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Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

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This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

Towards Inclusion - A guide for organisations and practitioners

VAN EK, Vera,
SCHOT, Sander
2017

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This guide is the result of collaboration between Light for the World (LFTW), Mission East (ME), and ICCO Cooperation.

Based on decades of experience of working with the most marginalized and excluded communities, the three organizations cooperated to record their experiences in a publication which can be used in a variety of relief and development contexts. ‘Towards Inclusion’ is designed to be an easy to use reference for organizational and program/project development with a focus on gender responsiveness and disability inclusion.

The guide is made up of three parts:
• the first part guides users through the process of organizational self-assessment to determine readiness to change and identify key steps towards becoming a more inclusive organization.
• the second part introduces the ACAP framework, as a means of improving inclusion in programming via Access, Communication, Attitude and Participation. A range of tools for measuring and improving inclusion at all stages of the project cycle are provided.
• the third part provides guidelines for the people or ‘change facilitators’ who will guide organizations through the process of change towards becoming more inclusive.

The publication can be found at “Towards Inclusion Guide” and the accessible version of the publication can be downloaded. Both are free of charge.

Possibilities for organisation trainings and/or webinars on the practical application of the guide are under consideration. Contact ACAP@gmail.com.

Water justice, gender and disability : South Asian Water Studies (SAWAS), special issues, vol.5, no.4, June 2017

CLEMENT, Florian,
NICOL, Alan,
CORDIER, Sylvie
Eds
June 2017

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The papers in this volume on gender, persons with disabilities and WASH in South Asia help to provide important pointers on ways forward. A common thread throughout the four articles is that a constellation of challenges still exists, from 'exclusion' through prejudice at different levels, to institutional realities that render policy and other instruments ineffective in practice. In some cases, even, there remains a complete absence of key legal and policy instruments.  

Titles of the articles in this issue are: 

  • Planning for inclusion: exploring access to WASH for women and men with disabilities in Jaffna District, Sri Lanka
  • Breaking down Barriers: Gender and Disability in Access to Agricultural Water Management in Nepal
  • The Gender Gap between Water Management and Water Users: Evidence from Southwest Bangladesh​
  • Are policies enough to mainstream Gender in water and sanitation programs? Experiences from community managed drinking water supply schemes in India

WHO launches rehabilitation standards for Emergency Medical Teams

WORLD HEALTH ORGANISATION (WHO)
May 2017

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WHO together with health partners such as CBM, Handicap International, and the International Committee of the Red Cross, have released the ‘Emergency Medical Teams: Minimum Technical Standards and Recommendations for Rehabilitation’ which provides important guidance on how emergency medical teams (EMTs) can incorporate rehabilitation in their response to emergencies. Using the experiences from the 2015 Nepal earthquake, this video shows the impact it had on the lives of those injured years later and highlights the reasons why rehabilitation needs to be a core component of any emergency medical response. Integrating rehabilitation into the EMT response resulted in greater clinical care by producing important, cost-effective, and positive long term outcomes at the individual, family, and community levels

Cardiovascular diseases (CVD) and rehabilitation. Factsheet

HANDICAP INTERNATIONAL
March 2017

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Cardiovascular disease (CVD) refers to conditions that affect the heart and blood vessels. Most commonly this includes coronary heart disease (heart attacks), cerebrovascular disease (stroke) or raised blood pressure (hypertension). A stroke occurs when a blood clot (ischaemia) or a bleed (haemorrhage) disrupts the blood supply to part of the brain, starving that area of oxygen. Stroke is a leading cause of serious long-term disability. Common impairments and activity limitations from cardiovascular diseases are hemiplegia, word forming difficulties and slurring of speech, cognitive function, depression, sensory loss and shortness of breath. Different examples of rehabilitation in the care continuum are given. A case study of stroke in Nepal is provided. 

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

BIBHAV Acharya
et al
January 2017

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Abstract

Background

Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation.

Partnerships network

We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community.

Conclusions

We propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal.

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

ACHARYA, Bibhav,
MARU, Duncan,
SCHWARZ, Ryan
et al
January 2017

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"Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation."

Together towards an inclusive world (series of videos to celebrate CRPD's 10th anniversary)

Australian Disability and Development Consortium
December 2016

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ADDC and ten of its members have produced a series of short videos featuring persons with disability who are, or were, engaged in a disability-inclusive development (DID) project or initiative (in Australia or overseas). In these videos they share their personal stories and how disability inclusive development projects changed their lives, benefitted their communities and contributed to a more inclusive society.

The video series was officially launched during a parliamentary event in Canberra on 30 November 2016 in the presence of some of the persons featuring in the videos and of senior politicians from different Australian political parties.

The event was opened by an address by Senator Concetta Fierravanti-Wells, Minister for International Development and the Pacific. In her speech, she confirmed both the Australian government’s and her personal strong commitment to ensuring that all Australian development programs are disability-inclusive and to championing DID internationally. You will find a transcript of the Minister’s speech here attached.​

The wellbeing of children with developmental delay in Bangladesh, Bhutan, Laos, Nepal, Pakistan and Vietnam: An analysis of data from UNICEF’s Multiple Indicator Cluster Surveys

EMERSON, Eric,
SAVAGE, Amber,
LLEWELLYN, Gwynnyth
December 2016

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This report, produced by the University of Sydney’s Centre for Disability Research and Policy (CDRP),
uses data collected in rounds four and five of UNICEF’s Multiple Indicator Cluster Surveys programme (MICS) to describe the wellbeing of young children with and without developmental delay in six Asian countries. The United Nations Sustainable Development Goals (SDG) were used as a framework for identifying indicators of child wellbeing.

The report, authored by CDRP Disability and Inequity Stream Leader Professor Eric Emerson with Dr Amber Savage of the Family and Disability Studies Initiative, University of Alberta, Canada and CDRP Director Professor Gwynnyth Llewellyn, found that children with Developmental Delay in Bangladesh, Bhutan, Laos, Nepal, Pakistan and Vietnam are more likely than their peers to:
• Be living in poverty (SDG1). In five out the six countries children with developmental delay were more likely to be living in poverty than their peers
• Experience hunger (SDG2). In all six countries children with developmental delay were more likely to have experienced persistent severe hunger than their peers
• Suffer poor health (SDG3). On three indicators (poor peer relationships, diarrhoea and fever) children with developmental delay were more likely to have poor health than their peers. On three indicators (obesity, aggression and acute respiratory infections) there was no systematic difference between children with and without developmental delay.
• Experience barriers to quality education (SDG4). On all four indicators (attendance at early childhood education centre, family support for learning, access to learning materials in the home, maternal level of education) children with developmental delay were more disadvantaged than their peers.
• Experience barriers to clean water and sanitation (SDG6). On two indicators (improved sanitation, place to wash hands) children with developmental delay were more disadvantaged than their peers. On one indicator (improved drinking water) there was no systematic difference between children with and without developmental delay.

The authors noted that “Since the development of the United Nations Convention on the Rights of the Child (UNCRC) in 1998, increased attention has been paid to monitoring the well-being of children. The UN Convention on the Rights of Persons with Disabilities (UNCRPD) and UNCRC both contain explicit provisions regarding the rights of children with disabilities. These impose obligations on governments to act to ensure that children with disabilities enjoy the same rights and opportunities as other children. In order to promote the visibility of children with disabilities, enable better policy, and monitor progress, disaggregation of data related to children’s well-being on the basis of disability is needed."

Challenges to principled humanitarian action: Perspectives from four countries.

NORWEGIAN REFUGEE COUNCIL,
Handicap International
July 2016

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The purpose of this paper is to contribute to an increased understanding of the perceived and actual challenges humanitarians face in operational contexts as they apply the principles of humanity, impartiality, neutrality and independence. A snapshot is provided of four case studies; Colombia, Nepal, northern Syria and South Sudan. Through a combination of field research, headquarters interviews, desk research, and a webinar, views and observations are presented from the humanitarian community. These observations provide a glimpse into the challenges faced by principled humanitarians. As a result the paper puts forward seven recommendations intended to assist humanitarians and states to sharpen tools and strengthen approaches when implementing principled humanitarian protection and assistance. An addendum to this study provides perspectives from selected members of the donor community. This research was conducted through interviews with state representatives in Geneva, aiming to understand how donors perceive their responsibilities in upholding the humanitarian principles and the Good Humanitarian Donorship Principles. This final chapter highlights challenges faced by states while supporting principled humanitarian action, particularly in conflict zones. On the basis of this research, additional recommendations for both states and humanitarians are proposed to strengthen the adherence to the humanitarian principles

Disabled women's attendance at community women's groups in rural Nepal

MORRISON, J,
COLBOURNE, T,
BUDHATHOKI, B,
SEN, A,
ADHIKARI, D,
BAMJAN, J,
PATHAK, S,
BASNET, A,
TRANI, J F,
COSTELLO, A,
MANANDHAR, D,
GROCE, N
October 2015

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There is strong evidence that participatory approaches to health and participatory women’s groups hold great potential to improve the health of women and children in resource poor settings. Disabled women’s participation in women’s groups and other community groups in rural Nepal was investigated. A mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability was used. No significant differences were found between non-disabled and disabled women in the percentage of women attending at least one of the women’s groups. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence prevented women from attending groups. The findings are of particular significance because disabled people’s participation in broader community groups, not focused on disability, has been little studied.

Brief - Financial access to rehabilitation services

Handicap International
October 2015

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Presentations from the seminar are reported on the themes of: a diagnostic tool, universal health coverage, financial access experiences, Madagascar’s experience and advocacy. Presentations included: The economic diagnostic tool for physical and functional rehabilitation and its deployment in Burkhina Faso, Colombia and Laos;  Equity funds and cash transfers, link with UHC; Universal Health Coverage, contributory and case management schemes usable in order to finance physical and functional rehabilitation; Vietnam: Orthopaedic devices and fair cost recovery system;  Burundi: Financial access to healthcare and performance-based financing; Burkhina Faso: Equity fund for rehabilitation projects; Mali, Rwanda, Togo: Evaluation of three rehabilitation equity funds; Nepal: Cost calculation of assistive devices; Madagascar Experience (Operating and financial access of orthopaedic devices and physical rehabilitation services of Pzaga Mahajanga University Hospital,  Social Welfare Policy and Universal health coverage in Madagascar, Mutual Health Insurances)

CBR for inclusive development

KOOPMAN, Thomas
March 2015

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A short documentary on community based rehabilitation and disability-inclusive development.in Nepal. This video presents good practices as well as challenges in all domains of the CBR Matrix

Include us in education! : a qualitative research study on barriers and enablers to education for children with disabilities in Nepal

ZUURMOND, Maria
et al
December 2014

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A 2013 Plan study across 30 countries found that children with disabilities were on average 10 times less likely to go to school than children without disabilities. This report presents the findings of a follow-up second phase to the research with a qualitative study on barriers and enablers to education for children with disabilities in Nepal. The research looks at the experiences of 21 children aged 6 to 16 years (8 of them had dropped out of school while one had never been enrolled) through in-depth interviews conducted with 21 families (20 caregivers and 13 children), 9 key informant interviews, and visits to two special schools and one integrated school. The report presents the findings and makes recommendations for the way forward

Include us in education! : a qualitative research study on barriers and enablers to education for children with disabilities in Nepal : executive summary

December 2014

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A 2013 Plan study across 30 countries found that children with disabilities were on average 10 times less likely to go to school than children without disabilities. This executive summary report presents the findings of a follow-up second phase to the research with a qualitative study on barriers and enablers to education for children with disabilities in Nepal

Children with a disability in Nepal : new hope through CBR?

MOL, Tanja Ingeborg,
BRAKEL, Wim Van,
SCHREURS, Merel
May 2014

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This study assesses the impact of a community-based rehabilitation (CBR) programme on the quality of life (QoL) of children with disability and their families

Disability, CBR and Inclusive Development, Vol 25, No 1

Disability inclusion : translating policy into practice in humanitarian action

PEARCE, Emma
March 2014

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This report “documents positive practices and ongoing challenges to promote disability inclusion across UNHCR’s and its partners’ work in multiple countries and multiple displacement contexts. The report provides lessons and recommendations for other organizations and the wider humanitarian community on engaging persons with disabilities at all levels of humanitarian work. It draws on consultations with over 700 displaced persons, including persons with disabilities, their families, and humanitarian staff, in eight countries”

Note: This report is also offered in plain text format

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