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Inclusive participation of persons with disabilities in emergency preparedness and response practice guide

ROBINSON, Alex
PERTIWI, Praditya
March 2024

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The World Food Programme (WFP) has taken important steps to progress disability inclusion across its programming and operations. In late 2022, WFP commissioned the Nossal Institute, University of Melbourne in partnership with the Faculty of Psychology, Universitas Gadjah Mada, Indonesia to identify pathways for increasing disability inclusion in WFP’s emergency preparedness and response (EPR) programming.

The study explored WFP’s programming in Indonesia and the Philippines, including WFP’s advisory, technical assistance and service provision roles to government and partners and informed the development of this guide (see appendix 2). As general guidance on disability inclusion is increasingly available, the purpose of this guide is to contextualize disability inclusion in WFP’s emergency preparedness and response programming. The guide builds on core reference materials, such as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, 2019. While of wider relevance, this guide is directed at WFP’s EPR programming in Asia and the Pacific.

Rapid access to essential assistive technology for internally displaced people in Ukraine (‎AT10)‎: lessons learned report

WHO Regional Office for Europe
January 2024

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The “Rapid access to essential assistive technology for internally displaced people in Ukraine (AT10)” project was a WHO initiative, in partnership with the Ukrainian Ministry of Health, that took place in Ukraine starting in 2022, with funding from ATscale and the Ukraine Humanitarian Fund.

Its aim was to establish rapid service delivery mechanisms to provide 10 products that assist mobility and self-care to support the population with existing or new assistive technology needs. A novel aspect of this project was that the provision of assistive technology was integrated in the emergency response. Service providers were trained to provide the 10 products using the WHO Training in Assistive Products programme.

As of 31 March 2023, in the first phase of the project, 2458 assistive products had been provided by 10 health facilities in five oblasts [regions] in eastern Ukraine, meeting the assistive technology needs of 1485 people affected by the war. Through a process that was well coordinated, timely, acceptable to service users and sensitive to the challenges of the local context, the AT10 project met the assistive technology needs of the population and facilitated rehabilitation, community participation and ultimately community development.

This report describes the lessons learned from this project and outlines recommended actions for future provision of assistive technology as part of the health emergency response.

SOUTH SUDAN. Protection Analysis Update. Protection risks facing persons with disabilities and older persons

GLOBAL PROTECTION CLUSTER, UNHCR
October 2023

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This South Sudan Protection Analysis Update places a thematic focus on protection risks facing persons with disabilities and older persons.

The most recent census reported that 5% of the population in South Sudan, or approximately 424,000 people, were living with a disability. However, the current number is likely to be much higher, possibly reaching 1.2 million people, or 16% of the population, according to the global estimate. Data in South Sudan also suggests a rapid increase in the number of older persons each year, mounting to 5.1% of total population with this percentage expected to continue to steadily increase.

People with disabilities and older people in South Sudan are often excluded and face multiple challenges in accessing essential services and protection. Decades of civil war have increased the number of older people and persons with disabilities who are being left behind as they are unable to flee due to chronic health conditions and mobility impairments. People who have managed to flee the violence are often faced with barriers accessing protection and health services. Therefore, older people with and without disabilities in South Sudan face higher risks and greater challenges in getting the necessary humanitarian assistance.

Inclusive design and accessibility of the built environment in Freetown - an Inclusive Infrastructure Case Study from Sierra Leone

PATRICK, Michaela
MULDOWNEY, A
TURAY, A
KOROMA, B
McKINNON, I
October 2023

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Showcasing findings and recommendations for infrastructure, the built environment and urban development in Freetown, Sierra Leone, the case study provides actions towards creating a more accessible and inclusive city. Building a picture of the current state of inclusive design and accessibility of the built environment, the report sets out the potential for inclusive design to address existing barriers to inclusion for persons with disabilities.  

 

Research conducted in Sierra Leone included interviews, co-design workshops and photo diaries, with 15 stakeholders and 20 persons with disabilities living and working in the city.

 

Inclusive Infrastructure is a sub-programme of UK aid funded AT2030, testing ‘what works’ to improve access to life-changing Assistive Technology (AT) for all. The research demonstrates how access to AT is dependent on an enabling and inclusively designed built environment. The Sierra Leone case study is the fifth of six that help build a global picture of the current state of inclusion and accessibility in our cities through engaging local stakeholders and communities. 

 

The impact of corruption on the rights of persons with disabilities

ATLAS ALLIANCE
September 2023

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Corruption and discrimination go hand in hand. In 2021, Transparency International and the Equal Rights Trust published a report highlighting how corruption and discrimination reinforce each other, leaving marginalized groups with little room to access public services, exercise their human rights, and live their lives with dignity. In this seminar organized by Norad, CMI/U4 and the Atlas Alliance collectively, researchers and DPO representatives discuss research findings and the situation as lived experience for persons with disabilities.

What works

AUSTIN, Vicki
McKINNON, Anne
BELL, Diane
September 2023

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Presented at the Disability Innovation Summit: Inclusive Interactions conference organised by the GDI hub on 13 Sept 2023.

 

Outcomes of the first 5 years of the AT2030 project are summarised including: 15 AT country capacity surveys; 11 new assistive technologies; 31 AT ventures brought to sustainability and 70 journal papers. Funding thus far and for the future is also discussed.

Work to supply hearing aids to those with hearing loss in the global south, particularly in South Africa is outlined. Areas highlighted include: work with suppliers; work to ignite innovation and provide products at scale; work with UNICEF and the procurement catalogue; work with HEARX to provide screening and aid fine tuning via a phone app to enable community health AT service.

Questions from the audience highlight issues surrounding acquiring AT in the emergency/humanitarian setting  

How disabled people are leading innovation and systems change in the UK

KANODIA, Kush
September 2023

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The most important part of innovation in systems change is the lived experience.

The successful campaign to eliminate car park charges for people with disabilities at NHS hospitals in the UK is outlined. (Charges from over 200 hospitals are now dismissed).

The ongoing campaign to exempt all people with disabilities who are "Blue badge" holders from charges associated with ULEZ (ultra low emission zones) or the equivalent in cities in the UK is also described. The importance of integrating climate action and disability rights is highlighted.  

Local innovation and production ecosystem building in Nepal

OLDFREY, Ben
BAJRACHARYA, Amit Ratna
GURUNG, Ganga
LAL SHRESTHA, Pratisthil
CHANDRA THAPA, Ram
September 2023

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A series of short talks concerned with local innovation and production of AT devices in Nepal given by representatives of members of the associated ecosystem. A short history of the projects is presented. The devastating earthquake in 2015 and COVID both demonstrated the necessity for local innovation, production, repair and maintenance of AT. Three workstreams are ongoing: codesigning for individual needs; manual wheelchairs; and repair and spare part production. The need to develop local OT services in Nepal, particularly of bespoke provision, codesigning with the user to ensure achievable goals with a developed therapeutic intervention plan, is highlighted. Innovative AT associated with the knee joint and a diabetic foot and also a temperature monitoring device are shown and problems with local product validation are highlighted.  Ram Chandra Thapa (founder of Zener Technologies) describes the use of 3D printing in emergency engineering situations. He briefly describes his current project concerning wheelchairs, outlining associated difficulties, the local production ecosystem and the assessment of which parts are the most important for maintenance needs. The need for training and also finance to take a product from innovation to production are mentionned.

Persons with disabilities and climate change in Nepal: Humanitarian impacts and pathways for inclusive climate action

Jennifer M'Vouama, Humanity & Inclusion (HI)
Mosharraf Hossain, Team Leader, Global Inclusion Consulting Ltd
Sukharanjan Sutter, IRG Development Services Limited
Mahesh Ghimire, local consultant, Nepal
August 2023

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Climate change is affecting every region on Earth and already causing irreversible impacts. While it is a global phenomenon, its negative impacts are felt more intensely by poorer countries and poor communities heavily reliant on natural resources and lacking coping and adaptive capacities to deal with a changing climate. Within those poor communities and countries, persons with disabilities are often amongst the most marginalized people. They experience attitudinal, physical and communication barriers that undermine their access to services and opportunities supporting their well-being and resilience. For this reason, they tend to be disproportionately vulnerable to climate impacts, including more frequent and intense disasters, as those exacerbate pre-existing vulnerabilities. Yet, while it is acknowledged that climate change will exacerbate inequity should we fail to ensure inclusive and participatory decision-making processes in climate governance, disability inclusion in climate action largely remains marginally addressed. Persons with disabilities have been historically left out of climate responses at various levels, from local and national country plans to global negotiations occurring at the UN Conferences of the Parties1 (COP).


Nepal is experiencing an increasing number of climate-related disasters, with a global study ranking it as the fourth worst hit country in the world by weather-related loss events in 20172. Urban floods, landslides, extreme heat, storms, drought, and wildfires are very common climate disasters affecting communities across the country, especially rural populations and their natural resource-dependent livelihoods. Nepal’s vulnerability to climate change lies in its varied topography marked by steep terrain and remoteness, its diverse geo-climatic system and social vulnerability, exacerbated by challenges to deliver effective and comprehensive disaster risk reduction and management strategies. To address this serious threat to economic development and prosperity, Nepal has put in place a rich overarching climate change policy framework early on, encompassing dedicated policies and plans, as well as sectoral planning processes integrating climate resilience. Nepal has also established various leadership, coordination, and stakeholder engagement mechanisms to guide climate change policymaking, articulate implementation across the government’s three-tier federal structure, and ensure dialogue with key stakeholders including civil society actors.

Endorsed in 2011, Nepal’s Framework on Local Adaptation Plans for Action (LAPA) is a particularly praised initiative, promoting a bottom-up, inclusive, and flexible approach for integrating climate adaptation and resilience aspects into local planning. This pioneering, community driven process, places the adaptation needs and opportunities of most vulnerable and highly vulnerable groups at the heart of the approach. Gender considerations factoring intersecting factors of marginalization such as age and ethnicity have been given priority in these processes, to address women’s increasing economic insecurity and workload due to climate change. But inclusion of women with disabilities, or persons with disabilities in general in local adaptation planning has not been strongly evidenced to date.


According to Nepal Census 2022, 2.2% of the Nepali Population have some form of disability, mainly a physical disability. However, other sources estimate this figure to be much higher. Nepal ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2008 and passed the Disability Rights Act in 2017, establishing constitutional directives to support persons with disabilities and making it illegal to discriminate based on disability. Yet, perception of persons with disability in Nepal remains generally negative, due to persistent and deep-rooted Hindu religious beliefs associating disability with sinning in a previous life. Women and girls with disability face greater marginalization and discrimination and tend to be hidden away by families. Nepal’s caste system also plays a role in shaping the vulnerability of persons with disabilities. Thus, widespread stigma compounded by the intersectionality of certain factors, combined with structural inaccessibility, create significant barriers to have equal access to resources and participate in decision-making. This tends to translate into poor socio-economic status, poor health outcomes, and no or low education levels, especially among women and girls. Persons with disabilities in Nepal can register under social welfare to access several disability-targeted benefit packages, including a Disability Grant. However, the process tends to be paved with barriers, leading to high exclusion rates.
It is in this context that HI sought to better understand the unique challenges and opportunities for persons with disabilities in the face of climate change in Nepal. This report is intended to inform how persons with disabilities understand and perceive climate change, what is their experience of dealing with climate extremes, what is the impact on their health, livelihoods and support system, and their actual level of inclusion in climate adaptation planning. To capture those perspectives, HI surveyed 388 persons with disabilities across Nepal’s 7 provinces, consulted 20 key informants from the disability movement, government institutions, and the aid sector, and conducted 8 targeted focus group discussions to hear from women, youth, and persons representing diverse disability types. This report is a contribution to the growing evidence base documenting the disproportionate impacts of climate change on persons with disabilities and calling for disability-inclusive climate action at all levels of governance.

Strengthening rehabilitation in health emergency preparedness, readiness, response and resilience: policy brief

Pete Skelton
et al
July 2023

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Strengthening rehabilitation in health emergency preparedness, response, and resilience: policy brief outlines the evidence for rehabilitation in emergencies and the need for greater preparedness of rehabilitation services. It shows how existing guidelines support the integration of rehabilitation in emergencies and sets out the steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.

Case studies are provided from Japan, Nepal, Phillipines, Australian and Sweden

Mainstreaming Disability Inclusive Disaster Risk Reduction (DIDDR) in Community Based Inclusive Development: A Situation Analysis

GRECH, Shaun
July 2023

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Two publications, developed with the University of Cape Town, aim to provide development practitioners and organisations with the tools they need to ensure that a disability inclusive approach to disaster risk reduction can be integrated into all community development programmes.

A situation analysis reviews the situation and outlines the extent to which DIDRR is infused within CBID. The study points out the barriers in place and highlights the opportunities available to facilitate the process of mainstreaming DIDRR, which means building DIDRR into the core of community development programmes as opposed to these disciplines operating in separate spheres. This mainstreaming will not only ensure greater preparedness for disasters, but also protection of the gains made in community development programmes.

A major outcome of this study is a new set of guidelines for practice on the mainstreaming of DIDRR in community development: Mainstreaming DIDRR in CBID – Guidance for Planning and Practice

Mainstreaming Disability Inclusive Disaster Risk Reduction (DIDRR) in Community Development: Guidance for Planning and Practice.

GRECH, Shaun
July 2023

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Two new publications, developed with the University of Cape Town, aim to provide development practitioners and organisations with the tools they need to ensure that a disability inclusive approach to disaster risk reduction can be integrated into all community development programmes. A situation analysis reviews the situation and outlines the extent to which DIDRR is infused within CBID. 

A major outcome of this study is a new set of guidelines for practice on the mainstreaming of DIDRR in community development: Mainstreaming DIDRR in CBID – Guidance for Planning and Practice. In twenty action points, the guide provides pointers for practitioners on how community-based initiatives can become more informed about disasters and start mainstreaming DIDRR. It aims to stimulate reflection at multiple stages, from project planning to implementation and monitoring, to ensure DIDRR becomes an integral part of community-based programmes, in an effective, sensitive and responsive way.

The guidelines are available to download either as one document or as 20 separate action points.

 

 

 

Prevention against emerging infectious diseases: An Opportunity for Inclusive Health. Understanding the behavioural and social drivers (BeSD) of COVID-19 vaccination among persons with disabilities in Internally Displaced camps in Somalia/Somaliland

ZIVERI, Davide
ABDULLAHI, Hawaa
July 2023

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In close collaboration with the World Health Organization, Humanity & Inclusion adapted and piloted WHO’s behavioural and social drivers (BeSD) of vaccination tools to understand and analyze the perception of COVID-19 vaccines as well as the barriers and drivers of immunization among persons with disabilities in a humanitarian setting in Somalia/Somaliland. This study was funded by the Universal Health Coverage and Life Course (UHL) division of the Immunization, Vaccines and Biologicals (IVB) department of the World Health Organization, Geneva. Humanity & Inclusion also carried out a Risk Communication and Community Engagement (RCCE) project, contributing to the inquiry phase described in this report, to foster the right to health as well as access to COVID-19 vaccination in Somalia/Somaliland, funded by the Center for Disaster Philanthropy.

 

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Who is disabled? On whether the functional definition of disability targets the same individuals as the subjective definition

Judith Baart
Willem Elbers
Alice Schippers
May 2023

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With the increased attention to disability as a vulnerability criterion in the Sustainable Development Goals, international organizations and NGOs within the international development sector have started to pay explicit attention to persons with disabilities, including the collection of data on persons with disabilities. The Washington Group Short Set of Questions, which focuses on functional limitations, has been gaining popularity as an assessment tool for disability. This set of questions reflects a categorization of disability that does not necessarily correspond with subjective disability assessments, such as the yes/no question (“do you have a disability?”) which many development actors have used in their assessment tools when they collect disability data This study compares the subjective and the functional limitations assessment tools for disability to answer the question: do they identify the same individuals as persons with disabilities? Based on a survey carried out amongst persons with disabilities in Cambodia, we included both the Washington Group Short Set and a subjective question asking respondents to self-identify their disability type. We find that, although all respondents self-identified as disabled, not all respondents would be considered disabled according to the Washington Group Short Set of questions. In addition, there is little overlap between specific disability types according to a subjective classification method and the domains of functioning measured through the Washington Group methodology. Our findings affirm that categorization as abled or disabled depends on the tool used. This is important, as the assessment approach chosen by those collecting disability data can shape the design choices of policies and programs, and determine who benefits.

Inclusive Education Resources and Toolkit – Tools

CRESPI, Sylvia
LOSERT, Lynn
NEWMAN, Lorenzo
PELOSI, Alice
PONTOGOLIO, Silvia
September 2022

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Set of tools developed by Learn More consultancy firm within the Inclusive Education Resources and Toolkit. Available in 4 languages (Arabic, English, French, Spanish) the tools include:

 

Identifying children who are out of school or have dropped out
Making an Inclusive, Learner-friendly Classroom
Social and Emotional Learning in the Classroom
Accessible School WASH Checklist
Tip sheet: WASH for Children with Disabilities
Teachers Communities of Practice
Teacher Interview Guide: Personal Professional Development
A Lesson Plan Template
Universal Design for Learning
Organization and Management of School-community Liaison Committees
Elements of an Inclusive School Policy
Supporting Children’s Speech and Cognitive Development from Birth to Seven Years Old
Sparking grassroots coalition building
Disabled Peoples’ Organization (DPO) collaboration strategies
Stakeholder alignment workshop template

 

Published by Save the Children Italy, Save the Children Sweden

Assistive Technology in two humanitarian contexts: Bangladesh and Jordan

KETT, Maria
June 2022

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Despite increased focus on the need for assistive technology (AT), along with estimates of need and gaps in provision in humanitarian contexts, very little is actually known about how people who need AT are managing in these contexts. To address this need, this study explored four main questions: 

What do we currently know about the need for AT in humanitarian contexts?
How is this need currently met?
What gaps are there in the evidence about these needs?
What mechanisms are needed to ensure provision of AT in humanitarian contexts? 

It explored these questions through individual interviews with AT users and their families, as well as people working in the sector, in two humanitarian response contexts: Bangladesh and Jordan. In Bangladesh, we partnered with CBM Global and their local partner, the Centre for Disability in Development, and in Jordan, all those interviewed were beneficiaries of HelpAge International.

The questions focused on the areas identified as gaps in the initial literature review, and used qualitative methodologies to probe and gain further insight into gaps across the entire AT ecosystem.

Supporting young children with disabilities in humanitarian settings

BEILER, ROSALENGA BERMAN
ZUIDEMA, SUZANNE
BECKERLEGGE, FIONA
RODRIGUEZ GARCIA, DEBORAH MARIE
June 2022

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The rapid growth that occurs in the first years of life provides an opportunity to influence and improve developmental outcomes that may impact the entire course of an individual's life. Addressing the developmental needs of children with disabilities during this critical period is essential if they are to survive, flourish, learn, and be empowered (WHO, n.d.). 

Recognizing the importance of addressing all children's unique needs and acknowledging the influence of social stigma and misconceptions about disability that may lead to underdeveloped potential and social exclusion, we seek to advocate for and support the inclusion of young children with disabilities in Early Childhood Development in Emergencies programming. 

The webinar was moderated by Rosangela Berman Bieler, UNICEF’s Global Advisor on Disability, and included presentations on foundational concepts for disabilities-inclusive programming, and alternatives to address young children with disabilities needs in a resourceful, creative manner. 

Disability inclusive employment in urban Malawi: A multi-perspective interview study

REMNANT, Jennifer
WANGGREN, Lena
HUQUE, Sarah
SANG, Katherine
KACHALI, Limbani
RICHARDS, James
June 2022

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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and oftenreactive nature of non-governmental organisation (NGO ) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.

 

Journal of International Development, Volume 34, Issue 5

https://doi.org/10.1002/jid.3678

"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

Co-creating inclusive public spaces: Learnings from four global case studies on inclusive cities

PATRICK, Michaela
McKINNON, Patrick
June 2022

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Public spaces, including recreational and social spaces, are often not prioritised. Inclusive public spaces are fundamental to participation and inclusive in society. Including persons with disabilities in the design and planning of the built environment supports equal rights and helps identify people’s aspirations for inclusive environments. Four city case studies will be discussed in this paper: Ulaanbaatar, Mongolia; Varanasi, India; Surakarta, Indonesia; and Nairobi, Kenya.

 

The Journal of Public Space, 7(2), pp. 93–116

doi: 10.32891/jps.v7i2.1500.

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