Literature profiling on tourism, impairment and disability issues: A future directional guide

Background South African tourism is evolving towards accommodating disabled people. Within the same standpoint, the country receives ageing tourists as a major international tourism market from the Global North, whose access needs are similar to disabled people. The present article explored ‘blind and blank spots’ in the extant literature on tourism–impairment disability as a synchronised field within academic research to provide theoretical insights and gaps for the disability-tourism research community to consider the composite concept instead of individualistic concepts. Objective The objectives were: (1) to track knowledge development from 1990 to 2018 using a narrative literature review approach and (2) to justify future research areas previously overlooked and understudied within a tourism–impairments–disability perspective in South Africa and beyond. Method A narrative literature review search strategy was used. Keywords and synonymous terms were used in electronic searches of Scopus, ScienceDirect, Sabinet Online, Emerald Insights Journals, African Journals and Google Scholar. The literature screening process used predetermined inclusion and exclusion criteria for the data source. Content thematic analysis was adopted for the present study. Results The findings reflect a dearth of tourism–impairments–disability research in South Africa. Nonetheless, there is an observable pattern of slow growth in research after the 2000s. The extant literature is skewed towards the tourism supply side and sporadic on tourism demand (tourist experiences), education and skills development. Conclusions It is clear that the absence of scientifically developed knowledge on disability–impairments–tourism affects inclusive tourism growth. Therefore, the research community should consider disability-inclusive (accessible) tourism management, human resources and marketing practices and knowledge for teaching material in future research. Contribution The article mapped and provided insights that sets a research agenda for tourism research community to see the gaps in literature and/or knowledge for accessible tourism (disability-inclusive) tourism to be a game changer as found by UNWTO (2020) with low-resources setting. Thereby setting a tone towards call for more research that can uncover an economic narrative that shows a relationship between skills development, labour and consumer markets for the participation of diverse disabled persons as such is shown as understudied in Low-to-Middle income earning countries like South Africa.


Introduction
The Global North incepted activism and advocacy for disability inclusion through movements dating back to the 1970s (Nzo 2019). In the Global North, research and knowledge development in tourism began in the 1800s (Visser 2004). Nonetheless, tourism only began to be regarded in the academic research field in the 1970s in South Africa (La Fuente-Rodes et al. 2016;Adukaita et al. 2016;Booyens 2020). In the research space, the disability and tourism fields have been conducted separately in these past decades. This background draws attention to desktop research from 1990 to 2018, because it was a period: (1) covered by the primary study, of which the current article was an element and (2) when South Africa was positioned to be disability-inclusive through the Constitution of 1996, Chapter 2; the signing and ratification of the United Nations Convention for the Rights of Persons with Disabilities (UNCRPD) of 2006 in 2007; and the domestication of the said convention into a White Paper for Rights of Persons with Disabilities in 2015 (Kazou 2017). Despite the milestones mentioned above, disability, impairments (health and body conditions) and tourism as a joint field in research remained an area that was missing from the research agenda and the narratives and discourses (knowledge development) generated by scholars, universities (other higher education providers included) and research entities in South Africa.
According to Buhalis and Darcy (2013) and Darcy et al. (2020), impairment is the loss of limbs or parts of an individual body. On the one hand, disability has been an issue of debate amongst international, national organisations and individual academicians, of which researchers who are skewed towards medical models define disability as the inability of an individual to participate because of acquired impairment and health condition (Kazou 2017). On the other hand, disability researchers who uphold the social model's perspective regard disability as more about the interaction between persons with impairments' intrapersonal, interpersonal and environmental arrangements developed to solely cater to nondisabled counterparts (Vehmas & Watson 2014;. Simbaya et al. (2019) have an all-around interpretation of disability as an evolving concept that aims to facilitate full, optimal and effective participation of a disabled person without compromising their health needs, dignity, choice and independence when participating any type of activities in any community.
The present article uses the term 'disabled persons or disabled people' to refer to individuals who acquired impairment, whether at birth or with life circumstances like ageing, incidents and accidents. The usage of the above mentioned term, disabled people, implies that unless there is universal accessibility, the said people are being obstructed by an environmental arrangement that exacerbates the loss or limitation of the body (Kazou 2017). The loss mentioned above is due to environments created by others that create physical or social barriers that disable or obstruct an individual with an impairment from participating equally with nondisabled people in the community's normal life (Kazou 2017). Hence, the 'ability' of the individual who acquired an impairment is not being questioned, but the 'disability' can be associated with limited consideration for the access needs of the said people to participate in an environment that supports their capabilities . The argument in this article upholds the reality that both disabled and nondisabled people are heterogeneous in terms of their talents and role in socio-economic-based development. However, when it comes to empowerment initiatives like tourism education, it became a norm to bring access to information. Knowledge of diversity in all forms addresses attitudes, behaviours, choices, dignity, and independence of nondisabled people, whilst such is limited in considering disabled counterparts (Vehmas & Watson 2016;Simbaya et al. 2019;Makuyana & du Plessis 2022). As much as tourism's co-created economy is concerned, there are misconceptions about disability and a lack of understanding of the impact caused by either impairment or health conditions on tourism growth (Makuyana 2020). The limited knowledge development in said field exacerbates misunderstanding of health conditions (acquired impairments) (Kazou 2017), talent and diversity (Gronvik 2007), the workplace (Groschl 2007;2011) and tourism co-production and co-consumption (Darcy 2010). Therefore, the inclusion of disabled people is incomplete if socio-economic empowerment in tourism that upholds diversity is void of sufficient research that can inform the co-creation of resources to support inclusive tourism practices. For the study, tourism is considered a concept that describes the process when one voluntarily leaves one's usual place of residence to travel to another environment for any purpose for less than a year (Camilleri 2018).
The current article identifies obstacles tourism practices face in education, community and industry because of the limited contextualised research-based knowledge beyond legal compliance (La Fuente-Rodes et al. 2016;Darcy 2010). In most tourism organisations within the value chain, disability inclusion is furthered by individuals who have disabled family members (Makuyana & du Plessis 2022). Thus, inclusion emerges more from personal than organisational practices (TraVability 2018;Tan 2014). The three concepts are always presented separately from the tourism co-created economy, which leaves tourism stakeholders in a dilemma regarding implementing disability inclusion in the day-to-day management and business operations (Shaw & Cole 2004;Tan 2014). Based in the South African tourism research context, if the above mentioned concepts maintain the discourse reflects: • Tourism stakeholders' misunderstanding of disability inclusion, results in challenges in accommodating the needs of disabled guests. (Snyman 2002). • Mainstream tourism policy and other legislative frameworks (for education, community development and industry) are void of disability inclusion. Resulting in the formulation of separate disability policies that include disabled people in mainstream activities (Makuyana 2020). • Tourism experiences amongst disabled tourists reflect systemic discriminative attitudes and behaviours when co-producing and co-consuming tourism products and services (Breedt 2007 Darcy et al. (2020) blazed a trail in the transformation of disability tourism from a niche, specialised or small market to an accessible, mature tourism market because: • The Global North has more ageing tourists with adequate financial resources, supported with time to participate in tourism with more extended stays and spending, and they often travel with more than two people. • Ageing tourists share similar needs with disabled tourists but don't want to be labelled or identified as disabled tourists because of disablism that regards people who acquired impairments as homogeneous.
From a South African context, the Department of Tourism report (2011)

Conceptual framework
The current article presents a conceptual framework in Figure 1 below that shows tourism research has a parallel relationship to research on impairment and disability (exclusion and inclusion). The outcome and impact of research conducted as separate fields of study hardly relate to each other in principles and practice because of the absence of context and applicability. Figure 1 shows that research on tourism (hospitality, travel services, attractions and education included) can have a reciprocal linkage with disability and impairment as a composite concept. Accessible tourism research would unveil disability-inclusive approaches that are rooted in knowledge development. The present authors believe tourism requires a body of knowledge that informs the reality of impairments (health conditions) and disability within tourism practices. Such scientific knowledge is critical to enhancing a comprehensive and balanced understanding of the concepts in a composite and the relationship thereof. Previous studies on impairments, disability and tourism are important to ascertain the status quo (gap analysis) whilst identifying areas towards greater understanding of this composite concept and giving direction for future research.
The objectives of the article are: • to track knowledge development from 1990 to 2018 using a narrative literature review approach • to justify future research areas previously overlooked and under-studied within a tourism-impairments-disability perspective in South Africa and beyond.
Hence, firstly, as Snyder (2019) recommended, a narrative literature search strategy is outlined under the methods and design that allowed the review processes to gather and then analyse data. Secondly, the results and findings are presented. Thirdly, the findings are discussed, and lastly, the conclusions are presented.

Context: South Africa
South Africa is in the G20 group from an economic and political position. The said group has countries in the Global North that have developed their systems towards inclusive approaches (Nzo 2019; also see Table 1 below). Hence, socio-economic and political-led migrations prevail amongst the countries in such groups (tourism comes into the picture) (Haarhoff & De Klerk 2019). Therefore, South Africa needs to conform to disabilityinclusive tourism research (knowledge development). This is reinforced by Haarhoff & De Klerk (2019), who believe more than 66% of international tourism markets are tourists from Europe and the Americas who fall into the senior age category with access needs. In 2016, the tourists mentioned above spent R20 billion on leisure, accommodation and food in South Africa (Haarhoff & De Klerk 2019 Table 1 below). Additionally, South Africa understands diversity in socio-economic settings (Meyer & Meyer 2020). Amongst the African countries, South Africa has indicated an interest in the accessible tourism market as a matter of business, legal compliance and social value and cohesion (Department of Tourism report 2011). The Department of Tourism has established a Transformation Committee with designated positions from the South Africa Disability Alliance. In addition, the Tourism Grading Council of South Africa has developed a disability inclusion framework for the accommodation sector in collaboration with the South Africa Disability Alliance. According to Haarhoff & De Klerk (2019), South Africa serves international markets from countries with pro-disability inclusion legislation, hence posing the need for research in tourism, impairment and disability, considered a composite field of study (see also Table 1 below). Table 1 presents a list of examples of countries that are tourist source regions for South Africa and which have a legal position that advocates for disabled people. If South Africa relates to such states, the current authors believe that it is noble for South Africa to embed disability inclusion within tourism practices, thereby bringing the role of research to filling the research inconsistencies on impairments and disability issues within South African tourism and beyond. Therefore, the current study identifies areas previously researched and then provides information and/or gaps to enable the research community to conduct a more in-depth investigation and/or investigation on areas that have not yet been covered.
On the one hand, it is critical to take note of the relationship between impairments, disability and ageing, since approximately 53.0% of the global population live with a declared temporary and permanent impairment and have a propensity to travel (TraVability 2018; Disabled World 2016). On the other hand, global statistics record that 10% -20% of the global population has a declared impairment (Darcy et al. 2020; United Nations Development Programme 2018). In South Africa, 7.5% of the South African population comprises the disabled population group (Statistics South Africa 2014). The point here is, generally, at one point in life, one can acquire a form of impairment due to life incidences such as ageing, shortsightedness, pregnancy, accidents or being born impaired, amongst other causes (Luiza 2010). However, the intensity and experiences of disability always differ. All the persons mentioned above share tourism access needs. However, the emphasis and the context of acceptance, discrimination, stereotyping and marginalisation by society and the co-created tourism economic environment may differ (Makuyana & du Plessis 2022;Kazou 2017). This implies that individuals experience diverse types of discrimination as per the societally and economically perceived level of the impairment whenever they participate in socioeconomic activities like tourism (TraVability 2018; Disabled World 2016). The discussion above reinforces the need for research on the composite concept.

Terms and Definitions
Disability is defined in this study as an interactive process between an individual with an impairment, the environment and the impairment at intrapersonal and interpersonal dimensions (Makuyana & du Plessis 2022). In this context, impairment is considered an act of God that brings about a loss or deformation of a ligament or body part (Chikuta 2015a;Makuyana & Saayman 2018). Access needs refer to the willingness and ability to be involved and/or participate in opportunities offered to all humans for tourism that upholds universal accessibility approaches (Makuyana & du Plessis 2022;Nzo 2019). Universal accessibility and/or disability inclusion refers to the inclusion of disabled people by any means which upholds one's right to dignity, independence and choice to partake in all available opportunities or effective participation on an equal basis with nondisabled cohorts (Makuyana & du Plessis 2022;Darcy et al. 2020). Accessible tourism is the same as disability tourism and inclusive tourism, which implies the access needs of all people with a desire to participate in tourism regardless of the presence or absence of impairment. The terms mentioned above are used interchangeably, depending on geographical location (Darcy 2010;.

Design
The narrative literature review focused on the interconnection between tourism, impairments and disability from high-ranked databases that prefer developed countries (Global North) whilst taking cognisance of developing countries' journals. The electronic search is done as a gap analysis that would provide answers to the following questions: • What is the magnitude of research on tourism supply positioned in the context of inclusion of impairments and disability in South Africa and beyond? • What lessons can be learned from existing research on tourism products and service development incorporating impairments and disability? • To what extent does existing research embed tourism education (skills development) that incorporates impairments and disability for inclusive tourism growth? • Is there research on the influence of technological developments on tourism, impairments and disability for effective participation amongst disabled people? • Is there research (knowledge development) on impairment, disability and tourism as a combined concept for inclusive tourism growth in South Africa and beyond?

Data collection
The researchers conducted a literature search from the following electronic databases: Scopus, ScienceDirect, Sabinet Online, Emerald Insights Journals, African Journals and Google Scholar. The electronic search used keywords like inclusive tourism, access-needs in tourism, disability, impairment, tourism and related synonymous terms. A balance of five regional (continental) journals with full text written in English were considered in the review. On the one hand, predetermined inclusion of sources of data entails published research work on tourism, impairment and disability issues. On the other hand, predetermined exclusion criteria entail nonacademic and scientific work on tourism, impairment and disability issues, as separate fields of study were considered during the literature screening process, as shown in Table 2. Table 2 shows an objective electronic literature search guide as part of the reviewing process. The current article is an element of the unpublished primary (PhD) study by Makuyana (2020). The review paper would be published for the tourism, disability (academics and scholars) research community, practitioners and general readership to have access to the information beyond being kept in the university's repository.

Data analysis
The first and second authors independently reviewed each identified data source to determine eligibility and extract study information. The third author validated and verified the collected data whilst preparing and refining the article to make it ready for publication. Figure 2 shows the volume of studies identified, screened and included or excluded at each stage of study selection. All collected data were categorised into themes answering the research questions, as advised by Miles and Huberman's (1994) qualitative analysis approach. Figure 2 shows that the researchers retrieved data and adopted three steps. Firstly, an electronic literature search and second screening of research material from the 1990s to 2018 was conducted. The researchers followed Vergnes et al. (2010) by grouping the codes into themes, which established a scientific way of synthesising a plethora of information after exhaustively searching and objectively analysing (reduction and exploration of text) the studies dealing with tourismimpairments-disability issues. As reflected in Figure 2, research work in text format was gathered after reading the titles and abstracts. Full-text reading ascertained the alignment with the aim of the current review. All materials which addressed tourism, disability and impairments separately and work that was not on open access were discarded.
Secondly, data were extracted, and thirdly, data were analysed manually following a thematic approach as advised by Miles and Huberman (1994), and in vivo coding was also carried out (Holton 2007). The questions calling for narratives were subject to inductive or deductive thematic analysis, using in vivo open coding as Manning (2017) advised.

Identification of academic work via databases
Academic work identified from the following databases: African journals (n = 2500), Emerald insights journals (n = 4300), Google Scholar (n = 3000), Scopus (n = 1200) Academic work screened using abstract reading (n = 6500) Academic work sorted for full article reading (n = 500) Academic work assessed for eligibility (n = 300) Academic work included in review (n = 102)

Screening Identification
Non-academic work excluded: Reason 1 (n = 198) combined tourism, impairments, and disability Full-text academic work that was not on open access (n = 200) Non-academic work on impairments, disability and tourism (n = 6000) Academic work removed before screening: Duplicate articles removed (n = 500); articles removed as they were on disability; impairmerds and tourism separately (n = 4000) Examples of questions subject to inductive analysis: • What is the magnitude of research on tourism supply positioned in the context of inclusion of impairments and disability in South Africa and beyond? • What lessons can be learned from existing tourism research on products and service development that has incorporated impairments and disability?
Examples of questions subject to deductive analysis: • To what extent does existing research embed tourism education (skills development) that incorporates impairments and disability for inclusive tourism growth? • Is there research on the influence of technological developments on tourism, impairments and disability for effective participation amongst disabled people? • Is there research (knowledge development) on impairment, disability and tourism as a combined concept for inclusive tourism growth in South Africa and beyond?
This technique involves meaningful units of texts or codes being extracted, kept in a master list and reapplied to similar segments of text. Codes were also transformed into dummy variables in Microsoft Excel (for each code: 0 = not mentioned, 1 = mentioned in the extant literature) to represent code frequencies illustrated in numeric tables and percentages (quasi-statistics).

Results
The article aims to track knowledge development from 1990 to 2018 whilst justifying future research areas which would have been previously overlooked and under-studied within a tourism-impairments-disability perspective in South Africa and beyond. The findings are presented first to show the geographical or geospatial distribution from a global scope before narrowing it to South African-focused knowledge development. This is because of the interconnection of tourism co-created supply, demand and internationalisation of research and skills development.

Data distribution within the electronic databases (sources)
A total of 300 articles were reviewed, and only 102 articles from the four databases were used. The databases enabled access to 18 tourism and/or hospitality-related journals that had 55 articles and 11 journals unrelated to tourismimpairments-disability that had 40 articles. These were augmented by one tourism encyclopedia, three European and international organisational reports and one university repository that had two PhD theses, two master's dissertations and one handbook, as shown in Table 3. Table 3 records the distribution of tourism, disability and impairments as disaggregated by subject, namely tourismimpairments-disability, from 34 sources. However, the research revealed that scientific tourism-related journals have not yet regarded the tripod concept, namely tourismimpairments-disability (where impairments include health conditions), as one of their central research foci or themes. Tourism and hospitality sources contributed 51% of the data, whilst non-disability-related sources contributed 34%. A university repository and encyclopedias on tourism were 3%, whilst European organisational reports provided nine percent 9%.

Identified themes and subthemes
The analysis established five themes, namely: • tourism demand: disabled people (tourists) The themes had subthemes as follows: • Tourism supply had seven subthemes, namely heterogeneity, inclusion, reasonable accommodation, know-how, managing experiences during coconsumptions and co-production and product and service innovation. • Tourism demand: disabled people (tourists) had three subthemes: escapism, relaxation and recreation. Education and skills development had two subthemes, namely empowerment and self-development. Tourism-inclusive practices (generic tourism knowledge) had subthemes like involvement and participation.

Tourism demand: Disabled people (tourists)
The results are clustered under tourism demand, impairment and disability.  Table 4 indicates available knowledge in the type of collaborations amongst authors. On the one hand, seven studies were conducted by two researchers (co-authoring), whilst others were conducted by three researchers (co-authoring). On the other hand, five studies were undertaken by single authors. Table 4 shows Taiwan and South Africa had authors who each undertook two related studies on this subject, respectively. The rest of the studies were one-off investigations into disability, implying that there is low interest in studying disability and tourism as a combination of two fields.  a five year silence lasted until 2011. Table 4 shows 2011 to 2018 as having an exponential positive interest in developing knowledge on tourism (including attractions and activities), hospitality (accommodation) and disability and disabled persons as combined fields.
According to Table 4 above, between 1997 and 2000, research was skewed towards the subtheme of inclusion (universal accessibility) of disabled people (ageing people included) in tourism. In 2001, the research considered barrier-free (disabling environment alleviated) tourism for disabled people. In the same year, behaviours of tourism consumers with mobility impairments were documented. Table 4 presents 2006 as the year researchers identified determinants and constraints within the tourism demand side. Table 4 shows 2011 as the year that witnessed a widened focus to include identifying the needs, motivations and expectations of disabled tourists.
According to Table 4, 44% of the literature concentrated on barriers and challenges and constraints faced by persons with different impairments. Twenty-two percent of the demand-skewed research focused on the motivations of persons with impairments (disability). Seventeen percent of studies concentrated on persons with impairments' needs and expectations. Competitiveness of accessible destinations, the role of persons with different impairments in co-creation and consumer behaviour received 6% of the research attention, respectively. Finally, Table 4 presents a distribution of methods of research, which was skewed towards qualitative methods with 67%, a quantitative research approach with 11% and mixed methods with 22%.

Tourism supply: Inclusion of disabled people, impairments (health conditions) and disability
The research positioning the tourism supply side in relation to disability and impairments knowledge (research) as of 2018 is presented in Table 5 below.   Table 5). The findings reflect tourism and disability studies within the supply-side as considering ageing as one of the major tourism market segments. This concurs with the World Travel Tourism Council report (2017) that highlighted that amongst the international visitors for the past decade, more than sixtysix percent (66%) fall into a senior market that prefers accessibility in co-producing and/or co-consuming tourism products and services as the disabled people. The above discussion is in the context of the growth of accessible tourism which scholars regard as having three times the growth rate of disability-exclusive tourism. This is because of the ageing and retiring baby boomer generation, which dominates the demographics of most of the Global North (TravAbility 2020). TravAbility (2020) cites research by McKinsey and Company in the United States of America (USA) that found that the baby boomer generation controls 60% of total wealth, and 40% of their total expenditure is in areas such as hospitality and leisure amongst 50% of the population segment. In addition, the said population segment, at age 65, has 40% of the cohorts with an age-related disability, and by age 75, it rises to 60%. It is apparent that the ones without declared impairments and the support structures of the counterparts with declared impairments prefer the usage of universal accessible facilities foregoing exclusive ones (TravAbility 2018). Such travel characteristics are observable among the majority if visitors to South Africa as a tourism destination (Makuyana & du Plessis 2020).
The studies on tourism supply and disability were undertaken between 1990 and 2018 and considered a variety of tourism sectors: the general tourism industry had 57.0%, the accommodation sector only had 14.0%, the hospitality sector (accommodation and hotels) had 2.9%, tourism only had 2.9%, food and beverage had 5.7%, travel only had eight comma six percent 8.6%, leisure and accommodation had 2.9%, accommodation and travel had 2.9% and travel and leisure had 2.9%. An interesting aspect highlighted in Table 5 is that the year 2000 ignited greater progressive research on access needs (disability) of the tourism market and supply chain. Table 6 reveals that knowledge of disability and tourism can contribute to man-made and natural tourism products and service development and innovation that embraces the diverse needs of tourism market segments. Within this context, the current researchers classified such literature under research aligned with the tourism products and/or services from 1990 to 2018, which is presented in Table 6.    Table 6 presents 21% of the research themes skewed towards tourism product development. Whilst 29% of studies within the said period focused on experiences of the disabled tourist during co-production and co-consumption of tourism products, only 7% of the studies established a nexus between disability and tourism products and services. Within this tourism product or service-centred research, accessibility to information had 14%, whilst universal accessibility received 29% of research attention.

Technological influence on tourism, impairments and disability
The results revealed that tourism, like any other sector, has been continuously affected by the Internet of Things, amongst other technological advancements that enhance business efficacies if harnessed strategically. Thus, as highlighted in Table 7, disability-tourism studies reflect either the adoption or proposition of technological innovations, communications Research on tourism products and services that accommodates disabled people (in sequential order of years).

Authors
Year (marketing and public relations included) and intrapreneurial and entrepreneurial approaches that can take advantage of technology for a wider reach to disabled people. These can enable them to have better access to participate in tourism and hospitality.  Table 7). A research gap was observed from 2008 to 2011, followed by two years of continuous research between 2011 and 2012. After 2012, there was research silence on technological development in tourism and disability until 2018. The results reveal an interesting aspect of the exponential growth of research on technological advancements for tourism and disability, followed by research silence. On the one hand, a trend towards a collaborative research approach is preferred to single authorship, and only one solo author conducted research in the period under investigation. Table 6 shows that all studies adopted a qualitative research design.   Table 8). In 2010 and 2011, the same authors investigated attitude changes of students undergoing tourism skills development towards disabled guests. Such research reflects co-creation that places the role played by formal skills development as critical in the co-production and co-consumption of tourism and hospitality practices. Table 8 presents a three year research silence between 2011 and 2014. However 2014 broke the silence for a moment, and the aftermath witnessed a research break again until 2018 (see Table 8). Table 8 highlights that Europe is making strides in disability and/or accessible tourism-related skills development or education research. Nonetheless, there is still a need to develop more integrated tourism-impairments-disability knowledge within the contexts of individual countries (see Table 8). On the one hand, Table 8 shows limited research attention on tourism, impairments and disability as a composite concept within the formal human capital-capacity development in Africa, especially South Africa. Table 8 reflects implications that can emerge from the lack of professional capacity to manage and/or handle learners with impairments amongst tourism educators (Makuyana & du Plessis 2022;Makuyana & Saayman 2018;Scott, McGuire & Shaw 2003). It goes without saying that the said gap fosters challenges in the capacity and capability of the tourism and hospitality roleplayers (practitioners) when serving disabled tourists (guests) within the tourism value chain (Breedt 2007;Chikuta 2015a;Makuyana & du Plessis 2022;Snyman 2002; see also Table 8). The findings implicate the tourism and hospitality workplace readiness and know-how on disability inclusion as part of diversity management practices. Table 9 presents generic tourism, disability and impairments research within the tourism business system that thrives as a co-creation economy. Table 9 indicates that 50% of the tourism research and disability followed a general Eurocentric perspective. In addition, Italy and Greece h ave a combined a contribution of 25% to the above mentioned theme. Australia (Oceania) has 15.6%, while the American contributed 9.4% (including Brazil and Canada as case studies) to tourism and disability knowledge. Table 9 shows a trend towards co-authoring, which upholds collaborations and diversified views on tourism and   (from 1990-2018).

Year Sector Theme (area of focus) Design
General 2  2003 (see Table 9). The said study probed for a more extensive investigation to uncover the magnitude of disability beyond physical built environmental access (see Table 9). Table 9 reflects a change of focus from the consumer to the non-disabled and disabled staff to relate disability and work-production within the tourism and hospitality industry. Case studies were used to bring a progressive narrative about the inclusion of disabled people in tourism (see Table 9). The existing research has combined disability and tourism, leaving impairments or health conditions related to tourism because disabled people are heterogeneous, just like their nondisabled counterparts.

Discussion, contribution, implications and recommendations
The study reflects learning that the composite concept is still scarce, and the extant literature is skewed towards exploring the said concept within countries in the Global South, especially in South Africa. This seems inadequate to inform the tourism and hospitality co-created economy to understand and interpret disability and impairment related to production within a demand, supply and skills development perspective. Darcy (2010) and Darcy et al. (2020) have similar views and encourage in-depth research on different impairments in relation to tourism and disability inclusion. It is clear from the findings that the composite concept (disability, tourism and impairments or health conditions) has not yet been regarded as one of the main themes of tourism, hospitality, recreation and leisure in the academic journals and scholarly knowledge development space, especially from a country-contextualised course between 1990 and 2018. Therefore, this implies that in all identified themes such as tourism demand, supply, skills or human resources development (education), technological development and general tourism spaces, there is a need for collaborative research partnerships between tourism role players, organisations for disabled people and researchers for a contextual understanding of universal accessibility and reasonable accommodation (disability inclusion).
Based on the results, it is clear that the article can contribute by identifying gaps, though in an abstract form. The research community can regard the gaps as part of the research agenda for future studies. Accordingly, the findings reflect a need to develop knowledge on: • characteristics of disabled tourists (different types of impairments or health conditions) using age, gender, economic participation, consumer and/or buying behaviour and those who experience disability (including the elderly) • travel behaviours of disabled tourists • contextual relevance of universal accessibility in tourism sectors beyond the built environment, such as attitudes, diversity management and organisational culture • competencies (informal and formal or curriculum-based skills development) for sustainable know-how to manage and/or handle disabled people in tourism sectors • definitions of disability inclusion and reasonable accommodation for participation in tourism and the hospitality value chain • geospatiality and movement of disabled people (tourism sources and receiving regions) for destination management and competitiveness within accessible or inclusive tourism • the economic value of disability inclusion, whilst disaggregating such by age, type of impairments and access needs amongst other 'special requests' set by tourists who participated in tourism, thereby making better market segmentation within the tourism supply and demand value chain • interpretation of disability legislative frameworks for tourism and hospitality practices and contextualised inclusive socio-economic development (communitybased development included) • tourism and hospitality co-created innovation induced by disability inclusion (tourism for all) • human resources policy and practices to acknowledge disabled people as potential sources of labour for employment (selection, recruitment, retention, talent and diversity management) • employment and employability of disabled people in tourism and hospitality co-created economy, including work readiness, inclusion in the workspace, production and productivity and an inclusive labour market • tourism and hospitality-inclusive market research and marketing communication • inclusive tourism and hospitality management (practices, principles, planning, budgeting, economic empowerment index, information technological advancement and usage of such data for social and economic innovation) • readiness of the tourism and hospitality co-created economic development for accessible tourism and how the multifaceted industry is prepared for the evolving concept of 'tourism for all'.
The postulated research fields for the composite concept imply that the authors recommend the different organisations for disabled people to be open to dialogues with tourism roleplayers (education, industry and community) to bring a clear interpretation of inclusion in the lens of socio-economic production, co-creation and types of impairments and/or health conditions without compromising heterogeneity or their beneficiaries. For example, South Africa has the South Africa Disability Alliance, composed of 15 organisational members with databases that can foster the continuation of research to bridge the gaps identified in this current research. The above recommendation shares similarities with Darcy et al. (2020), Luiza (2010) and UNWTO (2020), as they believe accessible tourism is critical as one of the avenues to tourism recovery amidst and after the COVID-19 pandemic.
The study reflects potential benefits and strengths to uphold community cohesion if inclusive or accessible tourism is built on a composite concept. Research would develop sustainable http://www.ajod.org Open Access fundamentals to enable tourism skills development to mainstream disability proficiency as part of a curriculum outcome. Research that upholds impact assessment can fulfil a need for knowledge, willingness and buy-in amongst internal and external tourism and hospitality stakeholders to appreciate disabled tourists beyond a niche market. The abovementioned factors implicate investment decisions and business strategies within the tourism-disability space.

Conclusion
This study concludes that the extant literature explored disability and tourism perspectives that are inadequate to make the tourism and hospitality co-created economy understand disability inclusion in the context of tourism growth. Impairments or health conditions were not part of the existing discourse between 1990-2018. Therefore, there is a need for indepth research to enable skills development to embed disability inclusion from a composite concept. Learnings were determined from gaps in extant literature within tourism supply, demand, technological influence, skills development and general tourism sectors. Nonetheless, research attention differs amongst researchers and the context of the countries and continents. Overall, the tripod concept of tourism, impairments (health conditions) and disability is still under-researched. One can say it is still at the infant stage, as existing knowledge is still too generic and has only 'scraped the surface' issues of disability, thereby leaving tourism stakeholders in a dilemma when intending to implement inclusion. Yet research is an imperative for an evidence-based argument towards systemic inclusive or accessible tourism, particularly within the areas identified by the study, namely demand, supply, skills development, technological influence and general tourism sector knowledge. Research is needed in the areas mentioned above to fill the gaps whilst liaising and engaging disabilityconcerned organisations. This article contributes to mapping a field of research, synthesising the state of knowledge and creating an agenda for further research whilst providing the historical overview and timeline-based milestones in research on impairments, disability and tourism as a consolidated concept. Therefore, the limitation of the study is centered on lacking an empirical approach that would augment the review of extant literature for a limited period  only.