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The Effect of Age, Gender and Socioeconomic Status on Self-esteem, Body Image and Quality of Life of Amputees: An Evaluation Seven Years after the 2008 Sichuan Earthquake

LAM, Tin-Wai J
TANG, Long-Ching L
CHAU, WW
LAW, SW
CHAN, KM
2019

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Purpose: Psychological well-being is a growing concern in society. It is starting to play a pivotal role in the treatment and care of clients. This study aimed to evaluate the effect of age, sex and socioeconomic status on the self-esteem, body image and quality of life of the 2008 Sichuan earthquake amputees. Many of them are at a significant stage in their lives, especially those who are making the transition from childhood and adolescence into adulthood.

 

Methods: This cross-sectional study was conducted in October 2015. Forty-five participants were recruited from clinic sessions in Sichuan. The main outcome measures were Rosenberg Self-Esteem Scale (RSE), Chinese Amputee Body Image Scale (CABIS), and WHO Quality of Life-Bref Instrument (WHO-QOL-Bref). Results were analysed using Student’s T-test and Chi-square test where appropriate, and ANOVA for multi-group comparisons.

 

Results: Participants under 18 years of age scored higher in RSE (p=0.05), and lower in CABIS (p<0.005). They also scored higher in various QOL domains (D3: p<0.08, D4: p=0.06) and WHOQOL-Bref question 2 (p=0.06). Participants of different SES did not show any significant differences in the outcome measures. Female subjects scored higher in WHOQOL-Bref Question 1 (p=0.03).

 

Conclusion and Implication: Younger amputees have less body image distortion, higher quality of life and self-esteem compared to older amputees. Female amputees also appear to have a higher quality of life compared to male amputees. Socioeconomic status does not affect rehabilitation outcome and psychological well-being of amputees. However, the main factors affecting psychological well-being appear to be predominantly age and, possibly, gender.

Disability and global health: Special issue of International Journal of Environmental Research and Public Health

KUPER, Hannah
POLAK, Sarah
Eds
2019

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Papers included in this special issue are:

 

The waiting list. Addressing the immediate and long-term needs of victims of explosive weapons in Syria

O'REILLY, Claire
et al
2019

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This report looks at the challenges linked to the use of explosive weapons in the Syrian context for the provision of adequate immediate assistance and to plan for mid- to long-term assistance to the victims of explosive violence, to ensure their full recovery and inclusion into society. It is based on data and testimonies collected from humanitarian agencies, actors and patients across all areas of control in Syria. The testimony of Farah, a Syrian girl injured during the bombing of her school, and of her mother, is shared throughout the report to illustrate the challenges faced by victims. 

This report was compiled from June to August 2019 and relies on multiple sources, including review of both gray and academic literature, published and unpublished data from INGOs working in Syria response, firsthand interviews with patients and Syrian humanitarians working both inside Syria and from cross-border locations, and expatriate staff from INGOs and UN agencies. Interviews were conducted at a distance during June and July 2019 with 12 individuals, among which: 2 patients; 3 mine action operators; 4 medical staff, and 3 humanitarian workers 

An integrated approach to victim assistance in Cambodia & the role of Australia as supporting state

De BEAUPUIS, Gaetan
HOTTENOT, Elke
November 2018

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The objective of this case study was to review how Cambodia, as an affected state, and Australia as a donor, promote the provision of victim assistance in sectors including health, rehabilitation, disability, socio-economic development and poverty reduction. It documents promising practices and proposes next steps to ensure the sustainability of victim assistance provision in the near and long-term future. This study aims to inspire the mine action community in both affected and donor states to increase its contribution to victim assistance. This case study focuses on both prongs of the integrated approach to victim assistance by describing: i) Broader multi-sector efforts that reach casualties, survivors and indirect victims; and ii) Specific victim assistance efforts to improve victims’ quality of life deployed by mine action stakeholders, other actors in charge of coordinating victim assistance in Cambodia, and Australia as a donor state. An analysis of these specific efforts revealed that they fall into one of two of the following categories: a) Bridging gaps in data collection and service provision, or b) Advocating for, and facilitating, a multisector response.

 

Humanity & Inclusion (HI) and the Cambodian Mine Action and Victim Assistance Authority (CMAA) conducted the study in November 2017 in seven provinces. The methodology comprised three steps: a desk review of project documents, national plans and policies from a range of sectors with a focus on programmes funded by Australia; interviews with key personnel from the mine action and the disability sectors; and a field survey comprising 31 individual indepth interviews with 19 survivors and 12 other persons with disabilities (23 male and 8 female), 12 focus group discussions as well as field visits to observe the initiatives described in this publication. 

 

 

Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

L’autonomisation de personnes vulnérables, notamment des personnes handicapées, dans un contexte dépourvu de services et de ressources

ROCHE, Audrey
October 2017

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Cette publication est le produit d’un processus de capitalisation de l'expérience en insertion socioéconomique de personnes handicapées acquise par Handicap International et ses partenaires de mise en œuvre dans le cadre du projet TEAM CONGO à Kananga en RDC. L’objectif de cette capitalisation est d’une part, d’exposer la méthodologie en matière d’insertion socio-économique appliquée à Kananga, en détaillant les 2 principales bonnes pratiques - l’Accompagnement Social Personnalisé avec une approche holistique, et l’accès au capital économique via des micro-crédits- et les leçons apprises afin que les équipes d’Handicap International, les agences gouvernementales, et les organisations travaillant dans le domaine de l’Insertion socio-économique des personnes handicapées et personnes très vulnérables, puissent les utiliser dans le cadre de futures interventions. D’autre part, cette capitalisation vise à ébaucher des recommandations pour les futures interventions qui pourraient avoir lieu dans ce domaine en République Démocratique du Congo (RDC) ou dans des contextes similaires, dans lesquels les initiatives publiques ou privées en faveur de l'insertion économique des populations vulnérables comme l’offre de formation professionnelle, les opportunités d'emploi formel et l’accès au capital sont rares, voire même inexistantes. Une méthodologie d'action détaillée et adaptée à des contextes pauvres en ressources, sera ainsi proposée, à la lumière de l’expérience du volet d’insertion socio-économique du projet TEAM CONGO.

No One Left Behind: A review of social protection and disability at the World Bank

KARR, Valerie L
VAN EDEMA, Ashley
SIMS, Jacob
BRUSEGAARD, Callie
2017

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The 2030 Agenda for Sustainable Development cites poverty eradication as both the ‘greatest global challenge’ and an ‘indispensable requirement’ for sustainable development (UN, 2015). Unfortunately, the path between discourse and practice is rarely clear. This is especially true for the estimated one billion people with disabilities around the globe who face barriers and challenges to inclusion in mainstream development efforts; and for whom disability-specific projects and interventions are far and few between. This paper responds to the lack of available data focused on tracking the inclusion of persons with disabilities in mainstream poverty reduction efforts. It reports on work by a multidisciplinary research team in developing and piloting a methodology measuring disability inclusive investments in the World Bank’s active portfolio. The paper focuses specifically on the World Bank’s social protection portfolio, aligned with SDG 1 (End Poverty), and outlines a methodology for analysing project-level documentation, using key word searches, and codes aligned with the Sustainable Development Goals to determine the inclusion of persons with disabilities. Findings indicate that only a small percentage, 5%, of the World Bank’s active social protection portfolio explicitly include persons with disabilities as target beneficiaries. It goes on to argue that this dearth in disability inclusive development efforts exposes a vital need to systematically include the needs of this population in the planning for, provision of, and assessment of development assistance efforts. The paper concludes with a set of recommendations for ensuring future projects are inclusive from program development and implementation through to assessment of outcomes.

 

Disability & the Global South (DGS), 2017, Vol. 4 No. 1

Inequalities in access to health care for people with disabilities in Chile: the limits of universal health coverage

ROTAROU, Elena S
SAKELLARIOU, Dikaios
2017

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We analysed cross-sectional data collected as part of the National Socioeconomic Characterisation Survey (2013) in Chile, in order to explore if there are differences in access to health care between adult Chileans with and without disability. The study included 7459 Chilean adults with disability and 68,695 people without disability. Logistic regressions were performed in order to determine the adjusted odds ratios for the associated variables. We found that despite universal health coverage, Chileans with disabilities are more likely to report worse access to health care, even when controlling for socio-economic and demographic variables, including age, gender and income. Specifically, they are more likely to face greater difficulty arriving at a health facility, obtaining a doctor’s appointment, being attended to in a health facility, paying for treatment due to cost, and obtaining necessary medicine. Both people with and without disability are more likely to face difficulties in accessing health services if they are affiliated with the public health provider, an indication of the economic factors at play in accessing health care. This study shows that universal health coverage does not always lead to accessibility of health services and underlines the disadvantaged position of disabled people in Chile in accessing health services. While efforts have been made recently to improve equity in health care access, disability in Chile poses an additional burden on people’s access to health care, emphasising the necessity for policy to address this perpetual cycle of disadvantage for disabled people.

Exploring the Complexities of Leprosy-related Stigma and the Potential of a Socio-economic Intervention in a Public Health Context in Indonesia

DADUN, Dadun
PETERS, Ruth
LUSLI, Mimi
MIRANDA-GALARZA, Beatriz
VAN BRAKEL, Wim
ZWEEKHORST, Marjolein
DAMAYANTI, Rita
IRWANTO, Irwanto
BUNDERS, Joske
2016

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Purpose: This article explores the complexities of leprosy-related stigma and the potential effectiveness of a socio-economic intervention in Cirebon District, Indonesia.

 

Methods: A qualitative approach was adopted. 53 people affected by leprosy were interviewed, and 17 focus group discussions were conducted among people affected by leprosy, community and religious leaders, and health providers and other key persons who were all purposively selected.

 

Results:  People affected by leprosy face major socio-economic consequences. This was confirmed by key persons. Several opportunities for a possible socio-economic intervention were perceived, as also the barriers. People affected by leprosy are constrained by certain aspects of the health system (e.g., the health providers’ negative attitudes), views in society (e.g., misunderstandings about the condition, stigma), and the physical and social consequences of the disease (impairments, feelings of shame). Study participants identified strategies to deal with these barriers, as well as specific activities for a socio-economic intervention; in particular, the training of staff responsible for implementation.

 

Conclusion and Implications: Socio-economic interventions in the field of leprosy need to anticipate the barriers and develop strategies to deal with them. Cooperation between people working in the health system and those in the welfare / financial system is needed, to improve the quality of life of people affected by leprosy

End the cycle

CHRISTOFFEL BLINDENMISSION (CBM) AUSTRALIA
October 2016

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End the Cycle is a community awareness initiative promoting the human rights and empowerment of people with disabilities living in the world’s poorest countries. This website provides background information about the cycle of poverty and disability, highlights personal stories, and provides links to useful publications and related resources. Details are also provided about how to get involved with the initiative

World social science report, 2016 : Challenging inequalities; pathways to a just world

INTERNATIONAL SOCIAL SCIENCE COUNCIL
UNIVERSITY OF SUSSEX
INSTITUTE OF DEVELOPMENT STUDIES
September 2016

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This report focuses on the critical issues of inequalities and social justice and warns that unchecked inequalities could jeopardize the sustainability of economies, societies and communities, undermining efforts to achieve the Sustainable Development Goals (SDGs) by 2030. It highlights significant gaps in social science data about inequalities in different parts of the world and, to support progress towards more inclusive societies, calls for more robust research into the links between economic inequalities and disparities in areas such as gender, education and health. A short case study entitled "Consequences of inequality for persons with disabilities – experience of ADD International" is included.

Identifying Rehabilitation Workforce Strengths, Concerns and Needs: A Case Study from the Pacific Islands

GARGETT, Alexandra Lewis
LLEWELLYN, Gwynnyth
SHORT, Stephanie
KLEINITZ, Pauline
2016

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Purpose: This exploratory case study was undertaken to inform capacity development of the rehabilitation workforce in member nations of the Pacific Islands Forum (PIF).

 

Method: Participants at the 1st Pacific CBR Forum in June 2012 were key informants for this study. They comprised the disability focal points from government departments in each of the 14 countries, representatives of DPOs and disability service providers. The study was conducted in 3 phases:  a template to gather data on rehabilitation workers; key informant interviews; and, stakeholder workshops to identify strengths and needs of the rehabilitation workforce in the Pacific.

 

Results: The detailed case study findings suggest two critical drivers for rehabilitation health workforce development in the Pacific context. The first is leadership and commitment from government to serve rehabilitation needs in the community. The second is the urgent need to find alternative ways to service the demand for rehabilitation services as it is highly unlikely that the supply of specialist personnel will be adequate.

 

Conclusions: A multi-sectoral view of health and social service systems is a key element for the development of a rehabilitation health workforce. The endorsement of the WHO Global Disability Action Plan by the World Health Assembly in 2014 further enhances the opportunity to work collaboratively across sectors in Pacific countries. Specialist personnel are and will remain in short supply. There is opportunity for the region to lead the development of alternate workforce mechanisms through the training and supply of skilled community-based rehabilitation personnel.

Inclusive Business Creation - Good Practice Compendium

June 2016

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This compendium contains 20 case studies of public programmes in European countries that are successfully supporting business creation by people from disadvantaged and under-represented groups in entrepreneurship. The populations targeted by these programmes include youth, women, seniors, the unemployed, immigrants, ethnic minorities and people with disabilities. Each programme description details the programme’s activities and approach, assesses the challenges faced in development and implementation, and offers tips for successful transfer to other contexts.

Disability and social protection programmes in low- and middle-income countries: a systematic review

BANKS, Lena Morgon
MEAKLE, Rachel
MACTAGGART, Islay
et al
2016

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“This paper systematically reviews the evidence on whether persons with disabilities in low- and middle-income countries are adequately included in social protection programmes, and assesses the financial and non-financial impacts of participation. Overall, we found that access to social protection appears to fall far below need. Benefits from participation are mostly limited to maintaining minimum living standards and do not appear to fulfil the potential of long-term individual and societal social and economic development. However, the most notable finding of this review is that there is a dearth of high-quality, robust evidence in this area, indicating a need for further research.”

Report of the Special Rapporteur on the rights of persons with disabilities (theme: the right of persons with disabilities to participate in decision-making)

DEVANDAS-AGUILAR, Catalina
January 2016

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In the preparation of this study, a questionnaire was sent to Member States, national human rights institutions, agencies of the United Nations system, civil society organizations, and persons with disabilities and their representative organisations. As at 22 December 2015, 144 responses were received. The report covers the participation of persons with disabilities in political and public life (right to vote and be elected, right to access public service and right to participate in the conduct of public affairs). The report also covers participation of persons with disabilities in public decision making (importance of effective and meaningful participation, ensuring the participation of representative organisations of persons with disabilities, promoting consultation and the active involvement of persons with disabilities, and key areas for participation). Recommendations are presented.

Participation of persons with disabilities in political activities in Cameroon

OPOKUA, Maxwell Peprah
MPRAH, Wisdom Kwadwo
SAKA, Bernard Nsaidzedze
2016

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The right to participate in political activities is a fundamental human right for every citizen in a country, but this right is often not available to persons with disabilities. This study investigated the level of and barriers to political participation of persons with disabilities in the Buea municipality in Cameroon. A qualitative data collection method, consisting of three focus group discussions with 36 persons with disabilities was conducted. Participants were selected from three categories of persons with disabilities- visually impaired, hearing impaired and physically impaired- who were residing in the Buea municipality. The study found that the involvement of persons with disabilities in politics in the area was minimal as socio-economic, cultural and physical barriers hindered their participation in political activities at both local and national levels. The study concludes that there should be conscious efforts though affirmative actions to promote and respect the rights of persons with disabilities and make the political environment more accessible to persons with disabilities in Cameroon.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 2

To what extent is Universal Design for Learning “universal”? A case study in township special needs schools in South Africa

SONG, Yosung
2016

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This paper reports on a study examining the current challenges of developinginclusive education as well as the potential applicability of implementing principles of Universal Design for Learning (UDL) in two township special needs schools in South Africa. The philosophy of UDL has been advocated by many educators as a means of developing inclusive classroom environments in the Western world. Despite the growing popularity of UDL, its universal application, especially in places with limited resources, has remained somewhat unquestioned. Using a theoretical framework that is critical of Western-centered understandings of inclusive education and pedagogy, this paper examines how understanding the educational circumstances and teacher knowledge of a local context can inform the applicability of UDL principles. The findings of this study reveal that despite teachers’ recognition of the benefits of implementing UDL principles in their practice, the unique socioeconomic conditions in South African township schools make teachers doubt the feasibility of implementing this Western concept in their classrooms. Yet, at the same time, the findings illustrate how teachers are already employing practices that are consistent with UDL principles in an attempt to cater for the needs of diverse learners. The paper concludes by asserting the need to consider the unique economic and political contexts of the global South when determining the applicability of inclusive education strategies beyond Western contexts.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 1

Report of the Special Rapporteur on the rights of persons with disabilities (theme: the right of persons with disabilities to social protection)

DEVANDAS-AGUILAR, Catalina
August 2015

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'In the present report, the Special Rapporteur, Catalina Devandas-Aguilar, provides a study focusing on disability-inclusive social protection as a prerequisite for the universalization of social protection. She stresses that social protection is fundamental for achieving the social inclusion and active participation of persons with disabilities, and promoting their active citizenship. She also argues that to achieve disability-inclusive social protection, States must move away from traditional disability-welfare approaches towards embracing the innovative rights based model'

The prevalence of self-reported vision difficulty in economically disadvantaged regions of South Africa

NAIDOO, Kovin S
JAGGERNATH, Jyoti
RAMSON, Prasidh
CHINANAYI, Farai
ZHUWAU, Tom
ØVERLAND, Lene
2015

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Background: Vision impairment, resulting in vision difficulties, is a leading cause of disability, and hence one of the key barriers for people to access education and employment, which may force them into poverty.

 

Objectives: The objective of this study was to determine the prevalence of self-reported vision difficulties as an indicator of vision impairment in economically disadvantaged regions in South Africa, and to examine the relationship between self-reported vision difficulties and socio-economic markers of poverty, namely, income, education and health service needs.

 

Methods: A cross-sectional study was conducted in economically disadvantaged districts to collect data from households on poverty and health, including vision difficulty. As visual acuity measurements were not conducted, the researchers used the term vision difficulty as an indicator of vision impairment. Data were collected from 27 districts (74 901 respondents). Logistic regression analysis and chi-square tests were used to determine bivariate relationships between variables and self-reported vision difficulty. Kernel density estimators were used for age, categorised by self-reported and not reported vision difficulty.

 

Results: Prevalence of self-reported vision difficulty was 11.2% (95% CI, 8.7% – 13.7%). More women (12.7%) compared to men (9.5%) self-reported vision difficulty (p < 0.01). Self-reported vision difficulty was higher (14.2%) for respondents that do not spend any money. A statistically significant relationship was found between the highest level of education and self-reporting of vision difficulty; as completed highest level of education increased, self-reporting of vision difficulty became lower (p < 0.01). A significantly higher prevalence of self-reported vision difficulty was found in respondents who are employed (p < 0.01), 17% (95% CI: 12.8% – 21.1%).

 

Conclusion: The evidence from this study suggests associations between socio-economic factors and vision difficulties that have a two-fold relationship (some factors such as education, and access to eye health services are associated with vision difficulty whilst vision difficulty may trap people in their current poverty or deepen their poverty status). The results are thus indicative of the need for further research in South Africa.

Representation, access and contestation: Facebook and vision impairment in Jordan, India, and Peru

PAL, Joyojeet
ALFARO, Ana Maria Huaita
AMMARI, Tawfiq W
CHHABRA, Sidharth
LAKSHMANAN, Meera
2015

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This paper presents qualitative research on the use of Facebook by visually impaired people and organizations representing them in Jordan, Peru, and India. We found that individuals and organizations have very different motivations and pathways for using social media. Social media serve as a means to help individuals with vision impairments to expand their social circles, network with casual acquaintances, and find various kinds of social and technical resources independently. However on issues of representation we found that social media have the potential to play a double-edged sword, reinforcing in some cases the same stereotypes that individual users of assistive technology (AT) sought to overcome by using technology in their professional lives. We find that individuals often characterize social media and assistive technology in the same vein — suggesting that for many parts of the global South, the dramatic change in the means and ability to leverage social and professional possibilities has not come from any one technology alone, but from a broader evolution of the technological environment available to people with vision impairments. Access to social media and technology disrupt an environment in which social and economic spaces for people with disabilities are still a zone of contestation between a dominant discourse of vision impairment enforced by generations of negative representations of disability, and a new world of technology users challenging representations and assumptions as engaged, connected professionals.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

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