Browsing by Author "Marshall, J."

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Communication rehabilitation in sub-Saharan Africa: The role of speech and language therapists
(African Journal of Disability, 2018-04) Wylie, K.; McAllister, L.; Davidson, B.; Marshall, J.
Background: Workforce factors present a significant barrier to the development of rehabilitation services for people with communication disabilities in sub-Saharan Africa (SSA). Exploring how the work of speech and language therapists (SLTs) in the region is organised and delivered can provide insight into existing services, areas for future workforce development and improved rehabilitation access for people with communication disability. Objectives: This paper describes the employment and service provision patterns and work roles of a sample of SLTs in SSA. Method: A broad, purpose-designed, mixed-methods survey was designed to collect data from SLTs living in Anglophone countries of SSA. Descriptive statistics and qualitative content analysis were undertaken. This paper reports on a subset of data from the wider survey. Results: A description of the employment and work roles of the 33 respondents to the survey and characteristics of their service users is presented. SLTs were commonly employed within private and not-for-profit sectors and frequently worked in temporary jobs. SLTs engaged in a range of work roles, including capacity building and training others. Services were provided by SLTs across age ranges, health conditions and settings, with paediatric, urban services commonly reported. Costs for service users and urban-centred services give indications of barriers to service access. Conclusion: Knowledge of the way in which speech and language therapy services are organised and provided has the potential to shape the development of communication disability rehabilitation in SSA. This research has identified a range of issues requiring consideration as the profession develops and grows.
Community service providers' roles in supporting communication disability rehabilitation in Majority World contexts: An example from Ghana
(International Journal of Speech-Language Pathology, 2019-08-22) Wylie, K.; Davidson, B.; Marshall, J.; Bampoe, J.O.; Amponsah, C.; McAllister, L.
Purpose: In Majority World countries, where speech-language pathology services are extremely limited, people with communication disabilities (PWCD) may seek help from a range of service providers. This qualitative research aimed to explore the nature of community services offered to people with communication disabilities who seek help in Accra, Ghana. Method: Semi-structured interviews were conducted with nine individuals from three professions: pastors (3), doctors (3), and herbalists (3) exploring services that they may offer to PWCD seeking help. Interviews were analysed using Thematic Network Analysis. Result: Six global themes described beliefs about communication disability, types of intervention, explanations provided to people with communication disabilities, promoting communication, processes for selecting treatments, and links between service providers. Interventions encompassed physical, spiritual, psychosocial and environmental approaches, with the notion of plural beliefs interwoven through a number of themes. Conclusion: In Ghana, and other Majority World contexts, service providers in sectors not commonly associated with communication disability rehabilitation may have important roles to play in supporting people with communication disabilities. Understanding the contributions of other service providers may assist the growing profession of speech-language pathology to collaborate across sectors, to develop specific, culturally responsive approaches to service development.
The importance of SDG 17 and equitable partnerships in maximising participation of persons with communication disabilities and their families
(International Journal of Speech-Language Pathology, 2022) Dada, S.; Wylie, K.; Marshall, J.; Rochus, D.; Bampoe, J.O.
Background: Equitable partnerships across borders, sectors and communities are integral in creating shared understanding, novel solutions and sustainable development. Sustainable development goal (SDG) 17: Partnerships for goals, focuses on strengthening global partnerships. This highlights the importance of partnership as a tool to support the achievement of all SDGs. Partnerships are particularly vital to creating sustainable and appropriate services to support people who experience communication or swallowing disability and their families, in under-served communities, where services and expert personnel may be limited and where innovative strategies are required for working with families and communities to improve service accessibility. Purpose: To reflect on key principles underpinning the creation of a speech–language pathologists’ (SLPs’) community of practice, designed to support SLPs from high-, low- and middle-income countries to develop equitable partnerships, aimed at supporting people who experience communication or swallowing disability their families. Result: We draw on the authors’ experiences of building partnerships to enhance participation for people who experience communication or swallowing disability. We discuss the need for global partnerships and challenges with current funding mechanisms. Conclusion: We use the principles of the speech–language pathology community of practice and concepts from the Partnership Accelerator 2030 Agenda to frame reflections and recommendations. This commentary paper focuses on partnerships for the goals (SDG 17).
Maximizing the Benefits and Minimizing the Risks from the Contribution of “Outsiders” to the Development of Services for Persons with Communication Disability in Sub-Saharan Africa
(Springer, Cham, 2023) Owusu, N.A.V.; Marshall, J.; Sowden, R.
Abstract Background: Services for persons with communication disability are scarce in many low- and middle-income countries, including most countries in sub-Saharan Africa (SSA). Speech–language therapists (SLTs) from high-income countries have long been involved in supporting service developments in SSA. This has often been through short-, medium-, or long-term posts (e.g., through individuals being employed by nongovernmental organizations, working as volunteer expatriates, or being locally employed), delivering direct services to clients and their families, training other professionals, and/or educating SLTs. Consultants working on a short-term basis advise universities and government ministries on the establishment of speech–language therapy (SLT) services and educational programs. There is some professional literature guiding SLTs from high-income countries on how to prepare for such work, but little has been written about what low- and middle-income country-based professionals, clients, or their families think about or would like from outsider SLTs. Furthermore, there is little or no evidence indicating what makes outsider support successful. Methodology: Two SLTs, with a combined experience of over 40 years (a Ghanaian SLT and an SLT based in the UK with considerable experience working in low- and middle-income countries), present a written dialogue about insiders and outsiders working together in low- and middle-income country contexts. Four fictitious case examples of outsider-insider experiences of collaboration are then given, illustrating points made in the dialogue. The third author then reports on part of her PhD study of an SLT insider-outsider collaboration in Uganda. Results/Discussion: Learning from all three sections and the previously published literature is then used to generate recommendations for maximizing the benefits of insider-outsider SLT collaborations in low- and middle-income countries.
Self-Help and Help-Seeking for Communication Disability in Ghana: Implications for the Development of Communication Disability Rehabilitation Services
(Globalization and Health, 2017-12) Wylie, K.; McAllister, L.; Davidson, B.; Marshall, J.; Amponsah, C.; Bampoe, J.O.
Background In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. Methods A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. Results One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors – including the Western healthcare, religious, and traditional sectors. Conclusions Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.