Prosthetic and orthotic devices play a significant role in enhancing the quality of life for individuals with disabilities by improving mobility, health, psychological well-being, and socio-economic opportunities. However, access to these assistive devices remains a considerable challenge, particularly in resource-limited settings. The aim of this systematic review was to explore and categorise the existing barriers and challenges that affect access to limb orthoses and prostheses in sub-Saharan African countries. A systematic search of seven databases was conducted to identify relevant studies using the search terms: 'prosthesis' or 'orthosis' and sub-Saharan African countries and variations of each term. Quality assessment of each study was completed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale and the Oxford Levels of Evidence. Twenty-two journal articles were included for review following database search and screening, evaluating a total of 3726 participants. Results were organised into four generalised themes, and each theme was categorised into sub-themes. The review identifies multifaceted barriers to accessing and utilising limb prostheses and orthoses in sub-Saharan Africa, primarily driven by economic constraints and cultural barriers. The lack of multidisciplinary rehabilitation teams further contributes to fragmented and inefficient service delivery. Orthotic and prosthetic training centers and colleges are underdeveloped, facing problems such as ineffective teaching methods, outdated curricula, inadequate research facilities, and a shortage of experienced professionals. This review synthesises evidence on barriers to prosthetic and orthotic access in sub-Saharan Africa, categorising challenges into thematic domains and highlighting gaps in service delivery, education, and workforce capacity to inform policy, practice, and future research directions.

Autistic learners benefit from demonstrating academic knowledge with the help of assessment accommodations, guided by South African examination policies, such as the National Policy Pertaining to the Conduct, Administration and Management of Examinations and Assessment for the National Senior Certificate Examination. However, stakeholder perspectives on accommodations remain under-explored. This study explored stakeholder perspectives (autistic adults, caregivers, educators, psychologists, speech-language therapists and occupational therapists) on assessment accommodations for autistic learners in South African schools. A web-based questionnaire was distributed nationally to professionals and caregivers (n = 92). Quantitative data were analysed descriptively, and qualitative responses were thematically coded. Stakeholders reported a persistent policy-practice disconnect, with educators lacking the knowledge of accommodation policies, as well as the training to implement accommodations, particularly for autistic learners. Similarly, current policies do not adequately accommodate the needs related to sensory regulation and anxiety. Considerable variability emerged in accommodation preferences, reflecting both the heterogeneity of autistic learners and the differences across stakeholder groups. Respondents also prioritised universal design elements such as simplified language, redundancy and clearer assessment layouts, which are not currently considered in South African policy. Overall, findings highlight the need for expanded and individually tailored assessment accommodations informed by diverse stakeholder input. The findings highlight a disconnect between policy and practice. Broader autism-specific accommodations are crucial to support equitable assessment conditions in South African schools, especially for learners with sensory and communication challenges. This study provides insight into stakeholder experiences and suggests that current assessment policies may inadvertently exclude autistic learners. The findings support the need for inclusive, contextually relevant assessment strategies. The contribution aligns with the focus of the journal on disability inclusion by advancing evidence-based recommendations that promote full participation of neurodivergent learners in education systems, particularly within under-resourced and diverse settings.

Background: The global prevalence of attention deficit hyperactivity disorder (ADHD) is increasing. Children with ADHD are exposed to various risk factors that adversely affect their quality of life. Treatment is paramount to counteract these risks. Current research focuses on how parents and teachers perceive children’s experience of living with and taking ADHD medication. This study included children as participants, enabling their agency. Objectives: This study aimed to investigate whether ADHD medication is a risk or resilience factor for children diagnosed with ADHD. Method: A qualitative approach and a phenomenological research design were used in this study. Nine children taking ADHD medication in a mainstream private school were purposefully sampled as the study’s participants. Data were obtained using semi-structured interviews, focus groups and children’s drawings and analysed using thematic analysis. Results: Participants identified that experiencing somatic side effects of ADHD medication and not taking prescription medication for ADHD were both risks, while taking prescription medication for ADHD was reported to enable their resilience. The study found that although children with ADHD face risks associated with taking medication for ADHD, they also reported that their medication helped them cope with the ADHD symptoms. Conclusion: These findings demonstrate that medication serves as both a risk and a resilience factor for children with ADHD. Thus, interventions must be implemented to mitigate the risks and maintain the resilience factors associated with taking prescription medication. Contribution: These findings can inform interventions to support children in mitigating the risks associated with ADHD medication and foster children’s resilience.

Abstract: Background: Lower limb prostheses improve functioning and quality of life after amputation. The challenges in prosthetic service provision in South Africa have been researched. However, possible solutions have not been explored. Objectives: This article presents obstacles to prosthetic services in the Eastern Cape province of South Africa, and suggests research and development, health systems and clinical care solutions to alleviate these obstacles. Method: Using a pragmatic approach, current evidence, unpublished research, grey sources and author expert opinion are presented in an integrated manner to show the barriers and recommendations for solutions in five key areas that are budget, supply chain and stock barriers, poor continuity of care, insufficient human resource numbers and skills, unrecorded demand for services, and geographical stumbling blocks. Results: Tender documents, ring fencing budgets and appointing professional procurement officers are recommended to address supply chain barriers. Conscientious record keeping and an audit of appointment practices are recommended to enhance continuity of care. Outreach clinics, compulsory community service and skill shifting should be explored in response to geographical barriers and shortage of human resources. Early screening and referral might decrease waiting times. Innovative manufacturing strategies such as 3D printing and direct socket manufacturing should be researched. A database can assist with predicting new device-repair and replacement needs. Conclusion: Prosthetic service delivery is a complex open system, and a systems approach should be followed when implementing any of the suggested solutions. Contribution: The suggested solutions might assist in alleviating the barriers experienced in prosthetic service delivery in low-resourced settings.

The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.

The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.

The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.

The journal is published for the purpose of advancing scholarship in disability studies and rehabilitation sciences in a uniquely African context. Widely read by scholars, professionals and students, it encourages scholarly exchange between all disciplines and academics from low, middle and high-income countries to work towards the improvement of human development and its practices across the continent.

BackgroundWorkplace inclusion for employees with chronic conditions such as multiple sclerosis (MS) remains a challenge because of the episodic and invisible nature of symptoms, leading to stigma, disclosure dilemmas and inadequate accommodations. Traditional approaches to disability inclusion often fail to address the lived realities of employees with MS, necessitating a deeper exploration of how individuals and organisations construct meaning around disability and inclusion.ObjectivesThis study explores how employees with MS experience workplace inclusion, self-management and disclosure drawing on sensemaking theory and the Social Model of Disability. The study also employs a reflexive approach, centring the voices of employees to generate actionable insights for employers and disability advocates.MethodAn exploratory qualitative research design was adopted involving semi-structured interviews with 13 employees diagnosed with MS in South Africa. Thematic analysis was used to identify patterns related to workplace adaptability, disclosure and support structures. Researcher reflexivity was incorporated to acknowledge positionality and enhance the study’s depth.ResultsWorkplace adaptability, including flexible work arrangements and empathetic leadership, play a critical role in ensuring inclusion for individuals with MS in the work environment. However, disclosure remains a complex decision influenced by stigma and workplace culture. Psychological safety and proactive organisational sensemaking significantly impact employees’ experiences.ConclusionFor meaningful workplace inclusion, organisations must move beyond compliance-driven policies and foster an environment where employees with MS feel valued and supported.ContributionBy integrating reflexivity, sensemaking theory and the Social Model of Disability, this study offers valuable contributions to the discourse on disability inclusion.

BackgroundAdapted Physical Education (APE) focuses on tailoring school Physical Education (PE) to the needs of learners with special educational needs (LSEN), promoting their optimal physical and psychosocial development, which is also one of the priorities of the Brazil, Russia, India, China and South Africa (BRICS) organisation in addressing the health issues of its people. In view of limited available literature, more research is needed on the state and status of APE in BRICS.ObjectiveTo explore the current state and status of APE in the BRICS countries.MethodEmploying the qualitative document analysis methodology, school curriculum documents and education policies in the BRICS countries were analysed inductively within an interpretivist perspective, based on the frameworks of Bronfenbrenner’s Ecological Systems Theory and the Cultural-Historical Activity Theory.ResultsAlthough BRICS policies mandate the inclusion of LSEN in PE in mainstream and special schools, specific guidelines for adapting activities in PE could only be found in governmental documents of Russia, India and China. Teachers of LSEN are required to be qualified in special or inclusive education, but specialised undergraduate and professional APE teacher training is not equally available in all BRICS countries. Specific requirements regarding the assessment of LSEN within APE are also lacking.ConclusionMore comprehensive guidelines are needed regarding teaching strategies, curriculum content, assessment and professional development in APE to address challenges in APE implementation across BRICS countries.ContributionImplementing the recommendations of this study would enhance the physical and psychosocial development of LSEN in BRICS countries.