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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.

How CBM Australia supports engagement with government for disability inclusion and prevention

CBM AUSTRALIA
March 2016

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CBM Australia engages both directly and indirectly with governments. Indirectly, CBM Australia supports other organisations, for instance disabled people’s organisations or civil society organisations to engage with governments. This report looks at the different ways that CBM partners seek influence government and promote sustainability. It considers the different roles and relevance of activism, advocacy, service delivery and advisory approaches.

 

The cases in this report were identified and gathered through semi-structured interviews with CBM’s Program Officers, Technical Advisors, regional/country office and project staff in-country, as well as drawing on reports and evaluations. The report starts with a section explaining the four different approaches to working with government, followed by a brief introduction to each approach, highlighting what CBM are doing and the key lessons learned. Each section is followed by case studies giving more detailed insight into how CBM are engaging, key achievements, challenges and the lessons learned. Fifteen case studies covering key projects from CBM Australia’s International Programs and the Inclusive Development Team are described in this report.

Beneath the rhetoric: Policy to reduce the mental health treatment gap in Africa

COOPER, Sara
2015

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In this paper I problematize knowledge on reducing the ‘gap’ in treatment produced by 14 national mental health policies in Africa. To contextualize this analysis, I begin with a historic-political account of the emergence of the notion of primary health care and its entanglement within decolonization forces of the 1960s. I unpack how and why this concept was subsequently atrophied, being stripped of its more revolutionary sentiments from the 1980s. Against this backdrop, I show how, although the 14 national mental health policies are saturated with the rhetoric of primary health care and associated concepts of community participation and ownership, in practice they tend to marginalize local meaning-systems and endorse a top-down framework heavily informed by colonial medicine. The policies thus end up reproducing many of the very Eurocentric assumptions that the original primary health care notion sought to transcend. More specifically, the paradigms of evidence-based research/practice and individualised human rights become the gatekeepers of knowledge. These two paradigms, which are deeply embedded within contemporary global mental health discourse, are legislating what are legitimate forms of knowing, and by extension, valid forms of care. I argue that a greater appreciation of the primary health care concept, in its earliest formulation, offers a potentially fruitful terrain of engagement for developing more contextually-embedded and epistemologically appropriate mental health policies in Africa. This in turn might help reduce the current ‘gap’ in mental health care treatment so many countries on the continent face.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

Surviving spinal cord injury in low income countries

ØDERUD, Tone
2014

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Background: Mortality rates from injuries are higher for people from poorer economic backgrounds than those with higher incomes (according to the World Health Organization [WHO]), and health care professionals and organisations dealing with people with disabilities experience that individuals with spinal cord injury (SCI) in low income countries face serious challenges in their daily lives.

 

Objectives: The aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual) and the situation of persons living with SCI in low income settings.

 

Method: Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals.

 

Results: There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges.

 

Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

Disability in national strategic plans on HIV and AIDS : a review on the national response to the interrelations of disability and HIV in eastern and southern Africa|Final report

GRANT, Kitty
STRODE, Ann
HANNASS-HANCOCK, Jill
December 2009

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This report examines national AIDS and HIV strategic plans (NSPs) in eastern and southern Africa and includes findings, discussions and best practice examples on the integration of disability throughout the countries. "Generally, the findings of the report show that less than 50% of the countries in Eastern and Southern Africa recognise disability as an issue of concern, or specifically recognise the vulnerability of people with disabilities to HIV and AIDS within their NSPs. Furthermore, it found that even where countries have recognised disability as an issue, there is limited specific guidance within the NSP on HIV-related service provision to meet the needs of people with disabilities. Only one country, South Africa, showed extensive integration of disability into the various focus areas of its NSP." The report concludes with recommendations and provides detailed appendices of national reports for each country surveyed

PLACE in Zimbabwe : identifying gaps in HIV prevention among orphans and young people in Hwange District, 2006

SINGH, Kavita
et al
April 2008

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The Priorities for Local AIDS Control Efforts (PLACE) method is a tool to identify areas where HIV transmission is most likely to occur, and within these areas, to identify gaps in prevention programmes. In Zimbabwe, the PLACE method was used to understand what risk factors are putting adolescent girls (orphans and non-orphans) and young women 18-24 years of age at risk of acquiring HIV. Because there is an indication that men may sexually abuse adolescent girls in their homes and because it was believed that some adolescent girls may not frequent public places, a household survey was added to the PLACE method

Safeguarding the health sector in times of macroeconomic instability : policy lessons for low- and middle-income countries

HADDAD, Slim
BARIS, Enis
NARAYANA, Delampady
2008

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This publication presents the results of an international initiative to document the effects of how health systems in the developing world have responded to macroeconomic austerity and adjustment measures. Are these systems flexible and resilient to changes or are they rigid? In which circumstances and under which conditions do health systems respond favourably or unfavourably? What are the success stories? Country studies from Burkina Faso, Zimbabwe, India, Thailand, Mexico, and Colombia discuss lessons learned and identify policy measures for safeguarding the health sector

Missing the target #5 : improving AIDS drug access and advancing health care for all

INTERNATIONAL TREATMENT PREPAREDNESS COALITION (ITPC)
December 2007

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This report documents how the mobilisation around AIDS is driving health systems advancement in China, Dominican Republic, Zimbabwe, Russia, Kenya, India, Cameroon, Zambia and Cambodia, and it highlights the need for improvements in broader systems of care and services to meet the needs of people living with HIV & AIDS and the communities in which they live. It also considers ARV procurement, registration and stock-outs in Argentina, Belize, Cambodia, China, Dominican Republic, India, Malawi, Morocco, Nigeria, Philippines, Russia, Uganda, Zambia, Zimbabwe

HIV/AIDS communication in selected African countries : interventions, reponses and possibilities

PARKER, Warren
RAU, Asta
PEPPA, Penny
2007

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This review looks at communication activities around HIV prevention in 11 countires in South and East Africa operating in 2006 at a national level. It considers the variations in HIV epidemiology between countries, and the heterogeneity within them, and examines the different approaches to communication that are used. The country summaries include a synopsis of the epidemiology, indicators of knowledge, behaviour and service uptake and information about HIV and AIDS prevention communication, activities, approaches and funding

Are disabled peoples’ voices from both south and north being heard in the development process?|A comparative analysis between the situation in South Africa, Zimbabwe, United Kingdom and Northern Europe

DUBE, A K
CHAROWA, Gladys
May 2005

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This study reveals that there are major differences between the South and the North regarding issues involving persons with disabilities. It shows that the North provides devices for disabled persons and maintains high standards in disability; whereas countries in the South have weak acts of parliament, in addition to the fact that much of the South does not have social security benefits

USAID project profiles : children affected by HIV/AIDS

UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
January 2005

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This document presents profiles of 114 projects (90 country-specific, 12 regional, and 12 global) funded by USAID. It includes a section on USAID projects that support access to education in Africa. The project profiles include the names of implementing organisations, funding periods and amounts, objectives, strategies, key accomplishments, priority activities for the year ahead, and materials and tools available to other projects that can help meet the needs of children and youth affected by HIV and AIDS. The diversity of these projects demonstrates the US government's efforts to meet the wide variety of needs of children and youth affected by HIV and AIDS. Approaches vary in both strategy and scale. The vast majority of projects work with communities to identify opportunities that strengthen existing resources without undermining local ownership. In many places, communities are already mobilised and have systems in place to identify, protect, and provide basic necessities to the most vulnerable children. USAID supports the strengthening and monitoring of these existing activities

Psychosocial support training manual

WALKER, Lynn
2005

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This document recognises that psychosocial support for children affected by HIV and AIDS is as important as responding to their material needs. It explores children's experience of loss and grief, and suggests ways to deal with aggressive behaviour and to overcome stigma and discrimination. Some of the topics discussed are accompanied by useful handouts. It is designed as a training tool for professionals working directly with children or in community building projects

Disability and HIV & AIDS : a participatory rapid assessment of the vulnerability, impact and coping mechanisms of the disabled people on HIV/AIDS

NGANZI, Patrick
MATONHODZE, George
2004

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This study assesses the vulnerability, impact and coping mechanisms of disabled people on HIV and AIDS, and suggests strategies for developing an HIV and AIDS programme for disabled people’s organisations. Using participatory methodologies of inquiry, the study found that disabled people perceive themselves to be at higher risk of HIV infection due to their disability, regardless of their awareness levels. Their social exclusion from the mainstream HIV/AIDS services makes the situation worse. The study revealed that the many myths and misconceptions around HIV and disability increase the vulnerability of disabled people to HIV/AIDS, such as the belief that sex with a disabled person cleanses a person of HIV/AIDS. It also revealed that disabled people have limited access to HIV/AIDS information and limited use of HIV/AIDS services mainly because of the nature of their disability, the location of the facilities and the attitudes of service providers. In conclusion, the study revealed that disabled people are at a higher risk of infection by sexually transmitted infections and HIV/AIDS due to their exclusion from mainstream HIV interventions. This situation is further exacerbated by the lack of policy framework on disability and HIV and AIDS

Disability and HIV & AIDS : a participatory rapid assessment of the vulnerability, impact, and coping mechanisms of parents of disabled children on HIV & AIDS

NGANZI, Patrick
MATONHODZE, George
2004

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This study assesses the vulnerability, impact and coping mechanisms of parents of disabled children on HIV/AIDS and suggests strategies for developing an HIV and AIDS programme. Using participatory methodologies of inquiry, the study found that the parents of disabled children are at a higher risk of infection to sexually transmitted infections (STI) and/or HIV and that the risk increases as the parents try to cope with having a disabled child. Therefore, a disabled child in a family acts as one of the pre-disposing factors to the parents' infection and when an infection happens in a home, the quality of care for the very disabled child is compromised causing a vicious cycle of disability and HIV/AIDS at the household level.The study recommends that target-specific interventions should be designed and implemented for the parents of disabled children to address issues of HIV/AIDS and disability, empowerment and gender issues as well as sexual reproductive health

The development, implementation and evaluation of interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe : a literature review of evidence-based interventions for home-based child-centred development

STREBEL, Anna
2004

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This short paper gives a literature review of many programmes aimed at supporting orphans and vulnerable groups in the southern Africa region. It is not an in-depth survey, but provides a compact and accessible guide to the many different community initiatives that have been undertaken. It finishes with a short section on the lessons to be learned from care programmes

A description of the selected interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe

DLAMINI, Phetsile K
2004

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This report contributes to phase one of a research programme which explores the social, political, economic and systemic determinants that affect vulnerability to HIV. This report documents existing interventions to gain more in-depth knowledge of interventions at grassroots level, identify their strengths and weaknesses, and consider opportunities and threats; analyse and assess the outcomes of such interventions and whether objectives were met, including the impact on vulnerable children, their families and communities, considering nutritional and education status, and psychosocial well-being; ascertain the level of awareness around HIV and AIDS, and especially of prevention strategies and care

Young people we care! : a book of ideas for young people supporting each other in their communities

SHERMAN, Judith
September 2003

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This book is designed to help groups of young people support either younger children or their peers who are living in communities and households affected by AIDS. It can also be used by home-based care organisations that want to involve young people in their home-based care activities. Written for a facilitator or young person with a good knowledge of HIV/AIDS and facilitation experience, it aims to prepare a group of young people to implement the community activities. It includes participatory activities to help young people think through a number of topics. The community activities section is written for young people and suggests ways to help support other young people and children in the community

Education and HIV/AIDS : a sourcebook of HIV/AIDS prevention programmes

WORLD BANK. Education Team
2003

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Education sectors of affected countries are playing an increasingly important role in the fight against HIV/AIDS. This sourcebook aims to support efforts by countries to strengthen the role of the education sector in the prevention of HIV/AIDS. It provides concise summaries of programmes around Africa, highlighting the main elements of the programme as well as what lessons can be learned from them

Children, HIV/AIDS and communication in South Africa : a literature review

FOX Susan
OYOSI Salome
PARKER Warren
May 2002

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This literature review covers key issues relating to children aged 3-12 and HIV/AIDS, including discrimination, grief, children's rights, and knowledge and understanding of HIV/AIDS. The impact on the child, family and community is discussed in detail, particularly in terms of the psycho-social impact of bereavement and how this impacts on the child at different stages in its development. Various community programmes within southern Africa are highlighted, which support children to develop life skills. The influence, role and practice of the media in working with and reaching children is addressed, and case studies of South African media projects such as Soul Buddyz and Takalani Sesame are provided

Understanding community responses to the situation of children affected by AIDS : lessons for external agencies. Draft paper prepared for the UNRISD project HIV/AIDS and Development

FOSTER, Geoff
March 2002

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This is a key report that documents community responses and coping mechanisms towards the HIV/AIDS pandemic in relation to children affected by AIDS (CABA) and orphans and vulnerable children (OVC). Fostering families are under enormous strain and local initiatives at the community level have been little studied or documented, and few organisations have sought to encourage their development. The paper analyses some of these initiatives and encourages external agencies to support them through building the capacity of local responses rather than imposing external solutions

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