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Product Narrative: Prostheses. A market landscape and strategic approach to increasing access to prosthetic devices and related services in Low- and Middle-Income Countries

LIAO, Cynthia
SEGHERS, Frederick
SAVAGE, Margaret
FINEBERG, Alison
AUSTIN, Vicki
HOLLOWAY, Catherine
OLDFREY, Ben
April 2020

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While about 1.5 million people undergo amputations every year, WHO estimates that only 5-15% of amputees who need prosthetic devices in LMICs have access to them. High prices of prosthetic services in lower- and middle-income countries (LMICs), combined with high indirect costs for users (for example to travel to service points), make prosthetic services unaffordable to many of the people who need them. 

Prosthetic services can be made more affordable by: 1) increasing the number of service units (in particular, by leveraging decentralised service models and the innovative technologies that enable them); 2) establishing reimbursement schemes that encapsulate all costs to the user; and 3) leveraging alternative forms of financing for both capacity-building and user financing.

An opportunity exists to transform access to prosthetic services and products in LMICs, but this will require a coordinated effort between: 1) governments to expand service capacity; 2) global stakeholders to provide guidance on products and technologies; 3) suppliers to expand market presence and offerings; and 4) donors to support these activities. 

Five strategic objectives are proposed to accelerate access to prosthetic services in LMIC

Politically disabled: barriers and facilitating factors affecting people with disabilities in political life within the European Union

WALTZ, Mitzi
SCHIPPERS, Alice
2020

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Diversity is a current buzzword in politics, but in the EU, people with disabilities are not achieving the gains made by women and ethnic minorities. This research examined barriers and facilitating factors through a literature review and interviews with politicians and political activists in five European countries. Six categories of barriers and facilitating factors were found: networks, recruitment and mentoring, resources (money, time and energy), the “hierarchy of impairments,” accessibility of political spaces and activities, and laws and policies. Key recommendations include removing access barriers to political participation, from voting to holding office, including physical and procedural barriers in political spaces; ensuring that equalities legislation covers politicians; eliminating barriers imposed by benefits systems; promoting direct support for political activists, candidates and office-holders with disabilities, including access to necessary services and supports; encouraging parties to recruit and mentor disabled people with leadership potential; and considering quotas and job-sharing.

  • Not many disabled people are active in politics. In the EU, about 15% of people have an impairment, but only around 1% of politicians do.
  • Inclusion at school and in social groups makes it easier to get into political jobs or to try to get elected.
  • Some disabled political activists, volunteers, candidates and office-holders don’t get the support they need.
  • Political parties can help by finding disabled people, supporting them, and helping them get involved in politics.
  • Our article provides several ideas about how to make it easier for disabled people to run for office and work in politics.

Opening the GATE: systems thinking from the global assistive technology alliance

LAYTON, Natasha
BELL, Diane
BUNING, Mary Ellen
CHEN, Shih-Ching
CONTEPOMI, Silvana
RAMOS, Vinicius Delgado
HOOGERWERF, Evert-Jan
INOUE, Takenobu
MOON, Inhyuk
SEYMOUR, Nicky
SMITH, Roger O
DE WITTE, Luc
2020

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Purpose: 

This paper describes international actions to collaborate in the assistive technology (AT) arena and provides an update of programmes supporting AT globally.

 

Methods: 

The World Health Organisation (WHO) identifies the severe global uneven distribution of resources, expertise and extensive unmet need for AT, as well the optimistic substantial capability for innovations and developments in appropriate and sustainable AT design, development and delivery. Systems thinking and market shaping are identified as means to address these challenges and leverage the ingenuity and expertise of AT stakeholders.

 

Results: 

This paper is a ‘call to action’, showcasing emerging AT networks as exemplars of a distributed, but integrated mechanism for addressing AT needs globally, and describing the Global Alliance of Assistive Technology Organisations (GAATO) as a vehicle to facilitate this global networking.

 

Conclusion:

 Partners in this Global Alliance aim to advance the field of assistive technology by promoting shared research, policy advocacy, educating people and organisations within and outside the field, teaching, training and knowledge transfer by pulling together broad-based membership organisations.

The effect of school leadership on implementing inclusive education: how transformational and instructional leadership practices affect individualised education planning

LAMBRECHT, Jennifer
LENKEIT, Jenny
HARTMANN, Anne
EHLERT, Antje
KNIGGE, Michel
SPÖRER, Nadine
2020

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Fostering equity by offering the best education possible to all students is one of the main goals of inclusive schooling. One instrument to implement individualised education is individualised education planning (IEP). IEP requires cooperation between special and regular teachers. From research on school leadership it is known that leadership styles are connected to the way, school leaders use their scope of action with respect to fostering collaboration. However, little is known about the relationship between the leadership of a school, the provision of structures for collaboration, and the implementation of IEP in an inclusive context. The article focuses on the question to what extent transformational (TL) and instructional leadership (IL) are connected to the provision of structures for collaboration and how TL and IL as well as structures for collaboration relate to the implementation of IEP directly and indirectly. Based on data of N = 135 German schools, a path model was calculated. It revealed medium relations between TL, IL, and structures for collaboration as well as a medium effect from structures to collaboration on implementation of IEP. The effect from TL towards implementation of IEP was fully mediated by structures for collaboration, while the effect from IL persisted.

Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone

AENISHANSLIN, Justine
AMARA, Abu
MAGNUSSON, Lina
April 2020

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Purpose: To explore the experiences of persons with physical disabilities accessing and using rehabilitation services in Sierra Leone.

 

Materials and methods: Interviews of 38 individuals with differing physical disabilities in three locations across Sierra Leone. An inductive approach was applied, and qualitative content analysis used.

 

Results: Participants faced several barriers to accessing and using rehabilitation services. Six themes emerged: The initial and ongoing need for rehabilitation throughout life; challenges with the cost of rehabilitation and transportation to reach rehabilitation services; varied experiences with rehabilitation staff; coming to terms with disability and encountering stigma; the struggles without and opportunities with rehabilitation services; and limited knowledge and availability of rehabilitation services.

 

Conclusions: There is a continued need to address the barriers associated with the affordability of rehabilitation through the financing of rehabilitation and transportation and exploring low-cost care delivery models. Rehabilitation services, assistive devices, and materials need to be available in existing rehabilitation centres. A national priority list is recommended to improve the availability and coordination of rehabilitation services. Improved knowledge about disability and rehabilitation services in the wider community is needed. Addressing discriminatory health beliefs and the stigma affecting people with disabilities through community interventions and health promotion is recommended.

Disability considerations during the COVID-19 outbreak

WORLD HEALTH ORGANISATION (WHO)
March 2020

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This overview gives actions for the disabled persons and their household, for governments, for healthcare workers , for disability service providers and for the community to mitigate the effects of the COVID-19 outbreak.

COVID19 Resource Key advocacy messages, questions to ask on inclusion and signpost to resources to learn more

Dr. Werner-Freybergstr
March 2020

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The COVID pandemic continues to escalate across the world, this document has been prepared to;

  • Provide some top-line advocacy messages that can be used for advocacy and communications,
  • Give a few questions example that you can ask yourself/or other stakeholders to check how people with disabilities are being included,
  • Provide key resources for further reading. We recognise the importance of safe, evidence-based messages, and stand by the advice of the World Health Organisation on health-related issues, of the Inter-Agency Standing Committee on international coordination, and of the International Disability Alliance on inclusion of people with disabilities in the COVID-19 response. 

COVID-19 RESPONSE A unique expertise to fight the virus

HUMANITY & INCLUSION (HI)
March 2020

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Humanity & Inclusion’s teams are assessing its scope for action and plans to use its expertise in emergency situations, working with and for people with disabilities and older people, and its experience of past epidemic situations to protect the most vulnerable. HI has experience in major epidemics of ebola and cholera.

 

HI published a repository of resources on disability inclusion and COVID-19 as a member of the International Disability and Development Consortium (IDDC) and the CORE Group Disability Inclusive Health Technical Advisory Group

Mental health and psychosocial considerations during the COVID-19 outbreak

WORLD HEALTH ORGANISATION (WHO)
March 2020

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The considerations presented in this document have been developed by the WHO Department of Mental Health and Substance Use as a series of messages that can be used in communications to support mental and psychosocial well-being in different target groups during the outbreak. Target groups are: general popluation; healthcare workers; team leaders or managers of health facilities; carers of children;  older adults; people with underlying health conditions and their carers; people in isolation 

COVID-19: How to include marginalized and vulnerable people in risk communication and community engagement

UN WOMEN
TRANSLATORS WITHOUT BORDERS
March 2020

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Recommendations for inclusion of marginalised and vulnerable groups in risk communications and community engangement are made. Groups considered are: children; people with disabilities; women and girls; pregnant women; persons living with HIV; gender based violence survivors; refugees and migrants; elderly; people in existing humanitarian emergencies; people with pre-existing medical conditions; sexual and gender minorities; ethnic minorities.

Participation in Practice: Examples of inclusive action for a “Participation Revolution”

March 2020

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Humanitarian organizations and donors have committed to change the way humanitarian action is carried out and create a “Participation Revolution.” In this webinar issues addressed included:

  • inclusion of the people and communities affected by humanitarian crises in practice;
  • how organizations are ensuring that the voices of the most vulnerable groups considering gender, age, ethnicity, language, and special needs are heard and acted upon;
  • how program activities and budgets are designed to support the changes that affected people demand


In this webinar, organized on 26 March 2020 by PHAP and the Steering Committee for Humanitarian Response, we took stock of the progress to date on workstream six of the Grand Bargain and heard success stories from the field that can help agencies achieve a sustained change in how they design and deliver their programs.

 

A full transcript is available. Webinar registrants were asked to provide what they thought, in their context, was the most important factor enabling participation in practice and what they thought was the most important factor preventing participation in practice. Answers are provided in an Annex.

Recommendations for Immediate COVID-19 Action

Marcie Roth
March 2020

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This document provides recommendations for rapid response solutions for federal and state governments to close the real and anticipated gaps in the COVID-19 outbreak and public health emergency-related continuity of operation for people with disabilities, older adults, and people with access and functional needs. Our recommendations include contingency plans for disability and aging services, supports, and programs funded directly with federal or state funds or through federal assistance to state, local, tribal and territorial governments and non-government providers.

COVID 19 disability inclusion emergency response: by the albino foundation, disability inclusion Nigeria

March 2020

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In order to reduce the spread and impact of COVID 19 on persons with disabilities globally, The Albino Foundation-DISABILITY INCLUSION NIGERIA PROJECT in alignment with the recommendations of International Disability Alliance (IDA) has come up with simple steps to mitigating the virus within this vulnerable population. The basic measures includes:

1.0 Persons with disabilities

2.0 Government

3.0 Members of the public

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

BROOKS, Samantha K
WEBSTER, Rebecca K
SMITH, Louise E
WOODLAND, Lisa
WESSELY, Simon
GREENBERG, Neil
RUBIN, Gideon James
March 2020

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The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

 

RAPID REVIEW VOLUME 395, ISSUE 10227, P912-920, MARCH 14, 2020

DOI:https://doi.org/10.1016/S0140-6736(20)30460-8

Pages

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