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Sightsavers' approach to making health services inclusive for everyone

Sightsavers
April 2019

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Sightsavers has produced a new film that sets out our work to make health care services accessible and inclusive for everyone. It focuses on our programmes in Bhopal, India and Nampula, Mozambique. This highlights how we work and share learnings globally, but also shows how programmes can be made locally relevant by working with partners with direct experience.

The film showcases some of the people who work hard to make our inclusive health programmes a success, from Sightsavers experts and government health workers to leaders of disabled people’s organisations.

To find out more our inclusive health work and how we are developing best practice in terms of inclusive health programmes, visit our website: https://www.sightsavers.org/disability/health/

Disability and global health: Special issue of International Journal of Environmental Research and Public Health

KUPER, Hannah
POLAK, Sarah
Eds
2019

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Papers included in this special issue are:

 

Realisation of sustainable development goals by, for and with persons with disabilities: UN flagship report on disability and development 2018

UNITED NATIONS DEPARTMENT FOR ECONOMIC AND SOCIAL AFFAIRS (UNDESA)
December 2018

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This report represents the first UN systemwide effort to examine disability and the Sustainable Development Goals (SDGs) of the 2030 Agenda for Sustainable Development at the global level. The report reviews data, policies and programmes and identifies good practices; and uses the evidence it reviewed to outline recommended actions to promote the realization of the SDGs for persons with disabilities. Over 200 experts from UN agencies and International Financial Institutions, Member States and civil society, including research institutions and organizations of persons with disabilities, contributed to this report. The report covers new areas for which no global research was previously available, for example, the role of access to energy to enable persons with disabilities to use assistive technology. It also contains the first global compilation and analysis of internationally comparable data using the Washington Group on Disability Statistics short set of questions. Reviews of legislation from 193 UN Member States were conducted and analysed for this report to highlight good practices and to assess the current status of discriminatory laws on voting, election for office, right to marry and others

Shaping health systems to include people with disabilities. K4D emerging issues report

DEAN, Laura
et al
November 2018

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People with disabilities are at a heightened risk of communicable and non-communicable diseases and these diseases can cause debility and disability. Health needs of these people often extend beyond requiring continual longterm medical support to addressing broader social inequities. Key areas that are likely to be critical in re-orientating health systems from a biomedical approach towards inclusive health systems that are more responsive to the needs of people with debility and disability in low and middle-income countries (LMICs) are offered in this report and cover the following:

 

  • 1. Nothing about us without us: prioritising person-centred health systems
  • 2. Responding to issues of access in mainstreaming disability within health systems
  • 3. Ensuring the provision of specialised services
  • 4. Community based rehabilitation 
  • 5. Improving the collection and use of disability related data against modified legal and policy frameworks
  • 6. Partnerships are paramount
  • 7. Financing and social protection 

Case studies are provided from Sudan, India, Liberia, Uganda and Nigeria

Learning From Experience: Guidelines for locally sourced and cost-effective strategies for hygiene at home for people with high support needs.

World Vision/CBM Australia
May 2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HYGIENE AT HOME FOR PEOPLE WITH HIGH SUPPORT NEEDS
This document is one of two developed in the Jaffna District and describes strategies that used to assist households and individuals in hygiene tasks at home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka.

NOTE: The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

NOTE:
The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Disability, health and human development

MITRA, Sophie
2018

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This open access book introduces the human development model to define disability and map its links with health and wellbeing, based on Sen’s capability approach. The author uses panel survey data with internationally comparable questions on disability for Ethiopia, Malawi, Tanzania and Uganda. It presents evidence on the prevalence of disability and its strong and consistent association with multidimensional poverty, mortality, economic insecurity and deprivations in education, morbidity and employment. It shows that disability needs to be considered from multiple angles including aging, gender, health and poverty. Ultimately, this study makes a call for inclusion and prevention interventions as solutions to the deprivations associated with impairments and health conditions.

 

Chapters include:

  • The Human Development Model of Disability, Health and Wellbeing
  • Measurement, Data and Country Context
  • Prevalence of Functional Difficulties
  • Functional Difficulties and Inequalities Through a Static Lens
  • Dynamics of Functional Difficulties and Wellbeing
  • Main Results and Implications

 

Inclusion of marginalised Aboriginal and Torres Strait Islander peoples with neurocognitive disability in the National Disability Insurance Scheme (NDIS)

TOWNSEND, Clare
McINTYRE, Michelle
LAKHANI, Ali
WRIGHT, Courtney
WHITE, Paul
BISHARA, Jason
CULLEN, Jennifer
2018

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Given the ambiguity surrounding the extent and experience of neurocognitive disability (NCD) among marginalised Aboriginal and/or Torres Strait Islander peoples in Australia, evidence regarding the level and nature of NCD is crucial to ensure equitable access and inclusion into the National Disability Insurance Scheme (NDIS). This paper reports the results of the implementation of The Guddi Protocol (a culturally informed and appropriate screening protocol for Aboriginal and/or Torres Strait Islander peoples) at two locations in Queensland. Results indicated high levels of NCD, and additional qualitative data revealed a number of factors associated with the complex disablement of study participants, namely: i) intergenerational trauma; ii) a social context of disadvantage, marginalisation and exclusion; and iii) the nonidentification of disability. The results are linked to implications for NDIS inclusion for this population, and recommendations are made. Unless the extent and nature of complex disability and the issues surrounding culturally safe policy, and service design and engagement are addressed with and by Aboriginal and Torres Strait Islander peoples, including those who experience complex disablement, marginalised people will continue to be effectively excluded from the NDIS.

 

Disability and the Global South, 2018, Vol.5, No. 2, 1531-1552

Disability Inclusive Health Technical Advisory Group established by Core Group

2018

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In 2018, CORE Group prioritised a Disability Inclusive Health agenda and established the Disability Inclusive Health Technical Advisory Group (TAG), based on requests from the global practitioner community, to address gaps in disability inclusivity in health programming and advocacy. The Disability Inclusive Health Technical Advisory Group is open to all CORE Group members and associates, as well as non-members.

 

CORE Group’s Interest Groups are convened based on need. The Interest Groups are: Disability Inclusive Health Technical Advisory Group; Humanitarian-Development Task Force; and Noncommunicable Diseases Interest Group.

Policy development: An analysis of disability inclusion in a selection of African Union policies

GROCE, Nora
LANG, Raymond
SCHNEIDER, Marguerite
KETT, Maria
COLE, Ellie
July 2017

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Contemporary debates in international development discourse are concerned with the non‐tokenistic inclusion and participation of marginalized groups in the policy‐making process in developing countries. This is directly relevant to disabled people in Africa, which is the focus of this article. The United Nations Convention on the Rights of Persons with Disabilities delineates the principles of inclusion in society. Furthermore, the African Union (AU) plays a key role in advising its Member States about disability issues, and this advice should be reflected in disability‐inclusive policies. This article analyses nine policy or strategy documents produced by the AU, covering the policy domains of education, health, employment and social protection that are crucial to the inclusion of disabled people in international development. These were analysed according to seven discrete elements (rights, accessibility, inclusivity, implementation plans, budgetary allocations, enforcement mechanisms or disaggregated management information systems) using a rating scale of one to four, with four being the highest level of inclusion. The process (for example, level of consultation), the context (for example, the Sustainable Development Goals) and actors involved in the policy development were reviewed as far as was possible from the documents.

Dev Policy Rev. July 2017
https://doi.org/10.1111/dpr.12323

Progress Report on the implementation of the European Disability Strategy (2010-2020)

EUROPEAN COMMISSION
February 2017

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The Strategy is the main instrument to support the EU's implementation of the UN Convention on the Rights of Persons with Disabilities (UNCRPD). Progress in all eight areas of the strategy is reported: accessibility, participation, equality, employment, education and training, social protection, health and external action. Initiatives such as the Directive on Web Accessibility, the proposal for a European Accessibility Act, the EU Disability Card project (being piloted in 8 Member States) and provisions in the Erasmus+ programme (allowing better mobility for students with disabilities) are highlighted. 

 

This report presents progress achieved in the first five years of the Strategy and assesses implementation. Many stakeholders have contributed to this work. The United Nations reviewed how the EU has been implementing its obligations under the UNCRPD3, and issued Concluding Observations with concrete recommendations for follow-up. These contain guidance on priority issues while also highlighting the steps already taken (see Annex 3). The European Parliament and the European Economic and Social Committee subsequently prepared their own reports on the implementation of the UNCRPD, while civil society organisations provided analysis and proposals (see Annex 4). The Commission also launched a public consultation to collect views from a broad range of stakeholders on the current situation of persons with disabilities and the impact of the Strategy so far, gathering more than 1,500 contributions (see Annex 1). This report also looks at the role of the supporting instruments and at the implementation of the UNCRPD within the EU institutions. Finally, it looks ahead at how the Strategy will continue to deliver on its objectives. In addition, the report includes a comprehensive and up-to-date overview of EU legal acts with an impact on disability matters (Annex 5)

 

SWD(2017) 29 final

The economic costs of exclusion and gains of inclusion of people with disabilities : evidence from low and middle income countries

BANKS, Lena Morgon
POLACK, Sarah
2015

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This report, formed of two parts, provides robust empirical basis to support the theorized disability-poverty link. The first section presents a systematic review of the literature on the relationship between disability and economic poverty. The second section explores the economic consequences of the exclusion and inclusion of people with disabilities in the areas of education, employment and health. The key pathways through which these economic costs may arise are discussed and studies that have attempted to quantify the financial impacts are reviewed

World report on ageing and health

WORLD HEALTH ORGANIZATION (WHO)
2015

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This report lays out framework for the development of new strategies to bring the right programmes, information, and services to an ageing international community. The report focuses on policy development, healthy ageing and health in old age, health systems and long – term care systems.  The report concludes by presenting a series of recommended next steps to realising the vision of a world that is more friendly to an ageing population

Youth with disabilities

GROCE, Nora
KETT, Maria
April 2014

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Of all groups of youth, the group about which we know the least are youth with disabilities. In transition between childhood and adulthood, these are the years when all young people go through physical and psychological maturation, are expected to complete their education, acquire skills and assume a social identity that will enable them to fully participate in their communities and societies. This working paper discusses the issues faced by young people with disabilities and what is known and not known about this distinct age group

Working Paper 23

 

Spinal cord injury

WORLD HEALTH ORGANIZATION (WHO)
November 2013

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WHO factsheet on spinal cord Injury (SCI) presents key facts related to spinal cord injury (SCI).  It includes the following details: background information; prevalence; demographic trends; mortality; the health, economic and social consequences of SCI; prevention; improving care and overcoming barriers; and WHO response

Fact sheet N°384

Sustaining human development : addressing NCDs and disability across the lifecourse

THE NCD ALLIANCE
et al
2013

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This report explores three interconnected global trends — a growing burden of non-communicable diseases (NCDs), the rising prevalence of disability, and changing global population demographics (including rapidly ageing populations). The report highlights that there issues were collectively neglected as policy priorities during the era of the Millennium Development Goals (MDGs). It stresses that the unique opportunity to ensure a future framework that fully integrates NCDs, that goals and targets drive progress for all people including persons with disabilities, and that a lifecourse and rights-based approach underpins all goals and targets to ensure no one is left behind

Mainstreaming disability in disaster management : a toolkit

HANS, Asha
et al
2012

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The toolkit promotes an understanding of the main issues and concerns from the perspective of people with disabilities in the context of disasters and provides an understanding for integration and mainstreaming. The comprehensive toolkit provides a step by step approach for the inclusion of disability in disaster management. 

  • It provides the user with a resource to help plan in mainstreaming disability in disaster management
  • A guidance note, which summarizes the mainstreaming needs and enables users to understand them from the perspective of a Person with Disability.
  • A guidance on the most appropriate methodology to be adopted for including disability in the disaster management process, to monitor and evaluate it; a good practice scenario and a road map.
  • A checklist for use and FAQs are provided in the last section. Section wise essential readings and a reference, which refers specifically to the issue, has been provided to give the background and deeper understanding. Most of these are accessible through the Internet. At the end of the document additional references are provided. This section refers to the most important writings, handbooks and guidelines available. As very few resources have been developed on the subject, generic material has been included

​This toolkit is intended for use by policy makers, government officials, members of Panchayati Raj Institutions, non-government organisations, disabled peoples organisations and disaster management practitioners

Personalised social support : thoughts, method and tools in an approach of proximity social services

RELANDEAU, Audrey
et al
May 2010

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This paper is a methodological guide to personalised social support to enhance understanding, thinking about and practising this approach to social work. It is targeted at field workers and public services’ or association advisers responsible for receiving, informing, guiding and supporting people with disabilities and other vulnerable groups.
This guide is divided into three sections. First, a "principles and benchmarks" section explores the theoretical aspects of social work, development and personalised social support. This section is followed by a "Practical guide" targeted at social workers, facilitators and advisers responsible for providing support and provides an in-depth guide to implementing personalised social support, based on various intervention techniques and practical tools. This section also offers a section devoted to project managers or social mecha¬nism coordinators, featuring benchmarks for the development and follow-up of a social support service. The third section features a "Toolbox" consisting mainly of tools sourced from Handicap International programmes

Towards well-being for Afghans with disability : the health challenge

BAKHSHI, Parul
TRANI, Jean-Francois
2006

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This report is part of the National Disability Survey in Afghanistan. It aims to identify the number of Afghans with a disability, the barriers they face, and their access to rehabilitation services and other health provision. This report is inclusive of the needs of people with psycho-social disabilities and represents the first steps toward developing a systemic approach to health and disability provision in Afghanistan

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