Exploring context for implementation of inclusive education for children with developmental disabilities in mainstream primary schools in Ethiopia

A large gap in provision of services for children with developmental disabilities has been identified in Ethiopia, especially in the education system. Including children with disabilities in mainstream schools is encouraged by policies, but progress in this direction has been limited. This study aimed to explore stakeholders’ perspectives on contextual factors relevant for inclusive education for children with developmental disabilities in mainstream schools in Addis Ababa, Ethiopia. Data were collected through semi-structured interviews with 39 local stakeholders, comprising caregivers of children with developmental disabilities, school teachers and principals/managers, non-governmental organisation representatives, government officials, clinicians and academics/consultants. We used template analysis to code the data and map them onto domains of the Context and Setting dimensions of the Context and Implementation of Complex Interventions framework (Pfadenhauer et al., 2017). Stakeholders discussed frameworks in the Legal and Ethical context endorsing the right of all children to education. However, they reported multiple reasons why children with developmental disabilities in Addis Ababa have limited access to education, either in special or mainstream schools. First, individual features, such as gender and support needs, discussed in the Epidemiological context, may affect the likelihood of a child with developmental disabilities to be accepted in school. Transportation challenges are a key barrier in the Geographical context. Socio-economic and Socio-cultural contexts present barriers at the levels of the nation, school and family, mostly related to limited services and material and financial resources and limited awareness of developmental disabilities. Stakeholders believe the currently limited but growing commitment in the Political context can support progress towards the removal of these barriers. Our findings can form the basis for development of an implementation plan that addresses such barriers and capitalises on existing facilitators.埃塞俄比亚在发育障碍儿童的服务供给方面存在显著缺口，且在教育体系中这一问题尤为突出。尽管政策鼓励将残疾儿童纳入主流学校，但该方向的推进进展始终有限。本研究旨在探究埃塞俄比亚亚的斯亚贝巴主流学校中，发育障碍儿童融合教育（inclusive education）相关情境因素的利益相关者视角。研究通过半结构化访谈收集数据，访谈对象共39名本地利益相关者，涵盖发育障碍儿童照护者、学校教师与校长/管理者、非政府组织（Non-Governmental Organisation, NGO）代表、政府官员、临床医师以及学术研究者/顾问。本研究采用模板分析法对数据进行编码，并将其映射至《复杂干预的情境与实施框架》（Context and Implementation of Complex Interventions framework, Pfadenhauer等，2017）的情境与设置维度各领域中。利益相关者探讨了法律与伦理情境下的相关框架，此类框架旨在保障全体儿童的受教育权利。但他们同时指出，亚的斯亚贝巴的发育障碍儿童无论在特殊学校还是主流学校，均面临教育机会有限的问题，并详述了多方面成因。其一，流行病学情境中提及的个体特征（如性别与支持需求），可能会影响发育障碍儿童被学校录取的概率。地理情境层面，交通难题是核心阻碍因素。社会经济与社会文化情境则在国家、学校与家庭层面均构成障碍，主要涉及服务供给不足、物资与财力资源匮乏，以及对发育障碍认知水平有限等问题。利益相关者认为，当前政治情境下的投入虽有限但正逐步增加，这可为消除上述障碍提供助力。本研究结果可为制定针对性实施方案奠定基础，该方案旨在解决上述障碍并充分利用现有促进因素。