‘Impairments of the brain’: Global South perspectives on childhood neurodevelopmental disability

Abstract

The word 'disability' does not exist in most African languages. There are words for impairments that describe the 'missing' or affected body parts, but no specific words to characterize, for instance, neurodevelopmental conditions. In this narrative review we focus on the different interpretations of neurodevelopmental conditions in Uganda and discuss the importance of cultural concepts and the intersectionality of family-centred care, poverty, and neocolonialism when working with children with 'impairments of the brain'. We suggest that these concepts should be taken into consideration in health care service provision and public health awareness campaigns, and the need to rethink how disabled children can be included in a 'global' health approach. We explain how applying biomedical categories used in the Global North to diagnose children is only ethical if this information will benefit the child and is accompanied by supportive actions that are relevant to the child and family setting.We argue for the enhancement of community-based structures of belonging and interdependence that are already in place and strengthening of family and community networks to continue the care and co-responsibility for children with 'impairments of the brain'.

Overview of Cochrane systematic reviews for rehabilitation interventions in individuals with cerebral palsy: A mapping synthesis

“…Furthermore, the guidelines do not give specific recommendations and highlight the need for more research on low‐cost, impairment‐based interventions specifically targeting these areas 43–45 . Therefore, our findings could drive future research to investigate the most appropriate post‐BoNT‐A injection treatment based on a multimodal approach to optimize a personalized treatment and encourage favourable outcomes.…”

The developing brain: Challenges and opportunities to promote school readiness in young children at risk of neurodevelopmental disorders in low- and middle-income countries

“…Studies performed in LMICs indicate that a combination of caregiver group sessions ran by health professionals in combination with (a) tele-coaching by health professionals and/or (b) home visits by trained lay CHWs may be feasible means to deliver intervention services in infants at increased likelihood of or with neurodevelopmental disorders (82,83). In the implementation of these early intervention services, it is important to recognize cultural diversity in understanding neurodisability (84). Accordingly, the first steps in early intervention consist of discussing with the family the child's condition, its significance for child, family and community, and the goals of early intervention.…”

“…In LMICs, families generally are firmly imbedded in the local community, as LMIC-societies function more collectivistic than societies in the individualistic HICs (85). The interdependent societal organization in LMICs may offer specific opportunities for early intervention (84), e.g., through the help of lay CHWs. Cultural integration is a prerequisite for successful early intervention in LMICs (86-88).…”

Can Global South perspectives lead to effective Global South solutions?

“…EDITOR-As health professionals and family members working with disabled children in the Global South, we welcome Bannink Mbazzi and Kawesa's study. 1 As they, and many other disability researchers previously have pointed out, environmental, cultural, and ethnic factors play a significant role in understanding how families of children with neurodevelopmental disabilities cope, adapt, and attach meaning to the diagnosis and the concept of disability.…”