{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:57:05Z","timestamp":1778605025703,"version":"3.51.4"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Most of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>The present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 69.2% of PWDs were female individuals. Many PWDs were aged 10\u201320\u2009years (57% of the sample size). Physical\/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (<jats:italic>F<\/jats:italic>\u2009=\u200935.11, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.0001). The adjusted score increased from the baseline value of 45.02\u2009\u00b1\u20092.38 to 61.07\u2009\u00b1\u20092.25, 65.24\u2009\u00b1\u20092.67, and 68.46\u2009\u00b1\u20092.78, at 4, 8, and 12\u2009months, respectively. Compared to the baseline, all timepoints were significantly different, indicating a significant impact of the intervention, which became stable after 4\u2009months and was preserved until 12\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PWDs faced many endeavors for sustainability and challenges resulting from a lack of inclusive policies and practices, leading to their exclusion from education, employment, and healthcare. Using implementation science approaches could bridge the gap and make policies and practices more effective.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1190722","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T04:28:38Z","timestamp":1706675318000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Using an innovative family-centered evidence toolkit to improve the livelihood of people with disabilities in Bamenda (Cameroon): a mixed-method study"],"prefix":"10.3389","volume":"11","author":[{"given":"Mirabel Nain","family":"Yuh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria Akah","family":"Ndum Okwen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rigobert Hanny Pambe","family":"Miong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola Luigi","family":"Bragazzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jude Dzevela","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Movahedi Nia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetamiyaka Tezok","family":"Kinlabel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okwen","family":"Patrick Mbah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"ref1","article-title":"World report on disability (WHO)","author":"Hartley","year":"2015"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"113","DOI":"10.15446\/revfacmed.v63n3sup.50132","article-title":"Disability and poverty: two related conditions. A review of the literature. Revista Facultad de","volume":"63","author":"Pinilla-Roncancio","year":"2015","journal-title":"Medicina"},{"key":"ref3","volume-title":"World report on disability: Main report (English)","year":"2011"},{"key":"ref4","article-title":"Fixing the broken promise","year":"2015"},{"key":"ref5","first-page":"7","article-title":"\u201cRational for the focus on children with disabilities,\u201d","volume-title":"Towards Inclusive Education for Children with Disabilities: A guideline","year":"2009"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.16993\/sjdr.841","article-title":"Research methods and practices of doing disability studies in the global south","author":"Katsui","year":"2021","journal-title":"Scand J Disabil Res."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1186\/s12889-020-09266-4","article-title":"Determinants of caregiver burden of persons with disabilities in a rural district in Egypt","volume":"20","author":"Ghazawy","year":"2020","journal-title":"BMC Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1111\/jar.12209","article-title":"Caring for adults with intellectual disability: the perspectives of family Carers in South Africa","volume":"29","author":"McKenzie","year":"2016","journal-title":"J. Appl. Res. Intell. Disabil."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"44","DOI":"10.21955\/aasopenres.1115132.1","article-title":"Supporting families to cope with children with disabilities through discourse, innovation and best practices in Cameroon","volume":"3","author":"Yuh","year":"2020","journal-title":"AAS Open Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3233\/WOR-121521","article-title":"Comparison of barriers to employment among youth with and without disabilities in South Africa","volume":"46","author":"Cramm","year":"2013","journal-title":"Work"},{"key":"ref11","volume-title":"Disability and poverty: a global challenge","author":"Eide","year":"2011"},{"key":"ref12","first-page":"1","article-title":"Culture, beliefs, and disability","year":"2017","journal-title":"Toolkit On Disability For Africa"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5463\/dcid.v28i4.666","article-title":"The family and disability in Ghana: highlighting gaps in achieving social inclusion","volume":"28","author":"Opoku","year":"2017","journal-title":"DCID."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"873362","DOI":"10.3389\/fresc.2022.873362","article-title":"The burden of disability in Africa and Cameroon: a call for optimizing the education in physical and rehabilitation medicine","volume":"3","author":"Cannata","year":"2022","journal-title":"Front Rehabil Sci"},{"key":"ref15","first-page":"1","article-title":"The prevalence of impairments and disabilities in the north west region (Cameroon)","volume":"15","author":"Cockburn","year":"2014","journal-title":"Health Sci Dis"},{"key":"ref16","first-page":"171","article-title":"The burden of disability in Cameroon","volume":"73","author":"Foti","year":"2017","journal-title":"Ig Sanita Pubbl"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"73","DOI":"10.11604\/pamj.2017.27.73.12167","article-title":"Functioning and disability in recent research from Cameroon: a narrative synthesis","volume":"27","author":"Ray","year":"2017","journal-title":"Pan Afr Med J"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"15","DOI":"10.4073\/csr.2015.15","article-title":"Community-based rehabilitation for people with disabilities in low- and middle-income countries: a systematic review","author":"Lemmi","year":"2015","journal-title":"Campbell Syst Rev."},{"key":"ref19","unstructured":"The North West Cameroon Disability Study Summary Report, London School of Hygiene and Tropical Medicine (LSHTM)2014"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1080\/1034912X.2014.998174","article-title":"Community knowledge, beliefs, attitudes, and practices towards children with spina bifida and hydrocephalus in Uganda","volume":"62","author":"Bannink","year":"2015","journal-title":"Intl J Disabil Dev Educ"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/BF01173031","article-title":"Thoughts about encounters between nondisabled and disabled peers: Situational constraints, states-of-mind, valenced thought categories","volume":"15","author":"Fichten","year":"1991","journal-title":"Cognit Ther Res"},{"key":"ref22","volume-title":"Fixing the broken promise of education for all: findings from the global initiative on out-of-school children","year":"2015"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1057\/s41599-019-0253-6","article-title":"The twenty-first century experimenting society: the four waves of the evidence revolution","volume":"5","author":"White","year":"2019","journal-title":"Palgrave Commun"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2919","DOI":"10.22605\/rrh2919","article-title":"Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi","volume":"15","author":"Lorenzo","year":"2015","journal-title":"Rural Remote Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/09614524.2015.983461","article-title":"Community rehabilitation workers as catalysts for disability: inclusive youth development through service learning","volume":"25","author":"Lorenzo","year":"2015","journal-title":"Dev Pract"},{"key":"ref26","unstructured":"Disability inclusive development in UNDP: guidance and entry points1902018"},{"key":"ref27","unstructured":"Washington DCThe World Bank2015"},{"key":"ref28","unstructured":"Disability inclusion2022"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1190722\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T04:28:47Z","timestamp":1706675327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1190722\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":28,"alternative-id":["10.3389\/fpubh.2023.1190722"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1190722","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]},"article-number":"1190722"}}