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Beckerlegge F1, Mumbere D2
1Kyaninga Child Development Centre, Fort Portal, Uganda, 2Kyaninga Child Development Centre, Kasese, Uganda
Background: Children with disabilities (CWDs) are one of the most marginalised groups worldwide. Widespread local beliefs that disabilities are an untreatable curse, causes children and their families to be excluded from their communities and educational institutions. This misunderstanding is a huge barrier to the progress, learning and independence of many children.
In Uganda, disability affects more than 13% (2.5 million) of children but access to rehabilitation services is extremely limited, with more than 73% of rehabilitation services located in the 7 major urban centres; disproportionately 83% of the population is rural dwelling.
Purpose: Kyaninga Child Development Centre (KCDC) was established in 2014 to create equal opportunities for CWDS in Western Uganda. KCDC's innovative, Community-Based Rehabilitation model enables access to specialist therapy services that would otherwise be unavailable, unreachable and unaffordable. Health education to parents, community leaders, healthcare and community workers promotes social inclusion and dispels stigma and misunderstanding.
Methods: Local observations and in-depth interviews with stakeholders, community members and district officials identified a severe shortage in accessible rehabilitation services across the district. High transport costs, long travel times and poor functional outcomes were identified as barriers.
As a result, KCDC offers free and comprehensive multi-disciplinary rehabilitation and training services, through a daily outpatient clinic in the 2 sites of Fort Portal and Kasese and home visits, health centre and school outreach programmes across 5 districts. Entrepreneurial business training is offered to all families for economic empowerment. Additionally, parent education and peer support groups are offered regularly, as well as training workshops for healthcare and community workers and teachers.
Results: Accessible and affordable Community-Based Rehabilitation (CBR) services are now available in 5 districts in western Uganda, and to date, over 1,400 CWDs, of which 41% have cerebral palsy, have received therapy intervention and adaptive equipment, such as locally made seating systems, parallel bars and wheelchairs. Increased school enrolment at 31% for CWDs in the region, compares favourably to the national rate of 9%.
Overall, more than 3,000 community members have increased awareness and understanding of disability, resulting in reduced stigma and isolation for families with CWDs. Parents, village-health teams, teachers and more than 300 healthcare workers have received more comprehensive training on identifying and managing CWDs.
Partnerships have been generated with 19 local health centres and 21 local schools, as well as district government offices, providing better healthcare, education and advocacy for all.
Conclusion(s): Barriers to accessing rehabilitation in Uganda include poor distribution of services, unaffordability, poor access and high transport costs. These have been significantly reduced in Western Uganda, through the CBR model, with increased access and awareness, resulting in improved quality of life for CWDs and their families, and greater social inclusion and understanding in communities.
Implications: It is feasible to have a CBR model in rural areas where transport links are limited, and many families live in extreme poverty. A CBR model bridges the gap in providing the much needed health care to CWDs, which may be missing in the health system. It restores hope to the families and greater functional outcomes for CWDs.
Keywords: Community-Based Rehabilitation, Disabilty, Children
Funding acknowledgements: KCDC is supported by Kyaninga CDC Trust, Unreasonable East Africa, Elma Foundation, Habitat for Humanity Uganda, THET Health Partnership Scheme.
In Uganda, disability affects more than 13% (2.5 million) of children but access to rehabilitation services is extremely limited, with more than 73% of rehabilitation services located in the 7 major urban centres; disproportionately 83% of the population is rural dwelling.
Purpose: Kyaninga Child Development Centre (KCDC) was established in 2014 to create equal opportunities for CWDS in Western Uganda. KCDC's innovative, Community-Based Rehabilitation model enables access to specialist therapy services that would otherwise be unavailable, unreachable and unaffordable. Health education to parents, community leaders, healthcare and community workers promotes social inclusion and dispels stigma and misunderstanding.
Methods: Local observations and in-depth interviews with stakeholders, community members and district officials identified a severe shortage in accessible rehabilitation services across the district. High transport costs, long travel times and poor functional outcomes were identified as barriers.
As a result, KCDC offers free and comprehensive multi-disciplinary rehabilitation and training services, through a daily outpatient clinic in the 2 sites of Fort Portal and Kasese and home visits, health centre and school outreach programmes across 5 districts. Entrepreneurial business training is offered to all families for economic empowerment. Additionally, parent education and peer support groups are offered regularly, as well as training workshops for healthcare and community workers and teachers.
Results: Accessible and affordable Community-Based Rehabilitation (CBR) services are now available in 5 districts in western Uganda, and to date, over 1,400 CWDs, of which 41% have cerebral palsy, have received therapy intervention and adaptive equipment, such as locally made seating systems, parallel bars and wheelchairs. Increased school enrolment at 31% for CWDs in the region, compares favourably to the national rate of 9%.
Overall, more than 3,000 community members have increased awareness and understanding of disability, resulting in reduced stigma and isolation for families with CWDs. Parents, village-health teams, teachers and more than 300 healthcare workers have received more comprehensive training on identifying and managing CWDs.
Partnerships have been generated with 19 local health centres and 21 local schools, as well as district government offices, providing better healthcare, education and advocacy for all.
Conclusion(s): Barriers to accessing rehabilitation in Uganda include poor distribution of services, unaffordability, poor access and high transport costs. These have been significantly reduced in Western Uganda, through the CBR model, with increased access and awareness, resulting in improved quality of life for CWDs and their families, and greater social inclusion and understanding in communities.
Implications: It is feasible to have a CBR model in rural areas where transport links are limited, and many families live in extreme poverty. A CBR model bridges the gap in providing the much needed health care to CWDs, which may be missing in the health system. It restores hope to the families and greater functional outcomes for CWDs.
Keywords: Community-Based Rehabilitation, Disabilty, Children
Funding acknowledgements: KCDC is supported by Kyaninga CDC Trust, Unreasonable East Africa, Elma Foundation, Habitat for Humanity Uganda, THET Health Partnership Scheme.
Topic: Disability & rehabilitation; Paediatrics; Service delivery/emerging roles
Ethics approval required: No
Institution: N/A
Ethics committee: N/A
Reason not required: This is an overview of a service delivery model, and any data presented is from general project monitoring and project management. Informed verbal or written consent is received from all clients, or their caregivers, prior to any therapy intervention. Ethics committee approval is not required for presentation of established service delivery models. This has been clarified with the WCPT abstract team (Rachel Moore).
All authors, affiliations and abstracts have been published as submitted.
