ArticleBMJ paediatrics open2026
'It was just a normal day!' Caregiver perspectives of the impact of the COVID-19 pandemic on children living with disabilities in South Africa.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildren with disabilities were unlikely to be included in response strategies during the COVID-19 pandemic in the poorest countries that prioritise medical models. We aimed to understand the impact of COVID-19 on these children and their families in South Africa, through the lens of the WHO International Classification of Functioning, Disability and Health (ICF) framework, to advance service delivery that could make a difference to their lives.
methodsCaregivers of children with developmental disabilities from an online parent network (n=400), initiated by Shonaquip Social Enterprise during the COVID-19 pandemic, were invited to participate in an online survey in October 2021, to understand their experiences. A quantitative analysis was conducted using Stata Statistical Software. NVivo 14, QSR International, enabled an iterative thematic analysis, using the ICF Framework.
resultsOut of 400 parents surveyed, 68 (17%) responded. They reported declines in child health (n=11, 16%), contracting COVID-19 infections (n=6, 9%) and demise (n=2, 3%) alongside food insecurity (n=42, 62%), income losses (n=17, 26%) and restricted educational access (n=22, 32%) during the pandemic. Caregiving was described as 'very stressful' (n=33, 49%) and some needed substances to cope (n=5, 7%). Parents expressed that services for children with disabilities were not prioritised during the pandemic. Although the parent network empowered resilience, strong themes of isolation were equivalent to their pre-pandemic experiences.
conclusionBy collaborating with community organisations, and leveraging technology, we reached vulnerable populations during the pandemic in South Africa. By contextualising the ICF framework and 'F-Words', we exposed the challenges of families which may be compared with a crisis in low- and middle-income countries, beyond a pandemic. Whereas COVID-19 forced us to reimagine addressing these needs, this is a call to relisten and rebuild systems around children with disabilities. Bridging research to practice gaps and strengthening family resilience should be 'just a normal day'.
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