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      The perception of disability by community groups: Stories of local understanding, beliefs and challenges in a rural part of Kenya

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          Abstract

          Cultural narratives on disability have received much attention over the past few decades. In contexts of poverty, limited information and everyday challenges associated with having, or caring for someone with a disability, different understandings have emerged. A project was set up to promote disability awareness in neighborhood communities in a rural part of Kenya, using a process of reflection and education. This paper reports on the first aspect–reflection. The aim was to investigate local understanding of disability as a co-constructed concept. The research questions were: 1. What cultural beliefs shape local understanding of disability? 2. What challenges are perceived to be associated with disability? A phenomenological approach was adopted. Focus group discussions were conducted with twenty-one community groups involving 263 participants and audio-recorded. The data were transcribed and thematic analysis was carried out. Visual maps were created to illustrate any interconnections, before establishing the final conclusions. Local beliefs attributed disability to: human transgression of social conventions, particularly concerning inappropriate family relations, which invoked a curse; supernatural forces affecting the child; the will of God; unexplained events; and biomedical factors. Challenges associated with disability related to the burden of caregiving and perceived barriers to inclusion, with stress as a shared bi-product. Local understanding of disability in this rural part of Kenya demonstrated overlapping explanations and plurality of beliefs. Two possible interpretations are offered. Firstly, oscillation between explanatory lines demonstrated instability, affecting broader acceptance of disability. Secondly, and more positively, in the face of challenges, the desire to make sense of the existing situation, reflected a healthy pluralism.

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          Understanding Disability

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            Qualitative Research Designs

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              The neglected burden of caregiving in low- and middle-income countries.

              The number of persons with disability worldwide is estimated at more than one billion, and low- and middle-income countries (LMIC's) have particularly high prevalence. The consequences of disability have garnered growing attention, but the burden of caregiving for persons with disease or disability remains largely unquantified especially in LMIC's.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: ResourcesRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – review & editing
                Role: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                3 August 2017
                2017
                : 12
                : 8
                : e0182214
                Affiliations
                [1 ] School of Health Sciences, University of East Anglia, Norwich, United Kingdom
                [2 ] Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
                [3 ] Department of Psychiatry, University of Oxford, Oxford, United Kingdom
                [4 ] London School of Hygiene and Tropical Medicine London, United Kingdom
                Universita degli Studi di Perugia, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-7396-9205
                Article
                PONE-D-17-12087
                10.1371/journal.pone.0182214
                5542666
                28771637
                c597eda3-2e18-46a2-bbff-3675b7a0ecfb
                © 2017 Bunning et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 March 2017
                : 16 July 2017
                Page count
                Figures: 2, Tables: 0, Pages: 20
                Funding
                Funded by: CP Trust
                Award Recipient :
                The project is supported by the CP Trust. Charles Newton is Wellcome-funded. Finally, we would like to acknowledge the support of KEMRI in funding the open-access publication.
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Disabilities
                Social Sciences
                Sociology
                Culture
                Social Sciences
                Sociology
                Human Families
                Biology and Life Sciences
                Behavior
                People and Places
                Population Groupings
                Families
                Mothers
                People and Places
                Geographical Locations
                Africa
                Kenya
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Custom metadata
                Data are not freely available because of the terms for data sharing included in the consent forms for this study. For anyone interested in accessing the data, they can write to the Data Governance Committee of the KEMRI Wellcome Trust Research programme who will review the application and advise and ensure that uses are compatible with the consent obtained from participants for data collection in this study. Requests can be sent to the coordinator of the Data Governance Committee on Data_Governance_Committee@ 123456kemriwellcome.org .

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                Uncategorized

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