‘Impairments of the brain’: Global South perspectives on childhood neurodevelopmental disability

• Published in: Developmental medicine and child neurology 2022-10, Vol.64 (10), p.1193-1201
• Main Authors: Bannink Mbazzi, Femke, Kawesa, Elizabeth S.
• Format: Article
• Language: English
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.15253

The word ‘disability’ does not exist in most African languages. There are words for impairments that describe the ‘missing’ or affected body parts, but no specific words to characterize, for instance, neurodevelopmental conditions. In this narrative review we focus on the different interpretations of neurodevelopmental conditions in Uganda and discuss the importance of cultural concepts and the intersectionality of family‐centred care, poverty, and neocolonialism when working with children with ‘impairments of the brain’. We suggest that these concepts should be taken into consideration in health care service provision and public health awareness campaigns, and the need to rethink how disabled children can be included in a ‘global’ health approach. We explain how applying biomedical categories used in the Global North to diagnose children is only ethical if this information will benefit the child and is accompanied by supportive actions that are relevant to the child and family setting. We argue for the enhancement of community‐based structures of belonging and interdependence that are already in place and strengthening of family and community networks to continue the care and co‐responsibility for children with ‘impairments of the brain’. What this paper adds Cultural concepts, family‐centred care, poverty, and neocolonialism are key in defining disability in the Global South. Diagnosis of a neurodevelopmental condition should be accompanied by supportive actions relevant to the child's setting. Interventions need to build on family and community‐based structures of belonging and interdependence. Health care services and public health awareness campaigns should be made culturally relevant. What this paper adds Cultural concepts, family‐centred care, poverty, and neocolonialism are key in defining disability in the Global South. Diagnosis of a neurodevelopmental condition should be accompanied by supportive actions relevant to the child's setting. Interventions need to build on family and community‐based structures of belonging and interdependence. Health care services and public health awareness campaigns should be made culturally relevant. Illustrated by a case study of a Ugandan boy with an ‘impairment of the brain’, this paper describes the impact of medical models, poverty, and neocolonialism, and the importance of cultural interpretations, communities, and family‐centred care for children with neurodevelopmental disabilities in the Global South Video