A study to explore the role of community disability workers in facilitating livelihood opportunities for disabled youth in rural areas of Southern Botswana

Master Thesis

2015

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University of Cape Town

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Purpose: This study aimed to explore the role of Community Disability Workers (CDWs) in facilitating livelihood opportunities for disabled youth in rural Southern Botswana. The CDWs in the study worked in Community- based Rehabilitation (CBR) programmes. The elements of the Livelihood component of CBR Guidelines include skills development, self-employment, waged employment, financial assistance and social security. In particular, the study presented the knowledge, skills, practices (activities and methods), and strategies used by CDWs to facilitate access to the livelihood opportunities for disabled youths in rural areas. The literature review explored CBR as a strategy for addressing the needs and demands of people with disabilities. Botswana has implemented a CBR programme which is co-ordinated at the Rehabilitation Division of the Ministry of Health and involves disabled people, health professionals, the community and Non-Governmental Organisations (NGOs). Community health workers coordinate disability activities in rural as well as urban areas and comprise a range of health care practitioners namely physiotherapists, social workers, rehabilitation technicians, rehabilitation officers and health education assistants. In this study, community health workers were referred to as CDWs and only those with tertiary qualifications (certificate, diploma or degree level of training) were used as participants. Methodology: A qualitative research approach using a case study design was adopted. Purposive sampling was used to select seven participants from districts in the southern part of Botswana to participate in the study. The unit of study were the practices of the CDW in facilitating access to livelihood opportunities for disabled youth. Qualitative data was collected through semi-structured interviews with the CDWs. Interviews were digitally recorded and later transcribed verbatim. Analysis of data involved coding for themes and categories emerging from the data in the context within which it appeared. The environmental chapters of the International Classification of Functioning, Disability and Health (ICF) were used for data interpretation. Findings: The findings of the study illustrated the role of CDWs in facilitating livelihood opportunities for disabled youth. Five themes that emerged were related to CDWs’ own experience of disability and rural environments, their knowledge and experience in facilitating livelihoods; their practices and strategies; the barriers to participation experienced by disabled youth; and lastly, the CDWs’ suggestions for increasing participation and inclusion of disabled youth in livelihood opportunities. The findings established that CDWs were involved in facilitating access to health facilities and assistive devices as well as education and skills development. Some strategies used were advocacy, networking, information dissemination, role modelling and follow-ups on former students. The barriers identified were inadequate disability policy; absence of disability friendly public facilities and transport; a poorly resourced public education system and inaccessible job markets. Suggestions made by CDWs included having inclusive policies and structures; addressing educational and training needs; accountability regarding employment; and community sensitisation and mobilisation. The Discussion chapter interpreted the findings in terms of current literature and developed two further themes. One addressed the environmental factors impacting on disability and the other one addressed successful strategies to enhance livelihood opportunities in light of these environmental factors. Recommendations included facilitating information on accessibility of assistive devices; minimising barriers to natural and made-made changes to the environment; building a network of supportive relationships; changing attitudes of community as well as government leadership; and facilitating implementation of inclusive services, systems and policies. In Conclusion, CDWs are well placed to facilitate accessibility of livelihood opportunities for disabled youth. However, they need to be empowered with necessary resources such as disability inclusive policies, systems and services, attitudinal changes and revision of their training modules.
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