Communication rehabilitation in sub-Saharan Africa: The role of speech and language therapists.

Karen Wylie,Julie Marshall,Bronwyn Davidson,Lindy Mcallister

doi:10.4102/ajod.v7i0.338

Abstract

BackgroundWorkforce factors present a significant barrier to the development of rehabilitation services for people with communication disabilities in sub-Saharan Africa (SSA). Exploring how the work of speech and language therapists (SLTs) in the region is organised and delivered can provide insight into existing services, areas for future workforce development and improved rehabilitation access for people with communication disability.ObjectivesThis paper describes the employment and service provision patterns and work roles of a sample of SLTs in SSA.MethodA broad, purpose-designed, mixed-methods survey was designed to collect data from SLTs living in Anglophone countries of SSA. Descriptive statistics and qualitative content analysis were undertaken. This paper reports on a subset of data from the wider survey.ResultsA description of the employment and work roles of the 33 respondents to the survey and characteristics of their service users is presented. SLTs were commonly employed within private and not-for-profit sectors and frequently worked in temporary jobs. SLTs engaged in a range of work roles, including capacity building and training others. Services were provided by SLTs across age ranges, health conditions and settings, with paediatric, urban services commonly reported. Costs for service users and urban-centred services give indications of barriers to service access.ConclusionKnowledge of the way in which speech and language therapy services are organised and provided has the potential to shape the development of communication disability rehabilitation in SSA. This research has identified a range of issues requiring consideration as the profession develops and grows.

Highlights

Despite an increasing global focus on inclusion and the rights of people with disabilities (PWD), rehabilitation services continue to be extremely limited in countries of the Majority World, including in sub-Saharan Africa (SSA)
Increasing the availability of rehabilitation and habilitation services for PWD is critical and forms one of the three objectives of the World Health Organization’s Disability Action Plan 2014–2021 (2015). (Note: In this paper the terms Majority and Minority World are used to replace the terminology ‘developed’ and ‘developing’ countries.) This paper focuses on workforce factors limiting the development of rehabilitation services for people with communication disability (PWCD) in SSA
Thirty-two jobs were held by 22 African nationality speech and language therapists (SLTs) and 12 jobs were held by non-African nationality SLTs

Summary

Introduction

Despite an increasing global focus on inclusion and the rights of people with disabilities (PWD), rehabilitation services continue to be extremely limited in countries of the Majority World, including in sub-Saharan Africa (SSA). (Note: In this paper the terms Majority and Minority World are used to replace the terminology ‘developed’ and ‘developing’ countries.) This paper focuses on workforce factors limiting the development of rehabilitation services for people with communication disability (PWCD) in SSA. While debates about disability theory continue (Shakespeare & Watson 2002), in practice the biopsychosocial model of disability (World Health Organization 2001) has become widely adopted in rehabilitation This model is represented in the International Classification of Functioning Disability and Health (World Health Organization 2001) and represents disability as a result of the inter-relationship between a health condition, personal and contextual factors, subsequently impacting a person’s activities and participation. Exploring how the work of speech and language therapists (SLTs) in the region is organised and delivered can provide insight into existing services, areas for future workforce development and improved rehabilitation access for people with communication disability

Objectives

Results

Discussion

Conclusion