scholarly journals A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia

2018 ◽  
Vol 1 (2) ◽  
pp. 45-58
Author(s):  
Ee Lin Tay ◽  
Chee Piau Wong

Purpose:  Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.Method:  A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.


2008 ◽  
Vol 40 (1) ◽  
pp. 83-96 ◽  
Author(s):  
M. MAZHARUL ISLAM ◽  
KAZI MD ABUL KALAM AZAD

SummaryThis paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children’s survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999–2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban–rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural–urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant–native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural–urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor–non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant’s children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban–rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.


2021 ◽  
Vol 19 (1) ◽  
pp. 13-22
Author(s):  
Mahta Alsadat Aarabi ◽  
◽  
Kianoush Abdi ◽  
Mohammad Saeed Khanjani ◽  
◽  
...  

Objectives: One of the most essential needs of children with Autism Spectrum Disorder (ASD) is using rehabilitation services. However, these services are associated with numerous challenges. The present study aimed to identify the perceptions of the parents of children with ASD and rehabilitation service providers about the challenges of using rehabilitation services in Iran. Methods: This was a qualitative study. In total, 27 participants were selected from the parents of children with ASD and rehabilitation service providers to these children, based on purposive sampling method; we considered maximum variation and sampling continued until data saturation. The necessary data were collected by semi-structured and in-depth interviews. The interviews lasted from July to December 2020 and MAXQDA was used for data analysis. Results: The challenges of children with ASD in accessing and using rehabilitation services were identified and categorized into 6 main classes, as follows: the lack of a systematic support system; the lack of commitment to observing professional ethics; neglecting the structure and policy of rehabilitation; the lack of comprehensive ASD diagnostic and rehabilitation protocols; inadequate knowledge and attitude, and the lack of feasible access to services. Discussion: Policymakers, service providers, and managers must be aware of the challenges of rehabilitation services for ASD; subsequently, they are expected to pay special attention to this issue. This study provided evidence for the above-mentioned groups for accessing and using rehabilitation services among ASD. Besides, the obtained data could help to improve the services they receive and their living conditions; ultimately, they help improve their quality of life.


2018 ◽  
Vol 43 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Ugendrie Naidoo ◽  
Liezel Ennion

Background: Persons with disabilities who reside in rural areas experience challenges accessing and utilising health services and rehabilitation. Due to the high prevalence of diabetes mellitus in rural regions, the risk of having a lower-limb amputation is increasing. Comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Objective: To explore the barriers and facilitators to accessing rehabilitation experienced by persons with lower-limb amputations in a rural setting. Study Design: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 11 conveniently sampled participants from three sub-district hospitals in the rural iLembe district, Kwa-Zulu Natal, South Africa. Data were collected using semi-structured interviews to explore the barriers and facilitators perceived by persons with lower-limb amputations in a rural region. Results: The three main barriers identified in this study were environmental factors, financial constraints and impairments. These barriers negatively impacted the participant’s utilisation of rehabilitation. The two main facilitators identified were environmental facilitators and personal factors which aided participant’s utilisation of rehabilitation. Conclusion: Access to rehabilitation was mainly hindered by the challenges utilising transport to the hospital, while self-motivation to improve was the strongest facilitator to utilising rehabilitation. Clinical relevance Rehabilitation is essential in preparation for prosthetic fitting. If a person cannot access rehabilitation services, they will remain dependent on caregivers. Highlighting the challenges to utilisation of rehabilitation in rural areas can assist to reduce these barriers and improve the functional status of persons with lower-limb amputations.


2020 ◽  
pp. 026010602094973
Author(s):  
Udaya S Mishra ◽  
Balakrushna Padhi ◽  
Rinju

Background: Calorie undernourishment is often associated with poverty but India presents a unique scene of decline in money-metric poverty and rise in calorie deprivation. Existing literature has varied explanation towards this effect. However, neither are the poor entirely calorie compromised nor do all the non-poor qualify calorie compliance. Aim: This is an attempt at verifying whether calorie undernourishment is a result of choice of food basket or the inadequacy of food expenditure. Method: An answer to this question is attempted with the exploration of data obtained from the National Sample Survey Organization’s Consumption Expenditure of Indian households for the periods 2004–2005 and 2011–2012. Results: Findings reveal that over the last one decade, the average per capita per day calorie intakes have slightly increased from 2040.55 Kcal in 2004–2005 to 2087.33 Kcal in 2011–2012, which has led to the increased share of well-nourished households from 20.21% in the 61st round to 22.78% in the 68th round of survey in rural areas, whereas the similar increase in urban areas is from 36.1% to 40.65%. Conclusions: Calorie undernourishment among the non-poor is observed that calorie undernourishment, if any, among the non-poor is entirely due to choice but the same among the poor has a divide between choice and inadequacy. The urban poor are calorie compromised more due to choice rather than inadequacy as against their rural counterparts. With higher poverty, calorie, non-compliance among the poor is more due to choice when compared with lower magnitude of poverty. These observations form a basis for contesting the common understanding that calorie compromise is entirely driven by inadequacy/incapacity of food expenditure. could be viewed in terms of the food choices made, especially among the poor while setting the minimum threshold of food expenditure to be calorie compliant.


2018 ◽  
Vol 16 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Dirgha Raj Shrestha ◽  
Shibesh Chandra Regmi ◽  
Ganesh Dangal

Unsafe abortion is affecting a lot, in health, socio-economic and health care cost of many countries. Despite invention of simple technology and scientifically approved safe abortion methods, women and girls are still using unsafe abortion practices. Since 2002, Nepal has achieved remarkable progress in developing policies, guidelines, task shifting, training human resources and increasing access to services. However, more than half of abortion in Nepal are performed clandestinely by untrained or unapproved providers or induced by pregnant woman herself. Knowledge on legalization and availability of safe abortion service among women is still very poor. Stigma on abortion still persists among community people, service providers, managers, and policy makers. Access to safe abortion, especially in remote and rural areas, is still far behind as compared to their peers from urban areas. The existing law is not revised in the spirit of current Constitution of Nepal and rights-based approach. The existence of abortion stigma and the shifting of the government structure from unitary system to federalism in absence of a complete clarity on how the safe abortion service gets integrated into the local government structure might create challenge to sustain existing developments. There is, therefore, a need for all stakeholders to make a lot of efforts and allocate adequate resources to sustain current achievements and ensure improvements in creating a supportive social environment for women and girls so that they will be able to make informed decisions and access to safe abortion service in any circumstances.


2004 ◽  
Vol 5 (1) ◽  
pp. 30-41 ◽  
Author(s):  
Pim Kuipers ◽  
Glenys Carlson ◽  
Sandra Bailey ◽  
Anshu Sharma

AbstractCommunity-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.


Afrika Focus ◽  
2012 ◽  
Vol 25 (2) ◽  
Author(s):  
Busani Mpofu

After independence in 1980 Zimbabwe’s cities experienced a proliferation in the number of squatter camps. This was because of the failure of the urban economy to offer adequate housing and jobs, leaving peri-urban space as the only sanctuary for the urban poor to live in and eke out a living informally. The promotion of rural ‘growth points’ by the national government to promote rural development to discourage migration to urban areas failed. Yet, a poor policy response by the state to this negative outcome of rapid urbanisation that aims to reverse this rural-urban migration has led to unending confrontations between its various arms and squatters who continue to be regarded as encroachers. Focussing on Bulawayo, the second largest city in Zimbabwe, and based on interviews, archival research, Council minutes and newspapers, this article critiques the state’s urban development policy vis-à-vis squatters and informality. It is argued that the persist- ence of a salient perception by government officials that all Africans belong to rural areas and have access to land they can fall back on in hard times serves as a vital lubricant to the state’s action of forcibly sending squatters to rural areas. This ignores the historical pattern of rapid urbanisation and the growth of informal economies supporting the livelihoods of thousands of people. I seek to add to the literature on low-cost housing shortages, urban squatters and peri-urbanism in Zim- babwe and on studies of informality in Third World cities in general. Key words: squatters, outcasts, informality, institutional weaknesses, peri-urban Bulawayo, Zimbabwe 


2020 ◽  
Author(s):  
◽  
Mpumelelo Dolo

Water is regarded as the most important substance found on earth. There is no substitute for it. The daily running of production businesses, industrial firms and agricultural production that help sustain the economy of countries are largely dependent on the availability of water for them to function. The importance of water cannot be over emphasised. The food which is consumed daily depends on water; it can therefore be safely concluded that without water there would be no food, and without food there would be no life. Despite the importance of water in relation to human life, animals and plants, research studies show that the its availability becoming increasingly deficient around the globe. Water levels of major dams and rivers around the world are dropping, limiting the supply of potable water to those dependent on them. Global warming is one factor that is influencing the dropping of water levels, through evaporation. Other factors include climate change, drought and population growth. In South Africa, the government has been fighting a continuous battle of trying to address the backlog of water infrastructure, particularly in the areas which were disadvantaged by the apartheid government. These areas include rural areas, small towns (semi-urban) and townships. The Eastern Cape province in South Africa is top of the list from a backlog point of view. Rural dwellers migrate to urban areas for various reasons such as better education, better health care, job opportunities and more efficient services. Water supply is one of the services which is more adequately supplied in the cities compared to the rural areas. Even though the supplied water in the urban areas of the Eastern Cape is not the best standard when compared to other cities around the country or the world, it is still at an acceptable standard. Thus, this study was conducted to seek ways of improving the supply of water in the urban and rural areas of the Eastern Cape. The availability and the quality of water differs between the urban and rural areas. The purpose of this study was to seek ways of bridging the gap between these areas while improving the standard of water supply in both rural and urban areas. While working towards improving the lives of the Eastern Cape people, the study also seeks to promote water preservation and awareness to the people of the province. In order to find better alternatives which have been tested in various places around the world, an in-depth literature review was conducted in the study. This functioned as an effective comparison of what is obtained in different places around the world and the context of this study, which is the Eastern Cape. A survey method was used to gather data regarding the problems surrounding water supply and options that could be adopted to remedy those problems. The survey was conducted in the form of a self-observation assessment, questionnaire for households in urban and rural areas and interview sessions with prominent government entities and local technical service providers. The survey covered the whole spectrum of individuals and groups that play a major role in the supply and usage of water. The study was conducted within three municipalities of the Eastern Cape. These municipalities cover approximately two-third of the Eastern Cape considering the size of population in those areas. The municipalities covered by the study were: Amathole District Municipality (ADM), Buffalo City Metropolitan Municipality (BCMM) and OR Tambo District Municipality (ORTDM). The findings from the study showed that indeed the standard of water supply between urban and rural areas was not equal. This relates to the purification methods, the convenience of collecting water by users, the quality of infrastructure being constructed (due to good or poor monitoring during construction) and the quality of the water as well as operation and maintenance response from the various service providers. Moreover, it was found that there was an acceptable level of awareness by citizens when it comes to using water, and precautions to save it were being taken by some. However, some dominant factors such as poor management, poor infrastructure resulting in leaks, climate change, run-offs and population growth were putting a strain on the existing water resources which is not coping with the increasing demand by people. Recommendations made in the study to balance the supply of water in rural areas and urban areas include: improving the purification of water so as to achieve a standard quality within the Eastern Cape; that rural areas be allowed to have an option of having yard or house connections, particularly those who are willing to pay rates at a scale suiting their class or standard; and that water service providers make it their responsibility to extend reticulation networks if there is expansion or development of more houses in rural areas in order to keep the distance minimal to standpipes


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