scholarly journals Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Mary Wickenden ◽  
Diane Mulligan ◽  
Gertrude O. Fefoame ◽  
Phoebe Katende
Keyword(s):  
Qualitative Data ◽  
Policy And Practice ◽  
Group Discussions ◽  
Community Based ◽  
Participatory Approaches ◽  
Consultation Process ◽  
Research Activities ◽  
Community Based Rehabilitation ◽  
Key Stakeholders ◽  
New Guidelines

Background: The focus of this paper is the new broadened conceptualisation of community-based rehabilitation (CBR), which promotes the empowerment and inclusion of people with disabilities (PWDs) in diverse ways within their communities. New guidelines for CBR were launched in October 2010 by WHO/ILO/UNESCO/IDDC, and this paper describes part of the process by which these were produced using participatory approaches involving International Non-Government Organisations (INGOs) and local partners. The paper reviews the evolution of CBR and describes how grassroots consultation by INGOs working with key stakeholders in the disability arena can influence policy on disability issues, and reciprocally how policy change can inform organisations’ practice and research activities. This ongoing bidirectional influence is illustrated with data from the participatory consultation process about the new CBR guidelines carried out by Sightsavers in Uganda and GhanaObjectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document.Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries.Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team.Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes have prompted organisations to adapt their own policies and programmes in order to be more responsive to the local needs and concerns of PWDs.

scholarly journals Effect of Training “Boda-boda” Riders on Community-Based Referrals for Maternal Outcome: A Case of Busoga Region, Uganda

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Muluya Kharim Mwebaza ◽  
Mugisha John Francis ◽  
Kithuka Peter ◽  
Kibaara Kenneth Rucha ◽  
Muwanguzi David Gangu ◽  
...  
Keyword(s):  
Health Facility ◽  
Qualitative Data ◽  
Health Centre ◽  
Health Centers ◽  
Group Discussions ◽  
Community Based ◽  
Key Stakeholders ◽  
And Control ◽  
The Impact

Many pregnant mothers miss antenatal care attendance and health facility deliveries despite several interventions either due to knowledge gap on the benefits or lack of transport means to reach the health centre. Therefore, training of “boda-boda” (motor-cycle) riders in Busoga Region in Uganda was conducted to determine its effect on health facility-based deliveries. The study was a non-randomized control trial with intervention and control groups from selected health centers and communities in Busoga Region. Interventions included the training of boda-boda riders for 5 days to give them knowledge; with a six months follow-up to determine the impact of training. Questionnaires, interviews and focus group discussions were used to collect quantitative and qualitative data. Descriptive statistical analysis was computed for the quantitative data and thematic analysis for qualitative data. Findings revealed improved knowledge of boda-boda riders on maternal referrals from 49.1% to 79.0% in the intervention arm compared to 43.8% to 45.2% in the control arm. Use of boda-boda transport by mothers improved from 0% to 70.5% in the intervention arm compared to only 0% to 51.2% in the control arm. Also, of the 70.5% of the mothers who used boda-boda transport, 69.4% were transported by trained boda-boda riders and only 30.6% by un-trained boda-boda riders. Apart from age (p=0.000; CI=2.785 – 53.284) and ownership of the motorcycle (p=0.002; CI=0.992 – 8.658), the rest of the socio-demographic determinants of health facility-based deliveries were not statistically significant. Age of boda-boda riders (25–34 years, p=0.000) and ownership of the play a pivotal role in the improvement of health facility-based deliveries. Training of boda-boda riders and other key stakeholders impacted on the community based maternal referrals in the study area.

scholarly journals “We can’t handle things we don’t know about”: perceived neurorehabilitation challenges for Malawian paediatric cerebral malaria survivors

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexandra Boubour ◽  
Sebastian Mboma ◽  
Tracy Võ ◽  
Gretchen L. Birbeck ◽  
Karl B. Seydel ◽  
...  
Keyword(s):  
Cerebral Malaria ◽  
Data Gathering ◽  
Group Discussions ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Exploratory Approach ◽  
Holistic Understanding ◽  
Multiple Regions ◽  
Trained Staff ◽  
Rehabilitation Personnel

Abstract Background We sought to identify perceptions of neurorehabilitation challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methods An exploratory approach was used to qualitatively investigate the perceived neurorehabilitation challenges for paediatric CM survivors. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs). Results FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable. Conclusions There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

scholarly journals “Like a doctor, like a brother”: Achieving competence amongst lay health workers delivering community-based rehabilitation for people with schizophrenia in Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246158
Author(s):  
Laura Asher ◽  
Rahel Birhane ◽  
Solomon Teferra ◽  
Barkot Milkias ◽  
Benyam Worku ◽  
...  
Keyword(s):  
Pilot Study ◽  
Problem Solving ◽  
Health Workers ◽  
Core Competencies ◽  
Lay Health Workers ◽  
Personal Factors ◽  
Group Discussions ◽  
Community Based ◽  
Peer Supervision ◽  
Community Based Rehabilitation

Background There are gaps in our understanding of how non-specialists, such as lay health workers, can achieve core competencies to deliver psychosocial interventions in low- and middle-income countries. Methods We conducted a 12-month mixed-methods study alongside the Rehabilitation Intervention for people with Schizophrenia in Ethiopia (RISE) pilot study. We rated a total of 30 role-plays and 55 clinical encounters of ten community-based rehabilitation (CBR) lay workers using an Ethiopian adaptation of the ENhancing Assessment of Common Therapeutic factors (ENACT) structured observational rating scale. To explore factors influencing competence, six focus group discussions and four in-depth interviews were conducted with 11 CBR workers and two supervisors at three time-points. We conducted a thematic analysis and triangulated the qualitative and quantitative data. Results There were improvements in CBR worker competence throughout the training and 12-month pilot study. Therapeutic alliance competencies (e.g., empathy) saw the earliest improvements. Competencies in personal factors (e.g., substance use) and external factors (e.g., assessing social networks) were initially rated lower, but scores improved during the pilot. Problem-solving and giving advice competencies saw the least improvements overall. Multimodal training, including role-plays, field work and group discussions, contributed to early development of competence. Initial stigma towards CBR participants was reduced through contact. Over time CBR workers occupied dual roles of expert and close friend for the people with schizophrenia in the programme. Competence was sustained through peer supervision, which also supported wellbeing. More intensive specialist supervision was needed. Conclusion It is possible to equip lay health workers with the core competencies to deliver a psychosocial intervention for people with schizophrenia in a low-income setting. A prolonged period of work experience is needed to develop advanced skills such as problem-solving. A structured intervention with clear protocols, combined with peer supervision to support wellbeing, is recommended for good quality intervention delivery. Repeated ENACT assessments can feasibly and successfully be used to identify areas needing improvement and to guide on-going training and supervision.

scholarly journals “We Can’t Handle Things We don’t Know About”: Perceived Neurorehabilitation Needs and Challenges for Malawian Paediatric Cerebral Malaria Survivors

2020 ◽  
Author(s):  
Alexandra Boubour ◽  
Sebastian Mboma ◽  
Tracy Võ ◽  
Gretchen L. Birbeck ◽  
Karl B. Seydel ◽  
...  
Keyword(s):  
Cerebral Malaria ◽  
Data Gathering ◽  
Group Discussions ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Exploratory Approach ◽  
Holistic Understanding ◽  
Multiple Regions ◽  
Trained Staff ◽  
Rehabilitation Personnel

Abstract Background: We sought to identify perceptions of neurorehabilitation needs and challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methods: An exploratory approach was used to qualitatively investigate current available neurorehabilitation services; investigate the needs of caregivers, CM survivors, providers, and the community; and identify challenges and methods to accessing neurorehabilitation services. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs).Results: Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs). FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable.Conclusions: There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

scholarly journals “We can’t handle things we don’t know about”: Perceived neurorehabilitation challenges for Malawian paediatric cerebral malaria survivors

2020 ◽  
Author(s):  
Alexandra Boubour ◽  
Sebastian Mboma ◽  
Tracy Võ ◽  
Gretchen L. Birbeck ◽  
Karl B. Seydel ◽  
...  
Keyword(s):  
Cerebral Malaria ◽  
Data Gathering ◽  
Group Discussions ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Exploratory Approach ◽  
Holistic Understanding ◽  
Multiple Regions ◽  
Trained Staff ◽  
Rehabilitation Personnel

Abstract Background: We sought to identify perceptions of neurorehabilitation challenges for paediatric cerebral malaria (CM) survivors post-hospital discharge at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.Methods: An exploratory approach was used to qualitatively investigate the perceived neurorehabilitation challenges for paediatric CM survivors. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). Eighteen data-gathering sessions were conducted with 38 total participants, including 3 FGDs with 23 primary caregivers, 11 IDIs with healthcare workers at QECH, and 4 IDIs with community-based rehabilitation workers (CRWs).Results: FGDs revealed that caregivers lack important knowledge about CM and fear recurrence of CM in their children. Post-CM children and families experience substantial stigma and sociocultural barriers to integrating into their community and accessing neurorehabilitative care. At a community-level, rehabilitation infrastructure, including trained staff, equipment, and programmes, is extremely limited. Rehabilitation services are inequitably accessible, and community-based rehabilitation remains largely unavailable.Conclusions: There is an urgent need to establish further training of rehabilitation personnel at all levels and to build accessible rehabilitation infrastructure in Malawi for post-CM patients. Additional work is required to expand this study across multiple regions for a holistic understanding of neurorehabilitation needs.

Developmental Social Work in Disability Issues

2019 ◽  
Author(s):  
Masateru Higashida
Keyword(s):  
Social Work ◽  
Field Research ◽  
Social Investment ◽  
Disabled People ◽  
Policy And Practice ◽  
Theoretical Frameworks ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Local Stakeholders ◽  
Colour Version

(This is a full colour version.) In this ambitious book composed of the author’s published articles, he develops practical and theoretical frameworks for social work in disability issues. He explores practical strategies for promoting social and economic participation of disabled people from the perspective of developmental social work, whilst examining the situation of their socioeconomic participation in rural Sri Lanka. Based on these theoretical and practical frameworks, together with policy analysis of community-based rehabilitation (CBR), the field research was undertaken collaboratively with local stakeholders in three districts. The findings suggest that developmental social work practices, including an indigenous approach, social investment, and a multi-sectoral approach, could address the vicious cycle of inadequate education, poverty, and marginalisation. This book also explores the implications of these findings for policy and practice in other contexts.

scholarly journals Caregiver satisfaction with a multidisciplinary community-based rehabilitation programme for children with cerebral palsy in South Africa

2017 ◽  
Vol 59 (2) ◽  
pp. 48
Author(s):  
Magugu Ngubane ◽  
Verusia Chetty
Keyword(s):  
South Africa ◽  
Health Professionals ◽  
Parental Satisfaction ◽  
Rehabilitation Programme ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
Children With Cerebral Palsy ◽  
The Impact

This study sought to determine the levels of satisfaction and experiences of caregivers with a multidisciplinary rehabilitation programme. A total of 26 caregivers were recruited at 3 health settings in South Africa. A survey based on the Multidimensional Assessment of Parental Satisfaction for Children with Special Needs and focus-group discussions were conducted at the end of programme. The majority of the respondents were mothers and unemployed. The participants were generally satisfied with the rehabilitation. However, participants held on to myths, stereotypes, and beliefs about the cause of disability and explained the impact of stigma on having a disabled child in their communities. Caregivers perceived the benefit of rehabilitation but believed that lack of communication and consultation with health professionals limited the care. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1254929

scholarly journals Implementing Supported Self-Management in Community-Based Stroke Care: A Secondary Analysis of Nurses’ Perspectives

2020 ◽  
Vol 9 (4) ◽  
pp. 985
Author(s):  
Lisa Kidd ◽  
Joanne Booth ◽  
Maggie Lawrence ◽  
Anne Rowat
Keyword(s):  
Healthcare System ◽  
Qualitative Data ◽  
Secondary Analysis ◽  
Stroke Care ◽  
Self Management ◽  
Stroke Survivors ◽  
Policy And Practice ◽  
Community Based ◽  
Multiple Levels ◽  
Insight Into

The provision of supported self-management (SSM) is recommended in contemporary guidelines to address the longer-term needs and outcomes of stroke survivors and their families, yet its implementation across stroke pathways has been inconsistent. This paper presents a secondary analysis of qualitative data, which aims to identify and offer insight into the challenges of implementing SSM from the perspectives of community stroke nurses (n = 14). The findings revealed that the implementation of SSM in stroke is influenced by factors operating at multiple levels of the healthcare system. Contextual challenges arise because of different understandings and interpretations of what SSM is, what it comprises and professionals’ perceptions of their roles in its implementation in practice. A professionally controlled, one-size-fits-all model of SSM continues to be reinforced within organizations, offering few opportunities for nurses to deliver contextually tailored and person-centred SSM. In conclusion, there are many professional concerns and organizational tensions that need to be addressed across multiple layers of the healthcare system to achieve the consistent implementation of contextually tailored and person-centred SSM following a stroke. Attempts to address these challenges will help to narrow the gap between policy and practice of implementing SSM, ensuring that stroke survivors and families benefit from SSM in the longer-term.

scholarly journals Program Evaluation of A Community-Based Drug Rehabilitation Center: The Perspectives of The Persons Who Use Drugs (PWUDs)

2021 ◽  
Vol 9 (2) ◽  
pp. 164-176
Author(s):  
Argel Bondoc Masanda ◽  
Gino Cabrera ◽  
Alain Bernard Andal ◽  
Clarissa Delariarte ◽  
Gil Jeff Tanganco ◽  
...  
Keyword(s):  
Meaning In Life ◽  
Positive Attitude ◽  
Qualitative Data ◽  
Sense Of Self ◽  
Drug Rehabilitation ◽  
Rehabilitation Center ◽  
Group Discussions ◽  
Community Based ◽  
Quantitative Results ◽  
Higher Purpose

Bahay Pagbabago ni Apong Pilar is a community-based, church-initiated, and DDB (Dangerous Drugs Board) recognized and accredited formation shelter in San Simon, Pampanga. Using the sequential explanatory design, this study conducted surveys and focused-group discussions with 32 reformists to assess the shelter's formation program based on the reformists' standpoints. Quantitative results using Spearman's rank correlations showed that there seemed to be a significant relationship between attitude towards livelihood (ρ (2) = 6.589, sig. = 0.037*, p < 0.05) and spiritual activities (ρ (27) = 0.587**, p < 0.01), as formative components of the program, and perceived self-improvement (ρ (2) = 13.573, sig. = 0.001**, p < 0.01) during their stay in the formation shelter. It suggests that as the reformist develops a more positive attitude towards the livelihood, sports, and spiritual activities being offered at the formation center, it is also more likely that they may develop a higher sense of self-improvement.  Qualitative data yielded three general themes: (1) finding a higher purpose and deeper meaning in life through spiritually uplifting undertakings; (2) having family-oriented treatment, making them feel nothing less of their humanity; and (3) having holistic and dynamic activities, those that focus on the developmental facets. These are the elements deemed by the reformists as important, which constitute effective reintegration to their families, communities, and society.

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