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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/

Coordination between health and rehabilitation services in Bangladesh: Findings from 3 related studies

PRYOR, Wesley, HASAN Rajib
MARELLA, Manjula
NGUYEN, Liem
SMITH, Fleur
JALAL, Faruk Ahmed
CHAKRABORTY, Ripon
HAQUE, Mazedul
MOSTOFA, Golam
HASAN, Rajib
April 2019

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The unmet need for rehabilitation is profound and is likely to worsen as population health shifts towards longer lives lived with more ill-health and disability. The WHO Global Action Plan on Disability and the Rehabilitation 2030 framework [1] call for quality evidence to inform targeted responses.
The intent of this work is to examine six IDSCs (Integrated Disability Service Centres) in detail but to use the results to inform new activities through the network of more than 100 Integrated Disability Service Centres, with potential to influence practice in other services. As such, results of this work have the potential to directly inform policy decisions concerning future investments in rehabilitation services in Bangladesh and bring awareness to key stakeholders on current challenges and potential solutions.

Research was conducted during March-October 2018 in Kurigram, Tangail, Manikgonj, Dhaka and Narsingdi districts of Bangladesh to map out the current trends and determinants of good coordination
between health and rehabilitation, emphasising quantitative measures of: timeliness, continuity, acceptability, availability and integration

Quality rehabilitation for all. Lessons learnt from integrating rehabilitation services in two general hospitals in Bangladesh

BAART, Judith
RAHMAN, Nafeesur
November 2017

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Working from the theory that integrating basic rehabilitation care within the health care system in Bangladesh, rather than as a stand-alone service, could greatly improve awareness of and access to rehabilitation services, CDD piloted setting up therapeutic care centres within hospitals. This report presents the lessons learned.

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."

Rehabilitation in health systems

WORLD HEALTH ORGANISATION (WHO)
2017

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This document provides evidence-based, expert-informed recommendations and good practice statements to support health systems and stakeholders in strengthening and extending high-quality rehabilitation services so that they can better respond to the needs of populations. The recommendations are intended for government leaders and health policy-makers and are also relevant for sectors such as workforce and training. The recommendations and good practice statements may also be useful for people involved in rehabilitation research, service delivery, financing and assistive products, including professional organisations, academic institutions, civil society and nongovernmental and international organisations. The recommendations focus solely on rehabilitation in the context of health systems. They address the elements of service delivery and financing specifically. The recommendations were developed according to standard WHO procedures, detailed in the WHO handbook for guideline development

Strengthening community and primary health systems for tuberculosis. A consultation on childhood TB integration

UNICEF
2016

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An estimated one million children between the age of 0-14 fall ill with tuberculosis (TB) every year, over 67 million children are infected and might develop active disease at any time. In 2013, the WHO with key partners launched the Roadmap for Childhood TB, outlining ten key actions to improve outcomes for children affected by TB, including improved data, development of child-friendly tools for diagnosis and treatment, engagement of key stakeholders at all levels of the system, and the development of integrated family- and community-centred strategies to provide comprehensive and effective services at the community level. A consultation on childhood TB integration took place in New York on June 1 and 2, 2016 to stimulate further the dialogue. The meeting addressed 7 topics: perspectives on childhood TB; country discussions on integration; integrating childhood TB interventions into service delivery; an opportunity for TB risk assessment at the community level: TB/HIV adapted integrated community case management (iCCM); childhood TB integration at the national, district, and community level; and financing childhood TB integration 

UNICEF 2016-2030 Strategy for Health “at a glance”

UNICEF
2016

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This provides an overview of UNICEF’s 2016-2030 Strategy for Health which "aims to: end preventable maternal, newborn, and child deaths; and promote the health and development of all children. With the first goal, UNICEF commits to maintaining focus on the critical unmet needs related to maternal, newborn and under-5 survival. With the second, UNICEF highlights the importance of also looking beyond survival and addressing the health and development needs of older children and adolescents. The Strategy emphasises the importance of prioritising the needs of the most deprived children and promotes multi-sectoral approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts by encouraging risk-informed programming in all contexts"

World report on ageing and health

WORLD HEALTH ORGANIZATION (WHO)
2015

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This report lays out framework for the development of new strategies to bring the right programmes, information, and services to an ageing international community. The report focuses on policy development, healthy ageing and health in old age, health systems and long – term care systems.  The report concludes by presenting a series of recommended next steps to realising the vision of a world that is more friendly to an ageing population

UNICEF’S STRATEGY FOR HEALTH (2016-2030) (full version)

UNICEF
2015

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For the five year period 2016-2020, UNICEF’s Strategy for Health sets two overarching goals: 1. End preventable maternal, newborn and child deaths 2. Promote the health and development of all children. To achieve these goals, the Strategy considers the health needs of the child at all life stages. It highlights the need for intensified efforts to address growing inequities in health outcomes, including a particular focus on addressing gender-specific needs and barriers that may determine whether boys and girls are able to reach their full potential in health and well-being. Working together with global and local partners, UNICEF will promote three approaches to contribute to these goals: addressing inequities in health outcomes; strengthening health systems including emergency preparedness, response and resilience; and promoting integrated, multisectoral policies and programmes. The three approaches described underpin a "menu of actions” from which country offices can select, based on their situation analysis, country programme focus, and context. 

Universal health coverage for inclusive and sustainable development. A synthesis of 11 country case studies.

MAEDA, Akiko
ARAUJO, Edson
CASHIN, Cheryl
HARRIS, Joseph
IKEGAMI, Naoki
REICH, Michael R.
et al
2014

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Universal health coverage (UHC) for inclusive and sustainable development synthesises the experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The UHC policies for each country are examined around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The path to UHC is specific to each country, but countries can benefit from experiences of others and avoid potential risks

Globalising mental health or pathologising the global south? : mapping the ethics, theory and practice of global mental health

MILLS, China
FERNANDO, Suman
Eds
2014

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In response to moves from the World Health Organisation (WHO) and the Movement for Global Mental Health (MGMH) to redress the unequal access to mental health care in low and middle-income countries (LMIC) compared to high-income countries (HICs), the papers in this special issue of Disability and the Global South seek to highlight the issues of simply exporting a system developed in the global North irrespective of social and cultural context and lay the ground for (re)imagining and practising healing and support differently in LMICs and in HICs. The issue is a collection of 14 articles, including voices from the field

Disability and the Global South, Vol. 1, No.2

Towards preventing torture and ill-treatment in health-care settings

MENDEZ, Juan E
February 2013

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"The present report focuses on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. It identifies the policies that promote these practices and existing protection gaps. By illustrating some of these abusive practices in health-care settings, the report sheds light on often undetected forms of abusive practices that occur under the auspices of health-care policies, and emphasizes how certain treatments run afoul of the prohibition on torture and ill-treatment. It identifies the scope of State's obligations to regulate, control and supervise health-care practices with a view to preventing mistreatment under any pretext. The Special Rapporteur examines a number of the abusive practices commonly reported in health-care settings and describes how the torture and ill-treatment framework applies in this context. The examples of torture and ill-treatment in health settings discussed likely represent a small fraction of this global problem"
A/HRC/22/53

Giving with one hand...evaluation of post-earthquake physical rehabilitation response in Haiti, 2010 : a systems analysis

TATARYN, Myroslava
BLANCHET, Karl
2012

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This report presents the evaluation of the post-emergency rehabilitation response in Haiti in order to assess what had been achieved, to learn from good and not-so-good practice, and to promote the development of an effective rehabilitation sector in the future.This evaluation provides evidence, to inform humanitarian organisations, about what must be done in a post-disaster situation so that people with disabilities have access to relief and protection on an equal basis with others, and what is required in the long-term to develop a good rehabilitation service

Institutional care for older people in developing countries : the case of Buenos Aires, Argentina

SHERLOCK-LLOYD, Peter
REDONDO, Nelida
2009

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"This paper examines the quality of care provided by old age homes in developing countries. It draws attention to the growing demand for such services and the emergence of a largely unregulated private sector. The paper reviews the findings of a survey of 101 private old age homes conducted in Buenos Aires, Argentina during 2004 and 2005. This reveals that the quality of care leaves much to be desired, and that the rights, autonomy and dignity of older people are often neglected. Particular issues of concern are the repressive managerial structures (including the use of restraints and medication), questionable processes of admission, and limited support for dependent residents. The paper calls for long term care to be given a higher policy profile in developing countries than is currently the case"
Journal of Population Ageing, Vol 2, No 1-2

A health handbook for women with disabilities

MAXWELL, Jane
WATTS BELSER, Julia
DAVID, Darlena
February 2007

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This book deals with practical advice on health care for women with disabilities. It has been developed in partnership with health care professionals and disabled women in over 42 countries. It covers the key issues of disability in the community; accessible health care; mental health; sexual health; family planning; and child birth. The book is written in a practical and accessible style, suitable for anyone with an interest in disability, social development and women's health issues. In particular, the book offers a valuable insight into 'real-life' personal experiences of disabled women

Social capital and health : does egalitariansim matter? A literature review

ISLAM, M Kamrul
et al
2006

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This literature review provides an overview of the notion and practice of social capital and its impact on health. The study found significant relationships between health and social capital, irrespective of a country's degree of egalitarianism. However, in egalitarian countries, contextual social capital seems less relevant in explaining health differences across places

Caring for landmine victims

INTERNATIONAL COMMITTEE OF THE RED CROSS (ICRC)
June 2005

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This booklet examines the challenges involved in providing assistance to landmine victims, many of whom cannot be provided with sufficient care because of poverty and a lack of health facilities. It also highlights the responsibilities of states to the Ottawa Convention and the new protocol on explosive remnants of war (ERW), and encourages increased efforts by both health-care systems and governments to support the victims

Global health watch 2005-2006 : an alternative world health report

LEMA, Claudia
et al
2005

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This report is the result of a collaboration of leading popular movements, NGOs, activists, academics and health workers. It provides an evidence-based analysis of the political economy of health and health care and challenges policies and initiatives of global organisations including the World Bank, the World Health Organization and UNICEF. Many key issues relevant to health are covered, including health care services and systems, health of vulnerable groups, climate change, food and water, education, armed conflicts. Part E also provides and assessment of the impact global institutions, transnational corporations and rich countries. This report is a call for action, directed to health workers and activists and national and international policy-makers

Innovations in supporting local health systems for global women's health : summary report of the Wye River, MD conference

PINHO, Helen de
KELLER, Elisabeth
BEHRMAN, Greg
2005

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This report summarises the key themes emerged during the 2005 symposium on 'Innovations in Supporting Local Health Systems for Global Women's Health'. It includes the 'Wye River Call to Action for Global Women's Health', which urges changes in the priorities that shape policies and resource allocation, universal access to health care, systematic changes in the health systems, and efforts in poverty reduction and development strategies

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