scholarly journals “When They See a Wheelchair, They’ve Not Even Seen Me”—Factors Shaping the Experience of Disability Stigma and Discrimination in Kenya

Author(s):  
Giulia Barbareschi ◽  
Mark T. Carew ◽  
Elizabeth Aderonke Johnson ◽  
Norah Kopi ◽  
Catherine Holloway

Disability stigma in many low- and middle-income countries represents one of the most pervasive barriers preventing people with disabilities from accessing equal rights and opportunities, including the uptake of available assistive technology (AT). Previous studies have rarely examined how disability stigma may be shaped through factors endemic to social interactions, including how the use of assistive technology itself may precipitate or alleviate disability stigma. Through two strands of work, we address this gap. Via a series of focus groups with Kenyans without disabilities (Study 1) and secondary data analysis of consultations with Kenyans with disabilities and their allies (Study 2), we identify shared and divergent understandings of what shapes disability stigma and discrimination. Specifically, Kenyans with and without disabilities were cognizant of how religious/spiritual interpretations of disability, conceptions of impairments as “different” from the norm, and social stereotypes about (dis)ability shaped the experience of stigma and discrimination. Moreover, both groups highlighted assistive technology as an influential factor that served to identify or “mark” someone as having a disability. However, whereas participants without disabilities saw assistive technology purely as an enabler to overcome stigma, participants with disabilities also noted that, in some cases, use of assistive technologies would attract stigma from others.

2015 ◽  
Vol 24 (5) ◽  
pp. 382-394 ◽  
Author(s):  
M. Semrau ◽  
S. Evans-Lacko ◽  
M. Koschorke ◽  
L. Ashenafi ◽  
G. Thornicroft

Aims.This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs.Methods.Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian.Results.Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs.Conclusion.Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.


2021 ◽  
Vol 13 (21) ◽  
pp. 11758
Author(s):  
Giulia Oggero ◽  
Louise Puli ◽  
Emma Maria Smith ◽  
Chapal Khasnabis

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and achievements in the Summer Paralympic Games by income level and sex, including in events requiring assistive products (wheelchairs, hand cycles/trikes, and prostheses). A retrospective secondary analysis of publicly available data was conducted. Participation, sex, and medal tally data were extracted from data available on the International Paralympic Committee website and archives. Data regarding income and population were collected from publicly available data available from the World Bank website. Participation in the Summer Paralympic Games differs significantly by income level (p = 0.000) with high- income countries sending, on average, more Paralympians than low- and middle-income countries. There is a significant difference between male and female participation (p = 0.00), with approximately 29% of all Paralympians being female. High-income countries demonstrate significantly higher achievement than low- and middle-income countries (p = 0.000), including in events requiring assistive products (p = 0.007). Despite growth in overall participation, low- and middle-income countries remain severely underrepresented in both participation and achievement at the Paralympic Games, especially in the events that require high quality assistive products to succeed. More equitable participation and achievement in the Paralympics may be supported by addressing the barriers for females, for people from low- and low-middle income countries, and for those without access to high quality assistive products required.


2019 ◽  
Vol 4 (5) ◽  
pp. e001560
Author(s):  
Carinne Brody ◽  
Say Sok ◽  
Sovannary Tuot ◽  
Marija Pantelic ◽  
Enrique Restoy ◽  
...  

IntroductionThis systematic review aims to determine if combination HIV prevention programmes include outcome measures for empowerment, inclusion and agency to demand equal rights and measure the relationship between empowerment and HIV prevention outcomes.MethodsAn electronic literature search of PubMed, POPLINE, Index Medicus and Google Scholar was conducted between August and October 2018. We included studies that evaluated combination prevention programmes that had all three types of intervention components and that specifically serve members of populations disproportionately affected by HIV published from 2008 to 2018. The selected studies were screened for inclusion, and relevant data abstracted, assessed for bias and synthesised.ResultsThis review included a total of 15 studies. Findings indicate that combination HIV prevention programmes for marginalised populations have delivered a variety of theory-based behavioural and structural interventions that support improvements in empowerment, inclusion and agency. However, empowerment, inclusion and least of all agency are not measured consistently or in a standardised way. In addition, analysis of their relationships with HIV prevention outcomes is rare. Out of our 15 included studies, only two measured a relationship between an empowerment, inclusion or agency outcome and an HIV prevention outcome.ConclusionThese findings suggest that policy-makers, programme planners and researchers might need to consider the intermediate steps on the pathway to increased condom use and HIV testing so as to explain the ‘how’ of their achievements and inform future investments in HIV prevention. This will support replication and expansion of programmes and ensure sustainability of the programmes.PROSPERO registration numberCRD42018106909


2022 ◽  
pp. bjsports-2021-104545
Author(s):  
Emily Anne Rutland ◽  
Sakinah C Suttiratana ◽  
Sheila da Silva Vieira ◽  
Rekha Janarthanan ◽  
Michael Amick ◽  
...  

ObjectivesInterpersonal violence is an increasingly recognised risk of sport participation and causally linked to negative physical and mental health outcomes. Para athletes from low- and middle-income countries may be at highest risk of physical, psychological, sexual and neglect-related violence due to various factors; however, their perceptions of these abusive behaviours are unknown. This study examined the perceptions and experiences of abuse in para athletes from three lower resourced countries: Ghana, India and Brazil.MethodsQualitative data from semistructured focus group interviews conducted with 26 individuals were collected to explore characteristics of abuse observed, navigated and experienced by para athletes. The framework method for multidisciplinary qualitative research guided data analysis.ResultsAthletes identified a wide range of abusive behaviours they experienced within and outside of sport, including psychological, emotional, physical, sexual and neglect-related violence, which operated on both interpersonal and systemic levels. Most athletes described three less easily recognised forms of abuse in greater detail and more frequently than others: financial abuse, neglect and disability stigma.ConclusionIt is important to hear directly from athletes with diverse experiences and backgrounds and to integrate their insights and priorities into sport safeguarding policies, programmes and interventions. Understanding the requirements and challenges of para athletes and para sport is needed to achieve safe, equitable and inclusive sport. As new insights from diverse sport settings are added to the evidence base, globally balanced, athlete-generated and locally relevant preventative strategies can better protect all athletes.


Author(s):  
Nicole Votruba ◽  
Mirja Koschorke ◽  
Graham Thornicroft

People with mental illness frequently face challenges related to knowledge, attitudes, and behaviour. These challenges are more commonly known as stigma and discrimination, and appear universally with local and regional variations in their content and manifestations. They display in low levels of mental health literacy among the general population (ignorance/knowledge), negative affect towards people with experience of mental illness (prejudice/attitudes), and social exclusion and diminished citizenship for people with mental illness (discrimination/behaviour). This chapter looks at how people with mental illness are impacted by stigma and discrimination, considering the evidence of the implications of these knowledge, attitudes, and behaviour, and summarizes the literature on what can be done to effectively reduce stigma and discrimination. Increasingly strong evidence suggests that personal and social contact methods, including filmed/virtual contact, are the most strongly evidence-based method to reduce stigma and discrimination. Yet, most evidence is from high-income countries and tested for short- to mid-term efficacy. This evidence gap increases the need for more evidence from low- and middle-income countries and validation of sustainability in more long-term studies. In summary and for future research and interventions, service users will the key partners in anti-stigma programmes, and interventions specifically locally and culturally adapted for use in low- and middle-income countries are a pressing priority.


2011 ◽  
Vol 35 (1) ◽  
pp. 20-29 ◽  
Author(s):  
Johan Borg ◽  
Anna Lindström ◽  
Stig Larsson

Background: The ‘Convention on the Rights of Persons with Disabilities’ (CRPD) requires governments to meet the assistive technology needs of citizens. However, the access to assistive technology in developing countries is severely limited, which is aggravated by a lack of related services.Objectives: To summarize current knowledge on assistive technology for low- and lower-middle-income countries published in 1995 or later, and to provide recommendations that facilitate implementation of the CRPD.Study design: Literature review.Methods: Literature was searched in web-based databases and reference lists. Studies carried out in low- and lower-middle-income countries, or addressing assistive technology for such countries, were included.Results: The 52 included articles are dominated by product oriented research on leg prostheses and manual wheelchairs. Less has been published on hearing aids and virtually nothing on the broad range of other types of assistive technology.Conclusions: To support effective implementation of the CRPD in these countries, there is a need for actions and research related particularly to policies, service delivery, outcomes and international cooperation, but also to product development and production.Clinical relevanceThe article has a potential to contribute to CRPD compliant developments in the provision of assistive technology in developing countries by providing practitioners with an overview of published knowledge and researchers with identified research needs.


2020 ◽  
Vol 42 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Percy Herrera-Añazco ◽  
Maycol Suker Ccorahua-Ríos ◽  
Mirian Condori-Huaraka ◽  
Yerika Huamanvilca-Yepez ◽  
Elard Amaya ◽  
...  

ABSTRACT Introduction: Acute kidney injury (AKI) is a common disorder that causes high healthcare costs. There are limited epidemiological studies of this disorder in low- and middle-income countries. The aim of this study was to describe trends in the age-standardized incidence and mortality rates of AKI in Peru. Methods: We conducted an ecological study based on a secondary data sources of the basic cause of death from healthcare and death records obtained from establishments of the Ministry of Health of Peru for the period 2005-2016. The age-standardized incidence and mortality rates of AKI were described by region and trend effects were estimated by linear regression models. Results: During the period 2005-2016, 26,633 cases of AKI were reported nationwide. The age-standardized incidence rate of AKI per 100,000 people increased by 15.2%, from 10.5 (period 2005-2010) to 12.1 (period 2011-2016). During the period 2005-2016, 6,812 deaths due to AKI were reported, which represented 0.49% of all deaths reported for that period in Peru. The age-standardized mortality rate of AKI per 100,000 people decreased by 11.1%, from 2.7 (period 2005-2010) to 2.4 (period 2011-2016). The greatest incidence and mortality rates were observed in the age group older than 60 years. Conclusions: During the study period, incidence of AKI increased and mortality decreased, with heterogeneous variations among regions.


2021 ◽  
Vol 1 (3) ◽  
pp. 425-430
Author(s):  
Astri Nadia Hidayat ◽  
Novita Ariani ◽  
Ida Rahman Burhan

   Cervical cancer was one of the most common malignancies in women and was the leading cause of death from cancer, especially in low and middle-income countries (developing countries). The high incidence and mortality rate in developing countries was caused by the lack of knowledge about cervical cancer and limited access to early detection, so that patients come late for treatment and were diagnosed when their condition were severe and the disease had progressed to an advanced stage. This study was conducted in the Medical Record Installation section of Dr. M. Djamil Padang Hospital on 11 August - 2 September 2020. The results of the study were obtained from secondary data from medical records, and data collection was taken by total sampling. Samples that have met the inclusion criteria in this study were 84 patients diagnosed with cervical cancer at Dr. M. Djamil Padang Hospital in 2019. The results showed cervical cancer patients at Dr. M. Djamil Padang Hospital in 2019 were mostly in the ≥50 year age group (51.2%), multiparous category (77.4%), and High School/ equivalent category (70.2 %). Keywords : Risk Factor, Cervical Cancer, Age, Parity, Education Level


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