Leslie Swartz

Leslie Swartz
Stellenbosch University | SUN · Department of Psychology

PhD

About

441
Publications
124,035
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13,592
Citations
Additional affiliations
January 2011 - present
Royal Holloway University of London
January 2009 - December 2011
Anglia Ruskin University
January 2007 - present
University of Melbourne

Publications

Publications (441)
Article
Various studies show that COVID-19 is widening existing disparities. Given the pre-existing disparities experienced by South African persons with disabilities, the pandemic may disproportionately impact persons with disabilities and deepen inequalities. Thus, we answer the key research question: what are the experiences and perceived challenges of...
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Introduction Transfeminine people in South Africa have a high HIV risk due to structural, behavioural, and psychosocial factors. Transfeminine people and feminine identifying men who have sex with men (MSM) are often conflated or grouped with transgender or MSM categories in HIV service programming, although they don’t necessarily identify as eithe...
Article
The COVID-19 pandemic exposed a range of existing inequalities. People with disabilities are disadvantaged worldwide and frequently denied spaces within personal and public contexts. This article focuses on the environmental and functional experiences of people with disabilities and service providers in South Africa during the pandemic. Lockdown co...
Article
Objectives To examine healthcare professionals (HCPs) attitudes, beliefs and preparedness towards the management of Para athlete mental health during the Tokyo 2020 and Beijing 2022 Paralympic Games. Methods A cross-sectional observational study was conducted. National Paralympic Committee’s HCPs (n=857) working at the Tokyo 2020 and Beijing 202...
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Purpose: Improving quality of life (QoL) is a major goal of rehabilitation following spinal cord injury (SCI). However, people with disabilities in resource constrained contexts have limited access to rehabilitation and poorer health outcomes, including QoL. There is a paucity of qualitative research on the experiences of persons with SCI involved...
Article
Purpose: Activity-based Training (ABT) represents the current standard of neurological rehabilitation. Robotic Locomotor Training (RLT), an innovative technique, aims to enhance rehabilitation outcomes. This study aimed to conduct a randomized pilot and feasibility trial of a locomotor training program within South Africa. Materials and methods:...
Article
The use of complementary and alternative medicine in the treatment of breast cancer is widely documented in low- and middle-income countries. However, there are limited data on the use of complementary and alternative medicine among breast cancer patients in South Africa. In this study, we examined the use of complementary medicine among a small sa...
Article
Objective To explore the prevalence of symptoms of mental health conditions and burnout of healthcare professionals (HCPs) working during the Tokyo 2020 Paralympic Games and the Beijing 2022 Paralympic Winter Games. Methods In this cross-sectional, observational study, HCPs working during the Tokyo 2020 and Beijing 2022 Paralympic Games were asked...
Article
This study employed a cross-sectional, qualitative individual interview methodology to explore South African women with physical disabilities' experiences of intimate partner and sexual violence, inclusive of non-consensual and coerced sexual intercourse. For the participants, disability was a factor that intersected with gender norms to create vul...
Preprint
Full-text available
Introduction: Transfeminine women in South Africa have a high HIV risk due to structural, behavioural, and psychosocial factors. Transfeminine women and feminine identifying men who have sex with men (MSM) are often conflated or grouped with transgender or MSM categories in HIV service programming, although they don’t necessarily identify as either...
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Background: Despite the widespread utilisation of complementary and or alternative medicine (CAM) by breast cancer patients in low-and-middle-income countries, few disclose CAM use to their physicians. Objective: This study examines disclosure CAM use among a small sample of women attending a breast cancer clinic in a public health hospital in t...
Article
Objective: Both cognitive impairment and alterations in white matter tissue microstructure are well recognised in schizophrenia. We investigated whether differences in white matter microstructure underpin cognitive impairments in patients with first-episode schizophrenia spectrum disorders when controlling for multiple confounding factors. Method...
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Background: In South Africa, medical doctors functionally decide whether a primary caregiver can access state-funded social assistance cash transfers (‘social grants’) for the care of their disabled child. In this paper, we unpack the subjective experiences of one group of doctors in the country’s Western Cape province who are involved in conductin...
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In 2020, the African Network of Evidence to Action on Disability (also known as AFRINEAD) hosted its 10th conference in Cape Town. This paper synthesises inputs by the three authors as plenary addresses, particularly focusing on the challenges and opportunities of centring African voices in disability research. Our concern in this article is to eng...
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In 2020, the African Network of Evidence to Action on Disability (also known as AFRINEAD) hosted its 10th conference in Cape Town. This paper synthesises inputs by the three authors as plenary addresses, particularly focusing on the challenges and opportunities of centring African voices in disability research. Our concern in this article is to eng...
Chapter
Systems-thinking is a useful approach to deepen our understanding of the linkages, relationships, interactions, and behaviours that, together, comprise and shape our health systems. Offering a comprehensive range of opinion and scholarship from experts located across the world (Europe, North-America, Africa, Asia, and Oceania), spanning a wide rang...
Preprint
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Background: In South Africa, medical doctors functionally decide whether a primary caregiver can access state-funded social assistance cash transfers (‘social grants’) for the care of their disabled child. In this paper, we unpack the subjective experiences of doctors involved in conducting assessments for the care dependency grant, designed to sup...
Article
Crenshaw’s concept of intersectionality has been used to include different dimensions of difference and exclusion. We suggest here, however, that intersectional analyses may paradoxically further exclude discussions of the impact of disability in interaction with other factors. We outline three ways in which intersectionality may be incorrectly use...
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Organisations have long played an effective role in advocating for and actioning crucial developmental and humanitarian functions around the world, often under challenging conditions, as well as servicing the health needs of persons with disabilities. This article reports on the experiences of organisations of (or that serve) persons with disabilit...
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Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and necessary, and to have access, on an equal basis to persons without disabilities, to community living. We conducted a scoping review of the peer-reviewed and grey literature on com...
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Background: A disability studies approach seeks to understand and address political and social issues that affect disabled individuals. Disability studies scholars employ various models of disability to address and oppose the oppression and discrimination of disabled individuals. A disability studies approach, however, has largely been absent in s...
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People with disabilities are often left behind in emergencies, and this is a risk during the COVID-19 pandemic. With approximately 3.8 million people living with disabilities in South Africa, it is not clear how they were considered during the initial and ongoing stages of strict lockdown. Through an online administered survey study, we explored th...
Chapter
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The chapters in this collection are reflections of the intellectual, emotional and day-to-day experiences of professional staff engaged in academic development. They provide the reader with glimpses of how academic developers at one South African university are continuously shaping their identities through sense-making processes, how they creativel...
Article
In this study we explore the hospital care experience of women following stillbirths in an impoverished urban setting in the Western Cape Province of South Africa. A qualitative research methodology was used with the collection of primary data using the Free Association Narrative Interview Method with 10 women who experienced stillbirths at a gover...
Article
While intellectual disability is experienced worldwide, with much greater rates in contexts of poverty, relatively few studies on intellectual disability have been conducted in low- and middle-income countries. High levels of intellectual disability in South Africa exist alongside high levels of poverty, malnutrition and poor or inaccessible health...
Article
Objective Reducing alcohol use during pregnancy is a pressing public health priority in Sub-Saharan Africa, but insight into the factors that influence prenatal drinking practices is lacking. This study investigated perceptions of, and motivations for, alcohol consumption during pregnancy and associated practices in a rural district of Lesotho. Me...
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For people with disabilities, appropriate social protection interventions can contribute to breaking the cyclical relationship between poverty and disability and may improve social inclusion. In South Africa, a national social assistance programme provides ‘social grants’ to individuals on the basis of poverty, age, or disability. These grants have...
Article
Although South Africa has numerous impressive policies for inclusion, the unfortunate fact on the ground is that the rhetoric of inclusion is still not reflected in reality. The majority of students with visual impairments are still in special schools where they have to contend with very poor learning conditions. For example, in 2015, 17 out of the...
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Intellectual disability is common in low- and middle-income countries, but there are few healthcare services available. As part of a larger study, we investigated spiritual healers’ beliefs about intellectual disability and family support in Cape Town, South Africa. All eight healers interviewed believed that the church has a role to play in assist...
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Culturally appropriate spiritual care is increasingly recognised as a crucial component of spiritual care. As part of a larger study, we were interested in cultural and racial issues as experienced by spiritual carers in a hospice in Cape Town, South Africa. We conducted one-on-one interviews and focus group discussions with a cohort of spiritual c...
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Background Access to appropriate specialist level services for children with intellectual disability is challenging in Africa, with very few services available. Much literature on the utilisation of services by carers of children with intellectual disability in Africa emphasises the supposed incompatibility between indigenous and western beliefs, f...
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While palliative care is beginning to gain prominence in South Africa, spiritual care remains less understood. Spiritual care is less prioritised and, consequently, this service, if offered, is mostly entrusted to volunteers. It therefore becomes prudent to understand who these volunteers are, what motivates them to volunteer, and how they see spir...
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People with disabilities, especially those living in low- and middle-income countries, experience significant challenges in accessing healthcare services and support. At times of disasters and emergencies, people with disabilities are further marginalised and excluded. During the coronavirus disease 2019 (COVID-19) pandemic, many people with disabi...
Article
Migration is an increasingly common feature of life globally. This article discusses visits in South African transnational families of diverse origins, exploring the importance and meaning of physical co-presence by examining the role of visits in delivering mutual ‘visibility’ – the ability to see and be seen – when family members meet in person....
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Background: Childhood trauma may contribute to poorer premorbid social and academic adjustment which may be a risk factor for schizophrenia. Aim: We explored the relationship between premorbid adjustment and childhood trauma, timing of childhood trauma's moderating role as well as the association of clinical and treatment-related confounders wit...
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Background: Households with a disabled member, be they a caregiver or a child, are poorer than households not affected by disability. Poverty, caregiving as a person with a disability and being the caregiver of a child with a disability can lead to increased parenting stress. Objectives: The objective of this study was to examine whether parenting...
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Since South Africa became a democracy in 1994, there have been concerted efforts to change health care in a range of ways, making health care more accessible to a diverse population in a very unequal country. Part of these efforts involves changing the demographics of the healthcare workforce which in fields like psychology and medicine was predomi...
Article
Globally, spiritual care is recognized as an important component of palliative care. In the Global North spiritual care training is gaining momentum and being prioritized, but not so in the Global South. This study seeks to establish what the national spiritual care training needs are in hospice palliative care settings with formalized spiritual ca...
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Background: The prevalence of intellectual disability was high in Africa, particularly amongst low socio-economic communities. Despite this, there was limited literature on primary caregivers and parents of people with intellectual disabilities regarding their experience raising an individual with the condition, especially within the African contex...
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Background Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual ca...
Article
This study explored the subjective experiences of 12 South African women diagnosed with recurrent breast cancer. Women were invited to take part in unstructured narrative interviews, and to complete a diary in which they could reflect on their breast cancer experiences. Most responded to their recurrence with an optimistic stance. Religious beliefs...
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The widespread use of faith-based and traditional healing for mental disorders within African contexts is well known. However, normative responses tend to fall within two camps: on one hand, those oriented towards the biomedical model of psychiatry stress the abuses and superstition of such healing, whilst critics adopting a more ‘local’ perspectiv...
Article
This brief commentary is a response to the helpful responses to our article on the problem of the concept of gentle violence in obstetric care. We find ourselves in substantial agreement with our interlocutors. We suggest that naming individual actions on the part of health care personnel as violent may not be necessary for changing the behavior of...
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Appropriate assistive technology has the potential to considerably enhance quality of life, access to health and education, and social and economic participation for people with disabilities. Most disabled people in the world live in low- and middle-income countries where access to assistive devices and other support is severely lacking. There is l...
Article
With the growing concern of human rights in health, the word “violence” is being used to describe apparent disrespectful treatment received by women by either health care practitioners or health care systems. As the definition of violence in health care settings broadens, questions arise over the impact of the term in describing objective reality....
Article
Presently, limited studies have explored how disabled Muslim men construct their masculinities. The present article examines how five young adult Muslim men in the Western Cape, who stutter, talk about their masculinities. A series of semi-interviews were conducted with these men. These semi-structured interviews were analyzed according to Edley’s...
Chapter
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In this short chapter, Rosabelle, one of the project participants, writes a personal story about how sport had a hugely positive impact on her self-confidence, body image and ultimately her sense of sexuality. Rosabelle’s personal narrative is co-written with one of the researchers, who provides theoretical insights relevant to conceptualising and...
Chapter
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In this chapter, we will explore the intersections of disability and masculinity. We will look at how disability influences how men are viewed by others, and how men with disabilities view themselves as masculine and as sexual beings. We also look at the influence of culture on masculinity in the South African context. We draw on existing research...
Chapter
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In Chapter 10.1007/978-3-030-55567-2_1 we provided a discussion of participatory research as a method for doing research, and provided an outline of what we did in the research project upon which this book is based. In this final chapter, we reflect back on our experiences of doing a participatory research project of this kind.
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In this chapter, we investigate some of the social (e.g. negative attitudes about sexuality and parenthood) and structural (e.g. inaccessible health care facilities) barriers that people with physical disabilities face when trying to lead a pleasurable, safe, and healthy sexual life. We do this by presenting an accessible review of the existing res...
Chapter
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In this chapter, we introduce central concepts and theories relevant to thinking about disability and sexuality in the global South. We discuss what we mean by physical disability, sexuality, gender, and embodiment, and provide a brief description of the research study on which this book is based. Here, too, we provide a rationale and outline for t...
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Background South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local iss...
Book
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This open access edited volume explores physical disability and sexuality in South Africa, drawing on past studies, new research conducted by the editors, and first-person narratives from people with physical disabilities in the country. Sexuality has long been a site of oppression and discrimination for people with disabilities based on myths and...
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Qualitative researchers are increasingly making use of multiple media to collect data within a single study. Such approaches may have the potential to generate rich insights; however, there are also potential methodological challenges in simultaneously analyzing data from multiple media. Using three case studies from our work with women who had rec...
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People with disabilities have greater healthcare needs and are more likely to experience poor health, however, their access to healthcare remains compromised compared to people without disabilities. Despite this well recognised need, people with disabilities often face barriers to accessing healthcare and they face additional risks to their well-be...
Article
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Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa,...
Article
Purpose: This study discussed the reports by participants in a randomised controlled trial of a novel intervention for spinal cord injury (SCI) rehabilitation in Cape Town, South Africa. Materials and methods: Sixteen participants were randomised to rehabilitation involving the use of robotic locomotor training, a novel technology, or to a group re...
Preprint
Full-text available
1) Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa...
Article
Full-text available
The past 3 decades have seen researchers increasingly examine masculinity within the context of disability. However, there remains a gap in impairment-specific research. The present study seeks to examine the discourses of masculinities among young adult men in Western Cape Province who stutter. Semistructured interviews and focus groups were used...
Article
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During disasters, when resources and care are scarce, healthcare workers are required to make decisions and prioritise which patients receive life-saving resources over others. To assist healthcare workers in standardising resources and care, triage policies have been developed. However, the current COVID-19 triage policies and practices in South A...
Preprint
Full-text available
Background: South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local is...
Preprint
Full-text available
Background: South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local is...
Article
Arson is a recurrent problem in Kenyan secondary schools. Although school violence – notably gun violence – has received significant attention, there has been less academic attention paid to school arson, especially in Africa. This study explores how newspaper reports in Kenya framed school arson and links these framings to broader questions about...
Article
In South Africa, clinicians working in public psychiatric hospitals are mainly fluent in English and Afrikaans, while the majority of patients are not proficient in these languages. Due to a lack of professional interpreting services, informal, ad hoc interpreters are commonly employed in public psychiatric hospitals. We collected data on language...
Article
This article explores the way in which nurses working in a high‐risk and dangerous environment understand and speak about their work caring for mothers following stillbirths. As far as we are aware, it is the first study of its kind from a low‐ or middle‐income country, and the first on this topic to apply the theoretical insights of Menzies Lyth i...
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In line with global non-discrimination legislative changes and inclusive education policies, the number of disabled students in higher education institutions are increasing. Previously, disabled students were excluded from higher education. Currently, however, higher education institutions are expected to have disability statements and policies, an...
Article
Despite there being much research on the needs of students with more visible disabilities, this is not the case with students with invisible disabilities such as psychosocial disabilities – especially in university settings. The unique needs of students with psychosocial disabilities have received less attention with not much research in this area....
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Background Post‐apartheid, understanding and management of intellectual disability remain poor in South Africa, complicated by various contextual and cultural explanations used to describe and conceptualize this condition. Method We conducted 20 semi‐structured interviews with primary caregivers and parents of children with intellectual disability...
Article
Since the 1970s, research has illuminated the personal and social dimensions of the experience of stuttering in the discipline of speech-language pathology. However, the disabling experiences of individuals who stutter remain underrepresented within the body of scholarship. We searched for articles published in English, between 1990/01/01 and 2017/...
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It is important to give voice to people with lived experience of suicidal behaviour, but as with all narrative data, insider accounts raise methodological and interpretive challenges. A key question is that of how to work with narratives about suicide in a way that affirms both the value and the limitations of the data, so that qualitative evidence...
Article
Globalization and the mobility of people across domestic and international boundaries have become part of the rhythm and tempo of the modern world, and increasingly the elderly remaining behind comprise a sizable and integral part of contemporary society. Their successful adaptation has become an important consideration not only for them, but for t...
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Despite there being much research on students with more visible disabilities, this is not the case with students with invisible disabilities such as psychosocial disabilities – especially in university postgraduate settings. Students with psychosocial disabilities have the decision to disclose their status to their research supervisors and this has...
Article
In multilingual societies, where researchers and participants often do not speak the same language, research is a challenge as a mismatch of understanding between researchers, research instruments and participants often occurs. Reporting on the translation process is crucial because of the potential implications for the validity of the data that fo...
Article
We explored the experiences of South African families across the racial divide regarding the burden of care of elderly parents of their emigrating children. The emergence of information and communication technologies has transformed these families’ abilities to stay connected despite distance and enables family members to maintain relationships of...
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Background: Language and communication lie at the heart of good quality mental health care and are a vital, yet complex, part of the diagnostic and treatment process. In South African mental health care, ad hoc interpreting arrangements are the status quo. However, these can cause both clinician and patient shame and distress. Objective: Though th...
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Background: Research into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff responses to sti...
Article
Research into the abuse of women during childbirth has increased over recent years. Many studies have focussed on labouring women, how they may be physically maltreated, neglected, or shouted at, and on how their needs are unmet by healthcare practitioners. As part of a larger study focussing on staff responses to stillbirths, we wanted to focus ou...
Article
This paper presents a theoretically-informed psychosocial analysis of the case of M, a physically disabled man from South Africa. We use M’s account as a platform from which to consider projection, melancholic suspension and grief, as these are played out in the negotiation of dependency in relationships for disabled people. Making use of a case st...
Article
In this article, we explore the impact of South African families' emigration on parents/grandparents who must renegotiate their lives in their loved ones' physical absence. We adopted a transnational perspective in a bigger qualitative project to consider both sides of the migratory spectrum. Here we focus on elderly family members who remain behin...
Article
Photovoice is presented here as an emancipatory, participatory research method with the potential to put minority subjects in charge of their own representation. Drawing on research with disabled people conducted in South Africa, we argue that the meaning of images is often hostage to interpretations which reify untruths about the subject. We consi...
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Background: Health seeking in many African countries typically involves making use of multiple healing systems, including indigenous and faith systems, as well as biomedical healthcare systems. These different systems have co-existed for many years in Africa, including in Ghana. Aim: In this article, we examine the formalising processes that non-b...
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Background: For many people in African countries, various forms of health care are utilised for the treatment of illness. This pluralistic nature of health seeking includes the use of indigenous, faith and allopathic medicines for care. Aim: In this article, our aim was to gain insight into the existing knowledge on indigenous and faith healing in...
Article
Community engagement in biomedical trials is to ensure ethical conduct in research, yet it has been criticised regarding power and exploitation of vulnerable communities where trials take place. This makes community engagement processes complex. We report on one example of how the global politics of biomedical research and local issues of contempor...
Article
The living conditions studies (LCS) on disability are a survey method that has been used in a standardised manner across eight countries in southern Africa. This paper discusses an evaluation of the LCS that were carried out between 2000 and 2015. The methodology of this evaluation was a desk top study as well as interviews with relevant stakeholde...
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In this article, we discuss how our academic research on disability and international development in five African countries has benefited hugely from active collaboration with advocates, practitioners, and policymakers, ultimately ensuring that research evidence is used to inform policy and practice. Whilst building such partnerships is seen as goo...
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Traditional and faith healing is a common practice in many low- and middle-income countries due to resource limitations and belief systems, particularly for disorders such as mental disorders. We report on the beliefs about mental illness from the perspective of one category of alternative healers in Ghana-the Muslim faith healers. We also report o...
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In a rapidly transforming world, cultural assimilation and the hybridity of clients and therapists are increasingly acknowledged. Juxtaposed against universalist and relativist discourses in Cultural Psychiatry, the elucidation of perceived “difference” from cultural norms, constructed as being observed in the lives of either the client, or therapi...
Article
Objectives This narrative review summarises the literature on the mental health of Paralympic athletes, explores possible reasons for the paucity of research in this area and suggests directions for future research. Methods A systematic search of PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Scopus, and C...
Article
Background: Although sexuality is a ubiquitous human need, recent empirical research has shown that people without disabilities attribute fewer sexual rights and perceive sexual healthcare to benefit fewer people with disabilities, compared to non-disabled people. Within a global context, such misperceptions have tangible, deleterious consequences...
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People with disabilities experience barriers in the integration phase of employment. The aim of this article was to examine the experiences of people with disabilities relating to job application forms and advertisements, interviews, confidentiality and disclosure of disability, as well as medical and psychometric testing. Qualitative data on the b...
Article
Migration is a social phenomenon impacting upon family life and conceptualisations of care. Simultaneously, technological advances allow families to stay connected. Care issues in the context of disability and aging may affect family relationships and how families develop. What is little understood is how these issues in migrant families affect a ‘...
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Background: Low- and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice guidelines based on research findings from high-income countries. While the context of health organizations is increasingly recogniz...
Article
Within the last two decades, the South African government drafted impressive policies to fully include and accommodate students with visual impairments within higher education. However, in interviews with 23 students with visual impairments at two South African universities, we found that legislation has yet to fully permeate the embodied experienc...

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