The role of stigma in accessing education for people with disabilities in low and middle-income countries: a review of the evidence

People with disabilities are often subjected to stigma, which can keep them from realising their full potential and their human rights, including the right to education. The UN agenda for Sustainable Development Goals, underscores the urgent need to eliminate and ensure equal access in education to vulnerable groups, including people with disabilities. Thus, it is important to understand the different barriers and facilitators, which are preventing or enabling people with disabilities in their access to inclusive quality education. This report presents findings from a scoping review conducted to give an overview of the evidence-base on the role of stigma in accessing education for people with disabilities in low and middle-income countries (LMICs). Twenty-three articles from LMICs met the predetermined inclusion criteria. These articles described some of the ways stigma is affecting access to and equity in education, especially attitudes coming from teachers, school staff and structures, peers, parents and children's own felt stigma. In turn, these attitudes reflect societal stigma which is due to lack of knowledge and a societal view of disability, based on the medical model of impairment and limitation. There is a need for capacity building of teachers and of changing the medical view of disabilities in society. Evidence-based awareness campaigns and research on the implementation of inclusive education in low and middle-income countries is needed. ISBN: 978-82-14-06715-6publishedVersio

Predictors of negative beliefs toward the sexual rights and perceived sexual healthcare needs of people with physical disabilities in South Africa

Background: Although sexuality is a ubiquitous human need, recent empirical research has shown that people without disabilities attribute fewer sexual rights and perceive sexual healthcare to benefit fewer people with disabilities, compared to non-disabled people. Within a global context, such misperceptions have tangible, deleterious consequences for people with disabilities (e.g., exclusion from sexual healthcare), creating an urgent need for effective strategies to change misperceptions. Methods: To lay the groundwork for developing such strategies, we examined predictors of the recognition of sexual rights of people with physical disabilities within the South African context, derived from three key social psychological literatures (prejudice, social dominance orientation and intergroup contact), as well as the relationship between sexual rights and beliefs about sexual healthcare. Data were obtained through a cross-sectional survey, given to non-disabled South Africans (N = 1989). Results: Findings indicated that lack of recognition of the sexual rights for physically disabled people predicted less positive beliefs about the benefits of sexual healthcare. In turn, high levels of prejudice (both cognitive and affective) toward disabled sexuality predicted less recognition of their sexual rights, while prejudice (both forms) was predicted by prior contact with disabled people and possessing a social dominance orientation (cognitive prejudice only). Evidence was also obtained for an indirect relationship of contact and social dominance orientation on sexual healthcare beliefs through prejudice, although these effects were extremely small. Conclusion: Results are discussed in terms of their implications for rehabilitation, as well as national-level strategies to tackle negative perceptions of disabled sexuality, particularly in contexts affected by HIV.Implications for rehabilitation Findings demonstrate an empirical link between prejudice toward disabled sexuality, lack of recognition of sexual rights and viewing sexual healthcare of less benefit for disabled people. Consequently, there is need for increased attention to these dimensions within the rehabilitative context. Contact with disabled people, including dedicated interventions, is unlikely to meaningfully impact beliefs about the benefits of sexual healthcare

Using locational data in a novel mixed-methods sequence design: Identifying critical health care barriers for people with disabilities in Malawi

The primary aim of this study was to determine which health care barriers were most important for people with disabilities in Malawi. To accomplish this, we devised a sequential mixed-methods research design that integrated locational survey data and qualitative data from field studies. Our secondary aim was to evaluate this research design not only as a design-solution to our particular research objective, but as a tool with more general applicability within social sciences. Malawi has one of the most underserved health service populations in the world with chronic resource shortages and long travel distances where people with disabilities are at a particular disadvantage. Nevertheless, our results show that even in a resource scarce society such as Malawi it is the interpersonal relationships between patients and health service providers that has the largest impact on the perception of access among patients. Our results also suggest that the sequential mixed-methods design is effective in guiding researchers towards models with strong specifications.publishedVersio

Impairment, socialization and embodiment: The sexual oppression of people with physical disabilities

People with disabilities face multiple forms of social exclusion, discrimination, and oppression, including in the domain of sex and sexuality. From a critical psychoanalytic viewpoint, social responses to persons with impairments are strongly unconsciously mediated, and often dominated by projections based on archaic anxieties about dependency, vulnerability, and shame. Where disability meets sexuality, these defenses may be more prominent still, resulting, for one example, in the prejudiced myth that people with disabilities are disinterested in, or not capable of, sex. Using this theoretical stance, this paper examines how the developmental role of family and societal influences on the social constructions of sexuality and disability are internalized, resisted, and negotiated by two South Africans with physical disabilities. Data are drawn from interview material elicited via photovoice methodology. The interview narratives and photographic images are used to explore how sexual oppression may be internalized, creating intra-psychic barriers to inclusion for this already structurally disadvantaged group

(Re)presenting the self: Questions raised by a photovoice project with people with physical disabilities in South Africa

Photovoice is presented here as an emancipatory, participatory research method with the potential to put minority subjects in charge of their own representation. Drawing on research with disabled people conducted in South Africa, we argue that the meaning of images is often hostage to interpretations which reify untruths about the subject. We consider how photovoice projects may give rise to images that perpetuate the subjugation of their subjects, but could also facilitate an emancipatory politics of self-representation through photography, constituting a challenge and not only the discursive regimes and ideologies which underlie dominant aesthetics

Dating persons with physical disabilities: The perceptions of South Africans without disabilities

There is good reason to believe that the attitudes of persons without disability towards dating a person with a physical disability might be unfavourable. However, in general, and in the Global South in particular, there is a dearth of research in this area. This study sought to take the first step in addressing this lack of enquiry, by surveying the attitudes of a general population sample in South Africa towards dating people with physical disabilities, using a vignette. Data from 1,723 survey respondents were analysed thematically. Findings reveal largely negative attitudes towards people with physical disabilities. Respondents without disability perceived numerous barriers to dating a person with a physical disability, including social stigma, anxiety, and concerns about the burden of care they believed such a relationship would place upon them. However, there was some evidence to suggest that some positive attitudes do exist, and a few respondents were open to dating a person with physical disabilities. Findings contribute to a nuancing and expanding of the ‘myth of asexuality’ among physically disabled people by showing that people with physical disabilities are actively desexualised by persons without disability. Future research is needed to explore how the inclusive attitudes, of which we did find evidence here, can be further cultivated

The meaning of participation : reflections on our study

CITATION: Hunt, X., et al. 2021. The meaning of participation : reflections on our study. In: Hunt X., Braathen S.H., Chiwaula M., Carew M.T., Rohleder P., Swartz L. (eds). Physical disability and sexuality. Palgrave Macmillan, Cham. doi:10.1007/978-3-030-55567-2_10.The original publication is available at https://link.springer.comPublication of this chapter was funded by the Stellenbosch University Open Access FundIn Chapter 1 we provided a discussion of participatory research as a method for doing research, and provided an outline of what we did in the research project upon which this book is based. In this final chapter, we reflect back on our experiences of doing a participatory research project of this kind.https://link.springer.com/chapter/10.1007/978-3-030-55567-2_10Publisher's versio

Withdrawn, strong, kind, but de-gendered: Non-disabled South Africans’ stereotypes concerning persons with physical disabilities

The present paper examines stereotyping in relation to physical disability and gender in the South Africa. Cross-sectional data for the present study were gathered using free response items in a large survey (n = 1990) examining the attitudes of people without disability towards different facetsof sexuality and disability. The most prominent stereotypes found in thepresent study were those which characterised PWPD as withdrawn and shy, SuperCrips, or happy, funny, and kind. The findings in the present papersuggest that stereotypes of PWPD are not overwhelmingly de-sexualising, but are undifferentiated by gender

The sexual lives of people with disabilities within low- and middle-income countries: A scoping study of studies published in English

Although approximately 80% of the global population of people with disabilities reside in low- and middle-income countries, very little is known about their sexual lives due to a lack of empirical data. The purpose of this scoping review is to provide a data-driven overview of low- and middle-income countries concerning what topics in disability and sexuality have been investigated, where this research has been carried out, and how this research has been conducted. It is concluded that: a) disability and sexuality research in African countries focuses predominantly on contexts of vulnerability, b) the sexuality of people with disabilities within many low- and middle-income countries has received little or no empirical investigation, c) and there have been very few experimental studies on disability and sexuality conducted in low- and middle-income countries in general. Recommendations for future research are discussed

Intimacy, intercourse, and adjustments: Experiences of sexual life of a group of people with physical disabilities in South Africa

There is a growing recognition of the sexual and reproductive rights of people with disabilities, and, since the World Report on Disability (WHO, 2011), increased international attention has been given to these issues. Past research, however, suggests that this group encounter barriers to sexual and reproductive rights, which are both physical and attitudinal. Against this backdrop, this paper employs a sequential mixed qualitative methodology to explore the practical and subjective experiences of 13 people with physical disabilities in South Africa, with regards to their sexual lives and experiences of sexuality. These experiences were marked by concerns about their ‘fitness’ as sexual beings, and indicated that social forces were key in shaping their expectations for their own sexual life