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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.

Forecasting Zika Incidence in the 2016 Latin America Outbreak Combining Traditional Disease Surveillance with Search, Social Media, and News Report Data

MCGOUGH Sarah F. ,
BROWNSTEIN John S.,
HAWKINS, Jared B. ,
SANTILLANA Mauricio
et al
January 2017

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"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."

2016 Synthesis of Voluntary National Reviews

UNITED NATIONS SECRETARIAT DEPARTMENT FOR ECONOMIC AND SOCIAL AFFAIRS (UNDESA)
January 2017

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"This report synthesizes some of the findings of the VNRs (voluntary national reviews) from twenty - two countries, drawing primarily from the written reports and executive summaries of the majority of countries. It uses a theme based analysis drawn largely from the voluntary common guidelines contained in the Annex to the Secretary-General’s report on critical milestones towards coherent, efficient and inclusive follow-up and review at the global level. The report examines reporting countries’ efforts to implement the 2030 Agenda, including challenges, gaps, achievements and lessons learned" 

School Violence and Bullying: Global Status Report

UNESCO
January 2017

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"A 2012 report by the Special Representative of the Secretary-General on Violence against Children1 notes that ‘more than one billion children around the world attend school. Many of these children enjoy their right to be taught in a safe and stimulating environment. For many others, however, schooling does not guarantee such opportunity. These girls and boys are exposed to bullying, sexual and gender-based violence, corporal punishment and other forms of violence… Many are also exposed to schoolyard fighting, gang violence, assault with weapons, and sexual and gender-based violence by their own peers. New manifestations of violence are also affecting children’s lives, notably the phenomenon of cyberbullying via mobile phones, computers, websites and social networking sites. The symposium is one of a series of international meetings UNESCO has organised to address school violence and bullying and it is intended to promote evidence-based action by educators, policy makers, professionals and practitioners in the education, health and other sectors. Consequently, this report aims to provide education sector stakeholders with a framework for planning and implementing effective programmes to prevent and respond to school violence and bullying as part of wider efforts to address violence against children." 

The economic burden of dementia in China, 1990–2030: implications for health policy

WORLD HEALTH ORGANIZATION
January 2017

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Objective To quantify and predict the economic burden of dementia in China for the periods 1990–2010 and 2020–2030, respectively, and discuss the potential implications for national public health policy. Methods Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs – e.g. the costs of transportation – and indirect costs due to loss of productivity. We excluded comorbidity-related costs.

Findings The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030.

Conclusion In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.

Autism and eating issues: an interview with Dr Elizabeth Shea

THE NATIONAL AUTISTIC SOCIETY
January 2017

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Dr Elizabeth Shea is Clinical Psychologist at the Birmingham Food Refusal Service. Elizabeth kindly agreed to be interviewed for Network Autism when she attended the XI Autism-Europe International Congress hosted by the National Autistic Society in 2016.

In this video Elizabeth discusses some of the common eating issues that autistic people may experience. She explores why autistic people may struggle with eating issues and outlines how professionals can best support them.

Individual interview questions

1. Can you tell us how you first became interested in autism?

2. Can you tell us about your current work?

3. What are the most common eating issues that you see for autistic people?

4. Can you highlight some of the reasons why autistic people may develop eating issues?

5. What are the most effective treatments for eating issues for autistic people?

6. What advice would you have for professionals working with autistic people who maybe struggling with eating issues?

Greece: Refugees with Disabilities Overlooked, Underserved

HUMAN RIGHTS WATCH
January 2017

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Refugees, asylum seekers, and other migrants with disabilities are not properly identified and do not enjoy equal access to services in reception centres in Greece.  On the basis of research carried out in mainland Greece and on the Greek islands in October 2016 and January 2017, and follow-up phone interviews in December 2016 and January 2017, Human Rights Watch found that asylum seekers and refugees with disabilities are not properly identified in Greece, in part because of a rushed registration process and the need for better guidance for staff. Without an adequate understanding of the scale and needs, aid agencies cannot respond effectively. Problems with equal access to water and sanitation services, food distribution, shelter, and health care including mental health and psychosocial support are reported.

Zero Project report 2017. Employment work and vocational education & training

FEMBAK, Michael
et al
January 2017

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The results of the Zero Project Survey 2016–2017 consisting of 21 questions with a particular focus this year on employment and vocational and educational training are presented. After five years of Social Indicator research, for the first time data trends are published as well as comparisons between world regions. The Social Indicators section also includes analysis of data availability on youth employment with regards to Sustainable Development Goal (SDG) 8, and of the “data gap” of persons with disabilities living in institutions. 56 Innovative Practices have been selected, and 13 common solutions and “threads” have been identified.  11 Innovative Policies have been selected, and 13 ways to create a significant impact have been identified.

 

School and classroom disabilities inclusion guide for low- and middle-income countries

BULAT, Jennae,
HAYES, Anne
et al
January 2017

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This guide provides strategies and recommendations for developing inclusive classrooms and schools. We specifically address the needs of Sub-Saharan African countries, which lack the resources for implementing inclusive education. However, our strategies and recommendations can be equally useful in other contexts where inclusive education practices have not yet been adopted. Strategies for enhancing existing school and classroom environment and instruction include: modify the physical environment; modify classroom managment strategies; ensure social inclusion; adopt best instructional practices; apply strategies for students with sensory disabilities; and use assistive technologies. Strategies for adopting response to intervention include: tier by tier implementation; individualised education plans; and planning for school wide adoption of inclusive practices and a multilevel system of support.

 

 

Inclusive teaching and learning in higher education as a route to excellence

DISABLED STUDENTS SECTOR LEADERSHIP GROUP,
LAYER, Geoff
January 2017

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The report encourages UK higher education providers (HEPs) to look at how they can support and offer the best environment for disabled students. It considers the requirement to provide ‘reasonable adjustments’ under the UK Equality Act 2010, and suggests actions to mitigate risks associated with that. It has been produced by the Disabled Student Sector Leadership Group, a sector-led group. 

DFE-00044-2017

Towards an inclusive judicial system. Penal process and psychosocial disability

Documenta. Analyses and action towards social justice
January 2017

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This report gives a first general insight on barriers people with disabilities are facing when they have to deal with the criminal justice system as accused of having committed a criminal act in the Federal District. Its purpose is to provide a reflection on how the justice system could cope with their special needs in a more appropriate way, to ensure that human rights and access to justice of people with disabilities occur on equal basis with others.

The probability that people with psychosocial disabilities are faced with the criminal justice system is higher than for the rest of the population. This can be explained to a large extent by the existing incomprehension concerning disability, which is even more of an issue when it comes to psychosocial disability as it seems to be one of the less well understood and one of the more stigmatized as well.

In addition to the preconceptions and the lack of capacity building, we may add the existence of a discriminatory penal legislation which keeps on looking at people with disabilities as if they weren’t subject with rights and obligations, but insists on an anachronistic vision that looks at them as objects requiring treatment and cure.

Vulnerability- and resilience-based approaches in response to the Syrian crisis: Implications for women, children, and youth with disabilities

Women's Refugee Commission
January 2017

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Since the beginning of the Syrian crisis, which is now heading into its sixth year, the WRC has worked with partners on the ground to promote the inclusion of refugees with disabilities—an estimated 22% of the population—in assistance programs and in the decision-making process.

In a protracted and complex crisis, humanitarian actors continue to look for ways to strengthen protection and assistance. Vulnerability considerations have typically determined the design and implementation of humanitarian programs. However, program models are emerging in the Syria response that focus on a resilience-based approach—emphasizing skills, capacities, strengths, and assets.

Recognizing the increased attention to resilience in the Syria response, the WRC undertook a project to examine how vulnerability and resilience-based approaches are supporting the protection and empowerment of Syrian refugee women, children, and youth with disabilities.

The WRC has identified a set of actions that must be taken to ensure that the resilience of diverse populations amongst refugees with disabilities are recognized and fostered in programming. While the findings and recommendations are drawn from the Syria crisis, we believe they have relevance across other humanitarian settings.

Evaluating the impact of a community–based parent training programme for children with cerebral palsy in Ghana

ZUURMOND, Maria
et al
January 2017

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"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".

Right to health: Reality of persons with spina bifida and hydrocephalus

MCPHERSON. Amy
January 2017

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"This report maps the situation of persons with SBH in relation to healthcare access and is a follow up of the CRPD Concluding Observations Art.25. Through a comprehensive survey, IF collected valuable data on the experiences, satisfaction, and perceptions of healthcare coverage of individuals with SBH across Europe. Based on its findings, the financial coverage of treatment and assistive products for patients with SBH is grossly insufficient across the EU. Europe as a whole lacks multidisciplinary care and specialised SBH teams, which translates into long waiting times and insufficient knowledge of the SBH specificities. 

Considering these findings, IF urges the EU Member States to adequately support the healthcare needs of persons with SBH, and to invest more substantially into creating multidisciplinary clinics that can help avoid preventable complications 11 and may reduce the overall burden 12 on the patient and the system. In addition, the Member States should actively support creation of the European Reference Networks as a way of improving care for persons with SBH. IF also calls on the European institutions for support in training medical professionals on rights of persons with disabilities."

Accessibility Guide Improving public transport services through awareness of staff about persons with disabilities and persons with reduced mobility

EUROPEAN DISABILITY FORUM
December 2016

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Presentation

To mark the International Day of Persons with Disabilities (3 December), the International Association of Public Transport (UITP), IRU (World's Road Transport organisation) and EDF jointly publish an 'Accessibility Guide' to improve customer service for persons with disabilities and persons with reduced mobility.

The publication aims to show that service quality and inclusiveness are of paramount importance for the public transport sector.

The guide is one of the initiatives that we are undertaking to raise awareness amongst staff about the barriers still existing to a fully inclusive public transport system and how to best overcome them. It is targeted at public transport staff regularly interacting with passengers and can be used in the context of disability awareness trainings.

About the guide:

Gunta Anca, EDF Vice-President: “With this accessibility guide we want to give simple tips and advice on how to improve service for persons with disabilities. There is really nothing to be afraid of – we are passengers like everyone else, just sometimes we need a little bit more of your support and understanding.”

Thomas Avanzata, Director of the European Department at UITP: “An average person does not know much about persons with disabilities. With this guide, we hope to close the knowledge gap for our bus drivers and be able to offer an improved service to persons with disabilities. We are very happy about the cooperation with EDF and IRU and optimistic that such small initiatives can make a difference on the ground, especially at times where financial resources for costly infrastructure works are scarce.”

Rémi Lebeda, who leads IRU’s work on passenger transport in Europe: “This accessibility guide is an excellent tool to improve the quality of service offered to people with disabilities by drivers and operators. We thank EDF and UITP for their excellent cooperation in working on this important issue. In further recognition of the International Day of Persons with Disabilities the guide will also be available in accessible format.”

European Human Rights report, issue 1 – 2016 Marking 10 years of the United Nations Convention on the Rights of Persons with Disabilities in Europe

LEENKNECHT An-Sofie,
CONTE Carmine
December 2016

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Here is the first issue of a series of European Human Rights Reports launched by European Disability Forum. This first issue focuses on the 10th anniversary of the CRPD giving an overview of the state of play and progress made with regards to the CRPD in Europe.

It was launched on the occasion of a 2-day conference organised by the European Commission and EDF on 29-30 November 2016, as 2016’s European Day of Persons with Disabilities marked the 10th anniversary of the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), . The conference gathered together around 400 participants including people with disabilities and their representative organisations, associations and companies working to improve the life of people with disabilities, government representatives, EU institutions representatives, academics and many others. Together they have been discussing and ethe progress made in the European Union (EU) to promote the rights of persons with disabilities in line with the CRPD: each panel gave an overview of the legal and policy framework, and how it had changed, followed by personal testimonies and examples.
 
 

Guidelines for Consulting with Children & Young People with Disabilities

PLAN
December 2016

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What is this document?

This document provides a guidance on the importance of consulting with children with disabilities. It provides practical suggestions for consulting with children and young people with disabilities in a variety of situations. It aims to equip individuals working on child rights with the knowledge and skills necessary to communicate with children with a variety of disabilities.

This document sets out tips and suggestions for the entire consultation process including: planning for the consultation, general considerations for consulting with children with disabilities, specific tips for communicating with children with different types of impairments, and some case study examples. 

Who is this document for?

This document is a guide for Plan and partner staff on how to work with children to ensure that children with disabilities are consulted with and heard in Plan programmes. This could include:

• Field staff

• Researchers and consultants

• Community leaders and members

• Government officials

• Facilitators and trainers

• School teachers

• Plan National Office and Country Office staff

These guidelines can be used in all contexts including at a national policy level, in communities, during development projects and in humanitarian settings.

The Functions of Disabled People’s Organisations (DPOs) in Low and Middle-income Countries: a Literature Review

YOUNG, Rebekah,
REEVE, Mathew,
GRILLS, Nathan
December 2016

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Purpose: The aim of this study was to review peer-reviewed literature on the roles and functions of Disabled Peoples’ Organisations (DPOs) in low and middle-income countries, and their outputs and outcomes for people with disabilities.

Method: Online databases were searched without date or language limiters (Medline, CINAHL, Scopus, Embase and Cochrane), using a combination of two key word search strategies. Eleven studies were selected for inclusion in this review on the basis of predetermined inclusion and exclusion criteria. Included studies underwent quality assessment using the Critical Appraisal Skills Programme (CASP) and Downs and Black’asss criteria for quality assessment. Data for thematic analysis was then grouped under the broad themes of: participation and factors that facilitate participation; development of partnerships and connections; and self-development and self-help.

Results: There was some evidence within the included studies to suggest that DPOs can produce significant, positive outcomes for persons with disability in terms of factors such as employment rates, access to microfinance and bank loans, accessibility of housing, acquisition of orthopaedic devices, involvement in civil society, development of friendships and networks, and participation in training programmes. Although the studies under review largely did not investigate the long-term impact of the reported DPO functions and outputs, some of the short-term outputs may be considered proximal indicators of outcomes such as increased empowerment and well-being. Conclusion: The 11 studies in this review suggested that DPOs can be effective in achieving their stated aims of promoting well-being, participation and rights of people with disabilities in low and middle- income countries.
 

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