An investigation into the perceptions of “outsider” contributions to sustainable services for people with communication disabilities, in majority world countries

Sowden, Ryann (2018) An investigation into the perceptions of “outsider” contributions to sustainable services for people with communication disabilities, in majority world countries. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Background Services for people with communication disability (PWCD) are extremely limited in Majority World countries. Speech and language therapists (SLTs) provide many services for PWCD, but in Majority World countries the number of SLTs is small. Outsider (foreign) SLTs have been involved in providing services for PWCD in Majority World countries. Little is known about insiders’ (country nationals) and outsiders’ preferences for outsider-involvement; whether outsider involvement in the development of services follows a common trajectory; or what best practice for outsiders in developing sustainable services for PWCD in the Majority World should be. The aim of this study was to investigate the processes and perceptions of collaboration between insiders and outsiders, in developing services for PWCD in Majority World countries, with a particular emphasis on the contribution and roles of outsiders. Methods A two-phase, exploratory, mixed-method study used ethnographic and survey case study approaches. In phase one, interviews, document analysis, and participant observation were carried out in Uganda. Phase two formed a pilot study using a written survey with participants from five Majority World countries. Data were analysed using content analysis, Thematic Network Analysis and descriptive statistics. Results Ten thematic networks and three categories were generated from the two phases. Exploration of these resulted in 18 findings, which were integrated and synthesised to produce seven key statements. These key statements related to topics of power, roles, exchange, culture and development approaches. Discussion and Conclusions This study has added to the knowledge base by revealing insiders’ and outsiders’ perceptions of challenges of their power, roles and cultural appropriateness; their need for fair exchanges of contributions; and the need for plans, flexibility and overall commitment to ensuring sustainability. The key statements showed insider preferences for outsider contributions and provide valuable guidance for outsider involvement at different stages of collaboration.