3 - Allied Health Professions

Development of disability services for underserved majority world countries

This case study describes the impact of research on the lives of people with speech, language and communication disabilities in Majority world countries.

Research by MMU’s Juliet Goldbart and Julie Marshall led to a Nuffield-funded mentoring project resulting in the first speech and language therapy-qualifying programme in East Africa.

Related research resulted in a model of service delivery in slum areas of Kolkata (Calcutta) that has been rolled out to 69 sites across the Greater Kolkata area.

Underpinning Research

Although people in the Majority World are disproportionately affected by disability, provision of healthcare and education is severely limited.

Findings from MMU research in India informed the development of a service delivery model.

Action research methods employed by MMU led to a culturally appropriate and sustainable model of service delivery.

In parallel Royal College of Speech and Language Therapy funded research, MMU showed that UK SLT programmes were not appropriate for students from countries with little history of SLT services.

Poor preparation and support meant that the number of students who returned home to take up SLT posts was extremely limited, despite government and third sector funding.

MMU helped establish the first SLT qualifying programme in East Africa. Julie Marshall devised mentoring support and guidance that has subsequently been Nuffield funded.

Key References

Marshall J., Goldbart, J. & Evans, I. (2004). International students of speech and language therapy in the UK: do we meet their needs? International Journal of Language and Communication Disorders 39(2): 269-284. DOI: 10.1007/s10734-004-6350-4.

Sen, R. & Goldbart, J.(2005). Partnership in Action: Introducing family-based intervention for children with disability in urban slums of Kolkata, India, International Journal of Disability, Development & Education, 52 (4), 275-311.

Wylie, K., McAllister, L., Davidson, B & Marshall, J. (2013) Changing practice: Implications of the World Report on Disability for responding to communication disability in underserved populations. International Journal of Speech Language Pathology 15(1), 1-13. DOI: 10.3109/17549507.2012.745164


The original action research project in five Kolkata slums has expanded and there is now 7 partners and 552 participants working in 69 slums helping 772 children and adults. The impact is growing outside Kolkata, with one corporate organisation providing services in two rural villages.

Marshall has been directly involved in planning East Africa’s first SLT programme, at Uganda’s Makerere University devising a mentoring scheme to provide support and guidance.

This project, Nuffield funded since 2011, provides training for graduates and SLTs working in Kenya as well as mentoring for university staff.

Two cohorts have graduated from the programme and are now working in Uganda, Kenya, Tanzania, Nigeria and Rwanda, adding significantly to the small numbers of SLTs in these countries.

People with communication disabilities and their family members have been empowered by involvement in the project’s advisory group and feature on the website.

Graduates from the Makerere SLT programme have developed the Association of Speech and Language Therapists in East Africa, and organised the Biennial East African Conference on Communication Disability, which in 2012 had representation from 16 countries.

DfID funding enabled Juliet Goldbart to develop a training course called “Learning About the World” that has been distributed by IICP since 1999. Goldbart has delivered training in West Bengal, Delhi, Mumbai, Mysore and Chennai.


Report from Association of Speech and Language Therapists in East Africa

RIHSC website with project profile

Julie Marshall profile

Juliet Goldbart profile