Using Ripple Effects Mapping to translate an innovative service model for children with disabilities in Lusaka, Zambia.

OBJECTIVES

Describe the use and output from Ripple Effects Mapping, a participatory process to evaluate the impact of a program to decrease stigma toward children with disabilities (CWD) living with families in low-income compounds in Zambia.

STUDY

DESIGN

Participatory, group-based process that occurs at one time with retrospective reflection.

METHODS

In Dec. 2024, health facility staff, community partner staff, community outreach workers, women with CWD, and a pastor participated in Ripple Effects Mapping in Lusaka, Zambia. Participants interviewed each other using four open-ended questions, such as "Share a story or highlight a success that you had based on your involvement with Kusamala+. What did this lead to? How did it happen?" Real-time mind mapping was done while participants shared their interviews and additional written notes were added. Inductive analysis created preliminary themes that were validated by the participants. Using the Social Model of Disability and deductive analysis, the mind-maps were quantified across domains.

RESULTS

Briefly, 50% of the participant responses indicated improved access to education, 30% of the responses were related to decreased social isolation, 48% of responses indicated more services were available, and 19% indicated that there were improved policies and practices at the institutional level. The Ripple Effects Mind Map and the application to the Social Model of Disability revealed strong positive impacts due to Kusamala+.

CONCLUSIONS

Kusamala + had substantial positive impacts in the community and for families. Ripple Effects Mapping is an effective and adaptable tool to evaluate program impacts.