‘Maybe I will give some help…. maybe not to help the eyes but different help’: an analysis of care and support of children with visual impairment in community settings in Malawi

Journal article


Gladstone, M, McLinden, M, Douglas, G, Jolley, E, Schmidt, E, Chimoyo, J, Magombo, H and Lynch, P (2017). ‘Maybe I will give some help…. maybe not to help the eyes but different help’: an analysis of care and support of children with visual impairment in community settings in Malawi. Child: Care, Health and Development. 43 (4), pp. 608-620.
AuthorsGladstone, M, McLinden, M, Douglas, G, Jolley, E, Schmidt, E, Chimoyo, J, Magombo, H and Lynch, P
Abstract

Background Visual impairment in children is common in low and middle-income settings. Whilst visual impairment (VI) can impact on the development of children, many reach full potential with appropriate early intervention programmes. Although there is increased emphasis on early child development globally, it is not yet clear how to provide specific programmes for children with VI in low and middle-income settings. This study aims to identify facilitators and barriers to the provision of a developmental stimulation programme for children with VI in rural and urban Malawi. Methods We undertook 6 focus groups, 10 home observations and 20 in-depth interviews with carers of children with VI under 6 years in urban and rural Southern Malawi. We utilised topic guides relating to care, play, communication and feeding. Qualitative data were subject to thematic analysis that included placing themes within Bronfenbrenner’s ecological framework. We established authenticity of themes through feedback from participants. Results We identified themes within Bronfenbrenner’s framework at five levels: (1) blindness acting as a barrier to stimulation and communication, health and complex needs all affecting the individual child; (2) understanding of VI, ability to be responsive at the microsystem level of the carer; (3) support from other carers at microsystem level within a mesosystem; (4) support from other professionals (knowledge of, identification and management of children with VI, responsibilities and gender roles, environmental safety and prejudice, stigma and child protection all at the level of the exosystem. Discussion This study has revealed the requirements needed in order to produce meaningful and appropriate programmes to support nutrition, care and early stimulation for children with VI in this and similar African settings. This includes supporting carers to understand their child’s developmental needs, how to better communicate with, feed and stimulate their child; offering advice sensitive to carers’ responsibilities and professional training to better support carers and challenge community stigma

Keywords11 Medical And Health Sciences; 13 Education; 17 Psychology And Cognitive Sciences; Developmental & Child Psychology; Pediatrics
Year2017
JournalChild: Care, Health and Development
Journal citation43 (4), pp. 608-620
PublisherLondon South Bank University
ISSN0305-1862
Digital Object Identifier (DOI)doi:10.1111/cch.12462
Publication dates
Print09 Apr 2017
Publication process dates
Deposited04 Apr 2018
Accepted13 Mar 2017
Accepted author manuscript
License
CC BY 4.0
File Access Level
Open
Permalink -

https://openresearch.lsbu.ac.uk/item/86zvw

  • 9
    total views
  • 29
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Related outputs

Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial.
Wall, M, Hayes, R, Moore, D, Petticrew, M, Clow, A, Schmidt, E, Draper, A, Lock, K, Lynch, R and Renton, A (2009). Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial. BMC Public Health. 9 (1), p. 207.
The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results.
Phillips, G, Renton, A, Moore, DG, Bottomley, C, Schmidt, E, Lais, S, Yu, G, Wall, M, Tobi, P, Frostick, C, Clow, A, Lock, K, Petticrew, M and Hayes, R (2012). The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results. Trials. 13 (1), p. 105.
Physical activity in deprived communities in London: examining individual and neighbourhood-level factors.
Watts, P, Phillips, G, Petticrew, M, Hayes, R, Bottomley, C, Yu, G, Schmidt, E, Tobi, P, Moore, D, Frostick, C, Lock, K and Renton, A (2013). Physical activity in deprived communities in London: examining individual and neighbourhood-level factors. PLoS ONE. 8 (7), p. e69472.
Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey.
Kimani, K, Lindfield, R, Senyonjo, L, Mwaniki, A and Schmidt, E (2013). Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey. PLoS ONE. 8 (8), p. e70009.
The impact of climatic risk factors on the prevalence, distribution, and severity of acute and chronic trachoma.
Ramesh, A, Kovats, S, Haslam, D, Schmidt, E and Gilbert, CE (2013). The impact of climatic risk factors on the prevalence, distribution, and severity of acute and chronic trachoma. PLoS Neglected Tropical Diseases. 7 (11), p. e2513.
Types of social capital and mental disorder in deprived urban areas: a multilevel study of 40 disadvantaged London neighbourhoods.
Bertotti, M, Watts, P, Netuveli, G, Yu, G, Schmidt, E, Tobi, P, Lais, S and Renton, A (2013). Types of social capital and mental disorder in deprived urban areas: a multilevel study of 40 disadvantaged London neighbourhoods. PLoS ONE. 8 (12), p. e80127.
Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.
Bozzani, FM, Griffiths, UK, Blanchet, K and Schmidt, E (2014). Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals. BMC Health Services Research. 14 (1), p. 94.
Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services.
Senyonjo, L, Lindfield, R, Mahmoud, A, Kimani, K, Sanda, S and Schmidt, E (2014). Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services. PLoS ONE. 9 (8), p. e104128.
Disability inclusive elections in Africa: a systematic review of published and unpublished literature
Virendrakumar, B, Jolley, E, Badu, E and Schmidt, E (2018). Disability inclusive elections in Africa: a systematic review of published and unpublished literature. Disability and Society. 33 (4), pp. 1-30.
The cost of mapping trachoma: data from the Global Trachoma Mapping Project
Trotignon, G, Jones, E, Engels, T, Schmidt, E, McFarland, DA, Macleod, CK, Amer, K, Bio, AA, Bakhtiar, A, Bovill, S, Doherty, AH, Khan, AA, Mbofana, M, McCullagh, S, Millar, T, Mwale, C, Rotondo, LA, Weaver, A, Willis, R and Solomon, AW (2017). The cost of mapping trachoma: data from the Global Trachoma Mapping Project. PLoS Neglected Tropical Diseases. 11 (10), pp. 1-19.
Integration of Eye Health into Primary Care Services in Tanzania: A Qualitative Investigation of Experiences in Two Districts.
Jolley, E, Mafwiri, M, Hunter, J and Schmidt, E (2017). Integration of Eye Health into Primary Care Services in Tanzania: A Qualitative Investigation of Experiences in Two Districts. BMC Health Services Research. 17 (823), pp. 1-12.
Cohort differences in exercise adherence among primary care patients referred for mental health versus physical health conditions.
Tobi, P, Kemp, P and Schmidt, E (2017). Cohort differences in exercise adherence among primary care patients referred for mental health versus physical health conditions. Primary Health Care Research and Development. 18 (5), pp. 463-471.
Education and social inclusion of people with disabilities in five countries in West Africa: a literature review
Jolley, E, Lynch, P, Virendrakumar, B, Rowe, S and Schmidt, E (2017). Education and social inclusion of people with disabilities in five countries in West Africa: a literature review. Disability and Rehabilitation.
Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries
Tripney, J, Hogrebe, N, Schmidt, E, Vigurs, C and Stewart, R (2017). Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries. Research on Social Work Practice.
The impact of climate on the abundance of Musca sorbens, the vector of trachoma
Ramesh, A, Bristow, J, Kovats, S, Lindsay, SW, Haslam, D, Schmidt, E and Gilbert, C (2016). The impact of climate on the abundance of Musca sorbens, the vector of trachoma. Parasites & Vectors. 9 (1).
Mixed methods evaluation of a primary eye care training programme for primary health workers in Morogoro Tanzania
Mafwiri, M, Jolley, E, Hunter, J, Gilbert, CE and Schmidt, E (2016). Mixed methods evaluation of a primary eye care training programme for primary health workers in Morogoro Tanzania. BMC Nursing. 15 (1).
Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon
Senyonjo, L, Oye, J, Bakajika, D, Biholong, B, Tekle, A, Boakye, D, Schmidt, E and Elhassan, E (2016). Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon. PLoS Neglected Tropical Diseases. 10 (8), pp. e0004905-e0004905.