Purpose: This study aimed to explore the role of Community Disability
Workers (CDWs) in facilitating livelihood opportunities for disabled youth in
rural Southern Botswana. The CDWs in the study worked in Communitybased
Rehabilitation (CBR) programmes. The elements of the Livelihood
component of CBR Guidelines include skills development, self employment,
waged employment, financial assistance and social security. In particular,
the study presented the knowledge, skills, practices (activities and methods),
and strategies used by CDWs to facilitate access to the livelihood
opportunities for disabled youths in rural areas.
The literature review explored CBR as a strategy for addressing the needs
and demands of people with disabilities. Botswana has implemented a CBR
programme which is co-ordinated at the Rehabilitation Division of the
Ministry of Health and involves disabled people, health professionals, the
community and Non-Governmental Organisations (NGOs). Community
health workers coordinate disability activities in rural as well as urban areas
and comprise a range of health care practitioners namely physiotherapists,
social workers, rehabilitation technicians, rehabilitation officers and health
education assistants. In this study, community health workers were referred
to as CDWs and only those with tertiary qualifications (certificate, diploma
or degree level of training) were used as participants.
Methodology: A qualitative research approach using a case study design
was adopted. Purposive sampling was used to select seven participants from
districts in the southern part of Botswana to participate in the study.
The unit of study were the practices of the CDW in facilitating access to
livelihood opportunities for disabled youth. Qualitative data was collected
through semi-structured interviews with the CDWs. Interviews were digitally
recorded and later transcribed verbatim. Analysis of data involved coding for
themes and categories emerging from the data in the context within which it
appeared. The environmental chapters of the International Classification of
Functioning, Disability and Health (ICF) were used for data interpretation.
Findings: The findings of the study illustrated the role of CDWs in
facilitating livelihood opportunities for disabled youth. Five themes thatemerged were related to CDWs’ own experience of disability and rural
environments, their knowledge and experience in facilitating livelihoods;
their practices and strategies; the barriers to participation experienced by
disabled youth; and lastly, the CDWs’ suggestions for increasing
participation and inclusion of disabled youth in livelihood opportunities.
The findings established that CDWs were involved in facilitating access to
health facilities and assistive devices as well as education and skills
development. Some strategies used were advocacy, networking, information
dissemination, role modelling and follow-ups on former students. The
barriers identified were inadequate disability policy; absence of disability
friendly public facilities and transport; a poorly resourced public education
system and inaccessible job markets. Suggestions made by CDWs included
having inclusive policies and structures; addressing educational and
training needs; accountability regarding employment; and community
sensitisation and mobilisation.
The Discussion chapter interpreted the findings in terms of current
literature and developed two further themes. One addressed the
environmental factors impacting on disability and the other one addressed
successful strategies to enhance livelihood opportunities in light of these
environmental factors.
Recommendations included facilitating information on accessibility of
assistive devices; minimising barriers to natural and made-made changes to
the environment; building a network of supportive relationships; changing
attitudes of community as well as government leadership; and facilitating
implementation of inclusive services, systems and policies.
In Conclusion, CDWs are well placed to facilitate accessibility of livelihood
opportunities for disabled youth. However, they need to be empowered with
necessary resources such as disability inclusive policies, systems and
services, attitudinal changes and revision of their training modules.