Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Abstract

Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. ä Implications for RehabilitationThere needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.

Barriers and facilitators to healthcare access for children with disabilities in low and middle income sub-Saharan African countries: a scoping review

“…Although there were 29 countries in Africa that allocated less than $50 per person to healthcare, papers included in this study were from only nine Sub-Saharan countries. Of the 15 articles discussed in this review, four papers reported on Ethiopia [11][12][13], two on Zimbabwe [14,15], two on Malawi [16,17], two on Cote d'Ivoire [18,19], one on Rwanda and Uganda [20], one on Uganda [21], one on Kenya [22], one on Zambia [23] and one on Nigeria [24] (Table 1 in Appendix).…”

“…Theme 2: Accessibility of services and systems Availability of health services, clinical pathways, and qualified healthcare staff Available research showed that CwDs in Zambia, Malawi, and Kenya have limited access to healthcare services including community and hospital services in populated areas [16,22,23]. Therefore, caregivers would take their children to be treated by traditional healers instead of seeking medical attention [23].…”

The perception of disability by community groups: Stories of local understanding, beliefs and challenges in a rural part of Kenya

“…Limited support services and poor access to knowledge may be contributing factors [2–3]. Communal narratives have emerged to explain the presence of disability.…”

Anticipated Barriers to Implementation of Community-Based Rehabilitation in Ribeirão Preto, Brazil

“…In contrast with this epidemiological trend, most health systems are insufficiently equipped to respond to the needs of people with disabilities (Chatterji et al, 2015;Prince et al, 2015). In many lower-income territories, physical rehabilitation services are in short supply (Bunning et al, 2014;Wylie et al, 2016;Agho & John, 2017;Jesus et al, 2017;Krug & Cieza, 2017). Besides, in those areas, people with disabilities typically experience more financial, transportation or attitudinal barriers to access needed healthcare than people without disabilities (Mlenzana et al, 2013;Abdi et al, 2015;Neille & Penn, 2015;van Hees et al, 2015;Ganle et al, 2016;Munthali et al, 2017;Visagie et al, 2017;Vergunst et al, 2017) , even though people with disabilities usually have higher health needs, higher risks of chronic and secondary health conditions, higher cost of living, and finally, lower earnings and lower employment rates (Mitra et al, 2009;Rimmer et al, 2011;World Health Organisation and World Bank, 2011;Gudlavalleti et al, 2014;Mitra et al, 2017).…”

“…Consideration of community-based initiatives is required to address all these issues and to meet the health, rehabilitation and societal needs of people with disabilities, especially in lower income, socially-vulnerable territories (Bunning et al, 2014;Gilmore et al, 2017).…”