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Prevention against emerging infectious diseases: An Opportunity for Inclusive Health. Understanding the behavioural and social drivers (BeSD) of COVID-19 vaccination among persons with disabilities in Internally Displaced camps in Somalia/Somaliland

ZIVERI, Davide
ABDULLAHI, Hawaa
July 2023

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In close collaboration with the World Health Organization, Humanity & Inclusion adapted and piloted WHO’s behavioural and social drivers (BeSD) of vaccination tools to understand and analyze the perception of COVID-19 vaccines as well as the barriers and drivers of immunization among persons with disabilities in a humanitarian setting in Somalia/Somaliland. This study was funded by the Universal Health Coverage and Life Course (UHL) division of the Immunization, Vaccines and Biologicals (IVB) department of the World Health Organization, Geneva. Humanity & Inclusion also carried out a Risk Communication and Community Engagement (RCCE) project, contributing to the inquiry phase described in this report, to foster the right to health as well as access to COVID-19 vaccination in Somalia/Somaliland, funded by the Center for Disaster Philanthropy.

 

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"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

Disability & inclusion survey, Malakal Protection of Civilians site

International Organization for Migration’s Displacement Tracking Matrix (IOM DTM)
February 2021

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The International Organization for Migration’s Displacement Tracking Matrix (IOM DTM), Protection and Mental Health and Psycho-Social Support teams joined efforts with Humanity & Inclusion (HI) to undertake an assessment of the level of access to services and the barriers faced by persons with disabilities within Malakal Protection of Civilian site (PoC site). The United Nations High Commissioner for Refugees (UNHCR) and the Danish Refugee Council (DRC) contributed to the qualitative component of the study as the main Protection and Camp Coordination and Camp Management (CCCM) actors operating within the PoC site. The study, based on data collected between March 2020 and June 2020, aims to improve the knowledge base available to the humanitarian community about access to services by persons with disabilities living in the site. It provides a quantitative estimate of the prevalence of disabilities among the IDP population and an assessment of the barriers faced by persons with disability in accessing humanitarian services across sectors. It also seeks to empower persons with disabilities living within the PoC site, giving them the opportunity to express their concerns and preferences with regards to possible solutions and targeted interventions. It is hoped that the resulting data will help camp management and other service providers operating within Malakal PoC site, including IOM, UNHCR and DRC, to better account for the concerns and needs of persons with disability in humanitarian programming and service delivery. This study builds onto and expands previous studies in Naivasha IDP Camp (formerly Wau PoC AA Site) and Bentiu PoC Site.

Guidance note on the inclusion of persons with disabilities in the COVID-19 CCCM response

UNHCR INCLUSION TECHNICAL WORKING GROUP, SYRIA PROTECTION CLUSTER (TURKEY)
February 2021

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This guidance note provides an overview of the risks that persons with disabilities face in the COVID-19 response regarding accessing humanitarian services and proposes actions to address these risks within the CCCM response specifically. This note draws on the IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, 1 CCCM chapter, applying these to the northwest Syria COVID-19 response

Considering age and disability in the Rohingya response

ASSESSMENT CAPACITIES PROJECT (ACAPS)
February 2021

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This report evaluates existing data on the Rohingya refugee response. It highlights the key challenges and constraints faced by persons with disabilities (PwD) and older people in accessing essential services and explores how COVID-19 and related containment and risk mitigation measures have affected humanitarian programming for PwD and older people. It also identifies information gaps and challenges linked to disability prevalence in the camps

 

This secondary data review focuses on the Rohingya refugee camps in Cox’s Bazar and combines publicly available secondary data with 11 key informant interviews conducted with age and disability experts working on the humanitarian response. The interviews took place between 1 July–30 August 2020 with experts from the UN, national NGOs, INGOs, and the International Red Cross and Red Crescent Movement.  

Minimum standards for camp management

CAMP COORDINATION AND CAMP MANAGMENT (CCCM) CLUSTER
2021

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In a humanitarian crisis, camps and camp-like settings are often the only places where internally displaced persons (IDPs) and refugees can seek protection and assistance.


These Minimum Standards for Camp Management describe the minimum actions needed to support meaningful engagement within a site as well as planning and coordination between sectors and agencies. They aim to clarify the role of any site management agency working on a daily basis in humanitarian settings and to set out minimum levels of quality of that work. Although called the Minimum Standards for Camp Management, the standards apply to all contexts where displaced people seek shelter, protection and other support, and the term “site” is used unless a specific camp context is meant.

 

Annex 1 provides a disability inclusion monitoring checklist. This checklist is not exhaustive nor meant to replace participatory approaches but can be used as a complementary tool by site managers willing to assess the overall inclusiveness of a site, or as a tool to support the development of an inclusive strategy for persons with disabilities.

Disability inclusion annual report 2020

UNITED NATIONS RELIEF AND WORKS AGENCY (UNRWA)
December 2020

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The number of Palestine refugees registered by UNRWA recently grew to 5.7 million (from 5.5 million in 2019) in all its five field of operations in Jordan, Lebanon, Syria, Gaza and the West Bank. Among them are Palestine refugees with disabilities, who have long-term impairments, which in interactions with attitudinal, institutional, and environmental barriers prevent their full and effective participation on an equal basis with others in society. Persons with disabilities constitute an estimated 15 per cent of the global population1, and may constitute a higher percentage in humanitarian contexts, such as Syria, the West Bank and Gaza, in particular, which are UNRWA fields of operations.

 

The main actions undertaken in 2020 discussed in the report are:

  • targeted and disability-specific services for persons with disabilities
  • disability inclusion through programmes
  • inter-agency coordination
  • international protection advocacy

Self-reported barriers to activities of daily living of persons with disabilities living in IDP sites in northwest Syria

UNHCR INCLUSION TECHNICAL WORKING GROUP, SYRIA PROTECTION CLUSTER (TURKEY)
November 2020

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This brief aims to describe the lived experience of persons with disabilities in northwest Syria and highlight needs and key barriers to engagement in personal, domestic and community-based activities of daily living, which includes access to and engagement with humanitarian organisations. The analysis of these difficulties forms the basis of key pragmatic recommendations for humanitarian actors

COVID-19 in humanitarian contexts: no excuses to leave persons with disabilities behind! Evidence from HI's operations in humanitarian settings

HUMANITY & INCLUSION (HI)
June 2020

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This collection and review of evidence aims to illustrate how the COVID-19 crisis triggers disproportionate risks and barriers for persons with disabilities  (men, women, boys and girls) living in humanitarian settings. It highlights recommendations for humanitarian actors, to enhance inclusive action, aligned with existing guidance and learnings on disability inclusion. It is based on evidence, including testimonies, collected by HI programs in 19 countries of intervention. Special efforts were made to reflect the voices of persons with different types of disabilities, genders and ages, residing in different geographical areas and living circumstances, including refugee and internally displaced persons’ settlements and hostcommunities.

 

Evidence has been collected through primary data collection among HI teams and partners, working in countries impacted by the COVID-19 pandemic in April/May 2020. Data was extracted from assessments conducted by HI and partners in Bangladesh, Egypt, Haïti, Indonesia, Philippines, Jordan, Lebanon, Somaliland and Togo. Testimonies from affected communities, staff and partners were collected in Kenya, Myanmar, Pakistan, Palestine, Philippines, Somaliland, South Sudan, Rwanda, Thailand, Uganda and Yemen.  

 

Displaced persons with disabilities face additional challenges to protect themselves and their families and barriers to access services, in camps that were not built for COVID-19

Learning Needs Assessment Report: Skills for impact - Rohingya Humanitarian crisis response, Bangladesh Local Humanitarian Aid Workers

AHSANUL ISLAM, Suman
et al
June 2020

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The Rohingya humanitarian crisis response in Cox’s Bazar (CXB) is a fairly new and complex experience for the humanitarian aid workers in Bangladesh. Aid workers are responsible for responding effectively in a very demanding context and acquire certain skills and competencies to adapt to the extreme workload. Since the current response in CXB began in 2017, local humanitarian aid workers (LHAWs) have gathered tremendous amount of learnings and experiences.

 

The objective of this LNA is to outline the knowledge, skills, capacity gaps and learning needs of LHAWs working in CXB. 

 

This LNA focuses on understanding LHAWs’ skills, knowledge and behaviour - both operational & technical. It analyses individuals' ability to contribute and implement response plans and respond effectively to the humanitarian crisis. Analysis focuses on understanding LHAWs’ capacity in addressing the needs of specific beneficiary groups such as children, women & girls, people with disability (PwD), elderly and people with chronic health issues. Quantitative and qualitative data was collected in November 2019.

 

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.

How can the health of people with disabilities in humanitarian camps be supported during the COVID-19 pandemic? - Evidence brief

HUNT, Xanthe
2020

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More than 10% of the world’s 35 million displaced people are people with disabilities. People with disabilities and their families are at significant risk of discrimination, stigma, violence, and marginalisation, and get little access to adequate services in humanitarian camps. Disabled people are frequently sidelined during health sector planning in humanitarian camps, and healthcare access is a particular challenge. The COVID-19 pandemic, and measures necessary for its containment, pose a particular threat and challenge in humanitarian settings. Containment measures such as mass ‘stay-at-home' orders, social distancing, self-isolation and quarantine are often unsuitable for, or difficult to implement in, camp settings. People in humanitarian camps, then, need special consideration within the COVID-19 response. However, among people in humanitarian camps, people with disabilities are particularly vulnerable to being left behind or overlooked in COVID-19 planning and programming. Their double vulnerability as refugees and disabled people warrants special consideration.

 

Evidence in considered and recommendations provided.

Disability & inclusion survey, Wau PoC AA

INSTITUTE OF MIGRATION (IOM)
HUMANITY & INCLUSION
CCCM CLUSTER
October 2019

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The International Organization for Migration's Displacement Tracking Matrix (10M DTM) and Humanity & Inclusion (HI) joined efforts to undertake an assessment of the level of access to services and the barriers faced by persons with disabilities within Wau Protection of Civilian Adjacent Area site (PoC AA or PoC site). The study, based on data collected in February 2019, aims to improve the knowledge base available to the humanitarian community about access to services by persons with disabilities living in the PoC site. It provides a quantitative estimate of the prevalence of disabilities among the IDP population and an assessment of the barriers faced by persons with disabilities in accessing humanitarian services across sectors. It also seeks to empower persons with disability living within the PoC site, giving them the opportunity to express their concerns and preferences with regards to possible solutions and targeted interventions.

Disability and displacement in times of conflict: Rethinking migration, flows and boundaries

BERGHS, Maria
2015

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In this paper, I try to understand the changed relationship of conflict to migration as seen through a lens of fluidity and what that entails for disabled people - particularly what boundaries and borders are at stake. Secondly, I investigate migration through the idea of ‘ontological insecurity’ and try and link this to ideas of (dis)/ableism. Then, I attend to what happens when boundaries are enforced in the humanitarianism of a refugee camp, to explain how territoriality of such a setting unmakes people into ‘strangers’. I show how the structural violence of poverty leads to a necessary fluidity and illustrate how people use this to combat the ‘unmaking’ of the self and reinsert themselves back into social life and relationships. Lastly, I examine the place of biolegal politics in medical humanitarianism and explore the relationship to ‘necropolitics’ and its consequences.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 1

Disability-inclusive healthcare in humanitarian camps: Pushing the boundaries of disability studies and global health

MIRZA, Mansha
2015

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A significant proportion of forced migrants live in humanitarian camps located in remote regions of the global South. Disabled persons have been historically neglected within camp programs across all service sectors, especially healthcare. This paper describes an exploratory research study on healthcare access for forced migrants with disabilities in the context of humanitarian camps. Based on the methodological framework of rapid ethnography, the research involved guided tours, community mapping exercises, ethnographic observations, and semi-structured interviews in a refugee camp in southern Africa. Additional key informants from other sites were interviewed remotely using a convenience sampling strategy. Several important insights emerged from the research including: misperceptions about the health-related needs of disabled persons, their specialized health needs falling outside the ‘social minimum’ of humanitarian healthcare, and concerns about distributional ethics in relation to disability-inclusive healthcare. The research also highlighted barriers and strategies for addressing disability-specific health needs given significant resource constraints in humanitarian camps. These findings are discussed in light of practical and theoretical challenges in the fields of disability studies and global health.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 1

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