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Cleaver S.1,2, Magalhães L.3, Bond V.4,5, Nixon S.2,6
1University of Toronto, Rehabilitation Sciences Institute, Toronto, Canada, 2International Centre for Disability and Rehabilitation, Toronto, Canada, 3Universidade Federal de São Carlos, São Carlos, Brazil, 4University of Zambia, School of Medicine, Zambart, Lusaka, Zambia, 5London School of Hygiene and Tropical Medicine, Department of Global Health and Development, London, United Kingdom, 6University of Toronto, Department of Physical Therapy, Toronto, Canada
Background: Physiotherapists working to develop rehabilitation services in the low-resource environments of the global South are often encouraged to collaborate with “disabled persons' organizations (DPOs).” This encouragement is appropriately grounded in concerns for the agency and empowerment of persons with disabilities, yet current understandings of DPOs are superficial and sometimes mistaken. For example, outsiders often presume that DPOs have a specific structure and focus (e.g., service provision or human rights advocacy), while the members of the DPOs see their organizations differently. These understandings are at very least inadequate to inform physiotherapists working to develop collaborations with DPOs. Worse, these understandings could be misleading.
Purpose: To explore the construction and orientation of two DPOs in Western Zambia in order to contribute to a more nuanced understanding of the diversity of DPOs in the global South.
Methods: This study is a subset of a larger collaborative qualitative research project led by a North American physiotherapist working with two DPOs in Western Zambia. One participating DPO was based in an urban area whereas the other was rural. The larger research project focused upon the perspectives of DPO members with respect to their understandings of disability and approaches to the improvement of the situation of persons with disabilities. Data were collected through focus group discussions, individual interviews, and participant observation fieldnotes written by the primary investigator. For this study we conducted a thematic analysis of data related to
1) the members descriptions of their motivations to establish the DPOs and the DPO activities,
2) observations of the structure of the DPOs, and
3) the contexts in which the DPOs operated.
Results: The two DPOs had very different structures. Whereas the urban DPO was formalized with clearly-defined membership, the rural DPO was fluid and willing to adapt its membership to the researchers preferences. Despite these differences, the members of both DPOs described the motivations to organize in terms of opportunities to secure material resources. In the urban context, a local government office had provided incentives for persons with disabilities to formalize DPOs. By contrast, in the rural context, there was a history of visitors who arrived with their own agendas. Although the two DPOs had different structures, each of these was organized to maximize its opportunity to secure material resources according to its context.
Conclusion(s): This study demonstrated how DPOs can be structured different ways according to their specific contexts. The motivations leading to the establishment of these DPOs could be indicative of a common concern of persons with disabilities in Western Zambia: securing material resources. Understanding the structure of DPOs and the motivations leading to their establishment can be informative for physiotherapists looking to collaborate with DPOs.
Implications: Physiotherapists striving to collaborate with DPOs should be cognizant that these organizations can be structured in a multitude of ways.
Physiotherapists should tailor their approach to collaboration to the specific structure of DPOs and the contexts in which these organizations operate.
Funding acknowledgements: The investigators were supported by Canadian Institutes for Health Research (CIHR) and W. Garfield Weston Foundation.
Topic: Disability & rehabilitation
Ethics approval: Ethics approval was obtained from the University of Toronto Health Science REB and the University of Zambia Social Science REC.
All authors, affiliations and abstracts have been published as submitted.
