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Sightsavers' approach to making health services inclusive for everyone

Sightsavers
April 2019

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Sightsavers has produced a new film that sets out our work to make health care services accessible and inclusive for everyone. It focuses on our programmes in Bhopal, India and Nampula, Mozambique. This highlights how we work and share learnings globally, but also shows how programmes can be made locally relevant by working with partners with direct experience.

The film showcases some of the people who work hard to make our inclusive health programmes a success, from Sightsavers experts and government health workers to leaders of disabled people’s organisations.

To find out more our inclusive health work and how we are developing best practice in terms of inclusive health programmes, visit our website: https://www.sightsavers.org/disability/health/

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

Disability and global health: Special issue of International Journal of Environmental Research and Public Health

KUPER, Hannah
POLAK, Sarah
Eds
2019

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Papers included in this special issue are:

 

More at risk: how older people are excluded in humanitarian data

TANYANG, Gaynor
VENTURES, Lumina
2019

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This report evaluates existing policies and practices on how older people have been excluded from data in disaster preparedness and humanitarian responses in Bangladesh, India, Nepal, Pakistan, Sri Lanka, Cambodia, Indonesia, Myanmar, the Philippines, Thailand and Vietnam.

In order to evaluate existing policies and practices in the collection of inclusion data, the research employed two main methods: a review of documents and a survey. The review of documents was conducted in three stages: a global literature review, followed by a policy review and a practice review. The survey analysed the responses of 72 respondents from 10 countries .

Unmet needs and use of assistive products in two districts of Bangladesh: Findings from a household survey

PRYOR, Wesley
NGUYEN, Liem
ISLAM, Qumrun Naher
JALAL, Faruk, Ahmed
MANJULA, Marella
December 2018

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Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs and unmet needs for AP, and current access patterns in Bangladesh. The ATA-N was incorporated in a Rapid Assessment of Disability (RAD), a population-based survey to estimate prevalence and correlates of disability. In each of two unions of Kurigram and Narsingdi districts, 60 clusters of 50 people each aged two years and older were selected using a two-staged cluster random sampling process, of whom, 4250 (59% Female; 41% Male) were adults, including 333 using AP. We estimate 7.1% of the studied population used any AP. AP use is positively associated with age and self-reported functional difficulty. The proportion of people using AP is higher for mobility than for sensory and cognitive difficulties. Of all people with any functional difficulty, 71% self-reported an unmet need for AP. Most products were home or self-made, at low cost, but provided benefits. Needs and unmet needs for AP are high, especially for people with greater functional difficulties. Assessing unmet needs for AP revealed important barriers to scale that can inform policy and practice.

Int. J. Environ. Res. Public Health 2018, 15(12), 2901;
doi:10.3390/ijerph15122901

Disability prevalence & unmet needs for services: A rapid assessment of disability in Kurigram and Narsingdi, Bangladesh

JALAL, Faruk Ahmed
MOSTOFA, Md. Golam
HAQUE, Md. Mazedul
MARELLA, Manjula
CHAKRABORTY, Ripon
PRYOR, Wesley
November 2018

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This paper was presented at the 3rd World Disability & Rehabilitation Conference 2018 was held from 12th and 13th November 2018 in Kuala Lumpur, Malaysia. People with disabilities and researchers, practitioners, policy makers, industry experts, university faculty and organizations along with advocates and volunteers working with people with disabilities participated and presented their original and unpublished results of conceptual, constructive, empirical, experimental, experiential or theoretical work through abstract and poster presentation. Total 33 participants presented their abstract and poster throughout this conference. The theme of WDRC 2018 was “Global advocacy and rights of people with disabilities”

3rd World Disability & Rehabilitation Conference (WDRC 2018) - Book of abstracts

O'CONNOR, Loren
Ed
November 2018

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The 3rd World Disability & Rehabilitation Conference 2018 was held from 12th and 13th November 2018 in Kuala Lumpur, Malaysia. People with disabilities and researchers, practitioners, policy makers, industry experts, university faculty and organizations along with advocates and volunteers working with people with disabilities participated and presented their original and unpublished results of conceptual, constructive, empirical, experimental, experiential or theoretical work through abstract and poster presentation. Total 33 participants presented their abstract and poster throughout this conference. The theme of WDRC 2018 was “Global advocacy and rights of people with disabilities”

Saving lives and leaving no one behind - The Gaibandha Model for disability-inclusive disaster risk reduction

ROTHE, Manuel
BROWN, David
NEUSCHAFER, Oliver
October 2018

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"The Gaibandha Model" good practices guide outlines a framework for successful disability-inclusive disaster risk reduction programming. It is based on the experience of CBM and its partners in implementing community-based disaster risk reduction programs in some of the most flood-affected communities in Bangladesh. The model puts people with disabilities at the center of disaster risk reduction. They are the agents for change, working with the community to improve local systems of disaster prevention, preparedness and response to become more accessible and inclusive.

Access to assistive products in Kurigram and Narsingdi, Bangladesh. Policy brief 2.

HUMANITY & INCLUSION BANGLADESH
et al
August 2018

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This ‘policy brief’ outlines findings on Assistive technology and Products (AP) needs, unmet needs and access patterns arising the Rapid Assessment of Disability (RAD) study conducted in 2016 and 2017, in partnership between the Bangladesh Bureau of Statistics (BBS) and Humanity & Inclusion (HI) Bangladesh, with technical oversight from the Nossal Institute for Global Health, University of Melbourne, Australia. The study was part of the HI project: Towards Global Health: Strengthening the Rehabilitation Sector through Civil Society funded by the European Union. Findings from the 4254 adults surveyed in the two districts are reported here.

 

The purpose of this component of the RAD study was to learn about the usage of AP, characteristics of AP users, barriers to use of AP, unmet and met needs of AP, and to highlight major policy implications for AP service provision, in two target areas of Kurigram and Narsingdi. The survey includes an adapted version of Washington Group (WG) ‘short set’ of Disability Questions. A modified version of the WHO’s draft Assistive Technology Assessment Tool (needs module) – or the ‘ATA-needs’, was also implemented. Findings from this study also helped modify and improve the draft ATA-needs tool

Disability and climate resilience research project

KETT, Maria
COLE, Ellie
August 2018

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This 14-month exploratory research project aimed to increase the understanding of the links between disability and climate resilience, and in turn to support the delivery of policy and programme work that builds the resilience of people with disabilities to climate shocks and stresses. 

 

The research comprises: an extensive literature review to identify the current evidence and gaps; a global online survey to identify current practices being implemented in the field around climate change and climate-related disasters, and the extent to which disability issues are addressed in programming; policy analyses, complemented by key informant interviews with policymakers and practitioners; and focus group discussions with people with disabilities in climate-impacted areas of Bangladesh and Kenya. This report synthesises the results of the desk- and field-based research, and outlines implications of the findings for policy and programming and identifies recommendations for further action. It is hoped that the findings highlighted in this report can be extrapolated to develop more disabilityinclusive practice and will also be applicable for other contextually marginalised people

Disability, CBR & Inclusive Development, Volume 29, No.2, 2018 (Summer 2018)

July 2018

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Research articles are:

  • Lived Experience of Psychosocial Disability and Social Inclusion: A Participatory Photovoice Study in Rural India and Nepal
  • Barriers and Facilitators for Wheelchair Users in Bangladesh: A Participatory Action Research Project
  • A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia
  • Effect of Abacus Training on Numerical Ability of Students with Hearing Loss
  • Cross-Cultural Adaptation and Evaluation of Psychometric Properties of Persian Version of Supports Intensity Scale among Adults with Intellectual and Developmental Disabilities

Review:

  • Developmental Social Work for Promoting the Socioeconomic Participation of Persons with Disabilities: An Application of the Capability Approach
     

Brief reports:

  • Zero Rejection Policy in Admission of Children with Special Needs - Myth or Reality
  • Ujamaa and Universal Design: Developing Sustainable Tactile Curricular Materials in Rural Tanzania

Quality rehabilitation for all. Lessons learnt from integrating rehabilitation services in two general hospitals in Bangladesh

BAART, Judith
RAHMAN, Nafeesur
November 2017

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Working from the theory that integrating basic rehabilitation care within the health care system in Bangladesh, rather than as a stand-alone service, could greatly improve awareness of and access to rehabilitation services, CDD piloted setting up therapeutic care centres within hospitals. This report presents the lessons learned.

Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

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This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

Disability inclusion and the sustainable development goals : practices and challenges

AL-GHAIB, Ola Abu
WILM, Susanne
October 2017

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This research was commissioned on the occasion of the 2017 High-level Political Forum (HLPF) in New York to investigate how far the global commitment to disability has translated into implementation, monitoring and reporting processes at national and sub-national level. Four case studies were commissioned, exploring the extent of disability inclusion in alignment with the SDGs in Bangladesh, Kenya, Sierra Leone and Zambia. DPOs played a pivotal role in the research, with more than 40 DPOs consulted through key informant interviews and focus group discussions. In Zambia, the research was implemented by a local DPO – the Zambia Federation of Disability Organisations (ZAFOD). A literature review identified internet-based policy, legal and strategic documents related to disability and the 2030 Agenda, as well as documentation and reports on different SDG nationalisation initiatives.

 

A report summary is available.

 

Water justice, gender and disability : South Asian Water Studies (SAWAS), special issues, vol.5, no.4, June 2017

CLEMENT, Florian
NICOL, Alan
CORDIER, Sylvie
Eds
June 2017

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The papers in this volume on gender, persons with disabilities and WASH in South Asia help to provide important pointers on ways forward. A common thread throughout the four articles is that a constellation of challenges still exists, from 'exclusion' through prejudice at different levels, to institutional realities that render policy and other instruments ineffective in practice. In some cases, even, there remains a complete absence of key legal and policy instruments.  

Titles of the articles in this issue are: 

  • Planning for inclusion: exploring access to WASH for women and men with disabilities in Jaffna District, Sri Lanka
  • Breaking down Barriers: Gender and Disability in Access to Agricultural Water Management in Nepal
  • The Gender Gap between Water Management and Water Users: Evidence from Southwest Bangladesh​
  • Are policies enough to mainstream Gender in water and sanitation programs? Experiences from community managed drinking water supply schemes in India

Global Report on the participation of organisations of persons with disabilities (DPOs) in VNR Processes

INTERNATIONAL DISABILITY ALLIANCE
2017

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Within the Stakeholder Group of Persons with Disabilities, a working group was created on the Voluntary National Reviews (VNRs) aimed at raising awareness among Organisations of Persons with Disabilities (DPOs) to engage with their governments in the national consultation processes on SDG implementation, with particular focus on the 2017 44 volunteering countries. The VNR working group are compiling an outcome document reflecting the work that DPOs carried out at the national, regional and global levels. A comprehensive report – called the Global Report on DPO Participation in VNR Processes – will be issued in draft form prior to the HLPF and will be updated afterward with concrete findings. 

The report will showcase the national level DPO work carried out in different regions as well as best practices and challenges, and will serve as a case study for Member States. It will additionally be useful for DPOs as a model to engage with their government. The case study will feature the volunteering countries of Denmark, Italy, Sweden, Nigeria, Togo, Kenya, Ethiopia, Argentina, El Salvador, Peru, Guatemala, Indonesia, Bangladesh, India and Jordan.

Exploring the links between poverty and disability in rural Bangladesh

DAVIS, Peter
May 2017

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This paper explores the links between poverty and disability drawing from 60 qualitative life-history interviews conducted in rural Bangladesh, in 48 households, in three districts, in March 2016. The paper provides insights into the relationship between poverty and disability with the aim of informing policy and practice concerned with both reducing poverty and improving the life chances of people with disabilities. All of the households had a person with a disability as a member, and in three households, two household members had a disability. Mechanisms by which poverty caused or exacerbated disabilities, and also how people with disabilities fell into poverty, were prevented from escaping poverty, and, in some cases, succeeded in escaping poverty are explored. 
 

Global report on the participation of organisations of persons with disabilities (DPOs) in VNR (voluntary national review) processes

INTERNATIONAL DISABILITY ALLIANCE (IDA)
STAKEHOLDER GROUP OF PERSONS WITH DISABILITIES
2017

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"This global report raises awareness for DPOs and how to engage with their governments in the national consultation processes on SDG implementation. This case study features the volunteering countries of Argentina, Bangladesh, Denmark, El Salvador, Ethiopia, India, Indonesia, Italy, Kenya, Nigeria, Peru, Sweden and Togo.

The information summarised in the country chapters was derived from DPOs and partners working at the national level on SDG implementation and information may be subjective. The country chapters are structured to include; status of persons with disabilities, engagement in the voluntary national review process, thematic issues--poverty alleviation, healthcare, women with disabilities and accessibility—and analysis of the submitted VNR report

DFID data disaggregation action plan - Better data for better lives

UK DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (DFID)
UK AID
January 2017

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This action plan sets out the steps that the UK Department for International Development (DFID) will take to promote, provide and make use of their own development and humanitarian programme data which can be disaggregated on the basis of sex, age, disability status and geography (in the short term). It also has the objective to build the culture within DFID on disaggregated data, and to work with others to change the international development system on disaggregated data. A review is scheduled for 2020. Working with partners, influencing, capacity building and management information, research, analysis and reporting are outlined. Trailblazer country programmes with Bangladesh, Nepal, Zimbabwe and Rwanda are reported.

Good practice report on inclusive education and employment for people with disabilities in Bangladesh

HANDICAP INTERNATIONAL (HI)
2017

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This report is the output of a project titled “Advocating for Change for Persons with disabilities in South and South-east Asia” which was implemented by Handicap International for the period January 2013 – June 2014. In Bangladesh, the project supported Disabled People’s Organisations (DPOs) in 17 districts across the country, developing their capacity to advocate for rights of people with disabilities in education and employment. This report has been compiled to showcase good practices collected by DPOs and to promote practical recommendations, based on local evidence, on how to include people with disabilities in employment and education systems in Bangladesh. The Making it Work methodology was used as part of this project.

This report includes the 11 validated good practices including

  • to ensure access of people with disabilities to waged employment n factories
  • to ensure waged employment of people with disabilities though the Chamber of Commerce and Industries
  • to ensure access to start up capital for people with disabilities
  • to use local initiative to create educational opportunities for children with disabilities
  • to ensure access of students with disabilities to secondary education through social mobilisation by school authorities
  • to ensure access of children with disabilities to inclusive primary education
  • to ensure physical accessibility for children with disabilities in high schools
  • to ensure free of cost High School education for children with disabilities

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