Resources search

How Koalaa is aiming to create sustainable access to prosthetics globally

MARSHALL, Niall (Koalaa)
September 2023

Expand view

A short talk given in the Disability Innovation Summit: Inclusive Interactions conference organised by the GDI hub on 13 Sept 2023.

 

The start up, development and potential progress of a technology company manufacturing upper limb prosthetics is outlined. Pilot projects were set up and that in Sierra Leone is briefly described. It began with developing a network, listening to users comments, redeveloping the product and representing it to users. The challenges of the next step into larger scale manufactuing and supply, following positive outcomes from pilot projects round the world, are outlined. 

Rehabilitation in health systems: guide for action

WORLD HEALTH ORGANISATION (WHO)
May 2019

Expand view

There is great variation across countries regarding the rehabilitation needs of the population, characteristics of the health system and the challenges that face rehabilitation. For this reason, it is important for each country to identify their own priorities and develop a rehabilitation strategic plan. A rehabilitation strategic plan should seek to increase the accessibility, quality and outcomes of rehabilitation.

To assist countries to develop a comprehensive, coherent and beneficial strategic plan, WHO has developed Rehabilitation in health systems: guide for action. This resource leads governments through a four-phase process of (1) situation assessment; (2) strategic planning; (3) development of monitoring, evaluation and review processes; and (4) implementation of the strategic plan. This process utilizes health system strengthening practices with a focus on rehabilitation.

The Rehabilitation in health systems: guide for action provides practical help that directs governments through the four phases and twelve steps. The process can take place at national or subnational level. Typically phases 1 to 3 occur over a 12-month period, while phase 4 occurs over the period of the strategic plan, around 5 years. The four phases and accompanying guidance are outlined below

Towards independent living: Collecting examples from Europe

ANGELOVA-MLADENOVA, Lilia
March 2019

Expand view

This Collection is a joint initiative of the European Network on Independent Living (ENIL) and the European Disability Forum (EDF). It features examples from different EU Member States, which to a different extent facilitate the right to live independently in the community.

The examples are divided into four areas, presented in different chapters:

  • Legislation and funding: State Funded Peer-Counselling – Estonia; Direct Payments – Ireland.
  • Community-based support: Peer-Counselling for women with disabilities – Austria; Supported living for adults with intellectual disabilities – Croatia; Supported Decision-Making – The Czech Republic; Mobile Mental Health Units – Greece; Personal Assistance for People with Complex Disabilities – Sweden .
  • Involvement of disabled people: Co-Production in Social Care – United Kingdom; Participation of Organisations of People with Disabilities – Italy
  • Self-advocacy: Self-Advocacy of Disabled People – Romania

 

Global survey of inclusive early childhood development and early childhood intervention programs

VARGAS-BARON, Emily
et al
March 2019

Expand view

To learn more about the current status of IECD (inclusive early childhood development) and ECI (early childhood intervention) programs, three international organizations collaborated to conduct a global survey: RISE Institute; UNICEF; and the Early Childhood Development Task Force (ECDtf), which is within the Global Partnership on Children with Disabilities (GPcwd). This large survey was designed in 2016, was conducted in 2017, and the report was prepared in 2018.

 

The main objectives of the survey were to:

  • Map current implementation of IECD and ECI programs and related activities;
  • Describe key IECD and ECI program features;
  • Identify gaps and challenges in providing accessible IECD and ECI services;
  • Document factors associated with successful implementation and scale-up;
  • Generate recommendations to inform future policy and program development and national planning and implementation efforts.

 

The online survey targeted a range of programs, and activities including IECD and ECI services; rehabilitation and habilitation services; humanitarian, emergency, and child Global Survey of Inclusive ECD and ECI Programs 8 protection services; advocacy campaigns; and research and evaluation projects. 

 

Program respondents provided information on 426 programs that were implemented in 121 countries. 

Individualised funding interventions to improve health and social care outcomes for people with a disability: a mixed-methods systematic review. Campbell Systematic Reviews 2019:3

FLEMING, Padraig
et al
January 2019

Expand view

This Campbell systematic review examines the effects of individualised funding on a range of health and social care outcomes. It also presents evidence on the experiences of people with a disability, their paid and unpaid supports and implementation successes and challenges from the perspective of both funding and support organisations.

 

This study is a review of 73 studies of individualised funding for people with disabilities. These include four quantitative studies, 66 qualitative and three based on a mixed-methods design. The data refer to a 24-year period from 1992 to 2016, with data for 14,000 people. Studies were carried out in Europe, the US, Canada and Australia.

 

DOI 10.4073/csr.2019.3

WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights

WORLD HEALTH ORGANISATION (WHO)
2019

Expand view

SELF-CARE is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health-care provider. 

The purpose of this guidance is to develop a peoplecentred, evidence-based normative guideline that will support individuals, communities and countries with quality health services and self-care interventions, based on PHC (Primary Health Care) strategies, comprehensive essential service packages and people-centredness. The specific objectives of this guideline are to provide:

• evidence-based recommendations on key public health self-care interventions, including for advancing sexual and reproductive health and rights (SRHR), with a focus on vulnerable populations and settings with limited capacity and resources in the health system

• good practice statements on key programmatic, operational and service-delivery issues that need to be addressed to promote and increase safe and equitable access, uptake and use of self-care interventions, including for advancing SRHR.

The GRID Network: A Community of Practice for Disability Inclusive Development

COCKBURN, Lynn
MBIBEH, Louis
AWA, Jacques Chirac
2019

Expand view

Purpose: This paper aimed to provide an overview of the evaluation of the GRID Network (Groups for Rehabilitation and Inclusive Development) and the impact it had on its members.

Method:  Information was collected through a compilation of the resources developed during the project, and a summative evaluation process was employed at the end of the project. The paper is a short report on the summative evaluation.

Results: GRID Network members reported that the network was effective and beneficial. They developed new information and knowledge that was relevant to their local contexts; shared knowledge from local, national, and international sources; and, increased their skill in using social media for professional purposes. Recommendations include continuing with this kind of community of practice, with greater opportunities for more engagement and training; inclusion of more partner organisations; large group workshops and conferences; increased attention to advocacy for policy change; and, for more research to be carried out locally.

Conclusion and Implications: This project demonstrated that it is possible to develop and maintain a community of practice in a low-resource context on a minimal budget, even during times of political crisis. Further programme development, evaluation, and research are warranted to ascertain how this model can be scaled up to include a broader group of rehabilitation and other practitioners involved in disability inclusive development.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 84-94,  (2019)

MAANASI - A sustained, innovative, integrated mental healthcare model in South India

JAYARAM, Geetha
GOUD, Ramakrishna
CHANDRAN, Souhas
PRADEEP, Johnson
2019

Expand view

Studies in low and middle-income countries (LMICs) point to a significant association of common mental disorders with female gender, low education, and poverty. Depression and anxiety are frequently complicated by lack of disease awareness and non-adherence, the absence of care and provider resources, low value given to mental health by policy-makers, stigma, and discrimination towards the mentally ill. This paper aims to show that female village leaders/ community health and outreach workers (CHWs) can be used to overcome the lack of psychiatric resources for treatment of common mental disorders in rural areas.

A multidisciplinary team was set up to evaluate and treat potential clients in the villages. A program of care delivery was planned, developed and implemented by: (a) targeting indigent women in the region; (b) integrating mental health care with primary care; (c) making care affordable and accessible by training local women as CHWs with ongoing continued supervision; and (d) sustaining the program long-term.   Indigenous CHWs served as a link between the centre and the community. They received hands-on training, ongoing supervision, and an abridged but focused training module to identify common mental disorders, help treatment compliance, networking, illness literacy and community support by outreach workers. They used assessment tools translated into the local language, and conducted focus groups and client training programs. 

As a result, mental healthcare was provided to clients from as many as 150 villages in South India. Currently the services are utilized on a regular basis by about 50 villages around the central project site. The current active caseload of registered clients is 1930.  Empowerment of treated clients is the final outcome, assisting them in self-employment. 

Rural mental healthcare must be culturally congruent, and must integrate primary care and local CHWs for success. Training, supervision, ongoing teaching of CHWs, on-site resident medical officers, research and outreach are essential to continued success over two decades.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 104-113, Oct. 2019

 

 

Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST)

SKEMPES, Dimitrios
et al
October 2018

Expand view

The process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities is described.  A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. Fifty-six individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. Forty-one participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by a select number of participants.

 

Globalization and Health (2018) 14:96
https://doi.org/10.1186/s12992-018-0410-5

Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
2018

Expand view

This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

NOTE:
The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Services for people with communication disabilities in Uganda: supporting a new speech and language therapy professional

MARSHALL, Julie
WICKENDEN, Mary
2018

Expand view

Services for people with communication disability (PWCD), including speech and language therapists (SLTs), are scarce in countries of the global South. A SLT degree programme was established at Makerere University, Uganda, in 2008. In 2011, an innovative project was set up to provide in-service training and mentoring for graduates and staff of the programme. This paper describes the project and its evaluation over three years. Three types of input: direct training, face-to-face individual and group meetings, and remote mentoring, were provided to 26 participants and evaluated using written and verbal methods. The first two types of input were evaluated mainly positively, while remote mentoring received more mixed evaluations. Less positive evaluations were linked to factors including resourcing, cultural perceptions about professional roles and services, work patterns, power/status, engagement, perceptions of help-seeking, community recognition of the needs for services for PWCD. Findings suggest that participatory approaches, flexibility, reflexivity and open discussion with participants around support and work challenges, are important. Power gradients between white Northern ‘experts’ and relatively inexperienced East African SLTs, contributed to some challenges. Structural issues about degree programme structures and statutory bodies, provide lessons about the development of new services and professions in low-income settings. 

 

Disability and the Global South, 2018 Vol.5, No. 1

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

BAART, Judith
RAHMAN, Nafeesur
November 2017

Expand view

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.

Employment outcomes of skills training in South Asian countries: An evidence summary

ILAVARASAN, P Vigneswara
KUMAR, Arpan K
ASWANI, Reema
November 2017

Expand view

This evidence summary of systematic reviews provides insights for policy makers surrounding the impact of training programmes on employment outcomes. There are 11 studies included in this summary focusing on technical and vocational education and training (TVET), rehabilitation and counselling, personality development (including leadership training, stress management and communication skills training) and entrepreneurship training programmes.

 

The target groups covered in the included studies are diverse including people with disabilities, health workers, women and enterprises as a whole. The final studies comprise of one study each from 2011 and 2017; two studies each from 2013, 2015 and 2016; and three studies from 2014. The focus of this evidence is on low and middle income South Asian countries namely: Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka

QualityRights materials for training, guidance and transformation

WHO
2017

Expand view

"As part of the QualityRights Initiative, WHO has developed a comprehensive package of training and guidance modules. The modules can be used to build capacity among mental health practitioners, people with psychosocial, intellectual and cognitive disabilities, people using mental health services, families, care partners and other supporters, NGOs, DPOs and others on how to implement a human rights and recovery approach in the area of mental health in line with the UN Convention on the Rights of Persons with Disabilities and other international human rights standards".

Rehabilitation in health systems

WORLD HEALTH ORGANISATION (WHO)
2017

Expand view

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

Standards for prosthetics and orthotics

WORLD HEALTH ORGANISATION (WHO)
2017

Expand view

This document provides a set of standards and a manual for implementation to support countries in developing or improving high-quality, affordable prosthetics and orthotics services. Its aim is to ensure that prosthetics and orthotics services are people-centred and responsive to every individual’s personal and environmental needs. Implementation of these standards will support Member States in fulfilling their obligations under the CRPD and in meeting the SDGs, in particular Goal 3. With these standards, any government can develop national policies, plans and programmes for prosthetics and orthotics services of the highest standard. This document has two parts: the standards and an implementation manual. Both parts cover four areas of the health system:

• policy (governance, financing and information);

• products (prostheses and orthoses);

• personnel (workforce);

• provision of services

WHERE THERE IS NO REHAB PLAN A critique of the WHO scheme for Community Based Rehabilitation: with suggestions for future directions

MILES, M
2017

Expand view

Originally published at Mental Health Centre, Peshawar, 1985. Reprinted, 1997, Birmingham, UK, in revised format with minor corrections and updates. Online version, [2017 at ResearchGate],  with new introductory notes.

This paper examines with extensive documentation the theoretical and practical functioning and flaws of the WHO {World Health Organisation} Community Based Rehabilitation scheme currently  [i.e. 1985]  being field tested in a number of countries, and of the Manual Training Disabled People in the Community. The development of alternative CBR schemes in Asia, Africa and Latin America since the 1960s is outlined. It is demonstrated that the antithesis posited between 'Institution Based Rehabilitation' and 'Community Based Rehabilitation' is artificial, excluding as it does the middle ground of inexpensive, appropriate rehabilitation based at community-run neighbourhood centres. The strengths and weaknesses of neighbourhood centre based rehabilitation and the WHO‑style home‑based rehabilitation are compared, together with the many social, economic and demographic factors favouring the former approach. Cost considerations are examined in some detail. An account is given of experience in mobilising community resources for neighbourhood rehabilitation centres in Pakistan. Recommendations are made for future Community Rehabilitation plans, with emphasis on the development and dissemination of rehabilitation skills and information through appropriate media.

Report of the Special Rapporteur on the rights of persons with disabilities (theme: access to rights-based support for persons with disabilities)

DEVANDAS, Catalina
December 2016

Expand view

In her report, the Special Rapporteur provides an overview of the activities undertaken in 2016, as well as a thematic study on access to support by persons with disabilities. The study includes guidance for States on how to ensure the provision of different forms of rights-based support and assistance for persons with disabilities, in consultation with them. In preparing the study, the Special Rapporteur convened a regional expert consultation in Addis Ababa in September 2016 and analysed the responses to a questionnaire sent to Member States, national human rights institutions, agencies of the United Nations system, civil society organisations and persons with disabilities and their representative organisations. As at 5 December 2016, she had received 114 responses. 

Special appeal 2016 : Disability and mine action 2016

ICRC
November 2016

Expand view

This Special Appeal covers the funding requirements for physical rehabilitation activities for all persons with disabilities – among them, victims of armed conflict, other situations of violence and mines/ERW – as well as for initiatives related to mine action. It also summarizes the ICRC’s wider approach to addressing the needs of persons with disabilities, including its other efforts to facilitate the social and economic aspects of inclusion. The work of the Physical Rehabilitation Programme (PRP) and the Special Fund for the Disabled (SFD) is outlined. Topics associated with reducing the impact of weapon contamination and with promoting legal frameworks and government are discussed. 

The 2015 Nepal earthquake(s): Lessons learned from the disability and rehabilitation sector's preparation for, and response to, natural disasters

LANDRY, Michel
SHEPHARD, Phillip
LEUNG, Kit
RETIS, Chiara
SALVADOR, Edwin
RAMAN, Sudha
November 2016

Expand view

This article outlines lessons learned from 2015 Nepal earthquake that can be applied to future disasters to reduce overall disability-related outcomes and more fully integrate rehabilitation in preparation and planning. Information is presented on disasters in general, and then specficially on the earthquake(s) in Nepal. Field experience in Nepal before, during, and after the earthquake is described, and actions that can and should be adopted prior to disasters as part of disability preparedness planning are examined. Emerging roles of rehabilitation providers such as physical therapists during the immediate and postdisaster recovery phases are discussed. Finally, approaches are suggested that can be adopted to “build back better” for, and with, people with disabilities in postdisaster settings such as Nepal.

 

Physical Therapy, Volume 96, Issue 11, 1 November 2016, Pages 1714–1723

https://doi.org/10.2522/ptj.20150677

 

Pages

E-bulletin