Inclusion at the Workplace: An Exploratory Study of People with Disabilities in South Africa

The sexuality of people with disabilities in South Africa, as in other places in the world, has been a site of exclusion and oppression, with many myths and misconceptions being held. In the context of significant social inequalities and a major HIV epidemic, the exclusion of people with disabilities from being able to live fully sexual and sexually healthy lives presents an added personal burden. There is a small but growing body of research on disability and sexuality in South Africa, focused mostly on issues of sexual health risk. There is less focus on the social and interpersonal experiences of sexuality from the perspective of people with disabilities themselves. This chapter describes a participatory action research project, which aimed to challenge the myths about the sexuality of people with physical disabilities in South Africa. The project adopted multiple research methods, including innovative media and narrative methods, to explore societal attitudes as well as the subjective experiences of people with physical disabilities. The use of collaborative media methods allowed participants to challenge dominant, often stigmatising, representations of the sexual lives of people with disabilities, providing a personal lens in which to convey their experiences of sexuality, masculinity and femininity. (physical disabilities, South Africa, participatory research, societal attitudes, sexual exclusion)

Purpose. Disabled people in South Africa have been included, for the first time, in policy documents on HIV prevention. However, little is known about how persons with disabilities in South Africa may be at risk, or not. For policy to be implemented in effective practice, we need to know what the risk issues are for disabled people in South Africa.Methods. This study draws on qualitative findings from a survey and interview study exploring organisational responses to the HIV epidemic for disabled people. Qualitative data were analysed using thematic and discourse analysis.Results. An analysis of comments made about risk factors for HIV, identified sexual abuse as a key risk. Furthermore, findings suggest that disability stigma may be a key factor on increasing disabled people's vulnerability in engaging in unsafe sex.Conclusion. The findings provide much needed exploratory findings, in an area in which little is known; useful for considering issues for HIV prevention. However, caution needs to be taken that these findings are not the perspectives of disabled people themselves, and may reproduce accepted discursive truths.

Background: Participation comprises attendance and involvement in everyday situations. Picture My Participation (PmP) is an instrument intended to measure participation in children with disabilities, particularly in low and middle income countries.Aim: To investigate content validity and usefulness of PmP for measuring participation in children with intellectual disability (ID) in South Africa and Sweden.Methods: A picture supported interview with 149 children, 6–18 years, with and without ID. Twenty everyday activities were provided. The three most important activities were selected by the child. Attendance was rated on all activities. Involvement was rated on the most important.Results: All activities were selected as important by at least one child with ID in both countries. There were similarities in perceived importance between the children with and without ID from South Africa. The children from South Africa with ID were the only subgroup that used all scale points for rating attendance and involvement.Conclusion: The 20 selected activities of PmP were especially relevant for children with ID in South Africa. The usefulness of the scales was higher for the children with ID in both countries. PmP is promising for assessing participation across different settings but psychometrical properties and clinical utility need further exploration.

The South African Constitution asserts that persons with disabilities must have equal access to opportunities in society; however, the realisation of this mandate has remained a challenge. There is a need to create contextually relevant, inclusive structures that support equal access to opportunities for persons with disabilities in society. This article reflects on and highlights key considerations for an inclusive framework that facilitates access to opportunities for youth with disabilities in South Africa, which emanated from a study that explored how ongoing interaction with the performing arts can facilitate social and economic inclusion of youths with disabilities. The study adopted a qualitative research approach, using critical ethnography. Primary data were obtained from three focus groups with a total of 20 youth with disabilities who have attended performance events, as well as an in-depth interview with a disabled performer. The facilitation of access to equal opportunities for youth with disabilities must occur at a multidimensional level, involving both personal and systemic changes and levels of support. Complex barriers linked to the apartheid legacy also exist, some of which include access to resources and reduced self-determination, whilst positive factors such as internal resilience and skills development function as promising predictors of inclusion. Contextually relevant, disability-inclusive structures in South Africa must confront and address how youths with disabilities are uniquely impacted in present times by South Africa's history. The voices of youths with disabilities make a key contribution as their experiences must inform these inclusive structures which have the potential to enhance access to equal opportunities for them at both personal and systemic levels.

Purpose We investigated the relationship between disability and food security in South Africa using data from the General Household Survey (GHS). Materials and Methods Regression models were utilised with GHS data (2014–2018) to gauge the likelihood of food insecurity (the dependent variable) among individuals with disabilities. Socioeconomic and demographic traits of the 2018 GHS sample were analysed. All estimates were weighted and represented nationally at the individual level. Results In this study population (32 187) of food insecure people, 9.64% are disabled. Food insecurity impacts more Black people with disabilities (91%) versus those without disabilities (90%), and disabled women (65%) versus nondisabled women (58%). Most reside in KwaZulu-Natal. Those with disability grants lower food insecurity odds, while child support grant recipients face higher odds. Household size and education are significant predictors, while marital status and gender are not. Conclusion This study data justifies the need for disability-inclusive food security programmes in South Africa, especially amid crises like COVID-19. Significantly, there is a nil data finding about people with eating/swallowing disabilities whose needs intersect with food security. This emphasises the need for inclusive data collection that operates within a food sovereignty framework to increase the visibility of people with disabilities.

BackgroundSince the implementation of the inclusive education policy in 2001 in South Africa, several milestones have been celebrated. Nevertheless, studies have reported the significant challenges in the implementation of the policy for learners with disabilities across schools in South Africa, which impede transformation.ObjectivesReflecting on key research insights from a recent study, this article argues for the development of a Theory of Change (ToC) as a road map or blueprint for implementing inclusive education for learners with intellectual disabilities in South Africa. A ToC is imperative for bridging the gap between policy implementation and outcomes.MethodA qualitative research design was adopted for the study. Data were collected through a desktop review, 12 key informant interviews and 10 focus group discussions with key role players and stakeholders in various positions in the education system (i.e. senior education specialists, special needs teachers, one education operations support officer, a principal, deputy principals and head of departments). The data collected were analysed thematically.ResultsThe findings of the study highlighted progress regarding government financial resources and also the various structural barriers impeding the implementation of inclusive education for learners with intellectual disabilities.ConclusionThis article encourages the continued development of theories of change to promote the effective implementation and ensure quality inclusive education for learners with disabilities in South African schools.ContributionThis article contributes a potential ToC to guide the effective implementation of inclusive education policy and practices for learners with intellectual disabilities in the South African schooling system.

Local research has utilized both practical (youth with disabilities accessing sexual and reproductive health services) and theoretical knowledge (decoloniality, disability and sexuality) to understand the sexuality of persons living with disabilities. However, this knowledge has not been utilized to examine the visibility of disability and sexuality in South Africa's comprehensive sexuality education (CSE) scripted lesson plans (SLPs). A content analysis was conducted of all the Department of Basic Education's CSE SLPs (Grades 4–12). The study indicated that only in Grade 10 is disability and sexuality discussed in 3 activities. Within these activities, some attempt has been made to demystify certain misconceptions about the sexuality of disabled bodies (i.e. as celibate, asexual beings, with no romantic or sexual interests). The activities further debunk how various types of disabled bodies are sexual beings (i.e. not just those in wheelchairs). However, the fact that these discourses only emerge and left in Grade 10, raises concerns about the inclusivity of the CSE curriculum for disabled youth (e.g. CSE not acknowledging issues of power and consent amongst youth living with disabilities). A critical discussion is provided of the gaps identified and recommendations provided by existing practical and theoretical knowledge to inform the current CSE SLPs.

Background: South Africa has migrated the responsibility for early childhood development (ECD) centres from the Department of Social Services to the Department of Basic Education. This functional shift has ushered in consultations and discussions on how best to implement ECD, including opportunities the change may bring.Aim: By anchoring the understanding of ECD services in nurturing care, this study aimed to elucidate the provision of appropriate, inclusive services in early childhood development, including early childhood intervention, for children with disabilities in South Africa against the backdrop of the migration of services from one government ministry to another.Methods: This is an analytical article based on South African literature on ECD services, including interventions, with particular attention to children with disabilities, basing our understanding of these services in nurturing care.Results: We elucidate how the ideals of the Nurturing Care Framework can be achieved in the context of children with disabilities in South Africa using five themes: the need to localise services, developing tools and strategies for screening and early intervention, enhancing the efficacy of caregivers, supporting and training staff and collaborations.Conclusion: It is necessary to empower caregivers and professionals to address early childhood intervention and ECD needs of children with disabilities. Early childhood development centres are an important context for nurturing care, providing opportunities to promote and sustain health amongst a large number of children. Considering the function shift of ECD services in South Africa, these centres are well positioned to further nurturing care to children with disabilities through the provision of supportive environments that promote health and well-being.

Cognitive behavioural therapy (CBT), a western-developed therapy, may offer benefits to persons with disabilities. However, its applicability in South Africa, where stigma and limited resources significantly impact mental health, is uncertain. This autoethnography explores the first author's personal experiences in adapting CBT for persons with disabilities in South Africa, focusing on culturally sensitive interventions and innovative delivery methods. Spanning a year, data collection included personal journaling, field notes and reflexive memos. Rooted in constructivist epistemology, the study employed thematic analysis to integrate the first author's personal narrative with the broader cultural context. The study chronicles the discovery of innovative delivery methods, such as telehealth, and emphasises the critical importance of training local health professionals. Key findings address the evidence base for CBT, the successes and failures of adaptations, the knowledge gaps identified and promising directions for a more inclusive future. This autoethnography reflects on the path towards a mental health care system that effectively addresses the unique needs of persons with disabilities in South Africa. The study provides insights into the adaptation of CBT for a specific cultural context, highlighting the importance of culturally sensitive interventions and innovative delivery methods to improve mental health care for persons with disabilities in resource-constrained settings.

In Parkinson's disease (PD), inclusive research recruitment practices are essential to ensure that study findings are generalizable to diverse populations. The definition and implementation of inclusive recruitment practices are guided by the principles of equity, justice, engagement, and sustainability. However, practical implementation guidance is lacking. This paper shares insights from the Black and African American Connections to Parkinson's Disease (BLAAC PD) study, a PD genetics research study being conducted in the United States that enrolls individuals with and without PD. The inclusive recruitment strategy in BLAAC PD centers around four areas: training and working with study personnel toward equitable research practices, partnering with community members, creating culturally resonant study materials, and customizing practices at the local level. We provide practical examples implemented by BLAAC PD to address each of these areas. We share the materials and tools that the study utilizes for site training, recruitment, and community outreach and engagement. These approaches have potential for application in other PD research studies, to achieve greater diversity in PD research.

Despite the severity of the HIV epidemic worldwide, and particularly in southern Africa, persons with disabilities have until recently been generally excluded from consideration in HIV prevention campaigns. This chapter outlines the situation with regard to HIV/AIDS as it affects persons with disabilities. The chapter will begin by first providing an outline of the experience and prevalence of disability in South Africa, highlighting how little is known about how HIV affects persons with disabilities in South Africa. An outline of some of the international literature, including a recent global survey on HIV/AIDS and disability, will be presented. With the background of findings from international studies, we shall then look at the issue of HIV/AIDS as it affects persons with disabilities in South Africa, with reference to recent research in this area. The chapter will also discuss and highlight some of the current contested issues involved with regard to HIV/AIDS as a disability and the disability grant.

This review aims to summarize data published in the scientific literature and available on official websites on the epidemiology, policies and services for children and adults with intellectual disability in South Africa. There is a paucity of published literature on intellectual disability in South Africa. The lack of evidence-based publications within the prescribed review period of 12-18 months precludes an accurate description of the prevailing epidemiology and burden of disablement in this country. The few studies yielding epidemiological data were conducted prior to 2002. These suggest that the prevalence rate of intellectual disability is greater than in high-income countries. There is little data describing intellectual disability geographically and across population and age groups, further rendering it difficult to identify inequalities and differences in distribution. There is a high burden of preventable causes of intellectual disability. Despite the existence of policies and services for the population with intellectual disabilities in South Africa, recognition of and provision for their needs carries low priority. It is imperative that the information gap in epidemiology and the burden of disability be recognized in order to plan for and meet the needs of those with intellectual disability across the lifespan.

Across practice and policy, assistive technologies (ATs) are positioned as a pathway to economic inclusion for graduates with sensory disabilities in South Africa. Still, systemic barriers persist. Developing workable interventions requires in-depth attention to the lived experiences of graduates, which include knowledge on the way devices, systems and attitudes interact in everyday employment seeking and enterprise activities. The study endeavoured to examine how unemployed tertiary-level graduates with sensory disabilities in Gauteng use AT in seeking employment and practising entrepreneurship. Specific enablers and challenges were identified to provide an explanation of variation in economic participation. Interpretive methods guided the study within a qualitative design. Sixteen participants took part in semi-structured interviews: 10 unemployed graduates (with visual or hearing impairments), three human resources professionals and three helping professionals. Coding and analytic development followed Braun and Clarke's six-phase thematic approach. Overall patterns were organised into six themes: (1) discrimination and stigma, (2) accessibility, (3) use and effectiveness of AT, (4) training and support, (5) institutional and government support, and (6) self-initiated strategies and adaptation. Device access proved insufficient. Most constraints operated at the system level, consistent with the social model of disability, as stigma, accessibility failures, limited training and weak enforcement shaped outcomes. Sustained change had to address stigma, accessibility, training and support and accountable policy implementation through coordinated multi-stakeholder action. By centring graduate voices, this article contributed evidence on adaptability and multi-stakeholder lenses relevant to inclusive policy and practice in resource-constrained settings.

Despite numerous advancements in disability discourse, the experiences of persons with psychosocial disabilities have been shown to be characterised by marginalisation, victimisation and violations of numerous human rights. In this paper, I explore the problem of stigma on the basis of psychosocial disability as a central underlying factor that contributes to numerous forms of neglect and under-prioritisation. Using recent theoretical frameworks, I begin by examining the manner in which stigma is conceptualised, at individual and societal levels. I then consider the manner in which stigma – which is clearly a violation of the right to dignity and equality – also contributes to the violation of numerous related rights, including the right to health; the right to education; the right to freedom and security of the person; the right to vote; and the right to work. In doing so, I aim to demonstrate the myriad intersecting forms of marginalisation faced by persons with psychosocial disabilities in South Africa, and pay attention to some of the potential avenues through which stigma can be addressed and its associated human rights violations alleviated. I argue that the lack of implementation in respect of South Africa’s National Mental Health Policy Framework as well as the under-prioritisation of mental health as a public concern, themselves, indicate the stigmatisation of psychosocial disability. I suggest that addressing stigma requires attention to the causes of its manifestation, taking into consideration the problems of ignorance, prejudice and discrimination simultaneously. Similarly, however, I contend that a fourth problem, namely, the structures which render stigma possible, must also be taken into account if ‘structural violence’ is to be addressed.

Children with disabilities encounter obstacles attaining basic education. Significantly, previous studies on South Africa have shown that up to 70% of the children with disabilities are out of school. Despite efforts to support inclusive education through White Paper 6 policy, the deployment of resources and transformation of the education sector has been a slower process. The main objective of the article is to explore the challenges of basic education faced by children with disabilities in South Africa. The study was conducted during the COVID-19 pandemic using a qualitative research methodology. The data were collected using key informant interviews through online media platforms. The data analysis was conducted using computer-aided software in the form of ATLAS.ti 8. This study established several challenges faced by special needs schools, especially in the rural areas. These include a limited number of special needs schools, scholar transport, enrolment, lack of psychosocial and expert support, sanitation and infrastructure and the impact of COVID-19 pandemic on children with disabilities. The article concludes that even though White Paper 6 focusses on Special Needs Education in South Africa, there remains poor policy implementation to ensure inclusivity for learners with disabilities. The research provides an understanding of the challenges faced by children with disabilities to assist policy makers with recommendations and areas of concern to improve policy implementation of the White Paper 6 in South Africa.