In Ghana, the social interpretation of leprosy regardless of the language, culture and tradition engenders stigmatisation and discrimination that leads to social rejection and exclusion of persons who have been cured of the disease. Often, these persons are cared for by relatives who happen to live with them in a confined place. From the views of these caregivers, this paper identifies areas of stigmatising and discriminatory tendencies against people affected by leprosy who reside in a Leprosarium in Accra. A qualitative interview with semi-structured interviews were conducted for twenty caregivers.
The primary objective of this study is to estimate the expenditure in primary (outpatient) care incurred by leprosy patients in two different health system settings in India. The secondary objective is to compare the effect of the health systems on consumer behaviour and practices.
The study followed a cross-sectional design, where a cohort from the Union Territory of DNH (an administrative division ruled directly by the federal government) was compared with a cohort from Umbergaon block of Valsad district, Gujarat, India. A block is the smallest administrative unit under a district. The cohorts were leprosy cases detected between April 2015 and March, 2016. A sample of 120 participants from each group was selected randomly. In the financial year of 2015–16, DNH reported 425 and Umbergaon reported 287 cases.
A household survey was conducted between June and October, 2016 by means of a structured questionnaire collecting data on patient demographics, HH socioeconomic status, accessibility of health services, treatment seeking history and OPD expenditure. Respondents were asked to report on the last three OPD visits, either in a public or private facility, in the last 6 months.
The costs were categorized as direct and indirect expenditure. The direct part included the expenditure on consultation, investigations and medicines & supplies. The indirect part constituted expenditure on transport, food, and days lost during illness of the patient and attendant
PLOS Neglected Tropical Diseases, January 4, 2018
Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface.
Conflict and Health 2017 11:18
"Languages are dynamic and change over the years. Changes in sign languages have been usually initiated to accommodate the needs of the local Deaf community. With the increase in smartphone use, sign languages are influenced not only by the local Deaf community, but also by foreign Deaf people on the other side of the screen, regardless of their location. Smartphones influence the sign language itself and the Deaf community by connecting different communities of Deaf people through messages, shared information and experiences, and news delivery. The popularity of this technology among Deaf communities is a social phenomenon emerging from Deaf people themselves. Smartphones may promote the globalization of sign language, shortening distances between Deaf communities around the world"
Disability & Society, Volume 33, 2018 - Issue 2
Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. An international online survey was conducted via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people’s current capabilities to assist with this work. One of the areas of debate concerned whether and how work on the application of Cochrane methods in low and middle income countries should be prioritised.
Eur J Phys Rehabil Med 2017;53:814-7
This special issue of the Journal of Poverty & Social Justice has two aims. Firstly to provide new evidence on the implementation and impacts of conditionality for disabled benefits claimants in order to provide an empirical foundation for the contested claims on both sides of this debate and secondly to prompt further research in this area.
Article titles in this issue are:
- Benefits conditionality for disabled people: stylised facts from a review of international evidence and practice
- Does sanctioning disabled claimants of unemployment insurance increase labour market inactivity? An analysis of 346 British local authorities between 2009 and 2014
- Consequences of activation policy targeting young adults with health-related problems in Sweden and Denmark
- Assessment of work ability in competing strands of social insurance: the German case
- Welfare conditionality and disabled people in the UK: claimants' perspectives
- The bedroom tax in the Supreme Court: implications of the judgment
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
The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities. The objective is to summarise a complex and heterogeneous body of empirical research on the association of different social relationship constructs with mental health and wellbeing in physical disability and to highlight conceptual and methodological deficiencies in the field of research. The literature search included original articles published in English between January 1, 1995 and May 31, 2016. Data was extracted on study and participants’ characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesise findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality. Of the 63 included studies, 47 were cross-sectional and 16 longitudinal.
BMC Public Health (2017) 17:414
The transformation of community care for people with intellectual disabilities (ID) through enhanced access to assistive technology (AT) is discussed. The problems associated with lack of access to AT and the extent to which these occur are reported. Issues in lack of AT provision, including lack of global standards, are discussed. A call to action is made with reference to the appropriate parts of CRPD.
Disability and Rehabilitation: Assistive Technology, 12:5, 426-428
The central aim of this anthology of papers is to consider the place of law in political, social, scientific and biomedical developments relating to disability and other categories of ‘abnormality’. The papers consider how categories of abnormality relate to the privileged and frequently unmarked position of ‘normality’ and how legal interventions in abnormality relate to existing normative designations in the dominant cultural imaginary. This collection of papers has a range of disciplinary approaches
- Fit or fitting in: deciding against normal when reproducing the future
- Eccentricity: the case for undermining legal categories of disability and normalcy
- Eugenics and the normal body: the role of visual images and intelligence testing in framing the treatment of people with disabilities in the early twentieth century
- The construction of access: the eugenic precedent of the Americans with Disabilities Act
- Disability and torture: exception, epistemology and ‘black sites’
- Mental capacity and states of exception: revisiting disability law with Giorgio Agamben
- Not just language: an analysis of discursive constructions of disability in sentencing remarks
- Policing normalcy: sexual violence against women offenders with disability
- ‘The government is the cause of the disease and we are stuck with the symptoms’: deinstitutionalisation, mental health advocacy and police shootings in 1990s Victoria
- Disruptive, dangerous and disturbing: the ‘challenge’ of behaviour in the construction of normalcy and vulnerability
- Making the abject: problem-solving courts, addiction, mental illness and impairment
- Cripwashing: the abortion debates at the crossroads of gender and disability in the Spanish media
- ‘Figurehead’ hate crime cases: developing a framework for understanding and exposing the ‘problem’ with ‘disability’
Journal of Media & Cultural Studies, Vol.31, No.3, pp. 337-340
Mental health issues are the leading cause of disability in adolescents aged 15–19 years in all the world's regions, contributing 45% of their overall burden of disease. Early intervention to prevent mental health disorders is crucial to suicide prevention and to improve lifelong wellbeing. In April 2017, Mission Australia, in association with the Black Dog Institute (a research institute based in New South Wales) published the 5th Youth Mental Health Report. A survey of 21 000 Australian adolescents recorded 22·8% of young Australians meeting the criteria for probable serious mental illness (PSMI), as assessed by the Kessler 6 measure of non-specific psychological distress. Adolescent girls were almost twice as likely than boys to meet the criteria for PSMI. A significantly higher proportion of Aboriginal and Torres Strait Islander responders met the criteria for PSMI (31·6%) than non-Aboriginal and Torres Strait Islanders.
Vol. 389, No. 10080, p1670, 29 April 2017
Employee and employer perceptions on barriers existing among Information Technology (IT) and IT-enabled sectors to employ persons with disabilities (PWD) were investigated. Two hundred participants (147 PWD and 53 employers) from six organizations were included in the study, which was conducted in Hyderabad, India. A semi-structured questionnaire was administered to the participants. The study also documented enabling factors that have facilitated employment of PWD. An assessment of awareness levels among employers and employees with disabilities on the provisions of the Indian PWD Act (1995) was also undertaken.
Indian J Occup Environ Med. 2017 Jan-Apr; 21(1): 36–41
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.
In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15.
All asylum seekers transiting the 15 MSF-supported centres were invited to a psycho-educational session. A team of psychologists and cultural mediators then provided assessment and care for those identified with MH conditions. Potentially traumatic events experienced before and during the journey, as well as post-migratory living difficulties, were recorded. All those diagnosed with MH conditions from October 2014 to December 2015 were included in the study.
Among 385 individuals who presented themselves for a MH screening during the study period, 193 (50%) were identified and diagnosed with MH conditions. Most were young, West African males who had left their home-countries more than a year prior to arrival. The most common MH conditions were post traumatic stress disorder (31%) and depression (20%). Potentially traumatic events were experienced frequently in the home country (60%) and during migration (89%). Being in a combat situation or at risk of death, having witnessed violence or death and having been in detention were the main traumas. Lack of activities, worries about home, loneliness and fear of being sent home were the main difficulties at the AS centres.
MH conditions, potentially traumatic events and post-migratory living difficulties are commonly experienced by recently-arrived ASs, this study suggests that mental health and psychosocial support and improved living circumstances should be integrated into European medical and social services provided by authorities in order to fulfil their humanitarian responsibility and reduce the burden of assimilation on receiving countries.
Immigration Asylum seekers Refugee Mental health Italy Europe Traumatic event Operational research
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.
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.
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.
"In the absence of access to real-time government-reported Zika case counts, we demonstrate the ability of Internet-based data sources to track the outbreak. Our model predictions fill a critical time-gap in existing Zika surveillance, given that early interventions and real-time surveillance are necessary to curb mosquito transmission. Official Zika case reports will likely continue to be delayed in their release; thus, it is important that health and government officials have access to real-time and future estimates of Zika activity in order to allocate resources according to potential changes in outbreak dynamics. The methodologies presented here may be expanded to any country–and perhaps finer spatial resolutions–to identify changes in Zika transmission for public health decision-makers."
This special issue follows on from the symposium ‘Disability in the SDGs: Forming Alliances and Building Evidence for the 2030 Agenda’ held in London in 2016. The articles in this special issue consider the evidence base around the inclusion of people with disabilities, particularly with respect to health, poverty and education. The editorial reports that emerging evidence suggests that despite marginal changes in discourse, people with disabilities continue to be left behind in these areas, that large data gaps remain, data collected so far is not always comparable and qualitative research also remains scarce. What it means to ‘include’ and how to go about this is also discussed. Titles of papers in this issue are:
- Entering the SDG era: What do Fijians prioritise as indicators of disability-inclusive education?
- SDGs, Inclusive Health and the path to Universal Health Coverage
- No One Left Behind: A review of social protection and disability at the World Bank
- The capacity of community-based participatory research in relation to disability and the SDGs
- Measuring Disability and Inclusion in relation to the 2030 Agenda on Sustainable Development
Titles of research articles in this issue of the journal are:
- Community Action Research in Disability (CARD): An inclusive research programme in Uganda
- The Impact of Community-Based Rehabilitation in a Post-Conflict Environment of Sri Lanka
- Communication Disability in Fiji: Community Cultural Beliefs and Attitudes
- The Search for Successful Inclusion
- Effect of Music Intervention on the Behaviour Disorders of Children with Intellectual Disability using Strategies from Applied Behaviour Analysis
- The Effects of Severe Burns on Levels of Activity
"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."
While the medical conditions of newly migrated asylum seekers to Sicily were being addressed, the mental health of those who may have experienced trauma before, during, or after their migration was not addressed. "Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15."
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