This edition of the Disability inclusion helpdesk summarises the major announcements, events and reports published on 3rd December 2019, International Day of Persons with Disabilities.
Published at the same time as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, this report aims to support their uptake and promote learning by example. This report presents 39 short case studies on inclusive practices for persons with disabilities in humanitarian action and disaster risk reduction (DRR). It is designed for humanitarian stakeholders with limited experience of working with and for persons with disabilities, as well as for organizations of persons with disabilities (OPDs) planning to engage in humanitarian action and DRR. The report draws lessons from field practices, but does not provide technical guidance. The IASC Guidelines are the reference document to seek in-depth theoretical and technical information
The case studies focus on:
- Inclusive disaster risk reduction and preparedness
- Collecting and using disability disaggregated data for assessments and programming.
- Participation of persons with disabilities and their representative organizations in humanitarian response and recovery
- Removing barriers to access humanitarian assistance and protection.
- Influencing coordination mechanisms and resource mobilization to be inclusive
The evidence presented in this report was identified in 2017-2018 through a desk review of publicly available reports and internal documents on projects implemented by CBM, HI and IDA members, as well as their partners and affiliate members. Field visits to Lebanon, Jordan, Kenya, Nepal, and the Philippines conducted in 2018 also informed the case-study collection and documentation
This report illustrates how rehabilitation contributes to achievement of several of the Sustainable Development Goals (SDGs), improves global health, and promotes the realisation of human rights for all. The purpose of this report is to provide evidence to stakeholders upon which to build successful strategies to improve the availability of quality, coordinated, affordable, and user-centred rehabilitation. By situating disability and rehabilitation within global discourse and policy, it is intended to provide guidance on the implementation of effective rehabilitation-focused policy and practice, contributing to progress towards global development goals.
SDGs 1,3,4,5,8, 10 and 11 are considered
The report concludes with sets of specific recommendations for different stakeholders (states, donors and civil society, including disabled people’s organisations), which have the potential to strengthen rehabilitation services and improve the health and wellbeing of millions around the world. Included in annex are case studies of government donors and their progress towards meeting the recommendations set out in this report. These case studies are intended to serve as examples for stakeholders for how some of the recommendations have already been included within national policies and activities, where gaps exist and identify areas for improvement.
Supporting people with disabilities into employment is important not only in providing income, but research in Nepal has shown positive life changes including increased confidence, social status, and acquiring new skills. This document provides a rapid review of the evidence of the types of interventions used to reduce barriers and support people with disabilities into employment, as well as the impact of training programmes on employment and/or livelihood outcomes (Section 4). Case studies are included in Section 5 and Annex 1 to give further details on key learnings.
Case studies outlined are
- Vocational training programme by Madhab Memorial Vocational Training Institute (MMVTI), Bangladesh
- Gaibandha Food Security Project (Bangladesh)
- Self-help groups (Nepal)
- EmployAble programme (Kenya, Rwanda and Ethiopia)
- Economic Empowerment of Youth with Disabilities (Rural Uganda)
- Access to Livelihoods Programme (India, Sri Lanka, Bangladesh, Pakistan, the Philippines, South Africa)
Papers included in this special issue are:
- The UNICEF/Washington Group Child Functioning Module—Accuracy, Inter-Rater Reliability and Cut-Off Level for Disability Disaggregation of Fiji’s Education Management Information System
- Disability and Access to Sexual and Reproductive Health Services in Cameroon: A Mediation Analysis of the Role of Socioeconomic Factors
- Assessing the Impact of the Twin Track Socio-Economic Intervention on Reducing Leprosy-Related Stigma in Cirebon District, Indonesia
- Factors Influencing Disability Inclusion in General Eye Health Services in Bandung, Indonesia: A Qualitative Study
- Unmet Needs and Use of Assistive Products in Two Districts of Bangladesh: Findings from a Household Survey
- Analysis of Social Determinants of Health and Disability Scores in Leprosy-Affected Persons in Salem, Tamil Nadu, India
- Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi
- Intersections Between Systems Thinking and Market Shaping for Assistive Technology: The SMART (Systems-Market for Assistive and Related Technologies) Thinking Matrix
- Adverse Childhood Experiences in Children with Intellectual Disabilities: An Exploratory Case-File Study in Dutch Residential Care
- Risk of Exclusion in People with Disabilities in Spain: Determinants of Health and Poverty
- Implementation of the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Children and Youth with Cerebral Palsy: Global Initiatives Promoting Optimal Functioning
- Challenges in Accessing Health Care for People with Disability in the South Asian Context: A Review
- A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
- A Systematic Review of Access to General Healthcare Services for People with Disabilities in Low and Middle Income Countries
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 .
The main objective of this study was to assess the knowledge, attitude and stigma of leprosy amongst the community members living in Dhanusha and Parsa districts of Southern Central Nepal. A total of 423 individuals were interviewed using a structured questionnaire in Dhanusha and Parsa districts. Data was analyzed using both descriptive (frequency, percentage, median) and statistical inferences.
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 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.
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
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
- Developmental Social Work for Promoting the Socioeconomic Participation of Persons with Disabilities: An Application of the Capability Approach
- 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
This report presents the results of a monitoring project on the employment situation of persons with disabilities in Nepal. This study is part of a larger initiative called the DRPI AWARE (Asian Workplace Approach that Respects Equality) project. The project is a collaborative five-year initiative that is altering the perspective on employment of persons with disabilities in Nepal as well as India, and Bangladesh. DRPI methodology has been adapted to specifically target the monitoring of Article 27 – Right to Work and Employment of the CRPD. Participants with disabilities have focused specifically on the issues and statistics surrounding disability and employment. In each of the three monitoring sites (Hyderabad, Dhaka, Kathmandu), Monitors used an interview and focus group guide to capture a specialized data set and analyze violations of the right to work and employment. The interview and focus group guides were designed to capture various components of the employment process; including experiences of people with disabilities while job searching, during the interview process, during the training process, and on the job. People with disabilities themselves carried out the data collection, analyzed the data, and wrote this monitoring report ensuring these activities were by people with disabilities, for people with disabilities. Monitoring results have been used to identify barriers to employment, which will help direct actions for increasing sustainable employment for persons with disabilities. The module developed during this project may be used in other regions.
This report presents the results of a monitoring project on the employment situation of persons with disabilities in Nepal. The report is one step toward a comprehensive evaluation of Nepal’s constitutional, legal and policy framework. Findings scrutinise the country’s implementation of laws and policies based on the daily life experiences of persons with disabilities. These experiences are used to assess the level of rights violations, the reasons behind those violations, and possible solutions. This holistic report offers an in-depth analysis of the life circumstances for persons with disabilities, with a specific focus on employment. The analysis has been conducted in relation to fundamental human rights principles of dignity, autonomy, participation, inclusion and accessibility, non-discrimination and equality and respect for difference. The report highlights the degree of implementation of the constitution, laws, policies and programs, enacted to protect and advance the human rights, and specifically the employment rights, of persons with disabilities. The report also highlights the experiences of persons with disabilities with reflection of societal attitudes.
This study is part of a larger initiative called the DRPI AWARE (Asian Workplace Approach that Respects Equality) project. In each of the three monitoring sites (Hyderabad, Dhaka, Kathmandu), monitors used an interview and focus group guide to capture a specialized data set and analyze violations of the right to work and employment.
Social protection programmes are increasingly being adopted in low- and middle-income countries as a set of strategies for poverty reduction, improving livelihoods and decreasing inequality. Due to high levels of poverty and social exclusion, people with disabilities – who comprise upwards of 15% of the global population – have been identified as a key target group for inclusion in social protection, in both international guidelines and in national strategies. However, there is currently a lack of evidence on whether these programmes are adequately reaching and meeting the needs of people with disabilities.
The aim of this research was to assess the extent to which social protection systems in Nepal and Vietnam address the needs of people with disabilities. This research uses a mixed methods approach, combining a national policy analysis with district-level qualitative and quantitative studies in each country
Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities.
A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension.
PLoS ONE 12(12): e0188554
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)
This guide is the result of collaboration between Light for the World (LFTW), Mission East (ME), and ICCO Cooperation.
Based on decades of experience of working with the most marginalized and excluded communities, the three organizations cooperated to record their experiences in a publication which can be used in a variety of relief and development contexts. ‘Towards Inclusion’ is designed to be an easy to use reference for organizational and program/project development with a focus on gender responsiveness and disability inclusion.
The guide is made up of three parts:
• the first part guides users through the process of organizational self-assessment to determine readiness to change and identify key steps towards becoming a more inclusive organization.
• the second part introduces the ACAP framework, as a means of improving inclusion in programming via Access, Communication, Attitude and Participation. A range of tools for measuring and improving inclusion at all stages of the project cycle are provided.
• the third part provides guidelines for the people or ‘change facilitators’ who will guide organizations through the process of change towards becoming more inclusive.
The publication can be found at “Towards Inclusion Guide” and the accessible version of the publication can be downloaded. Both are free of charge.
Possibilities for organisation trainings and/or webinars on the practical application of the guide are under consideration. Contact ACAP@gmail.com.
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
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth.
The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes.
Reproductive Health, 2017
WHO together with health partners such as CBM, Handicap International, and the International Committee of the Red Cross, have released the ‘Emergency Medical Teams: Minimum Technical Standards and Recommendations for Rehabilitation’ which provides important guidance on how emergency medical teams (EMTs) can incorporate rehabilitation in their response to emergencies. Using the experiences from the 2015 Nepal earthquake, this video shows the impact it had on the lives of those injured years later and highlights the reasons why rehabilitation needs to be a core component of any emergency medical response. Integrating rehabilitation into the EMT response resulted in greater clinical care by producing important, cost-effective, and positive long term outcomes at the individual, family, and community levels
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