Collaborating with Communities and Higher Education to Address the Health-care Needs of Individuals with Disabilities in Ecuador

Access to basic needs and health care for Malawian prosthetic and orthotic users with lower limb physical disabilities: a cross-sectional study

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.

Examination of the short-term impact of a disability awareness training on attitudes toward people with disabilities: A community-based participatory evaluation approach

Background: Worldwide over a billion people live with a disability including 400,000 people in Ecuador. People with disabilities (PWD) face barriers to full participation in society. Barriers are generated by negative attitudes created through socio-cultural experiences. Awareness about disability can be facilitated through disability awareness training (DAT). Studies examining outcomes on DAT exist in high-resourced countries but are nonexistent in Ecuador. Study purposes:1) create a DAT using community input and conduct the training; 2) examine the impact of the DAT on attitudes toward and awareness of PWD; and 3) explore community perceptions regarding the impact of the DAT on action. Methods: Community-based participatory evaluation was employed to design and assess the impact of a DAT with 60 community members from Latacunga, Ecuador. The DAT incorporated a multi-modal approach (interactive discussion, problem-solving, hands-on activities) and was informed by the theory of planned behavior. Data sources were the Multidimensional Attitudes Scale (MAS) (Spanish version) administered pre- and post-DAT and interviews conducted with nine DAT participants. Results: Mann Whitney U revealed significant changes in two of four MAS constructs: emotion p = .005 and cognition p = .003. Five themes emerged from the interviews: 1) view of disability; 2) contact; 3) attitude; 4) training impact; and 5) action. Conclusion: In the short-term DAT may increase awareness of and decrease negative attitudes associated with disability. Effective strategies highlighted for raising awareness and improving attitudes were contact with PWD and education. Education leads to more positive perceptions of the barriers PWD face and their ability to participate in society.