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Action on COVID-19 Evidence on the Response of Disabled People’s Organisations during Pandemic

ADD International
October 2020

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In June 2020, ADD International conducted structured interviews with leaders from ten Disabled People’s Organisations (DPOs) which are participating in the Inclusion Works programme in three districts in Bangladesh to understand impact of and response to Covid-19 among DPOs.

 

Evidence from these interviews suggest that the economic impact of Covid-19 on persons with disabilities has been acute, and DPOs are taking critical action. DPOs are engaging with power holders to make relief, livelihood support and information accessible to persons with disabilities. DPOs are in touch with their members, but they face barriers in doing their work during this time, and more could be done to reach the most excluded.

Education for Every Ability. A review and roadmap of disability-inclusive education in East Asia and Pacific

UNICEF EAST ASIA AND PACIFIC
July 2020

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Rapid advances in education provision over the past few decades in East Asia and Pacific has led to considerable progress in integrating out-of-school children and adolescents in basic education. However, children with disabilities continue to face many barriers to accessing and completing quality primary education. While countries increasingly recognize the importance of making education systems more disability inclusive, many challenges remain to realising inclusive education for every child

 

The Education Section of UNICEF East Asia and Pacific Regional Office (EAPRO) commissioned a review of the progress of countries and UNICEF programmes in the region in advancing inclusive education for children, as part of its continued commitment to enabling equitable access to and participation of all learners in high quality and inclusive education. The mapping has a particular focus on programmes targeted for children with disabilities of pre-primary and primary school age, implemented from 2015 to 2019. 

 

This Report analyzes successes, innovative approaches, challenges, gaps and priorities for action in the region and proposes a roadmap for advancing Inclusive Education in the region

 

Final evaluation report project for ASEAN hometown improvement through disability-inclusive communities model

MEKONG INSTITUTE (MI)
May 2019

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This report covers the objectives, process, findings and recommendations of final evaluation on APCD Project for ASEAN Hometown Improvement through Disability‐Inclusive Communities Model. The project reached to the end of implementation in its second year and required a final evaluation to assess its achievements and non-achievements in against of its desired objectives from this project. The final evaluation has assessed the relevance, effectiveness, efficiency, impact and sustainability of the project. This report provides analysis of its findings from literature review and field visits during the evaluation and provides country-specific as well as overall recommendations for further implementation of this kind project in future. 

The Effect of Age, Gender and Socioeconomic Status on Self-esteem, Body Image and Quality of Life of Amputees: An Evaluation Seven Years after the 2008 Sichuan Earthquake

LAM, Tin-Wai J
TANG, Long-Ching L
CHAU, WW
LAW, SW
CHAN, KM
2019

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Purpose: Psychological well-being is a growing concern in society. It is starting to play a pivotal role in the treatment and care of clients. This study aimed to evaluate the effect of age, sex and socioeconomic status on the self-esteem, body image and quality of life of the 2008 Sichuan earthquake amputees. Many of them are at a significant stage in their lives, especially those who are making the transition from childhood and adolescence into adulthood.

 

Methods: This cross-sectional study was conducted in October 2015. Forty-five participants were recruited from clinic sessions in Sichuan. The main outcome measures were Rosenberg Self-Esteem Scale (RSE), Chinese Amputee Body Image Scale (CABIS), and WHO Quality of Life-Bref Instrument (WHO-QOL-Bref). Results were analysed using Student’s T-test and Chi-square test where appropriate, and ANOVA for multi-group comparisons.

 

Results: Participants under 18 years of age scored higher in RSE (p=0.05), and lower in CABIS (p<0.005). They also scored higher in various QOL domains (D3: p<0.08, D4: p=0.06) and WHOQOL-Bref question 2 (p=0.06). Participants of different SES did not show any significant differences in the outcome measures. Female subjects scored higher in WHOQOL-Bref Question 1 (p=0.03).

 

Conclusion and Implication: Younger amputees have less body image distortion, higher quality of life and self-esteem compared to older amputees. Female amputees also appear to have a higher quality of life compared to male amputees. Socioeconomic status does not affect rehabilitation outcome and psychological well-being of amputees. However, the main factors affecting psychological well-being appear to be predominantly age and, possibly, gender.

Development, reliability, and piloting of a wheelchair caster failure inspection tool (C-FIT)

MHATRE, Anand A
LACHELL, Stephanie
PEARLMAN, Jonathan L
2019

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Introduction: 

Wheelchair casters fail frequently in the field causing multiple user consequences and wheelchair breakdowns. To inform caster design improvement, there exists no validated tools that can collect caster failures. This need motivated the development of a user-reported, caster failure inspection tool (C-FIT).

 

Methods: 

To develop C-FIT, a multistep design and testing approach was used which included face validity testing, test-retest reliability testing and expert review. Reliability testing was conducted with two independent cohorts of wheelchair professionals who inspected caster failures physically and online through pictures. The tool was revised based on testing outcomes and expert feedback. For preliminary data collection and evaluating usability, C-FIT was piloted at wheelchair service centers in Scotland, Indonesia and Mexico.

 

Results: 

Caster failure items reported in the literature were screened to develop the initial list of C-FIT items. Face validity testing conducted through surveys with wheelchair experts (n = 6) provided 14 items for C-FIT inclusion. The test-retest reliability was found to be high for 10 items with physical failure inspections (n = 12). For each of these items, 75% or more participants had substantial to almost perfect agreement scores (κ = 0.6–1.0). Lower reliability scores were found with online failure inspections (n = 11). C-FIT received positive usability feedback from study participants and data collectors in the field. Pilot field data (n = 31) included comprehensive details about failures useful for manufacturers, designers and researchers to improve caster designs.

Conclusions: 

The C-FIT tool developed in this study has substantial reliability and can be used for documenting caster failures at wheelchair service centers.

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.

An Online Survey on Identification of Evaluation Capacity, Needs and Current Practice of Programme Evaluation in Community-based Rehabilitation

WEBER, Joerg
POLACK, Sarah
HARTLEY, Sally
2016

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Purpose: Evaluation of Community-based Rehabilitation (CBR) is important for developing good practice and providing a foundation for evidence of efficacy of practice. Since not much is known about the extent to which monitoring and evaluation (M&E) are carried out within CBR programmes, this study aimed to enhance knowledge by focussing on current M&E activities, the need and capacity of programmes to conduct evaluations and the challenges experienced. 

 

Method: An online survey of 15 questions was developed, field-tested and sent out to 236 CBR managers in Africa, Asia and Latin America.  

 

Results: The majority (86%) of the respondents indicated that their programmes had been evaluated in the past.While this was mainly done by international donors (87%), only around half of the respondents reported programme participants as the main audience. Just over half of the programmes (54%) included people with disabilities, their families and community members in evaluation processes. Insufficient financial resources were considered the most important challenge to conduct evaluation, particularly in the African region and among smaller programmes. The complexity of CBR was also indicated as an important barrier to evaluation.

 

Conclusions and Recommendations:  Although evaluations have been widely implemented in CBR programmes, many of them are not locally owned, and people with disabilities and their families are often not included in evaluation processes. The issues of limited financial resources and CBR complexity reflect current discussions in other areas of mainstream development. It is therefore recommended that models for evaluation in CBR should learn from, and be embedded in, ongoing developments in mainstream evaluation in international developm

Cross-cutting Capacity Building Learning Review

LIPSON, Brenda
GARBUTT, Anne
March 2016

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This short report is based on an analysis of the individual case studies on capacity building in Cambodia and Bangladesh. The purpose of this cross-case report is to present the views of the two consultants with regard to the following:

  • Points arising from the experiences in the two countries which shed light on the ADD approach and working model of capacity building.
  • Recommendations for ADD to reflect upon in its work to strengthen the capacity building model and the overall monitoring, evaluation and learning on this work.

Disability disaggregation of data : baseline report

JOLLEY, Emma
THIVILLIER, Pauline
SMITH, Fred
December 2014

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“This baseline report contains information on the initial steps (prior to the start of data collection) undertaken to include disaggregation of data by disability in two projects in Tanzania and India. The report includes information on project selection, development of an Monitoring and Evaluation (M&E) plan, adaptation of data collection tools and training of Country Office staff, partners and data collectors. This baseline also captures the knowledge, attitudes and practices of programme managers, decision makers and data collectors around disability, the availability of data, and the experiences of Sightsavers’ implementing staff”

Note: The user has given permission for the uploaded document to be reproduced and made publicly available on the Source website

Children with Disability in Nepal: New Hope Through CBR?

MOL, Tanja Ingeborg
BRAKEL, Wim Van
SCHREURS, Merel
2014

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Purpose: This study assesses the impact of a community-based rehabilitation (CBR) programme on the quality of life (QoL) of children with disability and their families.

 

Methods: A qualitative approach was applied, using two techniques - a ranking line and semi-structured interviews. Nineteen children (ranging from 4 –18 years of age) were interviewed in their homes located in three villages - Chapakhori, Bokraha and Madesha - in Nepal.

 

Results: Children with disability and their families ranked physical health, psychological health, empowerment and level of independence as the most important factors for their QoL. Of the 19 children, 13 had experienced positive changes in their life and 1 child reported a negative change. The positive changes related mainly to their physical health and functioning. The impact of these changes was felt in the ‘social’, ‘level of independence’ and ‘empowerment’ outcome categories. The children mentioned that they had more friends, experienced less stigma, could go to school and were more hopeful about the future.

 

Conclusions: This CBR programme has brought about changes in the QoL of all children with disability and their families. The majority of them reported a positive impact.

 

 

Disability, CBR and Inclusive Development, Vol 25, No 1

The key informant child disability project in Bangladesh and Pakistan

MACTAGGART, Islay
MURTHY, GVS
2013

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The Key Informant Method (KIM) has previously been tested by CBM, LSHTM and others, and found to be a valid method for the identification of children with severe visual impairment and blindness in Bangladesh, using community volunteers in the place of a door-to-door survey. This report outlines a study that set out to expand this and test whether voluntary, community-level Key Informants (KIs) could be trained to effectively identify children with moderate or severe physical impairments, sensory impairments (visual and hearing) or epilepsy in Bangadesh and Pakistan, and if so whether this process could be used to assess prevalence and plan appropriate referral services for children meeting these criteria

Impact Assessment of a Vocational Training Program for Persons with Disabilities in Bangladesh

NURI, Reshma Parvin
HOQUE, Tohidul
WALDRON, Samuel Matthew
AKAND, Mustafa Kamal
2012

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Purpose: The aim of this study was to evaluate the effectiveness of a vocational training programme in enabling 261 persons with disabilities to find employment in Bangladesh.

 

Methods: A qualitative method, which employed interviews and focus group discussions, assessed the effect of the training programme on key individual, societal and physical factors set out by the WHO International Classification of Functioning, Disability and Health (2001).

 

Results: 157 persons with disabilities (60%) secured employment after training. Of these, 74% reported that they were able to provide a better livelihood for their families, 92% reported increased social acceptance, and 83% reported improvement in overall quality of life. Of those who did not find employment, 15% cited issues related to the training course, 6% mentioned discriminatory attitudes of potential employers and 12% had problems related to physical access.

 

Conclusions and Implications: These results suggest that the vocational training programme improved the (re)entry of persons with disabilities into employment, which in turn aided their rehabilitation. However, discriminatory attitudes towards them at the workplace were reported.

 

 

Disability, CBR and Inclusive Development, Vol 23, No 3

Mainstreaming disability in the new development paradigm : evaluation of Norwegian support to promote the rights of persons with disabilities

INGDAL, Nora
NILSSON, Annika
2012

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"This report is the result of an external and independent evaluation of the Norwe¬gian Support to Promote the Rights of Persons with Disabilities in the last 11 years. The intention of the evaluation is to analyse the results of targeted and mainstreamed initiatives towards achieving the rights of persons with disabilities...The methodology included field visits in the four case countries: Malawi, Nepal, the Palestinian territory and Uganda to obtain a deeper understanding of how the rights of persons with disabilities have been promoted, and estimate the possible contributions of the Norwegian support. Afghanistan was included as a desk study"
Note: The report is available electronically and in printed version. A braille copy can be downloaded from the web. The four country reports, written in English, are available electronically. The summaries of the country studies are made available electronically, with translations to the relevant local languages Nepali, Arabic and Chewa. In addition an easy-read version in English and Norwegian of the main report is available electronically

Sustainability Criteria for CBR Programmes – Two Case studies of Provincial Programmes in Vietnam

MIJNARENDS, Donja M
PHAM, D
SWAANS, Kees
VAN BRAKEL, W H
WRIGHT, Pamela
2011

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Purpose: This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of such programmes.

 

Method: Two CBR programmes in Vietnam, one medical based and one comprehensive (medical, educational, livelihood, social and empowerment), were evaluated for requirements and the current situation. Four factors were taken into account - human resources, organisational setting, social and political environment, and financing. Data were collected through interviews with programme managers and focus groups with stakeholders from provincial, district and communal levels, and with persons with disabilities. Persons with disabilities also completed a questionnaire to evaluate their satisfaction with the programme and their involvement in it.

 

Results: The conditions needed for a sustainable CBR programme were identified: availability of human resources, training, monitoring and evaluation, collaboration, commitment and financing. The conditions missing at present were: a stable pool of human resources (in both programmes), collaboration between sectors and with local authorities (in the medical programme), and knowledge about how to maintain financing (in both programmes). Persons with disabilities were more satisfied with their involvement in the comprehensive programme than in the medical programme. Stakeholders proposed opportunities to increase sustainability; highest priority was given to a collaboration plan (comprehensive CBR programme) and to involvement of other sectors in the CBR Steering Committee (medical CBR programme).

 

Conclusions: Few differences were found in conditions needed for sustainability of the medical and comprehensive programmes. The existence of disabled persons’ organisations (DPOs) seemed to be associated with the level of satisfaction persons with disabilities felt with their involvement in the programme.

 

Limitations: The People’s Committee was not involved in this research, although their input was perceived to be important. Generalisation of the results of this study should be done with caution because health system structures and organisational levels of CBR differ.

Final evaluation of community based rehabilitation (CBR) programme

DEV LAFLE, Basu
December 2010

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This final evaluation report assesses how far the program has met the stated goal of improving the situation of children with disabilities through the fulfillment of child rights, appraises the sustainability of the program, assesses the project implementation, and provides lessons learned and best practices of the project. This report is useful for anyone interested in CBR programmes

Outcomes of people with psychotic disorders in a community-based rehabilitation programme in rural India

CHATTERJEE, Sudipto
et al
November 2009

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This article describes "the uptake and impact of a service using the community-based rehabilitation framework for people with psychotic disorders within a defined catchment area in a rural, impoverished community in India. The programme was implemented by the Ashagram Trust, a community-based nongovernmental organisation. We describe the functional (disability) outcomes of people with psychotic disorders; identify the determinants of their outcomes; and highlight the research and policy implications of this study for service provision in rural areas of low- and middle-income countries"
British Journal of Psychiatry, Vol 195, No 5

Are current guidelines for categorization of visual impairment in India appropriate?

MONGA, Parveen K
et al
October 2009

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Visual disability in India is categorised based on severity, and sometimes the disabled person does not fit unambiguously into any of the categories.  This study aimed to identify and quantify disability that does not fit in the current classification, and propose a new classification that includes all levels of vision. The research team found that around 10% of patients did not fall within did not fall within any of the existing categories, forcing the disability board to use its own judgement, and resulting in a tenancy to over-garde the disability. The authors propose a classification based on the national program in India for control of blindness' definition of normal vision (20/20 to 20/60), low vision ( < 20/60 to 20/200), economic blindness ( < 20/200 to 20/400) and social blindness ( < 20/400). It ranges from the mildest disability (normal vision in one eye, low vision in the other) up to the most severe grade (social blindness in both eyes).  The article concludes by acknowledging that the current classification of visual disabilities does not include all combinations of vision; some disabled patients cannot be categorised. The classification proposed by the authors is comprehensive, progresses logically, and follows the definitions of the national India program

Indian Journal of Ophthalmology, Vol 57, Issue 6

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