Maternal and newborn health needs for women with walking disabilities; "the twists and turns": a case study in Kibuku District Uganda

Background

In Uganda 13% of persons have at least one form of disability. The United Nations’ Convention on the Rights of Persons with Disabilities guarantees persons with disabilities the same level of right to access quality and affordable healthcare as persons without disability. Understanding the needs of women with walking disabilities is key in formulating flexible, acceptable and responsive health systems to their needs and hence to improve their access to care. This study therefore explores the maternal and newborn health (MNH)-related needs of women with walking disabilities in Kibuku District Uganda.

Methods

We carried out a qualitative study in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews (IDIs) among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted. Trained research assistants used a pretested IDI guide translated into the local language to collect data. All IDIs were audio recorded and transcribed verbatim before analysis. The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis.

Results

We found that women with walking disabilities had psychosocial, mobility, special services and personal needs.

Psychosocial needs included; partners’, communities’, families’ and health workers’ acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure, and responsive health services needs while personal MNH needs were; personal protective wear, basic needs and birth preparedness items.

Conclusions

Women with walking disabilities have needs addressable by their communities and the health system. Communities, and health workers need to be sensitized on these needs and policies to meet and implement health system-related needs of women with disability.

The effect of self-talk on the penalty execution in goalball

The purpose of this study was to examine the effectiveness and preference of the two different types of self-talk (instructional and motivational) on penalty execution skill in goalball and gain insight on the athletes' perceptions concerning self-talk use and its influence on their performance. The sample consisted of six female athletes, aged 26—40 years old (mean = 33 years), all members of the national goalball team representing Greece in the Paralympic Games in Athens 2004. In each experimental procedure, five athletes were the subjects of an instructional and a motivational self-talk test while executing 20 penalties, with a rest period following the first 10 penalties. One athlete was stable defending the other athletes' shooting and she was not involved in any test during each experimental procedure. Although non-parametric statistics indicated no difference on performance, the results revealed a percentage difference on performance ranging from 1.5 per cent to 26.1 per cent for each athlete in favour of instructional self-talk in all three experimental procedures. Finally, participants showed preference toward the use of instructional self-talk to improve their penalty execution skill.

A systematic review of the effects of motor interventions to improve motor, cognitive, and/or social functioning in people with severe or profound intellectual disabilities

While it is generally agreed that motor activity promotes motor, cognitive, and social development, the specific benefits in people with severe or profound intellectual disabilities (S-PID) are as yet unknown. The aim of this study was to systematically review the evidence related to motor interventions designed to improve motor, cognitive, and/or social outcomes in people with S-PID. A systematic review of empirical studies published between 1982 and 2012 was conducted using four databases (MEDLINE, PsycINFO, ERIC, and CINAHL). Data were extracted regarding the aim of the study, study design, sample characteristics, theoretical framework, intervention, the measurement tools utilized, and outcomes. Of 295 articles reviewed, 46 met our inclusion criteria and covered 45 different studies. Forty articles used single-subject designs and five used a group design. The majority of the articles focused on behavioural techniques with (n=21) or without (n=15) assistive technology. Theoretical frameworks were explicitly reported in nine (20%) of the 45 articles. Thirty-eight articles reported improvement in basic motor skills and eight articles reported improvement in recreational or more specialist motor skills. None of the articles reported negative effects due to motor interventions. Further research is required to determine which motor interventions are the most effective in improving motor outcomes and/or cognitive and social outcomes, and on the longer term effects of these interventions in people with S-PID.

Support Needs of Adults with Intellectual Disability Across Domains: The Role of Technology

People with and without disabilities universally value the goals of greater control and self-determination, inclusion and participation in their school or community, and enhanced social inclusion. Technology is an important support in achieving these goals. In this manuscript we examine the intensity of support needs, as measured by the Supports Intensity Scale, of persons with intellectual disability (ID) by severity of their intellectual deficit, as well as examining the level of support needs of individuals with co-occurring autism, mental health problems, and physical limitations. We compared the profiles of support needs of persons with ID and particular concomitant conditions and discussed the implications from these findings for the use of technology to address the support needs of people with intellectual disability.

Use of microswitches and speech output systems with people with severe/profound intellectual or multiple disabilities: a literature review

Microswitches and speech output systems are two forms of technology which have been used with people with severe/profound intellectual or multiple disabilities to help them reduce their isolation and interact with the surrounding world (i.e., thus obtaining environmental stimulation independently or requesting it efficiently). This paper reviews the studies which used microswitches and speech output systems with the aforementioned people during the 1986-1999 period, and discusses the research findings and the practicality of these two forms of technology. Some relevant issues for future research are also pointed out.