From the day they are born: a qualitative study exploring violence against children with disabilities in West Africa.

BACKGROUND: Despite the building evidence on violence against children globally, almost nothing is known about the violence children with disabilities in low and middle-income countries (LMICs) experience. The prevalence of violence against children with disabilities can be expected to be higher in LMICs where there are greater stigmas associated with having a child with a disability, less resources for families who have children with disabilities, and wider acceptance of the use of corporal punishment to discipline children. This study explores violence experienced by children with disabilities based on data collected from four countries in West Africa- Guinea, Niger, Sierra Leone, and Togo. METHODS: A qualitative study design guided data generation with a total of 419 children, community members, and disability stakeholders. Participants were selected using purposive sampling. Stakeholders shared their observations of or experiences of violence against children with disabilities in their community in interviews and focus groups. Thematic analysis guided data analysis and identified patterns of meaning among participants' experiences. RESULTS: Results illuminate that children with disabilities experience violence more than non-disabled children, episodes of violence start at birth, and that how children with disabilities participate in their communities contributes to their different experiences of violence. CONCLUSIONS: The study recommends policy-oriented actions and prevention programs that include children and their families in strategizing ways to address violence.

Global partnerships for international fieldwork in occupational therapy: reflection and innovation.

International fieldwork placements (IFPs) have become very popular among healthcare students including those in occupational therapy programmes. There are many potential benefits that can accrue to the students; however, there are critiques of international placements especially for students going to underserviced areas. The purpose of this paper is to provide a case study/model programme description that critically reflects on six partnerships in three underserviced countries that provide IFPs to students from one Canadian university. The personal opinions of each partner were collected verbally, by email and by a qualitative review of the past 10 years of partnership interaction. Some of the benefits reported by partners include the development of an increased number of sustainable long-term quality placements, orientation materials, student supports and the involvement of university faculty in research and capacity building projects in partner countries. A number of challenges were identified including the need for an expanded formal agreement, more bilateral feedback and examination of supervision models. This paper examines a limited number of partnerships with only one Canadian partner. Direct input of students is not utilized, although feedback given to co-authors by students is reflected. More research is needed on perspectives of partners in IFPs, impact of IFPs on clinical practice in student's home countries, impact of IFPS on underserviced areas and effective strategies for debriefing.

Disability in low-income countries: issues and implications.

This article reports on a study conducted for the Canadian International Development Agency by The International Centre for Disability and Rehabilitation at the University of Toronto. We critically examined the broad literature in the area of disability and development and in this article we identify the key issues which emerged. Most of the data were collected from existing literature in the academic and practice settings and from the publications of key NGOs and governments. We first, examine disability in the context of low-income countries, and then discuss key critical issues: disability and poverty, disability and health, disability and education, disability and gender, disability and children/youth, disability and conflict/natural disasters and disability and human rights. In all these areas we find reports of discrimination, stigmatisation and marginalisation. We conclude that, as we address issues of multi-cultural disability services in developed countries, it is important to bear in mind the various issues that many people with disabilities and their families bring with them as the result of immigrating from a developing country. Although we address these issues within our own countries, we must bear in mind the changes that are occurring due to globalisation.

A case study of the changing nature of a non-government organisation: a focus on disability and development.

PURPOSE: The purpose of this article is to describe the changing nature, process and structure of an international non-governmental organisation (NGO) in response to internal and external factors. METHOD: This article is based on the interview data collected for the study which focussed on the experiences and perception of key informants on trends related to official development assistance, local governments' perspective of the NGO as a development partner and the NGO's perception of corporate and foundation support. Qualitative descriptive data analysis was used. RESULTS: Three main themes were developed with the interview data. Our analysis indicated shifts in the: (1) vision/nature (single to cross disability focus), (2) structure (building internal and external relationships) and (3) process (from ad hoc to systemic evaluations). CONCLUSIONS: These broader issues of vision, structure (relationships) and evaluation within and outside of the organisation, needs to be addressed to provide a foundation upon which funding initiatives can be developed. A closer relationship between funders and projects/programmes would do much to enhance the partnership and would ensure that the projects are able to measure and report results in a manner that is conducive to increasing support.

Children with disabilities in low-income countries.

Disability is a major public health concern worldwide and the situation for children with disabilities is even more serious. The present article will focus on the issue of children with disabilities in low-income countries. Approximately one-third of the world's disabled population is children and many of these disabling conditions are preventable. In Africa, one the foremost causes of disability is infectious and communicable disease; the incidence of these diseases have been greatly reduced or eliminated in higher income countries. Other causes include war, trauma, accidents, and congenital and noninfectious diseases. The recent HIV/AIDS epidemic has further contributed to the prevalence of disability because many people living with HIV develop different types of impairments and functional limitations. Community-based rehabilitation is one approach that has been used in many low-income countries and which often focuses on children and their families. The work of one organization providing community-based rehabilitation in Tanzania is highlighted. The experiences of the coauthors in their work in Tanzania provide some field examples. For those readers who would like to become involved in international health, opportunities for engagement are described, including short-and long-term volunteer service or research experiences.