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The meaning of participation for children in Malawi: insights from children and caregivers

Nelson, F, Masulani-Mwale, C, Dusabe-Richards, Esther, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X and Gladstone, M (2017) 'The meaning of participation for children in Malawi: insights from children and caregivers'. Child: Care, Health and Development, Vol 43, Issue 1, pp. 133-143.

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Abstract

Background
Global rates of childhood disability are high and are estimated through tools that focus on impairment, functioning and activity. The International Classification of Functioning, Disability and Health has promoted a framework to define disability more broadly and to include participation. New outcome measures have now been created to assess participation of children with disabilities for use in research and clinical practice. In order to use these in other cultural contexts, the validity of concepts and tools developed should be evaluated prior to use. We aim to create a tool that would be relevant and valid to the cultural context of Malawi, but to do so, we first need to understand what participation means to children in Malawi.

Aim
The aim of this study is to explore what participation means for children (including those with and without disability) in rural Northern Malawi.

Methods
We used semi-structured interviews, focus group discussions, participatory action research and direct observations. Sixty-four participants were involved including children (8–18 years) with (14) and without disabilities (17), carers of children with (8) and without (6) disabilities, community members (14) and professionals/healthcare workers (5). Data analysis was carried out using the ‘framework’ approach.

Results
Activities reported by children, carers and community members fell within seven main themes or areas of participation. These include contribution to family life (chores and work), social activities (communicating and being with others), social activities (unstructured play), structured and organized activities, activities of daily living, education and schooling and entertainment (listening to and watching media).

Conclusions
This study provides concepts and ideas that may be utilized in developing a suitable measure of participation of children with disabilities for rural African settings. Many of the most important activities for all children relate to family and day-to-day social life.

Item Type: Article
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance
W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84.4 Quality of Health Care
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 590 Health education, Health communication
WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1111/cch.12422
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 25 Nov 2016 16:09
Last Modified: 02 Nov 2018 02:02
URI: https://archive.lstmed.ac.uk/id/eprint/6369

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