Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study

BackgroundMost of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interv...

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Main Authors: Mirabel Nain Yuh, Gloria Akah Ndum Okwen, Rigobert Hanny Pambe Miong, Nicola Luigi Bragazzi, Jude Dzevela Kong, Zahra Movahedi Nia, Tetamiyaka Tezok Kinlabel, Okwen Patrick Mbah
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2023.1190722/full
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author Mirabel Nain Yuh
Mirabel Nain Yuh
Mirabel Nain Yuh
Gloria Akah Ndum Okwen
Gloria Akah Ndum Okwen
Rigobert Hanny Pambe Miong
Rigobert Hanny Pambe Miong
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Jude Dzevela Kong
Jude Dzevela Kong
Jude Dzevela Kong
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Tetamiyaka Tezok Kinlabel
Tetamiyaka Tezok Kinlabel
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
author_facet Mirabel Nain Yuh
Mirabel Nain Yuh
Mirabel Nain Yuh
Gloria Akah Ndum Okwen
Gloria Akah Ndum Okwen
Rigobert Hanny Pambe Miong
Rigobert Hanny Pambe Miong
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Jude Dzevela Kong
Jude Dzevela Kong
Jude Dzevela Kong
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Tetamiyaka Tezok Kinlabel
Tetamiyaka Tezok Kinlabel
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
author_sort Mirabel Nain Yuh
collection DOAJ
description BackgroundMost of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs).ObjectiveThe main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs.MethodologyThe present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics.ResultsIn total, 69.2% of PWDs were female individuals. Many PWDs were aged 10–20 years (57% of the sample size). Physical/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (F = 35.11, p < 0.0001). The adjusted score increased from the baseline value of 45.02 ± 2.38 to 61.07 ± 2.25, 65.24 ± 2.67, and 68.46 ± 2.78, at 4, 8, and 12 months, respectively. Compared to the baseline, all timepoints were significantly different, indicating a significant impact of the intervention, which became stable after 4 months and was preserved until 12 months.ConclusionPWDs faced many endeavors for sustainability and challenges resulting from a lack of inclusive policies and practices, leading to their exclusion from education, employment, and healthcare. Using implementation science approaches could bridge the gap and make policies and practices more effective.
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spelling doaj.art-98418e1918164ab7bf3fa8108d89982e2024-01-31T04:28:28ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-01-011110.3389/fpubh.2023.11907221190722Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method studyMirabel Nain Yuh0Mirabel Nain Yuh1Mirabel Nain Yuh2Gloria Akah Ndum Okwen3Gloria Akah Ndum Okwen4Rigobert Hanny Pambe Miong5Rigobert Hanny Pambe Miong6Nicola Luigi Bragazzi7Nicola Luigi Bragazzi8Nicola Luigi Bragazzi9Nicola Luigi Bragazzi10Jude Dzevela Kong11Jude Dzevela Kong12Jude Dzevela Kong13Zahra Movahedi Nia14Zahra Movahedi Nia15Zahra Movahedi Nia16Zahra Movahedi Nia17Tetamiyaka Tezok Kinlabel18Tetamiyaka Tezok Kinlabel19Okwen Patrick Mbah20Okwen Patrick Mbah21Okwen Patrick Mbah22Okwen Patrick Mbah23Effective Basic Services (eBASE) Africa, Bamenda, CameroonAfrica Evidence Network (AEN), Johannesburg, South AfricaThe Partnerships for Inclusive Research and Learning (PIRL) Project, Toronto, ON, CanadaEffective Basic Services (eBASE) Africa, Bamenda, CameroonAfrica Evidence Network (AEN), Johannesburg, South AfricaEffective Basic Services (eBASE) Africa, Bamenda, CameroonAfrica Evidence Network (AEN), Johannesburg, South AfricaAfrica Evidence Network (AEN), Johannesburg, South AfricaThe Partnerships for Inclusive Research and Learning (PIRL) Project, Toronto, ON, CanadaDepartment of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, CanadaAfrica-Canada Artificial Intelligence and Data Innovation Consortium, Toronto, ON, CanadaEffective Basic Services (eBASE) Africa, Bamenda, CameroonThe Partnerships for Inclusive Research and Learning (PIRL) Project, Toronto, ON, CanadaDepartment of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, CanadaAfrica Evidence Network (AEN), Johannesburg, South AfricaThe Partnerships for Inclusive Research and Learning (PIRL) Project, Toronto, ON, CanadaDepartment of Mathematics and Statistics, Faculty of Science, York University, Toronto, ON, CanadaAfrica-Canada Artificial Intelligence and Data Innovation Consortium, Toronto, ON, CanadaEffective Basic Services (eBASE) Africa, Bamenda, CameroonDepartment of Information Technology, University of Ghana, Accra, GhanaEffective Basic Services (eBASE) Africa, Bamenda, CameroonAfrica Evidence Network (AEN), Johannesburg, South AfricaThe Partnerships for Inclusive Research and Learning (PIRL) Project, Toronto, ON, CanadaAfrica Centre for Evidence (ACE), University of Johannesburg, Johannesburg, South AfricaBackgroundMost of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs).ObjectiveThe main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs.MethodologyThe present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics.ResultsIn total, 69.2% of PWDs were female individuals. Many PWDs were aged 10–20 years (57% of the sample size). Physical/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (F = 35.11, p < 0.0001). The adjusted score increased from the baseline value of 45.02 ± 2.38 to 61.07 ± 2.25, 65.24 ± 2.67, and 68.46 ± 2.78, at 4, 8, and 12 months, respectively. Compared to the baseline, all timepoints were significantly different, indicating a significant impact of the intervention, which became stable after 4 months and was preserved until 12 months.ConclusionPWDs faced many endeavors for sustainability and challenges resulting from a lack of inclusive policies and practices, leading to their exclusion from education, employment, and healthcare. Using implementation science approaches could bridge the gap and make policies and practices more effective.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1190722/fulldisabilityfinancial instabilityinclusive policiesimproving livelihoodevidence portalsevidence ecosystem
spellingShingle Mirabel Nain Yuh
Mirabel Nain Yuh
Mirabel Nain Yuh
Gloria Akah Ndum Okwen
Gloria Akah Ndum Okwen
Rigobert Hanny Pambe Miong
Rigobert Hanny Pambe Miong
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Nicola Luigi Bragazzi
Jude Dzevela Kong
Jude Dzevela Kong
Jude Dzevela Kong
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Zahra Movahedi Nia
Tetamiyaka Tezok Kinlabel
Tetamiyaka Tezok Kinlabel
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
Okwen Patrick Mbah
Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
Frontiers in Public Health
disability
financial instability
inclusive policies
improving livelihood
evidence portals
evidence ecosystem
title Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
title_full Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
title_fullStr Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
title_full_unstemmed Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
title_short Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study
title_sort using an innovative family centered evidence toolkit to improve the livelihood of people with disabilities in bamenda cameroon a mixed method study
topic disability
financial instability
inclusive policies
improving livelihood
evidence portals
evidence ecosystem
url https://www.frontiersin.org/articles/10.3389/fpubh.2023.1190722/full
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