O3225: International Community Access to Child Health Project in Accra, Ghana - Rehabilitating Children with Disabilities: Community Engagement and Sensitisation

Background: This project aimed to improve the lives of children with disabilities (CWD) and was conducted at the Princess Marie Louise Children’s Hospital and high schools within and outside the hospital's catchment area in Accra, Ghana.

The Childhood Physiotherapy unit in this hospital was poorly equipped and needed remodeling to rehabilitate CWD effectively. Its limited staffing and size could not meet the service demand. Most parents/caregivers of these children were not well educated on their children’s condition and not trained to manage them effectively at home, considering that a significant proportion come from remote areas. Lastly, CWD and their parents face stigmatization in Ghana because of the public’s poor knowledge and the lack of sensitization on the issue and their needs.

To address these barriers, a project was created in the hospital and funded in partnership with Child Family Health International (CFHI) and the International Community Access to Child Health (ICATCH) grant from the American Academy of Pediatrics from 2020 to 2023.

Methods: In Year 1, the Physiotherapy Unit was redesigned, and the infrastructure was upgraded to improve the space for staff and the CWD family unit during therapy.

In Year 2, four (4) educational and training workshops were held for 145 parents/caregivers to demystify false beliefs about disability, learn about their children’s conditions, and practice best handling/positioning and feeding for CWD home care.

In addition, during Years 1 and 2, CFHI global health virtual practicum interns created educational tools on disability (pamphlets, posters, and PowerPoint presentations) during the COVID-19 pandemic in preparation for Year 3.

In Year 3, educational outreach on disability was conducted in four (4) schools to reach over 2000 high school students, and printed educational tools were distributed. Knowledge was evaluated through a quiz/debate competition between schools.

Results: Staff, CWD and parents/caregivers have benefited from the upgrade as the unit is much better organized for effective rehabilitation.

Parents/caregivers showed improvement in knowledge of disability and skills acquisition for home care techniques, assessed through pre- and post-questionnaires after training sessions and follow-up visits in the unit.

Students exhibited knowledge and advocacy skills through outstanding performances in school quizzes, impromptu speeches, and debate competitions held on a disability.

Other noteworthy benefits included a reduction in the out-of-pocket costs of hospital visits, a reduction in the Physiotherapy team’s overall workload, and the evolution of Peer-group support, which helped build confidence and understanding in parents' participation in children’s rehabilitation.

Conclusion: Infrastructure improvement for therapy, parental education, and involvement through building skills for home care is crucial for CWD to thrive in Ghana. If engaged, children can be agents of change and great advocates for other children and people with disabilities. The project emphasized the collaboration of CWD families with school authorities and other stakeholders.