Abstract
BackgroundIn low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community.MethodsA qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability.ResultsOne hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors – including the Western healthcare, religious, and traditional sectors.ConclusionsUnderstanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.
Highlights
In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited
This paper reports on responses to seven survey questions related to help-seeking and self-help
There was a higher proportion of university educated participants, when compared to the general population [58], which may be related to sites selected or as a result of community members with higher education being more comfortable participating in surveys
Summary
In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. The development of responsive and relevant rehabilitation services is crucial in low and middle-income countries (LMICs), including those of sub-Saharan Africa (SSA) where many people with disabilities (PWD) continue to lack access to basic rehabilitation services [2,3,4,5]. The recent high-level meeting, ‘Rehabilitation 2030 - A Call for Action,’ brought together stakeholders from across the globe to discuss the ways forward, and included a commitment by participants to work towards developing the rehabilitation workforce relevant to each country context [9]. Challenges in achieving an appropriate skill-mix amongst rehabilitation workers, are well documented barriers to the development of appropriate rehabilitation services [10, 11]
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