International Journal of Educational Development 91 (2022) 102574

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International Journal of Educational Development

journal homepage: www.elsevier.com/locate/ijedudev

Inclusive education for children with visual impairments in sub-Saharan

Africa: Realising the promise of the Convention on the Rights of Persons
with Disabilities
Guy Le Fanu *, Elena Schmidt , Bhavisha Virendrakumar
Sightsavers, Oakfield House, 35 Perrymount Road, Haywards Heath, West Sussex RH16 3BW, United Kingdom

A R T I C L E I N F O A B S T R A C T

Keywords: According to the Convention on the Rights of Persons with Disabilities, children with disabilities are entitled to
International development an education that is longitudinally, locationally, pedagogically, environmentally, and consequentially inclusive.
Disabilities The evidence base shows children with visual impairments in various sub-Saharan African contexts are not yet
Educational quality
able to access such provision. To improve this situation, development actors need to appreciate the multi-layered
Role of education
Inclusion
educational needs of these children and promote child-centred, contextually appropriate forms of provision. This
in turn will require sustained investments in education systems, along with changes to development modalities
and mind-sets.

1. Introduction Assembly adopted the 2030 Development Agenda. Sustainable Devel­

Over the last thirty years, there has been increased awareness of the
need for education systems around the world to become disability in­
clusive. This has been attributed to civil society activism (both within
countries and globally) and the signing, endorsement, and ratification of
international agreements such as the Convention on the Rights of the
Child (United Nations [UN], 1989), the Jomtien Declaration (UNESCO,
1990), the Salamanca Statement (UNESCO, 1994), the Dakar Frame­
work for Action (UNESCO, 2000), and the Convention on the Rights of
Persons with Disabilities (UN, 2006) (Ainscow and César, 2006; Sri­
vastava et al., 2015; Wapling, 2016). However, donor agencies, with
honourable exceptions such as USAID, have been criticised for their lack
of action (Metts and Metts, 2000; Lei and Myers, 2011; Grimes and
Bagree, 2012), as have national governments (World Health Organiza­
tion [WHO] and The World Bank, 2011). Indeed, the Millennium
Development Goals neither mentioned disability nor tracked whether
the goals were achieved for people with disabilities (Kupar and Grech,
2017).
On 25 September 2015, the 193 countries of the UN General
opment Goal (SDG) 4 commits state and non-state actors around the
world to providing “inclusive, equitable and quality education” for
children with disabilities by 2030 (UN, 2015) – provision that should
encompass both “early childhood development, care and pre-primary
education” (Target 4.2) and primary and secondary education (4.1).
The rights of people with disabilities to social goods are not only
addressed in SDG 4, but SDG 8 (pertaining to economic growth), SDG 10
(reducing inequality), SDG 11 (human environment), and SDG 17
(implementation of the SDGs). Furthermore, the declaration at the start
of Agenda 2030 establishes disability as a cross-cutting theme, spanning
all the SDGs.
Agenda 2030 should ensure state and non-state actors attach greater
priority to inclusive education for children with disabilities, especially
as the SDGs enjoy significant global support due to the participatory
process which generated them and their broad transformative agenda
(Fukuda-Parr, 2016; Stevens and Kanie, 2016). Indeed, there is already
evidence that this is happening (UNESCO, 2020). However, education
actors will need to convert strengthened commitments into practical
action.

* Corresponding author.
E-mail addresses: glefanu@sightsavers.org (G. Le Fanu), eschmidt@sightsavers.org (E. Schmidt), bvirendrakumar@sightsavers.org (B. Virendrakumar).

https://doi.org/10.1016/j.ijedudev.2022.102574
Received 9 August 2021; Received in revised form 29 January 2022; Accepted 25 February 2022
Available online 7 April 2022
0738-0593/© 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
G. Le Fanu et al.
This article discusses education provision for children with visual
impairments (WHO, 2007)1 in sub-Saharan Africa, a region composed of
46 countries with a total population of over a billion (World Bank,
2021b). Within the region, it has been estimated that there are 350,674
children aged 0–15 who are blind out of a global total of 1,025,260
(Burton et al., 2021). It is plausible that there are significantly more
children with low vision (Gilbert and Ellwein, 2008). This article as­
sesses the extent to which these children in selected contexts access
inclusive education and, in the light of this analysis, identifies ways in
which the international development community (IDC) can promote
such provision, drawing on the theoretical framework developed by
Mason et al. (2019). This framework critically examines the work of the
IDC and, in the light of this, identifies ways in which the IDC can more
productively engage with local partners and stakeholders to promote
culturally and contextually appropriate development that meets the
needs of these learners in all their diversity. Though focusing on children
with visual impairments, this article has broader relevance for other
children with disabilities who face similar challenges. Sub-Saharan Af­
rica has been selected as the area for study as, despite considerable
progress in recent years, it is the region with the lowest educational
enrolment, retention, and completion rates in the world (Harber, 2017).
In such circumstances, children with disabilities are likely to be
disproportionately disadvantaged and identifying ways of improving
this situation becomes essential.
2. Conceptualising inclusive education
While Agenda 2030 refers to inclusive education, it does not define
inclusive education. In this article, the conceptualisation of inclusive
education in General Comment 4 (GC4) on Article 24 of the Convention
on the Rights of Persons with Disabilities (UN, 2016) has therefore been
adopted. According to GC4, children with disabilities need to access a
continuum of educational support, extending from early childhood
development delivered in homes and communities through to primary,
secondary, and tertiary education. Once enrolled in formal education,
these children should be taught in “regular learning environments” (ibid,
p. 7) – that is, learn alongside their fully-sighted peers in local com­
munity schools and other mainstream centres of learning rather than,
say, special schools. This provision should reflect a “whole person
approach” and be responsive “to different strengths, requirements and
learning styles” (p. 5). It should be delivered in supportive environments
in which “all members of the community are welcomed equally, with
respect to (the different types of) diversity” (p. 5) and which are phys­
ically accessible – for instance, are easily navigable, adequately illumi­
nated, and sufficiently sound-proofed (so students can hear as clearly as
possible and are not distracted by external stimuli). Every aspect of this
provision should be directed towards maximising “the development of
the personality, talents and creativity of persons with disabilities” (p. 7)
and “the full and equal participation of persons with disabilities in so­
ciety” (p. 16). GC4 therefore conceptualises inclusive education longi­
tudinally (in terms of its duration), locationally (in terms of the sites in
which it is delivered), pedagogically (in terms of the quality of learning
opportunities), environmentally (in terms of social inclusiveness and
physically accessibility), and consequentially (in terms of resulting
1
For WHO, the term children with visual impairments covers both children
who are blind and children with low vision. The former have a visual acuity of
3/60 or worse, or a corresponding field loss to less than 10˚in the better eye
with best possible correction, while the latter have a visual acuity of less than
6/18 but equal to or better than 3/60, or a corresponding visual field loss to less
than 20◦ in the better eye with the best possible correction. A significant mi­
nority of these children have additional disabilities – for instance, have dual
sensory loss or a cognitive impairment. We have also included children with
unadjusted refractive error in this category as, denied appropriate refraction,
they are effectively disabled.
2
International Journal of Educational Development 91 (2022) 102574
educational and social outcomes).2
The discussion of pedagogical inclusion is particularly rich in GC4
and has significant implications for the education of children with visual
impairments. According to GC4, teachers should employ “reasonable
accommodations” (UN, 2016, p. 2) – simple, contextually-appropriate
teaching and learning adaptations responsive to the needs of children
with disabilities. In the case of children with visual impairments, these
accommodations can include teachers adapting tasks (for instance,
through reducing the amount of reading involved) and promoting
cooperative learning (in which children support one another’s learning)
(Mason and McCall, 1997; Le Fanu et al., 2018; McLinden et al., 2020).
Self-evidently, these learner-friendly accommodations will often be
helpful for other students. Secondly, teachers and other staff can provide
necessary “continuous personalised support” (UN, 2016, p. 23). In the
case of children with visual impairments, this support can take various
forms, including orientation and mobility instruction, braille tuition,
and daily living skills training – a spectrum of provision that not only
enables these children to succeed academically, but participate in a full
range of school and community activities. Thirdly, children with dis­
abilities should access necessary assistive technology. For children with
low vision, this technology can include optical aids, such as spectacles,
and non-optical aids, such as reading-stands and thick-tipped pens. For
children who are blind, severely visually impaired, or have progressive
eye conditions, this technology can include braille writing equipment
and reading materials. Such assistive technology and associated per­
sonalised support in turn enables students with visual impairments to
access “alternative modes…and formats of communication” (p. 11),
namely braille and large print – another stipulation of GC4. Finally,
curricula should “be adapted to meet the needs of all children” (p. 24) –
for instance, broadened to include the types of specialist tuition and
training listed above.
Implicit in the pedagogical prescriptions of General Comment 4 is a
set of assumptions about the educational needs of children with dis­
abilities, including children with visual impairments. On the one hand,
GC4 recognises these children have the same sets of needs as other
children due to their shared humanity and experience of being in the
world. Like other children, they therefore benefit from learning in
stimulating environments in which they are treated with respect and
consideration. On the other hand, GC4 recognises these children have
accentuated or even additional requirements due to the impact of their
impairments on their functioning, along with other people’s non-
productive responses to their impairments, such as teasing and
bullying, social segregation, and over-protective parenting. In the case
of children with visual impairments, children who are blind need to be
provided with systematic and extended opportunities to learn through
their non-visual pathways, and children with low vision similarly need
to be provided with learning opportunities that compensate for their
lack of sight while simultaneously providing them with opportunities to
utilise their residual vision (Mason and McCall, 1997; Le Fanu et al.,
2018; McLinden et al., 2020).
These requirements evolve during childhood. For instance, in early
childhood, children with visual impairments require the stimulation that
will enable them to bond with their primary caregivers despite the lack
of visual interaction, to explore the world despite the lack of visual in­
centives, and to acquire self-care skills despite the lack of opportunities
for visual imitation (Stone, 1997; Lynch et al., 2018). They also vary
between children. To provide one example, children with deafblindness
will require “activity based” education programmes delivered in “reac­
tive environments” that enable them to acquire the capacities to “inte­
grate sensory input” and “use information to solve problems” (Knoors
and Vervloed, 2003, p. 24).
2
These are the authors’ terms, not terms used in General Comment 4.
G. Le Fanu et al.
3. Methodology
The research question was: to what extent are children with visual
impairments in selected sub-Saharan Africa contexts able to access in­
clusive education as conceptualised in General Comment 4 on Article 24
of the Convention on the Rights of Persons with Disabilities?
3.1. The panoramic perspective
To answer this question, we sought to obtain a panoramic ‘bird’s eye’
picture of educational realities for children with visual impairments in
selected sub-Saharan African countries.
Accordingly, we analysed quantitative data collected through the
Education Management Information Systems (EMISs) of 11 countries:
Cameroon, Ghana, Kenya, Liberia, Malawi, Mali, Nigeria, Senegal, Si­
erra Leone, Uganda, and Zambia. These were all countries where
Sightsavers (the organisation for which we work) had established edu­
cation programmes and consequently developed close working re­
lationships with the Ministries of Education. Sightsavers programme
staff and, in two cases, consultants visited the ministries to collect the
data through a questionnaire, with responses being collected manually
in an Excel spreadsheet for ease of reference and analysis. These local
experts not only collected statistical data, but through engaging with
ministerial staff obtained supplementary information that helped con­
textualise the data.
The ministries were asked to provide data on the numbers of children
with visual impairments enrolled in regular schools, special schools, and
integrated schools. ‘Integrated schools’ are mainstream schools in which
children with disabilities are taught separately at least part of the time in
‘resource rooms’ or ‘units’. Such data – if reliable (collected uniformly)
and if valid (collected effectively) – would identify the proportion of
students with visual impairments in each country learning alongside
their peers in mainstream schools and thus locationally included in edu­
cation. The ministries were also asked to provide transition and
completion data across successive phases of education (pre-primary,
primary, and secondary), as such data would show the extent to which
these students were longitudinally included in education. Finally, the
ministries were asked to provide available data on education outcomes,
as this would provide some insight into the extent to which these stu­
dents were consequentially included in education. To better understand
educational realities for specific groups, we requested that the above
data be provided for girls and boys with visual impairments, children
with low vision, children who were blind, and children with visual im­
pairments and additional disabilities.
3.2. The grounded perspective
As well as obtaining a panoramic picture, we wanted to obtain a
grounded understanding of educational realities in selected schools.
Such an understanding would enable us to obtain a more nuanced un­
derstanding of the extent to which children were pedagogically and
environmentally included in specific contexts.3 It would also enable us to
identify the proximate factors shaping this provision, such as availability
of assistive technology and social norms and values. Having acquired
this understanding, we would be able to generate “theoretical proposi­
tions” (Yin, 2003, p. 10) about educational realities for children with
visual impairments in sub-Saharan Africa that could potentially be
tested in other sub-Saharan contexts and evaluated in the light of
broader bodies of data and information, and thus contribute to the
development of “scientific generalizations” (ibid).
We therefore carried out a literature review of published and un­
published case studies of education provision for children with visual
3
See introduction for an explanation of the terms locational, longitudinal,
pedagogical, environmental, and consequential inclusion.
3
International Journal of Educational Development 91 (2022) 102574
impairments in sub-Saharan Africa. These were identified through a
search strategy of electronic data bases and the websites of international
organisations, using the keyword ‘Africa’ in combination with thematic
terms such as education, disability, inclusion, and visual impairment
and restricting our search to studies written between 2010 and 2021.
Once identified, the studies were assessed in terms of the depth and
relevance of the study coverage and their methodological quality (see
discussion below). Sixteen studies were considered valuable for the
analysis – ten articles published in peer-reviewed scientific journals,
three organisational reports, and three dissertations. A coding frame was
then developed which included the categories and sub-categories for the
analysis along with their associated definitions – for instance, ‘braille
writing equipment’ was identified as a sub-category of ‘assistive tech­
nology’. A step model of deductive category application was then
employed to identify patterns within the data. According to Kohlbacher
(2006), the advantage of this method is that it “synthesise(s) openness –
as claimed by the qualitative research paradigm – and theory-guided
investigation…usually demanded by the hypothetical-deductive para­
digm” (p. 25).
The case studies were set in Botswana (Shumba and Abosi, 2011;
Habulezi and Phasha, 2012; Habulezi, Batsalelwang, and Malatsi, 2017),
Ghana (Gregorius, 2016; Asamoah et al., 2018), Lesotho (Ralejoe,
2021), Namibia (Human, 2010), Nigeria (Brydges and Mkandawire,
2017), Senegal (Ceralli, 2019), Malawi (Lynch, Lund, and Massah,
2014), Malawi and Zambia (Verngård, 2019), South Africa (Fish-­
Hodgson and Khumalo, 2015; Morelle, 2016; Morelle and Tabane,
2019), and Tanzania (Miles, Westbrook, and Croft, 2018; Mmbaga and
Kisenha, 2018). The studies analysed education provision in individual
schools, clusters of schools, and, in one case, across a country (Fish-­
Hodgson and Khumalo, 2015). Some of the studies focused on main­
stream schools, some compared mainstream with segregated provision,
and others focused on special schools only. Some discussed primary
schooling, some secondary, and some both. Three of the studies focused
on specific groups of children with visual impairments – children with
albinism (Lynch et al., 2014) and children with deafblindness (Mmbaga
and Kisenha, 2018; Verngård, 2019).
In 13 of the 16 studies, the researchers collected data from diverse
sources, enabling “data source triangulation” (Hammersley and Atkin­
son, 1995, p. 230), and through multiple methods, enabling “method­
ological triangulation” (Cohen et al., 2000, p. 113). These methods
included document analysis, questionnaires, semi-structured interviews,
focus group discussions, and school and classroom-based observation.
As a result, the researchers were able to study selected issues in depth,
openness, and detail, as they identified and attempted to understand the
categories of information that emerged from the data (Lister et al.,
2001). The other three case studies were based on in-depth interviews
with students with visual impairments which enabled the researchers to
“understand the world as seen by the respondents” (Patton, 2014, p. 21).
12 of the studies were authored or co-authored by African scholars who,
through combining their scientific expertise with insider understanding,
were particularly well-placed to grasp “the cultural and linguistic
complexities of given phenomena” (McNess et al., 2013, p. 4).
4. Results
4.1. The panoramic perspective
4.1.1. The EMIS data
Eight of the 11 Ministries of Education provided sex-disaggregated
data for primary enrolment. The other three countries (Cameroon,
Nigeria, and Sierra Leone) did not provide any enrolment data. As
outlined in Table 1, the data showed disproportionately small numbers
of girls enrolled in primary education in five of the eight countries. In
these five countries, the Gender Parity Index for children with visual
impairments (GPI-VI) – the ratio of girls to boys in education – was
significantly less than 1.00 and in two of them less than 0.5. In these
G. Le Fanu et al. International Journal of Educational Development 91 (2022) 102574

Table 1
Primary enrolment figures and comparative GPIs for children with visual impairments in selected sub-Saharan countries (Source: EMIS data provided by Ministries of
Education in 2019 and World Bank, 2021d).
Ghana Kenya Liberia Malawi Mali Senegal Uganda Zambia

Boys 214 6390 488 17789 125 105 24790 5004

Girls 133 5746 429 17843 127 113 12002 2300
Total 347 12136 917 35632 252 218 36792 7304
GPI-VI 0.62 0.90 0.88 1.00 1.02 1.08 0.48 0.46
GPIa 1.02 1.00 0.99 1.03 0.90 1.15 1.03 1.02
a
Global primary GPIs were provided for the following years: Ghana (2020); Kenya (2016); Liberia (2017); Malawi (2019); Mali (2018); Senegal (2020); Uganda
(2107); and Zambia (2017). See World Bank (2021d).

countries, the GP-VI was also significantly lower than the ‘global’ GPI – (World Bank, 2021e).
the GPI for all the students in the country (World Bank, 2021d). The data showed large numbers of children were enrolled in primary
While the data indicated that girls with visual impairments were special schools in Kenya (2,419 out of a total of 12,136), Uganda (3,680
disproportionately excluded from primary schooling in certain coun­ out of 36,792), and Zambia (1,094 out of 7,304). While the numbers of
tries, the data should be treated with caution. Specifically, the data for children enrolled in secondary special schools were significantly lower
Ghana only covered children who were blind and enrolled in special in Kenya and Uganda, the number remained high in Zambia (1,038 out
schools, the data for Mali only covered students enrolled in special of 3,137).
schools, the data for Senegal only covered students enrolled in main­ Even if the data had been more comprehensive, the data would have
stream schools, and the data for Zambia only covered children enrolled been of questionable reliability and validity due to the fragility of EMISs
in special and integrated schools. in the countries studied. In the case of Kenya, the Ministry of Education
Six countries provided data on the total number of children enrolled reported that some staff lacked the IT skills to enter data correctly. The
in both primary and secondary education. As Table 2 shows, the data Ministry also reported that head teachers sometimes exaggerated the
indicated that large proportions of children with visual impairments in number of children with disabilities in their schools to collect enhanced
four of these six countries were not transiting from primary to secondary capitation allowances. Even if data-collection systems had been stron­
education. While relatively large proportions of the total number of ger, the data would have been problematic due to conceptual and
students with visual impairments were enrolled in secondary education operational difficulties in defining and measuring visual impairment
in Ghana and Zambia (47.7% and 30% respectively), the percentages and associated terms such as blindness and low vision (Loeb et al.,
were much lower for Kenya (5.3%), Liberia (13.8%), Malawi (8.5%), 2018).
and Uganda (9.2%). It might seem the figures for the latter countries
should have been much higher, given their global progression to sec­ 4.1.2. Findings from other data sets
ondary school rates of 99%, 80%, 86%, and 59% respectively (World Wodon et al. (2019) provide an alternative picture of educational
Bank, 2021c).4 Again, though, the EMIS data should be treated with realities for children with visual impairments in sub-Saharan Africa.
caution. The primary and secondary data from Ghana only included Analysing the most recent census data from 13 countries,5 they found
students who were blind and enrolled in special schools. The primary that there was a significant ‘disability gap’ between children with visual
and secondary education data from Zambia only included students in impairments and their non-disabled peers. Children with visual im­
special and integrated schools, as is the case for the secondary data from pairments were less likely than their peers to ever enrol in education, to
Kenya. It is plausible that significant numbers of children in Kenya and complete a full course of primary education, and to be perceived as
Zambia were not dropping out of education when they graduated from literate (see Table 3). Wodon et al. also found that girls with visual
special and integrated primary schools but enrolling in mainstream impairments were less likely than boys to enrol in school, although more
secondary schools. likely to complete a full course of primary education and be perceived as
Enrolment data for secondary education were not disaggregated by literate (again, see Table 3). Compared to EMIS data, census data can
sex for Malawi and Kenya, but in the other four countries the secondary
Gender Parity Index for children with visual impairments (GPI-VI) was
very low – 0.70 for Ghana, 0.81 for Liberia, 0.76 for Uganda, and 0.32 Table 3
for Zambia. These GPIs contrast with global GPIs for these countries of Disability Gaps between Children with Visual Impairments and Children without
1.00 (2020), 0.77 (2015), 0.79 (2007), and 0.6 (1988) respectively Disabilities in sub-Saharan Africa (%) (Source: Wodon et al., 2019) Sample: 13
sub-Saharan Africa countries.
No disability Visual impairment Gap
Table 2
Ever enrolled (12 years old)
Numbers of children with visual impairments enrolled in primary and secondary Boys 76.0 70.6 5.4
education according to EMIS data (Source: EMIS data provided by Ministries of Girls 74.4 69.8 4.6
Education in 2019). Primary completed (16 years old)
Boys 50.3 46.2 4.1
Ghana Kenya Liberia Malawi Uganda Zambia
Girls 48.8 49.3 -0.5
Primary 347 12136 917 35632 36792 7304 Perceived as literate (12 years old)
education Boys 62.2 56.8 5.4
Secondary 316 680 147 3326 3709 3137 Girls 62.1 60.1 2.0
education
Total 663 12816 1064 38958 40501 10441
% in sec.ed. 47.7 5.3 13.8 8.5 9.2 30

4
Global secondary progression rates were provided for the following years:
Kenya (2015); Liberia (2016); Malawi (2011); and Uganda (2016).
5
Census data were analysed for the following countries and years: Benin
2013; Burkina Faso 2006; Ethiopia 2007; Ghana 2010; Kenya 2009; Liberia
2008; Malawi 2008; Mali 2009; Mozambique 2007; Senegal 2012; South Africa
2011; South Sudan 2008; Zambia 2010.

4
G. Le Fanu et al.
potentially provide a more comprehensive overview of education re­
alities for children with visual impairments because data are collected at
the population level and from a representative sample of households.
For the same reason, census data can potentially enable comparisons
between children with visual impairments and other children. Never­
theless, Wodon et al. note the findings should be treated with caution.
For instance, some of the census data were over 10 years old, censuses
tend to underestimate the number of children with visual impairments,
and it is likely inconsistent methods were used to identify children with
visual impairments.
Census data also enable comparisons to be made between different
age-groups as data are obtained on all household members. Wodon et al.
were therefore able to establish that the educational situation for chil­
dren with visual impairments had significantly improved in recent de­
cades in terms of primary enrolment, primary completion, and
acquisition of literacy. They also found the gains for girls were partic­
ularly striking – for instance, while boys with visual impairments were
now 5.2% points more likely to complete a full course of education, girls
with visual impairments were 17.9% points more likely to do so. How­
ever, Wodon et al. concluded that, despite these improvements, the
disability gap between children with visual impairments and children
without disabilities had not lessened over this period.
Comparing data for children with visual impairments with data for
other children with disabilities, Wodon et al. concluded that children
with visual impairments in these countries were generally faring better
in education than other children with disabilities. An analysis of data
collected by Multiple Indicator Cluster Surveys in eight African coun­
tries between 2017 and 2019 found enrolment rates for children with
sight loss and children with hearing loss were equivalent to those of non-
disabled children – in contrast to children with intellectual impairments
and children with multiple disabilities (Zhang and Holden, 2022).
However, the authors note that sample sizes for specific disability types
were very small and did not include any children who were blind or deaf
(who might plausibly be considered more likely to be excluded from
education).
4.2. The grounded perspective
According to General Comment 4, pedagogical inclusion requires
reasonable accommodation, personalised support, responsive curricula,
and access to assistive technology and alternative modes and formats of
communication (as required). To be environmentally inclusive, schools
must be socially supportive and physical accessible (see introduction).
4.2.1. Reasonable accommodation
Observing classrooms in primary schools in Tanzania, Miles et al.
(2018) found that experienced teachers adopted various accommoda­
tions to meet the requirements of students with visual impairments, such
as producing learning materials in different fonts and writing in large
print on the blackboard. The teachers also adopted generic
child-friendly strategies such as using real life objects to explain abstract
concepts, “patient repetition” (p. 78), and “step by step instruction” (p.
78). However, these approaches were not adopted by all the teachers in
the study. The authors also noted the teachers’ practice was constrained
by material barriers (such as large classes and shortage of instructional
resources) and non-material barriers (such as time-tabling arrangements
and over-crowded curricula). In Lesotho, teachers slowed the pace of
lessons to better explain complex concepts to students with visual im­
pairments – something appreciated by other learners facing similar
challenges but resented by those who felt it compromised their exami­
nation preparations (Ralejoe, 2021). In contrast, students in South Af­
rica (Morelle and Tabane, 2019) and Nigeria (Brydges and Mkandawire,
2017) reported their teachers ignored their needs – for instance, did not
relay what they had written on the board. Due to lack of teacher
expertise and specialist resources, three studies reported secondary
students had little or no access to science and mathematics (Human,
5
International Journal of Educational Development 91 (2022) 102574
2010; Brydges and Mkandawire, 2017; Habulezi et al., 2017) – subjects
that can be particularly challenging for students with visual impair­
ments as they not only theorise about visual phenomena, but represent
these theories visually in diagrams, graphs, illustrations, tables, and
symbols. In Namibia and Lesotho, students did not participate in sports
for the same reasons.
4.2.2. Personalised support
In Ghana (Asamoah et al., 2018), Nigeria (Brydges and Mkandawire,
2017), and South Africa (Morelle and Tabane, 2019), students with vi­
sual impairments reported they received little or no individualised
support from their teachers in the classroom. Instead, teachers delegated
this responsibility to other students who either refused to provide this
support or provided it inexpertly and grudgingly. By contrast, Ceralli
(2019) reported successful examples of cooperative learning in primary
schools in Senegal. Some of the Senegalese teachers also voluntarily
gave up their spare time to provide students with braille tuition and
orientation and mobility training, thus enabling them to access an
expanded curriculum. In Tanzania, teaching assistants (whose salaries
were covered by an international NGO) supported children with deaf­
blindness in school and at home, enabling these students to access an
expanded curriculum (Mmbaga and Kisenha, 2018). As a result, these
children became more secure and self-confident, more aware of them­
selves and their environment, and acquired various sets of skills,
including fine and gross motor skills, daily living skills, and communi­
cation skills.
4.2.3. Assistive technology
Shortages of assistive technology were noted in several case studies.
In Nigeria, the students had to purchase their own braille writing
equipment (Brydges and Mkandawire, 2017). In South Africa, it was
reported that no specialist equipment was available from the local ed­
ucation authority (Morelle, 2016). In a secondary school in Botswana,
students accessed sophisticated equipment (closed circuit televisions,
tape recorders, electronic braillers), but there was a shortage of white
canes necessary for orientation and mobility instruction (Habulezi and
Phasha, 2012). In another secondary school in Botswana, lack of
specialist resources was attributed to bureaucratic mismanagement at
different levels of the education system rather than lack of funds, as was
the school’s inability to provide students with appropriately worded and
formatted examination papers (Habulezi et al., 2017). Even though the
schools in Senegal were comparatively well-provisioned due to funding
from an international NGO, the students were unable to access full sets
of braille textbooks (Ceralli, 2019), presumably due to the logistical
challenges of transcribing material from print to braille. In their study of
students with albinism in Malawi, Lynch et al. (2014) found that only
three of the 60 students with albinism in their study had received pre­
scribed spectacles. Lynch et al. also found that these children suffered
from lack of wide-brimmed hats to protect them from the sun. Denied
their own class readers, they had to peer over the shoulders of their
classmates to read shared texts – a problematic task given their visual
acuities and lack of access to refraction.
4.2.4. Accessibility
Social attitudes and practices varied considerably between and
within the schools. In several case studies, it was reported students with
visual impairments were not only socially isolated but sometimes bullied
by other students who exploited their lack of sight – for instance, by
stealing from them (Human, 2010; Brydges and Mkandawire, 2017;
Asamoah et al., 2018; Verngård, 2019). By contrast, the fully sighted
students in Senegal not only enthusiastically provided classroom assis­
tance, but accompanied their classmates to and from school, acting as
their sighted guides. In Tanzania, it was reported that the children with
deafblindness and their peers played together and had started to develop
friendships (Mmbaga and Kisenha, 2018). Schools also varied in terms of
their physical accessibility. In Senegal, staff and students removed
G. Le Fanu et al.
obstacles and hazards from classrooms and grounds, enabling students
with visual impairments to navigate school environments with greater
ease and freedom. Efforts were also made to reduce noise in and around
classrooms to allow these students (and others) to effectively utilise their
sense of hearing. However, Verngård (2019) found classrooms in
Malawi and Zambia were inimical to learning, particularly for students
with sensory impairments, due to glaring sunlight, faded blackboards,
and metal roofs that amplified the sound of rain. In Namibia, South
Africa, and Lesotho, the children felt physically endangered when
travelling around their schools (Human, 2010; Morelle and Tabane,
2019; Ralejoe, 2021).
4.2.5. Mainstream compared with segregated provision
The analyses of mainstream schools can be contrasted with those of
more segregated forms of provision. When interviewed by Gregorius
(2016), former and current special school students in Ghana reported
their schools were havens that had assisted them to develop feelings of
self-acceptance and self-worth. This was not only because they believed
they had received a sound academic education and acquired valuable
skills (for instance, braille literacy), but because they felt they had
generally been treated with respect and consideration by the staff. They
also appreciated the feeling of social solidarity engendered by learning
alongside other children with visual impairments. Gregorius contrasts
the largely positive experiences of these students with the more negative
experiences reported by students enrolled in mainstream schools.
However, other studies raise serious concerns about special schooling in
sub-Saharan Africa. Assessing the 22 special schools enrolling children
with visual impairments in South Africa, Fish-Hodgson and Khumalo
(2015, p. 12) reported a “range of pressing infrastructural, resource and
curriculum-based issues”. They also highlighted the safeguarding risks
associated with residential special school provision, particularly when it
is poorly resourced, maintained, and monitored. When a sample of
children with visual impairments enrolled in special schools in Botswana
completed a questionnaire, the majority reported they had not only been
required to carry out domestic chores for their teachers, but had been
sexually, physically, and emotionally abused by them (Shumba and
Abosi, 2011). In Malawi, parents chose to send children with albinism to
residential resource centres because of concerns about their safety
(Lynch et al., 2014). (See analyses of social attitudes and practices to­
wards children with albinism in southern African countries by Baker
et al., 2010, Mswela, 2017, and Franklin et al., 2018.) Unfortunately,
once enrolled in the centres, these children were unnecessarily taught to
read and write braille rather than print. In this case, parents prioritised
social protection over locational inclusion and at the expense of peda­
gogical inclusion.
5. Discussion and conclusion
Through analysing statistical data (including EMIS data provided by
Ministries of Education), we endeavoured to obtain an overview of the
educational situation for children with visual impairments in selected
sub-Saharan African countries (‘the panoramic perspective’). Through
analysing case studies of education provision in various countries, we
endeavoured to obtain a more granular picture of educational realities in
specific settings (‘the grounded perspective’).
5.1. Reviewing the evidence
5.1.1. Reviewing the quantitative evidence
EMIS data showed fewer girls than boys recorded as enrolled in
primary and secondary education in selected countries, as well as
disproportionately small numbers of children recorded as enrolled in
secondary as opposed to primary education. In three Anglophone
countries, large numbers of children were enrolled in special primary
schools. However, as discussed, the data were not comprehensive and
lacked reliability and validity. Census data from 13 countries indicated
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International Journal of Educational Development 91 (2022) 102574
children with visual impairments were less likely than their peers to
enrol in school and, if enrolled, to leave primary school early and ach­
ieve poor education outcomes. While girls were less likely than boy to
enrol in education, they generally fared better once enrolled. Here again
though, the data should be treated with caution.
If EMISs across sub-Saharan Africa were strengthened so they
collected data that were reliable, valid, and comprehensive it would be
possible to draw firmer conclusions about the educational situation for
children with visual impairments, disaggregated by sex and severity of
impairment. If EMISs collected other types of disability data – such as
data on school facilities and resources – it would be possible to identify
factors impacting on educational access and quality for these children.
Analytic comparisons could be made both within countries and between
countries with the above data. If more national surveys were carried out,
such as the recent Multiple Indicator Cluster Surveys in eight African
countries (Zhang and Holden, 2022) but this time with adequate sample
sizes for disability types, it would be possible to identify the percentages
of children with visual impairments enrolled in education and, again,
make comparisons with other demographic groups and between and
within countries. If other forms of high-quality evidence-generation
were carried out in these countries, including qualitative research, it
would be possible to carry out mixed methods national case studies that
synthesised different data sets (see discussion below).
5.1.2. Reviewing the qualitative evidence
As well as analysing statistical data, we carried out a literature re­
view of 16 case studies of education provision from ten countries to
identify recurring themes. Several studies identified examples of good
practice and highlighted the creativity and commitment of local stake­
holders. However, 14 of the studies raised serious concerns about the
quality of education provision. (The sets of schools in the other two
studies had received significant financial and technical assistance from
international NGOs.) In these studies, children with visual impairments
did not access the multiply-inclusive education to which they are enti­
tled according to the Convention on the Rights of Persons with Dis­
abilities – an education that is pedagogically, environmentally, and
consequentially, as well as longitudinally and locationally, inclusive (see
introduction).
Collectively, the case studies reviewed in this article identified
various ‘micro’ factors directly impacting on education provision for
children with visual impairments. These included demoralised and
under-prepared staff, high student-teacher ratios, ‘teaching to the test’,
constrained school budgets, antiquated school infrastructure, and
sometimes problematic social norms and values. The studies also
alluded to the broader ‘macro’ factors shaping the micro factors. These
included overly prescriptive curricula, summative assessment systems,
and poorly disseminated policy frameworks, sometimes lacking consis­
tency, specificity, and relevance. They also included the limited capacity
of under-funded government agencies working in challenging circum­
stances to provide schools and communities with the necessary services
and resources. Similar factors may impact on education provision for
children with visual impairments elsewhere in the region due to the
fragility of education systems in many sub-Saharan African countries
(Harber, 2017), but it is not possible to make generalisations until the
necessary research has been carried out (see previous section).
5.2. Addressing the challenge of inclusion
How can the international development community best promote
inclusive education for children with disabilities, including children
with visual impairments, in challenging sub-Saharan contexts? Drawing
on the theoretical framework developed by Mason et al. (2019), we
argue this is only possible if development actors recognise the diverse,
holistic, and evolving needs of children with visual impairments and
respond in contextually sensitive ways. Mason et al. point out that this
sort of development approach is likely to prove far more effective than
G. Le Fanu et al.
its polar-opposite – the top-down imposition of rigid conceptualisations
of ‘best practice’. Moreover, this approach reflects an “ethic of respect”
(p. 6).
5.2.1. Recognising children’s needs
As discussed in the introduction to this article, children with visual
impairments, along with other children with disabilities, have the same
sets of needs as other children due to their shared humanity and expe­
rience of being in the world. Consequently, children with visual im­
pairments, like their fully sighted peers, need to access broad and
balanced curricula delivered in safe, supportive, and stimulating
learning environments. However, these children also have additional
and accentuated educational needs due to the impact of their impair­
ments on their functioning, along with people’s sometimes non-
productive responses to their impairments. As a result, they require
enhanced education provision in the form of reasonable accommoda­
tions, individualised support, assistive technology, and disability in­
clusive guidance and counselling. Before enrolling in school, they need
to be provided with the early childhood care and education that will
assist them to develop the various capacities that will enable them to
participate in formal education. The needs of some children with visual
impairments, such as children with deafblindness, are particularly
complex and only met through developmental curricula, at least initially
(Knoors and Vervloed, 2003).
To some extent the needs of children with visual impairments are
trans-contextual. All children who are blind need to be provided with
good quality opportunities to learn through their non-visual pathways.
For instance, they need to acquire orientation and mobility skills to
navigate environments and master braille or some other tactile system to
become literate. Similar generalisations can be made about children
with low vision. However, the precise forms these needs take may vary
according to context, as may their significance. For instance, children
living in urban and rural areas face contrasting orientation and mobility
challenges, and braille users living in predominantly oral cultures (in
which little or no information is available in braille) must possess the
skills to engage with these cultures. While being sensitive to context,
development actors should critically engage with contexts, as ‘estab­
lished practices’ may stigmatise and discriminate against children with
disabilities through limiting their curricular options or excluding them
from mainstream education. Furthermore, contexts are fluid. For
instance, while many children in sub-Saharan Africa at present have
little or no access to ICT, they are likely to have increased access to
Smartphones, E-readers, and even computers with refreshable braille
displays as they grow older.
5.2.2. Responding to children’s needs
Since the adoption of the Paris Declaration in 2005, national gov­
ernments have increasingly adopted education sector plans (ESPs)
(Bissio, 2013). These plans, five to ten years in duration, are developed
by Ministries of Education in consultation with relevant agencies from
other ministries, civil society organisations, and development partners.
ESPs potentially provide opportunities for incorporating disability in­
clusion perspectives in long-term, system-strengthening programmes.
Unfortunately, large development agencies have sometimes exerted
disproportionate influence over ESP processes at the expense of local
actors (Mundy et al., 2010; Winther-Schmidt, 2011; Bissio, 2013),
leading to the uncritical transfer of policy and practice. In the field of
inclusive education, there is a danger that this will result in the
wholesale acceptance of universal design for learning (UDL), an
approach developed in the United States and endorsed by USAID (USAID
Liberia, 2020; USAID Bangladesh, 2021) and the World Bank (2021a).
UDL requires teachers to provide children with “multiple means of
engagement…representation (and) expression” (Hayes et al., 2018, p. 5)
and, given these demands, is likely to prove infeasible in resource-poor
education settings, unless modified and combined with ‘home-grown’
approaches. Similarly, Ministries of Education in sub-Saharan Africa are
7
International Journal of Educational Development 91 (2022) 102574
increasingly expected to collect disability disaggregated data in line
with the requirements of Agenda 2030 – but their EMISs will only
perform this task effectively if they have the required capacity and local
stakeholders are convinced this process will result in enhanced educa­
tion provision for children with disabilities (Wicander, 2011; UNESCO
Institute for Statistics, 2019).
Among civil society organisations, organisations of people with dis­
abilities (OPDs) are particularly likely to be marginalised within ESP
processes due to disabling attitudes, practices, and environments and
their limited financial resources and technical capacities (Grischow,
2015; Deepak, 2018; Van den Brink et al., 2020). Additionally, OPDs,
particularly umbrella organisations of OPDs headquartered in capital
cities, can be internally divided, insufficiently consultative, and domi­
nated by people from certain impairment groups (ibid). Development
actors therefore need to find ways of ensuring local stakeholders,
particularly people with disabilities, are provided with meaningful op­
portunities to contribute to the development, implementation, and
subsequent review and revision of ESPs. They also need to assist OPDs to
expand their capacities and networks so they can participate effectively
in these processes.
Given the increased focus on education sector plans, there is a danger
that development actors will prioritise large sector-wide programmes
aligned with ESPs at the expense of small-scale projects (Samoff, 2004).
This would be counter-productive, as the latter can be highly effective if
they have clear aims and objectives, are grounded in analyses of specific
situations, are owned by local stakeholders, respond flexibly to changing
circumstances, and pilot innovations that can be scaled up beyond the
project area (ibid). Lynch et al. (2018) have described an early childhood
care and education project in Malawi that possessed these qualities. At
the start of the initiative, participants identified simple ways in which
caregivers (predominantly mothers) could bond with their children and
stimulate their development. Age-appropriate, illustrated cards in En­
glish and Chichewa were then produced, describing these activities.
After receiving a short training, community workers visited the care­
givers to share information about the child, discuss possible activities,
model them for the caregivers, and jointly identify a small number of
activities for the caregivers to try out between visits. The caregivers
were then given cards to use at home, along with low-cost local­
ly-sourced toys, to carry out agreed communication and play activities –
for example, a rattle to increase a child’s ability to stretch their arms and
reach for objects. Post-intervention, the caregivers reported that they
had stronger relationships with their children, they were more willing to
let them go outside to play, and they were more positive about their
future. It was also reported that social attitudes had improved because of
the increased visibility of the children in communities.
The training package developed by Lynch et al. posits young children
with visual impairments have multi-layered needs that can only be met
through structured, play-based interactions with their primary care­
givers in safe and supportive environments. Many of the approaches in
their package were adapted from Care for Development (WHO, 2012), a
training package developed for use in a wide variety of contexts with
parents of both disabled and non-disabled children. This indicates that
contextually sensitive educational approaches do not need to be con­
textually specific: approaches effective in one context may be effective
in other contexts, given similarities between these contexts and the
needs of children, although sometimes these approaches may need to be
modified.
As previously discussed, General Comment 4 on Article 24 of the
Convention on the Rights of Persons with Disabilities states that children
with disabilities should study in mainstream classes alongside their
peers throughout their education. Interviewed by Verngård (2019),
stakeholders in Malawi and Zambia expressed contrary views, stressing
the potential benefits of integrated education in which selected children
receive time-limited specialist instruction (such as braille tuition) in the
quieter, more educationally conducive environments of resource rooms
within mainstream schools. They pointed out such provision, if it were
G. Le Fanu et al.
of good quality, would ensure the children acquired the specialist skills
(such as braille literacy) to succeed in these schools. In short, they
believed integrated education enabled rather than impeded inclusive
education. This tension between rights-based global prescription and
local preferences based on situated understanding shows the need for
conceptualisations of inclusive education to be responsive to local re­
alities and the real life needs of children with disabilities – an approach
that has been termed “grounded inclusionism” (Le Fanu, 2013, p. 40). It
is harder to justify special schooling for children with visual impair­
ments, particularly if it is residential, as it is a highly segregatory and
comparatively expensive form of provision (Myers, 2016). However,
there is evidence that these institutions sometimes provide more sup­
portive and accommodative learning environments for children with
visual impairments than their mainstream alternatives (Gregorius,
2016) and are therefore more inclusive in certain respects.
5.3. Implications for the international development community
To adopt a person-centred, context-sensitive approach, development
actors need to critique discourses which underestimate or exaggerate the
complexity of the educational needs of children with disabilities, and
therefore either advocate ‘one size fits all’ or unnecessarily segregated
and specialist education provision. They also need to critique discourses
that advocate universalistic approaches to educational development and
consequently disregard context and culture. Furthermore, they need to
critically engage with development modalities that reinforce the above
discourses through excluding local stakeholders, especially persons with
disabilities, from development processes. This in turn requires radical
structural change to rectify “the inequalities in knowledge, infrastruc­
ture and resources (that) need to be addressed to secure the capabilities
for respectful dialogue between partners” (Mason et al., 2019, p. 7).
Such engagement also requires a philosophical sea-change – a willing­
ness by these actors to recognise the complexity of development con­
texts, their uncertain understanding of these contexts, and the value of
local knowledge, including the situated, often tacit, knowledge of
practising teachers and other community members (McGrath and King,
2004). Finally, development actors need to engage with development
contexts through providing increased, sustained, and targeted donor
assistance (The Economist, 2021). These contexts have become
increasingly challenging in sub-Saharan Africa as debt-burdened gov­
ernments have struggled to meet the needs of increasing numbers of
students while coping with the impact of global warming, other envi­
ronmental threats, and the Covid-19 pandemic on education systems
(Cleland and Machiyama, 2017; International Monetary Fund, 2020;
The Economist, 2020). The pandemic has disproportionately affected
children with disabilities, as they have been slower to reenrol than other
students and, confined to their homes, have suffered high levels of stress,
violence, and neglect (Orsander et al., 2020).
These challenges must be addressed by the international develop­
ment community if children with visual impairments in sub-Saharan
Africa, along with other children with disabilities, are to enjoy inclu­
sive education of good quality as promised by the Convention on the
Rights of Persons with Disabilities and the Sustainable Development
Goals.
CRediT authorship contribution statement
Guy Le Fanu, Conceptualization, Methodology, Formal analysis,
Writing – original draft, Writing – review & editing, Elena Schmidt,
Conceptualization, Methodology, Formal analysis, Writing – review &
editing, Bhavisha Virendrakumar, Methodology, Formal analysis,
Writing – review & editing.
8
International Journal of Educational Development 91 (2022) 102574
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