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Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

Supporting young children with disabilities in humanitarian settings

BEILER, ROSALENGA BERMAN
ZUIDEMA, SUZANNE
BECKERLEGGE, FIONA
RODRIGUEZ GARCIA, DEBORAH MARIE
June 2022

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The rapid growth that occurs in the first years of life provides an opportunity to influence and improve developmental outcomes that may impact the entire course of an individual's life. Addressing the developmental needs of children with disabilities during this critical period is essential if they are to survive, flourish, learn, and be empowered (WHO, n.d.). 

Recognizing the importance of addressing all children's unique needs and acknowledging the influence of social stigma and misconceptions about disability that may lead to underdeveloped potential and social exclusion, we seek to advocate for and support the inclusion of young children with disabilities in Early Childhood Development in Emergencies programming. 

The webinar was moderated by Rosangela Berman Bieler, UNICEF’s Global Advisor on Disability, and included presentations on foundational concepts for disabilities-inclusive programming, and alternatives to address young children with disabilities needs in a resourceful, creative manner. 

Early detection tools for children with developmental delays and disabilities in the Middle East and North Africa

UNITED NATIONS CHILDREN'S FUND (UNICEF)
June 2022

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This technical brief was developed to support specialists in countries of the Middle East and North Africa (MENA) region to select which early detection tools best fit their needs and context by comparing various tools that have been used in theregion and lessons learned in using and adapting those tools to local contexts.

Global Report on Assistive Technology

WORLD HEALTH ORGANISATION (WHO)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
May 2022

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The WHO-UNICEF Global Report on Assistive Technology (AT) reveals that more than 2.5 billion people need one or more assistive products, such as wheelchairs, hearing aids, or apps that support communication and cognition. Yet nearly one billion of them are denied access, particularly in low- and middle-income countries, where access can be as low as 3% of the need for these life-changing products.

The Global Report provides the best available evidence about the barriers currently preventing access, how access can be improved, and how enabling environments and AT can enable persons with disabilities to enjoy their human rights while generating a tremendous return on investment for governments. The report also makes 10 key recommendations for concrete actions that will improve access to AT, for everyone, that needs them. 

Access to assistive technology for children with disabilities is often the first step for childhood development, access to education, participation in sports and civic life, and getting ready for employment like their peers. Children with disabilities have additional challenges due to their growth, which requires frequent adjustments or replacements of their assistive products.

Barriers and facilitators to providing assistive technologies to children with disabilities in Afghanistan

WHITAKKER, Golnaz
WOOD, Gavin
February 2022

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Due to the impacts of the ongoing conflict, Afghanistan’s child population is at high risk of being born with or acquiring a primary or secondary disability. According to a recent estimate, up to 17 per cent of Afghanistan’s children live with some form of disability. Assistive technologies (AT) – the systems, services and products that enhance the functioning of people with impairments – are likely to be required by a large proportion of children with disabilities in Afghanistan. Afghanistan has signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which includes a commitment to provide AT equitably to all who need it. However, little action has been taken to meet this commitment, and there continues to be a vast gap between the need for AT and its provision. This work presents the landscape of AT provision, the barriers and facilitators to provision, and provides recommendations to begin to close the gap. 

Semi-structured interviews were conducted to build on the evidence in the literature, and to understand the factors affecting AT provision in Afghanistan

Safe Back to School: Guide for supporting inclusive and equitable learning for the most marginalised children

SAVE THE CHILDREN
September 2021

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This guide will support field level staff to ensure that all children have access to safe learning opportunities that meet their individual needs. It outlines the barriers to learning that the most marginalised have access to safe learning opportunities that meet their individual needs. It outlines the barriers to learning that the most marginalised and excluded groups of children face and recommends interventions to support their inclusion in remote learning and their return to school. The guide also recommends key resources to use when designing interventions for inclusive and equitable learning.

Sections are included on mild, moderate and severe disabilities. 

Right from the start: build inclusive societies through inclusive early childhood education

GLOBAL EDUCATION MONITORING REPORT TEAM
July 2021

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Early childhood education has the potential to expand opportunities for disadvantaged children, provided that programmes use inclusion as a guiding principle. While the international community has committed to inclusive education, countries vary in their efforts to extend this goal to early childhood. Universal access is the basis of inclusion, and countries must address barriers related to socio-economic status, ethnicity, gender, language, disability and remoteness. Cooperation among multiple actors to identify special needs early and provide integrated services is needed, as are inclusive curricula that support children’s socioemotional development and identity formation. Finally, educators must be given the knowledge, training, and support to implement inclusive practices and work with families from all backgrounds

 

Policy paper 46.

Inclusive education training guide

LEWIS, Ingrid
July 2021

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This package is designed to assist with the training of staff within CBM and its partners. It has been prepared with country and regional advisory staff in mind but will have value for project/ programme management and other staff too. It has been designed for use with small groups of participants (e.g., maximum 10-15).

This training package focuses on inclusive education. It interprets inclusive education in a broad sense as a dual process of bringing about education system change, at all levels of education, to the benefit of all learners; and supporting the needs of individual learners, especially those with disabilities. It is not a training about specific impairments, nor will it show participants how to identify, teach and support learners with specific impairments. Instead the package helps participants to understand better the overarching challenges being faced and the systematic programme and advocacy approaches that CBM, its partners and other similar organisations need to engage with.

 

This training package consists of the following booklets:

A Inclusive education and CBM

B Inclusive education and the community

C Participation and achievement for all learners

D Education system change

Preventing lifelong impairment: Access to clubfoot treatment in low and middle income countries

CLINTON HEALTH ACCESS INITIATIVE (CHAI)
July 2021

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Congenital talipes equinovarus (CTEV), commonly known as clubfoot is one of the most common congenital conditions, affecting 1 in 800 births. Left untreated, it can lead to life-long impairment, impacting participation in society, education, and employment. Most children with clubfoot can be successfully treated with the Ponseti method, a low-cost, cost-effective, and minimally invasive treatment protocol. Despite progress, less than 1 in 5 children born with clubfoot in low- and middle-income countries (LMICs) currently receive treatment.

Recommendations are made to increase this treatment rate.

Preventing lifelong impairment: Access to clubfoot treatment in low and middle income countries

CLINTON HEALTH ACCESS INITIATIVE (CHAI)
July 2021

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Congenital talipes equinovarus (CTEV), commonly known as clubfoot is one of the most common congenital conditions, affecting 1 in 800 births. Left untreated, it can lead to life-long impairment, impacting participation in society, education, and employment. Most children with clubfoot can be successfully treated with the Ponseti method, a low-cost, cost-effective, and minimally invasive treatment protocol. Despite progress, less than 1 in 5 children born with clubfoot in low- and middle-income countries (LMICs) currently receive treatment

Clubfoot services require coordination and leadership between different departments within health ministries. Both are often missing

 

Frequently Asked Questions: Questions you have about inclusive education but didn’t know whom to ask

INCLUSION INTERNATIONAL
June 2021

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Inclusion International is often asked what we mean by “inclusive education”. Here are the most common questions from our members together with our responses. The responses are based on the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and General Comment 4 issued by the UN CRPD committee, which outlines the implications of the CRPD for inclusive education.

Questions:

  • What is inclusive education?
  • What are the differences between exclusion, segregation, integration and inclusion?
  • What are the key ingredients of an inclusive education system?
  • What are some of the steps toward achieving inclusive education?
  • What is the difference between an inclusive education system, an inclusive school and inclusive classroom/practices?
  • What is meant by the “twin–track” approach to funding inclusive education?
  • What is the difference between accessibility and reasonable accommodation?
  • How can teachers provide equal opportunities for all students within their allocated classrooms?
  • Is transforming special schools into resource centres a good strategy for moving towards an inclusive system?
  • What is sometimes called “inclusive education” but is not?
  • What are the benefits of inclusive education for students with disabilities?
  • Is inclusive education good only for students with disabilities?
  • Is inclusive education more expensive than segregation?

Disability-inclusive child safeguarding guidelines

WATTERS, Lauren
ORSANDER, Martina
May 2021

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Able Child Africa and Save the Children partnered to create the first international Disability-inclusive child safeguarding guidelines. These guidelines provide advice on how to plan for disability-inclusive child safeguarding, with practical solutions for organisations and practitioners working across development and humanitarian sectors on how to include children with disabilities in each step of the process.

For ease of reading, mini-read versions of the guidelines have also been developed. Part 1 outlines practical guidance for organisations. Part 2 outlines practical guidance for practitioners. For a full glossary and resource list, please refer to the full guidelines.

A Swedish cultural adaptation of the participation questionnaire Functional Scale of the Disability Evaluation System – Child version

AXELSSON, Anna Karin
ULLENHAG, Anna
ÖDMAN, Pia
2021

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Purpose: The aim was to culturally validate a questionnaire about children’s/youth’s participation to be used in a Swedish context.


Methods: FUNDES-Child, based on the well-established CASP, was chosen. Questions about engagement and hindering factors were added to the existing questions about frequency and independence in 20 activity areas. Using a qualitative, explorative design, 16 interviews with children/youths/caregivers were made to explore opinions about the questionnaire. Follow-up interviews confirmed the result of the revised questionnaire. Qualitative content analysis was performed.

 

Results: The interviews provided support for the questionnaire’s relevance by being a tool to assess important aspects of participation, to gain insights into one’s own/the child’s participation, and to promote ideas about what causes the degree of participation. To achieve comprehensiveness, no activity area was found to be missing nor superfluous. However, some examples were needed to be modified where “parades” are unusual in Sweden and therefore removed, while “singing in choir” was added. In search for comprehensibility, opinions about the layout of the first version were raised and a varying degree of understanding of wording and concepts were found and thus taken into account. 

 

Conclusions: The questionnaire can be used for establishing meaningful goals and to potentially increase children’s participation.

How to talk to kids about disability inclusion

NANYENYA, Godfrey
April 2021

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Godfrey Nanyenya's work as a disability and inclusion specialist, involves community outreaches in the slum communities of Kampala engaging families raising children with disabilities in physiotherapy and inclusive home schooling. He encourages parents to talk to their children about disability as a normal topic. He suggests ways to approach the subject including: 

  • normalise disability
  • be mindful of language
  • keep it value neutral
  • don't shame them for their questions
  • say I don't know
  • point out similarities
  • make it a continuous conversation

Joint submission on promoting and protecting the human rights of women and girls in conflict and post-conflict situations

HUMAN RIGHTS WATCH
HUMANITY & INCLUSION
INTERNATIONAL DISABILITY ALLIANCE
WOMEN ENABLED INTERNATIONAL
WOMEN'S REFUGEE COMMISSION
April 2021

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Joint submission on promoting and protecting the human rights of women and girls in conflict and post-conflict situations on the occasion of the twentieth anniversary of Security Council resolution 1325 by Humanity & Inclusion, Human Rights Watch, International Disability Alliance, Women Enabled International and the Women’s Refugee Commission.

This submission sets out information and recommendations on promoting and protecting the human rights of women and girls with disabilities in conflict and post-conflict situations. Women and girls with disabilities are disproportionately impacted by armed conflicts, yet remain underreported and excluded from peace and security processes. Women and girls with disabilities account for nearly one-fifth of all women and girls worldwide and face multiple and intersecting forms of discrimination based on their gender, as well as their disability. Sustainable peace, recovery and inclusive humanitarian action requires the full, equal and meaningful participation of diverse women, including women and girls with disabilities. The Office of the High Commissioner on Human Rights, in its report, should request member states, the Human Rights Council and its mechanisms, as well as other stakeholders to ensure that monitoring and reporting on the experiences of women and girls in conflicts includes the specific experiences of women and girls with disabilities, and ensure their meaningful participation in conflict prevention, response, peacekeeping and peacebuilding.

Leave no girl with disabilities behind: Ensuring efforts to advance gender equality in education are disability-inclusive.

DIAMOND, Gloria
CASTRES, Pauline
April 2021

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This advocacy brief from the UN Girls’ Education Initiative (UNGEI) and Leonard Cheshire draws attention to the main barriers to education for girls with disabilities, in the context of major opportunities for advocacy and tangible change in 2021.  The recommendations outlined are targeted at world leaders, governments, ministries, UN agencies and NGOs. They offer a framework for rights-based action and principles towards gender-responsive and inclusive education, to ensure that no girls with disabilities are left behind. 

The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair

SOL, Marleen E
VERSCHUREN, Olaf
HOREMANS, Henricus
WESTERS, Paul
VISSER-MEILY, Johanna M A
DE GROOT, Janke F
Fit-for-the-Future Consortium
2021

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Purpose: To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exer- cise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. Methods: Youth using a manual wheelchair (n 1⁄4 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardio- respiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test.

 

Results: Multilevel model analysis showed significant positive effects for PA (p1⁄40.01), WMS (p<0.001), confidence in wheelchair mobility (p<0.001), aerobic (p<0.001), and anaerobic performance (p<0.001). Unpaired sample t-tests underscored these effects for PA (p<0.01) and WMS (p<0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility.

 

Conclusions: A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.

Family Planning for Women and Girls with Disabilities

Dr FRASER, Erika
CORBY, Nick
MEANEY-DAVIS, Jessie
2021

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This is an updated evidence review looking at the evidence on factors affecting access to and uptake of family planning for women and girls with disabilities in low- and middle-income countries and the evidence on good practice on increasing full free and informed contraceptive choice for women and girls with disabilities.

 

Query:

1) What is the evidence on factors affecting access to and uptake of family planning for women and girls with disabilities in low and middle income countries, highlighting examples from FP2020 commitment-making countries?

2) What is the evidence on good practice on increasing full free and informed contraceptive choice for women and girls with disabilities – from the same countries or elsewhere? 

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