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Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries

WALLACE, Sarah
MACTAGGART, Islay
MORGON BANKS, Lena
POLACK, Sarah
KUPER, Hannah
June 2020

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The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs).

A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties.

The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression

Accountability, feedback & complaints mechanisms in humanitarian responses to migration

KAHN, Clea
June 2020

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This guidance aims to give humanitarian actors a guidance for developing their accountability mechanisms in the context of mixed migration, with a focus on complaints and feedback mechanisms. Excellent guidance already exists on how to implement feedback and complaint mechanisms in humanitarian contexts, and this is not intended to replace or duplicate those. It should be read as a supplement, to provide additional reflection for humanitarian actors working in migration contexts.

The development of this guidance was based on a review of existing literature, including research studies, guidelines and training materials. More than 30 interviews were conducted with representatives of more than 20 organisations working in Africa, the Americas, the Middle East and Europe. Particular support was received from Start Network’s MERF member organisations.

Cameroon: People With Disabilities Caught in Crisis - Funds Needed to Scale Up Humanitarian Response

HUMAN RIGHTS WATCH
August 2019

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Over the past three years, Cameroon’s Anglophone regions have been embroiled in a cycle of violence that has claimed an estimated 2,000 lives and uprooted almost half a million people from their homes. People with disabilities caught in the violence struggle to flee to safety when their communities come under attack. They also face difficulties in getting necessary assistance.

Between January and May 2019, Human Rights Watch interviewed 48 people with disabilities living in the Anglophone regions, their family members, representatives of UN agencies, and national and international humanitarian organizations to investigate how the crisis in the North-West and South-West regions has disproportionately affected people with disabilities. Some of their stories are presented.

 

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:

 

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study

McTAGGART, Islay
et al
April 2018

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There is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian setting. A population-based case–control study of adults (18+) with and without disabilities was undertaken in North-West Cameroon and in Telangana State, India. It was found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others

 

Prevalence of HIV infection among people with disabilities : a population-based observational study in Yaounde, Cameroon (HandiVIH)

DE BEAUDROP, Pierre
et al
January 2017

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In the HandiVIH study, an estimation and a comparison of HIV prevalence and associated risk factors between people with and without disabilities. In this cross-sectional, population-based, observational study, two-phase random sampling was used to recruit adults with disabilities and a control group matched for age, sex, and residential location from households of the general population. The Washington Group Short Set of Questions on Disability was used to identify people with disabilities. An HIV test was administrated and a life-course history interview carried out with participants. The primary outcome was the prevalence of HIV among participants with and without disabilities. The study took place in Yaoundé, Cameroon, between Oct 2, 2014, and Nov 30, 2015. 

The Lancet HIV · January 2017 

DOI: 10.1016/S2352-3018(16)30209-0

How CBM Australia supports engagement with government for disability inclusion and prevention

CBM AUSTRALIA
March 2016

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CBM Australia engages both directly and indirectly with governments. Indirectly, CBM Australia supports other organisations, for instance disabled people’s organisations or civil society organisations to engage with governments. This report looks at the different ways that CBM partners seek influence government and promote sustainability. It considers the different roles and relevance of activism, advocacy, service delivery and advisory approaches.

 

The cases in this report were identified and gathered through semi-structured interviews with CBM’s Program Officers, Technical Advisors, regional/country office and project staff in-country, as well as drawing on reports and evaluations. The report starts with a section explaining the four different approaches to working with government, followed by a brief introduction to each approach, highlighting what CBM are doing and the key lessons learned. Each section is followed by case studies giving more detailed insight into how CBM are engaging, key achievements, challenges and the lessons learned. Fifteen case studies covering key projects from CBM Australia’s International Programs and the Inclusive Development Team are described in this report.

Participation of persons with disabilities in political activities in Cameroon

OPOKUA, Maxwell Peprah
MPRAH, Wisdom Kwadwo
SAKA, Bernard Nsaidzedze
2016

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The right to participate in political activities is a fundamental human right for every citizen in a country, but this right is often not available to persons with disabilities. This study investigated the level of and barriers to political participation of persons with disabilities in the Buea municipality in Cameroon. A qualitative data collection method, consisting of three focus group discussions with 36 persons with disabilities was conducted. Participants were selected from three categories of persons with disabilities- visually impaired, hearing impaired and physically impaired- who were residing in the Buea municipality. The study found that the involvement of persons with disabilities in politics in the area was minimal as socio-economic, cultural and physical barriers hindered their participation in political activities at both local and national levels. The study concludes that there should be conscious efforts though affirmative actions to promote and respect the rights of persons with disabilities and make the political environment more accessible to persons with disabilities in Cameroon.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 2

Disability & the Global South (DGS), 2016, Vol. 3 No. 2

2016

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Articles include:

  • Towards a ‘mind map’ for evaluative thinking in Community Based Rehabilitation: reflections and learning
  • Participation of persons with disabilities in political activities in Cameroon
  • The medical inadmissibility of intellectual disability: A Postcolonial reading of Canadian immigration systems
  • Research principles and research experiences: critical reflection on conducting a PhD dissertation on global health and disability
  • Contingencias normalizadoras en la relación Discapacidad–Trabajo en Francia y Uruguay

Using Postcolonial Perspectives to Consider Rehabilitation with Children with Disabilities: The Bamenda-Toronto Dialogue

NIXON, Stephanie A
COCKBURN, Lynn
ACHEINEGEH, Ruth
BRADLEY, Kim
CAMERON, Debra
MUE, Peter N
SAMUEL, Nyingcho
GIBSON, Barbara E
2015

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This article discusses tensions in children’s rehabilitation that came to light through a series of ‘postcolonial dialogues’ amongst Canadian and Cameroonian participants. We defined ‘tensions’ as conflicts, contrasting ways of seeing things, and/or taken-forgranted ideas that shape issues related to rehabilitation for children with disabilities. These tensions were identified, articulated, and deconstructed through an iterative, multi-phase dialogue among eight individuals who identify as people with disabilities, rehabilitation providers, and/or rehabilitation researchers in Cameroon and Canada. The tensions discussed in this article problematize conceptualizations of disability and of client-centred care, the role of pain as a reinforcement tool in rehabilitation, and assumptions about poverty and religion in the context of rehabilitation practice. We present this synthesis to achieve several aims: (1) to provide multiple ways for rehabilitation providers and others to better understand these particular substantive issues; (2) to model the use of a critical lens as an approach for thinking about rehabilitation that promotes reflective and deliberate practice and that can be applied across contexts; and, (3) to promote dialogue about postcolonial and other critical perspectives on rehabilitation with children and with other groups.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 2

Disability and the Global South (DGS), 2015, Vol. 2, No. 2 Special issue: Disabled children and disabling childhoods in the global South

2015

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Articles include:

  • EDITORIAL Frames and debates for disability, childhood and the global South: Introducing the Special Issue
  • Using Postcolonial Perspectives to Consider Rehabilitation with Children with Disabilities: The Bamenda-Toronto Dialogue
  • Vietnam’s children’s experiences of being visually or hearing impaired
  • Disabling streets or disabling education? Challenging a deficit model of street-connectedness
  • Revolutionary entanglements: Transversal mappings of disability in the favela
  • For Michael Charlie: Including girls and boys with disabilities in the global South/North
  • Childhood Sexual Abuse and Disability: A critical study of an invisibilized constituency in India
  • Interrogating the impact of scientific and technological development on disabled children in India and beyond

The north west Cameroon disability study

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

The north west Cameroon disability study : summary report

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents a summary of the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

Building the evidence base in disability : research summary

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This research summary of presents the aims, methods and key findings from two disability studies in Cameroon and India. The studies developed a comprehensive population-based survey methodology that is compatible with the International Classification of Functioning (ICF), and explored the inter-relationship between the components of this framework

Tools for the journey from North to South: A collaborative process to develop reflexive global mental health practice

SUFFLING, Kate
COCKBURN, Lynn
EDWARDS, Kimberly
2014

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ICDR-Cameroon is a group working on disability and inclusion issues in Cameroon. Through their mental health work, various complex social, ethical, and relational issues have been encountered and the need arose to engage in a reflexive process that would integrate shared experiences, the broader discourse on global mental health, and other resources. The group participated in discussion, story sharing, research, and critical analysis, a process from which a document called ‘Tools for the Journey’ was created as a road map for the group’s work. The document includes a position statement outlining the group’s stance on various issues, in addition to additional resources. This paper describes the group’s reflexive process in creating Tools for the Journey, the benefits of this process in terms of group and individual understanding and development, and the challenging themes encountered in their work in Cameroon.

 

Disability and the Global South, 2014, Vol. 1 No. 2

Disability and the Global South (DGS), 2014, Vol. 1, No. 1

2014

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Articles include:

  • EDITORIAL :  Introducing Disability and the Global South (DGS): we are critical, we are open access!
  • Youth with Disabilities in Law and Civil Society:  Exclusion and inclusion in public policy and NGO networks in Cambodia and Indonesia
  • Performing the Stare in Indra Sinha’s Animal’s People  
  • Disability Sport in Sub-Saharan Africa: From Economic Underdevelopment to Uneven Empowerment
  • Does Africa Dream of Androids?
  • Mendicidad y discapacidad en la Ciudad de Buenos Aires: un síntoma de nuevas formas de  vulnerabilidad social
  • Facilitating Disability Inclusion in Poverty Reduction Processes: Group Consensus Perspectives from Disability Stakeholders in Uganda, Malawi, Ethiopia, and Sierra Leone
  • Disability, poverty and Education: perceived barriers and (dis)connections in rural Guatemala 

Disability and the Global South, 2014, Vol. 1, No. 2 - Special issue: Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health

2014

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Articles include:

  • EDITORIAL Globalising Mental Health or Pathologising the Global South? Mapping the Ethics, Theory and Practice of Global Mental Health
  • How ‘evidence-based’ is the Movement for Global Mental Health?
  • Reciprocity in Global Mental Health Policy
  • Culture, Politics and Global Mental Health
  • Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo- colonial state
  • Faith Healing in India: The Cultural Quotient of the Critical
  • Mental Health Care, Diagnosis, and the Medicalization of Social Problems in Ukraine
  • Passive-Aggressive: Māori Resistance and the Continuance of Colonial Psychiatry in Aotearoa New Zealand
  • Neurasthenia Revisited: Psychologising precarious labor and migrant status in contemporary discourses of Asian American nervousness
  • Tools for the journey from North to South: A collaborative process to develop reflexive global mental health practice

The IMF, the global crisis and human resources for health : still constraining policy space

LEFRANÇOIS, Fabien
February 2010

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This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"

Sexual vulnerability and HIV seroprevalence among the deaf and hearing impaired in Cameroon

TOUKO, Adonis
et al
February 2010

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This article describes a study to investigate the prevalence of HIV in people who are hearing impaired among the population of Yaounde, the capital of Cameroon, and assess their sexual vulnerability, through interviews and, in most cases, HIV testing. The research concludes that hearing impairment is a significant risk factor for contracting sexually transmitted infections and HIV, and that more research is needed into the impact of HIV and AIDS on people with disabilities, particularly those who are hearing impaired, in order to tackle this vulnerability

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