Mobility as a Basic Human Right: A Situated Understanding of Mobility among Persons with Physical Disabilities in Rural Talensi District, Ghana

doi:10.21203/rs.3.rs-2234162/v1

Mobility is a requisite for human well-being and cannot be compromised. The mobility barrier research has focused on urban areas, leaving rural areas with few studies on critical challenges related to movement in both the natural and built environment. This study then sought to fill this gap. Snowballing was used to select 75 Persons With Physical Disabilities in the District for a household survey. Face-to-face interviews were conducted with the Association of Persons with Physical Disabilities, and the Officers from the Department of Social Welfare to provide further insights into the findings. The data gathered were coded, categorized, and analyzed to identify patterns to create an understanding of the mobility barriers among Persons With Physical Disabilities. The topographical features of the district, consisting of stones, rocks, valleys, hills, and slopes, have made maneuvering extremely difficult for people with disabilities. The built environment, such as small entrances and bad roads, and high ramps have created mobility barriers for people with disabilities. The presence of native stairs and smaller gates forced people with disabilities to park their wheelchairs outside their homes. The lack of a sidewalk puts disabled people at high risk of accidents as both share the same road with vehicles. The study recommended that rural homes and roads be designed and built to make their disability responsive.

Architecture, Design and Planning

Mobility Obstacles

Person with Disability

Rural Talensi District

Geological Setting

Ghana.

Mobility is an essential requirement for human well-being and thus cannot be bargained for (see United Nations, 2006). Mobility is defined as the ability to walk safely and freely, and it is a prerequisite for accessing social, economic, political, cultural, and physical needs. Mobility disabilities can be inborn or acquired (Kwame et al., 2014), and the built environment is critical for people with such disabilities. Nagi (1991) defined disability as an individual's inability to perform socially assigned responsibilities expected of them within a given socio-cultural context. Disability refers to obstacles encountered while working, such as impairments, activity limitations, and participation constraints (WHO, 2011). Disease, injury, or health conditions cause disability (Barnes & Mercer, 2003). According to the 2004 Global Burden of Diseases report, about 978 million people, or 15.3% of the world's population, have some form of disability.

PWDs face numerous physical barriers to accessing the built environment and other social needs. This event implies that efforts must be made to remove physical or social barriers that limit the social inclusion of PWDs (UN, 1994). Mahmood et al. (2012), opines that the designs and construction of homes and public places are not disability-responsive, preventing people with disabilities from accessing their social, economic, political, and cultural needs. This idea implies that people with disabilities are unable to gain access to facilities and programs that will help them achieve the Sustainable Development Goals (Schulze, 2010). The mobility barriers in urban areas are well documented (see Clake et al. al, 2009; Kwame et.al, 2014).

However, these works have extensively explored mobility barriers in urban areas, leaving rural areas with few studies on critical challenges related to mobility barriers of Persons with Physical Disabilities (PD) in both the natural and built environments. This study then sought to fill this gap. Against this background, the research question is; how do nature and the built environment impede the movements of Persons With Physical Disabilities in rural Talensi District? The research is divided into five sections. The first section provides an overview of mobility and disability. The second part examines the conceptual model of mobility. Section three delves into the methodological approach, section four presents the findings and discussions of the study and the conclusions and recommendations are in the last section.

Definitions of Concepts

Mobility is essential to human well-being (UN, 1948), and cannot be negotiated (Lawson, 2006). The difficulty or inability to walk or move from one location to another to carry out daily routine is referred to as mobility impairment (Clarke et al., 2009). Mobility refers to the ability of a person to move around freely without the support of another and not get hurt or harmed in the process, either by walking alone or using a device or transportation, to reach their destination (Rantakokko et al. 2013).

Disability refers to impairments, limitations, and restrictions in activities. Disability is influenced by trends in health conditions and trends in the environment as well as traffic crashes, natural disasters, conflicts, diet, and drug abuse (WHO, 2013). Physical disability is related to accessibility and movement restrictions, the incapability to use limbs and the body constructively to move from one place to another due to palsy, stiffness, pain, and loss of a part. Individuals with disabilities are usually marginalized and discriminated against (Bickenbach et al., 2017). The built environment is defined as buildings, spaces, and products that are created by society and are increasingly recognized for human development (Jackson and Kochtitzky, 2001).

Models Of Disability

The religious model of disability perceived disability as a punishment from God for sins that are committed by the victim of circumstance (Pardeck and White Potato, 2012). The idea is that the punishment is for acts of wrongdoing against fundamental laws and decrees. However, it is not solely the individuals' sin that is considered a potential explanation for their disability. The medical model of disability conceived disability as a medical drawback that lives within the individual. It views disability as an issue of the individual which is directly caused by a disease, or other health problems and needs medical treatment (Mitra, 2006). This model suggested that addressing the medical infirmity will give a solution to the disability. However, this model ignores the environmental and social obstacles that caused disabilities (Mitra, 2006).

The social model of disability views disability to be initiated by the social environment which does not accept individuals with impairments to take part fully in society as a result of environmental, attitudinal, and institutional barriers (Mitra, 2006). Mcewan and Pantryman (2007) argued that the social model of disability relies on assumptions that technical and environmental solutions are universally accessible.

Disability in Ghana

In Ghana, around 3.1% of females have disabilities, which is higher than 2.9% of males. Rural residents outstrip urban residents in terms of people with disabilities. Physical disability accounted for 25.4% of all disabilities, with sight or visual impairment accounting for 40.1%. The lowest percentage was 13.7% for speech impairment. (Ghana Statistical Service, 2012). The available literature depicts various types of disability (see Table 1) in the district. Roughly 87.1 percent of the population with disabilities in the district lives in the periphery zones (see Ghana Statistical Service, 2012).

Table 1

Types of Disability in Telensi District
Type of Disability	Percentage
Sight	42.8
Hearing	22.3
Physical	18.4
Speech	14.0
Source, Ghana Statistical Service, 2012

Ghana has signed various international agreements including the Convention on the rights of PWD and the African Decade of the Disabled Persons. Although the goal of these agreements is to protect the fundamental freedoms and human rights of all PWD and to promote and respect their inherent dignity, PWD in Ghana continues to face various forms of discrimination. In Ghana, the Persons of Disability Act 2006, Act 715, and the Ghana National Disability Policy were enacted to protect people with disabilities from discrimination in public and social life (Ashigbi et al. 2017). This has been described as a step forward in freeing people with disabilities from social segregation (see Oduro, 2009; Eleweke, 2013; Asante and Sasu, 2015; Ashigbi et al. 2017).

The Civil Society Organizations (CSOs) and the Ghana Federation of the Disabled (GFD), the national umbrella organization for people with disabilities, joined the fight for the rights of people with disabilities, including members such as the Ghana Association of the Blind (GAB), the Ghana Society of the Physically Disabled (GSPD), Ghana National Association of the Deaf (GNAD), Society of Albinos Ghana (SOAG), Parents Association of Children with Intellectual Disability (PACID) and Share Care Ghana (SCG).

From the perspective of epistemological belief, knowledge was co-constructed with participants with disabilities in rural areas of the study communities. The beliefs and values of people with disabilities were highly respected. The study assumed that there is one real truth to be discovered or that there are multiple realities based on different perspectives of beliefs and knowledge of participants with disabilities in rural areas of the study localities. The employed used a sequential explanatory design to explore the research questions. The research design establishes the parameters for data collection and analysis (Patton, 1990). Data is collected and analyzed in a sequential explanatory design to reflect both qualitative and quantitative evidence (see Agyeman et. al, 2022).

A preliminary investigation was done to be conversant with the mobility challenges of PD in the Talensi district. A visit was made to the Department of Social Welfare (DSW), the Development Planning Unit, and the Association of Persons with Disability (APD) to collect primary data and establish a rapport for the subsequent data collection exercise. Before the primary data collection process, secondary data on mobility among physically challenged persons were reviewed to identify the critical variables to be analyzed in this study. Secondary data were drawn from peer-reviewed articles, books, reports, published dissertations, institutional reports from organizations affiliated with the Association of Persons with Disabilities, and other relevant materials that helped the study provide insights into the study.

The primary data process begins with a survey to ascertain the demographic characteristics and observe the household characteristics of Persons with Physical Disabilities in the selected communities and further select PD for the structured interview. Due to the lack of a database for PD, snowballing was used to select PD in the selected communities. A qualitative approach is suitable to discover and identify variables that provide a rich understanding of people's thoughts, behaviors, and actions (see Cresswell, 2003 as cited in Agyeman, 2021). Face-to-face interviews were conducted with the Association of PD, the Talensi District Assembly, and the Social Welfare Office to provide further insights into the findings. The interview responses were read severally to identify the key variables for analysis. The data gathered were reduced, coded, and categorized to create a logical chain of the mobility barriers among PD in the study area.

Ethical Approval

Before data collection, ethical clearance was sought from the School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST).

Informed Consent

All respondents were informed either written or verbal consent was obtained from them. Individual respondents were asked to sign or thumbprint a written informed consent form. Participants who were not comfortable with signing or thumb printing were allowed to give verbal consent. Participation was voluntary, and one was allowed to withdraw anytime one wanted. Confidentiality was maintained using number identifiers on audio recordings, transcripts, and interview notes.

Conflict of interests

There are no conflicts of interest.

Funding

The author bore the cost of undertaking this research and as such has no potential of adversely influencing the article’s content.

Characteristics of Respondents

Age of Respondents

From Table 2, 89 respondents, accounting for 29%, are in the 15-30 age range. Likewise, 48% of respondents fall in the 30-40 age group. The remaining 23% fall in the age group of 40 and over. The majority of respondents are between 30 and 40 years old. This shows that most of the people with physical disabilities in the district were young people.

Table 2

Age of Respondents
Age	Percentage
15–30	29
30–40	48
50 and above	23
Total	100
Source: Field Survey, 2020

Sex of Respondents

Disability is predominant among females (see WHO, 2011; Titumir and Hossain, 2005; Singal et al., 2009). Naami (2015) identified a pattern in the gender distribution of people with disabilities in northern Ghana. Naami (2015) further argues that women have more PD than men across all age groups. The gender distribution of people with disabilities is a key consideration when planning different responses to mobility problems faced by people with physical disabilities. The empirical data (see Table 3) shows that 44% of the respondents were males and 56 % were females. This means that most people with disabilities in the district were females.

Table 3

Sex of Respondents
Sex	Percentage
Female	56
Male	44
Total	100
Source: Field Survey, 2020

Marital Status of Respondents

Marriage is an important social institution and an indicator for measuring social responsibility and trust (see GSS, 2012). The results (see Table 4) show that 25% of the respondents were single and 37% were married. 5% were divorced, and 12% were widowed. This implies that most people with disabilities were married.

Table 4

Marital Status of Respondents
Marital Status	Percentage
Single	25
Married	37
Divorced	5
Widowed/Widower	12
No Response	20
Total	100
Source: Field Survey, 2020

Occupational Status of Respondent

The labor market is unfavorable for people with physical disabilities, even those with higher education, due to increased competition from physically active people (Kassah, 2005; Daniel et al. 2007). Many people with disabilities are begging to be released from their deplorable economic and social situations (Kassah, 2005). Wood and Lazzari (1997) discovered that PD is widely used in developed countries. In Ghana, policies and programs have been enacted to improve the well-being of people with disabilities. For instance, the Revised National Population Policy Action Plan, for example, was launched to include people with disabilities in political, social, and cultural development.

However, the empirical data (see Table 5) show that 41% of the respondents were unemployed, 33% were farmers, 11% were basket makers, 8% were students, and 7% were trading. This indicates that most people with disabilities in the Talensi district were unemployed and a few were engaged in peasant agriculture.

Table 5

Occupational Status of Respondent
Occupation	Percentage
Farming	33
Unemployed	41
Student	8
Trading	7
Basket Weaving	11
Total	100
Source, Field Survey, 2020

Educational Background of Respondents

The United Nations Convention on the Rights of Persons with Disabilities requires that persons with disabilities must be guaranteed the right to education without discrimination. However, there are still a large number of children and youth who are prevented from attending school due to stigma and terrorization (Slikker, 2009). Of the 4,231 people with disabilities in the district, 71.1% have never attended school (see GSS, 2012). The empirical data show that 64% of PD surveyed have never attended school. While 24% had primary education and 12% completed Junior High School or Middle school education.

Table 6

Educational Background of Respondents
Educational Background	Percentage
Never	64
Primary	24
Junior High School or middle education	12
Total	100
Source: Field Survey, 2020

Mobility barriers of the PD in the Talensi District

Geological Settings

Physical barriers reduce mobility (Schopp et al, 2002 as cited in Naetey, et-al, 2018). For instance, Emerson, (2002) concluded that geological features such as hillslopes, landscapes, steep gradients, mountains, and valleys impede mobility. Kassah's (2008) research shows that people with physical disabilities were not able to move freely with their wheelchairs in steep gradients and mountainous areas. The empirical findings show that the landscape is rippling with plains, gentle slopes with a slope of 1% to 5% with some isolated rocky crags and some plateau slopes (GSS, 2012). It falls in the Birimian, Tarkwaian, and Voltarian rocks of Ghana, proving the availability of minerals such as gold. The greater part of the district (see Figures 1 and 2) is covered with rocks, stones, valleys, and mud.

The district consists of granite rocks. From November to December, which is the harmattan season, the rocks make a strange whistle when the wind from the Sahara blows through the northern region. The area has slightly gentle slopes with some scattered rocks and some upland slopes. The district has an inclined slope that makes the land slippery, especially during the rainy season, making it difficult for those with PD to move around.

In an interview, one of the respondents stated that,

"using the wheelchair to walk in the hilly areas is very difficult for me; I used to think that getting the wheelchair would move better, but it is not easy for me at all."

Travel Characteristics

The Persons with Disability 2006, Act 715 states that public transportation and buildings be constructed and built to make their disability responsive. Per this act, restraints for wheelchair users, ramps, and bus lifts have been removed in urban areas to aid the mobility of PD (see Naetey, et-al, 2018). Kwame et. al, ( 2014) suggests that approximately 2000mm is required to allow wheelchair users to access roads. In the case of the Talensi district (see Figure 3), none of the routes had a pedestrian walkway where PD could use their wheelchair. The lack of a sidewalk puts disabled people at high risk of accidents as both share the same road with vehicles. The lack of a pedestrian walkway has made it difficult for people with physical disabilities to move freely. Roads in various communities were unmetered and unfit for use. The roadsides have deep pits that threaten the mobility of people with disabilities. For example, during the interview, one of the respondents from Yikpemeri stated,

"Moving outside my home is a difficult task for me, especially passing down the road to the town."The cars are just passing by, and if I don't take care, I might get hit by one. They have not cleared the pedestrian path for us to use on the road. I'm not sure whether to drive on the left or right side of the road. Some drivers and motorcycle riders honk their horns to warn me that I am driving on the wrong side of the road. I always find it difficult to go to town when I have something to do there."

Another respondent stated,

"We are afraid of using the road because there is no pedestrian walkway. On my way home one night, a car hit one of the natives of this village and died, this kept me from moving out, especially at night. This is how I prefer to spend my time at home. I will not risk my life unless there is a child to lead me."

Building Entrances

One of the factors impeding mobility is the entrance to the homes (Ash et al., 2020). Clarke (2014) concluded that wheelchair users have a difficult time moving around both inside and outside of their homes. Bigonnesse et al. (2018) research shows that barriers such as narrow walkways and narrow checkout points reduced mobility. Ansah and Owusu (2012) stated that most planners and contractors do not take disabled people into account when planning and building infrastructure. However, Jackson et.al, (2001) concluded that most urban buildings are disability responsive.

In the case of the Talensi District, most of the houses did not have ramps to aid the mobility of PD. The presence of an indigenous staircase without a handrail and smaller gates affects wheelchair users. The entrances of the houses are small, and the door handles were above the reach of wheelchair users. The corridors were below five meters making it difficult for wheelchair users to move around. For example, during the interview, one of the respondents stated, "Because of this corridor, I am unable to leave and venture outside."

Another respondent stated,

"Returning to this compound will be difficult due to some small corridors and entrances." If I don't get a child to push me from behind, it's difficult for me, which is stressful and upsetting, so you'll always see me sitting here."

This study sought to provide an understanding of the mobility barriers among Persons With Physical Disabilities in the Rural Talensi District. The geological features of the district, consisting of stones, rocks, valleys, hills, and slopes, have made maneuvering extremely difficult for people with disabilities. The built environment, such as small entrances and bad roads, and high ramps have created mobility barriers for PD. The presence of native stairs and smaller gates forced people with PD to park their wheelchairs outside their homes. The lack of a sidewalk puts both disabled and non-disabled people at high risk of accidents as both share the same road with vehicles. The absence of a pedestrian walkway has made it difficult for people with physical disabilities to move freely. Roads in various communities are unfit for use. The roadsides have deep pits that threaten the mobility of people with disabilities. Future research should examine the planning response to mobility obstacles in the Talensi district. The study recommended that rural homes and roads be designed and built to make them disabilities responsive. The Government of Ghana through its Agencies and Departments should ensure that the provisions made in the Persons With Disability Act 2006 are executed.

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Mobility as a Basic Human Right: A Situated Understanding of Mobility among Persons with Physical Disabilities in Rural Talensi District, Ghana

Status:

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Abstract

Figures

Introduction

Literature Review

Models Of Disability

Disability in Ghana

Methodology

Declarations

Results And Discussion

Conclusions And Recommendations

References

Status:

Version 1