Gona Joseph K, Hartley Sally, Newton Charles R J
KEMRI/Wellcome Trust, Kilifi, Kenya.
Rural Remote Health. 2006 Jul-Sep;6(3):553. Epub 2006 Sep 6.
Cross-sectional surveys have been used widely for identifying children with disabilities, but they have several disadvantages. The surveys concentrate on identifying impairments and do not encourage the participation and ownership of the community. Participatory rural appraisal (PRA) provides a cost-effective and efficient method that reflects the local perceptions of disability and involves local people. These factors are important for sustainability in resource-poor countries.
To evaluate the application of PRA to identifying children with disabilities in a rural setting.
PRA was used to identify children with disabilities in two rural sub-locations in Kilifi, Kenya. Data were collected through 12 focus group discussions and 12 social mapping activities. A purposive convenience sample of teachers, village leaders and women groups participated in the PRA. The perceptions of disability were established before identification of the children. The categories of identification were based on these local perceptions. The qualitative data were analyzed thematically and validation was performed through triangulation.
Disability was perceived locally as the existence of impairments, activity limitations and participation restrictions. Disabilities were associated with traditional beliefs including witchcraft, evil spirits and punishments from God. In some cases these categories were mutually exclusive and in others they were concurrent. Children who had lost their parents and were not being cared for by relatives (disadvantaged orphans) were also perceived as disabled children by teachers and local women, but not by community leaders.
The results suggest that PRA is an efficient and cost-effective method of identifying children with disabilities according to local perceptions, and it may be useful in community-based rehabilitation as an alternative to surveys.
横断面调查已被广泛用于识别残疾儿童，但它们存在一些缺点。这些调查集中于识别损伤，不鼓励社区的参与和自主。参与式农村评估（PRA）提供了一种具有成本效益且高效的方法，该方法反映了当地对残疾的看法并让当地人参与其中。这些因素对于资源匮乏国家的可持续性很重要。
评估参与式农村评估在农村地区识别残疾儿童中的应用。
在肯尼亚基利菲的两个农村分区，采用参与式农村评估来识别残疾儿童。通过12次焦点小组讨论和12次社会绘图活动收集数据。教师、村长和妇女团体的便利样本参与了参与式农村评估。在识别儿童之前确定对残疾的看法。识别类别基于这些当地看法。对定性数据进行主题分析，并通过三角验证进行验证。
当地将残疾视为存在损伤、活动受限和参与受限。残疾与包括巫术、恶鬼和上帝惩罚在内的传统信仰有关。在某些情况下，这些类别相互排斥，在其他情况下则同时存在。失去父母且无人照顾的儿童（弱势孤儿）也被教师和当地妇女视为残疾儿童，但社区领袖不这样认为。
结果表明，参与式农村评估是一种根据当地看法识别残疾儿童的高效且具成本效益的方法，作为调查的替代方法，它可能在社区康复中有用。
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