Background: Caring for children with disabilities in Tanzania involves significant challenges, including stigma, limited support and mental health risks. A cultural collective for caretakers of children with disabilities enrolled at a primary school was established to address these issues.Objectives: The study aims to explore the experiences of caregivers who started a cultural collective and to assess its impact on their lives in the short term.Method: This study used a community-based participatory research (CBPR) approach with a sequential mixed-methods design. Data were collected over a period of 8 weeks, while the participants in this study established a collective in Dar es Salaam. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using Braun and Clarke’s method for thematic analysis.Results: As assessed by a validated and normed questionnaire, Patient Health Questionnaire-9 (PHQ-9), 63% of the caregivers showed signs of depression before starting work in the collective. Economic needs, education and the desire for support were the primary motivations for joining. Starting the collective improved social support, fostered agency and began to enhance caregivers’ financial conditions.Conclusion: The collective addressed caregivers’ needs for economic improvement, social support and mental support, and the experience was vitalising for the caretakers.Contribution: This study deepens our understanding of holistic interventions for children with disabilities and their families in urban Africa. It offers valuable insights into a crucial stage of developing contextually relevant interventions for vulnerable, poverty-stricken populations. It provides a model that can be adapted for similar interventions in comparable contexts.

Background: Play is integral to optimal childhood development. Occupational therapists often use play to improve play skills. However, when it comes to learners with autism spectrum disorder (ASD) in South Africa, there is limited research regarding play-based interventions that address the underlying motivators of play, namely, social play and playfulness.Objectives: In this study, the authors present a rationale for the development of a protocol for a study aiming to measure the impact of the Playbox Africa Intervention. This is a play-based occupational therapy intervention with the aim of enhancing the playfulness, social play and occupational performance of South African children with ASD.Method: The study will utilise a within-subject, repeated measures design and will be implemented over 16 weeks with 8–10 learners (aged 3–8 years) with ASD attending a developmental-centre environment in Johannesburg, South Africa. The playfulness and social play of the learners will be assessed using the Test of Playfulness (ToP). The modified Canadian Occupational Performance Measure (M-COPM) will be used to measure occupational performance factors.Results: Given that this protocol outlines an intervention that has not yet been implemented, there are no results to report on.Conclusion: The development of this protocol could encourage the adaption of existing play-based protocols, for children with ASD, perhaps within different settings or varying support needs.Contribution: Additionally, it could lay the foundation for future clinical trials and culturally relevant play-based interventions to be developed in the South African special needs context.

Background: 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.Objectives: The main objective of the article is to explore the challenges of basic education faced by children with disabilities in South Africa.Method: 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.Results: 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.Conclusion: 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.Contribution: 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.

Background: Technical Vocational Education and Training (TVET) in South Africa is often viewed as the ‘Cinderella’ of higher education, with many matriculating students choosing mainstream universities instead. This preference stems from stigma and misconceptions that label TVET students – often from poorer working-class backgrounds – as less intelligent than their university peers. The lived experiences of students with physical and learning disabilities in these institutions are particularly underexplored.Objectives: This study aimed to illuminate the experiences of students with disabilities at five TVET colleges in Gauteng, South Africa.Method: Using a phenomenological approach, the study conducted story exercises and individual interviews with a convenience sample of 40 students with disabilities.Results: The findings reveal that TVET education predominantly serves black students from marginalised backgrounds, with students with disabilities facing significant barriers in accessing both the curriculum and the physical environments of the colleges. Despite numerous challenges, a resilient narrative emerged among these students, rooted in African traditional values.Conclusion: This article contributes to knowledge on disability inclusion in higher education by showcasing the challenges and resilience of students with disabilities in South Africa’s TVET system.Contribution: The study employed innovative methodologies, such as picture stories, to co-create knowledge with students living with disabilities.

While all women are at risk of gender-based violence (GBV), it is essential to acknowledge that women are not a homogenous group and that women who are Deaf may experience GBV differently. This study aimed to answer the question: What are the perceptions and experiences of GBV among women who are Deaf? The study's objectives were to explore and describe these women's understanding of GBV terminology, their perceptions of GBV and challenges regarding support strategies in place to respond to their unique circumstances. A qualitative study with four workshops was conducted with 60 participants. The data collected were analysed using thematic analysis. The results yielded three themes that intrinsically spoke to women's understanding of GBV terminology, perception of GBV and challenges accessing support. The results highlight that women who are Deaf are at a greater risk of GBV. Participants emphasised the importance of exploring the perceptions of GBV among men who are Deaf. Findings also indicated women's challenges when seeking support. The findings underscore the necessity of offering specific assistance to Deaf women facing GBV. Based on the study findings, it can be concluded that those providing support in GBV matters should receive specialised training in GBV, including Deaf culture and South African sign language. The study findings contribute to the field of disability and the development of effective GBV strategies and programmes that are inclusive of women who are Deaf within a South African context.

Diabetes mellitus (DM) is a global health concern that has greatly affected South Africa. The gap in the current management of DM has resulted in complications such as lower extremity amputations (LEAs) and death. Eastern Cape province reflects this struggle, with disparities in access to healthcare and poor health outcomes. Understanding survival rates and associated factors between the urban Livingstone Hospital and the rural Nelson Mandela Academic Hospital can improve health interventions and outcomes. This study compared the survival rate of patients in urban areas and those in rural areas. This retrospective cohort study was conducted in an urban and a rural hospital by reviewing existing medical records of diabetic patients who underwent an LEA between 2016 and 2019. The retrospective cohort study examined 439 diabetic-related LEA cases. This study found that residing in rural areas significantly decreased the risk of mortality by 62% compared with living in the urban areas. Factors such as haemoglobin A1c (HbA1c) levels, nephropathy, cardiovascular disease, human immunodeficiency virus (HIV), other comorbidities and level of amputation significantly influenced survival probabilities. Survival analysis indicated a significant difference in the 3-year survival probabilities of the two groups, favouring rural residency (p = 0.001). The biggest cause for concern between the two regions was uncontrolled blood glucose levels as this resulted in high mortality rates. Insights from this study have shown that introducing podiatry and orthotics at primary healthcare (PHC) could improve foot care and reduce diabetic-related LEAs and mortality.

COVID-19 had an impact on all sections of society, including people with disabilities. The authors aimed to explore the needs and experiences of people with disabilities in Zambia during the COVID-19 pandemic. In this hermeneutic phenomenological study, we used a semi-structured interview guide to collect data from a purposive and snowball sample of 40 people with disabilities and their caregivers. The participants were from 11 districts in 6 provinces in Zambia. The in-depth interviews were done between July 2022 and November 2022. Data were managed in NVivo and analysed using reflexive thematic analysis. The three themes included: (1) awareness and experience of public health measures on COVID-19 among people with disabilities; (2) experience of othering and stigmatisation as people with disability during the COVID-19 pandemic and (3) experience of COVID-19 symptoms and having COVID-19 among people with disabilities. Interventions were largely unresponsive to the needs of people with disabilities, exacerbating the risk of exposure to infection. In future, adaptations like emergency risk communication in braille, audio and sign language interpretation in adapted communication formats should be made. Further studies are needed to quantify the gaps in access to health, explore policies and strategies to improve health outcomes for people with disabilities in LMICs like Zambia. The findings may contribute to the development and enhancement of policies and interventions responsive to the needs of people with disabilities in future pandemics in the Zambian context.