Staff characteristics and the exclusion of persons with disabilities: evidence from the microfinance industry in Uganda

This study uses survey data from the microfinance industry in Uganda to investigate whether there are differences among industry staff members in beliefs and views regarding persons with disabilities. For several of the questions, various staff sub-groups respond significantly differently. A recurring result is that staff members who have a relative with disabilities often express views that differ from the views of other staff members. Moreover, we find significant differences related to the age of the staff members. For instance, younger staff members are more positive and optimistic regarding the potential to reach more clients with disabilities. The employment position of the individual staff member also appears to be relevant: credit officers are relatively more likely (than other staff types) to indicate that discrimination could be a problem in the microfinance industry. Interestingly, we do not observe any differences in views and beliefs that are related to staff member gender.     

Income characteristics and the use of microfinance services: evidence from economically active persons with disabilities

The purpose of this empirical research from Uganda is to provide initial insight into the ‘black box’ of understanding the economic behaviour of persons with disabilities and about their use of microfinance services. First, we analyse the income levels of persons with disabilities in relation to their sources of income. Second, we study the income sources and income levels for different types of disabilities. Finally, we analyse how income level and income source relate to the use of microfinance services for persons with disabilities. We present evidence that farmers with disabilities and persons with visual impairments have lower income levels than other persons with disabilities. We then document that those with the lowest income levels have the least access to microfinance services, in particular services from formal institutions. Moreover, respondents involved in farming and manufacturing have less access to formal microfinance services than those involved in retail/wholesale or service activities.     

Perceived barriers to accessing health services among people with disabilities in rural northern Namibia

People living with disabilities (PWD) face unique problems in dealing with conventional healthcare facilities. We investigate the experiences of PWD as they access healthcare facilities in rural Namibia. More specifically, we investigate structural–environmental and process barriers to accessing health facilities. The study relied on semi-structured interviews and purposive sampling. The results showed PWD find it difficult to walk to health centers for treatment due to lack of transport, money to pay for treatment and toilet facilities and the distance is too far for people with lower-limb disabilities. There is a need to consider the unique issues affecting access to healthcare for people living with disabilities to achieve equitable access to healthcare services.     

Promoting choice and control in residential services for people with learning disabilities

This paper discusses the gap between policy goals and practice in residential services for people with learning disabilities. Drawing on a nine month ethnographic study of three residential services, it outlines a range of obstacles to the promotion of choice and control that were routinely observed in the culture and working practices of the services. Issues discussed include conflicting service values and agendas, inspection regimes, an attention to the bigger decisions in a person's life when empowerment could more quickly and effectively be promoted at the level of everyday practice, problems of communication and interpretation and the pervasiveness of teaching. We offer a range of suggestions as to how these obstacles might be tackled.     

Beyond friendship: the nature and meaning of close personal relationships as perceived by people with learning disabilities

Many people with learning disabilities aspire to having friends and to forming close relationships. Often the latter are discouraged, but for those who enter into such a relationship little is known about the meaning and value it brings to their lives. The aim of this study was to gain an insight into the close relationships of eight couples with learning disabilities using a combination of dyadic and one-to-one interviews. Data collection and analysis was informed and guided by the core principles of grounded theory. Five significant types of benefits were identified from having close personal relationships, namely: comradeship, a sense of contentment, availability of mutual support, coping with the ups and downs of relationships, and a continuing commitment. Service providers could do more to facilitate the formation of close meaningful relationships, and strategies for doing this need to be identified and evaluated.     

Social enterprises as enabling workplaces for people with psychiatric disabilities

In recent years, western governments influenced by neoliberalism have emphasized paid work as a key route to social inclusion and community participation for people with psychiatric disabilities. Although paid work can offer many rewards, access to mainstream employment for people with psychiatric disabilities is difficult as they continue to encounter discrimination and a lack of workplace accommodation. One response to these challenges has been the creation of social enterprises as ‘alternative spaces’ of employment for people with psychiatric disabilities. On the basis of interviews with key informants from 21 different social enterprises across Ontario, Canada, this paper critically analyzes the strategies used by organizations to create jobs that are both accommodating for people, but also conducive to the ongoing success of the business.     

The use of photovoice with people with intellectual disabilities: reflections,challenges and opportunities

Photovoice is part of the growing use of participatory research approaches with people with intellectual disabilities. In this paper we explore the process, opportunities and challenges associated with the use of photovoice with people with intellectual disabilities, illustrated through a research project entitled ‘This Is Me’. Photovoice requires researchers to share power and control in the research process and to tolerate uncertainty. Large investments in time and money are also required. These challenges, however, are outweighed by the benefits of the use of photovoice with people with intellectual disabilities. Photovoice creates a space where people with intellectual disabilities can meaningfully participate and exert control in the research process, and as such is an empowering experience. As a participatory research approach, photovoice is accessible and offers the opportunity for people with intellectual disabilities to develop new skills, confidence and experience inclusiveness in their own terms.     

Education of people with disabilities: a capability-context framework of culture

People with disabilities find themselves at the margins of ideas on education in the rights-based and the agency-focused frameworks (the capability approach). This article socially situates the rights-based framework to extend agency as an educational opportunity to make it participatory in cross-cultural contexts, and individually locates the agency-focused framework to enhance agency as multi-dimensional educational experience-outcome journeys across cultural contexts. This extended scope of rights and enhanced capacity of agency is advanced as the capability-context framework of culture. The framework focuses on analytically distinct yet connected emerging agents with capabilities of both dialogical discourses (retrospective reflexivity – macro-mechanisms) and dialectic narratives (bounded participation – micro-structures), which can provide access to deep social structures, and their many ways of being (micro-mechanisms) and specific ways of doing (macro-structures) that enable, but also disable the social choices of people with disabilities, to open new possibilities for them, and for all across contexts.     

Social capital, social inclusion and services for people with learning disabilities

Both social capital and social inclusion have emerged as significant concepts for human services in the last decade and yet their inter-relationship remains largely unexplored. This article argues that, whilst they are similar in their vision for a healthy society, they adopt sufficiently different perspectives to stimulate and challenge each other. This can be well illustrated by reference to services for people with a learning disability. Commissioners and providers of learning disability services are encouraged through this article to harness both concepts in order to assist in the process of modernizing services and increasing life opportunities for the people they support. It is argued that it is not possible to understand the full consequences of adopting either theoretical position without an adequate understanding of the other. Examples are given of the implications of this for advocacy services, day opportunities, rural communities, transition and staff training.     

Exclusion of HIV-positive people with disabilities in the media

This current issue piece aims to address the harmful exclusion of people with disabilities in the Iranian media. In a case study, this author collected news related to statistics of HIV-positive people covered by popular news websites written in the Persian language between June 2011 and June 2012. Within the analysed electronic texts, no reference was made to the number of HIV-positive people with disabilities. Under the rubric of critical discourse analysis, one can argue that this lack of representation may also be linked to a more general level of discourse that constitutes the marginalization of people with disabilities. This damaging exclusion both legitimizes and reproduces the ideology that people with disabilities are social minorities who can be excluded to the benefit of powerful people. This current issue piece also discusses the potential negative consequences of excluding HIV-positive people with disabilities from the discourse of HIV/AIDS in the media. Ultimately, the conceivable reasons for the Iranian government failure or refusal to publish the statistics of HIV-positive people with disabilities will be provided. Studies from various countries could shed more light on the exclusion of HIV-positive people with disabilities in the media and the interplay between HIV/AIDS and disability issues.     

Transitions to part-time work at older ages: the case of people with disabilities in Europe

This paper analyses the labour-force transitions of older workers with disabilities in general, particularly workers’ transitions to and from part-time employment within a European context. Using the two first waves (2004 and 2007) of the Survey of Health, Ageing and Retirement in Europe, we compare transitions between employment statuses for disabled and non-disabled individuals, even after controlling for different disability trajectories. In addition, we employ a multivariate framework to examine the determinants for remaining in part-time work in 2007 for those individuals who were part-timers in 2004. The results show that older people with long-term disabilities have a higher probability of staying in a part-time job than their compared counterparts. Policy-makers must promote part-time employment as a means of increasing employment opportunities for older workers with disabilities and support gradual retirement opportunities with flexible and reduced working hours.     

Inequities in health outcomes and access to health care in South Africa: a comparison between persons with and without disabilities

Health is a fundamental human right and if health care is to be universal and equitable it should not be less accessible to some sectors of society than to others. The objective of this study was to compare health outcomes and access to health care between persons living with disabilities and their non-disabled counterparts. The research was based on secondary data analysis of wave 1 of the National Income Dynamic Survey. Results from the study indicated that people with disabilities reported a higher incidence of communicable and non-communicable diseases, lower access to medical insurance and greater use of public health care than their non-disabled counterparts. In conclusion, the findings highlight the inequities in health outcomes and access to health services for people with disabilities and emphasise the need for disability-friendly health care policies that reduce barriers to accessing health care.     

It takes a sister: sisterhood and Black womanhood in families of people with intellectual and developmental disabilities

This study explores the sibling relationships of Black women with sisters who have intellectual and developmental disabilities in the southeast United States including Georgia, South Carolina, Florida, and Louisiana. The researchers used disability/critical race theory to understand the perceptions and stigmas associated with disability relating to social, cultural, and psychological structures within sibling relationships. Results were captured in four themes: cultural perceptions of family and extended kin; sibling relationships; beliefs about the self as a sister; and siblings’ identities. The findings from this study will contribute to research in disability studies by providing a better understanding of the intersections of identities and the familial experiences of diverse families.     

Unmet health care needs of people with disabilities: population level evidence

The present study examined population level data on unmet needs for adults with physical, sensory and cognitive disabilities, using the National Population Health Survey. The study revealed that disabled adults (aged 20–64) reported more than three times as many unmet health care needs as their non‐disabled counterparts. Even after controlling for the effects of age, gender and poor health, disability had a significant effect on the perception of unmet needs, particularly disabilities associated with pain, hearing impairment and emotional problems. The greatest deterrent to receiving needed services among individuals with disabilities was cost. Despite being publicly funded and thereby presumably equally accessible to all, the health care system in Canada fails to meet the needs of some of its most vulnerable constituents – adults with disabilities.     

A qualitative analysis of child protective services practice with children with developmental disabilities

The purpose of this study was to examine Child Protection System (CPS) practice with children with developmental disabilities. This study used an emergent design, ethnographic interviews, purposive sampling, inductive data analysis, and grounded theory building. Ethnographic interviews were conducted with foster families, administrators, intake screeners, special investigators, and workers in one local CPS office. Participants expressed concern about the ability to identify disabilities, placement options, services to meet complex needs of children with disabilities, training and support for families, collaborative arrangements with other agencies, and disability training for CPS workers. Findings suggest strategies for improving CPS practice for children with developmental disabilities.     

Sexual abuse in adulthood: Ongoing risks for people with learning disabilities

This paper reports findings of a 3-year research programme into the sexual abuse of adults with learning disabilities conducted at the University of Kent. Inconsistent reporting to and by services can be seen in the results, including lack of agreed practice around consent to sexual activities between service users. Abuse is also perpetrated by staff, volunteers, family members and other known and trusted adults. Thus both definition and detection are important competencies for services to develop. Abuse reported was predominantly perpetrated by men on both women and men with learning disabilities, and the gender issues raised by tackling sexual abuse in unequal staff teams, with their male style of management and a female workforce, are considered. Outcomes of the reporting process are considered and services for adults are urged to take a more proactive stance.     

Forced marriage of people with learning disabilities: a human rights issue

This paper reports some of the findings of an exploratory study which sought to better understand the demographics of forced marriage of people with learning disabilities and the contexts in which such marriages may occur. It was found that forced marriages of people with and without learning disabilities showed broad similarities in relation to ethnicity, some differences in terms of age and substantial differences in terms of gender. Men and women with learning disabilities are equally likely to be victims of forced marriage. The reasons for people with learning disabilities being forced to marry are most often associated with a desire on the part of families to secure permanent care, but can also be associated with cultural (mis)understandings of the nature of disability. These findings are contextualised by considering the relationship between forced marriage, human rights and learning disability.     

Citizens with learning disabilities and the right to vote

This paper asks, in the context of recent legislative changes, what can be done to support more citizens in England and Wales with learning disabilities to vote in national elections? This issue is addressed through (i) a review of recent disability access campaigns that have reported discrimination against, and the under‐representation of, adults with disabilities in UK elections; (ii) a review of recent research undertaken in the USA into the assessment of competence to vote and research undertaken in England that conclusively documents the under‐representation of voters with learning disabilities in the 2005 general election. It is proposed that a ‘functional approach’ to developing an individual's capacity to vote could help to fulfil Article 29 of the United Nations' Convention on the rights of persons with disabilities that gives all people the same political rights.     

Employment situation and life changes for people with disabilities: evidence from Nepal

In this study we attempt to bring attention to the situation of people with disabilities in the developing world by focusing on the labor market of Nepal. Utilizing a unique dataset collected from people with hearing, physical, and visual impairments through questionnaire-based interview methods, we compare across employment based on type of impairments and education levels to identify variation in occupational choices, as well as examining any positive life changes brought by employment. Results indicated that people with hearing, physical or visual impairments often dominated a specific employment sector. Numbers of people with physical, hearing and visual impairments were respectively large in the non-governmental organization sector, restaurants, and local schools. In addition to income, greater social inclusion, respect in the community, more friends, increased confidence, and discovering the new abilities were some of the positive life changes experienced by employees with disabilities.     

Supporting people with intellectual disabilities to take part in focus groups: reflections on a research project

This paper discusses how support offered to people with intellectual disabilities who take part in research might affect the resultant data. People with intellectual disabilities from a long‐stay hospital, a day centre and a self‐advocacy group, all in the UK, participated in focus groups during a research project on nurse advocacy. Their supporters were staff employed by those services who were familiar with and to the group members. The support given to participants reflected the ethos of the services involved, relating either to the medical or the social model of disability. The paper argues that the philosophy of care influencing supporters of research participants with intellectual disabilities may have profound effects on the support provided. It may facilitate or inhibit open exchange of information. It may also aid clarification or cause contamination of the resultant data.