The following journal article has just been accepted for publication and will be included in Suzanne's PhD.
Hopf,
S. C. & McLeod, S. (2015, in
press). Services for people with communication disability in Fiji: Barriers and
drivers of change. International
Electronic Journal of Rural and Remote Health Research, Education, Practice and
Policy.
Here is the abstract:
The
World Report on Disability calls upon
all nations to “remove the barriers which prevent [people with disabilities]
from participating in their communities; getting a quality education, finding
decent work, and having their voices heard” (p. 5). People with communication
disability (PWCD), as a consequence of their atypical communication, may be more
likely to be excluded from society, and denied their basic human rights than
other people with disability (Wickendon, 2013). Fiji, a multicultural and
multilingual nation in the south-western Pacific Ocean has limited services for
PWCD. Service providers in Fiji include disability care workers, special
education teachers, traditional healers, and a small number of visiting
volunteer speech-language pathologists. This paper outlines the historical and
current barriers to, and drivers of change for service development for PWCD in
Fiji.
Five
barriers to service development for PWCD in Fiji were identified. (1) A major
structural barrier is the small population size to develop appropriate
infrastructure including professional education programs. (2) Geographical
barriers include the dispersed geography across 300 islands, low population
density, the rural-urban divide, and risk of disaster via cyclones and
flooding. (3) Linguistic diversity, while culturally important, can present a
barrier to the provision of quality services that are available in the
languages spoken by PWCD. (4) The cultural barriers include historical political
instability that has become more stable due to the recent democratic elections.
The social climate impacts development of services that are appropriate for
different dominant cultural groups. (5) Finally, financial barriers include the
low gross domestic product, low financial security and low human development
index; however, the financial outlook for Fiji is steadily improving due to the
change in political stability.
Three
levels of drivers of change were identified. Macro-level drivers included Fiji’s
endorsement of international policy and increased globalisation (e.g.,
tourism). Meso-level drivers of change included: receipt of foreign aid and
support from international non-government organisations (NGOs), development of
disability inclusive legislation and policy within Fiji, and strengthening of
government policies that support disabled people’s organisations. Micro-level
drivers of change included: establishment of disabled people’s organisations by
consumers, adoption of disability inclusive policy and procedures by service
providers, and changes in the perceptions of disability within the general
community.
Fijian
prevalence data confirms that there is an underserved population of PWCD in
need of specialist services. Significant advocacy work in the disability field
by Fijian and international disabled people’s’ organisations has led to the
Fiji government signing international policy (e.g., Convention on the Rights of
Peoples with Disabilities, CRPD); inclusion of disability rights in national
legislation (e.g., 2013 Constitution of Fiji Islands); and localised policy and
practice documentation (e.g., inclusive education policy by the Fiji Islands
Ministry of Education). Continued service development is required if Fijians
with communication disability (FWCD) are to have their needs met. The drivers
of change at all levels are positioned well to overcome current barriers to change;
however, a coordinated approach including macro-, meso-, and micro-level
drivers is required to ensure the future development of adequate services for
PWCD in Fiji.
