A perspective from Bolivia on the implications of the World Report on Disability for people with communication disabilities

Abstract

Implications of the World Report on Disability for people with communication disabilities (PWCD), as described by Wylie, McAllister, Davidson, and Marshall (2013), include a drive for better demographic information, increased campaigning, and organizational change to improve speech-language pathology services. Qualitative data collected from PWCD and their families in Bolivia provide the baseline for this response. The benefits of collecting population survey information are recognized, but data reinforce the continued need to ensure a positive impact at caseload level. In a country where rhetoric is far removed from lived experience, the starting points for change are very different from those in Minority world countries. A supply and demand model is suggested as an equitable way of balancing efforts to overcome barriers to a better service. Knowledge and information are shown to be key in catalyzing the demand side for the service, while the importance of a solid evidence base for practice would help to improve supply. Although a warning against importing dominant Minority world models of service delivery is outlined by Wylie et al., findings from Bolivia support a more hybrid and nuanced approach that takes into account complex global influences of information flows, past and present.