Unmet health, welfare and educational needs of disabled children in an impoverished South African peri-urban township.
BACKGROUND
Childhood disability in South Africa has failed to receive adequate attention from governmental agencies, such as the health, education and social welfare departments, despite there being more than 1 million disabled children in the country. This study sought to assess the unmet rehabilitation, education and welfare needs of disabled children living in a peri-urban township.


METHODS
As no register of disabled children existed, snowball sampling was used to recruit a convenience sample of 156 disabled children living in Orange Farm township near Soweto, South Africa. Children's impairments, their health and educational needs, and the availability and utilization of services were assessed using a structured interview.


RESULTS
Few disabled children attended pre-school (35%) or school (44%). Only a quarter (26%) of children in need of rehabilitation received such services. Children with motor impairments were more likely to receive rehabilitation than those with intellectual impairment (44% vs. 8%, P < 0.0001). Of the 233 assistive devices required, only 64 (28%) had been issued. Less than half (45%) of the children entitled to a social assistance grant were receiving it. Lack of money, limited awareness about available services, and bureaucratic obstacles were the main reasons offered by caregivers for the low utilization of available services and resources.


CONCLUSIONS
Children with disabilities living in Orange Farm are not enjoying the rights and services to which they are entitled. Innovative, co-ordinated service delivery strategies, and better-informed caregivers combined with community recognition of, and support for, the needs of disabled children are required to address these unmet needs.
Saloojee
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G
Childhood Disability Research Project, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. gsaloojee@icon.co.za
Phohole
M
M
Saloojee
H
H
IJsselmuiden
C
C
D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D019988:Children with Disabilities / Q000193:education / Q000534:rehabilitation; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020380:Needs Assessment; D011204:Poverty Areas; D012946:Social Welfare; D013019:South Africa; D014505:Urban Population; D035862:Vulnerable Populations / Q000523:psychology