
| | - Rachel Lindoewood
- Brecon Children’s Centre, Powys Teaching Health Board, Brecon, Wales, UK
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Zhong X, Zhao X, Liu Z, Guo Y, Ma L. Childhood disability and its associated perinatal characteristics in Bao'an district of Shenzhen, China. BMC Public Health 2020; 20:1540. [PMID: 33050912 PMCID: PMC7552345 DOI: 10.1186/s12889-020-09623-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disability has become a public health issues in China and around the world. This study aimed to report prevalence of children with disability by gender, delivery mode, birth weight, gestational age, birth defect and impairment type in the past 15 years in Baoan District, Shenzhen. METHODS Data of children with all types of disability from year 2004 to 2018 was obtained from the registry database of Baoan Disabled Persons Federation. Their perinatal information, including gender, delivery mode, birth weight, gestational age, birth defect were traced from Shenzhen Maternal and Child Health Management System and compared with the whole registered population live births information in this district. Data of children with disabilities were included to calculate the prevalence (%). RESULTS An overall prevalence of children disability was 1.02% in Baoan district, Shenzhen, in the past 15 years. The overall as well as mental disability prevalence rose from the first 5 years period (2004 to 2008) to the second 5 years of 2009 to 2013, and then dropped to the lowest level in the third 5 year of 2014-2018. Mental disability and intelligent disability accounted for the highest proportion. More than 70% of all kinds of the disabilities except mental disability were detected before 1 year old, 87% of the mental and intelligent disabilities were found before 3 years old. The Percentages of male, premature, low birth weight infants and children with cesarean, birth defect in disable children were higher than in whole population live birth children. CONCLUSIONS The overall prevalence of disability declined in the district after specific policy engagement. Mental and intelligent disabilities were still the most common disability in the district. The age of 0-3 years was an important period for early childhood detection and intervention.
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Affiliation(s)
- Xue Zhong
- Department of Child Healthcare, Shenzhen Baoan Women's and Childiren's Hospital, Jinan University, No.56 Yulv Road, Xin'an Street, Baoan District, Shenzhen City, 518100, Guangdong Province, China
| | - Xiaoli Zhao
- Department of Child Healthcare, Shenzhen Baoan Women's and Childiren's Hospital, Jinan University, No.56 Yulv Road, Xin'an Street, Baoan District, Shenzhen City, 518100, Guangdong Province, China
| | - Zhuoya Liu
- Department of Child Healthcare, Shenzhen Baoan Women's and Childiren's Hospital, Jinan University, No.56 Yulv Road, Xin'an Street, Baoan District, Shenzhen City, 518100, Guangdong Province, China
| | - Yuqin Guo
- Department of Child Healthcare, Shenzhen Baoan Women's and Childiren's Hospital, Jinan University, No.56 Yulv Road, Xin'an Street, Baoan District, Shenzhen City, 518100, Guangdong Province, China
| | - Liya Ma
- Department of Child Healthcare, Shenzhen Baoan Women's and Childiren's Hospital, Jinan University, No.56 Yulv Road, Xin'an Street, Baoan District, Shenzhen City, 518100, Guangdong Province, China.
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Hashemi G, Wickenden M, Bright T, Kuper H. Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies. Disabil Rehabil 2020; 44:1207-1220. [PMID: 32956610 DOI: 10.1080/09638288.2020.1817984] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
METHODS Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eligible studies were identified. RESULTS Findings suggest that the people with disabilities' choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types of barriers: cultural beliefs or attitudinal barriers, informational barriers, and practical or logistical barriers. CONCLUSION In order to achieve full health coverage at acceptable quality for people with disabilities, it is necessary not only to consider the different barriers, but also their combined effect on people with disabilities and their households. It is only then that more nuanced and effective interventions to improve access to primary healthcare, systematically addressing barriers, can be designed and implemented.IMPLICATIONS FOR REHABILITATIONPeople with disabilities in both high income and low- and middle-income country settings are more likely to experience poorer general health than people without disabilities.Barriers to accessing primary healthcare services for people with disabilities result from a complex and dynamic interacting system between attitudinal and belief system barriers, informational barriers, and practical and logistical barriers.Given primary healthcare is often the initial point of contact for referral to specialty care and rehabilitation services, it is crucial for people with disabilities to access primary healthcare services in order to get appropriate referrals for such services, specifically rehabilitation as appropriate.To achieve full health coverage at acceptable quality for people with disabilities, starting with primary healthcare, it is necessary for healthcare stakeholders, including rehabilitation professionals, to consider the combined and cumulative effects of the various barriers to healthcare on people with disabilities and their families and develop an understanding of how healthcare decisions are made by people with disabilities at the personal and the household level.
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Affiliation(s)
- Goli Hashemi
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK.,Department of Occupational Therapy, Samuel Merritt University, Oakland, CA, USA
| | - Mary Wickenden
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Intersecting inequalities, gender and adolescent health in Ethiopia. Int J Equity Health 2020; 19:97. [PMID: 32539778 PMCID: PMC7296636 DOI: 10.1186/s12939-020-01214-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/04/2020] [Indexed: 01/22/2023] Open
Abstract
Background Until recently, global public health initiatives have tended to overlook the ways that social factors shape adolescent health, and particularly how these dynamics affect the specific needs of adolescents in relation to information about puberty, menstruation and sexual health. This article draws on mixed methods data from rural and urban areas of Ethiopia to explore how access to health information and resources - and subsequently health outcomes - for adolescents are mediated by gender and age norms, living in different geographical locations, poverty, disability and migration. Methods Data was collected in 2017–2018 for the Gender and Adolescence: Global Evidence (GAGE) mixed-methods longitudinal research baseline in three regions of Ethiopia (Afar, Amhara and Oromia). Quantitative data was collected from over 6800 adolescents and their caregivers, with qualitative data obtained from a sub-sample of 220 adolescents, their families and communities. Adolescent participants shared their experiences of health, illness and nutrition over the previous year; their knowledge and sources of information about sexual and reproductive health and puberty; and their attitudes toward sexual and reproductive health. Regression analysis was used to explore differences by gender, age, rural/urban residence, and disability status, across a set of adolescents’ health knowledge and other outcomes in the quantitative data. Intersectional analysis was used in analysing the qualitative data. Results Analysis suggested that gender inequality intersects with age, disability and rural/urban differences to shape young people’s access to information about puberty, with knowledge about this topic particularly lacking amongst younger adolescents in rural areas. Drought and lack of access to clean water exacerbates health challenges for adolescents in rural areas, where a lack of information and absence of access to preventive healthcare services can lead to permanent disability. The research also found that gaps in both school-based and alternative sources of education about puberty and menstruation reinforce stigma and misinformation, especially in rural areas where adolescents have higher school attrition rates. Gendered cultural norms that place high value on marriage and motherhood generate barriers to contraceptive use, particularly in certain rural communities. Conclusions As they progress through adolescence, young people’s overall health and access to information about their changing bodies is heavily shaped by intersecting social identities. Structural disadvantages such as poverty, distress migration and differential access to healthcare intersect with gender norms to generate further inequalities in adolescent girls’ and boys’ health outcomes.
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Magnusson L, Finye C, Enstedt C. Access to basic needs and health care for Malawian prosthetic and orthotic users with lower limb physical disabilities: a cross-sectional study. Disabil Rehabil 2020; 43:3764-3771. [PMID: 32356469 DOI: 10.1080/09638288.2020.1752316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To investigate access to basic human rights such as health, a standard of living adequate for health, education, work, marrying and establishing a family, and voting for prosthetic and orthotic users with lower limb disabilities in Malawi.Materials and methods: A cross-sectional design and a questionnaire were used to collect data from 83 participants.Results: Most participants reported their overall physical and mental health as good (60 [72%] and 50 [60%], respectively) and said they could access medical care (69 [83%]). Fifty (60%) participants had access to food, 72 (87%) had access to basic water, and 55 (66%) lived in housing adequate for their health. Most participants had studied in school (74 [89%]) but only 27 (33%) of the participants were working. Forty-three (52%) were married and 53 (64%) had children. Seventy-six (92%) participants could vote if they wished.Conclusions: Rurality and high costs of transport and medication increase the barriers to accessing several basic human rights for people with lower limb physical disabilities. Interventions to target these barriers and increase access to secondary school, employment, and income could improve health equity for people with physical disabilities in Malawi and similar contexts.Implications for RehabilitationIn Malawi, the convention on the rights of persons with disabilities is yet to be implemented.Policy makers in Malawi need to take actions to increase access to regular and specialized healthcare services for persons with physical disabilities including financial support to afford medications and transport to reach health services.Policy makers in Malawi need to take actions to increase access to secondary and higher education, and employment for persons with physical disabilities to increase their possibilities to earn an income.
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Affiliation(s)
- Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Clifford Finye
- Prosthetic and Orthotic Centre, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Catrin Enstedt
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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No One Left Behind? Comparing Poverty and Deprivation between People with and without Disabilities in the Maldives. SUSTAINABILITY 2020. [DOI: 10.3390/su12052066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 2030 Sustainable Development Goals call for the disaggregation of all indicators by disability and other characteristics so as to “leave no one behind” from development progress. Data on disability, however, is acknowledged to be lacking, which is essential for informing policy and planning. Consequently, this study estimates the prevalence of disability in the Maldives and compares indicators of poverty and living conditions between people with and without disabilities, using nationally-representative, population-based data (n = 5363). The prevalence of disability was estimated at 6.8%. Overall, this research finds that people with disabilities are at risk of being left behind from progress across multiple Sustainable Development Goal domains, including in combatting income poverty, food insecurity and exclusion from health, education, work and social participation, and vulnerability to violence. Further, amongst people with disabilities, people with cognitive and mental health impairments, people living outside the capital, Male’, and children and working-age adults tend to face the highest levels of deprivation.
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Murphy R, Jolley E, Lynch P, Mankhwazi M, Mbukwa J, Bechange S, Gladstone MJ, Schmidt E. Estimated prevalence of disability and developmental delay among preschool children in rural Malawi: Findings from "Tikule Limodzi," a cross-sectional survey. Child Care Health Dev 2020; 46:187-194. [PMID: 31925814 PMCID: PMC7027747 DOI: 10.1111/cch.12741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 01/05/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Early childhood development (ECD) is a critical stage in children's lives, influencing future development and social integration. ECD research among children with disability and developmental delay in low- and middle-income countries is limited but crucial to inform planning and delivery of inclusive services. This study is the first to measure and compare the prevalence of disability and developmental delay among children attending preschool centres in rural Malawi. METHODS A cross-sectional survey was conducted in 48 preschool centres in Thyolo district, Malawi. Data were collected from parents or guardians of 20 children per centre. Disability was ascertained using the Washington Group/UNICEF Child Functioning Module. Child development was measured using the language and social domains of the Malawi Development Assessment Tool. RESULTS A total of 960 children were enrolled; 935 (97.4%) children were assessed for disability and 933 (97.2%) for developmental delay; 100 (10.7%) children were identified as having a disability. The prevalence of disability was higher among children 5+ years (n = 60; 29.3%) than children 2-4 years (n = 40; 5.5%); 109 of 933 (11.7%) children were classified as having developmental delay, 41 (4.4%) in "language" and 77 (8·3%) in "social" domains. CONCLUSIONS This study found that disability and developmental delays are common among preschool children in Malawi. It is one of the first to measure disability and delay among children in a preschool setting in Africa.
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Affiliation(s)
| | - Emma Jolley
- Health and Disability ResearchSightsaversChippenhamUK
| | - Paul Lynch
- Vision Impairment Centre for Teaching and ResearchUniversity of BirminghamUK
| | | | | | | | | | - Elena Schmidt
- Strategic Programme Innovation, Development and Research, Sightsavers, ChippenhamUK
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