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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 .

Creating an inclusive school environment

DOUGLAS, Susan
Ed
2019

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This publication draws together research and learning from around the world, in papers which highlight the need for inclusive education and some of the steps being taken to implement it. 

The settings brought to life here reveal the work of teachers, leaders and policy makers in geographically and culturally diverse situations. In each of the chapters we see the challenges they face and the significant efforts they make to ensure access to, and engagement with, a quality education for all children. The collection includes 15 case studies:

 

Special educational needs and disability section:

  • Teaching for All: mainstreaming inclusive education in South Africa
  • Successful inclusive education starts with teachers: what have we learned? A multi-country case study
  • Teaching English as a second language to the visually impaired in disadvantaged contexts: a case study from Chiapas, Mexico
  • The Theatre of the Classroom

Displaced populations section

  • Teaching on the run: safe learning spaces for internally displaced persons
  • Developing resilience through English language teaching in youth centres across Iraq
  • Capacity building for inclusive classrooms: the Living Together training
  • Integrating Syrian refugee children and their parents into Lebanese early education systems

Gender and inclusion in the classroom section

  • A gender equality and social inclusion approach to teaching and learning: lessons from the Girls’ Education Challenge
  • Teacher development and gender equality in five Nigerian states
  • Creating gender-inclusive schools in Turkey: the ETCEP project in action
  • Education, English language, and girls’ development: exploring gender-responsive policies and practices in Nepal

Minority ethnic groups in the classroom

  • Social inclusion and the role of English language education: making a transition from school to higher education in India
  • Storytelling for diverse voices
  • Inclusive education in marginalised contexts: the San and Ovahimba learners in Namibia

 

DRPI Manual: Roadmap to Work. A model for persons with disabilities

RIOUX, Marcia
et al
January 2019

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DRPI AWARE (Disability Rights Promotion International Asian Workplace Approach that Respects Equality): Roadmap to Work is aimed at individuals and organizations committed to the employment rights of persons with disabilities. DRPI AWARE is a collaborative six year project promoting access to opportunities in the labour force for people with disabilities. With an evidence-based understanding of the reasons for the under-employment, unemployment, and precarious employment, DRPI AWARE works with employers to increase job opportunities for people with disabilities in Dhaka (Bangladesh), Kathmandu (Nepal) and Hyderabad (India). The DRPI AWARE project team is sharing this model because it has been tested and used in India, Nepal, and Bangladesh with significant success. It represents a new way forward for realizing the employment rights of people with disabilities and ensuring jobs for people with disabilities. The model can be used as a guide by others who are designing new, or revamping existing, employment projects, strategies, schemes, programs, and inclusive employment practices. This manual provides lessons learned and the outcomes of the DRPI AWARE project and proposes a model for building an inclusive employment ecosystem. It calls for a new way of thinking about disability and of how to ensure a larbour market that equally welcomes all, including those with disabilities.

Inclusive services for persons with disabilities in Jadimura Camp, Cox's Bazar

HUMANITY & INCLUSION (HI)
2019

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In November 2018, with the support of UK Aid, Humanity & Inclusion (HI) conducted a participatory assessment of access to humanitarian assistance for persons with disabilities in Jadimura Camp, Teknaf, Cox’s Bazar District. The team evaluated both the barriers for persons with disabilities, as well as the facilitators that improve access to such assistance. They surveyed 63 refugees with disabilities including men, women, boys, and girls, in addition to 11 humanitarian service providers working in the camp.

Headline facts and recommendations are presented.

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.

Primary health care seeking behaviour of people with physical disabilities in Bangladesh: a cross-sectional study

TALUKDAR, Jhalok Ronjan
MAHMUD, Ilias
RASHID, Sabina
September 2018

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People with disabilities constitute about 10% of the total population of Bangladesh. They are more likely to experience poor health than those without disabilities. However, there is a lack of evidence on their primary health care (PHC) seeking behaviour for their general illness. The aim of this study was to understand the PHC seeking behaviour of people with physical disabilities (PWPDs), and to investigate the determinants of such behaviours. 282 PWPDs, aged ≥18 years, were studied using a structured questionnaire. Participants were recruited from the out-patient department of a rehabilitation centre in Dhaka between November and December 2014.

 

Archives of Public Health (2018) 76:43 

https://doi.org/10.1186/s13690-018-0293-1

 

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

Developing inclusive practices through action learning: Inclusive education cross-country peer-review of Bangladesh (Hope project) and Indonesia (IDEAL project)

GRIMES, Peter
HEIJNEN-MAATHUIS, Els
April 2018

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The aim of the review was to create a capacity building and professional learning opportunity based on inclusive education experience and expertise in another context. The background, methodology, findings of the study are enclosed within the document. Specific objectives include: (1) to create focused peer-to-peer sharing and learning opportunities across countries, (2) record key strategies, opportunities, remaining challenges and achievements, (3) document lessons learned for targeted quality improvements during the last year of each project, and (4) use information collected for developing a responsible, phased exit strategy for 2018.

Defying the barriers

KHONDKAR, Laila
HAQUE, Reazul Md
January 2018

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Research summaries, case studies and process documentation from “Inclusive Protection and Empowerment Project for Children with Disabilities (IPEP)” are presented.  The aim of the project was to build resilience and capacity among children with disabilities and to create a violence-free community for them. The project ran in five districts of Bangladesh i.e. Sylhet, Dhaka, Barishal, Rangpur and Gaibandha from 2014- 2017. 

 

The research topics were:

  • Understanding the Vulnerabilities of Children with Disabilities Living in both Government-run and Private Residential Institutions
  • The Vulnerabilities of Children with Disabilities from Low-income Households
  • Social Protection Schemes Relevant to Children with Disabilities and their Families 

 

Growing Together. Child participation through the project journey. Management of a children’s club by the children themselves

HANDICAP INTERNATIONAL
December 2017

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An overview is presented of a project in Bangladesh, Pakistan and Thailand to:

  • To support communities in raising socially and emotionally healthy kids in refugee/IDPs camps and in host communities.
  • To create opportunities for children with disabilities and other vulnerable children (0-12 years old) including children at risk of developmental delays/psychological distress in displacement contexts, to learn and develop safely while having fun.
  • Using “play” as key driver to learn and develop safely children’s potential while having fun.

The project was implemented using:

  • Existing HI tools (Personalized Social Support, Adapted Physical Activity, etc.)
  • Tools piloted in IKEA project (Blue Box, low-cost toy making, inclusive playgrounds, Ideas box)
  • Environmental Footprint Assessment across 3 project sites

Monitoring & evaluation was carried out using techniques including

  • Scopeo (Sc-ore O-f Pe-rceived O-utcomes) Kids
  • Participatory M&E approaches (digital story telling, child-child video interview etc) 

Presented at the People at the centre Seminar, Dec 2017 

 

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)

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