Saloojee G, Phohole M, Saloojee H, IJsselmuiden C
Childhood Disability Research Project, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
Child Care Health Dev. 2007 May;33(3):230-5. doi: 10.1111/j.1365-2214.2006.00645.x.
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.
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.
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.
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.
尽管南非有超过100万残疾儿童，但该国的政府机构，如卫生、教育和社会福利部门，并未对儿童残疾问题给予足够关注。本研究旨在评估生活在城郊城镇的残疾儿童未得到满足的康复、教育和福利需求。
由于不存在残疾儿童登记册，采用滚雪球抽样法，便利抽取了156名生活在南非索韦托附近奥兰治农场镇的残疾儿童作为样本。通过结构化访谈评估儿童的损伤情况、健康和教育需求以及服务的可获得性和利用情况。
很少有残疾儿童上幼儿园（35%）或上学（44%）。需要康复服务的儿童中只有四分之一（26%）获得了此类服务。运动功能受损的儿童比智力受损的儿童更有可能接受康复治疗（44%对8%，P<0.0001）。在所需的233件辅助器具中，仅发放了64件（28%）。有权领取社会援助补助金的儿童中，不到一半（45%）实际领取了该补助金。照顾者给出的服务和资源利用率低的主要原因是缺钱、对现有服务的了解有限以及官僚主义障碍。
生活在奥兰治农场的残疾儿童未享受到他们应有的权利和服务。需要创新、协调的服务提供策略，以及了解情况更多的照顾者，同时社区要认识并支持残疾儿童的需求，以满足这些未得到满足的需求。
