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Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

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

 

Global AgeWatch Insights. The right to health for older people, the right to be counted

ALBONE, Rachel
et al
2018

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This report considers the progress being made to achieve older people's right to health amid the global drive towards universal health coverage. It explores how older people are currently accessing health services and what changes need to be made to improve on this. It considers the role of data in driving and informing changes to health systems and the services they deliver. Data must be collected with and about older people to ensure adequate evidence for service design and delivery that is targeted and appropriate. This report explores the adequacy of current data systems and collection mechanisms and how, alongside health systems, they must be adapted in an ageing world. 

 

This report is supported by 12 country profiles (for Argentina, Colombia, El Salvador, Kenya, Lebanon, Moldova, Myanmar, Pakistan, Serbia, Tanzania, Vietnam and Zimbabwe; see Appendix 1). These provide national information on trends in the physical and mental health status of older people, and population-level information on access to UHC. The profiles are supplemented by data mapping, showing the national data available on older people’s health in the 12 profile countries, and revealing the data gaps. The data mapping results are available at www.GlobalAgeWatch.org.

Hear my voice: old age and disability are not a curse. A community-based participatory study gathering the lived experiences of persons with disabilities and older people in Tanzania

MRISHO, Mwifadhi
FAKIH, Bakar
GREENWOOD, Margo
STEFF, Marion
2016

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Community based participatory research (CBPR) was used to provide evidence on the specific nature and experiences of persons with disabilities and older people from their own perspectives in Tanzania, through the lens of social, political, economic and cultural inclusion. The aim was to strengthen efforts to provide services for and improve the lives of people living in the rural and urban settings of Nachingwea and Kibaha Urban Municipal Council. Twenty-nine peer researchers (nine persons with disabilities, 10 older people and 10 Tanzanian Non-Governmental Organisation (NGO) members working in these communities) were involved in the study. A total of 106 stories were collected. Eight priority areas emerged and were chosen by peer researchers for further discussion in groups: access to education and quality learning; access to health services; issues fed back from NGOs; poverty relating to income and dependence; attitudes towards witchcraft and albinism; relationship difficulties and marriage breakdowns; sexual violence and gender issues; poor treatment from family
 

Voices of the marginalised

2016

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The aim of 'Voices of the Marginalised' is to bring the perspectives of those who live in poverty or who are highly marginalised, including those with disabilities, older people and people living with mental health problems, into post-2015 policymaking. Focusing on Bangladesh and Tanzania, people with disabilities and older people were asked to become researchers themselves, and were trained to collect and analyse stories from peers in rural and urban areas.

Mainstreaming disability and ageing in water, sanitation and hygiene sector

JONES, Hazel
September 2013

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This report presents the findings of a desk study that provided an overview of the current state of disability and ageing issues in WASH, from the perspective of the WASH sector. Both disabled and older people were looked at together, because many frail older people, although they may reject the label ‘disabled’, experience impairments that limit their daily activities, which result in them facing similar kinds of barriers to accessing WASH

Making a living last longer : insights into older people's livelihood strategies

ERB, Susan
2011

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This research report explores the challenges faced by older people in securing a sustainable livelihood in four countries. The research found that older people face significant barriers in achieving livelihood security due to lack of regular, predictable and sufficient cash income such as non-contributory pensions. Gender, destitution, and emergency preparedness emerged as cross-cutting issues that affect older people’s livelihood challenges regardless of location. The research also found that older people have only limited access to microfinance institutions (MFIs) and banks, and therefore to credit and savings facilities. It concludes by highlighting key guiding principles for governments, community-based organisations, NGOs, MFIs and others working to support older people to achieve greater livelihood security

Documenting good practices at partner level

MUTUVI, Kavutha
MAINA, Gacheru
LACKEY, Douglas
2011

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This report documents the good practices of HelpAge and its partners while implementing a regional advocacy programme to mitigate the impact of HIV and AIDS among older people in six sub-Saharan African countries. It presents information about what is working and not working in different situations and contexts by highlighting and documenting the lessons learned and the process of what works, how and why. This resource is useful for anyone interested in the impact of HIV and AIDS among older people in Africa

Building bridges: a home-based care model for supporting older carers of people living with HIV

HELPAGE INTERNATIONAL (HAI)
July 2010

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This summary guideline describes a model for supporting older home-based carers developed by HelpAge International in Tanzania, which is being implemented in several districts. The model has four elements: collecting baseline data, training older carers in home-based care and counselling, setting up support groups and linking older carers to services. This resource is useful to people interested in home-based care for supporting older carers of people living with HIV

Achieving income security in old age for all Tanzanians : a study into the feasibility of a universal social pension

DANIEL, Smart
et al
May 2010

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"This report summarises the findings of an investigation into the feasibility of achieving universal access to old age income security through a social pension in Tanzania." The feasibility study provides an analysis of the cost, fiscal sustainability and financing options for a universal pension and concludes that introducing income security payments for all older Tanzanians is likely to significantly reduce old age poverty

Social protection policy : responses to older people’s needs in Zanzibar

PEARSON, Anna
2009

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This report presents the social protection findings of a study that examines the needs of older people on the archipelago of Zanzibar. The study presents an analysis and develops policy recommendations on social protection and health, making links between the two areas where possible. This report is useful to anyone interested in social protection policy in Zanzibar

Salt, soap and shoes for school: evaluation report|The impact of pensions on the lives of older people and grandchildren in the KwaWazee project in Tanzania’s Kagera region

HOFMANN, Stefan
et al
August 2008

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This report examines the findings of a project supporting older people and their dependents in Tanzania. It reveals that even small pensions are effective in bringing stability and dignity to the lives of older people and help to improve the quality of life of other household members

The ageing and development report : a summary. Poverty, independence and the world's older people

RANDEL, Judith
GERMAN, Tony
EWING, Deborah
Eds
1999

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This is a summary of a report on the circumstances of older people in developing countries and countries in transition. It has chapters on economic security, health, family and community life, poverty, gender, and emergencies. It also includes information on demographic trends and ageing in specific countries and regions. It is suitable for planners, managers, trainers and students

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