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Purpose: Persons with disabilities affecting lower-limb function use ankle- foot-orthoses (AFO) and knee-ankle-foot-orthoses (KAFO) on a regular basis. However, the effectiveness of these devices in daily use is seldom evaluated, especially in the developing world. This study aimed to evaluate user satisfaction with lower-limb orthotic devices while performing a broad spectrum of daily life activities in Pakistan, and to document the desired outcomes.

Method: A survey was conducted among orthotic device users in the out-patient departments of three hospitals in Lahore, Pakistan. The survey questionnaire was devised by adapting the Prosthetic Evaluation Questionnaire to suit orthotics evaluation. Fifty-four AFO and KAFO users participated in the study.

Results: Most users felt comfortable while walking on even surfaces with their orthoses. However, donning/doffing these, climbing stairs and performing certain routine activities were considered problematic for most people. Energy conservation was the most desired AFO feature, while the KAFO users wanted automatic knee-joint function.

Conclusion and Implications: Overall satisfaction with the existing lower- limb orthoses is adequate. Yet, significant improvements are needed in terms of energy efficiency and comfort while walking on different terrains. Further research is required in order to improve the functioning of the existing orthotic devices.

HI Pakistan has recently completed a UN Women funded project ”Empowering women with disabilities (EWwD)” focusing on the social and economic empowerment of the women with disabilities. The project was implemented at Islamabad capital territory (ICT), Peshawar, Nowshera and Karachi. This project has directly benefited more than 600 women with disabilities , whereas about 30 DPOs and a number of public private departments / institutions have also been engaged and benefitted.

HI Pakistan collected the stories of project beneficiaries and published to highlight the impact of the project and to integrate the lesson learnt in program cycle management.

The intersection between age, gender and disability and the use of assistive technology (AT) by older people, in emergency response and as a tool for disaster risk reduction (DRR) is explored. The report shows that AT can have a positive impact on independence, vulnerability reduction and resilience building for older women and men in humanitarian crises. This report urges for sensitization and capacity building of humanitarian organizations for the inclusion and promotion of assistive product (AP) provision in humanitarian response and offers insight into key areas to enable AT provision to successfully meet the needs of older people.

The study employed primary research methods to gather both quantitative and qualitative information through a semi-structured survey with HelpAge programme beneficiaries in five countries: Bangladesh, Indonesia, Myanmar, Nepal and Pakistan. The survey incorporated the Washington Group short set of questions (WGQs), designed to identify people with functional difficulties in six core functional domains: mobility, vision, hearing, cognition, self-care and communication (Washington Group on Disability Statistics, 2016). The report also summarises secondary research including a literature review, information from rapid needs assessments carried out by HelpAge, and maps out relevant policy changes which have led to better recognition of the intersectionality and importance of AT for older men and women.

The use of cash and vouchers as part of humanitarian responses has increased significantly over the past decade. It is a commitment in the Grand Bargain between some of the world’s largest donors and humanitarian organisations, which aims to get more means into the hands of people in need. Disability inclusion has also become a key part of international humanitarian frameworks, such as the Charter on Inclusion of Persons with Disabilities in Humanitarian Action. While provision of cash is a way to allow aid to take a form which responds to the real needs of people affected by disasters, barriers remain to the participation of persons with disabilities in such schemes

The fourth issue of this journal focuses on “Preparedness for Disability Inclusive Disaster Risk Reduction” and encourages writers to share initiatives undertaken by the humanitarian community in the Pakistan or suggest future interventions.
 

Articles included are:

• Towards disability inclusive DRR programming in Pakistan
• Age and disability inclusive DRR
• Enhancing disaster preparedness for effective response and to “Build Back Better” 
• Preparedness for disability inclusive Disaster Risk Reduction policies focusing women with disabilities in crisis situation
• Disability inclusion without proper knowledge can cause further disability- A personal experience 

 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)

Pakistan is committed to fulfilling the vision of 2030 Agenda, and is the first country in the world to localize the SDGs of 2030 Agenda after a unanimous parliamentary resolution was passed on 19 February, 2016. The federal and provincial governments have established SDG units in their respective planning and development departments. This report analyses 6 SDGs and their respective provisions in UNCRPD in Pakistan. 

This report selected SDG 01, 03, 04, 08, 11, and 16 and their progress in Pakistan. A participatory methodology was adopted whereby the data was collected through interviews, questionnaires and it focused on group discussions from the Disabled People’s Organizations (DPOs) based in Islamabad, Peshawar, Lahore, Karachi, Quetta, Gilgit-Baltistan, and Azad Jammu and Kashmir. The data was collected in two phases: phase-I involved interviews while phase-II involved focused group discussions.

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 

Originally published at Mental Health Centre, Peshawar, 1985. Reprinted, 1997, Birmingham, UK, in revised format with minor corrections and updates. Online version, [2017 at ResearchGate],  with new introductory notes.

This paper examines with extensive documentation the theoretical and practical functioning and flaws of the WHO {World Health Organisation} Community Based Rehabilitation scheme currently  [i.e. 1985]  being field tested in a number of countries, and of the Manual Training Disabled People in the Community. The development of alternative CBR schemes in Asia, Africa and Latin America since the 1960s is outlined. It is demonstrated that the antithesis posited between 'Institution Based Rehabilitation' and 'Community Based Rehabilitation' is artificial, excluding as it does the middle ground of inexpensive, appropriate rehabilitation based at community-run neighbourhood centres. The strengths and weaknesses of neighbourhood centre based rehabilitation and the WHO‑style home‑based rehabilitation are compared, together with the many social, economic and demographic factors favouring the former approach. Cost considerations are examined in some detail. An account is given of experience in mobilising community resources for neighbourhood rehabilitation centres in Pakistan. Recommendations are made for future Community Rehabilitation plans, with emphasis on the development and dissemination of rehabilitation skills and information through appropriate media.