Disabilities In South Africa Research Articles

Early Childhood Development: The Disability Policy and its implications for occupational therapists

The White Paper on the Rights of Persons with Disabilities encapsulates the vision not only for persons with disabilities in South Africa, but for every member of a diverse society. This paper discusses the vision of inclusion and mainstreaming contained in the White Paper and critiques the specific provisions for early childhood development, exploring their implications for training and practice of occupational therapists. Recommendations are made as to how these can be strengthened in achieving the vision of an inclusive society in which young children with disabilities are able to realise their potential. Key words: children with disabilities, early childhood development, inclusion, mainstreaming, policy

Intimacy, intercourse and adjustments: Experiences of sexual life of a group of people with physical disabilities in South Africa.

There is a growing recognition of the sexual and reproductive rights of people with disabilities, and since the World Health Organisation's World Report on Disability, increased international attention has been given to these issues. Past research, however, suggests that this group encounter barriers to sexual and reproductive rights, which are both physical and attitudinal. Against this backdrop, this article employs a sequential mixed qualitative methodology to explore the practical and subjective experiences of 13 people with physical disabilities in South Africa, with regard to their sexual lives and experiences of sexuality. These experiences were marked by concerns about their 'fitness' as sexual beings and indicated that social forces were key in shaping their expectations for their own sexual life.

Disability facilitators’ views of their work with children with disability in South Africa

Children in under resourced areas can be disadvantaged in terms of education and health care, and can experience social hardship. Within South Africa, social, health and educational support for ‘at...

Disability facilitators' views of their work with children/youth with disability in South Africa

Children and youth including those with impaired body function or structure, in under resourced areas, can be disadvantaged in terms of education and health care, and can experience social hardship. Within South Africa, personal, health and education support to individual children and their families in under-resourced areas is provided by care workers from the National Association of Child Care Workers. This organisation also provides training and support to their care workers to take on the role of Disability Facilitator, to extend their services to children with impaired body function or structure. This study established the views of Disability Facilitators about their work. Fourteen participants (aged 25–54years) were individually interviewed at their own worksite. Two themes were identified from the data - Empowerment and Burden of responsibility.The theme of ‘Empowerment’ encapsulated how participants viewed disability more widely than as it relates to impaired body function and structure. Disability Facilitators empowered children and their families in a holistic way, and advocated within their community to address negative perceptions about disability. They supported the wellbeing and participation of children with disability within their local communities, and perceived their work as motivating and worthwhile. However, the second theme ‘Burden of responsibility’ encapsulated the challenges in feeling solely responsible for disability support in their community and in providing care and support for children living in dysfunctional families. They recommended all care workers receive training about disability issues to reduce the burden of responsibility on themselves. This study has demonstrated the worth of Disability Facilitators to address the challenges inherent in disabling environments. This approach to service provision offers useful insights that could be adapted into other countries and contexts.

The sexual and reproductive rights and benefit derived from sexual and reproductive health services of people with physical disabilities in South Africa: beliefs of non-disabled people

There is a body of theoretical work, and some empirical research, which suggests that non-disabled people assume people with physical disabilities are not suitable romantic partners, do not have sexual drives or desires, or are not sexually active. It has also been proposed that people with physical disabilities face barriers to sexual healthcare access which are structural as well as social. The present paper explores non-disabled South Africans’ beliefs concerning the degree to which non-disabled respondents enjoy sexual and reproductive rights, and benefit from sexual and reproductive healthcare, compared to people without disability. Using a survey, we asked 1989 South Africans to estimate the degree to which people with physical disabilities and people without disability have sexual rights, and benefit from sexual and reproductive healthcare services, respectively. Respondents were more likely to support the idea that the population without disability were deserving of sexual rights compared to people with physical disabilities. Respondents were more likely to rate the degree to which people with physical disability benefit from sexual and reproductive healthcare as less than that for people without physical disabilities. These findings provide some of the first empirical support that non-disabled people perceive people with physical disabilities as having fewer sexual and reproductive rights, and deriving less benefit from sexual and reproductive health services, than the population without disability. To have diminished sexual rights, and benefit less from sexual and reproductive healthcare, we suggest, evinces a negation of the sexual and reproductive needs and capacity of people with physical disabilities.

Disability Discrimination and the Right of Disabled Persons to Access the Labour Market

Inequality, discrimination and transformation remain the key challenges which most employers are faced with in the South African labour market. Key among such challenges has also been employers' ability to ensure that persons with disabilities access the labour market. In this paper I highlight employment discrimination experienced by persons with disabilities in South African workplaces, which often prohibits them from accessing employment opportunities. I argue that employers need to consider employing persons with disabilities and also reasonably to accommodate them within South African workplaces. I further illustrate efforts by the legislature to eradicate forms of unjustified discrimination against persons with disabilities through the enactment of the Employment Equity Act 55 of 1998. I argue that all of us need to understand how cultural, social, physical and other barriers continue to prevent persons with disabilities in South Africa from enjoying their constitutional rights to equality, freedom and human dignity, and further, that it is desirable that society at large and government work together towards eradicating barriers which prevent persons with disabilities from accessing the labour market.

Entrepreneurial Barriers that are Confronted by Entrepreneurs Living with Physical Disabilities: A Thematic Analysis

Living with a physical disability can interfere with an individual’s ability to participate actively in economic and social life. It is imperative to comprehensively understand the entrepreneurial barriers hindering the development of entrepreneurs living with physical disabilities. In spite of the increasing research on entrepreneurship, there seems to be a paucity of studies that have investigated the entrepreneurial barriers that are faced by entrepreneurs living with physical disabilities in South Africa. This study set out to explore the entrepreneurial barriers that are confronted by entrepreneurs living with physical disabilities. In this study, data were collected within the Sebokeng Township, which is an African township located in the Vaal Triangle, south of Johannesburg in South Africa. A qualitative research approach was used to collect data for the study. The researchers gathered qualitative data by means of semi-structured face-to-face interviews and focus groups. The analysis of the qualitative data was conducted through the use of thematic analysis. The themes that emerged from the findings include lack of equipment and machinery, discrimination, business networking, hardships in obtaining start-up capital, knowledge of support centres for entrepreneurs living with physical disabilities, and lack of education and training. Each theme was discussed individually, followed by substantiating quotes. Most respondents stressed that the barriers they face hinder the survival and growth of their ventures. The paper suggested that in order to help entrepreneurs living with physical disabilities, the South African government must formulate some schemes that are most necessary for their improvement and betterment of their life.

Entrepreneurial Barriers that are Confronted by Entrepreneurs Living with Physical Disabilities: A Thematic Analysis

Living with a physical disability can interfere with an individual’s ability to participate actively in economic and social life. It is imperative to comprehensively understand the entrepreneurial barriers hindering the development of entrepreneurs living with physical disabilities. In spite of the increasing research on entrepreneurship, there seems to be a paucity of studies that have investigated the entrepreneurial barriers that are faced by entrepreneurs living with physical disabilities in South Africa. This study set out to explore the entrepreneurial barriers that are confronted by entrepreneurs living with physical disabilities. In this study, data were collected within the Sebokeng Township, which is an African township located in the Vaal Triangle, south of Johannesburg in South Africa. A qualitative research approach was used to collect data for the study. The researchers gathered qualitative data by means of semi-structured face-to-face interviews and focus groups. The analysis of the qualitative data was conducted through the use of thematic analysis. The themes that emerged from the findings include lack of equipment and machinery, discrimination, business networking, hardships in obtaining start-up capital, knowledge of support centres for entrepreneurs living with physical disabilities, and lack of education and training. Each theme was discussed individually, followed by substantiating quotes. Most respondents stressed that the barriers they face hinder the survival and growth of their ventures. The paper suggested that in order to help entrepreneurs living with physical disabilities, the South African government must formulate some schemes that are most necessary for their improvement and betterment of their life.

Supported Employment for people with mental disabilities in South Africa: cost calculation of service utilisation

INTRODUCTION: Supported Employment (SE) is a strategy that facilitates positive employment outcomes for people with mental disabilities in open labour market settings. SE's cost-effectiveness has been established internationally, but not in South Africa. This paper reports on the cost and affordability of SE services offered to people with mental disabilities in South Africa. METHOD: A longitudinal descriptive study was used to determine the cost of SE service components utilised by people with mental disabilities, from two programmes in the Western Cape. The utilisation of service elements was captured in 15-minute time units. Data collection continued for 12 months, commencing when a job had been identified and preparation for placement had ensued. Time utilisation data were used to calculate cost, using a government sessional salary (R189/hour) and a medical aid reimbursement rate (R367/hour) of occupational therapists acting as job coaches. FINDINGS: The findings show SE services to be less than 10% of the cost of a monthly disability grant, and 10% - 21% lower than the current subsidy per consumer in a protective workshop. CONCLUSION: Evidence from the study thus reflects the cost of SE services to people with mental disability as substantially lower than the current government investment in disability grants and protective workshops subsidies. Key words: psychiatric disability; intellectual disability; vocational rehabilitation; reasonable accommodation; return to work

Help, harm or hinder? Non-governmental service providers’ perspectives on families and gender-based violence against women with intellectual disabilities in South Africa

Through in-depth interviews with service providers from non-governmental organisations (n = 58), this article describes the intricacy of familial relationships for women with intellectual disabilities in South Africa who experience gender-based violence. The findings suggest that families navigate social stigma, limited resources and isolation, whilst trying to be vigilant against gender-based violence and disability-related violence, and respond to it as it happens. However, family members are also simultaneously implicated in violence perpetration. We suggest that a social relational model of disability could help account for these crucial intra-familial dynamics.

Stigma on the basis of psychosocial disability: a structural human rights violation

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.

The invisible employee: reasonable accommodation of psychosocial disability in the South African workplace

While many disabilities are observable, and thus are generally accepted by employers as requiring accommodation on the job (eg in the form of assistive technology, duty modifications and medical devices), psychosocial disability is not obvious. In fact, it is sometimes referred to as ‘the invisible disability’.1 This paper considers the challenges faced by people with psychosocial disabilities to access and retain meaningful work. It explores international and national legal frameworks and jurisprudence relating to the rights of persons with disabilities in the workplace, and demonstrates that challenges relating to regulation of disclosure; lack of clarity regarding the provision of reasonable accommodation and the undue hardship limitation; and societal and self-stigma remain significant barriers to the equal participation of persons with psychosocial disabilities in South Africa’s workplaces. I suggest that South Africa is failing to meet some of its obligations in terms of the Convention on the Rights of Persons with Disabilities and that there are weaknesses in the conception of disability inherent to the Employment Equity Act. To conclude, I offer recommendations relating to how these shortcomings might be rectified for the benefit of employees living with psychosocial disabilities.

Barriers to the Implementation of the Health and Rehabilitation Articles of the United Nations Convention on the Rights of Persons with Disabilities in South Africa.

Background: The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is a milestone in the recognition of the human rights of persons with disabilities, including the right to health and rehabilitation. South Africa has signed and ratified the CRPD but still has a long way to go in reforming policies and systems in order to be in compliance with the convention. This paper seeks to fill a gap in the literature by exploring what the barriers to the implementation of the health and rehabilitation articles of the CRPD are, as identified by representatives of the disability community. Methods: This investigation used a qualitative, exploratory methodology. 10 semi-structured interviews of a purposive sample of representatives of disabled persons organizations (DPOs), non-governmental organizations (NGOs), and service providers in South Africa were conducted. Participants were drawn from urban, peri-urban, and rural settings in order to reflect diverse perspectives within South Africa. Data was analysed using a multi-stage coding process to establish the main categories and relationships between them. Results: Six main categories of barriers to the implementation of the health and rehabilitation articles of the CRPD were identified. Attitude barriers including stigma and negative assumptions about persons with disabilities were seen as an underlying cause and influence on all of the other categories; which included political, financial, health systems, physical, and communication barriers. Conclusion: The findings of this study have important implications for strategies and actions to implement the CRPD. Given the centrality of attitudinal barriers, greater sensitization around the area of disability is needed. Furthermore, disability should be better integrated and mainstreamed into more general initiatives to develop the health system and improve the lives of persons living in poverty in South Africa.

A relevant practical course for mental health care providers in South Africa

<p>The South African Mental Health Care Actdefines mental health care provider as a person providing mental health care services to mental health care users and includes mental health care practitioners. Mental health care practitioner means a nurse, psychiatrist or registered medical practitioner, psychologist, occupational therapist or social worker who has been trained at an accredited institution to provide prescribed mental health care, treatment and rehabilitation services. For a South African mental health provider to render high-quality mental health care, treatment and rehabilitation services, that mental health care provider should have been exposed to theory and practical teaching and learning in Intellectual Disability (ID). One of the most relevant practical courses for intellectual disability in South Africa is offered by the Sunshine Association.</p>

Education on an Equal Basis: A Comparison of Persons With and Without Disabilities in South Africa

The South African education crisis is well documented in the literature. While strides have been made to rectify the inequalities in education arising from apartheid era policies, and while South Africa ratified the United Nations Conventions for the Rights of People with Disabilities, these actions have yet to translate into meaningful changes for persons with disabilities. To investigate the status of educational attainment, this article uses South Africa’s National Income Dynamics Study to analyse the disparities in education for adults with and without disabilities. Education is a key mechanism of leverage for functionings. The findings show that persons with disabilities fare worse in educational attainment than persons without disabilities, but that race and geographic location play a larger role in predicting educational attainment than disabilities. In addition, age also contributes to educational disparities. The findings of this study are integral in the call from the Presidency to ‘strengthen the country’s response to the needs of [persons with disabilities] … and to monitor progress’ of educational attainment for persons with disabilities (20-year review, 2014, p. 73).

Has the Policy Window Closed? A Critical Analysis of South Africa’s Inclusive Education Policy

To assess whether the policy window opened by White Paper Six (WP6) has closed, this article traces the historical path of the policy and reviews pertinent policy documents and research to date on inclusive education in South Africa. Two research questions are explored: 1. What is the present state of inclusive education for students with disabilities in South Africa? 2. What factors facilitate or inhibit the understanding and implementation of WP6? Results reveal a negative state of inclusion in present day South Africa based on teacher, student, and parent attitudes towards the policy and disability. Furthermore, many barriers and few facilitators of inclusion were found. The analysis concludes by making policy recommendations and posing alternatives.

The Expanded Programme on Immunisation in South Africa: A story yet to be told.

During the past two decades, immunisation has saved millions of lives and prevented countless illnesses and disabilities in South Africa(SA). However, vaccine-preventable diseases are still a threat. A vaccine-preventable disease that might lead to a 1- or 2-week illness in anadult, could prove deadly for infants, children or elderly people. Vaccination protects oneself and one's family. For example, adults are themost common source of pertussis (whooping cough) infection in infants, which can be deadly for the latter. This article demonstrates thecommitment of the SA government to immunisation, highlights key milestones of the Expanded Programme on Immunisation (EPI) anddispels the myth that the EPI in SA is in shambles.

Additional Layers of Violence: The Intersections of Gender and Disability in the Violence Experiences of Women With Physical Disabilities in South Africa.

South Africa has unprecedented levels of violence and many South African women are exposed to violence during their lifetime. This article explores how gender and disability intersect in women's experiences of violence during their lifetime. Repeat in-depth qualitative interviews with 30 physically disabled women in Cape Town reveal that women with physical disabilities are exposed to various forms of violence, and shows how their impairments shape their violence experiences. The most common forms of violence women with disabilities experience are psychological violence, financial abuse, neglect, and deprivation, with disability stigma playing a central role and contributing to how women with disabilities are exploited and dehumanized. Constructions of women as asexual shape their sexual relationships and experiences of sexual violence. This article identifies that women with disabilities are more at risk and experience additional layers of violence than women without disabilities. These additional risks and layers of violence need to be recognized and inform interventions to prevent and respond to violence against women with disabilities in the country. Prevention of violence against women with physical disabilities in South Africa needs to address the role of disability stigma that shapes the types of violence they experience, change gender norms, and create accessible and safe environments and economic empowerment opportunities.

“Our children have the right to an education too”: Strategies employed by Orange Farm Caregivers of Children with Disabilities in Pursuit of the Right to a Basic Education

Purpose: This paper aims to understand the agency that caregivers who participated in a CBR empowerment component programme exercised, in order to promote the rights of their children with disabilities to a basic education. Methods: An interdisciplinary theoretical framework and qualitative methodology were used to examine the agency and the opportunity structures within which the caregivers operate. Focus group discussions, case study interviews and secondary Programme data were analysed using manual thematic analysis. Results: Thousands of children with disabilities in South Africa are effectively denied the right to a basic education as a result of discriminatory norms, stigmatising discourses and unjust power relations. Yet, a group of caregivers have successfully advocated for their children with disabilities in the township of Orange Farm, Gauteng. Their lobbying has contributed to the establishment, by the State, of a new school. Conclusion and Implications: The findings suggest that human rights advocacy movements, as well as disability organisations, would do well to recognise and encourage the power and agency possessed by caregivers of children with disabilities. Catalysing civic action and providing opportunities for active citizenry and self-help seem to nurture increased efficacy and competence at navigating systems and accessing rights. While advocacy organisations may act as proxy agents, direct and collective agentic strategies should be nurtured. In implementing inclusive education, policy makers and the Department of Education should recognise the role that caregivers of children with disabilities can play, and the potential contribution that their motivation, resourcefulness, and disability-related knowledge can make.

Childhood disability population-based surveillance: Assessment of the Ages and Stages Questionnaire Third Edition and Washington Group on Disability Statistics/UNICEF module on child functioning in a rural setting in South Africa.

BackgroundEpidemiological information on childhood disability provides the basis for a country to plan, implement and manage the provision of health, educational and social services for these vulnerable children. There is, however, currently no population-based surveillance instrument that is compatible with the International Classification of Functioning, Disability and Health (ICF), internationally comparable, methodologically sound and comprehensively researched, to identify children under 5 years of age who are living with disability in South Africa and internationally. We conducted a descriptive pilot study to investigate the sensitivity and specificity of translated versions of the Ages and Stages Questionnaire Third Edition (ASQ-III) and the Washington Group on Disability Statistics/UNICEF module on child functioning (WG/UNICEF module) as parent-reported measures. The aim of our study was to identify early childhood disabilities in children aged 24–48 months in a rural area of South Africa, to determine the appropriateness of these instruments for population-based surveillance in similar contexts internationally.MethodsThis study was conducted in the Xhariep District of the Free State Province in central South Africa, with 50 carers whose children were registered on the South African Social Security Agency (SASSA) database as recipients of a grant for one of the following: Care Dependency, Child Support or Foster Care. The researchers, assisted by community healthcare workers and SASSA staff members, conducted structured interviews using forward–backward translated versions of the ASQ-III and the WG/UNICEF module.ResultsBoth measurement instruments had a clinically meaningful sensitivity of 60.0%, high specificity of 95.6% for the ASQ-III and 84.4% for the WG/UNICEF module, and the two instruments agreed moderately (Kappa = 0.6).ConclusionSince the WG/UNICEF module is quicker to administer, easier to understand and based on the ICF, it can be considered as an appropriate parent-reported measure for large-scale, population-based as well as smaller, community-specific contexts. It is, however, recommended that future research and development continues with the WG/UNICEF module to enhance its conceptual equivalence for larger-scale, population-based studies in South Africa and internationally.