Using community/researcher partnerships to develop a culturally relevant intervention for children with communication disabilities in Kenya

Abstract

Purpose. The objective of this study is to develop a culturally relevant community-based intervention for children with communication disabilities in Kenya through a community/researcher partnership. The resulting intervention is for use in a randomized control trial which will be reported at a later stage. Method. Using a qualitative approach, initial data was collected through focus group discussions with women, disabled people and traditional dancers. The groups examined the needs, problems and challenges faced by disabled children and their families. This generated the content and structure for a series of participatory workshops with a further two women's groups. These workshops strove to generate a culturally relevant community-based intervention programme for children with communication disabilities and their families. The content and balance of the resulting intervention was observed to be different from existing programmes described in the literature. Notably it included many culturally appropriate strategies for increasing social integration and raising community awareness. Results. The process of generating a locally relevant community-based rehabilitation intervention is potentially transferable and has particular relevance to the estimated 80% of the world where there are no formal rehabilitation services for children with disabilities and where women's groups are a strong element of local culture. Conclusion. (i) Community/researcher partnerships can be used to develop interventions; (ii) such interventions are different from those imported from other cultures; and (iii) this process is transferable and can be part of the preparations for a Randomized Control Trial.

Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century

“…These include studies focused on tailoring approaches to indigenous populations in Oceania [98, 99] or the local development of culturally relevant, community-based interventions for children with disabilities in Kenya [100]. Finally, some international clinical education/service placements, from higher to lower income countries, have overcome cultural implementation barriers [101–105].…”

“…While policies for universal rehabilitation coverage might be in place, supplying underserved areas may also require implementing (i) trans-disciplinary models of rehabilitation practice [75, 77, 111]; (ii) more accessible, locally shaped forms of rehabilitation service delivery (community-, home-, tele-based) [59, 69, 77, 81, 100] and finally (iii) response outreach programs that cut across institutional (public, private, NGOs) and traditional healthcare silos [69, 77, 81, 138, 139]. …”

A source of strength and empowerment? An exploration of the influence of disabled children on the lives of their mothers in Karachi, Pakistan

“…It is widely recognised that the support of family caregivers, mostly women, is an important contribution to the quality of life experienced by children and adults with disabilities in the home and community-based setting [1,2]. When a child experiences functional impairments and possible longer term dependency on the parent, the increased demands of care-giving can be more challenging.…”

“…Therefore, the development of these services must consider the status and needs of the caregivers, mainly women as well as the child with disabilities. Strategies such as the economic empowerment of women, counselling and community-based social networks may potentially be important means for women to take transformative action for themselves and their children [1,19,22,[24][25][26].…”

The Human Resources Challenge to Community Based Rehabilitation: The Need for a Scientific, Systematic and Coordinated Global Response

“…Mid-level cadres have also been effectively trained as professionspecific assistants -providing rehabilitation services under supervision -for many years (WHO, 1992). Community-based workers -another level of training -have shown some promise in addressing geographical barriers to access (Hartley et al, 2009). As the World Report on Disability (WHO, 2011a) suggests, such workers "can work across traditional health and social services boundaries to provide basic rehabilitation in the community while referring patients to more specialised services as needed" and where they exist.…”