God’s Gift or Karma’s Curse? The Influence of Social Status on Social Constructs of Autism

Daw Aye Aye Pyone1, Nan Moe Kham2

1Department of Anthropology, Mandalay University, Myanmar, 2Social Policy & Poverty Research Group, , Myanmar

Globally, there has been a trend showing an increase in the reported prevalence of autism, with anecdotal evidence from Myanmar showing a higher reported prevalence of autism amongst wealthier families. However, definitions of autism are derived from societal norms for social functioning, which themselves are not only culturally embedded, but also highly dependent on broader contextual factors which shape expectations. This paper uses narrative research to explore how narratives are powerful agents in constructing and sustaining both the societal norms, and the epistemological framings of identity for those whose behaviour falls outside those norms. This illustrates not only a source of explanation for perceived higher prevalence rates of autism amongst wealthier families, but also highlights a continued source of inequalities, where powerful narratives in turn shape the given identities, and future possibilities, of children from different socio-economic backgrounds with non-neurotypical behaviour.


Daw Aye Aye Pyone has a particular research interest in the social construction of identity, including research with Zurich University on “Impact of bilingualism on language and identity of Pa-O people”. As a mother of a child with disabilities, she has strong personal as well as academic interest in how society constructs identity for children with autism.

Coordination Between Health and Rehabilitation Services in Bangladesh

Dr Wesley Pryor1, Dr Liem Nguyen1, Ms Fleur Smith1, Mr Rajib Hasan3, Mr Golam Mostafa2, Mr Faruk Jalal2, Dr Manjula Marella1

1Nossal Institute For Global Health, The University Of Melbourne, Melbourne, Australia, 2HI Bangladesh, Dhaka, Bangladesh, 3Jatiya Protibondhi Unnayan Foundation, Bangladesh

Coordination of care is a critical element of rehabilitation as it involves timely identification of the need; transfer of care between health and rehabilitation providers through effective information sharing and communication between providers and settings; flexible and adaptive care according the individual’s circumstances and needs; consistency; and establishing and maintaining a therapeutic relationship between the provider and individual. A mixed methods study involving a survey of 396 adult (18+ years) service users attending six Integrated Disability Service Centres (IDSCs) and key informant interviews with 19 key stakeholders and 19 service users of three IDSCs. Quantitative findings suggested there were delays with an average of around two years between experiencing a health problem and accessing rehabilitation. People with stroke and fractures tended to access rehabilitation earlier. Qualitative findings support survey findings with stakeholders acknowledging delays in timely referrals from health facilities to rehabilitation services. Referral pathways between medical and rehabilitation services is reported to be poor and not monitored. Awareness on the rehabilitation services provided through PSOSKs was generally poor among medical stakeholders. Misconceptions about rehabilitation in the communities, superstitious beliefs in traditional treatments, family caregivers’ role and location of services were highlighted as major factors affecting the coordination of care.



The Situation of People with Disabilities in the Laos PDR

Dr Manjula Marella1, Liem Nguyen1, Chandalin Vongvilay2, Donna Koolmees2, Alounny Keosouvanh2, Chantavad Nalesouphan2, Somphet Keovongxay2, Fleur Smith1, Alex Robinson1, Wesley Pryor1

1Nossal Institute For Global Health, The University Of Melbourne, Melbourne, Australia, 2World Education Laos, , Lao People’s Democratic Republic

Community Based Inclusive Development (CBID) projects are being implemented in two districts of the Lao PDR as part of the USAID Okard Activity, which is a five-year program to improve the lives of people with disabilities and their households. A baseline survey was undertaken in the two target districts (Xayphouthong and Kham) for the CBID project. A cross-sectional population-based household survey using a two-stage cluster random sampling was undertaken with 5,158 respondents from both districts. In addition, a qualitative study comprising key informant interviews and focus group discussions with key stakeholders, people with disabilities and their families and community members was undertaken. There are a significant proportion of people with disabilities in both districts with a prevalence of 13.3% in Kham and 9.9% in Xayphouthong districts. People with disabilities are more likely to be older, have lower living standards, have lower education levels, unemployed and have poorer health and wellbeing than people without disabilities. People with disabilities are less likely to participate in the communities and social gatherings and have poor access to services. Barriers to participation and accessing services can be largely attributed to negative attitudes in the community, lack of accessible services and means to travel to services.


Dr Manjula Marella is a Senior Research Fellow at the Nossal Institute for Global Health, The University of Melbourne. Her research interests are measurement of disability and its impact, evaluation of disability inclusive development programs and development and validation of client-reported outcome measures using qualitative and quantitative techniques.

Epistemic Communities in Health System Strengthening: Place-Based Research in Bali

Mr I Nyoman Sutarsa1

1Medical School, The Australian National University, Australia

Like any social institution, health systems place actors and people at the centre and are shaped by power dynamics that underlie societal interactions. Recognising how individuals, groups, organisations, and networks derive their power is critical to unpack how and why power flows in particular directions as well as how it might be used to promote equity-oriented health systems. Different expressions of power interact one another to shape political priorities and policy trajectories. Drawing from a 10-months place-based research in Bali Province, this paper presents the emergence of epistemic communities, interlinked and organised networks of local NGOs and academia, as key actors in the practice of health system strengthening. The paper raises the concern that these partnerships on one hand improve local research capacity and program implementation, but on the other hand are also an effective instrument for power acquisition to deploy control over the local research agenda, health systems programming and interventions. This paper examines how political capital can be enhanced through social networks, expertise and economic resources to navigate the direction of power flows. It argues that political capital as a dimension of power exertion is visible through collective actions to influence health systems and service delivery.


Mr I Nyoman Sutarsa is a Ph.D. scholar at the ANU Medical School examining health systems strengthening interventions in Indonesia.



The Asian Studies Association of Australia (ASAA) is the peak body of university experts and educators on Asia in Australia. Established in 1976, we promote and support the study of Asia in Australian universities and knowledge of Asia among the broader community. Our membership is drawn mainly from academics and students, but also includes industry and government Asia experts. We take a strong interest in promoting knowledge about Asia in schools and in contributing to state and Commonwealth government policies related to Asia. We provide informed comment on Asia to a broad public through our bulletin, Asian Currents, and specialist research articles in our journal, Asian Studies Review. Four book series published under our auspices cover Southeast Asia, South Asia, East Asia and Women in Asia.

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