Environmental barriers experienced by urban and rural disabled people in South Africa

Impairments pose a certain degree of difficulty to disabled people, however the impact of the environment is the major cause of disability. Despite the fact that the disabling effect of environmental factors is acknowledged, little research has been done to explore the impact of the environment on varying degrees of disability and different impairments. The aim of this study was to investigate the experience of disabled people with regard to environmental barriers in an urban as opposed to a rural setting. The specific objectives were to identify which items within the International Classification of Functioning, Disability and Health (ICF) checklist of environmental factors presented people with disability with the most barriers and to see whether the barriers were different for those living in a rural as opposed to an urban setting. The study was conducted amongst Xhosa speaking people in the Eastern and Western Cape aresa of South Africa which have, respectively, 5.8% and 4.1% disability prevalences. A descriptive, analytical, cross-sectional study was used to gather the data. The primary data collection tool was the Xhosa version of the ICF checklist. The sample consisted of 468 respondents, with 375 living in the Eastern Cape and 93 in the Western Cape. Physical problems were reported by 54.6 % of the sample, 14.6% had had an intellectual impairment and 9.9% had visual, hearing or speech problems. Approximately 2% of the sample reported more than one impairment. The prevalence of the different types of impairments between the two areas was similar. Respondents from the urban area reported experiencing more barriers in the categories Products and technology and the Natural and built environment, while respondents from the rural area experienced more barriers with Attitudes. An equivalent number of people in the respective areas identified barriers in the Services category. In this study the face and construct validity of the ICF appeared to be acceptable and it is recommended that further studies be conducted to establish the reliability and content and concurrent validity of the instrument.