Community-Based Interventions Improve the Quality of Life for Children Living With Disabilities, Zambia

Children living with disabilities in Zambia face many barriers to quality of life. This study evaluated any participation in activities, the number of activities and which activities of a community-based intervention impacted quality of life among children living with disabilities and their families.

We used a pre-post evaluation design for 228 families with a child living with disabilities who participated from 2019 to 2021 in Kusamala+, a multifaceted community-based intervention. Participation in five activities (home visits by community caregivers, play therapy, church talks, physiotherapy and registration with the Zambian Association of Persons with Disabilities) (that provided cash transfers for families) was associated with change in the three Beach Center Family Quality of Life domains of emotional, physical and disability-related quality of life. Analysis included descriptive statistics, calculating change in quality of life over time and multinomial linear regression that compared any versus no participation, the number of events and which event was most associated with quality of life change.

All three domains increased, with a statistically significant change in physical and disability-related quality of life. Nearly all families participated in at least one activity. The most common activity was the community caregiver home visits (87%), followed by assessment by the Zambian Association of Persons with Disability (68%), physiotherapy (49%), play therapy (41%) and church talks (20%). Regression models indicated that physiotherapy was an important predictor of positive change in all three domains, community caregiver visits and play groups were key for emotional quality of life improvement, and Zambian Association of Persons with Disability registration was important for improvement in physical and disability-related domains. Play groups were also associated with positive change for disability-related quality of life.

Community-based interventions that reduce barriers to access and increase social support and physical well-being are key to improving the quality of life for CLWD and their families in low-resource settings.