Browsing by Author "Seymour, Nikola"

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    Community-based rehabilitation workers’ perspectives of wheelchair provision in Uganda : a qualitative study
    (AOSIS Publishing, 2019-04-24) Seymour, Nikola; Geiger, Martha; Scheffler, Elsje
    Background: The challenges of wheelchair provision and use in less resourced settings are the focus of global efforts to enhance wheelchair service delivery. The shortage of professional wheelchair service providers in these settings necessitates the collaboration of multiple stakeholders, including community-based rehabilitation (CBR) workers, whose role needs to be further understood. Objectives: The aim of this study was to determine what CBR workers in three areas of Uganda perceived as (1) the challenges with wheelchair provision and use, (2) the factors contributing to these challenges, (3) the role they themselves can potentially play and (4) what facilitators they need to achieve this. Method: This qualitative study in the transformative paradigm comprised focus group discussions to gather perceptions from 21 CBR workers in three areas of Uganda, each with an operational wheelchair service, participant observations and field notes. Thematic analysis of data was implemented. Results: Community-based rehabilitation workers’ perceptions of challenges were similar while perceived causes of challenges differed as influenced by location, historical and current wheelchair availability and the CBR workers’ roles. Their main responsibilities included assistance in overcoming barriers to access the service, transfer of skills and knowledge related to wheelchairs, follow-up of users for wheelchair-related problem-solving, and user and community empowerment. Conclusion: Community-based rehabilitation workers can contribute in various ways to wheelchair service delivery and inclusion of wheelchair users; however, their capabilities are not consistently applied. Considering the diversity of contextual challenges, CBR workers’ range of responsive approaches, knowledge of networks and ability to work in the community make their input valuable. However, to optimise their contribution, specific planning for their training and financial needs and effective engagement in the wheelchair services delivery system are essential.
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    Community-based rehabilitation workers’ perspectives of wheelchair provision in Uganda : a qualitative study
    (AOSIS, 2019) Seymour, Nikola; Geiger, Martha; Scheffler, Elsje
    Background: The challenges of wheelchair provision and use in less resourced settings are the focus of global efforts to enhance wheelchair service delivery. The shortage of professional wheelchair service providers in these settings necessitates the collaboration of multiple stakeholders, including community-based rehabilitation (CBR) workers, whose role needs to be further understood. Objectives: The aim of this study was to determine what CBR workers in three areas of Uganda perceived as (1) the challenges with wheelchair provision and use, (2) the factors contributing to these challenges, (3) the role they themselves can potentially play and (4) what facilitators they need to achieve this. Method: This qualitative study in the transformative paradigm comprised focus group discussions to gather perceptions from 21 CBR workers in three areas of Uganda, each with an operational wheelchair service, participant observations and field notes. Thematic analysis of data was implemented. Results: Community-based rehabilitation workers’ perceptions of challenges were similar while perceived causes of challenges differed as influenced by location, historical and current wheelchair availability and the CBR workers’ roles. Their main responsibilities included assistance in overcoming barriers to access the service, transfer of skills and knowledge related to wheelchairs, follow-up of users for wheelchair-related problem-solving, and user and community empowerment. Conclusion: Community-based rehabilitation workers can contribute in various ways to wheelchair service delivery and inclusion of wheelchair users; however, their capabilities are not consistently applied. Considering the diversity of contextual challenges, CBR workers’ range of responsive approaches, knowledge of networks and ability to work in the community make their input valuable. However, to optimise their contribution, specific planning for their training and financial needs and effective engagement in the wheelchair services delivery system are essential.
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    Exploring CBR workers’ perceptions of their role in wheelchair provision in three areas of Uganda
    (Stellenbosch : Stellenbosch University, 2016-03) Seymour, Nikola; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH ABSTRACT:Background: Wheelchair provision and use in less resourced settings face significant challenges. Global efforts to affect change include the WHO Guidelines on provision of manual wheelchairs in less resourced settings and the WHO wheelchair training resources. Multiple stakeholders are required to collaborate to affect improvement, and in contexts where community-based rehabilitation (CBR) is implemented CBR workers have a role to play. Objectives: The objectives of the study were to determine what CBR workers in three areas of Uganda perceive as the challenges with wheelchair provision and use; the factors contributing to these challenges; the role they can play and what they need to achieve this. Method: This qualitative, participatory study in the transformative paradigm gathered perceptions of twenty one CBR workers through three focus group discussions, in the north, west and central regions of Uganda. Findings: Limited availability of appropriate products; financial constraints of people with disabilities (PWD) and wheelchair services; and historical and societal influences on beliefs are perceived by CBR workers to affect utilisation of wheelchair services and mobility of PWD. Participation is further influenced by inadequate skills in wheelchair use; limited durability of products and environmental factors including physical and attitudinal barriers. CBR workers suggested strategies which, if strengthened with training and closer partnership with wheelchair services, can positively impact the provision and use of wheelchairs in less-resourced settings. Findings also indicate the need to address issues related to the position and empowerment of CBR workers. Conclusion: Contextual challenges to wheelchair provision and use in less-resourced settings would benefit from involvement of CBR workers. However, further efforts are required to increase the availability of appropriate wheelchairs and services, and to ensure the financial resources necessary to enhance effectiveness of both wheelchair services and community-based rehabilitation.