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The gap report

THE JOINT UNITED NATIONS PROGRAMME ON HIV AND AIDS (UNAIDS)
July 2014

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The goal of this report is to provide the best possible data on the global AIDS epidemic, with a particular focus on information and analysis on the people left behind. The report highlights these gaps firstly in regional terms, providing “Regional Snapshots” and then explores issues faced by the following 12 populations that have been left behind by the AIDS response: people living with HIV, adolescent girls and young women, prisoners, migrants, people who inject drugs, sex workers, gay men and other men who have sex with men, transgender people, children and pregnant women living with HIV, displaced persons, people with disabilities and people aged 50 years and older

How ‘evidence-based’ is the Movement for Global Mental Health?

INGLEBY, David
2014

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A central claim in publicity for the Movement for Global Mental Health is that the movement is both ‘rights-based’ and ‘evidence-based’. In this article we focus on the second claim, critically examining the evidence on which the movement’s programme is based. The concepts and methodology of the movement are those of mainstream Western psychiatry, so we first review briefly the inadequacies and inconsistencies of this framework, in particular the problems of identifying, measuring, explaining and treating ‘mental illnesses’. We conclude that the scientific knowledge base of contemporary psychiatry has been gravely distorted by its dependence on financing from the pharmaceutical industry, which has led to exaggerated attention on biomedical theories and treatments with a corresponding neglect of social factors and prevention. Second, we examine the problems of transferring this framework to low and middle-income countries. Adopting a biomedical view enables the movement to evade awkward questions regarding the cultural embeddedness of the issues it deals with and their relation to social, economic and political conditions in these countries. Confident claims are made by the movement about the nature and prevalence of ‘mental illnesses’ across the world, the burden they represent, and the benefits to be expected from tackling them by ‘scaling-up’ mental health services based on Western knowledge. However, cross-cultural psychiatric epidemiology is not sufficiently developed to be able to support any of these claims and the considerable quantities of data that are produced as ‘evidence’ turn out to be largely based on guesswork. The article concludes that Western psychiatry can certainly provide low- and middle income countries with instructive examples – but they are mainly examples of what not to do.

 

Disability and the Global South, 2014, Vol. 1 No. 2

Knowledge and use of contraceptive methods amongst deaf people in Ghana

MPRAH, Wisdom K
2013

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Background: Persons with disabilities in general face serious barriers to sexual and reproductive health (SRH) information and services due to institutional and attitudinal barriers. However, because deaf people have unique communication and linguistic needs, which are often misunderstood or ignored, they face greater barriers than other persons with disabilities. Whilst available data indicated that there is a wide gap between knowledge and usage of contraceptive amongst Ghanaians, little is known about the level of contraceptive knowledge and usage amongst deaf people.

 

Objectives: The objective of the study was to investigate the level of knowledge and use of contraceptive methods amongst deaf people in Ghana with the aim of understanding their contraceptive behaviour and to improve access.

 

Method: The study was a participatory SRH needs assessment utilising a two-phase, sequential, mixed methods design. The study included 179 participants, consisting of focus groups with seven executives of Ghana National Association of the Deaf (GNAD), 10 male deaf adults, and 9 deaf female adults. A total of 152 deaf people, made up of students, women, and men participated in a survey, whilst one hearing person served as a key informant.

 

Results: The findings of the study indicated that of the 13 methods shown in the survey, only three were known to about 70% of the adults and 60% of the students. Level of knowledge of the remaining nine methods was low.

 

Conclusion: Clear and effective policies are needed to guide the provision of SRH information and services for deaf people in Ghana.

International perspectives on spinal cord injury

BICKENBACH, Jerome
et al
Eds
2013

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This report assembles and summarizes information on spinal cord injury, in particular the epidemiology, services, interventions and policies that are relevant, together with the lived experience of people with spinal cord injury. It also provides recommendations for actions based on this evidence that are consistent with the aspirations for people with disabilities as expressed in the Convention on the Rights of Persons with Disabilities

HIV issues and people with disabilities: A review and agenda for research

GROCE, Nora
et al
January 2013

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The AIDS and Disability Partners Forum at the UN General Assembly High Level Meetings on AIDS in New York in June 2011 and the International AIDS Conference in Washington, DC in July 2012 underscore the attention to the impact of HIV and AIDS on persons with disabilities. However, research on AIDS and disability, particularly a solid evidence base upon which to build policy and programming remains thin, scattered and difficult to access. In this review paper, we summarise what is known about the intersection between HIV and AIDS and disability, paying particular attention to the small but emerging body of epidemiology data on the prevalence of HIV for people with disabilities, as well as the increasing understanding of HIV risk factors for people with disabilities. We find that the number of papers in the peer-reviewed literature remains distressingly small. Over the past 20 years an average of 5 articles on some aspect of disability and HIV and AIDS were published annually in the peer-reviewed literature from 1990 to 2000, increasing slightly to an average of 6 per year from 2000 to 2010. Given the vast amount of research around HIV and AIDS and the thousands of articles on the subject published in the peer-reviewed literature annually, the continuing lack of attention to HIV and AIDS among this at risk population, now estimated to make up 15% of the world's population, is striking. However, the statistics, while too limited at this point to make definitive conclusions, increasingly suggest at least an equal HIV prevalence rate for people with disabilities as for their non-disabled peers.

Rehabilitation : a crucial component in the future of HIV care and support

NIXON, Stephanie
et al
June 2011

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"Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years"
Southern African Journal of HIV Medicine, Vol 12, No 2

Global status report on noncommunicable diseases 2010

WORLD HEALTH ORGANIZATION (WHO)
2011

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"This report sets out the statistics, evidence and experiences needed to launch a more forceful response to the growing threat posed by noncommunicable diseases. While advice and recommendations are universally relevant, the report gives particular attention to conditions in low- and middle-income countries, which now bear nearly 80% of the burden from diseases like cardiovascular disease, diabetes, cancer and chronic respiratory diseases. The health consequences of the worldwide epidemic of obesity are also addressed"

Priority medicines for mothers and children 2011

WORLD HEALTH ORGANIZATION (WHO)
2011

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This resource presents a list of priority medicines for mothers and children to help countries and partners select and make available those medicines that will have the biggest impact on reducing maternal, newborn and child morbidity and mortality
WHO/EMP/MAR/2011.1

Review of leprosy research evidence (2002-2009) and implications for current policy and practice

VAN BRAKEL, Wim
et al
September 2010

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"The ILEP Technical Commission (ITC) advises ILEP member associations on technical aspects of leprosy. A major review of research evidence in leprosy was published prior to the International Leprosy Congress in 2002. This current report updates that review based on research published between 2002-2009 and focuses on interventions for prevention, early diagnosis, chemotherapy, reactions, prevention of disability, stigma measurement and reduction and rehabilitation in leprosy"
Leprosy Review, Vol 81, Issue 3

Treatment of tuberculosis guidelines

WORLD HEALTH ORGANIZATION (WHO)
2010

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These guidelines aim ..."to help national tuberculosis (TB) control programmes in setting TB treatment policy to optimise patient cure: curing patients will prevent death, relapse, acquired drug resistance, and the spread of TB in the community. Their further purpose is to guide clinicians working in both public and private sectors." This new edition of the guidelines integrates the detection and treatment of both HIV infection and multi-drug resistant TB

The race against drug resistance : a report of the Center for Global Development’s drug resistance working group

NUGENT, Rachel
BLACK, Emma
BEITH, Alexandra
2010

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This report makes clear the need for urgent action to address the growing crisis of drug resistance. While there is no simple solution, there are achievable steps,that the health community, governments, donors, and the pharmaceutical industry can take to slow the spread of drug resistance. It says that retaining the medicines available now, developing new ones and other technology, and ensuring these resources continue to save lives in future generations must become a priority for global and national health organisations, both public and private

World health statistics 2010

WORLD HEALTH ORGANIZATION (WHO)
2010

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This annual compilation of health-related data for the World Health Organization's 193 member states, includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets

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