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Barriers of Persons with Physical Disability Over Accessibility and Mobility to Public Buildings in Zambia Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 6 No. 1 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

To ensure that there is inclusiveness in the provision of services for PWDs the Zambian government ratified to the UNCRPD by enacting the Zambia PWDs ACT No. 6 of 2012 to precisely look at promoting and protecting the rights of PWDs. Despite this, there has been a lack of implementation of the ACT and specifically about accessibility and mobility of PWDs to public buildings. The aim of this study was to explain barriers to implementation of part five division five of The Zambia PWDs on Accessibility and Mobility to public buildings in Lusaka for PWDs. A qualitative case study approach was utilized with sample of 8 participants who by a method of purposeful and convenient sampling were drawn and using thematic method of analysis. This study found that there is a knowledge gap and reduced general knowledge about the ACT among policy implementers. There is need for awareness among people that own building in Lusaka of the Disability ACT. For the policy makers there is a need for prioritization through national planning, budgeting and various national programs.

An Assessment of the Health Literacy among Deaf People in Kapiri Mposhi District of Zambia Chiluba, Brian Chanda; Chibo, Mutale; Chiluba, Beatrice Mwaba; Thole, Beverly
Indonesian Journal of Disability Studies Vol. 6 No. 2 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

Health care is important to everyone and everyone should have equal access to health care. The literature available focuses mainly on high-income countries. It is therefore important to bear in mind that many Deaf people, especially in low and middle-income countries, are suffering from much greater health disparities. Deaf people rely on a visual language that does not have a written form. These individuals may lack proficiency in written English. Health literacy, as defined by the National Institutes of Health refers to how well a person can get the health information and services that they need, and how well they understand them. To assess the Health Literacy of Deaf people in Kapiri Mposhi District. This research was a qualitative study; it used a cross-sectional descriptive study design. Snowball sampling was done. The sample size was 15 participants. 10 Deaf individuals and 5 health care providers altogether. Interviews were conducted and manual transcription was used to analyse the data and translate it into themes. Deaf people in Kapiri Mposhi are not aware of issues pertaining to health and wellbeing. It appears that Deaf people, because of communication barriers faced, do not receive full disclosure of their medical situation and the alternatives are not discussed with them. Even when disclosure does occur, many Deaf people may not fully comprehend the options available to them because of communication difficulties with health care providers. This entails that the Deaf people in Kapiri Mposhi District have their health literacy extremely low.

Evaluating Evidence Based Practice of Physiotherapists and the Quality of Physiotherapy Services in Selected Health Facilities of Lusaka, Zambia Lupenga, Joseph; Namwila, Nkweto Natasha; Nkandu, Esther Munalula; Chiluba, Brian Chanda; Shula, Hastings Kachingwe
Indonesian Journal of Disability Studies Vol. 6 No. 2 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

There is an empirical argument that Physiotherapists have a moral and professional obligation to move away from assessment and treatment methods based on anecdotal testimonies or opinion and upgrade their method of practice to Evidence-Based Practice in order to remain alive in the era of scientific research. It is essential to evaluate the quality of service being delivered by referral hospitals. This study aimed to establish linkages of knowledge and awareness of evidence-based practice in selected hospitals of Lusaka and the service quality at the physiotherapy outpatient departments. This study employed a descriptive cross-sectional study. The study was based on primary data collected through a standardized SERVQUAL tool measuring the mean expectations and perception of performance for the quality of physiotherapy care. A total of 75 respondents including both physiotherapists and patients contributed to the study. Limited utilization of EBP practice was seen with only 3(5.1%) participants always and 26(4.1%) mostly reading research to guide the clinical decision. 18(31%) and 14(24.1%) respectively strongly agreed or agreed that the insufficiency of basic EBP skills was the primary barrier to the application of EBP in clinical practice. A negative mean gap score was observed across all five dimensions of the SERVQUAL tool for patients. Despite Physiotherapists in Lusaka being knowledgeable of evidence-based practice, negative gaps in quality of care being offered still persist, an indication that there is a needs to improve on patients' satisfaction with the services being provided.

Disability of Gait in Stroke Survivors: Physiotherapy Clinical Use of Visual Gait Analysis in Lusaka, Zambia Chiluba, Brian Chanda; Mwansa, Mulenga Gideon
Indonesian Journal of Disability Studies Vol. 6 No. 2 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

Stroke is one of the leading causes of severe handicap, disabling and impairing the ability to walk in 80% of all stroke survivors. Physiotherapists, all over the globe, use Observational gait analysis as a preferred method of gait assessment in their clinical practice to assess, monitor change, evaluate treatment and identify areas needing intervention in the rehabilitation of patients with gait disability. The objective of the study was to determine factors affecting the use of observational gait analysis in assessment of stroke survivors among physiotherapy practitioners at the University Teaching Hospital. The study was a cross sectional descriptive study aimed at determining the knowledge and factors affecting use of observational gait analysis and the adaption thereof as a Standard Observational Gait Assessment Tool at the University Teaching Hospital. The essential factors to the use of assessment tools were lack of guidelines and lack of knowledge on use of OGA. Also a lack of organizational support, lack of formal knowledge and no availability of assessment tools. To overcome these barriers, it is necessary to provide training of standardized assessment, and to recommend appropriate guidelines.

Barriers to Health Care for Disabled People: A Review of the Literature from Low Income Countries Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 6 No. 2 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

Over the years, they have been suggestions that people with disabilities face barriers when accessing health care services unlike their abled counter-parts. However, information regarding the nature of these barriers, especially for those in low income and middle income countries is not abundant and very sparse. signing of the United Nations Convention on the Rights of Persons with Disabilities on May 3, 2008 is one of the most important disability actions taken to date which marked national recognition of the rights for persons with disabilities, of which included access. The studies explored in this article review issues related to access to health care and those mostly used in areas within the Sub-Saharan as their sample site. The following document contains published studies that determine if disability limits access to health care and to attempt to identify what contextual factors (environmental and personal factors), interact with to limit this access. The findings were that people with disability who came from rural areas did find it harder to access healthcare than their urban counterparts. The major reason behind this is transportation from home to the health facility. A number of other reasons were also considered, such as no services were available.

Tackling Disability of Speech due to Stroke: Perspectives from Stroke Caregivers of the University Teaching Hospital in Zambia Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 6 No. 2 (2019)
Publisher : The Center for Disability Studies and Services Brawijaya University

Many stroke survivors usually have permanent disability such as aphasia, which results in the need for support from caregivers. Care required for stroke survivors differs depending on the type of stroke but there is little research done in this regard. However, current literature provides evidence that support services and interventions for caregivers, especially in relation to managing affective symptoms, are unsatisfactory. The aim of this study was to explore the experiences of caregivers handling aphasic stroke patients at the University Teaching Hospital. An explorative study utilizing qualitative phenomenological approach was utilized with sample of 15 participants who by purposeful sampling were drawn and using thematic method of analysis. This study found that caregivers go through a lot of things in caring for their loved ones and their experience involve a complicated and sometimes unpredictable interplay of multiple processes. Lack of preparedness in assuming the role of caregiving caused the caregivers to go through what seemed to be insurmountable challenges. There is therefore need of caregiver education so that they can deliver appropriate care to the stroke survivors.

Stroke Disability and Physiotherapy Interventions: A Quantitative Evaluation of Physiotherapy Treatment Approaches in Zambia Mpemba, Muatle; Shula, Hstings Kachingwe; Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 7 No. 1 (2020)
Publisher : The Center for Disability Studies and Services Brawijaya University

As a result of physical disability after stroke, most of the patients need physiotherapy. Due to different backgrounds, knowledge, clinical experiences, personal preferences, and continually developing clinical practices, physiotherapists use different methods to treat their stroke patients. This study was designed to determine physiotherapists' perspective on the physiotherapy interventions for stroke patients at the University Teaching Hospital and Levy Mwanawasa University Teaching Hospital in Lusaka. This was a cross-sectional study. Data was collected through a standardized questionnaire with modifications to fit the scope of the study. A total of 36 participants consisting of 23 Physiotherapists and 13 physiotherapy Technologists was considered. The data obtained was analyzed by using descriptive analysis and chi-square test was used to test the association. The results showed that PNF/Brumstrom (92%) was the most taught approach among the respondents in their professional education. The preferred treatment approaches in stroke rehabilitation which are used by Physiotherapists and physiotherapy Technologists are repetitive functional task practice (72%), motor learning (69%) and PNF/Brumstrom (67%). There is need to incorporate the newer physiotherapy treatment approaches into the physiotherapy practice as the scope of practice that reflects the latest evidence base improves the provision of services and contributes to better and cost-effective physiotherapy interventions for stroke patients.

Assessment of Non Communicable Diseases Awareness Among Pupils with hearing impairment at Munali High School in Lusaka, Zambia Mawani, Irwin Kabinje; Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 7 No. 1 (2020)
Publisher : The Center for Disability Studies and Services Brawijaya University

Among the neglected population in NCD awareness is the population of people with hearing impairment or deaf. Little effort is made to ensure that people are deaf are covered in these NCDs awareness programs. Hence this study aimed at assessing the NCDs awareness among people who are deaf in Zambia, particularly assessing the knowledge of NCDs risk factors, diagnosis and treatment. The study utilized a phenomenological study type with were 10 participants who were purposively sampled. 5 males and 5 females were chosen, 2 from Grade ten, 4 from Grade eleven and 4 from Grade twelve. These were chosen because of their ability to adequately read and understand English language. The study highlighted that among the many factors, the major factors were identified as; lack of communication between the health personnel and the deaf person (pupil), attitude (stigma) of the health personnel towards the person who are deaf (pupil), lack of health education in the school curriculum and lack of specific information on NCDs. Other identified factors were lack of regular health campaign within the school premises, lack of health materials on NCDs and poor organization of physical education.some issues such as lack of communication between the health personnel and them, the attitude of the health personnel, lack of health education in the school curriculum and lack of specific information on NCDs were found to be the major cause of low awareness among the target

Factors Contributing to Late Physiotherapy Intervention of Children with Cerebral Palsy at The University Teaching Hospital, Lusaka in Zambia Kanyembo, Chona; Chiluba, Brian Chanda; Moyo, Geoffrey
Indonesian Journal of Disability Studies Vol. 8 No. 1 (2021)
Publisher : The Center for Disability Studies and Services Brawijaya University

Introduction: Cerebral palsy is the leading cause of disability worldwide and Zambia has its fair share of cases. Most parents/caregivers of children with Cerebral palsy at University Teaching Hospital started attending physiotherapy late when their children were over one year Therefore, the aim of this study was to explore the perceptions of mothers towards factors contributing to late physiotherapy intervention of children with Cerebral palsy at University Teaching Hospital. Furthermore, assess the knowledge of mothers with children between 0-5 years on the role of physiotherapy in Cerebral palsy. Methodology: An exploratory study design using qualitative methods was used. Data collection techniques were FGDs that consisted of purposively sampling of 10 mothers of children with CP attending physiotherapy at University Teaching Hospital. Audio-recording from the FGDs was transcribed verbatim for each session by an independent person. The study employed thematic analysis for data analysis. The data was classified systematically by means of coding to identify key factors or issues such as concepts, categories, themes and the relationship between them. Results: This study identified four themes on factors that influence late physiotherapy intervention of children with Cerebral Palsy at University Teaching Hospital. These included: Socio-economic support; late referral for Physiotherapy; Caregiver's knowledge about Cerebral Palsy; and People's attitude towards Cerebral Palsy. Limited caregiver knowledge about the role of physiotherapy in Cerebral Palsy was reported to be due to; limited community awareness about physiotherapy; and lack of caregiver education. Conclusion: The present study sought to explore the perceptions of mothers towards factors contributing to late physiotherapy intervention in children with Cerebral Palsy. A diversity of factors that led to delayed intervention was highlighted. Rehabilitation professionals should be aware of the factors that impact mothers both positively and negatively in order to implement effective rehabilitation programs.

Factors Influencing Adherence to Physiotherapy Appointments for Children with Cerebral Palsy at Chilenje Hospital in Zambia: A Mother's Perspective (2017-2018) Foto, Dorcas; Moyo, Geoffrey; Chiluba, Brian Chanda
Indonesian Journal of Disability Studies Vol. 8 No. 1 (2021)
Publisher : The Center for Disability Studies and Services Brawijaya University

Adherence to treatment appointments by mothers of children with Cerebral Palsy is one of the factors affected in rehabilitation of a child with Cerebral Palsy, and this is cardinal to ensure effective rehabilitation outcomes for the child. Hence this study aimed to explore the factors influencing poor adherence to physiotherapy appointments by mothers of children with Cerebral Palsy at Chilenje Hospital, in Lusaka. A qualitative case study design utilising a phenomenological approach was conducted with a sample of 12 mothers of children with Cerebral palsy from Chilenje Hospital, Lusaka. Convenient sampling was utilized where mothers who were non-adhering were also purposefully selected into the study to better understand the factors affecting adherence to physiotherapy. The factors that contributed to caregivers defaulting scheduled therapy included economic constraints like unemployment and low education level, caregiver related factors such as marital challenges, and service centered factors such as challenges with the diagnosis of Cerebral Palsy and negative clinician attitudes. Majority of the caregivers admitted that they were motivated to attend therapy by observable improvements in their children. A combination of psychosocial, economic, child centered and service centered factors contributed to caregivers defaulting scheduled therapy. Interventions that may potentially improve caregiver attendance to scheduled therapy include community outreach services, efficient rehabilitation service provision at the hospitals, and facilitation of income generating programmes for mothers and caregivers.

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