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Coordination between health and rehabilitation services in Bangladesh: Findings from 3 related studies

PRYOR, Wesley, HASAN Rajib
MARELLA, Manjula
NGUYEN, Liem
SMITH, Fleur
JALAL, Faruk Ahmed
CHAKRABORTY, Ripon
HAQUE, Mazedul
MOSTOFA, Golam
HASAN, Rajib
April 2019

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The unmet need for rehabilitation is profound and is likely to worsen as population health shifts towards longer lives lived with more ill-health and disability. The WHO Global Action Plan on Disability and the Rehabilitation 2030 framework [1] call for quality evidence to inform targeted responses.
The intent of this work is to examine six IDSCs (Integrated Disability Service Centres) in detail but to use the results to inform new activities through the network of more than 100 Integrated Disability Service Centres, with potential to influence practice in other services. As such, results of this work have the potential to directly inform policy decisions concerning future investments in rehabilitation services in Bangladesh and bring awareness to key stakeholders on current challenges and potential solutions.

Research was conducted during March-October 2018 in Kurigram, Tangail, Manikgonj, Dhaka and Narsingdi districts of Bangladesh to map out the current trends and determinants of good coordination
between health and rehabilitation, emphasising quantitative measures of: timeliness, continuity, acceptability, availability and integration

“On the Margins” Education for children with disabilities in Kazakhstan

RITMANN, Mira
March 2019

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Thisd report presents findings of research into report into progress towards inclusive education for disabled children in Kazakhstan and also presents recommendations for future progress.

Field research for this report was carried out between September 2017 and December 2018. The report is based on over 150 interviews with children and young adults with disabilities, their families, and disability rights activists, in multiple cities in Kazakhstan: Almaty, Astana, Kostanay, Kyzylorda, Shymkent, and Taldikorgan. Human Rights Watch researchers visited one PMPK office, five inclusive schools, and four special schools in Almaty and one inclusive school in Kyzylorda. Human Rights Watch also visited three neurological-psychiatric institutions for children in Almaty, Karaganda, and Shymkent. Human Rights Watch met and corresponded with officials from the Ministry of Labor and Social Protection and exchanged letters with the Ministries of Education and Health, and with the Almaty City Administration.

Communication Matters!

Light for the World
January 2019

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The research Communication Matters! shows which obstacles persons with disabilities face in accessing public information and services. The research took place in three districts in the province of Pursat. 1171 persons with disabilities in 229 villages are reached.

Due to the research, many persons with disabilities were able to share their stories for the first time. Many persons were also found for the first time, because the team made an effort to visit everyone in the village.

Individualised funding interventions to improve health and social care outcomes for people with a disability: a mixed-methods systematic review. Campbell Systematic Reviews 2019:3

FLEMING, Padraig
et al
January 2019

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This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations.

 

This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia.

 

DOI 10.4073/csr.2019.3

Zero Project Report 2019: Independent living and political participation

FEMBEK, Michael
January 2019

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The Zero Project Report 2019 focuses on Article 19 (Living independently and being included in the community) and Article 29 (Participation in political and public life) of the UN CPRD, as well as related topics such as Article 12 (Equal recognition before the law) and Article 13 (Access to justice)

For 2019 the Zero Project selected 66 Innovative Practices and 10 Innovative Policies from 41 countries that positively impact the rights of persons with disabilities in their ability to live more independently and to take part in political life

 

This Report is composed of five main sections, summarizing the annual research, followed by an Annex:

• Executive Summary, including background information on this year’s research topic and the Zero Project methodology

• Innovative Polices and Practices: Fact Sheets and Life Stories

• Description of the Zero Project–Impact Transfer programme

• Description of EU-grant-funded TOPHOUSE projects

• A summary of this Report in easy language

• An Annex listing all Zero Project network members active in 2018–2019

The Zero Project Report is also available on the Zero Project Website in an accessible pdf format.

 

European Disability Forum, European human rights report - issue 3, 2019. Human rights

ULDRY, Marine
2019

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This is the third issue of European Disability Forum's annual European Human Rights report Series focus on Ensuring the rights of persons with disabilities to equality and non-discrimination in the European Union. The report includes a review of equality frameworks in each EU Member State and a section on multiple and intersectional forms of discrimination. The report aims to inform organisations of persons with disabilities and policymakers of the current state of protection against discrimination based on disability in the European Union and draws recommendations with the goal of reaching inclusive equality for all persons with disabilities. The first chapter provides background information about the UN Convention on the Rights of Persons with Disabilities. Chapter 2 describes what constitutes discrimination on the grounds of disability and the obligations of States under international human rights law. Chapter 3 focuses on multiple and intersectional discrimination, by examining the effect of the intersection of disability with other grounds of discrimination. Looking at current practice, Chapter 4 describes the state of play at national level, with Chapter 5 looking at the EU level, specifically considering the current gaps in ensuring better protection against discrimination based on disability. Finally, the report draws conclusions and recommendations addressed to the EU and its Member States.  

DFID’s strategy for disability inclusive development 2018-23

December 2018

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The UK Department for International Development (DFID)'s vision is a world where all people with disabilities, women, men, girls and boys, in all stages of their lives, are engaged, empowered and able to exercise and enjoy their rights on an equal basis with others, contributing to poverty reduction, peace and stability. A world where no-one is left behind.

Over the next five years DFID will prioritise four strategic pillars for action: (i) inclusive education, (ii) social protection, (iii) economic empowerment, and (iv) humanitarian action. To complement this focus DFID are adopting three cross-cutting areas, vital to disability inclusion, which will be consistently and systematically addressed in all of their work: (v) tackling stigma and discrimination; (vi) empowering girls and women with disabilities; and (vii) access to appropriate assistive technology.

DFID have introduced a new set of standards for all DFID business units to meet. The standards require all country offices and departments to; review their leadership and culture, engage with people with disabilities, influence others, adapt programming and improve data and evidence.

Diagnostic study on Disabled Peoples’ Organisations and National Union of Organisations of the Disabled in Liberia

DEEPAK, Sunil
HARRIS, Naomi
November 2018

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A diagnostic study was carried out by a consultant to the DASU project in collaboration with the national umbrella organisation “National Union of Organizations of the
Disabled” (NUOD) to assess the institutional capacities of Disabled Peoples’ Organizations (DPOs) in Liberia. The study involved DPOs from the national capital Monrovia and in three counties – Bong, Grand Gedeh and Nimba.
The study included an initial Desk Review, collection of case studies from the field and visits to the counties to meet the county DPOs. Following these, a workshop was organised
in Monrovia in which representatives of NUOD and the concerned DPOs took part. The workshop looked at the strengths and challenges faced by NUOD and DPOs, focusing on the skills needed for stronger and active DPO leadership.

Children with disabilities in situations of armed conflict - a discussion paper

THOMAS, Edward
et al
November 2018

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During armed conflict, children with disabilities are caught in a vicious cycle of violence, social polarization, deteriorating services and deepening poverty. Global estimates suggest there are between 93 million and 150 million children with disabilities under the age of 15.Given that disability is often not reported due to stigma there is reason to believe actual prevalence could be much higher. Although efforts to ensure the fulfilment of their rights have improved, girls and boys with disabilities continue to remain among the most marginalized and excluded segment of the population. This is amplified during situations of armed conflict. The barriers to full participation they face on a day-to-day basis are intensified and compounded when infrastructure is destroyed, and services and systems are compromised and made inaccessible. This results in the further exclusion and marginalization of children with disabilities, and prevents them from accessing schooling, health and psychosocial support, or a means of escape from conflict.

 

When systems and services break down, children are also left more susceptible to violence. Injuries sustained by many children during armed conflict may also lead to long-term impairments. There are six grave violations of children’s rights and protection in armed conflict that are on the agenda of the United Nations (UN) Security Council; killing and maiming, recruitment and use of children, rape or other sexual violence, abduction, attacks on schools or hospitals, and denial of humanitarian access. Governments around the world have committed themselves to respect, promote, and fulfil the rights of children with disabilities, including in situations of armed conflict, and progress is being made. Efforts by a broad range of actors to implement the CRPD, CRC and other human rights instruments include the development of standards to address the rights and needs of persons with disabilities in humanitarian crises, and guidance on making humanitarian response, development and peacebuilding more inclusive. Efforts to improve the collection and use of data concerning children and adults with disabilities are also underway. Yet, as this discussion paper makes clear, much more needs to be done. Investments in disability-inclusive humanitarian action and recovery from crises will pay off, contributing towards a dividend of peace built on greater equality, tolerance and justice. 

Women and young persons with disabilities: Guidelines for providing rights-based and gender-responsive services to address gender-based violence and sexual and reproductive health and rights

HOLOBOFF RADFORD, Anastasia
et al
November 2018

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This publications aims to provide practical and concrete guidelines for making Gender-Based Violence (GBV) and Sexual and Reproductive Health and Rights (SRHR) services more inclusive of and accessible to women and young persons with disabilities and for targeting interventions to meet their disability-specific needs.
 
Critical services for all victims and survivors of GBV include health services (e.g. first-line support, sexual assault examination and care, mental health assessment and care), justice and policing services (e.g. assessment and investigation, perpetrator accountability and reparations, safety and protection, justice sector coordination), social services (e.g. crisis counselling; help lines; legal and rights information, advice, and representation; psychosocial support and counselling), and coordination at both the national and local level.

 

Fundamental SRHR services for women and young persons—with and without disabilities— include comprehensive sexuality education; information, goods, and services for the full range of modern contraceptive methods, including emergency contraception; maternal/newborn healthcare (including antenatal care, skilled attendance at delivery, emergency obstetric care, post-partum care, and newborn care); prevention, diagnosis, and treatment for sexual and reproductive health issues (e.g. sexually transmitted infections, including HIV, syphilis, and HPV, cancers of the reproductive system and breast cancer, and infertility); safe and accessible abortion, where it is not against the law; and post-abortion care to treat complications from unsafe abortion.

 

While the primary audience of these Guidelines is GBV and SRHR service providers and support staff, these Guidelines are also intended as a valuable resource for all stakeholders—including those in government, international organizations, and non-governmental organizations—involved in designing, developing, implementing, or advocating for GBV or SRHR services for women and young persons with disabilities. 

Measuring disability using the Washington Group questions

August 2018

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The Washington Group was set up by the United Nations Statistical Commission. It works with countries to produce better information about people with disabilities. The Washington Group has developed useful questions for countries to use to help find out whether a person has a disability, and to help collect data and information on what the differences are between people with disabilities and people without disabilities.

Improving social inclusion and empowerment for people with disabilities in low- and middle-income countries: why does it matter and what works?

WHITE, Howard
SARAN, Ashrita
POLLOCK, Sarah
KUPER, Hannah
July 2018

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The aim of the Rapid Evidence Assessment (REA) is to provide an assessment of the effectiveness of interventions to improve social inclusion and empowerment for people with disabilities in low- and middle-income countries (LMICs). The studies included in this REA are taken from the Disability EGM prepared by the Campbell Collaboration for DFID under the auspices of the Centre for Excellence for Development Impact and Learning (CEDIL). Eligible studies included systematic reviews and impact evaluations published in English from 2000 onwards that assessed the effectiveness of interventions for people with disabilities in LMICs. The REA focused on studies identified by the EGM process that included ‘social inclusion’ or ‘empowerment’ as study outcomes and used the World Health Organization CBR matrix as a framework to categorise the different interventions and outcomes considered by the studies available. Evidence limitations and gaps were identified. 

There were 16 eligible primary studies, including studies conducted in 12 countries: Bangladesh (two studies), Brazil, Chile, China (two studies), Ethiopia, India (three studies), Kenya (two studies), Malaysia, Thailand, Turkey, Uganda, and Vietnam (two studies). Five of the studies concern interventions for people with physical or sensory impairments, nine for people with mental health or neurological conditions, and two for all disability types.

Improving educational outcomes for people with disabilities in low and middle-income countries: why does it matter and what works?

KUPER, Hannah
SARAN, Ashrita
WHITE, Howard
July 2018

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The studies included in this Rapid Evidence Assessment (REA) are taken from the Disability Evidence and Gap Map (EGM) prepared by the Campbell Collaboration for the UK Department for International Development (DFID) under the auspices of the Centre for Excellence for Development Impact and Learning (CEDIL). Eligible studies included systematic reviews and impact evaluations published in English from 2000 onwards that assessed the effectiveness of interventions for people with disabilities in LMICs. Qualitative studies, process evaluations, and non-impact evaluations (e.g. crosssectional surveys) were not eligible for inclusion. Quality grading was applied to the literature, so that assessment could be made of where there was strong evidence and where evidence was limited or missing. The studies were grouped by education sub-outcomes related to different stages in education across the life course; that is: early intervention, primary education, secondary education, non-formal education, and lifelong learning. 

 

There were 24 eligible individual studies, including studies conducted in the Middle East (10), Asia (7), and Africa (5), one from Latin America, as well as one multicountry study

Young persons with disabilities: Global study on ending gender-based violence, and realising sexual and reproductive health and rights

McCLOSKEY, Megan
MEYERS, Stephen
July 2018

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This study provides an analysis on the situation of young persons with disabilities concerning discrimination and gender-based violence, including the impact on their sexual and reproductive health and rights. It also provides an assessment of legal, policy and programming developments and specific good practices in service delivery as well as best-standard prevention and protection measures. Finally, policy and programming recommendations are provided to assist in greater promotion of the rights of young persons with disabilities, with a particular emphasis on preventing and responding to gender-based violence, and realizing sexual and reproductive health and rights.

“They Stay until They Die” A lifetime of isolation and neglect in institutions for people with disabilities in Brazil

RIOS-ESPINOSA, Carlos
et al
May 2018

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This report documents a range of abuses against children and adults with disabilities in residential institutions in Brazil. The research is based on direct observations during visits to 19 institutions (known in Brazil as shelters and care homes), including 8 for children, as well as 5 inclusive residences for people with disabilities. In addition, Human Rights Watch researchers interviewed 171 people, including children with disabilities and their families, adults with disabilities in institutions, disability rights advocates, representatives of non–governmental organizations, including disabled persons organizations, staff in institutions, and government officials.

 

Research was carried out between November 2016 and March 2018 in the states of São Paulo (including São Paulo and Campinas), Rio de Janeiro (including Rio de Janeiro, Duque de Caxias, Niteroi and Nova Friburgo), Bahia (Salvador) and Distrito Federal (including Brasilia and Ceilândia).

Invisible victims of sexual violence. Access to justice for women and girls with disabilities in India

HUMAN RIGHTS WATCH
April 2018

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This report is based on 17 cases of sexual violence against women and girls with disabilities in eight Indian states. It comes five years after The Criminal Law (Amendment) Act, 2013 (the 2013 amendments) were adopted in India. It follows Human Rights Watch’s November 2017 report “Everyone Blames Me”: Barriers to Justice and Support Services for Sexual Assault Survivors in India, which found that rape survivors still face significant barriers obtaining justice and critical support services because legal and other reforms have not been fully realised.

This report finds that while the 2013 amendments have made significant progress in responding to the widespread challenges that victims of sexual violence endure, they have yet to properly develop and implement support for survivors with disabilities in the form of trainings and reforms throughout the criminal justice system. It highlights gaps in enforcement and calls for concrete measures to address the needs of women and girls with disabilities seeking justice for abuse. 

European Disability Forum, European human rights report - issue 2, 2018. Sustainable development goals

STEFF, Marion
et al
January 2018

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The second issue of the European Disability Forum annual European Human Rights report Series focuses on the 2030 Agenda for Sustainable  Development and the Sustainable Development Goals (SDGs). This report showcases to decision-makers and organisations of  persons with disabilities the link between the CRPD and the SDGs in Europe and in international cooperation. It suggests recommendations and advocacy opportunities for disability-inclusive SDGs.

South Sudan: People with disabilities, older people face danger

HUMAN RIGHTS WATCH
May 2017

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It is reported that people with disabilities and older people in South Sudan face greater risks of being caught in fighting and greater challenges in getting necessary humanitarian assistance. In February and March 2017, Human Rights Watch interviewed more than 45 people with disabilities and older people in displacement sites in Juba and Malakal, as well as in Panyijar county in the former Unity state, where the UN declared famine in two counties in February. Human Rights Watch also met with aid organizations and the South Sudan Human Rights Commission. The challenges faced by people with disabilities are reported.

Being disabled in Britain: a journey less equal

EQUALITY AND HUMAN RIGHTS COMMISSION
April 2017

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"Being disabled in Britain is a review into disability inequality in Great Britain. It builds on the Equality and Human Rights Commission’s statutory five-yearly report on equality and human rights progress in England, Scotland and Wales, Is Britain Fairer?.

We want this report to be used by UK and devolved governments to make improvements to law and policies, by local government to ensure services meet the needs of disabled people, and by disability groups to strengthen their case for change.

The report includes chapters on six areas of life, including education, work, health, justice and participation in politics, looking at where there has been progress and where there are still serious issues to be tackled. It also looks the experiences of those with different impairments and how these impact on people’s life chances"

Greece: Refugees with Disabilities Overlooked, Underserved

HUMAN RIGHTS WATCH
January 2017

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Refugees, asylum seekers, and other migrants with disabilities are not properly identified and do not enjoy equal access to services in reception centres in Greece.  On the basis of research carried out in mainland Greece and on the Greek islands in October 2016 and January 2017, and follow-up phone interviews in December 2016 and January 2017, Human Rights Watch found that asylum seekers and refugees with disabilities are not properly identified in Greece, in part because of a rushed registration process and the need for better guidance for staff. Without an adequate understanding of the scale and needs, aid agencies cannot respond effectively. Problems with equal access to water and sanitation services, food distribution, shelter, and health care including mental health and psychosocial support are reported.

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