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Empowering self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Impacts and their underlying mechanisms

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  • Karen Bunning
  • Joseph K Gona
  • Charles R Newton
  • Frances Andrews
  • Chantelle Blazey
  • Hannah Ruddock
  • Jessica Henery
  • Sally Hartley

Abstract

Bringing up a child with disabilities in a low-income setting is challenged by inadequate resources, limited psycho-social support and poverty. Not surprisingly, many caregivers experience fatigue, distress and isolation. To address and investigate these issues, action was taken to set up twenty self-help groups focusing on caregiver empowerment. A realist evaluation design was adopted to evaluate impacts associated with the self-help process and to identify mechanisms determining the outcomes. Monthly monitoring visits were conducted to the groups during a ten-month set-up period, at the end of which eleven active groups remained, nine having dissolved due to disputes, corruption and extreme environmental conditions. A facilitated intervention was delivered to the active groups (N = 154) over a six-month period. The members were guided to review and discuss topics such as economic empowerment, personal situation, peer support, community inclusion, access to health and education. Evaluation employed mixed methods using questionnaires (n = 75) and semi-structured interviews (n = 36) pre- and post-intervention. At baseline, the burden of caregiving was characterised by aloneness, challenges, stigma and discrimination. Post-intervention, caregiver agency was defined by togetherness, capacity-building, acceptance and well-being. Significant impacts associated with caregiver perceptions included increased social support, reduced severity of child’s disability and decreased effects of extrinsic factors affecting the caregiver’s role. Mechanisms of ‘handling goods and money’ and ‘social ties and support’ appeared to underpin the outcomes. Caregiver empowerment was associated with newly developed skills, social connectedness and resource mobilisation. Documentation of group processes contributes to the evidence on community-based inclusive development.

Suggested Citation

  • Karen Bunning & Joseph K Gona & Charles R Newton & Frances Andrews & Chantelle Blazey & Hannah Ruddock & Jessica Henery & Sally Hartley, 2020. "Empowering self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Impacts and their underlying mechanisms," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-21, March.
  • Handle: RePEc:plo:pone00:0229851
    DOI: 10.1371/journal.pone.0229851
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    References listed on IDEAS

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    1. Siwan Anderson & Jean-Marie Baland, 2002. "The Economics of Roscas and Intrahousehold Resource Allocation," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 117(3), pages 963-995.
    2. Steen Bengtsson & Nabanita Datta Gupta, 2017. "Identifying the effects of education on the ability to cope with a disability among individuals with disabilities," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
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    4. Kathleen Beegle & Luc Christiaensen & Andrew Dabalen & Isis Gaddis, 2016. "Poverty in a Rising Africa," World Bank Publications - Books, The World Bank Group, number 22575.
    5. Kinchin, Irina & Doran, Christopher M. & McCalman, Janya & Jacups, Susan & Tsey, Komla & Lines, Katrina & Smith, Kieran & Searles, Andrew, 2017. "Delivering an empowerment intervention to a remote Indigenous child safety workforce: Its economic cost from an agency perspective," Evaluation and Program Planning, Elsevier, vol. 64(C), pages 85-89.
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    Cited by:

    1. Roy McConkey, 2024. "Creating Family-Centred Support for Preschoolers with Developmental Disabilities in Low-Income Countries: A Rapid Review to Guide Practitioners," IJERPH, MDPI, vol. 21(6), pages 1-19, May.

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