This article reports from a pilot project in Uganda where the aim is to enable persons with disabilities to have access to mainstream microfinance services. Several lessons have already been learned: 1) entrepreneurs with disabilities are an untapped market opportunity for Micro Finance Institutions (MFIs); 2) to influence MFIs it is important to understand their business model and team up with key actors from the industry; 3) persons with disabilities are often misinformed about MFIs' terms and services and don't know how to tap these opportunities. Gradually a change in attitudes in MFIs and Disabled Peoples Organizations (DPOs) is observed. All MFIs participating in the project now report an increase in the number of clients with disabilities served. This is happening without the use of any economic incentives.
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Information and Communications Technology (ICT) has the potential both to enhance access for people with disabilities and to contribute to creating barriers. What we now call the digital divide actually began long before the introduction of computers — barriers have existed and still exist today with telephones, television, the Internet and other information technology. It is important to remember that people with disabilities have many different accessibility needs and that there are different ways to make technology accessible and that new accessibility needs emerge as technology changes. This paper looks at the state of accessibility policy in the U.S. in several technology infrastructures that may provide some lessons and directions for increasing inclusive information and communication technologies worldwide. For instance, if the many provisions involving technology in the UN Convention on the Rights of Persons with Disabilities are to have real and substantive meaning, policy and implementation at the infrastructure level must occur.
"Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions"
PLoS One, Vol 4, Issue 2
Community-Based Rehabilitation (CBR) is the method of choice for delivering services for people living with disabilities in many countries. HIV/AIDS is changing the daily lives of many women by adding to their responsibilities. How realistically can such women participate actively in community development activities like CBR? This paper examines the impact of HIV/AIDS on CBR in Dar es Salaam, Tanzania. Observational sessions and individual interviews were conducted with caregivers of children with disabilities, CBR workers and managers over a three month period. Among the findings was a significant decrease in CBR activities in families affected by HIV/AIDS. This change in family priorities was due to better knowledge of acute diseases and increased stigma of HIV/AIDS in comparison to disability. Older CBR workers were more likely to incorporate elements of HIV/AIDS care with CBR, while younger CBR workers were more likely to avoid HIV/AIDS support. The ability of CBR workers to adapt their working habits to an environment with high HIV/AIDS prevalence is linked to their sense of skill competence and their knowledge/beliefs about risk of infection. Further integration of CBR work with general health development initiatives may improve this situation.
Disability, as a product of person–environment interaction, is particularly sensitive to catastrophic events and disasters. Disasters are specific to a physical location, as are the resources needed to handle the aftermath of the event. Geographic information systems (GIS) technology provides the ability to spatially coordinate resources from separate systems, which is vital for emergency management. GIS provides the capacity to go beyond surveillance and identification of at-risk people with disabilities to actively address the spatial nature of the person–environment interaction. GIS may provide the basis for further investigation and development of the science of environmental factors in the person–environment interaction. Mapping resources, and not just people, in the environment can change the perception and portrayal of people with disabilities in disaster incidents from people with “special needs” to people and organizations that are community contributors. Disability policy advocates, working at the state level, need to get disability-relevant geospatial data into the critical infrastructure used for emergency planning and response. A map showing the proximity of available resources demonstrates the importance of GIS to people with disabilities by identifying available resources in disaster response and recovery.
Journal of Disability Policy Studies, Vol 17, No 4
This article considers the impact of AIDS on women’s roles and responsibilities within the household ‘care economy’. In particular, it emphasises that all interventions aimed at reversing the AIDS epidemic need to take into account the excessive work-load that members of the household, usually women, shoulder in responding to the needs of sick family members. Most notably, gender equality and care economy issues need to be identified by development programmes. There is also a need to implement policies that focus on issues such as treatment, prevention, education, economic empowerment and violence against women. The article argues that unless the care economy and the relations of gender inequality within the household are included in the design, implementation, monitoring and evaluation of such interventions, results will be compromised
Stigma is rife in many areas of health and healthcare and it has implicit impacts that are often overlooked. Due to the continued social construction of the stigma of leprosy, it is clear that a greater understanding is needed of how stigma is experienced. This study considers the experiences of marriage of those vulnerable to stigmatisation due to leprosy and more specifically identifies different experiences of leprosy-affected women and men and the possible implications.
A review is presented of the performance of health-workers In low and middle income countries and of strategies for improving their performances. An overview of issues and evidence about the determinants of performance is given. Health-worker practices are complex behaviours that have many potential influences. Reviews of intervention studies in low and middle income countries suggest that the simple dissemination of written guidelines is often ineffective, that supervision and audit with feedback is generally effective, and that multifaceted interventions might be more effective than single interventions. It is reported that few interventions have been evaluated with rigorous cost-effectiveness trials.
The Lancet, Volume 366, No. 9490, p1026–1035, 17 September 2005
This article suggests that many pharmaceutical companies and governments are reluctant to publicise the problem of counterfeit medicines to health staff and the public. It recommends mandatory reporting to governmental authorities, which should have a legal duty to investigate, issue appropriate public warnings, and share information across borders
This article presents a case-controlled study that estimated the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi, examines types of disability and associated clinical and socio-demographic factors and identifies needs, opportunities and barriers for rehabilitation in Malawi. This study reveals the magnitude of disability among HIV-infected children and the large unmet need for rehabilitation services. It recommends that this expanding issue is investigated further to provide an evidence base for holistic care for disabled children living with HIV
PLoS ONE, Vol 8, No 12
There is limited research into the sexual lives of mothers, particularly mothers with disabilities. This article examines the barriers to sexuality facing mothers with disabilities. These barriers include: stereotypes that disabled mothers are not sexual, lack of resources for essential aspects of parenting, and difficulty in creating time for personal and private adult activities. Recommendations are presented based on the experiences of disabled mothers.
For many people who are called disabled, having this label means to be excluded from the experience of 'an ordinary sexual life'. For those who are called intellectually disabled exclusion from experiences of any kind of positive sexual life is almost universal. This article explores how some people with intellectual disabilities have sought to open up pathways towards accessing experiences of sexual expression as a way to move forward towards being able to integrate a concept of sexuality into their lives. Two support workers are interviewed. Both are employed by a Human Services organization in Aotearoa, New Zealand, which provides long term support for people with intellectual disabilities. Their comments reveal that access to successful instances of sexual expression for people in this group are currently only available those who are articulate enough and persistent enough to keep trying until they succeed. Barriers to success are isolated and some wider issues surrounding what changes might positively affect this group are discussed.
This paper describes an advocacy campaign to ensure the effective implementation of South Africa's Domestic Violence Act. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. The experience presented highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena