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Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

Explosive ordnance in Syria: impact and required action

May 2022

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Explosive ordnance (EO) puts one in two people in Syria at risk of death and injury and impedes the delivery of crucial humanitarian assistance. However, the extent of EO in Syria and its devastating impact is not sufficiently known or discussed among donors and humanitarian actors. International humanitarian mine action (HMA) actors operating in Syria for over ten years have come together to address this gap, sharing data and insight from their work on the ground. They produced a report to highlight the extent of EO contamination in Syria; its devastating impact on people, vital infrastructure and provision of humanitarian assistance; the crucial activities performed by humanitarian mine action (HMA) actors; and the action required to address this issue

Sexual and Reproductive Health and Rights for All: Disability Inclusion from Theory to Practice Women’s Integrated Sexual Health 2 Action Project (WISH2ACTION)

BERGER, Gisela
ARESU, Alessandra
NEWNHAM, Jane
March 2022

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The overall objective of this Guideline is to support project and programme developers, Sexual and Reproductive Health (SRH) public and private service providers, and advocates to design, implement, monitor, and evaluate inclusive SRH programmes. Realising SRHR for all requires a comprehensive, multi-sectoral, and coordinated approach, involving a range of actors and actions. The Guideline is designed to be a resource on the human rights standards and key principles required to achieve disability inclusion, with more specific guidance available for actors working at different levels of SRH service programming and service delivery. This Guideline is intended primarily to support SRHR actors and practitioners who are active at the local level. The chapters provide relevant background information and refer to selected national and international data. It contains practical recommendations to support implementation and advocacy activities, accompanied by a list of the most relevant resources available on the subject

Accessibility audits and improvement of COVID-19 treatment centres in Nigeria

Sightsavers
January 2022

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A learning review was conducted between November 2020 and January 2021 to assess the implementation process and contribute to the evidence of what does and does not work in undertaking accessibility audits in emergency response situations, such as COVID-19, deploying Sightsavers’ accessibility audit methodology and toolkit under the Disability Inclusive Development (DID) programme, Inclusive Futures.

Engagement with Organizations of Persons with Disabilities. Learning about meaningful engagement in public health emergencies, including COVID-19

UNITED NATIONS CHILDREN'S FUND (UNICEF)
December 2021

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This report was produced under a United Nations Partnership on the Rights of Persons with Disabilities (UNPRPD) project to support countries in designing and implementing disability-inclusive response and recovery planning for COVID-19. Throughout this project, UNICEF documented examples of good practice and learnings from partnerships with organizations of people with disabilities (OPDs) in public health emergencies, including COVID-19. The objectives of this initiative were to gain a better understanding of the factors that facilitate effective partnerships between humanitarian actors and local, regional, and national OPDs, and the challenges to be addressed.

This report presents the findings from a ‘deep dive’ undertaken by UNICEF East Asia and the Pacific Regional Office to consider the experiences in Cambodia, Indonesia, the Lao People’s Democratic Republic, Malaysia, Myanmar, the Philippines and the Pacific. The target audience for this report includes OPDs and humanitarian actors at global, regional, and country levels.

The Globalization of the Diabetes Epidemic

BONNEAU, Claire
2021

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As globalization continues to bring everyone and everything closer together, not all of the trade-offs are necessarily positive. As we export our unique cultures and experiences around the globe, we also increase the spread of chronic health problems.

For much of the 20th century, a person’s likelihood of developing a chronic health disease like type II diabetes depended on the wealth of the country they lived in equally as much as their own biology and genetic factors. In wealthy, developed countries, people are much more likely to survive to old age and eventually pass away from diseases of affluence — chronic diseases like cancer, heart disease, and diabetes that primarily impact the ageing population. In contrast, people living in developing nations are much more likely to experience malnourishment, violence, and communicable diseases that have a major impact on their overall health and quality of life.

This distinction has proven to be true across many developed countries, including globalization giants like the United States. Even in the more economically disadvantaged areas of America, hardly anyone dies as a result of communicable diseases like tuberculosis, a disease that is still a serious problem in lesser developed nations. Alternatively, in low to middle-income countries, these types of health concerns are still a going concern. Alongside the increased risk of encountering a communicable disease, people living in these areas are also at a higher risk for developing diseases of affluence such as type II diabetes. In this way, people living in developing nations are more likely to experience cancer while also battling cholera infections, and someone living with diabetes is also more likely to be struggling with chronic malnourishment. This lack of distinction between diseases of affluence and communicable diseases puts people living in developing nations at a disadvantage.

In this new global landscape of health and disease, the impact of diabetes is truly overwhelming. Since 1980, the number of people living with diabetes has almost doubled from 152 million to between 285-347 million (1). As a result of this dramatic increase, health spending and global costs have also had to increase to meet the growing demand for care. In 2019, it is estimated that diabetes caused over 760 billion USD in health expenditures, making up about 10% of all global spending on adults (2).

As the prevalence of diabetes continues to grow around the world, we need to shift our attention to finding global solutions to this invisible epidemic. Understanding the connection between obesity, globalization, and diabetes is a great starting point in order to tackle this ever-growing global health problem.

Reclaiming SRHR of women and girls with disabilities

DAS, Shreshtha
August 2021

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The manual Reclaiming SRHR of Women and Girls with Disabilities was developed as part of ARROW’s initiative, ‘Defending SRHR of Women and Girls with Disabilities’ with inputs and insights incorporated from regional experts from multiple disciplines whose contributions enriched the content of the manual. The manual aims to equip women and girls with disabilities with necessary SRHR information and knowledge to make informed choices free from coercion, violence, discrimination, and abuse. The Manual, therefore, contains detailed Modules on gender, sexuality, disability, rights, and their interlinkages in the context of addressing sexual and gender-based violence against women and girls with disabilities. Through this, it seeks to provide accessible information and knowledge on SRHR to women and girls with disabilities in various contexts, including in the face of the ongoing Covid-19 pandemic.

 

A Training of Trainers (ToT) manual on disability rights, gender and SRHR.
 

Step Towards Disability Inclusive Sexual Reproductive Health: Learnings from WISH2ACTION Project

Faruk Ahmed Jalal
Esrat Jahan
Md. Tareq Mahmud
Md. Rakibul Islam
Md. Mazedul Haque
Samira Naher Tazreen
August 2021

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WISH2ACTION project is being implemented in Bangladesh since September 2018 and will end on 31 August 2021. During these years of implementation, HI worked to ensure the inclusion of persons with disabilities in the sector of sexual & reproductive health through community engagement as well as policy changes at the national level. Throughout the project period, many success stories & good practices were drawn as learning and could be used as a reference for future practices, and HI Bangladesh is delighted to introduce these documents of learning through this publication.

Preventing lifelong impairment: Access to clubfoot treatment in low and middle income countries

CLINTON HEALTH ACCESS INITIATIVE (CHAI)
July 2021

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Congenital talipes equinovarus (CTEV), commonly known as clubfoot is one of the most common congenital conditions, affecting 1 in 800 births. Left untreated, it can lead to life-long impairment, impacting participation in society, education, and employment. Most children with clubfoot can be successfully treated with the Ponseti method, a low-cost, cost-effective, and minimally invasive treatment protocol. Despite progress, less than 1 in 5 children born with clubfoot in low- and middle-income countries (LMICs) currently receive treatment

Clubfoot services require coordination and leadership between different departments within health ministries. Both are often missing

 

Empowering Kenyan women and girls with disabilities in managing menstrual health

UNITED NATIONS POPULATION FUND (UNFPA)
June 2021

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The partnership of UNFPA with This-Ability Trust, an organization that advances disability rights and inclusion by working with groups, to improve access to sexual and reproductive health information and services for women and girls with disabilities is reported. The partnership, which has reached 12,000 people in eight counties, also educates both recipients and caregivers on menstrual health management when distributing dignity kits with washable sanitary pads. The report highlights Mombasa-based Ms. Wanjiru who runs a group for persons with disabilities that includes a programme on sexuality for young women, whose families and caregivers are often uncomfortable discussing menstrual hygiene

Persons with disabilities in the context of armed conflict - Submission to the UN Special Rapporteur on the rights of persons with disabilities

HUMAN RIGHTS WATCH
June 2021

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Human Rights Watch provided input to the UN Special Rapporteur on the Rights of Persons with Disabilities for his thematic report to the 76th session of the United Nations General Assembly regarding the rights of persons with disabilities in armed conflict.

This submission was based on Human Rights Watch’s research in Afghanistan, Cameroon, the Central African Republic, Israel/Palestine, Jordan, Lebanon, South Sudan, and Syria. 

 

Six issues were focussed on in particular:

  • At higher risk during fighting
  • Availability of assistive devices
  • Access to basic services
  • Education for children with disabilities
  • Abuse and stigma
  • Mental health impact

Accountability for the rights of people with psychosocial disabilities: An assessment of country reports for the Convention on the Rights of Persons with Disabilities

EATON, Julian
CARROLL, Aleisha
SCHERER, Nathaniel
et al
June 2021

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The Convention on the Rights of Persons with Disabilities (CRPD) has been identified as a milestone in human rights protection, offering people with psychosocial disabilities the opportunity to hold their governments accountable for the realization of their rights. To facilitate such accountability, the country reports produced under the CRPD reporting process should adequately reflect these persons’ experiences and relevant positive or negative developments in the country. Our study used content analysis to review the extent and quality of reporting related to mental health and psychosocial disabilities in 19 country reports

 

Health and Human Rights Journal Volume 23/1, June 2021, pp. 175-189

A global agenda for inclusive recovery: Ensuring people with intellectual disabilities and families are Included in a post-COVID world

INCLUSION INTERNATIONAL
May 2021

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This report documents the experiences of people with intellectual disabilities and their families during COVID-19 and proposes a global agenda for inclusive COVID recovery developed by Inclusion International’s membership. The global agenda is a set of imperatives for policy and programming to ensure that “building back better” creates a more inclusive world.

Equal access without discrimination - The Right to Disability-Inclusive Health

LIGHT FOR THE WORLD
May 2021

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The right to the highest attainable standard of health is fundamental, as health is a precondition for equal participation in society. People with disabilities continue to experience discrimination, barriers and rights violations in their access to health. This Issue Brief outlines how governments, international organisations and development actors can mainstream disability inclusion into their health strategies, services and interventions.

Towards zero leprosy. Global leprosy (‎Hansen’s Disease)‎ strategy 2021–2030

WORLD HEALTH ORGANISATION (WHO), REGIONAL OFFICE FOR SOUTH-EAST ASIA
April 2021

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The Global Leprosy Strategy 2021–2030 “Towards zero leprosy” was developed through a broad consultative process with all major stakeholders during 2019 and 2020. Valuable inputs were provided by national leprosy programme managers, technical agencies, public health and leprosy experts, funding agencies and persons or members of communities directly affected by leprosy.

The Strategy aims to contribute to achieving the Sustainable Development Goals. It is structured along four pillars:

(‎i)‎ implement integrated, country-owned zero leprosy road maps in all endemic countries;
(‎ii)‎ scale up leprosy prevention alongside integrated active case detection;
(‎iii)‎ manage leprosy and its complications and prevent new disability; and
(‎iv)‎ combat stigma and ensure human rights are respected. Interruption of transmission and elimination of disease are at the core of the Strategy

Perspectives on assistive technology among older Norwegian adults receiving community health services

HALVORSRUD, Liv
HOLTHE, Torhild
KARTERUD, Dag
THORSTENSEN, Erik
LUND, Anne
2021

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Introduction: The western world is seeking increased implementation of assistive technology (AT) to meet the challenges of an ageing population. The objective of this study is to explore perspectives on AT use among home-dwelling older adults with or without cognitive impairment.

 

Methods: This study combines findings from a cross-sectional study with a questionnaire package (n = 83) and from qualitative individual interviews (n = 7) and is part of a larger study, the Assisted Living Project. Combining methods promotes complementary inquiries into a phenomenon.

 

Results: The participants already use ATs: TVs, social alarms, mobile phones, stove timers, electronic med- ical dispensers, PCs and tablet computers. They were both optimistic and skeptical of AT, and expressed different perspectives and expressed different perspectives on ATs in relation to usability, privacy and fear of losing personal face-to-face care.

 

Conclusions: This study reveals that older adults’ perspectives on AT are multifaceted and complex, and can partly be explained by the interacting factors in the HAAT model: person, technology, environment, and context. Further exploration in relation to older adults with health challenges, as well as ethical per- spectives on AT implementation, is required for this group.

A National Survey of the Social and Emotional Differences Reported by Adults with Disability in Ireland Compared to the General Population

McCONKEY, Roy
2021

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The disadvantages experienced by adult persons with disabilities are well documented. However, limited evidence is available on the extent of differences in comparison with the non- disabled population. In this study, selected indicators of social status and mental wellbeing derived from past research, were used with national samples of adult persons in Ireland with a disability (n = 440) and without a disability (n = 880) recruited through household quota sampling. In addition, comparisons were drawn with equivalent data derived from a contemporaneous national census. Although many of the differences were statistically significant, the effect sizes were mostly medium to low. Moreover, when the inter-relationships among the various indicators was taken into account using Discriminant Analysis, persons with disabilities were less likely to be employed; they reported lower levels of social engagement and had poorer emotional wellbeing. They were also older, more likely to be single and have no children. The study illustrates the potential of using comparative data to monitor the impact of national actions taken to reduce the inequalities experienced by persons with disability as well as highlighting the arenas into which professional supports need to be focused.

Family Planning for Women and Girls with Disabilities

Dr FRASER, Erika
CORBY, Nick
MEANEY-DAVIS, Jessie
2021

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This is an updated evidence review looking at the evidence on factors affecting access to and uptake of family planning for women and girls with disabilities in low- and middle-income countries and the evidence on good practice on increasing full free and informed contraceptive choice for women and girls with disabilities.

 

Query:

1) What is the evidence on factors affecting access to and uptake of family planning for women and girls with disabilities in low and middle income countries, highlighting examples from FP2020 commitment-making countries?

2) What is the evidence on good practice on increasing full free and informed contraceptive choice for women and girls with disabilities – from the same countries or elsewhere? 

Disability considerations for COVID-19 vaccination: WHO and UNICEF policy brief, 19 April 2021

WORLD HEALTH ORGANISATION (WHO)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
Eds
April 2021

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Persons with disabilities are disproportionately impacted by COVID-19, both directly because of infection, and indirectly because of restrictions to reduce the spread of the virus. Persons with disabilities are a diverse group, and the risks, barriers and impacts faced by them will vary in different contexts according to, among other factors, their age, gender identity, type of disability, ethnicity, sexual orientation, and migration status.

This document presents considerations and actions for the following stakeholders to ensure equity in access to vaccination against COVID‑19 for persons with disabilities:

− Persons with disabilities and their support networks

− Governments

− Health service providers delivering vaccinations

− Organizations of persons with disabilities

− Disability service providers

− Residential institutions and long-term care facilities

− Community

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