This document provides a rapid review of the evidence on disability inclusive approaches to HIV prevention and response. The purpose of this review is to inform DFID’s policy and programming around integrated approaches to HIV, care and treatment. After briefly outlining the methodology in section 2, section 3 provides an overview of the evidence base on disability and HIV programming, and section 4 provides an overview of key barriers to accessing HIV-related services for people with disabilities. Finally, section 5 provides a series of case studies highlighting lessons learned including key enabling factors. This review finds that overall the evidence base on disability inclusive HIV programming is limited, with the majority of evidence from disability-specific interventions targeted at specific groups of people with different impairments
This article presents disability-inclusive good practices, policy and program related opportunities. It highlights a series of facts and figures related to people with disabilities and HIV infection and the interaction between HIV and disability. The article goes on to outline Handicap International’s proposal to “remove HIV-related barriers for persons with disabilities” in a two-track approach that includes decision makers, service providers, and service users. Finally, the article shares discussions of successful inclusive practices involving HIV and persons with disabilities in various communities around the world and the key challenges and opportunities to include disability into HIV and AIDS
Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania. Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods. In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.
The purpose of this document is to share good practices and processes concerning the inclusion of disability issues in HIV policy and programming, drawing on specific experiences in Senegal, Ethiopia, Kenya, Rwanda and Cambodia and on lessons learned at international AIDS conferences. More specifically, it is intended to 1) provide a clear indication to HIV and AIDS practitioners that disability mainstreaming in HIV and AIDS is indeed possible and workable in various contexts and by implementing specific steps/initiatives; 2) transfer concrete knowledge and practices to disability stakeholders, including disabled people's organisations, on how to work in HIV and AIDS; and 3) persuade HIV-related development partners that more investment is needed to develop this knowledge base in order to bring about practical changes at micro, meso and macro levels, as well as among the population. The good practices are also intended to inspire and motivate other organisations and agencies to use and replicate them in other contexts and countries, if/when they are adapted to the needs and situations of people with disabilities and communities
This brief is an introduction to the lessons learned document on good practices about the inclusion of disability in HIV policy and programming. Good practices and processes concerning the inclusion of disability issues in HIV policy and programming are highlighted, drawing on specific experiences in Senegal, Ethiopia, Kenya, Rwanda and Cambodia and on lessons learned at international AIDS conferences
LL No 7 Brief
This report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services
Note : Accessible and easy read versions are available from the link above
With growing recognition that persons with sensory (blindness and deafness), physical, and intellectual disabilities are at risk for HIV, it is crucial to understand the HIV programming needs of persons with disabilities and challenges to accessing HIV-related services. The HIVCore project, funded by the U. S. Agency for International Development, conducted a situation analysis in Ghana, Uganda, and Zambia with persons with disabilities and service providers to describe existing HIV services for persons with disabilities, identify factors affecting access to and use of HIV services, and identify opportunities and gaps for addressing HIV service needs of persons with disabilities. By identifying the needs and challenges in HIV programming for persons with disabilities and by identifying existing programs, the findings from this assessment can be used to guide the implementation of disability-inclusive programming.
"This document aims to capture some of the key lessons learned from Handicap International’s New Partnership Initiative project in Rwanda, which started in 2008 with the objective to integrate persons with disabilities in HIV and Sexual Violence (SV) prevention efforts and service provision generally. It is the result of qualitative, multi-stakeholder study about how change occurred within the project and how the experience could be modelled for adaptation or replication in Rwanda or other contexts"
"This report presents an analysis and an overview of main issues in relation to social relationships, sexuality and reproductive rights that emerged from the different presentations and discussions during the workshop. Most of the discussions and presentations focused on difficulties, barriers and challenges. There were a few positive examples of activities that answer those challenges and overcome those barriers. There were also some ideas of what can be or should be done in this area" “"Going beyond the taboo areas in CBR" workshop, part 1
29 November 2012
"To achieve real and sustainable change, the post- 2015 framework must focus on the social transformations required to eradicate poverty and empower the most marginalised and excluded people. This report argues that such transformation cannot happen without tackling the underlying causes of gender inequality which, in turn, will not be successful without the political will and resources that a standalone goal on gender equality can provide"
"This policy paper describes Handicap International’s mandate and values in operational terms as applied to the theme of inclusive and integrated HIV and AIDS programming. It presents the approaches and references for Handicap International’s actions, choices and commitments. It aims to ensure coherence in terms of practices whilst taking into account different contexts. Essentially this is a guidance document for programme staff which defines the topic and outlines the target populations, methods of intervention (expected results, activities) and indicators for monitoring and evaluation. This policy aims to ensure that all projects carried out by Handicap International programmes are consistent with the methods of intervention presented"
This resource highlights that children and adolescents with disabilities are critical to achieving an AIDS-free generation. It provides information about family- and community-based responses for a disability-sensitive AIDS-free generation, and specific recommendations for working with children, adolescents and young people with disabilities in HIV programmes. Opportunities and entry points for implementation are given, as well as examples of materials developed by adolescents with disabilities and community-based organizations
“The Making HIV/AIDS Strategies Inclusive of People with Disabilities in Tanzania was a three-year project (February 2009-January 2012), implemented by CBM US and local partner Comprehensive Community Based Rehabilitation in Tanzania (CCBRT). The goal of the project was to increase access for people with disabilities and their caregivers to HIV and AIDS prevention, care, treatment and support services in Tanzania. Based on a review of project documents, interviews and success stories, the following three interlinked lessons learned categories and eleven lessons learned emerged as critical to the successful achievement of project objectives, and the lessons learned described in this report will provide a foundation for improving on future programming of similar projects”
This policy brief presents information highlighting that persons with disabilities are at equal or higher risk of HIV infection than the rest of the community for the following reasons: poor access to information on sexual and reproductive health and HIV&AIDS; poor access to health care, including HIV&AIDS services; poverty and marginalisation; and high rates of sexual abuse and exploitation. Recommended actions are provided to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services
"This policy brief is an introduction to Handicap International’s 2012 Policy Paper "Inclusive and integrated HIV and AIDS programming". Handicap International promotes an inclusive approach to improving quality of life and access to services for persons with disabilities. This means that basic health care and socioeconomic services are developed according to the principle of Universal Access, where all people with impairments (whether physical, sensory, intellectual or mental), have equal access and opportunities for participation. This inclusive approach also ensures that gender considerations and disparities are acknowledged as a cross-cutting issue"
Policy brief No 7
This chapter explores role playing, sociodramas, people’s theater, and puppet shows as forms of action-packed group story-telling for health workers. Each can be used to explore problems or situations by acting them out and learning processes are provided for both actors and watchers based upon participation and discovery
Chapter 27 of "Helping Health Workers Learn" by D. Warner and B. Bower
The purpose of this report is to "increases awareness of the structural barriers that people with disabilities experience in accessing good-quality services. The strategy promotes broad action to achieve universal access to HIV prevention for people with disabilities through full integration into all aspects of the HIV response"
Issues brief JC2362
This training of trainers manual has been designed as a guide for providers of HIV prevention, treatment, care and support and sexual and reproductive health (SRH) services to ensure services are disability-inclusive. This training is divided in 5 parts: Part 1 - Introduction; Part 2 - Disability awareness and disability inclusion; Part 3 - Disability-inclusive HIV prevention, treatment, care and support services; Part 4 - Disability-inclusive sexual and reproductive health services; Part 5 - Disability-inclusive HIV prevention integrated into sexual and reproductive health services. This manual is useful for anyone interested in trainings on disability-inclusive HIV services and disability-inclusive sexual and reproductive health for health workers
Note: the manual is available to download in three parts using the links provided
"Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years"
Southern African Journal of HIV Medicine, Vol 12, No 2
"This paper highlights the added discrimination that women with disabilities often face in the context of their disparate access to health care, especially in the areas of reproductive health services and sexual health education, and offers recommendations for a twenty-first century response to the vast health care gaps that impact this population"
Barbara Faye Waxman Fiduccia Papers on Women and Girls with Disabilities
Source e-bulletin on Disability and Inclusion