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Evidence and gap map of studies assessing the effectiveness of interventions for people with disabilities in low‐and middle‐income countries

SARAN, Ashrita
WHITE, Howard
KUPER, Hannah
January 2020

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The aim of this Evidence Gap Map (EGM) is to identify, map and describe existing evidence of effectiveness studies and highlight gaps in evidence base for people with disabilities in LMICs. The map helps identify priority evidence gaps for systematic reviews and impact evaluations. The EGM included impact evaluation and systematic reviews assessing the effect of interventions for people with disabilities and their families/carers. These interventions were categorized across the five components of community‐based rehabilitation matrix; health, education, livelihood, social and empowerment. Included studies were published from 2000 onwards until January 2018. The map includes 166 studies, of which 59 are systematic reviews and 107 impact evaluation

 

Campbell Systematic Reviews, vol.16, no.1, Mar 2020

DOI: 10.1002/cl2.1070

Disability inclusion helpdesk; evidence digest issue 2, December 2019

SDDirect
November 2019

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Produced by the Disability Inclusion Helpdesk. A summary of the latest evidence on disability inclusion in international development from programmes and researchers around the world are highlighted:

·         Access to health: the missing billion

·         Sexuality and disability for children and youth in China

·         Analysing INGO practice 

·         Disability and technology

·         Disability and inequality in Liberia 

·         Pregnancy, childbirth and motherhood in Nepal 

·         Violence against women and girls with disability in Nepal

 

Brief overviews are provided of policy and news from the UK, various UN organisations, Asia Pacific Social Protection Week and South Africa

 

Brief updates of DFID's (UK Departments for International Development) funded programmes are given including: Disability Inclusive Development (DID) Programme; Inclusion Works; The Disability Catalyst Programme; Programme for Evidence to Inform Disability Action (PENDA), Innovating Pathways for Employment Inclusion (IPEI)

India’s disability estimates: Limitations and way forward

RAKHI, Dandona
et al
September 2019

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With India preparing for the next decennial Census in 2021, disability estimates and data collection methodology between the Census 2011 and the most recent population-level survey for India and its states were compared, to highlight the issues to be addressed to improve robustness of the disability estimates in the upcoming Census.

 

Data from the Census 2011 and from two complementary nationally representative household surveys that covered all Indian states with the same methodology and survey instruments–the District-Level Household Survey-4 (DLHS-4, 2012–2013) and the Annual Health Surveys (AHS three rounds, 2010–11, 2011–12 and 2012–13) were used. Data from DLHS-4 and AHS 2012–13 round were pooled to generate estimates for the year 2012–13. Data collection methodology between the sources was compared, including the review of definitions of each type of disability. The overall, mental, visual, hearing, speech, and movement disability rate (DR) per 100,000 population were compared between the sources for India and for each state, and the percent difference in the respective rates was calculated
 

Global Disability Summit: One Year On – accountability report 2019

EQUAL INTERNATIONAL
September 2019

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This first accountability report, one year on from the Global Disability Summit 2018, presents independent analysis of the 171 sets of commitments made by governments and organisations at the Summit. It also sets out the results of a self-reporting survey completed by Summit participants, updating on progress made against their commitments so far.

 

The wider impact of the summit is discussed.

 

The results of the first GDS18 self-reporting survey demonstrate that significant progress has been made on implementation of the 968 Summit commitments. Work is reported to be underway on 74% of the commitments and 10% are reported as already completed, contributing towards an improved and increased visibility of disability inclusion within development and humanitarian action.

 

Appendix 2 gives country level case studies: Case study developed by Users and Survivors of Psychiatry Kenya; Case Study developed by the National Federation of the Disabled Nepal (NFDN); and Case Study developed by I Am a Human, Jordan

 

Making it count: The power of youth advocates in the disability movement

WILM, Suzanne
LEONARD CHESHIRE
HANKS, Phil
May 2019

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The 2030 and Counting pilot project sought to give youth with disabilities a seat at the table on the SDGs – providing them with the tools and confidence they need to become their own agents of change. This report provides an overview of the project, together with learnings and recommendations for the future.

In its pilot year, 2030 and Counting brought together young women and men with disabilities and DPOs from Kenya, the Philippines and Zambia to report on and advocate for their rights through the framework of the SDGs

The project had three consecutive phases: Training, Story gathering (data collection) and Influencing. 

In total, 332 reports were collected between June and September 2018. The highest number of reports were submitted under the theme of Education (44%), followed by Work (33%), and Health (14%). The category of Other, which almost entirely focused on discrimination in daily life, accounted for 8%. 80% of reporters had smartphones, offering the potential to increase the use of this feature in future.
 

Using the Washington Group Questions in humanitarian action (learning toolkit on disability data collection)

January 2019

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Humanity & Inclusion has created a learning toolkit to improve the collection of quality data on persons with disabilities and improve its use by humanitarian organisations.

 

Until now, existing guidance on the Washington Group Questions (WGQs) has been specific to national data collection efforts on persons with disabilities. To address the lack of guidance for humanitarian actors, Humanity & Inclusion (HI) is launching a learning toolkit on collecting data in humanitarian action, which includes an e-learning, a training pack for enumerators and various supporting resources that can all be found on the HI website.

 

Gathering evidence on the use of the WGQs in humanitarian action:

To respond to the need to collect, analyse and use data on persons with disabilities in humanitarian action, HI has been implementing a project, funded by the UK Department for International Development, to test and assess the use of the WGQs in humanitarian action. An action-research was carried out with over 30 humanitarian partners in Jordan, the Democratic Republic of Congo and the Philippines, with the evidence used to develop learning materials.

 

Development of a learning toolkit for humanitarian actors:

In addition to the findings of the action-research, HI gathered inputs from over 30 humanitarian organisations working in 22 countries to inform the design of the learning toolkit. Specific focus was given to the development of open source materials that would be accessible with screen readers, on mobile phones, and in hard to reach locations. The content was then informed by selected subject matter experts in inclusive humanitarian action and data collection.

 

What is included in the toolkit?

An e-learning on Collecting Data for the Inclusion of Persons with Disabilities in Humanitarian Action – The Application of the WGQs providing an entry point for humanitarian actors who would like to understand how to plan for and use the WGQs.

A Training Pack for enumerators giving guidance, session plans and activities to deliver training on using the WGQs (developed in collaboration with RedR UK).

Supporting resources providing practical guidance on the application of the WGQs in humanitarian contexts.

 

Who is this for?

The toolkit is tailored to a full range of humanitarian actors who would like to understand how to use the WGQs in their own work and organisations. The content has also been designed to provide technical guidance for programme and technical staff: with a practical focus on different topics relevant for the use of the WGQs –from the human rights based approach that underpins them, to their planning, use and the analysis of the data produced.

 

Where is the Toolkit available?

The e-learning is available now on disasterready.com and on Kayaconnect.org (accessible for mobile phones and tablets). Organisations interested in hosting the e-learning are welcome to contact the project team members. Toolkit resources and more information about the project are available for download in the project webpage.

Expectations management; employer perspectives on opportunities for improved employment of persons with mental disabilities in Kenya

EBUENYI, Ikenna, D
et al
January 2019

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In Kenya, the employment rate for persons with disabilities is about 1% compared to 73.8% for the general population, and the situation is even worse for persons with mental disabilities. Persons with mental disabilities are often regarded as “mad”, and stand little or no chance of employment. An exploratory study was undertaken with employers and potential employers to understand factors that hinder or facilitate their employment and to gain insight into employers’ perceptions of mental disability.

A mixed method study design was adopted, including in-depth interviews (n = 10) and questionnaires (n = 158) with (potential) employers in Kenya to explore the barriers and facilitators of employment for persons with mental disabilities

 

Disability and Rehabilitation, https://doi.org/10.1080/09638288.2018.1534006

 

More at risk: how older people are excluded in humanitarian data

TANYANG, Gaynor
VENTURES, Lumina
2019

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This report evaluates existing policies and practices on how older people have been excluded from data in disaster preparedness and humanitarian responses in Bangladesh, India, Nepal, Pakistan, Sri Lanka, Cambodia, Indonesia, Myanmar, the Philippines, Thailand and Vietnam.

In order to evaluate existing policies and practices in the collection of inclusion data, the research employed two main methods: a review of documents and a survey. The review of documents was conducted in three stages: a global literature review, followed by a policy review and a practice review. The survey analysed the responses of 72 respondents from 10 countries .

Rating early child development outcome measurement tools for routine health programme use

BOGGS, Dorothy
et al
January 2019

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Background identification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). ECD measurement tools were systematically assessed for accuracy and feasibility for use in routine services in low income and middle-income countries (LMIC).

Building on World Bank and peer-reviewed literature reviews, available ECD measurement tools for children aged 0–3 years used in ≥1 LMIC were identified and matrixed according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering ≥3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations

Community-Based Rehabilitation programming for sex(uality), sexual abuse prevention, and sexual and reproductive health: A scoping review

SCHINDELER, Tamara Lee
ALDERSEY, Heather
2019

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This scoping review explored the literature to understand how CBR programming has supported sex(uality), sexual abuse prevention, and SRH for people with disabilities. Relevant studies were identified in the academic and grey literature. This included six databases, the WHO website, and five Regional CBR Network websites. Relevant studies were selected using criteria and data was charted to examine the quantity, variation, and nature of CBR interventions. Fifteen studies were identified. The majority were implemented in Africa; targeted all people with disabilities, regardless of gender, age, or type of disability; and frequently focussed on the topic of HIV/AIDS.  The interventions were most commonly designed to educate people with disabilities on issues of sex(uality), sexual abuse prevention, or SRH.

 

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

Disability data collection: A summary review of the use of the Washington Group Questions by development and humanitarian actors

QUIGLEY, Nolan
et al
October 2018

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The Washington Group Questions on Disability are rapidly emerging as the preferred data collection methodology by the global community for national data collection efforts on disability. However, more and more development and humanitarian actors are now using the methodology in their own data collection efforts. This is beyond the original purpose of the questions, which was to generate usable data for governments. Leonard Cheshire and Humanity & Inclusion, two international charities focussed on disability and inclusion, have worked together to share learnings of recent research studies. These studies aim to understand how the Washington Group Questions (WGQ) have been used by development and humanitarian actors and the impact of using the methodology. This summary report outlines the key findings, analysis and conclusions about the application of the Washington Group Questions in a range of contexts. The report concludes with a number of recommendations for different stakeholders.

Disability and climate resilience research project

KETT, Maria
COLE, Ellie
August 2018

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This 14-month exploratory research project aimed to increase the understanding of the links between disability and climate resilience, and in turn to support the delivery of policy and programme work that builds the resilience of people with disabilities to climate shocks and stresses. 

 

The research comprises: an extensive literature review to identify the current evidence and gaps; a global online survey to identify current practices being implemented in the field around climate change and climate-related disasters, and the extent to which disability issues are addressed in programming; policy analyses, complemented by key informant interviews with policymakers and practitioners; and focus group discussions with people with disabilities in climate-impacted areas of Bangladesh and Kenya. This report synthesises the results of the desk- and field-based research, and outlines implications of the findings for policy and programming and identifies recommendations for further action. It is hoped that the findings highlighted in this report can be extrapolated to develop more disabilityinclusive practice and will also be applicable for other contextually marginalised people

Including children with disabilities in preschool education. Experiences of Plan International Mozambique

PLAN INTERNATIONAL
August 2018

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Between 2015 and 2017, Plan International Mozambique worked together with communities supporting 106 preschools in rural Mozambique. In late 2016, an approach was piloted in 18 community-based preschools to support them to be disability-inclusive. The overall goal was to increase the number of children with disabilities enrolled in Early Childhood Care and Education (ECCE) centres delivering quality early learning opportunities. The pilot took place over a 12 month period. Summarised findings about the current status of inclusion in preschool programmes run by Plan International Mozambique, case studies and lessons learned about the inclusion of children with disabilities in these programmes are provided.  

 

They describe five aspects that need to be considered to remove barriers and ensure that children with disabilities can access and benefit from early childhood education:

1. Work directly with the parents of children with disabilities

2. Address individual physical and medical needs of children with disabilities

3. Build the skills and confidence of caretakers

4. Equip and build a strong implementing team

5. Build evidence on what is happening and what (doesn’t) work

Measuring disability using the Washington Group questions

August 2018

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The Washington Group was set up by the United Nations Statistical Commission. It works with countries to produce better information about people with disabilities. The Washington Group has developed useful questions for countries to use to help find out whether a person has a disability, and to help collect data and information on what the differences are between people with disabilities and people without disabilities.

Women with disabilities, HIV and sexual violence: Data tell us they are still left behind

HUMANITY & INCLUSION (HI)
July 2018

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This leaflet intends to underline the existence of intersectional factors of vulnerability amongst Women with Disabilities with respect to HIV/AIDS and sexual violence in Burkina Faso and Guinea Bissau. The figures presented here are taken from two studies carried out in Burkina Faso and Guinea Bissau in 2017. In Burkina Faso, 28,667 people were interviewed in total, among whom 978 identified themselves as persons with disabilities (using the Washington Group Short Set of Questions). For the biobehavioral study in Guinea Bissau, 17,110 people were interviewed in total, among whom 1,147 identified themselves as persons with disabilities

Exploring the links between water, sanitation and hygiene and disability; Results from a case-control study in Guatemala

KUPER, Hannah
et al
June 2018

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A case-control study was conducted, nested within a national survey. The study included 707 people with disabilities, and 465 age- and sex-matched controls without disabilities. Participants reported on WASH access at the household and individual level. A sub-set of 121 cases and 104 controls completed a newly designed, in-depth WASH questionnaire.

Monitoring employment rights of people with disabilities in Kathmandu, Nepal, Holistic report 2018

PRASAI, Sagar
PANT, Aashish
June 2018

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This report presents the results of a monitoring project on the employment situation of persons with disabilities in Nepal. The report is one step toward a comprehensive evaluation of Nepal’s constitutional, legal and policy framework. Findings scrutinise the country’s implementation of laws and policies based on the daily life experiences of persons with disabilities. These experiences are used to assess the level of rights violations, the reasons behind those violations, and possible solutions. This holistic report offers an in-depth analysis of the life circumstances for persons with disabilities, with a specific focus on employment. The analysis has been conducted in relation to fundamental human rights principles of dignity, autonomy, participation, inclusion and accessibility, non-discrimination and equality and respect for difference. The report highlights the degree of implementation of the constitution, laws, policies and programs, enacted to protect and advance the human rights, and specifically the employment rights, of persons with disabilities. The report also highlights the experiences of persons with disabilities with reflection of societal attitudes. 

This study is part of a larger initiative called the DRPI AWARE (Asian Workplace Approach that Respects Equality) project. In each of the three monitoring sites (Hyderabad, Dhaka, Kathmandu), monitors used an interview and focus group guide to capture a specialized data set and analyze violations of the right to work and employment.

World Health Organization global disability action plan: The Mongolian perspective

KHAN, Fary
et al
April 2018

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The aim of this literature review and research was to provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO) Global Disability Action Plan (GDAP). A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n=77) from medical rehabilitation facilities (urban/rural, public/private) and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement) identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives

 

Journal of Rehabilitation Medicine, Volume 50, Number 4, April 2018, pp. 358-366(9)

https://doi.org/10.2340/16501977-2207
 

Education and disability: Analysis of data from 49 countries

UNESCO
March 2018

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Persons with a disability are among the population groups most likely to suffer from exclusion from education but data that permit an analysis of the links between disability and education remain scarce. This paper examines educational disparities linked to disability based on data from 49 countries and territories for five education indicators:

● Proportion of 15- to 29-year-olds who ever attended school

● Out-of-school rate (primary school age, lower secondary school age)

● Completion rate (primary education, lower secondary education)

● Mean years of schooling of the population 25 years and older

● Adult literacy rate (population 15 years and older)

 

The education indicators were calculated with data from three sources, collected between 2005 and 2015: Demographic and Health Surveys (DHS) sponsored by USAID, School-to-Work Transition Surveys (SWTS) by ILO, and population census data compiled by IPUMS-International. Comparability of the data across countries is limited because only some of the surveys and censuses used questions developed by the Washington Group on Disability Statistics to identify persons with a disability. The accuracy of the indicator estimates is also affected by sampling and non-sampling errors in the data, the small sample size of many of the surveys that were analysed, and the relatively small proportion of persons with disabilities in each country’s population. Moreover, because of the scarcity of national data, it is currently not possible to generate statistics on the status of persons with disabilities with regard to education that are regionally or globally representative.

Information Paper No.49

 

Education, work, and motherhood in low and middle income countries: A review of equality challenges and opportunities for women with disabilities

TEFERA, Belaynesh
et al
March 2018

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This systematic review examined the equality challenges and opportunities for women with disabilities in low- and middle-income countries (LMICs) to participate and succeed in education, employment, and motherhood. The search of Web of Science, PsychINFO, Google Scholar, and MEDLINE databases yielded 24 articles, which were subsequently passed through open, axial, and selective coding. The resulting review found that women with disabilities in LMICs have severe difficulty participating and succeeding in education, employment, and motherhood. 

 

Social Inclusion, Vol 6, No 1, 82–93

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