PSYCHOSOCIAL EFFECTS OF DISABILITY ON

ECONOMIC EMPOWERMENT OF PERSONS WITH

DISABILITY A CASE OF KISUMU COUNTY REFERRAL
HOSPITAL

BY

NAME: VAUS MUKAMI

ADM .NO: D/OT/20001/183

A RESEARCH PROJECT SUBMITTED TO THE

DEPARTMENT OF OCCUPATIONAL THERAPY IN PARTIAL
FULFILMENT FOR THE AWARD OF DIPLOMA IN
OCCUPATIONAL THERAPY

KENYA MEDICAL TRAINING COLLEGE

P.O BOX 30195 - 00100

NAIROBI.

JUNE 2023
 DECLARATION

I hereby declare that the research is my original work and has not been copied from any project
or relevant study nor has it been represented by any organization or college other than KMTC
Nairobi campus for academic purpose.

NAME; VAUS MUKAMI

ADM.NO; D/OT/20001/183

SIGNATURE:

ii | P a g e
 APPROVAL
With permission and approval of my internal supervisor

NAME; MADAM MARY MATHENGE

SIGNATURE:

DATE:

EXTERNAL SUPERVISOR

NAME; SYLVESTER WAKULWA

SIGNATURE:

DATE :

iii | P a g e
 DEDICATION
I dedicate this project to my parent Elias Mwirigi and Susan Mwirigi for them continue support
that made it possible for this work to come to a success, more particularly for their financial and
emotional support that allowed me to be capable of finishing the research.

iv | P a g e
 ACKNOWLEDGMENT

I would like to acknowledge and appreciate the love, care and mercies of Almighty God for good
health that enabled me come up with this research work. With great respect, I appreciate my
supervisors Madam Mary Mathenge and Mr. Sylvester Wakulwa whose tireless effort and advice
has seen me through this research. I would also like to appreciate KMTC Nairobi campus library
for the books that aide in my search of information.

Table of Contents
DECLARATION..............................................................................................................................................ii
APPROVAL...................................................................................................................................................iii
DEDICATION................................................................................................................................................iv
ACKNOWLEDGMENT...................................................................................................................................v
LIST OF ABBREVIATION..............................................................................................................................vii
DEFINITION OF TERMS..............................................................................................................................viii
ABSTRACT...................................................................................................................................................ix
CHAPTER ONE: INTRODUCTION..................................................................................................................1
1.1 BACKGROUND INFORMATION...........................................................................................................1
1.2 PROBLEM STATEMENT......................................................................................................................1
CHAPTER TWO: LITERATURE REVIEW..........................................................................................................4
2.1 INTRODUCTION.................................................................................................................................4
2.2 LEVEL OF PARTICIPATION..................................................................................................................4
2.3 SOCIAL EFFECTS...............................................................................................................................4
2.3.2 ISSUES OF ACCESS...........................................................................................................................5
2.2.3 SOCIAL EXCLUSION.......................................................................................................................6
2.4 PSYCHOLOGICAL IMPACT OF DISABILITY....................................................................................7
CHAPTER THREE: METHODOLOGY..............................................................................................................8
3.1 Introduction.....................................................................................................................................8

v|Page
 3.2 Study area..........................................................................................................................................8
3.2.1 Location........................................................................................................................................8
3.2.2 Population.....................................................................................................................................8
3.2.3 Climate............................................................................................................................................8
3.2.4 Health facilities...............................................................................................................................8
3.2.5 Economic activities......................................................................................................................9
3.3 Study design.....................................................................................................................................9
3.4 Sampling population......................................................................................................................9
3.5 Sampling technique...........................................................................................................................9
3.6 Sample size......................................................................................................................................9
3.7 Sample size determination................................................................................................................9
3.8 Study variables.................................................................................................................................10
3.8.1 Dependent variables.....................................................................................................................10
3.8.2 Independent variables..................................................................................................................10
3.9 Data collection tools........................................................................................................................10
3.1 Data analysis and presentation........................................................................................................11
3.11 Inclusion an exclusion criteria........................................................................................................11
3.11.1 Inclusion criteria.......................................................................................................................11
3.11.2 Exclusion criteria.........................................................................................................................11
3.12 Ethical consideration.....................................................................................................................11

APPENDIX I: A SAMPLE OF A QUESTIONNAIRE..........................................................................................25

APPENDIX II: RESEARCH BUDGET..............................................................................................................28
APPENDIX III: TIME FRAME........................................................................................................................29

LIST OF ABBREVIATION
D.F.I.D: Department of international development

vi | P a g e
D.R.P.I: Disability rights promotion international

K.M.T.C: Kenya medical training college

K.N.B.S: Kenya National Bureau of statistics

N.C.P.W.D: National census of people with disability

P.L.W.D: People living with disability

W.H.O: World health organization

vii | P a g e
 DEFINITION OF TERMS
Disability: is the outcome of complex interaction between the functional limitations arising from
a person’s physical intellectual, or mental condition and the social and physical environment.

Empowerment: can be described as a process that fosters power in people for use in their lives,
their communities, and their society, by acting on issues they define as important.

Participation: Involvement of all stakeholders, at all stages of development; on outcomes; on

empowerment; and on the important roles of disadvantaged group.

Social exclusion: a form of discrimination along a number of dimensions including gender,

ethnicity, people living with disability and age which reduces the opportunity for such groups to
gain access to social services and limits their participation.

ABSTRACT
Disability is defined as the outcome of complex interactions between the functional limitations
arising from a person physical, intellectual, or mental condition the social and physical
environment. The aim of this study was to find the psychosocial effects of disability on
economic empowerment of persons with disabilities a case of Kisumu county and referral
hospital from April to June 2023. The specific objective is the level of participation of
empowerment programs, the social effects of disability on empowerment programs and the
psychological effects of disability of empowerment programs. A cross- sectional study design
was used to gather the information on the psychosocial effects of disability on economic
empowerment of persons living with disability. A sample size of 20 respondents was issued with
questionnaires which they were required to fill and return. The data was analyzed through
manual and computer packages and the presentation of findings made using tables and figures.
The results obtained showed that people living with disability face exclusion, discrimination and

viii | P a g e
challenges that hinder their rights to participate in social life and it is recommended that people
living with disability should be empowered and included in development programs by involving
them in decision making, controlling of resources, making and implementing policy.

ix | P a g e
 CHAPTER ONE: INTRODUCTION

1.1 BACKGROUND INFORMATION

According to the department of international development, disability is defined as the

outcome of complex interactions between the functional limitations arising from a person
physical, intellectual, or mental condition the social and physical environment.

Over 1 billion people are estimated to experience disability. This corresponds to about 15% of
the world’s population with up to 190 million ,3.8% people aged 15 years and above having
significant difficulties in functioning (WHO ,2011; World Bank,2011)

In the united states, 26% of adults have some type of disability,13.7% of people with a mobility
disability,10.8% with a cognitive disability, 6.8% of people with disability have an independence
living disability with difficulty doing errands alone (Koori CA, Hollis ND, Cyrus AC –USA,
2016)

In many cultures in Africa, people believe that a disability is caused by factors such as an
influence of ‘past lives’ mystical intervention or the past actions of parents. People living with
disability in Africa face exclusion, discrimination and challenges that hinder their rights and
inclusion in community development (Geneva ,2011)

In Kenya, the world health survey suggests that the prevalence among the working age
population of PLWD is 8.6% with 11.6% in the rural areas and 4.4% in urban areas (Kenya
survey for PLWD, 2018)

In Kisumu county, the number of PLWD according to census in 2009 was 52,519 (NCPWD,
Kisumu,2019). In 2019, according to the latest statistics, the number was 39,929 PLWD which
translates to 4.0% of her total population (KNBS, 2019)

1|Page
1.2 PROBLEM STATEMENT

The impact of disability may take many forms. The physical pain, limitation of mobility,
disorientation, confusion, uncertainty, and a disruption of roles and patterns of social interaction.
This limits persons with disability from participation in the community hence they are excluded
from empowerment programs.

The cost of excluding people with disabilities from taking an active part in community life is
high and has to be borne by society, particularly those who take on the burden of care. It leads to
losses in productivity and human potential (Leandro Despoil, 1993)

The majority of people with disabilities find their situation affecting their chances in
participating as equal in social life. For this reasons, the researcher is interested in identifying the
effects of disability on community development in Kisumu county.

1.3 JUSTIFICATION OF THE STUDY

In studying the psychosocial effects of disability on economic empowerment of persons with

disability in Kisumu county hospital, the researcher creates awareness about psychosocial effects
of disability on economic empowerment and the importance of participation. By completing this,
the researcher will have met one of the requirements of being awarded a diploma certificate in
occupational therapy.

1.4 STUDY OBJECTIVES

1.4.1 BROAD OBJECTIVE

To determine the psychosocial effects of disability on economic empowerment on persons with

disabilities in Kisumu county and referral hospital.

1.4.2 SPECIFIC OBJECTIVES

1. To determine the level of participation of empowerment programs.

2. To find out the social effects of disability on empowerment programs.

3. To find out the psychological effects of empowerment programs.

2|Page
1.5 RESEARCH QUESTIONS

1. What is the level of participation of persons living with disability on empowerment

programs?

2. What are the social effects of disability on economic empowerment programs?

3. What are the psychological effects of disability on empowerment?

3|Page
 CHAPTER TWO: LITERATURE REVIEW

2.1 INTRODUCTION

This chapter consists of other researcher`s view in relation to this topic. This review is meant to
discuss the level of participation, social, and psychological effects of disability on empowerment
programs.

2.2 LEVEL OF PARTICIPATION

Recent years have shown a clear momentum towards the inclusion of persons with disabilities
through new global commitments; and the question is no longer whether to include but how to
include persons with disabilities. (Love.et.al)

Participation of persons with disabilities is acknowledged as leading to positive impact on

decision making process. It ensures that measures that can advance or hinder rights are identified
and discussed (Quinn G. Law 2017;)

The UN Human Rights Council (2016) highlights that participation itself can be a transformative
tool of change. In the case of PLWD, participation in political and public life enables one to take
part and have a voice in decision that affect oneself and one's community and country
(UNDESA, 2016b)

Dunn and Sygall (2014) explore successful strategies of mobility international USA led by a
woman with a disability for bridging the Gap between disability and humanitarian communities
and increasing the leadership capacity especially among women with disabilities.

2.3 SOCIAL EFFECTS

According to the disability funders, more than 20 million out of the united states, 6.6 million
families have at least one family member who has a disability. Social impacts are those

4|Page
consequences of disability that are experienced at the individual, family and community level (E.
Heland, UNDP,1992) These include poverty, issues of access as well as social exclusion. These
social impacts further affect how individuals and communities cope with disability.

2.3.1 POVERTY

A study of poverty and disability in Afghanistan and Zambia found evidence of lower access to
healthcare, education and labour market for people with disabilities. (Trani and Loeb,2012)
Poverty measured by an asset index is not statistically different between people with and without
disabilities (Trani and Loeb, 2012.p s19). It is often stated that disability is both a cause and
consequence of poverty. The majority of people with disabilities find their situation affects their
chances of going to school, working for a living, enjoying family life and participating as equal
in social life (C. lewis and S.Sygall, Miosa 1997).

Disability accentuates poverty because the systematic institutional, environmental and attitudinal
barriers that people with disabilities encounter in their daily lives result in their entrenched social
discrimination their lack of participation in the community. (Groce et.al; 2011,p.1497). This
leads to insufficient access to education ,isolation, inadequate housing and nutritious food. Lack
of ability to participate fully in legal and political processes, lack of preparation for and
meaningful inclusion in the work force (Woodburn,2013, p.80; Groce.et.al ;2011 ,p 1497).

2.3.2 ISSUES OF ACCESS

Komana(2015) used descriptive survey to undertake an evaluation of the infrastructural

mechanisms available to persons with disabilities in South Africa and found out that accessibility
affected disability mainstreaming in the department of agriculture of Limpompo. The researcher
reckons that persons with disabilities require to be given opportunity of access to building,
special training that may involve the use of friendly machine. These findings reinforce the need
to have disability participating in empowerment programs.

Daly.et .al (2013) is the seminal study on infrastructure as a significant access resource for
disabled persons proposed that state department needed to ensure that all necessary funding are
promptly availed to organization management authorities who wish to make modifications to
buildings, furniture , fittings or lighting in order to accommodate persons with disabilities.

5|Page
Eklund (2014) critics the Kenyan disability act for only defining physical accessibility such in
public buildings and public service vehicle whereas accessibility includes tools and specialized
services including the services of qualified interpreters for the deaf and qualified teachers for the
blind. The researcher views the universal design and barrier free approaches, physical
infrastructure and their part work well and serve every user safely in different circumstances
relevant to where it is implemented. This is important as the present study will look at all this
dimensions of infrastructure and found out how far they have influenced readiness to readiness to
participate in development projects by the disabled people.

2.2.3 SOCIAL EXCLUSION

In the past few decades, academic writers and theorists and disabled activists have developed the
view that the society itself disables physically impaired people. Disability is something imposed
on top of our impairments by the way we are unnecessarily isolated and excluded from full
participation in the society (UPIAS, 1975)

Hedlund (2000) remarks that although the physical reality of impairment might remain the same,
the way we think and communicate about it develops within certain contexts and can thereby
change. The disablement therefore emerges from the attitudes of a particular social context or
society and not the individual suffering from impairment.

Howard expands on the point, observing the organization of disabled people tend to view
disability as a social phenomenon developing a disability culture in opposition to the prevailing
disabling culture(Howard,1999a)

Consequently, it is argued that the key to dealing with disabled people problems lies not in
medical or health care or at the individuals level, but in changing society attitudes to impairments
so that people are no longer excluded (Hunn,2002, p.577)

It is argued that it is this disabling culture that has led to the social exclusion of people with a
disability. Social exclusion as defined by the social exclusion unit (SEU) within the office of the
deputy prime minister (ODPM) is a shorthand term for what can happen when people or areas
suffer from a combination of linked problems such as unemployment, poor skills, low incomes,

6|Page
poor housing, high crime environments, bad health and family breakdown (social exclusion
unit,2002)

2.4 PSYCHOLOGICAL IMPACT OF DISABILITY

A recent study found that adults with disabilities report experiencing more mental distress than
those without disabilities. In 2018, an estimated 17.4 million adults with disabilities experienced
frequent mental distress, defined as fourteen or more reported mentally unhealthy days in the
past 30 days. (Okoro CA, Zack MM,2018)

Disability is associated with heightened depressive systems and compromised daily mood, life
satisfaction and self -esteem (Caputo and Simon, 2013; Freedman et.al.2017) with prospective
studies documenting that effects operate from disability to distress, rather than vice versa
(Gayman, Turner and Cul 2008; Yang 2006)

The association between disability and compromised mental health is consistent with key themes
of the stress paradigm (Pearlin et.al,1981). Stressors encompass acute events, such as losing
one`s job, and chronic strains such as long term impairment. Persistent stress exposure also
threatens one`s immune, digestive, cardiovascular and sleep which render on vulnerable to
psychological issues. Disability also may diminish one`s internal coping resources including
mastery and self – esteem as well as internal coping resources (Carr Cornmen & Freedman,
2019)

7|Page
 CHAPTER THREE: METHODOLOGY

3.1 Introduction

This chapter consists of study area, study design, study population, sampling technique, sample
size, sample determination, study variables, data collection tools, data analysis and presentation,
inclusion and exclusion criteria including ethical consideration.

3.2 Study area

The study was conducted in Kisumu county hospital.

3.2.1 Location

Kenya is made up of 47 counties courtesy of the new constitution and Kisumu county is one of
them. The county is bordered by Homa bay county to the south, Nandi county to the North east,
Kericho county to the east, Vihiga county to the north west and Siaya county to the west. The
land area of Kisumu county totals 2085.9 km2

3.2.2 Population

According to the 2019 National census, Kisumu county has population of 1,155,574.

3.2.3 Climate

The climate in Kisumu is warm and overcast. Over the course of the year the temperature
typically varies from 64f to 88f and is rarely below 61f or above 93f. The month with the
highest relative humidity is February (54.00%)

8|Page
3.2.4 Health facilities

Kisumu county has numerous health care facilities serving the residents of the county. The main
hospitals include Kisumu county hospital, Jaramogi Oginga Odinga teaching and referral
hospital, Port Florence community hospital, Avenue hospital, Aga khan hospital and many more.

3.2.5 Economic activities

The major economic activities in Kisumu county are subsistence farming, livestock keeping,
fishing, small scale trading and tourism.

3.3 Study design

A descriptive cross- section study was used to determine the psychosocial effects of disability on
economic development of persons with disability a case of Kisumu County and referral hospital.

3.4 Sampling population

The study population was people living with disabilities in Kisumu county hospital attending
Occupational therapy clinic.

3.5 Sampling technique

The researcher used a convenient sampling technique to identify people living with disabilities.

3.6 Sample size

The sample size was 20respondent.

3.7 Sample size determination

Sample size was determined by using fisher method in 1990 as elaborated below,

N = Z2pq/ d2

Where,

9|Page
N = Desired sample size

Z = Standard normal deviation

P = Proportion of population with the characteristics of interest

0.50, q =1p

D = Degree of accuracy desired, usually set as 0.005/0.02

Hence,

Sample size = 1.962×0.50×0.50/0.502 = 384

The following formula is going to be used to determine the sample size.

Nf(n) / 1+n/N

Where nf = desired sample size for the population is less than 10000

N = Desired sample size

Therefore, NF = 384

1+ 384/20

1+19.20 =20

3.8 Study variables

3.8.1 Dependent variables

Psychosocial effects of disability.

3.8.2 Independent variables

Level of participation

Social effects

10 | P a g e
Psychological effects

3.9 Data collection tools

Questionnaires were used as the data collection tools.

3.1 Data analysis and presentation

Data was analyzed manually by using scientific calculator and presented in form of tables and
figures.

3.11 Inclusion an exclusion criteria

3.11.1 Inclusion criteria

Person living with disability in Kisumu County who will be willing to participate.

3.11.2 Exclusion criteria

Person living with disabilities who will not be willing to participate.

3.12 Ethical consideration

The researcher adhered to the rule of confidentiality concerning any information given by the
respondents and also would explain that the information is only for study purposes. The
respondents were not supposed to indicate their names during data collection. The letter of
authority was obtained from National commission for science, technology and innovation
through the director of KMTC to medical superintendent of Kisumu county administration.

11 | P a g e
12 | P a g e
CHAPTER FOUR: DATA ANALYSIS AND PRESENTATION

4.1 Introduction

Data was collected by use of questionnaires distributed at various respondents at Kisumu county
referral hospital. It involved 20 respondents who were required to give their responds on
demographic data, level of participation, social effects and psychological effects of disability.

4.2 DEMOGRAPHIC DATA

4.2.1 AGE

The figure below shows age distribution of the respondents. Respondent who had their age
between 18 -25 years were 20%, 26 – 35 years were 15%, 36 – 45 years were 25%, 45- 55 years
were 40%, over 55years were 0%

Age distribution

45 -55 years 36 -45 years 18 -25 years

Figure 1

13 | P a g e
14 | P a g e
4.2.2 Gender

Table 1: Gender distribution

GENDER FREQUENCY PERCENTAGE

MALE 13 65%

FEMALE 7 35%

The above table shows gender distribution of the respondents where 65% were male and 35%
were female.

4.2.3 Residence

Table 2: Residence distribution

RESIDENCE FREQUENCY PERCENTAGE

DISTRIBUTION
8 40%
URBAN

12 60%
RURAL

The table above shows residence distribution where 40% number of respondents resided in the
urban areas and 60% resided in the rural areas.

15 | P a g e
4.3 LEVEL OF PARTICIPATION

4.3.1 Frequency of participation

The table below represents the frequency of participation of persons with disability in economic
empowerment program where 50% of the total respondent reported that they don’t often
participate and 35% of the respondents that they do participate often and 15% who have never
participated.

Table 3: Frequency of participation

TRAINING FREQUENCY % IN LEVEL OF

PARTICIPATION

TRAINED 10 50

NOT OFTEN TRAINED 7 35

NEVER TRAINED 3 15

4.4 SOCIAL EFFECTS

4.4.1 Poverty

The study findings indicated that 70% of the respondents are partially dependent in their social
life to earn a living while 20% of the respondent are able to provide for their families with few
limitations, and 10% of the respondents are fully dependent on their family as seen in the figure
below;

16 | P a g e
 80

70

60

50

40

30

20

10

0
Partially dependent Minimal assistance Dependent

partially dependent minimal assistance dependent

Figure 5; Poverty

17 | P a g e
18 | P a g e
4.3.2: Issues of Access

The figure below represents the issues of access encountered by the respondents, 30% reported
about difficulties in accessing public buildings and public service vehicles and 70% reported of
fair infrastructures and environment modification which are convenient for them as seen in the
table;

Satisfied Disatsfied
Figure 6: Issues of access

19 | P a g e
4.3.3 Social exclusion

The figure below shows the frequency of persons living with disability interacting in
empowerment programs, 25% have interacted they were satisfied ,60% have interacted and they
were dissatisfied, 10% have interacted and were neither satisfied nor dissatisfied,5% have not
interacted in the empowerment programs as seen in the figure below;

70%

60%

50%

40%

30%

20%

10%

0%
Dissatisfied Satisfied Neither satisfied nor dissatisfied Never interacted

dissatisfied satisfied
neither satisfied nor dissatisfied never interacted

Figure 7: Social exclusion

20 | P a g e
4.3.4 Psychological effects

The figure below represents the type of stressors persons with disability have experienced, 25%
have had loss of self -esteem,20% have had stress, 30% experienced rejection and stigma, 25%
have experienced emotional breakdown.

35%

30%

25%

20%

15%

10%

5%

0%
rejection& stigma loss of self esteem stress emotional breakdown

rejection & stigma loss of self esteem stress emotional breakdown

Figure 8: Psychological effects

21 | P a g e
CHAPTER 5: DISCUSSION AND INTERPTATION

5.1 INTRODUCTION

The study aimed at finding the psychological effects of disability on economic empowerment of
persons living with disability in Kisumu county referral hospital. The study included
20respondent.

5.2 DISCUSSION AND INTERPRATION

Socio-demographic data findings of this study showed that the majority of the people living with
disability were male, they were aged between 45yrs-55yrs with most of them living in the rural
areas.

Regarding the residence in a study done by the world health survey (2018) suggests that the
prevalence among the working age population of persons living with disability is 8.6%with 4.2%
in the rural areas and 4.4% in urban areas.

Majority had participated in economic empowerment programs between the age 36-45yrs and
60% of them have often interacted.

On the level of participation, inclusion of PLWD should be done by empowering them whereby
they can be involved in decision making and taking leadership roles, this ensures that their rights
are identified and discussed (Quinn G.law,2017). About 60%of PLWD reported that they don’t
often participate in empowerment programs due to insufficient information on the programs.
Some also reported that people in leadership of persons living with disability do not fully engage
them or give them relevant information about empowerment programs in the community ,40%
reported that they participated empowerment programs more often of which most of them reside
in the urban.

On social effects, PLWD are unable to access healthcare, education labour market and this
hinders them from participating as equal in social life (C.Lewis, 1997), 70% of persons living
with disability among the working age population are dependent on their family members for
financial support. Majority of people living with disability find their situation affecting their
chances of going to school, working to get in-come and participating as equal in social life (C.
lewis and s. sygall,1997) 20% are dependent on their caregivers, 10% are able to earn a living by
the help of using assistive devices and special equipment’s and tools in their work places.

On finding about issues of access, about 30% reported of difficulties accessing some
infrastructures and mostly public service vehicles,70% of persons living with disability rated
accessibility of infrastructures 6 in a scale of 1-10. This indicates that issues of access to
buildings, public service vehicles and special training influence persons living with disability
readiness to participate in empowerment programs (Komana,2015)

22 | P a g e
On social exclusion, the society thinking and communication about PLWD within certain context
can be changed to avoid isolating and excluding PLWD from full participation in the society
(Hedlund,2000).About25% of the person living with disability reported having participated and
interacted well in empowerment programs within their communities while 60%reported having
interacted but were never satisfied with the program and15% of the persons living with disability
reported that they have never had a chance to interact due to their impairment limitation. This
indicates that social exclusion influence persons living with disability from full participation in
the community. This concurs with a study done by UPIAS,1975)

On findings about psychological impacts on persons living with disability, a study by (Okoro
CA,2018) found that PLWD experience more mental distress than those without disability
because of acute events such as losing one`s job, inability to perform activities of daily living
and chronic strain. About 30% reported have experienced stress, 25% others reported have
experienced emotional breakdown and 25% have experienced loss of self- esteem due to their
inability to fully participate and engage equally in social life.

23 | P a g e
CHAPTER 6: CONCLUSION AND RECOMMENDATIONS

Based on the objectives and findings of the study, the following are the conclusion. Most of
the people living with disability were male and they were aged between 45yrs -55yrs. People
living with disability are unable to participate fully in social life and empowerment programs due
to attitudes of particular social context in the society.

Social effects such as poverty, issues of access and social exclusion are consequences of
disabilities that are experienced at the individual, family, and community level that affect people
with disability from participating as equal in social life. Furthermore, people with disabilities
experience more psychological distress that encompasses acute events such as losing one`s job,
and chronic strains such as long term impairment.

RECOMMENDATION

The researcher recommends that the government of Kisumu should invest in people with
disability by modifying infrastructures like ramps, conducive staircases and other resources to
ease persons with disability participation in empowerment programs.

The researcher recommends empowerment programs for people with disability and inclusion of
them in both urban and rural areas to help them have the ability to understand development plans
and projects.

The researcher recommends that the county government should allocate all necessary resources
to enable persons with disability interact in empowerment programs such resources should
include human, financial and physical resources.

24 | P a g e
 REFERENCES
DFID (2000) Disability, Poverty and Development, United National Development Program.
w.w.w. livelihood.org/info.guidancesheet.

Geneva,2011. People Living With Disabilities in Africa Facing Discrimination and Exclusion.

Roger E.Hedlund, UNDP,1992, An Introduction To Community Based Rehabilitation.

Komano S.M. (2015): Evaluation of the employment and integration strategies of persons in
Limpopo department of agriculture.

Eklund T. E (2014): Mainstreaming Disability Issues in Kenya Public Service. In Watermeyer &
Swaartz; Disability and Social Change: A South African Agenda Child, South Africa.

Howard Martin, (1999b) Social Exclusion Zone, The Guardian; http: //w.w.w.guardian.co.uk.

Trani & Loeb (2022;) Poverty and Disability; Evidence from Afghanistan and Zambia, Journal
of International Development, Vol.24, page 19-52.

Clive Staples Lewis & S.Sygall ,(1997) The Contextual and Cultural barriers to equality and full
participation of people labeled with disabilities.

Catherine A. Okoro, & Strine, T.W, Balloz, L.S. et. al, Serious Psychological Distress among
adults with disabilities.

Caputo & Simon, 2013; 2017; The Psychological Consequences of Disability.

Geneva, 2011; World Health Organization and World bank, World Report On Disability.

UNDESA, OHCHR; Handbook for Parliamentarians; Realizing the rights of persons with
disabilities (2007) Social Exclusion Unit (2002) w.w.w.socialexclusionunit.gov.uk. accessed 18
February 2003

25 | P a g e
 APPENDIX I: A SAMPLE OF A QUESTIONNAIRE

Section A: Demographic Data

1. Gender:
a) Male ()
b) Female ()

2. Age: Tick whichever appropriate

a) 18 – 25 years ()
b) 26 - 35years ()
c) 36 - 45years ()
d) 45 - 55 years ()
e) Over 55yrs ()

3. Residence:
a) Rural ()
b) Urban ()

Section B: Level of Participation

4. Have you participated in any empowerment program?
Yes ()
No ()
If yes which one
a) How long was the participation?

How satisfied were you

Very satisfied ()
Satisfied ()
Unsatisfied ()
Very unsatisfied ()

26 | P a g e
Section: Social effect

5. a) Have you interacted with people in empowerment programs

Yes ()
No ()

c) If yes, how satisfying were you?

a. Strongly dissatisfied ()
b. Dissatisfied ()
c. Neither satisfied nor dissatisfied ()
d. Satisfied ()
e. Strongly satisfied

6. Do you get social support?

Yes ()
No ()
a) If yes, who offers the social support?
Friends ()
Family ()
Leaders ()
Support groups ()
Health professionals ()

Section C: Psychological effects

10. Indicate the type of stressors you have experienced in pursuit of economic
empowerment.
a. Lack of family support ()
b. Stigma ()
c. Depression ()
d. Stress ()
e. Emotional breakdown ()

27 | P a g e
 f. Rejection ()
g. Loss of self- esteem ()

Thank you very much for your participation and completing this questionnaire.

28 | P a g e
 APPENDIX II: RESEARCH BUDGET

ITEMS QUANTITY COST PER ITEM TOTAL COST

(KSH)

Research file 1 100 100

Biro pens 5 15 75

Ruled foolscaps 2 500 1000

Binding Proposal 2 200 400

Duplicating papers 1 1000 1500

Computer 1000
Services

Typing and 2 1000 2000

printing

Transport 1000 1000

TOTAL

7075

29 | P a g e
 APPENDIX III: TIME FRAME

EVENTS JUNE JULY SEPT MARC APRIL MAY JUNE

Topic selection

Proposal writing

Proposal submission
and approval

Data collection

Data analysis

Write up

Research project
submission

30 | P a g e
31 | P a g e