Nonmedical Barriers and Needs of Rural Children with Disabilities and Their Families in Asia: A Scoping Review

Background and Purpose: People with disabilities constitute a significant portion of the global population. However, the welfare of people with disabilities, particularly children with disabilities, has not been well protected. Children with disabilities in rural areas are especially vulnerable due to the lack of resources in those communities. Extant reviews stress medical or health-related barriers and focus on children with disabilities in Western or African contexts. This review is intended to address the existing gap in reviews and identify nonmedical barriers and needs confronting rural children with disabilities and their families in Asia. This knowledge can shed light on future directions of practice, policy interventions, and research.

Methods: This study followed a well-established five-stage scoping review protocol proposed by Arksey and O’Malley (2005). A comprehensive keyword search was performed in six main electronic databases: Bibliography of Asian Studies, APA PsycInfo, ERIC, Humanities International Complete, SocINDEX with Full Text, and Web of Science. Inclusion criteria included: 1) study participants were rural children (0-18 years old) with disabilities or their families/caregivers in Asia; 2) at least one outcome concerning barriers or needs of rural children with disabilities and their families/caregivers; 3) peer-reviewed journal articles from 2010 to January 2022; 4) written in English. The search resulted in 1091 articles. After the initial title and abstract screening, 43 full-text articles were reviewed. Our final sample was comprised of 20 articles that met the inclusion criteria.

Findings: We summarized the basic characteristics of each study: design, analytic methods, sample size, participant characteristics, study region, and disability type. The barriers and needs were categorized into four levels: family, school, community, and services. Family poverty and financial insecurity, caregivers’ mental health issues, as well as discrimination against the child were the identified barriers at the family level. The school-level barriers consisted of exclusion and discrimination from peers and teachers, limited educational resources, poor school outcomes, difficulty getting to school, and sexual harassment and violence against girls. At the community level, stigmatization of disabled children and their families and inaccessible transportation are the two major barriers. From the program and service perspective, limited/unequal access to information on resources and lack of social services and programs were the two primary barriers. We also elaborated on the needs of rural children with disabilities at the family, school, community, and service levels.

Conclusions and Implications: The scoping review illuminated prominent barriers and needs faced by rural children with disabilities and their families. It also highlighted that discrimination against girls and female caregivers at various levels was still prevalent in many rural contexts of Asian countries. Thus, targeted programs and policies focusing on gender-specific barriers and needs are indispensable. This review also revealed the importance of undertaking a holistic approach to support the family as a whole rather than only focusing on children. In addition, this study called for taking religion and cultural beliefs into consideration in the program design and implementation. Besides, this study offered concrete insights into future research directions in terms of methodologies, representativeness, and intersectionality.