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Repair strategies for assistive technology in low resource settings

OLDFREY, Ben
HOLLOWAY, Cathy
WALKER, Julian
McCORMACK, STEVEN
DEERE, Bernadette
KENNEY, Laurence
SSEKITOLEKO, Robert
ACKERS, Helen
MIODOWNIK, Mark
July 2023

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Purpose: To  investigate the  practices of  repair that  exist for  users of  mobility assistive products in  low resource settings, as  well  as  the  psychosocial impact that  the  repair, or  non-repair, of  these devices has on users’ lives.

Materials and Methods: This article collates data on repair practices and the responses from participants on  the  topic of  repair from studies conducted by  the  authors across four  different low  resource settings in  Kenya, Uganda, Sierra Leone, and  Indonesia. This  data was  then analyzed to  identify the  common themes found across geographies

 

DISABILITY AND REHABILITATION: ASSISTIVE TECHNOLOGY

https://doi.org/10.1080/17483107.2023.2236142 

Mainstreaming disability inclusive employment in international development

Mary Wickenden
Philip Mader
Stephen Thompson
Jackie Shaw
July 2022

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People with disabilities are under-represented in the global workforce, and this problem is often particularly acute inthe‘global south’. This is an editorial to a special issue that seeks to provide new perspectives on why this is the case. We deliberately wanted to place this collection in the Journal of International Development as a core development publication, rather than in a disability specific one, because we think it is important to ‘mainstream’ disability within development so that the international community can develop an increased understanding and awareness of disability dilemmas. The challenges faced by disabled people need to be tackled as part of all development thinking and programming.

Lives turned upside down in COVID-19 times: exploring disabled people's experiences in 5 low-and-middle income countries using narrative interviews

WICKENDEN, Mary
SHAW, Jackie
THOMPSON, Stephen
ROHWERDER, Brigitte
2021

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This article explores COVID-19 related experiences of disabled people in Bangladesh, Kenya, Nigeria, Nepal and Uganda. Narrative interviews generated storied responses, focussing on respondents' priorities, which enabled us to hear what was most significant for them and their families. 143 interviews were conducted online or by phone by 7 local researchers (3 disabled), with appropriate inclusive support. Nearly everyone was interviewed twice to capture the progression of impacts over time. The data was analysed thematically through a virtual participatory approach. An overarching 'subjective' theme of feelings experienced by the participants was labelled 'destabilisation, disorientation and uncertainty'. We also identified 'concrete' or material impacts. People experienced various dilemmas such as choosing between securing food and keeping safe, and tensions between receiving support and feeling increased vulnerability or dependence, with interplay between the emotions of fear, loss and hope. We found both the concept of liminality and grief models productive in understanding the progression of participants' experiences. Disabled people reported the same feelings, difficulties and impacts as others, reported in other literature, but often their pre-existing disadvantages have been exacerbated by the pandemic, including poverty, gender and impairment related stresses and discrimination, inaccessible services or relief, and exclusion from government initiatives.

Accelerating Disability Inclusive Formal Employment in Bangladesh, Kenya, Nigeria, and Uganda: What are the Vital Ingredients?

WICKENDEN, Mary
THOMPSON, Stephen
MADER, Philip
BROWN, Simon
ROHWERDER, Brigitte
March 2020

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This Working Paper provides an overview of disability as a concept and relevant global treaties and statistics, including evidence of trends and complexities in promoting disability inclusive employment broadly and with some focus on formal employment specifically. We describe the current situation in each of the four focus countries, demonstrating the similarities and differences between them. We then discuss some promising interventions that have been tried, usually on a small scale, in diverse settings, and which may be applicable in our four focus countries (Bangladesh, Kenya, Nigeria, and Uganda). Finally, we present the potential interventions that will be trialled in the Inclusion Works programme, using an innovation-driven, adaptive management approach.

 

The Inclusion Works programme (2018–2022), funded by the UK Department for International Development, aims to improve employment rates for people with disabilities in Bangladesh, Kenya, Nigeria, and Uganda. 

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Disability data in developing countries: opportunities to support inclusion

WALTON, Dan
January 2020

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A blog explaining how data can be a powerful tool for understanding the challenges and opportunities faced by people with disabilities in developing countries, and for improving their welfare and access to relevant services. High-quality disability data, when accessible and used effectively, can help communities and their advocates, policymakers and local officials better understand and prioritise interventions that benefit people with disabilities. However, it is unclear what data is currently available to these stakeholders, and how it could be improved to better support the inclusion of people with disabilities.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

How well is aid targeting disability?

WALTON, Dan
December 2019

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A blog explaining and categorising how international aid has been allocated to projects in a primary or a secondary disability component. It further classifies disability-relevant projects according to their particular focus on one or more of two areas:

Inclusion and empowerment projects have a focus on ensuring people with disabilities are included in benefits on an equal basis to people without disabilities.
Economic empowerment projects are a subset of inclusion and empowerment projects that have the deliberate purpose of improving employment opportunities and rights for people with disabilities.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Disability stigma in the Inclusion Works programme countries: an overview of the evidence

ROHWERDER, Brigitte
November 2019

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This report draws on and expands previous work looking at disability stigma in developing countries (written for K4D) and information on stigma in the situational analyses and labour market assessments of the four Inclusion Works programme countries. Factors which contribute to disability stigma, differences in the extent of stigmatisation and issues measuring stigma are discussed. An overview of disability stigma in each of the specific countries (Kenya, Bangladesh, Nigeria and Uganda) is provided. Interventions to reduce disability stigma are outlined, including interpersonal, intrapersonal and governmental/institutional interventions.

 

The Inclusion Works programme (2018–2022), funded by the UK Department for International Development, aims to improve employment rates for people with disabilities in Bangladesh, Kenya, Nigeria, and Uganda.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Impact of training programmes for people with disabilities (Disability Inclusion Helpdesk Report 5)

FRASER, Erika
ABU AL GHAIB, Ola
February 2019

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 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)

The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world

SHORE, Susan
2017

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Background: Lack of access to mobility for people with disabilities, particularly in less- resourced settings, continues to be widespread. Despite challenges to wheelchair delivery, the benefits to health, employment, social integration and life satisfaction are apparent.


Objectives: Previous studies have explored the impact of receiving a wheelchair on the lives of the users through cross-sectional or short-term longitudinal analysis. The current study was undertaken to evaluate whether previously reported changes were sustained after 30 months of use, and whether results varied between two differing models of a wheelchair.


Method: One hundred and ninety-one subjects from Peru, Uganda and Vietnam received one of two models of wheelchair provided by the Free Wheelchair Mission. Using interviews to record survey results, data were collected at the time the wheelchair was received and following 12 and 30 months of use. Variables of overall health, employment, income and travel were explored through non-parametric analysis.


Results: There was a significant improvement in overall health and distance travelled after 12 months, but these changes were no longer significant by 30 months (Friedman test for overall change, p = 0.000). Employment status showed a small but significant increase at 12 and 30 months (Cochran’s Q, p = 0.000). Reported income increased slowly, becoming significantly different at 30 months (Friedman test, p = 0.033). There was no association between the model of wheelchair received and the incidence of pressure ulcers, pain or maintenance required. There was higher satisfaction with the GEN_2 wheelchair at 12 months (p = 0.004), but this difference was not apparent by 30 months. Overall wheelchair satisfaction and maintenance levels were favourable.


Conclusion: While overall health status, and distance travelled into the community fluctuated over time, receipt of one of two models of a wheelchair in less-resourced settings of the world appears to have a positive sustained impact on employment and income. Further investigations should be carried out to confirm these results and explore the factors responsible for fluctuating variables. This study affirms the importance of long-term follow-up of outcomes associated with wheelchair distribution in less-resourced environments.

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Disability, CBR and inclusive development (DCID), 2017, Vol. 28 No. 1

2017

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Titles of research articles in this issue of the journal are:

  • Community Action Research in Disability (CARD): An inclusive research programme in Uganda
  • The Impact of Community-Based Rehabilitation in a Post-Conflict Environment of Sri Lanka
  • Communication Disability in Fiji: Community Cultural Beliefs and Attitudes
  • The Search for Successful Inclusion
  • Effect of Music Intervention on the Behaviour Disorders of Children with Intellectual Disability using Strategies from Applied Behaviour Analysis
  • The Effects of Severe Burns on Levels of Activity

Brief reports

  • Towards Accessible Built Environments in Universities in Ghana: An Approach to Inclusiveness Assessment
  • Physiotherapy Students’ Awareness of Community Health in India

Equal basis 2014 : access and rights in 33 countries

BURKE, Megan
PERSI VICENTIC, Loren
December 2014

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This report presents research about efforts to meet the needs and uphold the rights of persons with disabilities in four thematic areas: health care, rehabilitation, work and employment, and accessibility and enabling environments. Research findings are drawn from the experiences of landmine and cluster munition survivors and other persons with similar needs in 33 countries experiencing armed conflict or emerging from armed conflict or political or economic transition. Findings are placed within the context of relevant articles of the Convention on the Rights of Persons with Disabilities and the World Report on Disability

Disability inclusion : translating policy into practice in humanitarian action

PEARCE, Emma
March 2014

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This report “documents positive practices and ongoing challenges to promote disability inclusion across UNHCR’s and its partners’ work in multiple countries and multiple displacement contexts. The report provides lessons and recommendations for other organizations and the wider humanitarian community on engaging persons with disabilities at all levels of humanitarian work. It draws on consultations with over 700 displaced persons, including persons with disabilities, their families, and humanitarian staff, in eight countries”

Note: This report is also offered in plain text format

Fact sheet : refugees with disabilities

WOMEN’S REFUGEE COMMISSION
2014

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This factsheet highlights the issue of disabilities among refugees and conflict-affected population. It emphasizes actions undertaken by the Women’s Refugee Commission (WRC) and highlights their next steps in disability inclusion

Note: Also available in easy read format

Disability and disaster risk reduction : celebrating DRR day

CARE INTERNATIONAL
January 2013

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This resource is a special edition of CARE International's disaster risk reduction community of practice quarterly newsletter to celebrate global disaster risk reduction day.  It focuses on disability inclusion in disaster risk reduction programming and presents different organisations' experiences of inclusive disaster risk reduction in different regions

CI DRR CoP Newsletter, quarterly

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

Voices from the ground : landmine and explosive remnants of war survivors speak out on victim assistance

HANDICAP INTERNATIONAL
September 2009

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This report surveys landmine survivors’ opinions on assistance. The survey includes questionnaires and data from 1,645 survivors in 25 affected countries. The report finds that survivors are rarely included in decisions and activities destined to benefit them and subsequently more than two-thirds think that their needs are not taken into account when their governments makes plans to assist them. This document is useful for people interested in landmine survivor's opinions about governments supporting and reintegrating landmine survivors into society

Best practices in the socio-economic rehabilitation of persons affected by leprosy and other marginalised people in their communities: findings from nine evaluations in Bangladesh, India and Africa

VELEEMA, Johan P
2008

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This paper presents an overview of findings from the formal evaluation of 9 socio-economic rehabilitation programmes (SER), in 4 countries in Africa, in Bangladesh and in India from 2002-2005. Bringing together the recommendations resulted in a description of best practices in the implementation of socio-economic rehabilitation programmes, derived from actual experiences in different contexts.

All the 9 programmes focused on supporting individual leprosy-affected beneficiaries or their families. Four projects also supported other marginalised clients. The usual interventions were micro-credit, housing and sponsoring of education for the children.

The recommendations touched upon each of the five steps in individual rehabilitation: Selection of clients, needs assessment, choosing an intervention, monitoring / follow--up of clients during rehabilitation, and separation at the end of the rehabilitation process. The evaluators also suggested ways in which participation of the client in their own rehabilitation might be boosted, made recommendations for the organisational structure of programmes, on maximising community involvement and emphasised the importance of information systems and of investing in the programme staff. A number of recommendations were specific to the types of interventions implemented i.e, housing, education or micro-credit.

Evidence of the impact of SER on the quality of life of clients is limited, but suggests increased self-esteem and increased respect/status in the family and community.

 

Asia Pacific Disability Rehabilitation Journal, vol.19, no.1, 2008

Integrating mental health into primary care : a global perspective

WORLD HEALTH ORGANIZATION (WHO)
WORLD ORGANIZATION OF FAMILY DOCTORS (WONCA)
2008

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This report provides the rationale and know-how on integrating mental health into primary health care. It outlines primary care for mental health in context and then presents primary care for mental health in practice, highlighting 12 case studies and key lessons learnt from specific countries. A detailed annex on the core functions of primary care workers is provided, as well as 10 core principles of mental health integration. This resource is useful to anyone interested in integrating mental health into primary care

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