Survey of rehabilitation support for children 0-15 years in a rural part of Kenya

Abstract Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. Implications for Rehabilitation There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed

Social support needs for equity in health and social care: a thematic analysis of experiences of people with chronic fatigue syndrome/myalgic encephalomyelitis

BACKGROUND: Needs-based resource allocation is fundamental to equitable care provision, which can meet the often-complex, fluctuating needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This has posed challenges both for those providing and those seeking support providers, in building shared understanding of the condition and of actions to address it. This qualitative study reports on needs for equity in health and social care expressed by adults living with CFS/ME. METHODS: The participants were 35 adults with CFS/ME in England, purposively selected to provide variation in clinical presentations, social backgrounds and illness experiences. Accounts of experienced needs and needs-related encounters with health and social services were obtained through a focus group (n = 6) and semi-structured interviews (n = 35). These were transcribed and needs related topics identified through data-led thematic analysis. FINDINGS: Participants emphasised needs for personalised, timely and sustained support to alleviate CFS/ME impacts and regain life control, in three thematic areas: (1) Illness symptoms, functional limitations and illness management; (2) practical support and social care; (3) financial support. Access of people with CFS/ME to support from health and social services was seen to be constrained by barriers stemming from social, cultural, organisational and professional norms and practices, further heightened for disadvantaged groups including some ethnic minorities. These reduced opportunities for their illness to be explained or associated functional limitations and social disadvantages to be addressed through social support. Participants sought more understanding of bio-psycho-social aspects of CFS/ME, of felt needs of people with CFS/ME and of human rights and disability rights, for providing person-centred, equitable care. CONCLUSIONS: Changes in attitudes of health practitioners, policy makers and general public and more flexibly organised health and social care provision are needed to address equity issues in support needs expressed by people with CFS/ME, to be underpinned by research-based knowledge and communication, for public and professional education. Policy development should include shared decision-making and coordinated action across organizations working for people with CFS/ME, human rights and disadvantaged groups. Experiences of people with CFS/ME can usefully inform an understanding of equity in their health and social care

Natural kinds and the identity properties

El argumento de Krípke de la designación rígida de los términos de género natural es falaz porque no distingue los géneros naturales de las propiedades funcionales de segundo orden. Al aclarar los conceptos de género natural y de propiedad funcional podemos mostrar que si bien los términos de género natural designan sus referentes rígidamente, los términos de propiedad funcional no son designadores rígidos. Mis discusiones de las propiedades funcionales ayudarán también a disipar la preocupación sobre la existencia de supuestos casos de identidad contingente entre los enunciados teóricos de la ciencia. No hay ninguna identidad contingente, ni siquiera en la forma de la lógica de segundo orden: la identidad de propiedades es también una identidad necesaria. El principio de la identidad necesaria gobierna sin interrupción

Assessments: The contribution of occupatinal therapy

This article focuses on the contribution of occupational therapy in the assessment of older people in the care home setting

Introduction to personal development in social care

This, the second of the mandatory units for the new diploma, introduces you to personal development that can help you develop your professional practice

Cultural sensitivity, unconscious bias and quality of health care

As the population rises, health care professionals need to be culturally sensitive to an increasingly diverse population to deliver effective care. Swati Kale and Chia Swee Hong use case histories to demonstrate some of the challenges faced

Groupwork as a tool to combat loneliness among older people

One of the current care strategies aims to keep older people in their own homes, however independent living and caring for an ageing partner can exacerbate loneliness. Loneliness has been described as an unwelcome feeling or lack of companionship. Help the Aged has pointed out that participation in meaningful activities can reduce isolation and loneliness. The case studies of two different groups of older people show the positive impact of groups on older group members and the staff working with them. By providing companionship, engagement, support and activity, groupwork can bring structure to the lives of older people and their carers who may be feeling ‘lonely’ and ‘isolated’ and consequently can impact upon their quality of life. Groupwork is by no means the solution to reducing social isolation for everyone, however for some people it is a positive step in the right direction