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Older people’s perceptions of health and wellbeing in rapidly ageing low- and middle-income countries

ALBONE, Rachel
2019

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This report presents the findings of an analysis of data collected by HelpAge International and its network members using HelpAge’s Health Outcomes Tool. The tool is designed to collect data to better understand health and care in older age, and to measure the impact of HelpAge’s health and care programmes. It was developed in response to the challenges posed by the lack of data on older people’s health and care, particularly in low- and middle-income countries, and the resulting lack of understanding about how best to provide age, gender and disability sensitive services for older women and men. The tool was used between 2014 and 2017 in nine low- and middle-income countries across Africa, Asia and Latin America,1 and gathered data from over 3,000 older people. The findings are presented here in the context of the current debate and evidence on older people’s right to health.

This report explores three different areas in relation to ageing and health: older people’s access to health services; availability of care and support; and the impact both health, and care and support services have on older people’s health status, functional ability and wellbeing.

 

 

 

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

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.

Disability inclusion in disaster risk management - Promising practices and opportunities for enhanced engagements

GUERNSEY, Katherine
SCHERRER, Valerie
April 2018

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Disaster risk management aims to address vulnerability in order to reduce risk and therefore needs to consider the full range of vulnerability drivers, including those that affect persons with disabilities. This report presents the results of comprehensive review of the state of practice in disability-inclusive Disaster risk management (DRM) undertaken by GFDRR (Global Facility for Disaster Reduction and Recovery). The report is intended to help World Bank staff incorporate persons with disabilities and a disability perspective into their ongoing DRM work. The report will also be of interest to other development actors and stakeholders working on DRM.

Humanitarian inclusion standards for older people and people with disabilities

ADCAP
TILL, Celia
et al
February 2018

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The Humanitarian inclusion standards for older people and people with disabilities provide guidance across all areas and at all stages of emergency response to ensure older people and people with disabilities are not left out.

The standards consist of nine key inclusion standards, including identification, safe and equitable access, knowledge and participation, and learning. Alongside these, there are seven sector-specific inclusion standards, which include protection, shelter, health, and water, sanitation and hygiene.

Each standard comes with key actions, guidance, tools and resources, and case studies illustrating how older people and people with disabilities have been included in humanitarian responses.

The sector-specific standards provide guidance in three key areas: data and information management, addressing barriers to inclusion, and participation of older people and people with disabilities.

By implementing the key action points provided, organisations will build up a greater evidence base, deliver more inclusive programmes, and be able to better demonstrate impact on the lives of those most at risk during humanitarian crises.

The standards can be used as guidance during programme development, implementation and monitoring, and as a resource for training and advocacy.

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.

A situational analysis of disability and aging in Myanmar

ZEITZER, Ilene
2018

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The interaction of aging and disability is explored in the context of Myanmar. Blindness and deafness data are taken from the census. Carer givers and the family are discussed. Goverment and civil society responses are also discussed.

A briefing paper is also available.

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.

Towards Inclusion - A guide for organisations and practitioners

VAN EK, Vera
SCHOT, Sander
2017

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This guide is the result of collaboration between Light for the World (LFTW), Mission East (ME), and ICCO Cooperation.

Based on decades of experience of working with the most marginalized and excluded communities, the three organizations cooperated to record their experiences in a publication which can be used in a variety of relief and development contexts. ‘Towards Inclusion’ is designed to be an easy to use reference for organizational and program/project development with a focus on gender responsiveness and disability inclusion.

The guide is made up of three parts:
• the first part guides users through the process of organizational self-assessment to determine readiness to change and identify key steps towards becoming a more inclusive organization.
• the second part introduces the ACAP framework, as a means of improving inclusion in programming via Access, Communication, Attitude and Participation. A range of tools for measuring and improving inclusion at all stages of the project cycle are provided.
• the third part provides guidelines for the people or ‘change facilitators’ who will guide organizations through the process of change towards becoming more inclusive.

The publication can be found at “Towards Inclusion Guide” and the accessible version of the publication can be downloaded. Both are free of charge.

Possibilities for organisation trainings and/or webinars on the practical application of the guide are under consideration. Contact ACAP@gmail.com.

Minimum standards for age and disability inclusion in humanitarian action : pilot version

AGE AND DISABILITY CONSORTIUM
2015

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This pilot version of the Minimum Standards for Age and Disability Inclusion in Humanitarian Action has “been developed for use by all practitioners involved in humanitarian response, including staff and volunteers of local, national, and international humanitarian agencies, with the expectation that the inclusion of people with disabilities and older people is feasible at every stage of the response and in every sector and context. The Standards are intended to inform the design, implementation, monitoring and evaluation of humanitarian programmes; to strengthen accountability to people with disabilities and older people; and to support advocacy, capacity-building and preparedness measures on age and disability across the humanitarian system

 

The Standards are drawn from a wide-ranging review of existing guidance and standards developed by humanitarian actors over recent years. This includes material from organisations with a special focus on disability and/or older age, together with key documents, including the Sphere Handbook, the Sphere Companion Standards and the Core Humanitarian Standard on Quality and Accountability (CHS). The Minimum Standards for Age and Disability Inclusion do not create entirely new demands on humanitarian actors; rather, they clarify and reinforce what is already required if broader standards of impartial humanitarian programming and the principles of the Humanitarian Charter are to be upheld”

“We can also change” Piloting participatory research with persons with disabilities and older people in Bangladesh

BURNS, Danny
OSWALD, Katy
November 2014

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Sightsavers, HelpAge International, ADD International and Alzheimer’s Disease International worked together with the Institute of Development Studies (IDS) to bring the perspectives of those who live in poverty or who are highly marginalised into post-2015 policy making. The aim of the research was to understand better the experiences of social, political and economic exclusion of persons with disabilities and older people in Bangladesh from their own perspectives. Two groups (community and NGO) of peer researchers collected 70 stories from poor and/or excluded persons with disabilities and older people from each of the two sites: Bhashantek, an urban slum in Dhaka; and Cox’s Bazar, a rural area in southeast Bangladesh. From the stories collected and analysed in workshops, the peer researchers identified 13 priority areas that affect persons with disabilities and older people: accidents and disasters; livelihoods; access to education; medical treatment; family support; exclusion and mistreatment; superstition; access to services; mobility; marriage; land; rape and sexual abuse; the role of grassroots community-based organisations. Recommendations from the researchers are made in each area. The peer research programme was evaluated and guidelines for its use are provided.

Compendium of accessible WASH technologies

JONES, Hazel
WILBUR, Jane
2014

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This compendium of accessible WASH technologies is designed for use by staff, such as health workers and community volunteers, working directly with communities in rural areas of sub-Saharan Africa. A few examples of technologies are presented that families can adapt to suit their needs and budgets with many more options possible. Most of the ideas are geared towards disabled and older people, but are suitable for anyone who may have difficulty using standard facilities, such as pregnant women, children and people who are ill. The main focus is on household facilities, although some ideas might be useful for institutional facilities as well

Inequalities relating to health and the life course : disability, mental Illness and older age

SAMMAN, Emma
RODRIGUEZ-TACKEUCHI, Laura
November 2012

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"Issues related to early childhood feature prominently in the MDG framework (as do malnutrition, HIV status and malaria), and data collection in these areas is fairly advanced. Other sources of inequality are notable by their virtual absence - among these, older age, disability and mental illness, although these issues each appear to affect sizeable numbers of particularly vulnerable people throughout the world. A clear obstacle to ‘mainstreaming’ these sources of inequality in a new post-2015 agreement is the widespread lack of nationally representative internationally comparable data. This could arise from definitional or technical issues (what to measure and/or how), operational issues (e.g., resource or capacity constraints), attitudinal issues (relating to stigma) and/or lack of demand from data users. Greater attention is needed to explore these constraints and how they might be overcome. To this end, this paper discusses currently available data and its limitations, constraints to better data collection and efforts needed to adjust key international survey instruments- the World Bank’s Core Welfare Indicator Questionnaire (CWIQ) and Living Standards and Measurement Survey (LSMS), Macro International’s Demographic and Health Survey (DHS) and the UNICEF Multiple Indicator Cluster Survey (MICS) - to collect reliable data on these sources of inequality, alongside other household indicators"
Note: Accepted under the "Addressing Inequalities" Global Thematic Consultation - Call for Proposals for Background Papers, Oct 2012

The voices of the marginalised

CAIN, Emma
October 2012

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"Drawing on the experience of four organizations (ADD International, Sightsavers, HelpAge International, Alzheimer’s Disease International), this paper argues the case for a greater focus on horizontal inequalities which relate to social factors of ‘difference’, and which contribute to marginalization. By focusing on the experience of persons with disabilities, older people and people with mental health issues, the paper explores the dynamics and mechanisms which marginalize individuals, and calls for a greater focus on these issues in current and future development frameworks. The paper highlights the importance of bringing the ‘lived experience’ in to the analysis and policymaking process through initiatives such as the ‘Voices of the Marginalized’ research project which promotes the voice and participation of persons with disabilities, older people and people with mental health issues"
Note: Accepted under the "Addressing Inequalities" Global Thematic Consultation - Call for Proposals for Background Papers, Oct 2012

Guidance on including older people in emergency shelter programmes

HELPAGE INTERNATIONAL
INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESCENT SOCIETIES (IFRC)
2011

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Given the lack of attention to older people in shelter programmes, these guidelines provide the following five key action points for including older people in shelter programmes: understand the needs and capacities of older people; ensure that older people participate and are represented; target vulnerable older people; incorporate age-friendly in both household and community shelters; and promote coordination, cooperation and sharing. Clear information is provided for each action point action supported by case studies, and the recommendations provide a framework for the different phases of a shelter programme (temporary, transitional and permanent). This resource is useful for people interested in including older people in emergency shelter programmes

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

Guidance on including older people in emergency shelter programmes : a summary

HELPAGE INTERNATIONAL (HAI)
INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESENT SOCIETIES (IFRC)
2011

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This summary provides a brief introduction and recommends the following five key action points for including older people in shelter programmes: understand the needs and capacities of older people; ensure that older people participate and are represented; target vulnerable older people; incorporate age-friendly in both household and community shelters; and promote coordination, cooperation and sharing. This resource is useful for people interested in including older people in emergency shelter programmes

What do older people need in emergencies?|The experience in the Philippines after typhoon Ketsana

FORMILLEZA, Sammie P
2011

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This report presents a study on the experiences of older people in 5 rural and urban communities of the Philippines following Typhoon Ketsana. The research methods included key informant interviews (KII), focus group discussions (FGD) and a review of secondary materials. The results provide a summary of older people’s needs and problems on the following issues: basic food needs, shelter (including evacuation), water supply, health, clothing, household articles, bedding and livelihood activities. It is recommended that it is critical to work with the older people and their community organisations in identifying ways and means to address their concerns during disaster and recovery situations

The vulnerability and living conditions of older people in Addis Ababa

HELPAGE INTERNATIONAL ETHIOPIA
INTERNATIONAL ORGANIZATION FOR MIGRATION (IOM)
September 2010

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This report presents the findings of a city-wide survey that aimed to provide comprehensive information on the vulnerabilities and coping mechanisms of poor urban older people in Addis Ababa and to explore options for linkages to existing service and assistance programmes. The report presents a range of issues including food and income security, shelter, water and sanitation, health, HIV and AIDS, training, and family and community care. It concludes by making recommendations for improving older people’s food and income security, access to healthcare, and living environment. It calls for older women to be given special emphasis. This study is intended as a background and guide to government agencies, donors, international agencies and international and national NGOs in order to better target programmes and projects for older people

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