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Unmet needs and use of assistive products in two districts of Bangladesh: Findings from a household survey

PRYOR, Wesley
NGUYEN, Liem
ISLAM, Qumrun Naher
JALAL, Faruk, Ahmed
MANJULA, Marella
December 2018

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Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs and unmet needs for AP, and current access patterns in Bangladesh. The ATA-N was incorporated in a Rapid Assessment of Disability (RAD), a population-based survey to estimate prevalence and correlates of disability. In each of two unions of Kurigram and Narsingdi districts, 60 clusters of 50 people each aged two years and older were selected using a two-staged cluster random sampling process, of whom, 4250 (59% Female; 41% Male) were adults, including 333 using AP. We estimate 7.1% of the studied population used any AP. AP use is positively associated with age and self-reported functional difficulty. The proportion of people using AP is higher for mobility than for sensory and cognitive difficulties. Of all people with any functional difficulty, 71% self-reported an unmet need for AP. Most products were home or self-made, at low cost, but provided benefits. Needs and unmet needs for AP are high, especially for people with greater functional difficulties. Assessing unmet needs for AP revealed important barriers to scale that can inform policy and practice.

Int. J. Environ. Res. Public Health 2018, 15(12), 2901;
doi:10.3390/ijerph15122901

Minimum standards for protection, gender and inclusion in emergencies

INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESCENT SOCIETIES (IFRC)
November 2018

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The International Federation of Red Cross and Red Crescent Societies (IFRC) Minimum standards for protection, gender and inclusion in emergencies (2018) is in its second edition. The first pilot version of the IFRC Minimum standard commitments to gender and diversity in emergency programming was published in 2015. The pilot version has been tested globally by Red Cross and Red Crescent staff, volunteers and management in low-, medium- and high-scale disasters and humanitarian crises. This edition is the result of three years of testing, revision and feedback from protection, gender and inclusion (PGI) and sectoral specialists. New chapters, such as cash-based interventions, have been added as well as a stronger focus on sexual and gender-based violence and disability inclusion to align with the commitments of the IFRC and its member National Societies. This edition is accompanied by the IFRC Protection, gender and inclusion in emergencies toolkit (2018–2019).

This guidance presents Red Cross and Red Crescent staff, members and volunteers with a set of minimum standards for protection, gender and inclusion (PGI) in emergencies. It aims to ensure that the emergency programming of the International Federation of Red Cross and Red Crescent Societies (IFRC) and National Societies provides dignity, access, participation and safety for all people affected by disasters and crises.

It provides practical guidance on how to mainstream these four principles in all sectors, based on a consideration of gender, age, disability and other diversity factors. This includes limiting people’s exposure to the risks of violence and abuse and ensuring that emergency programmes “do no harm”.

The standards address protection, gender and inclusion concerns by providing practical ways to engage with all members of the community, respond to their differing needs and draw on their capacities in the most non-discriminatory and effective way. This helps to ensure that local perspectives guide assistance delivery. The standards also support incorporation of the seven Fundamental Principles of the International Red Cross and Red Crescent Movement.

Global Disability Summit 2018 - Summary of commitments

August 2018

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The key objective of the Global Disability Summit was to deliver ambitious new global and national level commitments on disability inclusion. National governments and other organisations made 170 sets of commitments around the four central themes of the Summit (ensuring dignity and respect for all, inclusive education, routes to economic empowerment and harnessing technology and innovation), as well as the two cross-cutting themes (women and girls with disabilities and conflict and humanitarian contexts), and data disaggregation.

 

Commitments made can be viewed in full on: https://www.gov.uk/government/collections/global-disability-summit-commitments

 

Global Disability Summit - commitments

August 2018

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A major outcome of the Global Disability Summit, July 2018, was the commitments of a large number of organisations to achieve the rights of people with disabilities in developing countires.

The commitments of each organisation are provided in the same format and are categorised by summit theme:

  1. Dignity and respect for all
  2. Inclusive Education
  3. Economic Empowerment
  4. Harnessing Technology and Innovation

Organisations making commitments are grouped in the following categories:

  • National Governments
  • Multilateral organisations
  • Private Sector organisations
  • Foundations
  • Civil society organisations
  • Research organisations
  • Other organisations

 

Access to assistive products in Kurigram and Narsingdi, Bangladesh. Policy brief 2.

HUMANITY & INCLUSION BANGLADESH
et al
August 2018

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This ‘policy brief’ outlines findings on Assistive technology and Products (AP) needs, unmet needs and access patterns arising the Rapid Assessment of Disability (RAD) study conducted in 2016 and 2017, in partnership between the Bangladesh Bureau of Statistics (BBS) and Humanity & Inclusion (HI) Bangladesh, with technical oversight from the Nossal Institute for Global Health, University of Melbourne, Australia. The study was part of the HI project: Towards Global Health: Strengthening the Rehabilitation Sector through Civil Society funded by the European Union. Findings from the 4254 adults surveyed in the two districts are reported here.

 

The purpose of this component of the RAD study was to learn about the usage of AP, characteristics of AP users, barriers to use of AP, unmet and met needs of AP, and to highlight major policy implications for AP service provision, in two target areas of Kurigram and Narsingdi. The survey includes an adapted version of Washington Group (WG) ‘short set’ of Disability Questions. A modified version of the WHO’s draft Assistive Technology Assessment Tool (needs module) – or the ‘ATA-needs’, was also implemented. Findings from this study also helped modify and improve the draft ATA-needs tool

The disability data portal

July 2018

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The Disability Data Portal provides a snapshot of the data globally available on people with disabilities in 40 countries. The portal also identifies where there are gaps in the current body of data. 

The portal was designed for the Global Disability Summit, held on 24 July 2018, and focusses on data relating to four thematic areas: inclusive education, stigma and discrimination, technology and innovation, and economic empowerment. 

The portal presents key development indicators relevant to the Summit themes, mostly drawn from the Sustainable Development Goals (SDGs), along with others relevant to the UN Convention on the Rights of Persons with Disabilities (CRPD)

Bridging the Gap: Examining disability and development in four African countries. The case for equitable education

GROCE, Nora
et al
June 2018

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Over the course of a three-year project the Leonard Cheshire Research Centre worked with research teams in four countries: Kenya, Sierra Leone, Uganda and Zambia to better understand the relationship between disability and development in each country across four domains: education, health, labour markets and social protection. This mixed methods research used a range of interrelated components, including policy and secondary data analysis, a household survey of 4,839 households (13,597 adults and 10,756 children), 55 focus group discussions and 112 key informant interviews across the four countries. 

 

This report explores key findings in relation to education. Key findings discussed include school attendance, cost of education, inability to learn and gap in educational attainment.

Disability inclusion and accountability framework

McCLAIN-NHLAPO, Charlotte
et al
June 2018

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The main objective of the Disability Inclusion and Accountability Framework is to support the mainstreaming of disability in World Bank activities. It lays out a road map for (a) including disability in the Bank's policies, operations and analytical work, and (b) building internal capacity for supporting clients in implementing disability-inclusive development programs. The primary target audience of the Framework is Bank staff but it is also relevant to the Bank's client countries, development partners and persons with disabilities. The framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities: nondiscrimination and equality, accessibility, inclusion and participation, and partnership and collaboration. 

 

The appendices to this framework highlight key areas in which the Bank can have a significant impact on the inclusion, empowerment, and full participation of persons with disabilities. These areas include transport, urban development, disaster risk management, education, social protection, jobs and employment, information and communication technology, water sector operations, and health care. 


Report No. 126977
 

Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

Inclusive service delivery for persons with disabilities in Mongolia

MAMUTKULOV, Raushenbek
ASIAN DEVELOPMENT BANK (ADB)
2018

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The Ensuring Inclusiveness and Service Delivery for Persons with Disabilities (PWDs) project in Mongolia aims to ensure access to improved services, employment opportunities, and more support through social welfare reform for PWDs.

Estimates of disability prevalence in Mongolia tend to be underreported, especially among older people, girls, and women, thus leaving a substantial number of persons with disabilities (PWDs) without the necessary services and protection. Early identification of disability is inadequate and current disability assessments follow an outdated, narrow medical approach. Many people perceive PWDs to be incapable of living independently and a burden to society.

A brief overview is given of a project aiming to ensure access to services and employment for PWDs to increase their autonomy and contribution to the economy and society in general.

(ADB Brief, Social Protection Brief, No.91)

The case for investment in accessible and inclusive WASH

PRYOR, Wesley
et al
April 2018

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Using current evidence and testimony from more than 60 WASH experts in 30 countries, this technical paper highlights evidence to argue that accessible and inclusive WASH is achievable at low cost, by using universal design, community-driven change, and existing knowledge, expertise and methods. The paper provides starting points to understand the impact of and case for accessible and inclusive WASH.

Assistive technologies in developing countries

ROHWERDER, Brigitte
March 2018

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This rapid review looks at examples of existing literature on the availability of assistive technologies and efforts to make these technologies more affordable and accessible in developing countries. Needs and access to assistive technologies are overviewed. The discussion of market characteristics of assistive technologies covers availability, affordability, quality, appropriate design, and awareness and demand.  Efforts to increase the affordability and accessibility of assistive technology are discussed covering: The Global Cooperation on Assistive Technology (GATE); the WHO Priority Assistive Products List; and EYElliance and eye health initiatives. Market shaping and community based approaches are discussed in this context.

 

This is a K4D helpdesk report. This report was commissioned by the UK Department for International Development (DFID)

Disability and inclusive education - A stocktake of education sector plans and GPE-funded grants

BANHAM, Louise
PAPAKOSTI, Elena
et al
March 2018

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This report was commissioned by the Global Partnership for Education’s Secretariat to take stock of how disability and inclusive education are included in education sector plans in 51 countries, including GPE-funded programs, such as education sector program implementation grants, program documents, implementation progress reports education sector analysis, if applicable, and other relevant GPE program documents.

This report documents progress and highlights the need to step up support to GPE partner countries on disability and inclusive education, to improve consideration of issues around disability and inclusion in education sector analysis and sector planning processes to better promote the achievement of GPE 2020 strategic goal 2, and to fulfill the transformative vision of Agenda 2030

Standard school eye health guidelines for low and middle-income countries

GILBERT, Clare
MINTO, Hasan
MORJARIA, Priya
KHAN, Imran
February 2018

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The purpose of these best practice guidelines is to provide direction to those planning and implementing eye health initiatives for schools, including policy makers, health care and educational authorities, health planners, eye care delivery organizations and professionals, in partnership with teachers, parents and children. In situations where resources for eye health are limited, decisions need to be made to ensure that programs not only address public health problems but are also implemented in a way that is effective, efficient and, wherever possible, sustainable. Systems for monitoring and plans for evaluation should also be developed at the outset. These practice guidelines provide an excellent learning resource for a module on school eye health that can be incorporated in optometry and ophthalmology residency curricula.  A section highlights some of the challenges in current school eye health initiatives and provides a framework in which school eye health is integrated into school health programs. Case studies are provided to emphasise the integrated approach and a 15-step approach, from situation analysis to monitoring and evaluation, is suggested. Practical recommendations for implementation are provided, including information on the equipment and technology required

 

This evidence-based document is based on best practice guidelines initially developed through a joint collaboration between Sightsavers International, the London School of Hygiene and Tropical Medicine and the Brien Holden Vision Institute

Disability and vocational rehabilitation in rural settings

HARLEY, Debra
et al
2018

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A graduate student textbook offered in 39 chapters, each with different authors and subjects. Abstracts, test questions and citations are freely available on-line. Full text is charged for. The book surveys rehabilitation and vocational programs aiding persons with disabilities in remote and developing areas in the U.S. and abroad. Contributors discuss longstanding challenges to these communities, most notably economic and environmental obstacles and ongoing barriers to service delivery, as well as their resilience and strengths. Considerations are largely of the US but there is a chapter on each of Asia and Pacific region, Australasia, Canada, Mexico, India, Turkey, Colombia and the UK. 

 

Household expenditure on leprosy outpatient services in the Indian health system: A comparative study.

TIWARI, Ajun
et al
January 2018

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The primary objective of this study is to estimate the expenditure in primary (outpatient) care incurred by leprosy patients in two different health system settings in India. The secondary objective is to compare the effect of the health systems on consumer behaviour and practices. 

The study followed a cross-sectional design, where a cohort from the Union Territory of DNH (an administrative division ruled directly by the federal government) was compared with a cohort from Umbergaon block of Valsad district, Gujarat, India. A block is the smallest administrative unit under a district. The cohorts were leprosy cases detected between April 2015 and March, 2016. A sample of 120 participants from each group was selected randomly. In the financial year of 2015–16, DNH reported 425 and Umbergaon reported 287 cases. 

A household survey was conducted between June and October, 2016 by means of a structured questionnaire collecting data on patient demographics, HH socioeconomic status, accessibility of health services, treatment seeking history and OPD expenditure. Respondents were asked to report on the last three OPD visits, either in a public or private facility, in the last 6 months. 

The costs were categorized as direct and indirect expenditure. The direct part included the expenditure on consultation, investigations and medicines & supplies. The indirect part constituted expenditure on transport, food, and days lost during illness of the patient and attendant

PLOS Neglected Tropical Diseases, January 4, 2018

https://doi.org/10.1371/journal.pntd.0006181

Caregivers' views on stigmatisation and discrimination of people affected by leprosy in Ghana

ASAMPONG, Emmanuel
DAKO-GYEKE, Mavis
ODURO, Razak
January 2018

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In Ghana, the social interpretation of leprosy regardless of the language, culture and tradition engenders stigmatisation and discrimination that leads to social rejection and exclusion of persons who have been cured of the disease. Often, these persons are cared for by relatives who happen to live with them in a confined place. From the views of these caregivers, this paper identifies areas of stigmatising and discriminatory tendencies against people affected by leprosy who reside in a Leprosarium in Accra. A qualitative interview with semi-structured interviews were conducted for twenty caregivers.

African Journal of Disability Vol 7 (2018) - Special collection: Disability and inclusion in Africa - The role of assistive technology

2018

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This journal provides

  • Nine original research articles on a variety of topics including the cost of raising a child with autism, experiences of care givers to stroke survivors, dyslexic's learning experiences, communication rehabilitation, disability and food security, hearing children of deaf parents and rehabilitation of stroke survivors. 
  • Three review articles: Intellectual disability rights and inclusive citizenship in South Africa: What can a scoping review tell us?; The benefits of hydrotherapy to patients with spinal cord injuries; Simple ideas that work: Celebrating development in persons with profound intellectual and multiple disabilities.
  • There is an opinion paper entitled - Deafening silence on a vital issue: The World Health Organization has ignored the sexuality of persons with disabilities
  •  There is a case study - Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa

Studying in UK as a disabled student

2018

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A brief introduction is provided about being a person with disabilities and a student in the UK. Information is given on rights, University’s office for disabled students, adjustments and scholarships and loans.

GEM report summary on disabilities and education

UNESCO
2018

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In support of the run-up to the 2020 GEM Report on inclusion and education, this paper contains summarised content related to disabilities and education in previous Global Education Monitoring (GEM) Reports since 2010. Reports cited from 2010 and 2015 monitored countries in the Global South. The GEM Report started monitoring countries in the Global North from the 2016 Report onwards only.

 

Topics covered include: compliance monitoring; the role of civil society organisations; lack of data; marginalisation; data on primary school attendance; intersection with other disadvantages; different education related challenges; and ten education policies to counteract marginalisation.

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