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Disability-inclusive health services toolkit : a resource for health facilities in the Western Pacific Region

WORLD HEALTH ORGANISATION (WHO) WESTERN PACIFIC
October 2020

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The United Nation Convention on the Rights of Persons with Disabilities upholds the rights of people with disabilities to access health services. The Disability- inclusive Health Services Toolkit: A Resource for Health Facilities in the Western Pacific Region supports the rights of people with disabilities to have the same access to health services as people without disabilities. The Toolkit provides practical guidance to managers and staff of health-care facilities and services, health policy-makers, and nongovernmental organizations on identifying and addressing barriers to health information and services. The Toolkit supports the achievement of universal health coverage (‎UHC)‎ by ensuring everyone can access health information and can benefit equally from health services.

Management of Undergraduate Community-Based Rehabilitation Programmes in the Philippines: A Cross-Sectional Survey

TRINIDAD, Pocholo B
SHIBU, Litty M
CABALLERO, Napoleon R
RAJAB, Ebrahim
2020

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Purpose: The survey aimed to identify common strengths and weaknesses regarding the characteristics, management and implementation of Community-Based Rehabilitation (CBR) training in the undergraduate curriculum of Schools of Physical Therapy in the Philippines, and make recommendations for improvement.

 

Method: A survey was conducted with the academic heads of CBR departments in 10 Physical Therapy schools. The institutions were selected through cluster sampling according to regional location. Nine of these were private institutions. Data was collected through a 24-item self-assessment survey distributed to the heads of the participating colleges /departments.

 

Results: A number of strengths and weaknesses were identified. The strengths were:  all schools had a 1 to 2-month clinical CBR course integrated into their undergraduate curriculum; CBR courses were supported by a course syllabus, learning outcomes, student assessment and clinical training manual; 80% of institutions had implementing policies and guidelines governing management of the CBR programme(s); at least one physiotherapist was involved in the management of the CBR programme(s); and, CBR activities were delivered in coordination with key stakeholders management, with emphasis on delivery of physical therapy services, disability prevention, health education, participation of persons with disabilities and community awareness. The weaknesses were: no head/programme coordinator for 30% of CBR programmes; 40% did not have clinical coordinators as designated management positions in the CBR programme; only 50% of academic staff received formal CBR training, of which 80% was provided through CBR summits and professional interaction with other physical therapists; and, only 50% of schools adopted a multidisciplinary approach to service delivery which was focused on the Health domain of the CBR Matrix.

 

Conclusion:  The CBR component of the undergraduate physical therapy curriculum in the Philippines can be improved. A shift in the teaching to transdisciplinary care and inter-professional learning is recommended. Regular review of the CBR indicators should be done by the schools, including the key stakeholders.  Challenges for CBR implementation were recruitment of community volunteers as CBR workers, availability of indigenous resources and finances to support CBR activities, and family participation in the rehabilitation of a relative with a disability. Each school should determine whether current human resources and training are adequate. Schools must be encouraged to jointly identify common problems in CBR education and share solutions. 

Physical Activity, Enjoyment and Quality of Life among Institutionalised Older Adults in Malaysia: A Cross-Sectional Study

KUTTY, Nizar Abdul Majeed
JABBAR, Mohammed Abdul Razzaq
NG KYLIE
2020

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Purpose: In many nations across the world it has become a priority to stimulate increased physical activity (PA) among elderly persons.  This study aimed to find the association between physical activity patterns and enjoyment of physical activity and health-related quality of life (HRQoL) among institutionalised older adults in Malaysia.

 

Method: A sample of institutionalised older adults (n=134, mean age = 73.72; SD = 8.59) was recruited from the Klang valley in Malaysia. In cross-sectional analyses, their physical activity, enjoyment of physical activity and quality of life were screened using the Physical Activity Scale for the Elderly, the 8-item Physical Activity Enjoyment Scale and the EuroQuol-5 Dimensions-5 Levels questionnaires, respectively. High levels of physical activity were associated with enjoyment of physical activity and health-related quality of life.

 

Results: In total, 41% of the participants met the guidelines of the Physical Activity Scale for the Elderly and 53% enjoyed physical activity. A positive correlation was found between the level of physical activity and its enjoyment (rs = .355, p <.001). Significant correlations were recorded between the dimensions of health-related quality of life and the level of physical activity (p < 0.001), except for pain/discomfort and anxiety/depression.

 

Conclusion: Providing opportunities for institutionalised older adults to engage in a variety of activities might help them to identify the kind of physical activity they enjoy and facilitate a lifelong physical activity routine.
 

The impact of COVID-19 on disabled people in Northern Ireland

FITZSIMONS, Sean
O'NEILL, Emma
CRAWFORD, Alison
September 2020

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Key findings and recommendations are reported from an online survey published in April 2020 to gather the experiences of disabled people, their families and carers during the COVID-19 outbreak in Northern Ireland. The survey went live on April 1st 2020 and closed on April 30th 2020.  Over 400 survey responses were received, including over 1300 written statements. 

Key findings are reported in the areas of: social care; physical health; mental health and emotional wellbeing; carers; accessing food and medicine; accessing information; employment and training; social security benefits and community support

Disability inclusive health, WASH and livelihoods in the COVID-19 response - Thematic guidance notes

AUSTRALIAN HUMANITARIAN PARTNERSHIP (AHP)
September 2020

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Practical guidance has been developed for disability inclusion within the priority sectors of Health, WASH, and Livelihoods and Food Security. This guidance has been developed to inform the AHP Disaster READY program and COVID-19 humanitarian response efforts, and contribute to sectoral understanding of inclusive humanitarian response and disaster preparedness.

Global leaders renew commitments on road safety

HUMANITY & INCLUSION (HI)
September 2020

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On 1st September 2020, the UN adopted a new Resolution on Road Safety to extend until 2030 the global commitments to improve road safety and launched the Second Decade of Action for Road Safety (2021-2030), thus encouraging greater efforts worldwide.  This builds on the Ministerial Declaration adopted in Stockholm in February 2020 and integrates the joint key asks of the many civil society organisations that have been advocating, over the past years, for stronger global leadership on road safety.

The Global Alliance of NGOs for Road Safety, of which Humanity & Inclusion (HI) is a member, has convened and leveraged the diverse voices of road users, road crashes victims’ associations, local organisations and international NGOs. This Resolution represents a great achievement for the global road safety community.

A country report: impact of COVID-19 and inequity of health on South Korea’s disabled community during a pandemic

LEE, Seungbok
KIM, Jongbae
2020

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The South Korean media boasts of its leading success–during the escalation of the coronavirus outbreak–in flattening of the curve thereby mitigating the grave outcomes of the public health crisis. Much of the success is reportedly attributed to the rapid and advanced development of test kits, essential equipment and implementation of protocols in precautionary measures. However, it has been an arduous task to stay afloat for one particular vulnerable community. The disabled citizens of Korea were confronted by the realities of health inequity during this disastrous period. Pre-existing the pandemic onset, the disabled community have faced stigmatization and under many circumstances de-prioritization by their own society. Through the lense of a visiting physician, my hope is to poignantly and respectfully share personal experiences and thoughts on these realties impacted by the COVID-19 pandemic in South Korea.

Employment of young people with mental health conditions: making it work

SUBRAMANIAM, Mythily
ZHANG, Yunjue
SHAHWAN, Shazana
VAINGANKAR, Janhavi Aijt
SATGHARE, Patrika
LIN TEH, Wen
ROYSTONN, Kumarasan
MING JANRIUS GOH, Chong
MANIAM, Yogeswary
LIANG TAN, Zhuan
TAY, Benjamin
VERMA, Swapna
ANN CHONG, Siow
2020

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Purpose: The current study was undertaken to understand and describe the meaning of work as well as the barriers and facilitators perceived by young people with mental health conditions for gaining and maintaining employment.


Materials and Methods: Employing a purposive and maximum variation sampling, 30 young people were recruited and interviewed. The respondents were Singapore residents with a mean age of 26.8 years (SD 1⁄4 4.5, range 20–34years); the majority were males (56.7%), of Chinese ethnicity (63.3%), and employed (73.3%), at the time of the interview. Verbatim transcripts were analysed using inductive the- matic analysis.

 

Results: Three global themes emerged from the analyses of the narratives, which included (i) the mean- ing of employment, (ii) barriers to employment comprising individual, interpersonal and systemic difficul- ties and challenges participants faced while seeking and sustaining employment and (iii) facilitators of employment that consisted of individual and interpersonal factors that had helped the young persons to gain and maintain employment.

 

Conclusions: Stigma and discrimination emerged as one of the most frequently mentioned employment barriers. These barriers are not insurmountable and can be overcome both through legislation as well as through the training and support of young people with mental health conditions.

Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies

HASHEMI, Goli
WICKENDEN, Mary
BRIGHT, Tess
KUPER, Hannah
2020

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Background: Access to healthcare contributes to the attainment of health and is a fundamental human right. People with disabilities are believed to experience widespread poor access to healthcare services, due to inaccessible environments and discriminatory belief systems and attitudes. Qualitative data on these bar- riers has not previously been systematically reviewed. A meta-synthesis was undertaken of qualitative studies exploring the barriers to primary healthcare services experienced by people with disabilities in low- and mid- dle-income countries.

 

Methods: Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eli- gible studies were identified.

 

Results: Findings suggest that the people with disabilities’ choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types of barriers: cultural beliefs or attitudinal barriers, informational barriers, and practical or logis- tical barriers.

 

Conclusion: In order to achieve full health coverage at acceptable quality for people with disabilities, it is necessary not only to consider the different barriers, but also their combined effect on people with dis- abilities and their households. It is only then that more nuanced and effective interventions to improve access to primary healthcare, systematically addressing barriers, can be designed and implemented.

Global Leprosy Update 2019

WORLD HEALTH ORGANISATION (WHO)
September 2020

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A yearly update providing data from 160 countries around the world on the state of leprosy. The data will be useful to policy-makers, planners and researchers. 

The main leprosy indicators are now all based on a denominator of 1 million population. The key indicators are the case detection rate, the disability rate and the case detection rate in children.

The sub-title, “Time to step-up prevention initiatives” is the main focus of the Editorial comment on the last 3 pages, emphasizing the Triple Zero targets

 

Weekly Epidemiological Record  4 SEPTEMBER 2020, 95th YEAR No 36, 2020, 95, 417–440

 

How can we measure disability in research related to the COVID-19 response?

MACTAGGART, Islay
KUPER, Hannah
August 2020

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There is growing evidence that COVID-19 is disproportionally impacting the lives of people with disabilities. This includes evidence of the increased risk of severe outcomes of contracting COVID-19 amongst people with existing health conditions, including many people with disabilities. It also includes a wide range of other potential impacts such as: reductions or disruptions in non-COVID-19 health or rehabilitation services, the effects of shielding on isolation and mental health, the implications of social distancing on people who require carer support, and the impact on poverty, participation and wellbeing due to disrupted disability-inclusive development programmes.

 

Measurement of disability in research has historically been contested and a number of different tools exist. Clear guidance is needed on how to determine which tool to use to understand the situation of people with disabilities in different settings, and plan responsive and inclusive COVID-19 programmes and policies to support their needs. Good quality, comparable data on disability is essential for tracking the impact of the COVID-19 pandemic, as well as prevention and mitigation interventions, amongst people with disabilities. Such evidence is also imperative for tracking progress towards the Sustainable Development Goals, and UNCRPD compliance.

 

This evidence brief synthesises findings from a scoping review of ICF-compatible tools to measure disability in population-based surveys with a focus on LMICs (2018), protocols and research outputs from seven population-based surveys of disability across Asia, Africa and the Pacific, secondary analyses of the South African Census, US National Health Interview Survey and three Demographic and Health Surveys, reflections from global stakeholders in disability measurement (including the UN Flagship Report on Disability), and evidence compiled for the upcoming Global Disability Research Massive Open Online Course at the London School of Hygiene & Tropical Medicine

COVID-19, Amplifying Voices: Our Lives, Our Say: Learning from COVID-19 through the experiences of blind and partially sighted persons across the world

ZAYED, Yana
et al
August 2020

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The World Blind Union (WBU) conducted a study to examine the extent to which COVID-19 pandemic has exposed some deep structural inequalities in society. Data gathered from the study is evidencing that persons with disabilities, older persons, and persons from lower socioeconomic status backgrounds are among those hardest hit by the pandemic. While this report puts a spotlight on the voices of blind and partially sighted persons, many of the experiences shared strongly resonate with numerous other studies that are also highlighting how marginalised groups have been affected by this crisis. Through this report, WBU hopes to raise awareness on the specifics of what those challenges have meant in reality for its constituents, as well as shed light on what have been effective resilience strategies for them. The study was made possible with the support of CBM Global

To understand the situation of our constituents, the World Blind Union (WBU) conducted a global survey in collaboration with key stakeholders. In April 2020, the WBU launched an open online survey for seven weeks in Spanish, French and English, seeking information from blind and partially sighted persons on how COVID-19 was impacting their day to day life. 853 people participated in the survey. The respondents expressed in their own words how their lives had been and continue to be impacted by the coronavirus pandemic. This report is a compilation of those voices. It depicts the ways in which COVID-19 response measures taken by state and non-state actors have created additional barriers and challenges for blind and partially sighted people. It also includes powerful testimonies on how people have shown resilience in the face of adversity.

 

 

Towards healthier homes in humanitarian settings

WEBB, Sue
WEINSTEIN SHEFFIELD, Emma
FLINN, Bill
August 2020

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Proceedings of the Multi-sectoral Shelter & Health Learning Day 14th May 2020

The Shelter and Health Multi-sectoral Learning Day was hosted online by Oxford Brookes University’s Centre for Development and Emergency Practice (CENDEP) and CARE International UK, on 14th May 2020. Instigated and led by the ‘Self-recovery from Humanitarian Crisis’ research group, the Learning Day aimed to facilitate the sharing of knowledge about the connections between housing and health, in order to inform humanitarian action and enhance the wellbeing of crisis-affected populations. 

Covid-19 tip sheets & book of flip charts

ENABLEMENT
August 2020

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In light of the Covid-19 pandemic, Enablement developed tip sheets on four main topics for Light for the World:


- Eating and drinking
- Epilepsy, Nodding Syndrome and medication
- Active lifestyle
- Communication


These are meant to support those working with and/or caring for children and adults with disabilities. The tip sheets include visuals and some supporting text.

The book of flip charts carries the same content as the tip sheets, with visuals on one side for the caregivers of people with disabilities to see, and slightly more elaborate text on the other page for the fieldworker.

Children with disabilities and COVID-19

UNICEF
July 2020

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This guidance has been produced for UNICEF’s East Asia and the Pacific Regional Office and UNICEF Australia. This document is intended for frontline workers, including UNICEF partners, health personnel, social workers, teachers, help line staff and community volunteers engaged in the COVID-19 response. It is recommended that this document is read in conjunction with the Minimum Care Package, CBM’s Disability Inclusion in COVID-19 Preparedness and Response guidance note, UNICEF’s EAPR Child Protection Emergency Preparedness and Response to COVID-19 and the global Technical Note: Protection of Children during the Coronavirus Pandemic

What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?

QURESH, Onaiza
SCHERER, Nathaniel
July 2020

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The question and the problem:

Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the COVID-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during COVID-19 and other recent pandemics, informing policy and practice during this crisis.

Preparedness of civil society in Botswana to advance disability inclusion in programmes addressing gender-based and other forms of violence against women and girls with disabilities

HANASS-HANCOCK, Jill
MTHETHWA, Nomfundo
MOLEFHE, Malebogo
KEAKABETSE, Tshiamo
2020

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Background: In low-income and middle-income countries women and girls with disabilities are more likely to experience violence than those without disabilities. Non-governmental organisations (NGOs) and disabled people’s organisations (DPOs) can help to address this. However, in countries like Botswana we know little about the preparedness of NGOs and DPOs to increase inclusion in and access to programmes addressing violence.

 

Objectives: To explore the capacity and preparedness of NGOs and DPOs to ensure that women and girls with disabilities can participate in and access programmes addressing violence.

 

Methods: A qualitative study was undertaken using interviews with 17 NGOs and DPOs in Botswana to understand the organisations’ level of and ability to deliver programmes addressing violence against women and girls.

 

Results: Both NGOs and DPOs lack elements of universal design and reasonable accommodation, and thus are inaccessible to some people with disabilities. Some programmes address violence against women but lack skills and resources to accommodate people with disabilities. In contrast, DPOs work with people with disabilities, but lack focus on violence against women with disabilities. Participants identified opportunities to fill these gaps, including adaptation of policies and structural changes, training, approaches to mainstream disability across programmes, development of disability-specific interventions and improved networking.

 

Conclusions: Botswana’s NGOs and DPOs are well positioned to address violence against women and girls with disabilities, but need to increase their accessibility, staff knowledge and skills and disability inclusion. Training, resource allocation and participation of women with disabilities in NGOs and DPOs is needed to drive this change.

 

 

African Journal of Disability, Vol 9, 2020

The digital lives of refugees and Kenyans with disabilities in Nairobi: A human-centred design approach to identifying mobile-enabled opportunities

HAMILTON, Zoe
CASSWELL, Jenny
ALONSO, Aline
July 2020

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This research focuses on disability, using human-centred design methods to better understand how refugees and Kenyans with visual and hearing impairments in Nairobi use mobile technology and potential opportunities that it could provide.

The target populations for the project were urban refugees and host communities with visual or hearing impairments in Nairobi, Kenya. 

 

This report is divided into four main sections, following an introduction, the second section focuses on insights learned from the hearing impaired, the third on the visually impaired and the fourth highlighting issues that were cross-cutting insights across both groups. Sections two and three include insights related to mobile, health and financial services. The fourth section includes insights related to humanitarian and disability support services

 

Inequalities in utilization of essential antenatal services for women with disabilities: An analysis of the 2017-18 Pakistan Demographic and Health Survey. DHS working paper. No.166

HAMEED, Waqas
ASIM, Muhammad
July 2020

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Although the number of disabled women entering motherhood is growing, there is little quantitative evidence about the utilization of essential antenatal care services by women with disabilities. The aim of this study is to examine inequalities in the use of essential antenatal services between women with and without disabilities.

This study analyzed data from the Pakistan Demographic and Health Survey 2017-18 on 6,791 women (age 15-49) who had a live birth in the 5 years before the survey. Multiple logistic regression was used to test the study hypothesis. 

Research questions addressed were:

1. What are the levels of inequalities in the use of essential ANC services between women with and without disabilities, and by the type of disability?

2. How is the relationship between women’s disability and the utilization of essential ANC antenatal moderated by women’s wealth status and urban versus rural residence? 

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