2013 http://informahealthcare.com/ids ISSN 0963-8288 print/ISSN 1464-5165 online Disabil Rehabil, 2013; 35(20): 1750–1755 ! 2013 Informa UK Ltd. DOI: 10.3109/09638288.2012.751461 PERSPECTIVES IN REHABILITATION Intellectual disability in Africa: implications for research and service development Judith Anne Mckenzie 1 , Roy McConkey 1,2 , and Colleen Adnams 3 1 Disability Studies Programme, Faculty of Health Sciences, School of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa, 2 Institute of Nursing and Health Research, University of Ulster, Belfast, UK, and 3 Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Abstract Although intellectual disability (ID) is probably the largest impairment grouping on the African continent, few indigenous research and evaluation studies have been undertaken. This article is an initial attempt to relate service delivery issues to an African research agenda. We critically analysed the available literature, drawing on academic publications and those of non- governmental agencies. In this process we identified several key issues for further investigation, namely: understanding ID in African contexts, access to education and health care, the provision of appropriate assistance and support, and income generation. We relate our analysis to the recommendations made in the World Report on Disability but with a specific focus on ID in Africa. The need for mainstreaming and prioritising ID in non-disability related and across impairment programmes is highlighted. We note the importance of families and emphasise the need to draw on informal and traditional forms of care and participation. The need for reliable research evidence to support practice is highlighted. We conclude with a call to action by and on behalf of individuals with ID to be included in the development priorities of the continent. ä Implications for Rehabilitation  Service provision for people with intellectual disabilities in Africa is not always well served by insights obtained from western research agendas.  Appropriate and effective rehabilitation requires an understanding of the context and the environment in which the disabled person operates.  Indigenous research into the provision of support to families and the inclusion of persons with intellectual disability into mainstream programmes as well as disability specific provision is recommended. Keywords Africa, disability research, intellectual disability, service provision History Received 4 June 2012 Revised 4 October 2012 Accepted 16 November 2012 Published online 25 January 2013 Background People with intellectual disability (ID) are amongst the most marginalised groups globally. They experience social exclusion on a much greater scale than their able-bodied counterparts and this experience is intensified within contexts of poverty such as those on the African continent [1]. Furthermore, even where services are available for persons with other impairments, ID is often neglected, in part due to a dearth of advocacy by and for them [2]. Research into ID is predominantly conducted in and about high- income countries [3]. Overall this reflects the greater investment by these governments in social services with more resources available to undertake research [4]. The situation of people with ID in developing contexts is starkly different to that of the countries of the global north, as will be elaborated upon in the discussion below, and yet this difference remains little understood or researched in the global literature on the topic [4]. The authors of this paper are all engaged in research on ID on the continent and have therefore identified the need for a position paper that highlights current trends and emerging issues in service provision and research. In developing this position, we refer to relevant research in the field of ID and, where possible, we draw from broader disability research on the continent. It is not our intention to provide a systematic review but rather to flag ways in which the research agenda can begin to address the pressing issues of the lack of service provision and social exclusion experienced by people with ID in Africa. Furthermore, we relate our discussion to the World Report on Disability [5] and to the UN Convention on the Rights of Persons with Disabilities (UNCRPD) [6] as these documents address human rights of all disabled persons, recognis- ing the global and common inequalities that exist. Methodology In this paper we address the question: What are the key issues that affect people with ID on the African continent? We sourced Address for correspondence: Judith Anne McKenzie, Disability Studies Programme, Faculty of Health Sciences, School of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa. Tel: þ27 21 4066318. E-mail: Judith.mckenzie@uct.ac.za Disabil Rehabil Downloaded from informahealthcare.com by University of Ulster at Coleraine on 11/19/13 For personal use only.