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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/

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.

 

 

 

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

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
 

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

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.

The Convention on the Rights of Persons with Disabilities and its implications for the health and wellbeing of indigenous peoples with disabilities: A comparison across Australia, Mexico and New Zealand

RIVAS VELARDE, Minerva C.
O'BRIEN, Patricia
PARMENTER, Trevor R
2018

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This paper explores how the expressed health needs of Indigenous peoples with disabilities resonate with the mandate of Article 25 ‘Health’ of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The perceptions of indigenous peoples with disabilities are investigated, regarding their access to, and expectations of, health care. Their views are compared to those of health workers, senior bureaucrats and United Nations delegates. An exploratory case study approach was taken to compare three jurisdictions: Australia, Mexico and New Zealand. The data collection techniques used involved semi-structured interviews, focus groups and field notes. The findings suggest that the health needs of indigenous peoples with disabilities are largely underserved and misunderstood by health departments. Specialised and preventive health care for those with disabilities was found to be particularly problematic. Poverty, discrimination and disenfranchisement emerged as being the possible major determinants of the ill health experienced by indigenous peoples with disabilities. The findings and conclusions outlined in this paper advocate the need to build capacity and rights literacy for indigenous peoples with disabilities, particularly with respect to the CRPD, in order to enhance its impact on the health of indigenous people. A legitimate redistribution of resources and decision-making in response to the expressed health needs of indigenous peoples with disabilities is needed if the vision of the CPRD is to be realised in relation to Article 25. 

 

Disability and the Global South, 2018, Vol.5, No. 2, 1430-1449

Report of the informal consultation on stopping discrimination and promotion inclusion of persons affected by Leprosy. New Delhi, 14–16 Nov 2017

COOREMAN, Erwin
WHO SEARO/Department of Control of Neglected Tropical Diseases
et al
2018

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An Informal Consultation on Stopping Discrimination and Promoting Inclusion of Persons Affected by Leprosy was held in New Delhi from 14 to 16 November 2017. Forty delegates with diverse backgrounds, experience and expertise enriched the discussions. Persons affected by leprosy brought to the table the challenges faced in daily life and suggested actions to be taken to reduce stigma and discrimination related to leprosy. Representatives of national programmes presented actions taken in their respective countries. The participants acknowledged the fact that stigma and discrimination related to leprosy still exists at a significant level. Information about stigma and discrimination related to leprosy needs to be collected in a more systematic manner to assess the magnitude of the problem and to further plan activities to reduce it.

Key recommendations from the consultation included counselling and reporting of incidences of discrimination. Efforts should be continued to inform facts about leprosy to the community.

The participants strongly recommended that leprosy programmes should adopt a ‘rights-based approach’ in line with the Sustainable Development Goals.

Do experiences and perceptions about quality of care differ among social groups in Nepal? A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

DEVKOTA, Hridaya Raj
MURRAY, Emily
CLARKE, Andrew
GROCE, Nora
December 2017

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Background
Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities.

Methods
A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension.

PLoS ONE 12(12): e0188554
https://doi.org/10.1371/journal.pone.0188554

Ensuring universal access to eye health in urban slums in the Global South: the case of Bhopal (India).

PREGEL, Andrea
et al
October 2017

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In the context of its Urban Eye Health Programme in Bhopal (India), Sightsavers launched a pilot approach aimed at developing an Inclusive Eye Health (IEH) model and IEH Minimum Standards.

Accessibility audits were conducted in a tertiary eye hospital and four primary vision centres located within urban slums, addressing the accessibility of physical infrastructures, communication and service provision. The collection and analysis of disaggregated data inform the inclusion strategy and provide a baseline to measure the impact of service provision. Trainings of eye health staff and sensitisation of decision makers on accessibility, universal design, disability and gender inclusion are organised on a regular basis.

A referral network is being built to ensure participation of women, people with disabilities and other marginalised groups, explore barriers at demand level, and guarantee wider access to eye care in the community. Finally, advocacy interventions will be developed to raise awareness in the community and mainstream disability and gender inclusion within the public health sector.

Healthcare provider's attitude towards disability and experience of women with disabilities in the use of maternal healthcare service in rural Nepal

DEVKOTA, Hridaya Raj
KETT, Maria
GROCE, Nora
MURRAY, Emily
June 2017

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BACKGROUND:
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth.

METHOD:
The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes.

Reproductive Health, 2017

Autism spectrum disorders

WORLD HEALTH ORGANISATION
April 2017

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This fact sheet provides key facts and an overview about autism spectrum disorders. Associated epidemiology, causes, assessment and management, social and economic impacts are briefly covered. The human rights of people with ASD are discussed and the WHO Resolution on autism spectrum disorders (WHA67.8) is introduced.

Right to health: Reality of persons with spina bifida and hydrocephalus

MCPHERSON. Amy
January 2017

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"This report maps the situation of persons with SBH in relation to healthcare access and is a follow up of the CRPD Concluding Observations Art.25. Through a comprehensive survey, IF collected valuable data on the experiences, satisfaction, and perceptions of healthcare coverage of individuals with SBH across Europe. Based on its findings, the financial coverage of treatment and assistive products for patients with SBH is grossly insufficient across the EU. Europe as a whole lacks multidisciplinary care and specialised SBH teams, which translates into long waiting times and insufficient knowledge of the SBH specificities. 

Considering these findings, IF urges the EU Member States to adequately support the healthcare needs of persons with SBH, and to invest more substantially into creating multidisciplinary clinics that can help avoid preventable complications 11 and may reduce the overall burden 12 on the patient and the system. In addition, the Member States should actively support creation of the European Reference Networks as a way of improving care for persons with SBH. IF also calls on the European institutions for support in training medical professionals on rights of persons with disabilities."

Global report on the participation of organisations of persons with disabilities (DPOs) in VNR (voluntary national review) processes

INTERNATIONAL DISABILITY ALLIANCE (IDA)
STAKEHOLDER GROUP OF PERSONS WITH DISABILITIES
2017

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"This global report raises awareness for DPOs and how to engage with their governments in the national consultation processes on SDG implementation. This case study features the volunteering countries of Argentina, Bangladesh, Denmark, El Salvador, Ethiopia, India, Indonesia, Italy, Kenya, Nigeria, Peru, Sweden and Togo.

The information summarised in the country chapters was derived from DPOs and partners working at the national level on SDG implementation and information may be subjective. The country chapters are structured to include; status of persons with disabilities, engagement in the voluntary national review process, thematic issues--poverty alleviation, healthcare, women with disabilities and accessibility—and analysis of the submitted VNR report

Advances in Autism, vol.3, no.3, 2017 Special issue: Improving access to healthcare

2017

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Special issue: Improving access to healthcare. The aim of this special issue is to stimulate discussion and new research on the health and health care of people with autism spectrum disorder. In a co-productive approach, we give people on the autism spectrum, their families and health care providers a voice to open an exchange between professionals and people with lived experience. The guest editorial is freely accessible. There are six papers:

 

  • Autism and healthcare
  • Quality of health and health services in people with fragile X syndrome: perspective of their parents
  • Transition tools and access to adult primary care
  • Systemic-attachment formulation for families of children with autism
  • An online ASD learning module for pediatric health care professionals
  • Pain in Rett syndrome: peculiarities in pain processing and expression, liability to pain causing disorders and diseases, and specific aspects of pain assessment

Disability in the sustainable development goals: critical reflections. Disability & the Global South (DGS), 2017, Vol. 4 No. 1 Special issue

2017

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This special issue follows on from the symposium ‘Disability in the SDGs: Forming Alliances and Building Evidence for the 2030 Agenda’ held in London in 2016. The articles in this special issue consider the evidence base around the inclusion of people with disabilities, particularly with respect to health, poverty and education. The editorial reports that emerging evidence suggests that despite marginal changes in discourse, people with disabilities continue to be left behind in these areas, that large data gaps remain, data collected so far is not always comparable and qualitative research also remains scarce. What it means to ‘include’ and how to go about this is also discussed. Titles of papers in this issue are:

  • Entering the SDG era: What do Fijians prioritise as indicators of disability-inclusive education?
  • SDGs, Inclusive Health and the path to Universal Health Coverage
  • No One Left Behind: A review of social protection and disability at the World Bank
  • The capacity of community-based participatory research in relation to disability and the SDGs
  • Measuring Disability and Inclusion in relation to the 2030 Agenda on Sustainable Development

Preventing the Zika virus: Understanding and controlling the Aedes mosquito

LOGAN, James
August 2016

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This free online course begins by considering the science behind the outbreak to try to understand where the Zika virus has come from, its symptoms, and its effect on infected individuals. The biology of the Aedes mosquitoes is explored. A range of methods employed to control the Aedes mosquito are highlighted. There is opportunity to exchange thoughts and ideas through course discussion with those on the front line in South America. Subtitles in Spanish and Portuguese are provided.

WHO : microcephaly and zika virus infection : questions and answers

COSTELLO, Anthony
February 2016

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Dr Anthony Costello, Director of WHO's Department of Maternal, Newborn, Child and Adolescent Health, answers some key questions on Microcephaly and Zika virus infection including concerning how a pregnant women would know if her baby is infected, what support would be needed if the child has Microcephaly and what steps can be taken to avoid being infected

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