To understand the impact of the COVID-19 public health response on families of children with disabilities in Central Uganda we conducted phone interviews with parents and children during the first 5 months of the outbreak (March - July 2020). Most parents and children were well informed about COVID-19 and were keen to adhere to government prevention measures. The majority said lock-down measures had a negative effect on their mental and physical health, social life, finances, education and food security. Access to medical services and medication for chronic illness had been limited or absent due to restrictions in travel, some facilities restricting access, and limited financial resources. The majority of parents reported loss of work which resulted in difficulties in finding enough food and paying rent. Parents worried about children missing education and friends. We suggest greater attention to children with disabilities and their families when implementing mitigating and long-term responses.
This report outlines findings on how children are uniquely affected by explosive weapons and how the aftercare that children receive is frequently inadequate or non-existent.
This report aims to assess the level of access that People with Disabilities have to services and institutions during the pandemic period, as well as to analyze their economic and financial needs to cope with the consequences of the crisis caused by COVID-19.
The survey was conducted in the form of a quantitative field survey. 360 individuals participated in the survey: 199, or 55.3%, of the participants were people with disabilities (PWDs) while the remaining 161 persons, or 44.7%, were guardians or parents of a person with disabilities. The survey was conducted in all 6 districts of the country. The questionnaire was designed to gather information on the perceptions, attitudes, behaviors and experiences of people with disabilities during the COVID-19 period.
A discussion on how persons with disabilities can manage the new normal. Learn about the safety protocols, the do's and don'ts, and other activities to help manage the stress and anxiety caused by the quarantine and COVID-19.
This event was made possible through the Voice LCDPFI project in partnership with the Las Pinas Persons with Disabilities Federation, Inc
In a humanitarian crisis, camps and camp-like settings are often the only places where internally displaced persons (IDPs) and refugees can seek protection and assistance.
These Minimum Standards for Camp Management describe the minimum actions needed to support meaningful engagement within a site as well as planning and coordination between sectors and agencies. They aim to clarify the role of any site management agency working on a daily basis in humanitarian settings and to set out minimum levels of quality of that work. Although called the Minimum Standards for Camp Management, the standards apply to all contexts where displaced people seek shelter, protection and other support, and the term “site” is used unless a specific camp context is meant.
Annex 1 provides a disability inclusion monitoring checklist. This checklist is not exhaustive nor meant to replace participatory approaches but can be used as a complementary tool by site managers willing to assess the overall inclusiveness of a site, or as a tool to support the development of an inclusive strategy for persons with disabilities.
The road map sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. Three foundational pillars will support global efforts to achieve the targets: accelerate programmatic action (pillar 1), intensify cross-cutting approaches (pillar 2) and change operating models and culture to facilitate country ownership (pillar 3).
The disease summaries annexed to the road map detail the current epidemiological status and burden of disease, core strategic interventions and progress towards the 2020 targets of the previous road map. The targets, sub-targets and milestones for 2030, and the critical actions required to achieve them, were used to generate the evidence in the road map document endorsed by the World Health AssemblY
This document provides guidance on how to incorporate disability inclusion within climate change programming in Iraq, Jordan, Lebanon, Occupied Palestinian Territories (OPTs), Syria, Turkey and Yemen. It is intended to inform the UK's Foreign, Commonwealth and Development Office’s (FCDO) climate change programming in the Middle East and North Africa (MENA) region.
The World Report on Hearing (WRH) has been developed in response to the World Health Assembly resolution (WHA70.13), adopted in 2017 as a means of providing guidance for Member States to integrate ear and hearing care into their national health plans.
Based on the best available evidence, this report presents epidemiological and financial data on hearing loss; outlines available cost-effective solutions and sets the way forward through ‘Integrated people-centered ear and hearing care’ (IPC-EHC). The report proposes a set of key H.E.A.R.I.N.G. interventions that must be delivered through a strengthened health system to realize the vision of IPC-EHC.
The WRH was developed in collaboration with experts and stakeholders in the field of ear and hearing care who informed the report’s strategic direction and ensured that it reflects a range of cultural contexts and approaches to hearing care. The report is global in its reach while keeping a special focus on low- and middle-income countries, where the number of people with hearing loss is not matched by the availability of services and resources.
Background: Across the world, frailty is part of the guidelines that are being developed in the COVID-19 pandemic for triaging in crisis situations. The Clinical Frailty Scale (CFS) evaluates the ability to perform daily tasks to identify frail individuals, potentially excluding those from intensive care (IC) treatment. Individuals with intellectual disabilities (ID) experience varying degrees of dependence, distinct from age-related physical deterioration. Using the CFS for triage in crisis situations could potentially unjustiably exclude individuals with ID from IC treatment. Our objective was to compare the classication of individuals with ID
into different frailty categories based on the CFS and the well-studied ID-frailty index and to determine suitability of CFS for evaluation of frailty in individuals with ID during the COVID-19 pandemic.
Methods: This retrospective analysis of the observational healthy aging and intellectual disabilities (HA-ID) study included 982 individuals with ID of ≥50 years, who were classied according to the CFS and the ID-frailty index.
Results: Of the cohort of 982 older adults with ID, 626 (63.7%) would be classifed as moderately frail (CFS score 6), but 92% of this group is not moderately frail according to the ID-frailty index. Furthermore, 199 (20.3%) would be classied as at least severely frail (CFS score 7–9), but 74.9% of this group is not severely frail according to the ID-frailty index. Overall, 730 out of 982 (74.9%) individuals would be incorrectly classied by the CFS as too frail to have a good probability of survival. The ID-frailty index predicts mortality better than the CFS in individuals with ID.
Conclusions: Our results show the CFS is not suitable to evaluate frailty in individuals with ID, with potential dramatic consequences for triage and decision-making during the COVID-19 pandemic. We strongly recommend using the ID-frailty index when assessing probability of survival for individuals with ID.
Background: Due to increased life expectancy, just as with the general population, people with intellectual disabilities are experiencing, and dying from, chronic and life-limiting conditions. This has led to an increase in the need for end-of-life care for people with intellectual disabilities. However, there is limited evidence as to what constitutes good end-of-life care from the perspectives of people with intellectual disabilities and their family members.
Methods: The study reported here aimed to nd out the care needs of people with intellectual disabilities at the end of life in Ireland. A grounded theory approach was employed to explore the perspectives of the participants. After obtaining appropriate ethical approval, 19 semi-structured individual interviews were carried out with 11 people with mild and moderate intellectual disabilities and eight family members to collect data which was subsequently analyzed through constant comparative analysis.
Results: The views of the participants suggested that providing personal care while vulnerable and dying, being with and communicating with the dying person, and meeting their spiritual needs, were considered as being essential at the end of life for people with intellectual disabilities.
Conclusion: The fndings from this study have shown that people with intellectual disabilities can engage with those around them and demonstrate how they would like to be cared for, and discuss what would be considered as being good care at the end of life.
An increase in descriptive evidence regarding person-centered approaches for older people with intellectual disability (ID) is important, due to increased life expectancy and the present lack of sufficiently underpinned interventions. This is especially true of interventions designed to increase well-being and quality of life. A specific Dutch example is the Integrated Emotion-Oriented Care approach. Despite its status as a good practice, its effectiveness has not yet been proved, nor has descriptive evidence been made available. The primary aims of this qualitative study are to identify the intervention components, to provide demonstrative illustrations and to gain an in-depth understanding of the use of these components in the day-to-day support of older people with ID. A content analysis of five key documents was carried out. Five semi-structured interviews were then conducted with early adopters, followed by a concept mapping study with daily users. The final stage in the data collection process was a series of five focus-group interviews with experts and experienced support staff. The five intervention components of Integrated Emotion-Oriented Care for older people with ID have been systematically identified and described in detail in five narrative summaries drawn up in collaboration with early adopters, experts and experienced support staff. This study provides valuable insights that offer descriptive evidence for Integrated Emotion-Oriented Care in the care for older people with ID. Both implications and possible opportunities for future research are discussed.
Between 1958 and 1961, the drug Thalidomide was prescribed in the UK as a treatment for morning sickness. It caused severe birth defects. Thalidomide survivors are now experiencing a range of secondary health problems, including depression and anxiety. Internationally, it is estimated that 40% to 50% of Thalidomide survivors have recently experienced common mental health problems. The aim of this study was to gather information about the pattern of symptoms of depression and anxiety amongst UK Thalidomide survivors. A cross-sectional postal survey of 182 UK Thalidomide survivors, which used Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Scale (GAD-7) to measure self-reported depression and anxiety, was conducted. Data were first analysed using descriptive statistics. A point-biserial correlation was used to examine whether being unable to work was associated with higher depression and anxiety scores. Prevalence of all levels of depression and anxiety was higher amongst the Thalidomide survivors than the general UK population but broadly similar to other groups of adults with disabling conditions. Being unable to work was associated with higher depression and anxiety scores. More research is needed to understand the relationship between early acquired physical disability and depression, in particular the implications, over the life course, of secondary health problems and changing social roles.
Recent advances in medical interventions have changed the prognosis for children with infantile-onset spinal muscular atrophy (SMA-1); however, little has been published regarding rehabilitation management. A rapid scoping review was conducted in November 2020 using Medline and CINAHL databases. Evidence supporting use of assistive devices and equipment to enhance participation, mobility, function, and posture in lying, sitting, and standing positions was sought. From 239 articles, only five studies (describing use of augmentative communication, manual and power mobility, supported standing and orthotic devices) met inclusion criteria. Results are presented alongside a case report of a 5-year-old boy (treated with Nusinersen since 7 months-of-age) who uses a variety of devices to enhance his activity and participation in family life. While reclined and tilted sitting positions as well as power mobility were previously considered for children with SMA-1, this child has progressed to supported upright standing, self-propelling a lightweight manual wheelchair indoors, communicating using multiple methods and taking steps in a dynamic mobility device. Power mobility was introduced in a switch-adapted cart at 11 months and he was independently exploring indoors and outside in his power wheelchair before 20 months. Research evidence is limited, but alongside the case report highlights the importance of a comprehensive and proactive approach to enhancing function, fun and participation with family and friends through adaptive equipment for children with significant and life-limiting disabilities.
Bridging the Gap I is designed to support the implementation and the monitoring of the Convention on the Rights of Persons with Disabilities (CRPD) and to contribute to the attainment of the Sustainable Development Goals inclusive of persons with disabilities. The project aims to develop tools to promote the rights, participation and inclusion of persons with disabilities in the implementation of the 2030 Agenda, in line with the CRPD.
One of the tools being developed within Bridging the Gap I are human rights based indicators on the CRPD. The indicators are listed. They are available in table format and accessible formats in English, French and Spanish
The Inclusive Education in the Sahel Project 2017-2021 implemented by HI and co-financed by NORAD and AFD (Burkina Faso) has created a “collaborative dynamic for organizations of persons with disabilities (OPDs) and civil society movements working in education at the regional level (West Africa) and national level (Burkina Faso, Mali, Niger) for the promotion of inclusive education”, and this study aims to capitalise on this dynamic. The ultimate goal of the project was to increase the number of children attending school in these three countries, especially children with disabilities and/or marginalised children. To achieve this objective, the project has developed an advocacy component aimed at sensitising communities about inclusive education on the one hand, and bringing about changes in education policies and sectoral plans to make them more inclusive, on the other hand.
- Children with disabilities are among the most excluded learners in the education system. The exponential development of ICTs(Information and Communication Technologies) throughout the world is a real opportunity to improve the educational inclusion of these children.
- The aim of the study was to: i) identify existing ICTs that can support the educational inclusion of children with disabilities; ii) identify the challenges to the implementation of these ICTs in the classroom in some of Handicap International’s French-speaking countries of intervention, namely Benin, Burkina Faso, Madagascar, Mali, Morocco, Niger, Senegal and Togo. The study consists of two separate documents: this report outlining the methodology of the study, the process for the development of the ICT Directory, and the main lessons learned, on the one hand, and a document listing the ICTs identified during the research, on the other hand.
- The study was based on secondary research, interviews with experts and with potential users of the ICTs in the intervention countries, namely teachers, parents and students with disabilities in Benin, Niger and Senegal.
The aim of this paper, based on desk research, is to analyse the barriers to access and retain formal employment of persons with disabilities which are framed in three categories according to where the barriers primarily manifest:
1. In the workplace among employers and co-workers without disabilities
2. Among persons with disabilities seeking or engaged in formal employment
3. In the wider social, physical and policy environment.
Although the study mainly focuses on Kenya and Bangladesh other countries’ literature on access to and retention of employment of persons with disabilities were reviewed where relevant. In the context where the global COVID-19 pandemic is breaking barriers to remote working one part of the solution will be to empower persons with disabilities with appropriate access to Information and Communication Technology, assistive devices and services, digital skills, creating more accessible and inclusive digital platforms for persons with disabilities which also hold the potential to improve working conditions and productivity for the whole workforce as well as enhancing resilience to potential future shocks.
GDI Hub Working Paper Series Issue 01
This study is was developed in the framework of the project “Improving inclusive education and employment for children and youth with disabilities” implemented by Save the Children in Kosovo and financed by Save the Children Italy. This project aims to empower boys and girls with disabilities in Kosovo to reach their full potential by promoting easier access to inclusive quality education and employment opportunities.
The aim of this study is to:
- analyse the skills of youth with disabilities, and their compatibility with the labour market needs in Kosovo;
- assess the needs of youth with disabilities in the employment context in Kosovo;
- identify the gaps that are hindering the inclusion of youth with disabilities in the labour market;
- investigate how youth with disabilities can advance towards the potential gradual approximation with the labour market needs in our country;
- access the availability of the potential employers to employ and accommodate persons with disabilities in the work places;
- to define how the labour market can improve the access of youth with disabilities.
Since 2012, the Kyrgyz government has pledged to close 17 residential institutions for children, including three for children with disabilities. But 3,000 children with disabilities remain in institutions.
This report is based on in-person visits to six institutions for children with disabilities and 111 interviews with children with disabilities, their parents, institution staff, and experts in four regions of Kyrgyzstan. It describes abuses in state care as well as barriers to education that often lead to a child’s segregation in a residential institution or special school, or their isolation at home.
Background: Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.
Methods: To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific).
Findings: Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34–2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235–392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588–636] and 83 million YLDs [62–106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68–1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed.
Interpretation: To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.
VOLUME 396, ISSUE 10267, P2006-2017, DECEMBER 19, 2020
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