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SOUTH SUDAN. Protection Analysis Update. Protection risks facing persons with disabilities and older persons

GLOBAL PROTECTION CLUSTER, UNHCR
October 2023

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This South Sudan Protection Analysis Update places a thematic focus on protection risks facing persons with disabilities and older persons.

The most recent census reported that 5% of the population in South Sudan, or approximately 424,000 people, were living with a disability. However, the current number is likely to be much higher, possibly reaching 1.2 million people, or 16% of the population, according to the global estimate. Data in South Sudan also suggests a rapid increase in the number of older persons each year, mounting to 5.1% of total population with this percentage expected to continue to steadily increase.

People with disabilities and older people in South Sudan are often excluded and face multiple challenges in accessing essential services and protection. Decades of civil war have increased the number of older people and persons with disabilities who are being left behind as they are unable to flee due to chronic health conditions and mobility impairments. People who have managed to flee the violence are often faced with barriers accessing protection and health services. Therefore, older people with and without disabilities in South Sudan face higher risks and greater challenges in getting the necessary humanitarian assistance.

Global Report on Children with Developmental Disabilities: from the margins to the mainstream

WORLD HEALTH ORGANISATION (WHO)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
September 2023

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This WHO-UNICEF Global Report is a call for action to intentionally include children and young people with developmental disabilities in renewed global and country level efforts to enable transformations towards the SDGs.  It proposes priority actions to accelerate individual-, family-, community-, and society-level changes to achieve inclusion and health equity. The report makes the case for greater investment and accountability to build inclusive and responsive multisectoral care systems for children and young people with developmental disabilities. Using findings from research and practice and guided by the tenets of international human rights conventions, the report provides key insights into the state of knowledge, policy, programming, and public monitoring in respect of developmental disabilities.

Inclusive Design and Accessibility in Medellín, Colombia. AT2030 Inclusive Infrastructure Case Studies

PATRICK, M
MULDOWNEY, A
ARRUBA PALACIO, M
AGUIRRE, M
McKINNON, I
August 2023

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

Medellín, Colombia is the sixth and final case study city under the Global Disability Innovation Hub (GDI Hub) led and UK Aid funded AT2030 Inclusive Infrastructure sub-programme. Colombia’s second largest city, Medellín is well-known for its progress in urban development in the last 20 years, moving forward from its violent history. Medellín has been designated a district of innovation and is known for innovative urban projects such as its cable cars and electric escalators that connect higher altitude, low-income communities on the peripheries of the city. This case study explores the current state of accessibility and inclusion in the city for persons with disabilities and helps understand whether such urban innovations are inclusive for all the city’s residents.

Medellín is home to nearly 80,000 persons with disabilities and Colombia does have strong legal frameworks in place to support persons with disabilities. However, this case study found that the numerous laws and regulations are not always well implemented and there is also a need to consider more diverse disabilities in city planning and design.

The research took place in 3 phases between December 2022 and May 2023, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk-based research and interviews. Phase 2 captured the lived experience of persons with disabilities through interviews, photo diaries and co-design activities. Phase 3 then synthesised the findings, running multiple in-person workshops to validate and create actions towards the creation of more inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life for persons with disabilities including, poverty, transport, housing, healthcare, public spaces and recreational activities. Quotes from participants are interwoven throughout the report and strengthen the concluding actions. The report recognises what has worked in Medellin as well as areas for improvement.

Mainstreaming Disability Inclusive Disaster Risk Reduction (DIDDR) in Community Based Inclusive Development: A Situation Analysis

GRECH, Shaun
July 2023

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Two publications, developed with the University of Cape Town, aim to provide development practitioners and organisations with the tools they need to ensure that a disability inclusive approach to disaster risk reduction can be integrated into all community development programmes.

A situation analysis reviews the situation and outlines the extent to which DIDRR is infused within CBID. The study points out the barriers in place and highlights the opportunities available to facilitate the process of mainstreaming DIDRR, which means building DIDRR into the core of community development programmes as opposed to these disciplines operating in separate spheres. This mainstreaming will not only ensure greater preparedness for disasters, but also protection of the gains made in community development programmes.

A major outcome of this study is a new set of guidelines for practice on the mainstreaming of DIDRR in community development: Mainstreaming DIDRR in CBID – Guidance for Planning and Practice

Prevention against emerging infectious diseases: An Opportunity for Inclusive Health. Understanding the behavioural and social drivers (BeSD) of COVID-19 vaccination among persons with disabilities in Internally Displaced camps in Somalia/Somaliland

ZIVERI, Davide
ABDULLAHI, Hawaa
July 2023

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In close collaboration with the World Health Organization, Humanity & Inclusion adapted and piloted WHO’s behavioural and social drivers (BeSD) of vaccination tools to understand and analyze the perception of COVID-19 vaccines as well as the barriers and drivers of immunization among persons with disabilities in a humanitarian setting in Somalia/Somaliland. This study was funded by the Universal Health Coverage and Life Course (UHL) division of the Immunization, Vaccines and Biologicals (IVB) department of the World Health Organization, Geneva. Humanity & Inclusion also carried out a Risk Communication and Community Engagement (RCCE) project, contributing to the inquiry phase described in this report, to foster the right to health as well as access to COVID-19 vaccination in Somalia/Somaliland, funded by the Center for Disaster Philanthropy.

 

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Assistive Technology Changes Lives: an assessment of AT need and capacity in England

AUSTIN, Vicki
PATEL, Dilisha
DANEMAYER, Jamie
MATTICK, Kate
LANDRE, Anna
SMITOVA, Marketa
BANDUKDA, Maryam
HEALY, Aoife
CHOCKALINGAM, Nachiappan
BELL, Diane
HOLLOWAY, Kathy
2023

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The aim of this research was to undertake a Country Capacity Assessment (CCA) to inform a more integrated approach to Assistive Technology (AT) provision in England. The results aim to support policymakers in identifying actions to strengthen service delivery to better meet disabled people’s needs, improving outcomes for AT users and reducing inefficiencies in the current approach. This report was prepared by Global Disability Innovation (GDI) Hub for the Disability Unit in the Cabinet Office His Majesty’s Government (HMG). The research was undertaken from November 2022 to March 2023 and led by the Global Disability Innovation (GDI) Hub, which is the World Health Organization (WHO) Global Collaborating Centre on AT access, using WHO tools in the Assistive Technology Assessment (ATA) suite

Cost analysis of 3D printing services implementation into public services to produce orthoses: An Ugandan case-study

NIZET, Alicia
BRUS, Aude
December 2022

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3D printing is a new technology and there is a need for producing evidence to justify and demonstrate its associated costs and benefits. Humanity and Inclusion has been implementing an innovative 3D printing project in Uganda, in the Omugo Refugee Settlement, to address the unmet rehabilitation needs of people with disabilities (PETRA Project) since November 2018. This project is implemented in collaboration with the public hospital of the Arua District (Arua Regional Referral Hospital). 

 

This study aims to calculate implementation and running costs of 3D printing services to produce orthoses in a public service (here ARRH), in addition to traditional services, in a developing context.

Specific objectives:

To define and detail all phases of the patient pathway for the 3D printed orthosis provision(from patients’ identification to orthoses delivery);

To evaluate costs of the 3D printed orthosis procurement (from patients’ identification to orthoses delivery) based on lifetime of digital material;

To give a better understanding on how to implement such a digital service in a public health structure.

 

The results of this study will allow HI, other organisations, States or potential donor to enrich their decisions on the implementation of 3D-printed orthoses production in their context of intervention - embedded in addition to traditional services or in remote areas where there is no traditional services.

 

Hypotheses, choices and data are based on the information collected through multiple sources and methodologies (desk review, semi-structured interviews, surveys, workshop, and literature review) and are specific to the context of Arua, Uganda. To calculate all the costs related to the service that produces and delivers 3D-printed orthoses, a matrix has been created.

Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

Assistive Technology in two humanitarian contexts: Bangladesh and Jordan

KETT, Maria
June 2022

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Despite increased focus on the need for assistive technology (AT), along with estimates of need and gaps in provision in humanitarian contexts, very little is actually known about how people who need AT are managing in these contexts. To address this need, this study explored four main questions: 

What do we currently know about the need for AT in humanitarian contexts?
How is this need currently met?
What gaps are there in the evidence about these needs?
What mechanisms are needed to ensure provision of AT in humanitarian contexts? 

It explored these questions through individual interviews with AT users and their families, as well as people working in the sector, in two humanitarian response contexts: Bangladesh and Jordan. In Bangladesh, we partnered with CBM Global and their local partner, the Centre for Disability in Development, and in Jordan, all those interviewed were beneficiaries of HelpAge International.

The questions focused on the areas identified as gaps in the initial literature review, and used qualitative methodologies to probe and gain further insight into gaps across the entire AT ecosystem.

Early detection tools for children with developmental delays and disabilities in the Middle East and North Africa

UNITED NATIONS CHILDREN'S FUND (UNICEF)
June 2022

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This technical brief was developed to support specialists in countries of the Middle East and North Africa (MENA) region to select which early detection tools best fit their needs and context by comparing various tools that have been used in theregion and lessons learned in using and adapting those tools to local contexts.

"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

Labour Market Assessment: Pakistan 2022

GLOW Consultants
May 2022

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This labour marker assessment has identified how the Pakistan market works and the possible entry points, so that youth with disabilities, are included in the benefits of growth and economic development. Initially the report focuses on analysing the macro-economic indicators and the sectoral contribution to GDP, followed by evaluation of labour market data, in order to identify employment rates and employment propensity of sectors and sub-sectors and to identify sectors with highest absorptive capacity. Priority subsectors were selected on the basis of the employment rate, GDP contribution and government prioritization. Value chain analysis of the selected priority subsectors was conducted to analyse possible entry point for people with disabilities in various stages of the value chain by identifying required skills and education. Subsequently, education stocks and flows were analysed to assess whether the demand of skills was coherent with the supply of skills. Existing systems were reviewed to assess the inclusion of people with disabilities in government initiatives and programmes. Likewise, government-formulated polices and legislation were appraised to understand their contribution in improving lives and safeguarding the rights of people with disabilities, followed by analyses of existing labour market information systems. Shortcomings and limitations in policies were identified, emerging issues were highlighted, and recommendations were provided to improve implementation of existing policies.

Global Report on Assistive Technology

WORLD HEALTH ORGANISATION (WHO)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
May 2022

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The WHO-UNICEF Global Report on Assistive Technology (AT) reveals that more than 2.5 billion people need one or more assistive products, such as wheelchairs, hearing aids, or apps that support communication and cognition. Yet nearly one billion of them are denied access, particularly in low- and middle-income countries, where access can be as low as 3% of the need for these life-changing products.

The Global Report provides the best available evidence about the barriers currently preventing access, how access can be improved, and how enabling environments and AT can enable persons with disabilities to enjoy their human rights while generating a tremendous return on investment for governments. The report also makes 10 key recommendations for concrete actions that will improve access to AT, for everyone, that needs them. 

Access to assistive technology for children with disabilities is often the first step for childhood development, access to education, participation in sports and civic life, and getting ready for employment like their peers. Children with disabilities have additional challenges due to their growth, which requires frequent adjustments or replacements of their assistive products.

Explosive ordnance in Syria: impact and required action

May 2022

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Explosive ordnance (EO) puts one in two people in Syria at risk of death and injury and impedes the delivery of crucial humanitarian assistance. However, the extent of EO in Syria and its devastating impact is not sufficiently known or discussed among donors and humanitarian actors. International humanitarian mine action (HMA) actors operating in Syria for over ten years have come together to address this gap, sharing data and insight from their work on the ground. They produced a report to highlight the extent of EO contamination in Syria; its devastating impact on people, vital infrastructure and provision of humanitarian assistance; the crucial activities performed by humanitarian mine action (HMA) actors; and the action required to address this issue

Global disability financing in the context of Covid-19

Development Initiatives
March 2022

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The main objective of this analysis is to track global financing towards disability in near real time, which is an extension of our work on real-time data on aid before and during Covid-19 and financial tracking on disability investments. The current analysis assesses changes in global disability aid financing in the context of Covid-19 between 2019 and the third quarter (Q3) of 2021. The review uses data from the International Aid Transparency Initiative (IATI) and considers full calendar years for 2019 and 2020 and three quarters in the year 2021.

Are persons with disabilities included in the effort to leave no-one behind? Mapping disability data in development in Asia and the Pacific

CBM GLOBAL’S INCLUSION ADVISORY GROUP
February 2022

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In the Asia Pacific region, UNFPA and partners work together to implement the Incheon Strategy to “Make the Right Real” for Persons with Disabilities. The Incheon Strategy is the region’s first set of disability-specific development goals to track progress towards the fulfilment of rights of persons with disabilities.

In the region, it is estimated that there are over 650 million persons with disabilities. However, without accurate, timely and disaggregated data, countries are unable to develop effective policies and programmes, monitor the wellbeing of persons with disabilities and evaluate the equity and impact of development efforts. This endangers country commitments to ‘leave no one behind’ and undermines their obligations to the Convention on the Rights of Persons with Disabilities.

This groundbreaking report demonstrates the importance of ensuring data is inclusive and provides recommendations for immediate action in order to improve the collection, analysis and reporting of disability data

Towards a disability-inclusive humanitarian response in South Sudan?

FUNKE, Carolyn
DIJKZEUL, Dennis
February 2022

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The Inter-Agency Standing Committee (IASC) Guidelines on the Inclusion of Persons with Disabilities in Humanitarian Action (2019) set out four ‘must do’ actions to identify and respond to the needs and rights of persons with disabilities. This study investigates how humanitarian organizations implement the four ‘must do’ actions in South Sudan. It shows that mainstream and inclusion-focused organizations actively promote their implementation to make disability inclusion an integral part of humanitarian action, investing heavily in capacity-building and awareness-raising at all levels of the response. Nevertheless, serious gaps and challenges to disability inclusion remain. 

Barriers and facilitators to providing assistive technologies to children with disabilities in Afghanistan

WHITAKKER, Golnaz
WOOD, Gavin
February 2022

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Due to the impacts of the ongoing conflict, Afghanistan’s child population is at high risk of being born with or acquiring a primary or secondary disability. According to a recent estimate, up to 17 per cent of Afghanistan’s children live with some form of disability. Assistive technologies (AT) – the systems, services and products that enhance the functioning of people with impairments – are likely to be required by a large proportion of children with disabilities in Afghanistan. Afghanistan has signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which includes a commitment to provide AT equitably to all who need it. However, little action has been taken to meet this commitment, and there continues to be a vast gap between the need for AT and its provision. This work presents the landscape of AT provision, the barriers and facilitators to provision, and provides recommendations to begin to close the gap. 

Semi-structured interviews were conducted to build on the evidence in the literature, and to understand the factors affecting AT provision in Afghanistan

Assistive Technology in urban low-income communities in Sierra Leone & Indonesia: Rapid Assistive Technology Assessment (rATA) survey results

CAREW, Mark
WALKER, Julian
OSSUL-VERMEHREN, Ignacia
BARTLETT DEVELOPMENT PLANNING
January 2022

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It is estimated by the World Health Organisation (WHO) that 15% of the world's population has a disability and one billion people need one or more Assistive Products (AP) but as little as one in ten have access to the device they need. There is however very little data to define this need for AP in low-resource settings. 

To contribute to the knowledge gap, the findings from the surveys presented in this report give a unique insight into disability prevalence and access to AT in five urban low-income communities in Sierra Leone and Indonesia, where a total of 4,256 individuals were surveyed using the rATA tool.

The rATA tool is designed for the rapid evaluation of the need, use, supply and impact of AT, Rapid Assistive Technology Assessment (rATA) is a new survey from WHO. A version modified by the Development Planning Unit-University College London (DPUUCL) was conducted in September 2019 for the research project “AT2030 community led solutions”, as part of the AT2030 programme led by Global Disability Innovation Hub.

Participatory planning process to design an inclusive education project, Kaduna, Nigeria

Sightsavers
January 2022

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The aim of the project was to plan an education project in Kaduna State which would demonstrate innovative, scalable approaches for: a) promoting inclusive education in primary
schools for children with disabilities; and b) incorporating disability inclusion perspectives in initial teacher training.

The project needed to adhere to Disability Inclusive Development (DID) programme
requirements, specifically regarding engagement with Organisations of Persons with
Disabilities (OPDs), ensuring “meaningful, accessible and inclusive consultation process with
partners (meaning OPDs) in the development of project proposals” which should detail the
process to identify and select partners and their role during implementation.

The objective of the nine-month planning phase project was to execute the project in
accordance with DID requirements and the concept note to achieve the following outcomes:

1. Assessment of educational provision for primary-aged children with disabilities in
selected schools in Kaduna State.

2. Assessment of disability inclusiveness of teacher training in two colleges of education
in Kaduna State.

3. Identification of innovative and scalable strategies for promoting inclusive
education/teacher training. The output under this outcome was the production of a
project proposal for an inclusive education project in Nigeria.

4. Evaluation of a disability-inclusive process for planning an innovative education project.
The output under this outcome was the production of a learning paper.

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