Disabilities In Ghana Research Articles

How can we create a diverse, equitable and inclusive workplace in society without the voice of disability? Lessons from Ghana

AbstractIn Africa, the work experiences of disabled people can help employers and the government build more inclusive workplaces. Nonetheless, research exploring disabled people's work experiences at various employment stages is limited, particularly in Africa. The study applies ethnographic research methods to examine the work experience of those with visual, speech, hearing, mobility and psychological disabilities in Ghana. Data were coded and analysed using content and descriptive methods. The findings suggest that disabled people face several barriers, including inadequate accommodation, negative stereotyping, stigmatization, discrimination and poor performance evaluation at work. This paper argues that transformational leadership is a prerequisite for African governments and private sector employers seeking to improve the workplace environment and build an inclusive culture within these spaces.

Testing the effect of an integrated-intervention to promote access to sexual and reproductive healthcare and rights among women with disabilities in Ghana: a quasi-experimental study protocol

BackgroundThere is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15–49 years in Ghana.MethodsA quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12 months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for confounders. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs.DiscussionLack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services.Trial registration Name of the registry: Pan African Clinical Trials Registry (PACTR). Trial ID: 14591. Date of registration: 02/01/2020. URL of trial registry record: https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=14591

The nature and extent of healthcare provision for people with intellectual disabilities in Ghana: A qualitative study.

Ghana has designated special schools with the mandate of training and equipping persons with intellectual disabilities with social functioning and vocational skills needed to promote their social inclusion. This study investigates the nature and extent of healthcare provision for persons with intellectual disabilities in their respective special schools. This research adopted a qualitative, but participatory approach to collect data from respective stakeholders. The findings reveal that some of these special schools do not have professional health workers, and most healthcare providers have challenges diagnosing and prescribing medication for this population due to the health workers' limited understanding of their healthcare needs, coupled with communication barriers. The researchers have suggested setting up of a special health department with personnel who have received training on intellectual disabilities. This department must undertake training for the housemothers in special schools, parents in the communities, and teachers in special schools.

Teachers’ experiences of classroom behaviour problems and mitigation strategies among students with visual disabilities in Ghana

ABSTRACT Behaviour problems among students with visual disabilities are mentioned as a challenge confronting teachers. This study explores teachers’ experiences of behaviour problems and strategies used to mitigate such problems among students with visual disabilities in Ghana. In-depth interviews were conducted with 15 purposively selected teachers. Thematic analysis was used to analyse the data. The findings are discussed using a psychological theory, namely the biological theories and psychodynamic theories. The study shows that students exhibit several classroom behaviour problems, categorised into physiological (emotional problems, noncompliance and aggression) and physical and social problems (verbal abuse, sleeping, talking, habitual lateness and teasing). Factors causing behaviour problems are negative attitudes of teachers, unfavourable teaching methods, the nature of the family, and classroom environment. The study concludes that behavioural (rewards and motivation, punishment, and classroom rules and regulations), humanistic (positive student-teacher relationship) and systemic (participatory teaching strategy and resource persons) approaches can be employed as mitigation strategies.

Sexual and reproductive health services utilisation amongst in-school young people with disabilities in Ghana.

BackgroundSexual and reproductive health (SRH) of young people including those with disabilities is a major public health concern globally. However, available evidence on their use of sexual and reproductive health services (SRHS) is inconsistent.ObjectiveThis study investigated utilisation of SRHS amongst the in-school young people with disabilities (YPWDs) in Ghana using the healthcare utilisation model.MethodsGuided by the cross-sectional study design, a questionnaire was used to obtain data from 2114 blind and deaf pupils or students in the age group 10-24 years, sampled from 15 purposively selected special schools for the deaf and the blind in Ghana.ResultsAbout seven out of every 10 respondents had ever utilised SRHS. The proportion was higher amongst the males (67.8%) compared with the females (62.8%). Young persons with disabilities in the coastal (OR = 0.03, 95% CI = 0.01–0.22) and middle (OR = 0.06, 95% CI = 0.01–0.44) zones were less likely to have ever utilised SRHS compared with those in the northern ecological zone. The blind pupils or students were more likely to have ever utilised SRHS than the deaf (OR = 1.45, 95% CI = 1.26–3.11).ConclusionsGenerally, SRHS utilisation amongst the in-school YPWDs in Ghana is high but significantly associated with some predisposing, need and enabling or disabling factors. This underscores the need for policymakers to consider in-school YPWDs as a heterogeneous group in the design and implementation of SRHS programmes. The Ghana Education Service in collaboration with the Ghana Health Service should adopt appropriate pragmatic measures and targeted interventions in the special schools to address the SRH needs of the pupils or students.

Prevalence of health insurance enrolment and associated factors among persons with disabilities in Ghana

Abstract: Research into healthcare-financing mechanisms remains an important public health issue and has therefore, received considerable attention in both international and local contexts. However...

Religion and Voting Behavior of Older Adults With Disabilities in Ghana

Voting is a necessary and inherent right of citizens in democracies to select public office holders who decide how public goods and resources are distributed and maintained. It is therefore critical that all citizens who are eligible are able to participate in one of the key aspects of political participation – voting. This study focused on the factors that influence the ability of older adult Ghanaians with disabilities to vote in local and national elections. The study sample of 923 respondents was drawn from the second wave of WHO SAGE study on Global Aging and Adult Health. The results of the logistic regression analyses showed that religion influenced the voting behaviors of all the three people with disabilities groups included in the study. But certain groups are also influenced by interaction with community leaders and personal political interests and characteristics, including gender. Given these findings, it is suggested that an impact community be established around the meaning and ethics associated with the religious activities people with disabilities participate in, and engage them through civic engagement, and personal and community development activities that empower them to live meaningful lives.

Disability and Household Welfare in Ghana: Costs and Correlates

Persons with disabilities face substantial barriers that impede their integration and participation in social and economic activities. Households with disabled members may be vulnerable to poverty due to the extra cost of living with a disability. However, there exists a knowledge gap in the magnitude of the extra cost of disabilities in sub Saharan Africa. Using data from a nationally representative household survey, this paper estimates the extra cost of disabilities in Ghana. The paper further examines the welfare effects of households with persons with disabilities. Based on the standard of living approach, we estimate the extra cost to households with a person with disability to be 26% of annual household consumption expenditures. Adjusting for the extra cost of poverty, the incidence of poverty increases from 38.5 to 52.9% amongst households with a disabled member. Our findings suggest the need to improve the efficiency of support programs to persons with disabilities to mitigate the extra costs of disabilities and reduce their vulnerability to poverty. In addition, enhancing access to economic opportunities and social services for persons with disabilities will be imperative to improve their quality of life and dignity.

Measurement of disability among people with severe mental disorders - pilot study to examine environmental impacts on mental health outcomes in Ghana

Background/aim: Mental Disorders are a leading cause of morbidity and suicide globally; around 2.15 million people live with mental disabilities in Ghana. While neurotoxic impacts of air pollution have been reported, little is known about effects on mental health outcomes. Possible impacts of household fossil fuel air pollution and mental disorders are largely unknown. In this exploratory study, we assessed participants’ level of self-reported disability and explore differences in disability scores by important sociodemographic/environmental characteristics. Methods: This pilot study was conducted among patients living with severe mental disorders in the Kintampo North Municipality and Kintampo South District of Ghana. The 12-item validated WHO Disability Assessment Schedule (WHODAS) 2.0 was used to measure participant’s level of functional disability. Descriptive statistics were calculated for all outcomes and patient characteristics. Household primary cookstove and fuel use for cooking or heating were assessed. We examined WHODAS scores by several characteristics, including gender, employment and marital status.Results: There were 70 participants who completed the survey within the pilot study period. The mean age was 38 years; the majority of participants were male (57%; 40/70). Most (31%; 22/70) of the study participants had Junior High/Middle School education, have never been married (57%; 40/70) and were not currently employed (83%; 58/70). More than half of the study participants (57%; 40/70) were living independently in their communities compared to 43% who needed assistance from family members. Overall, participants reported elevated WHODAS scores indicating their inability to function well on daily basis due to their mental disorder. About 93% (65/70) participants used traditional cookstove (3-stone fires) for cooking, with wood as the primary fuel. Conclusion: This pilot study provides preliminary findings to further explore environmental exposures, particularly household air pollution in relation to mental health outcomes and severity in a mixed-method study in Ghana.

\u2018They are my future\u2019: childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare

BackgroundPrevious research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana.MethodsA cross-sectional qualitative study was conducted with WWDs aged 18–49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data.ResultsNearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing.ConclusionOur findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.

Understanding the parental experiences of raising deaf children in Ghana

ABSTRACT Effective parenting promotes the physical, emotional, mental and social well-being of children. However, communication barriers between hearing parents and their deaf children can hinder these children’s upbringing and deprive them of the benefits of parental care and support services. While much is known about the challenges faced by persons with disabilities in Ghana, there is a dearth of knowledge about the parental experiences of raising deaf children. Face-to-face semi-structured interviews were conducted with 20 hearing parents of deaf children (3–15 years) to determine how they provided personal care to their deaf children, the support survices available to them and the challenges they faced. The participants spoke about their inability to communicate with their deaf children because they lacked sign language proficiency. This has had adverse impacts on the ability of most of the participants to provide basic skills training or determine their deaf children’s needs. We discuss the need to develop comprehensive support programmes to equip parents with skills to raise their deaf children.

Inclusive education for students with sensory disabilities in Ghana: views of students with disabilities about availability of resources in regular schools

Purpose Inclusive education is a “revolutionary” educational concept which seeks to promote the participation of all students in the teaching and learning process. Although several countries have revised their education system to promote the learning of all students in the same classroom, there are persistent barriers to effective inclusive practices. Within this discourse, there is a scarcity of studies focussing solely on students’ perspectives on resource availability. Due to the sizeable population of students with sensory disabilities in Ghana, this study sought to understand the perspectives of students with hearing (n = 74) and visual (n = 41) impairments on resource availability in regular schools. Materials and methods A total of 115 students with sensory disabilities were recruited from one special and two regular schools in Ghana using the Perceived Resources Questionnaire. The data were entered into the Statistical Package for the Social Sciences and subjected to t-tests, one and two-way independent analyses of variances and direct logical regressions. Results While the students were slightly positive about the availability of resources, there were differences between them in terms of disability type, gender and grade. Conclusion We discuss the need for policymakers to engage other stakeholders to expedite the supply of resources to regular schools to support inclusive practices. Implications for rehabilitation The importance of resources to facilitating inclusive practices cannot be overemphasised. The perspectives of students with disabilities about availability of resources in schools is unreported. Students with sensory disabilities were slightly positive about availability of resources in regular schools. There were differences between students with sensory disabilities who participated in this study.

From university-to-work: an in-depth exploration into the transition journey of graduates with sensory disabilities in Ghana

The importance of planned and supported transition processes for persons with impairments to move from one education institution to another, or from education to employment, cannot be overemphasised. In the Ghanaian context, while some attention has been given to the experiences of individuals with disabilities and their participation in universities, less attention has been paid to their transition journey to work. In this study, 27 persons with hearing and visual impairments were recruited to delve into their experiences. A semi-structured interview guide was developed and data were collected via face-to-face, virtual and telephone interviews, as well as focus group discussions. The results showed a lack of transition programmes for persons with sensory impairments who participated in the study. Also, participants were reluctant to disclose their impairments status when applying for employment. The study limitations, recommendations for future research and policy implications are discussed in detail. Points of interest Graduates with visual and hearing impairment have unique modes of communication. Effective transition from university to work will facilitate efforts towards promoting the acceptance and independence of graduates with hearing and visual impairments in society. While universities offer opportunities for the participation of all students, there seems to be a lack of transition programmes – from university to work – for graduates who participated in this study. Participants withheld information about their impairment when applying for jobs in order to ‘pass as normal‘ and avoid negative discrimination towards them. There is discussion of the need for participants to accept their physical impairments and to intensify their advocacy to preserve and promote the realisation of their right to work.

Factors Contributing to Challenges in Accessing Sexual and Reproductive Health Services Among Young People with Disabilities in Ghana

The United Nations’ Convention on the Rights of Persons with Disabilities mandates people with disabilities to enjoy equal rights in every sphere of their lives including the right to access sexual and reproductive health services (SRHS). However, young people with disabilities (YPWDs) continue to face challenges in accessing these services. This study, therefore, sought to assess the challenges YPWDs face in accessing SRHS in Ghana. The study employed a cross-sectional design and was carried out in 2017 among 2127 in-school YPWDs. Data used for this study were part of a national survey among 16 special schools in Ghana. Data were collected by trained field assistants with pretested questionnaires. The data were entered into the SPSS Version 23 and analysed with the STATA Version 14.2 for Mac OS. The data were analysed using both descriptive (frequencies and percentages) and inferential statistics (binary logistic regression models). The results from the regression analysis were presented as adjusted odds ratios (AORs) with their corresponding 95% confidence intervals (CI) signifying level of precision. Statistical significance was pegged at p value less than 0.05. At the descriptive level, the findings showed that the major challenges YPWDs faced in accessing SRHS are high cost of health services, physical challenges and problem of communication. The logistic regression analysis showed that females (AOR = 0.64, 95% CI = 0.44, 0.92), those in senior high school/technical/commercial (AOR = 0.56, 95% CI = 0.30, 0.75), those in the coastal zone (AOR = 0.47, 95% CI = 0.26, 0.85), the visually impaired (AOR = 0.50, 95% CI = 0.30, 0.82) and those who rated their health status as bad (AOR = 0.45, 95% CI = 0.26, 0.70) had lower odds of facing a challenge in accessing SRHS compared with males, those in primary school, those in the northern zone and those who rated their health status as very good, respectively. Young people with disabilities have challenges accessing SRHS. Therefore, there is the need for the Ministry of Health in collaboration with the Ministry of Education and other stakeholders to make it an intervention priority to train health personnel in the use of sign language and brails to equip them with knowledge and skills to enable them adequately address the challenges YPWDs face in accessing SRHS.

In search of universal health coverage \u2013 highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

BackgroundAccessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana.MethodsQualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data.ResultsThe study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care.ConclusionThe study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

How people with disabilities experience programs to prevent intimate partner violence across four countries

Women with disabilities are more vulnerable to violence, including intimate partner violence (IPV), yet the majority of emerging IPV prevention programs fail to explicitly consider the needs of participants with disabilities. Women and men living with disabilities engaged with IPV prevention programs in four countries were interviewed to explore how disability shaped their experiences of gender, violence, IPV, and whether the programs met their disability related needs. In-depth interviews were conducted with 16 women and 15 men living with disabilities in Ghana, Rwanda, Tajikistan and South Africa. The data were analysed thematically and compared across the settings. Participants described experiencing disability-related stigma, discrimination, exclusion, and for women, increased vulnerability to IPV. Barriers to full participation in programs included limited accessibility, and lack of disability-specific materials, recruitment or outreach. Enablers of inclusion included recruitment and monitoring strategies aimed at people with disabilities, partnering with a local disabled people’s organization, training staff in disability inclusion, and raising awareness of disability rights. The data encouragingly suggests that inclusion of women and men with disabilities in IPV prevention programs designed for the general population has beneficial outcomes. Inclusion can prevent violence, promote their wellbeing, support economic empowerment, and challenge disability-related stigma and discrimination.

Collaborative Efforts to Improve Opportunities for Children With Intellectual and Developmental Disabilities in Ghana

PurposeAlthough efforts have been made in Ghana to include children with disabilities in mainstream society, children continue to face barriers to education, rehabilitation, and support services. This article describes collaborative efforts made by the authors, U.S. speech-language pathologists, and a Ghanaian special educator to improve communication skills and academic opportunities for children with intellectual and developmental disabilities. Such initiatives include bringing alternative and augmentative communication into the classroom and establishing activities that promote linguistic concepts and literacy skills.ConclusionThis article is an effort to provide a service delivery model for speech-language pathologists and professionals working in low- and middle-income countries. In addition to the authors' efforts described in the article, this also highlights national initiatives that have improved the services for children with intellectual and developmental disabilities in Ghana.

The use of assistive technologies among children with disabilities: the perception of parents of children with disabilities in Ghana

Purpose Assistive technologies (ATs) are fundamental to the successful educational and societal inclusion of all children with disabilities. In particular, the use of ATs has been found to increase levels of independence in daily living and promote greater access to learning opportunities for children with disabilities. However, the knowledge base and baseline information on the use of ATs is limited in developing countries such as Ghana. In this study, we sought to explore the experiences of parents regarding the use of ATs by their children with disabilities in Ghana. Materials and methods We used a survey questionnaire consisting of both open- and closed-ended questions to explore the perspectives of parents with children with disabilities (n = 35) who were attending the rehabilitation unit of a referral hospital. Results Although participants acknowledged the benefits of ATs for the development and participation of their children in society, they noted barriers to the usage of ATs by their children. Among several barriers, parents mentioned that they lacked funds to purchase assistive devices. Some parents also mentioned the high cost of ATs and rehabilitation services. Conclusion The need for government to include rehabilitation services and ATs in the National Health Insurance Scheme to ease the burden on participants and other implications of the findings for policymaking are extensively discussed. Implications for rehabilitation In an environment where there is negative attitude towards children and parents with disabilities, ATs are expected to encourage the participation and acceptance in society. Although many participants were aware of the benefits of ATs to their children, they reported barriers to usage among their children with disabilities. This study shows that poverty, limited health facilities, unfriendly environment and stigmatisation were barriers encountered by parents. We conclude that the government should expand health and rehabilitation facilities to encourage access and participation.

Education for Women and Girls with Disabilities in Ghana : A Powerful Tool for Change

Women with disabilities (WWD) from countries around the world, including Ghana, are often deprived of public education. The World Report on Disability in 2011 estimated that literacy rates for WWD may be as low as 1%. This study employs critical feminist disability theory, combined with a phenomenological lens, to explore the educational experiences of ten Ghanaian WWD who have received public education in Ghana, and have had both positive and negative experiences. The results of these interviews yield policy and practice recommendations to improve access to, and success in education for more WWD in Ghana. These recommendations include the need to advocate and to implement Inclusive Education (IE) Policy in Ghana, to introduce disability studies in all school levels, to counteract negative cultural beliefs about people with disabilities, and to educate the public for changes in attitudes, especially teachers, students, and the community.

Extending social protection to persons with disabilities: Exploring the accessibility and the impact of the Disability Fund on the lives of persons with disabilities in Ghana

In many low-income countries, persons with disabilities are consistently denied access to essential services, contributing to a high incidence of poverty among them. The Goal 1 of the Sustainable Development Goals (SDGs) exhorts countries to develop appropriate social protection to serve as a springboard to alleviate poverty among all persons. The government of Ghana has introduced Disability Fund to provide one-off financial support to persons with disabilities through its decentralised political units. This is to enable persons with disability to participate in socio-economic activities. However, after a decade of the establishment of the fund, anecdotal evidence still shows that many persons with disabilities continue to live in deplorable conditions. Therefore, the main aim of this qualitative study was to explore the beneficial impact of the fund on the lives of persons with disabilities in Ghana. A semi-structured interview guide was used to collect data from 48 participants, comprising 20 males and 28 females with disabilities. The narratives from the participants revealed that only a few were able to access the fund. In their quest to access the fund, participants encountered barriers, such as lack of information, delays in disbursement and insufficient funds. The findings underscore the need for re-evaluation of the administration of Disability Fund and its disbursement processes. The implications of the findings for policy reform are extensively discussed.