Hear my voice: a community-based participatory study gathering the lived experiences of people with disabilities and older people in Tanzania

This is the final version of the article. Available from the publisher via the URL in this record.This study provides evidence on the specific nature and experiences of people with disabilities and older people from their own perspectives in rural and urban settings in Tanzania. Its aim was to better inform efforts to provide services for and improve the lives of people living in those regions. A community-based participatory approach was used, involving collaboration with the community. Peer researchers and research partners collected and analysed interviews with people with disabilities and older people, leading to policy and advocacy recommendations and early stage plans. Findings were framed in terms of experiences of participation and inclusion as impacted by physical, social and attitudinal factors, as well presented at individual, interpersonal and societal levels. They demonstrate how lack of access to healthcare and education, social limitations and powerful community attitudes were interwoven and exacerbated poverty in these contexts. Policy recommendations cover issues such as halting persecution and killings of people with albinism, support and guidance for families of children with disabilities, national policy on ageing legislation, and implementing and monitoring the UN Convention on the Rights of Persons with Disabilities

Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study

Background Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme. Methods Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach. Results Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system. Conclusions Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake