BackgroundIn low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community.MethodsA qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability.ResultsOne hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors – including the Western healthcare, religious, and traditional sectors.ConclusionsUnderstanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.

Ghana has a population of over 27 million people, of which 1 in 15 may have a communication disability. The number of speech and language therapists (SLTs) available to support these people remains remarkably small, presenting a major workforce challenge. As an emerging profession, there remain significant challenges around educating the first generation of SLTs. Ghana, however, has a healthy digital infrastructure which can be taken advantage of. We describe a comprehensive study which aimed to co-design a set of locally appropriate digital tools to enhance SLT training in Ghana. We contribute insights into how digital tools could support social learning and the transition from student to independent practitioner and future clinical supervisor. We offer a set of design recommendations for creating an online Community of Practice to enhance continuing professional development.

Purpose: In Majority World countries, where speech-language pathology services are extremely limited, people with communication disabilities may seek help from a range of 3 service providers. This qualitative research aimed to explore the nature of community services offered to people with communication disabilities who seek help in Accra, Ghana. Method: Semi-structured interviews were conducted with nine individuals from three professions: pastors (3), doctors (3), and herbalists (3) exploring services that they may offer to PWCD seeking help. Interviews were analysed using Thematic Network Analysis. Result: Six global themes described beliefs about communication disability, types of intervention, explanations provided to people with communication disabilities, promoting communication, processes for selecting treatments, and links between service providers. Interventions encompassed physical, spiritual, psychosocial and environmental approaches, with the notion of plural beliefs interwoven through a number of themes. Conclusion: In Ghana, and other Majority World contexts, service providers in sectors not commonly associated with communication disability rehabilitation may have important roles to play in supporting people with communication disabilities. Understanding the contributions of other service providers may assist the growing profession of speechlanguage pathology to collaborate across sectors, to develop specific, culturally responsive approaches to service development.

This preliminary qualitative description study explored knowledge from urban Ghanaians about the nature and impact of their self-reported voice problem. Ten Ghanaians were screened for a self-reported voice disorder using the Voice Handicap Index–10 (VHI-10), and they also completed a structured interview with a speech-language therapist. Content analysis was completed from interview responses using quantification of data. Four out of 10 adult Ghanaians demonstrated high VHI-10 scores that indicated a self-reported voice disorder. Themes that emerged included a recurring problem with voice, multiple vocal impairments, limitations with participating in vocal activities, and other health problems. Lack of financial resources and little knowledge about voice disorders were barriers to accessing care. In summary, four adult Ghanaians with a self-reported voice disorder described multiple problems with their voice, limiting their participation in vocal activities. Implications of these preliminary findings include early identification and improving voice care access to avoid handicapping voice problems.