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Hear my voice: old age and disability are not a curse. A community-based participatory study gathering the lived experiences of persons with disabilities and older people in Tanzania

MRISHO, Mwifadhi
FAKIH, Bakar
GREENWOOD, Margo
STEFF, Marion
2016

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Community based participatory research (CBPR) was used to provide evidence on the specific nature and experiences of persons with disabilities and older people from their own perspectives in Tanzania, through the lens of social, political, economic and cultural inclusion. The aim was to strengthen efforts to provide services for and improve the lives of people living in the rural and urban settings of Nachingwea and Kibaha Urban Municipal Council. Twenty-nine peer researchers (nine persons with disabilities, 10 older people and 10 Tanzanian Non-Governmental Organisation (NGO) members working in these communities) were involved in the study. A total of 106 stories were collected. Eight priority areas emerged and were chosen by peer researchers for further discussion in groups: access to education and quality learning; access to health services; issues fed back from NGOs; poverty relating to income and dependence; attitudes towards witchcraft and albinism; relationship difficulties and marriage breakdowns; sexual violence and gender issues; poor treatment from family
 

Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

KUMURENZI, Anne
GOLIATH, Charlyn
MJI, Gubela
MLENZANA, Nondwe
JOSEPH, Conran
STATHUM, Sue
RHODA, Anthea
2015

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Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform.

 

Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre.

 

Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study.

 

Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills.

 

Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

The challenges of disability in Pakistan : listening to the voices of mothers

ALI, Rabia
RAFIQUE, Sana
November 2015

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“This study was conducted with the aim to explore the experiences of mothers in dealing with children having disabilities in Rawalpindi, Pakistan. Through random sampling method 154 mothers of physically handicapped children studying in pre-schools and primary schools were selected as respondents…The data highlights that the disability of the children had been unexpected for all the mothers who participated in this research. The mothers reported to have been shocked (56%) and apprehended about the future of the children (41%)… The data demonstrates that measures taken by mothers to facilitate their children included seeking help from internet and engaging with support groups and friends”

European Scientific Journal, Vol.11

Community-based rehabilitation in a post-soviet environment in Azerbaijan : where society meets ideology

BURCHELL, Gwen
2015

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This paper explores UAFA’s experience, since 2002, in working with Azerbaijani stakeholders to move from the medical approach to disability, propagated by the Soviet model of planning and implementation, to a social, community-based approach. The paper highlights the common misconceptions and how these can be overcome, including the policy gaps that challenge effective implementation.

 

The importance of creating and maintaining a core team is discussed, alongside the process that UAFA has developed for building up teams of CBR workers. Finally, the paper raises the issue of introducing outcomes-based evaluation in a society that has no such prior experience, followed by an account of the continual challenge faced by most programmes–namely, how to achieve sustainable funding.

 

 

Disability, CBR and Inclusive Development, Vol 26, No 3

Towards a Core Set of Clinical Skills for Health-Related Community Based Rehabilitation in Low and Middle Income Countries

O’Dowd, Jessica
MacLachlan, Malcolm
Khasnabis, Chapal
Geiser, Priscille
2015

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Purpose: This research aims to identify a core set of clinical skills for working in a Community Based Rehabilitation (CBR) setting, and to discuss whether they are appropriate for task shifting to a new or an alternative cadre of rehabilitation workers.

 

Methods: The study focussed on work activities relating to the health component of the CBR Matrix. 40 health professionals working in CBR in Low and Middle Income Countries (LMIC) were surveyed to discover the clinical skills that were used most frequently during the past 3 months and to determine which of these skills were deemed most important in a CBR setting.

 

Results: A core set of clinical skills for health-related CBR work in LMIC were identified: advocacy and sensitisation; assessment, monitoring and reporting; behavioural and cognitive interventions; collaboration and referral; communication; continuing professional development; education; gait training; group work; home-based rehabilitation; manual therapy; neurofacilitation techniques; positioning; prescription of strengthening exercises; prescription of stretching programmes; provision of aids, assistive devices and technologies; psychosocial support; recreational therapy; self-care; sensory interventions; supervision; upper body rehabilitation; vocational rehabilitation and working with families.

 

Conclusions: It is possible to identify a core set of health-related CBR skills. These may be considered in the development of training programmes for new or alternative cadres of CBR workers, using a task-shifting model including appropriate support, supervision and referral mechanisms.

Implications: Further research is required to establish the generalisability of the skills sets identified here, both across contexts and different client groups and their needs. The identification of core sets of skills for other areas of the CBR Matrix - livelihood, social, empowerment and education – could similarly facilitate access to these domains for people with disabilities.

Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq : a randomized household cluster survey

LAFTA, Riyadh
et al
August 2015

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“The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.” The quantitative study shows the methodology used in the collection of data, the findings discovered through evaluation of the data gathered, and interpretation of how to best use those findings to serve specific populations”

 

 PLOS ONE, 10(8)

The need for a rehabilitation model to address the disparities of public healthcare for people living with HIV in South Africa

CHETTY, Verusia
HANASS-HANCOCK, Jill
June 2015

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This article advocates for the development and implementation of a model of care to guide rehabilitation of people living with HIV in South Africa. The paper begins by presenting the emerging evidence of rehabilitation in the context of HIV, and goes on to identify appropriate steps to develop a model of care based on this that would be applicable to South Africa

African Journal of Disability 4(1), Art. #137

Prosthetics & orthotics impact assessment : India and Bangladesh

COCHRANE, Helen
ROSARIO, Demetria
SINGH, Anil
GHOSH, Ritu
June 2015

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Mobility India is the only International Society for Prosthetics and Orthotics​ (ISPO) recognised program in India offering training for ISPO Category II single discipline. From 2002 to the time of the study Mobility India enrolled two hundred and twenty-one students. This study was conducted in association with ISPO’s USAID funded programme: ‘Rehabilitation of physically disabled people in developing countries’. Activities included: field visits to India and Bangladesh, interviewing Ministry officials, Heads of Clinical Services and Heads of Prosthetic and Orthotic Departments;  a partial audit of graduate clinical skills and competencies and determining the professional development needs of graduates in selected South-East Asian countries; and listening to service users, hearing stories of how services had directly impacted upon their lives. Services in India and Pakistan are outlined and 22 recommendations to help to further develop prosthetic and orthotic services are provided.

Rethinking the work capability assessment

BAUMBERG, Ben
et al
March 2015

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This report outlines the key research findings about the Work Capability Assessment (WCA) criteria of the Employment Support Allowance (ESA), a means tested benefit for those who are unable to find work in Britain. It presents the state of the UK’s existing assessment and then describes how seven key countries systematically assess incapacity, and the lessons these countries provide for reforming the WCA in the UK

CBR for inclusive development

KOOPMAN, Thomas
March 2015

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

Online resource for parents and carers of children with autism

SIVARAMAKRISHNAN, Shobha
March 2015

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An information resource for the parents, carers and any other health professionals involved in the welfare of children on the autism spectrum. Within this document, it is outlined what is meant by the term 'autism', possible signs to look for in assessing and diagnosing a condition on the spectrum, associated physical or mental impairments which can be associated with a condition on the spectrum, and finally how a healthcare or other relevant professional (eg. education) may be best able to manage the condition in a variety of conditions

Note: The user has given permission for the uploaded document to be reproduced and made publicly available on the Source website

Physiotherapy exercises for people with spinal cord injuries and other neurological conditions

MESSENGER, Peter
2015

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This website allows users to search for exercises appropriate for people with spinal cord injuries and other neurological conditions. Users can select exercises, save exercises into booklets and can access previously created booklets. This website is useful for physiotherapists, occupational therapists and other rehabilitation professionals
Note: users must be logged on to the website to save exercises into booklets and to access previously created booklets. Recommend that first time users review first time user information prior to logging on

Why should rehabilitation be integrated into health systems?

HANDICAP INTERNATIONAL
2015

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This advocacy briefing paper presents information about the importance of rehabilitation being integrated into health systems. It highlights a brief overview and definition of rehabilitation, and related key health facts and issues such as lack of access to rehabilitation, the value of rehabilitation and legal frameworks. It provides recommendations for stakeholders and suggests ways to measure progress

Advocacy briefing paper

A 10-year literature review of the impact of community based rehabilitation

BOWERS, Bob
KUIPERS, Pim
DORSETT, Pat
2015

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A thematic literature review of the impact of CommunityBased Rehabilitation (CBR) in low to middle-income countries was conducted. The review covered the period from 2002 to 2012, and the CBR Matrix was utilised to provide structure for the evidence. Seven studies that investigated the impact of CBR interventions in developing countries were included. A modified harvest plot was used to summarise the strength and nature of evidence provided in relation to the CBR Matrix. Quantitative studies tended to focus on the Health domain, while qualitative studies generally focussed on the Social and Empowerment domains. No evidence of CBR impact was found in the Education domain, and very little evidence was found pertaining to Livelihood. Overall, the evidence base related to the impact of CBR remains limited, both in terms of quantity and robustness of design.

 

 

Disability, CBR and Inclusive Development (DCID), Vol 26, No 2

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal : study protocol for a randomized controlled trial

COBBING, Saul
HANASS-HANCOCK, Jill
MYEZWA, Hellen
2015

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In this paper, the researchers develop a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. The study aims to  provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV.

The paper outlines a randomised control trial to test the programme, to be conducted at a public hospital in KwaZulu-Natal, South Africa. The trial will assess the participants’ quality of life, perceived level of disability, functional ability and endurance

Trials 16:491

Capturing the difference we make : community-based rehabilitation indicators manual

WORLD HEALTH ORGANIZATION (WHO)
2015

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This manual presents indicators that "capture the difference (Community-Based Rehabilitation) CBR makes in the lives of people with disabilities in the communities where it is implemented. This manual presents these (base and supplementary) indicators and provides simple guidance on collecting the data needed to inform them. The indicators have been developed to show the difference between people living with a disability and their families and those without disabilities in relation to the information reported in the indicators. This comparability provides valuable information to CBR managers, donors and government agencies alike, which can be used to guide decision-making, support advocacy and improve accountability. Further, the ability of the indicators to provide a comparison of the populations of persons with disability to persons without disability aligns with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that persons with disability have equal rights to those without disabilities...this manual serves to standardize the monitoring of differences made by in the lives of people with disabilities and their families, making it possible to compare the difference CBR makes across areas and countries. This manual aligns with the WHO Global Disability Action Plan 2014–2021, and may also be used to monitor other development plans in an easy and efficient way”

Guidelines for integrating gender-based violence interventions in humanitarian action: Reducing risk, promoting resilience and aiding recovery

WARD, Jean
LAFRENIERE, Julie
et al
2015

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The purpose of these Guidelines is to assist humanitarian actors and communities affected by armed conflict, natural disasters and other humanitarian emergencies to coordinate, plan, implement, monitor and evaluate essential actions for the prevention and mitigation of gender-based violence (GBV) across all sectors of humanitarian response. Part One presents an overview of GBV, provides an explanation for why GBV is a protection concern for all humanitarian actors and outlines recommendations for ensuring implementation of the Guidelines. Part Two provides a background to the ‘thematic areas’ in Part Three. It also introduces the guiding principles and approaches that are the foundation for all planning and implementation of GBV-related programming. Part Three constitutes the bulk of these Guidelines. It provides specific guidance, organized into thirteen thematic area sections: camp coordination and camp management; child protection; education; food security and agriculture; health; housing, land and property; humanitarian mine action; livelihoods; nutrition; protection; shelter, settlement and recovery; water, sanitation and hygiene; humanitarian operations support sectors. The importance of cross-sectoral coordination is highlighted in each section. It is also recommended that sector actors review the content of all thematic area sections. The Guidelines draw from many tools, standards, background materials and other resources developed by the United Nations, national and international non-governmental organizations, and academic sources. In each thematic area there is a list of resources specific to that area, and additional GBV-related resources are provided in Annex 1. The importance of indicators being disaggregated by sex, age, disability and other vulnerability factors is highlighted throughout.

Prosthetic and orthotic services in developing countries

MAGNUSSON, Lina
October 2014

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This thesis aims to generate further knowledge about prosthetic and orthotic services in developing countries, with a focus on patient mobility and satisfaction with prosthetic and orthotic devices, satisfaction with service delivery, and the views of staff regarding clinical practice and education. The findings are based on patient questionnaires in Malawi and Sierra Leone, including QUEST 2.0, as well as interviews with prosthetic/orthotic technicians in Sierra Leone and Pakistan

School of Health Sciences Dissertation series No. 56, 2014; No. 66, 2014

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