Resources search

Digital fabrication of lower limb prosthetic sockets

OLDFREY, Ben
BARBARESCHI, Giulia
WILLIAMS, Rhys
HOLLOWAY, Catherine
December 2020

Expand view

This innovation insight discusses current approaches to digital fabrication of lower limb prosthetics (LLP) sockets aimed at low resourced settings. Digital fabrication of LLPs sockets has been researched for a number of decades, yet these technologies are not widely adopted, and most of the activities within this domain reside in high-income settings. However, the majority of amputees are in LMICs where there is a severe lack of access to services. It is in LMICs then, that the advantages that digital technologies offer could be of particular benefit however little to no progress in digital workflow adoption has been made to date.

What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?

QURESH, Onaiza
SCHERER, Nathaniel
July 2020

Expand view

The question and the problem:

Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the COVID-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during COVID-19 and other recent pandemics, informing policy and practice during this crisis.

How can social protection responses to COVID-19 be made disability inclusive?

BANKS, Lena Morgon
HUNT, Xanthe
June 2020

Expand view

Question & problem

The COVID-19 pandemic and strategies essential for its containment are resulting in severe strains on economies, particularly in low- and middle-income countries (LMICs). These impacts will be felt most by groups already in or at risk of poverty, including the estimated 1 billion people with disabilities globally. Interventions to address the short- and long-term economic effects of the pandemic are urgently needed. Some countries have begun implementing or announced plans for interventions addressing the economic impacts of COVID-19, such as food assistance, emergency cash transfers, unemployment assistance or expansions to existing social protection programmes. As these programmes are developed, it is important to consider the extent to which their design and delivery is inclusive of people with disabilities. Failure to adequately include people with disabilities in this process will lead to widening inequalities.

Learning Paper – Inclusive Sports for Development Project

NEUPANE, Sudarshan
JALAL, Faruk Ahmed
CHAKRABORTY, Ripon
Md. ISLAM, Shafiqul
PAUL, Ashok Kumar
Md. MUHIT, Mubdiul
April 2020

Expand view

Children with disabilities in Bangladesh have equal access to play, recreation and leisure, and sporting activities, including in the school system (contributing to enjoyment of article 30 5.d of UNCRPD).

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

Expand view

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.

Aid out of reach: A review of the access to humanitarian aid for women and men, girls and boys with disabilities affected by Cyclone Idai, Mozambique

BAART, Judith
WESTER, Mirian
2019

Expand view

The objective of this study is to generate empirical evidence on the barriers to accessing aid for women and men, girls and boys with disabilities in a post-Cyclone Idai context. By doing so, it also seeks to contribute to policy development for an inclusive humanitarian response in Mozambique

The research followed a qualitative design, using interviews and focus group discussions followed by inductive analysis to reveal dominant themes and stories. Data was collected in 30 in-depth interviews with women and men, girls and boys with disabilities and/or caregivers in communities (Beira), as well as in resettlement sites (Dondo).

Disability stigma in the Disability Inclusive Development (DID) programme countries: an overview of the evidence

ROHWERDER, Brigitte
September 2019

Expand view

This literature review outlines factors contributing to disability stigma in low- and middle-income countries. Overviews of disability stigma in the six Disability Inclusive Development (DID) programme countries – Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania – are presented next. The review then looks at the literature on interventions to reduce disability stigma. Interventions aimed at addressing disability stigma in developing countries have been aimed at the intrapersonal and familial level; the interpersonal level; and the structural level.

How do we improve access to healthcare for people with disabilities?

HUNT, Xanthe
August 2019

Expand view

Gaining access to healthcare is often a challenge for people with disabilities in low- and middle-income countries. Part of this has to do with a general dearth of healthcare services in low-resource settings. But part of this difficulty has to do with structural, attitudinal, economic and social barriers to participation and healthcare which affect people with disabilities more than people without disabilities. This lack of access to healthcare is a problem because, in general, people with disabilities may need to access healthcare more frequently than people without disabilities. Full and equitable access to quality healthcare is a human right, and an important imperative of the global agenda. This evidence brief summarises what we know about how to improve access to healthcare for people with disabilities in low-resource settings.

What interventions are effective to support home-based carers?

HUNT, Xanthe
August 2019

Expand view

Question & problem

Many people with disabilities require the assistance of other people in order to go about their daily lives. In high-income countries, home-based carers are professional or para-professional workers who provide assistance to people with disabilities, in their homes. They are often well-trained, and remunerated for their services. However, individuals with disabilities in many low- and middle-income countries (LMIC) predominantly live with their family, and receive home-based care from family members. There are some stresses associated with giving care to others, and these include burnout, compassion fatigue, and an array of emotional and social consequences related to the caring role. The carers, too, need care. This evidence brief summarises what we know about how to support home-based carers, taking into consideration that these people, in LMIC, are often untrained, unpaid family members of the person for whom they are caring.

How do we ensure that children with disabilities are not bullied in school?

HUNT, Xanthe
August 2019

Expand view

Question & problem

Students with disabilities are bullied more often than their typically developing peers. Students in schools for children with disabilities may be victimized more often than students with disabilities in inclusive settings. Being bullied, which can take forms which are physical, verbal, indirect (relational, emotional, or social), and/or sexual, is associated with negative academic, social, and psychological outcomes for the victim. This evidence brief summarises what we know about how to prevent bullying of children with disabilities.

What works to improve educational outcomes of children with disabilities in school?

HUNT, Xanthe
August 2019

Expand view

Question & problem

For people with disabilities, a major determinant of social and economic outcomes in adulthood, is access to, and the adequacy of, education in childhood and adolescence. Yet, children with disabilities are less likely to be enrolled in, or complete, school. Further, there are substantial gaps in the evidence regarding what works to improve educational outcomes of children with disabilities in school. Educational outcomes, here include academic achievement, pass rates, and grade completion. Many studies measure child behaviour and proxy or distal outcomes in response to various interventions, but not actually how children with disabilities do in these domains. This is particularly the case in LMIC, where there is a dearth data about the effects of educational policies and practices on child educational outcomes.

How do we ensure that social protection assistance initiatives work for people with disabilities?

HUNT, Xanthe
August 2019

Expand view

Question & problem

Social protection systems and other financial assistance, including cash transfers and integrated benefits packages, may be important ways to facilitate the inclusion of people with disabilities in services and society. There is limited information, however, with regards to their impact in low- and middle-income settings. To understand how these programs work, it is important to recognise that there are disability-targeted entitlements, but people with disabilities may also be eligible for mainstream programmes aimed at other targeted groups, such as people of a certain socio-economic status. This evidence note summarises what is known about challenges faced by both of these types of initiatives, as well as evidence-based recommendations to strengthen them.

How do we provide mental health support to children with psychosocial disabilities in school?

QURESH, Onaiza
August 2019

Expand view

Question & problem

It is estimated that approximately 10-20% of children, adolescents and young people (under the age of 18) worldwide have a disabling mental health condition. Approximately two-thirds of the global youth population goes to school for a significant proportion of the day. The idea of delivering mental health support in the setting has gained prominence as a way to increase the coverage and accessibility of mental health support for children. While there is a wealth of evidence around school mental health approaches in HIC, there is limited information with regards to their impact in low- and middle-income settings. This evidence brief explores what has worked for the delivery of school mental health initiatives in diverse settings, as well as evidence-based recommendations to strengthen them.

What are the key considerations for including people with disabilities in COVID-19 hygiene promotion programmes?

WILBUR, Jane
HUNT, Xanthe
August 2019

Expand view

Question & problem

People with disabilities may be more likely to acquire COVID-19, and if infected may be more likely to experience serious symptoms, or die. Aside from those consequences of the pandemic related to morbidity and mortality, people with disabilities are often reliant on carers to aid with common daily tasks, and so social distancing measures may be unfeasible. Furthermore, safe water, sanitation and hygiene (WASH) services and facilities may be inaccessible to people with disabilities, and, in many settings, efforts to deliver services in a socially-distanced world have resulted in the roll out of digital or remote healthcare approaches which are sometimes not accessible or inclusive. One of the key interventions in response to the COVID-19 pandemic has been international attention, and improved funding, programming and media messaging in support of WASH. People with disabilities – who are most at risk of negative consequences of COVID-19 – most need access to such interventions. Yet, WASH access is considered to be one of the biggest challenges of daily life for many people with disabilities.

Uzbekistan: Case for inclusion

NAM, Galina
2019

Expand view

The inclusion of children with disabilities in mainstream education has become an important agenda for many developing countries. The Uzbekistan government has also attempted to provide equal educational opportunities to this previously excluded group of children. Despite these efforts, however, many children with disabilities remain segregated. The total number of children with disabilities under 16 years old in the country is 97,000 (Uzbek Society of Disabled People, 2014). The majority of them either study at specialised educational institutions, or receive home-based education. Those who are placed at specialised institutions are often deprived of resources and services necessary to receive adequate education (UNICEF, 2013). While limited by the lack of reliable empirical data and research, this article aims to present the current situation in the development of inclusive education in Uzbekistan. It outlines the major legislative documents intended to support inclusive education and identifies some of the current obstacles to inclusive education practices.

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Physical therapy for diabetic peripheral neuropathy: A narrative review

NIZAR, Abdul Majeed Kutty
JABBAR, Mohammed Abdul Razzaq
SREENIVASULU, Sura
2019

Expand view

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus in both developed and developing countries. It is found in about 10% of diabetic clients at diagnosis, and in the majority of clients 25 years down the line. Clients with pre-diabetes may also develop neuropathies that are similar to diabetic neuropathies. Long-term hyperglycemia can cause peripheral nerve damage, resulting in distal-predominant nerve fibre degeneration. Loss of feeling in the lower limbs is a high risk for limb amputation. Despite efforts to make an early diagnosis and to halt the progression of diabetic neuropathy, currently there is no effective treatment available at a global level, except for strict control of blood glucose.

Physical therapy can improve the overall quality of life of diabetes mellitus clients with peripheral neuropathy and can alleviate the symptoms of neuropathy. This paper assesses the effectiveness of interventions used by physical therapists to minimise dysfunctions in people with DPN. It reviews the different treatment strategies and presents evidence and conditions for its applications.
 

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Exploring the experiences of students with visual impairments at the University of Botswana

OATS, Reginald
DISELE, Chawapiwa
2019

Expand view

Purpose: This paper sought to document the responsiveness of the University of Botswana towards the academic needs of students with visual impairments. The study examined the academic experiences of students with visual impairments enrolled at the University and explored their information-seeking needs. The study was informed by the theory of social justice.

Method: This was a qualitative study. Data was collected from students with visual impairments and academic staff from different faculties at the University of Botswana, through document analysis, interviews and observation techniques.

Results: The findings revealed that students with visual impairments experience extra challenges compared to students without disabilities. This is mainly because they do not get full support to enable them to excel academically. Furthermore, lecturers use teaching methodologies that do not accommodate these students, and learning materials are not adapted to formats suitable for them. Access to information is another major concern that hinders the participation of students with visual impairments in tertiary institutions.

Conclusion: The study recommends that lecturers need to be trained on suitable methods to teach students with visual impairments and how best to deliver academic content to them.

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

The GRID Network: A Community of Practice for Disability Inclusive Development

COCKBURN, Lynn
MBIBEH, Louis
AWA, Jacques Chirac
2019

Expand view

Purpose: This paper aimed to provide an overview of the evaluation of the GRID Network (Groups for Rehabilitation and Inclusive Development) and the impact it had on its members.

Method:  Information was collected through a compilation of the resources developed during the project, and a summative evaluation process was employed at the end of the project. The paper is a short report on the summative evaluation.

Results: GRID Network members reported that the network was effective and beneficial. They developed new information and knowledge that was relevant to their local contexts; shared knowledge from local, national, and international sources; and, increased their skill in using social media for professional purposes. Recommendations include continuing with this kind of community of practice, with greater opportunities for more engagement and training; inclusion of more partner organisations; large group workshops and conferences; increased attention to advocacy for policy change; and, for more research to be carried out locally.

Conclusion and Implications: This project demonstrated that it is possible to develop and maintain a community of practice in a low-resource context on a minimal budget, even during times of political crisis. Further programme development, evaluation, and research are warranted to ascertain how this model can be scaled up to include a broader group of rehabilitation and other practitioners involved in disability inclusive development.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 84-94,  (2019)

A preliminary report of the audiological profile of hearing impaired pupils in inclusive schools in Lagos State, Nigeria

ASOEGWU, Chinyere Nkiruka
OGBAN, Loretta
NWAWOLO, Clement
2019

Expand view

Purpose: The programme to enrol hearing impaired pupils in inclusive schools in Lagos State, Nigeria, has been endorsed recently and is at a transitional phase. The study assessed the audiological profile of the enrolled pupils with hearing impairment.

Methods: After a random selection of 7 designated inclusive primary schools in Lagos State, a two-stage study was conducted. First, a questionnaire documenting audiological history was administered to the pupils with hearing impairment. This was followed by pure tone audiometry.

Results: Study participants were between 4 and 26 years of age (mean 12.8±4.1). About 158 (96.9%) of them had bilateral profound hearing loss. Method of communication for 132 (81%) was by sign language, followed by lip reading for 56(34.4%).

Conclusion: Severity of hearing impairment was profound among this category of enrolled students. Most of them had probably been transferred from schools for the Deaf to inclusive schools. Less severe degrees of hearing impairment may have been detected if audiological assessment had been mandatory for all the school children.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 95-103, Oct. 2019

MAANASI - A sustained, innovative, integrated mental healthcare model in South India

JAYARAM, Geetha
GOUD, Ramakrishna
CHANDRAN, Souhas
PRADEEP, Johnson
2019

Expand view

Studies in low and middle-income countries (LMICs) point to a significant association of common mental disorders with female gender, low education, and poverty. Depression and anxiety are frequently complicated by lack of disease awareness and non-adherence, the absence of care and provider resources, low value given to mental health by policy-makers, stigma, and discrimination towards the mentally ill. This paper aims to show that female village leaders/ community health and outreach workers (CHWs) can be used to overcome the lack of psychiatric resources for treatment of common mental disorders in rural areas.

A multidisciplinary team was set up to evaluate and treat potential clients in the villages. A program of care delivery was planned, developed and implemented by: (a) targeting indigent women in the region; (b) integrating mental health care with primary care; (c) making care affordable and accessible by training local women as CHWs with ongoing continued supervision; and (d) sustaining the program long-term.   Indigenous CHWs served as a link between the centre and the community. They received hands-on training, ongoing supervision, and an abridged but focused training module to identify common mental disorders, help treatment compliance, networking, illness literacy and community support by outreach workers. They used assessment tools translated into the local language, and conducted focus groups and client training programs. 

As a result, mental healthcare was provided to clients from as many as 150 villages in South India. Currently the services are utilized on a regular basis by about 50 villages around the central project site. The current active caseload of registered clients is 1930.  Empowerment of treated clients is the final outcome, assisting them in self-employment. 

Rural mental healthcare must be culturally congruent, and must integrate primary care and local CHWs for success. Training, supervision, ongoing teaching of CHWs, on-site resident medical officers, research and outreach are essential to continued success over two decades.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 104-113, Oct. 2019

 

 

Pages

E-bulletin

Source e-bulletin on Disability and Inclusion

Subscribe to updates