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Addressing barriers to employment for people with disabilities: evidence and lessons learned. Disability Inclusion Helpdesk Research Report No. 41

MEANIE-DAVIS, Jessie
COE, Sue
June 2020

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This work was carried out to answer the query: “What is the evidence available on interventions that effectively address the barriers to people with disabilities accessing and maintaining employment (decent work) in the agriculture and manufacturing sectors in low and middle income countries?”.

This paper provides an overview of findings from evaluations, research, and case studies on programmes that seek to address barriers to employment for people with disabilities in low and middle income countries (LMICs). There is extremely limited evidence available on this subject, particularly from mainstream agriculture, livelihoods and employment programmes. Almost all of the evidence available is from programmes with a specific focus on disability inclusion. Due to the lack of evidence available from interventions specifically focused on employment in the agriculture and manufacturing sectors, the scope of this query was expanded to include evidence from employment programmes that are not specific to one sector

This rapid evidence review identified three common programme approaches that seek to address different combinations of these barriers by working with different stakeholder groups: Single intervention approaches; Supply and demand approaches; and Systems approaches.

Disability inclusion in Nigeria : A rapid assessment

WORLD BANK
June 2020

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According to the World Health Organization, in 2018, about 29 million of the 195 million people who comprise Nigeria’s national population were living with a disability. Data from the 2018 Nigeria Demographic and Health Survey reveal that an estimated 7 percent of household members above the age of five (as well as 9 percent of those 60 or older) have some level of difficulty in at least one functional domain, seeing, hearing, communication, cognition, walking, or self-care; and 1 percent either have a lot of difficulty or cannot function at all in at least one domain. These estimated rates, while significant, are probably even higher because currently available data likely underestimate the prevalence. This rapid social assessment was undertaken to document the current socioeconomic status of persons with disabilities in Nigeria. Findings indicate that persons with disabilities lack access to basic services and that attitudinal barriers represent a major impediment to their socioeconomic inclusion. Inclusive policies are either nonexistent, weak, or inadequately implemented. 

Protection analysis: impact of COVID-19 measures on PSNs in refugee communities in Uganda

PERSONS WITH SPECIFIC NEEDS SUB-WORKING GROUP, UGANDA
May 2020

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The Persons with Specific Needs (PSN) sub working group is a collective of over 20 organisations including UN agencies, NGOs, Disabled Peoples Organizations (DPOs), and Government (Ministry of Gender, Labour and Social Development and Office of the Prime Minister) which regularly meets within the Uganda refugee coordination model to discuss issues relevant to refugees with specific needs, with a particular focus on persons with disabilities and older persons.

 

April 2020 the PSN SWG members started to collect evidence from a range of sources on the specific impact of the COVID-19 crisis and containment measures on PSNs within refugee communities in Uganda.

The impact of an inclusive education intervention on learning outcomes for girls with disabilities within a resource-poor setting

CAREW, Mark
DELUCA, Marcella
GROCE, Nora
FWAGA, Sammy
KETT, Maria
May 2020

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Background: Despite a global commitment to the right to education for persons with disabilities, little is known about how to achieve inclusive education in practice, particularly in low- and middle-income countries (LMICs), where the majority of the world’s people with disabilities reside. Moreover, although exclusion from education is magnified by intersecting gender and socioeconomic inequalities, there is especially little knowledge regarding what approaches to inclusive education are effective amongst girls with disabilities living in resource-poor settings.

 

Objectives: The objective of this article was to assess the impact of an inclusive education intervention led by a non-governmental organisation (NGO) on the educational attainment of girls with disabilities in the resource-poor Lakes region of Kenya.

 

Method: A quasi-experimental design was employed, where the literacy and numeracy educational attainment of the intervention and control groups was compared over two time points a year apart (Time 1 and Time 2; total matched N = 353). During this period, activities pertaining to six core components of a holistic inclusive education model were implemented.

 

Results: Relative to the control group, girls with disabilities in the intervention group reported a greater increase in literacy and numeracy attainment, adjusted for grade and level of functional difficulty.

 

Conclusion: Findings suggest that the intervention was successful in engendering additional improvements in the educational attainment of girls with disabilities from the resource-poor Lakes region of Kenya. Results highlight both the applicability of NGO-led interventions in settings, where national implementation of inclusive education is constrained, and the potential of taking such interventions to scale.

 

 

African Journal of Disability, Vol 9, 2020

The impacts of COVID-19 on people with disabilities: a rapid review. Disability Inclusion Helpdesk Query No: 35

MEANIE-DAVIS, Jessie
LEE, Harri
CORBY, Nick
April 2020

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There is currently very limited data and evidence on the impacts of COVID-19 on people with disabilities and pre-existing health conditions, with no disability-disaggregated data on mortality rates available in the public sphere. However, reports from the media, disability advocates and disabled peoples’ organisations (DPOs) point to several emerging impacts, including primary and secondary impacts including on health, education, food security and livelihoods.  Most of the available data is from high income countries (HICs) though reports from low- and middle-income countries (LMICs) are likely to emerge. Evidence was gathered by a rapid desk based review. Gaps are identified. 

 

The section concerned with lessons drawn from similar epidemics draws heavily on lessons learned from the Ebola outbreak in West Africa in 2014-2016, and touches on lessons from the Zika outbreak in 2015-2016 and the SARS pandemic in the early 2000s.10 It also touches briefly on SARS, MERS and H1N1 (swine flu). 

 

Primary and secondary impacts of COVID-19 on people with disabilities are reviewed.


People with disabilities are disproportionately impacted by COVID-19 not only because it can exacerbate underlying medical conditions, but because of attitudinal, environmental and institutional barriers to their participation in and benefit from the pandemic response. For example, inaccessible public health messaging and healthcare facilities, and stigma and discrimination.

Somalia Disability Inclusive COVID-19 WASH tip sheet

Humanity & Inclusion
April 2020

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This tip sheet provides an overview of the factors that may put persons with disabilities at heightened risk in the COVID-19 pandemic and response in humanitarian settings; and proposes actions to address these risks within the COVID WASH response.

Somalia Disability Inclusive COVID-19 health tip sheet

Humanity & Inclusion
April 2020

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This tip sheet provides an overview of the factors that may put persons with disabilities at heightened risk in the COVID-19 pandemic and response in humanitarian settings; and recommends actions to address these risks within your COVID health response. This note draws on actionable and evidenced recommendations from the IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, health chapter applying these to the COVID-19 pandemic, the WHO guidance for Disability inclusion in COVID-19 response, SODEN Statement on how COVID-19 is affecting persons with disabilities in Somalia and the practical field experience of HI and collaborating partners in Somalia.

“Disability Is Not Weakness” Discrimination and barriers facing women and girls with disabilities in Afghanistan

GOSSMAN, Patricia
April 2020

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Everyday barriers that Afghan women and girls with disabilities face are described.  Decades of conflict have decimated government institutions and development efforts have failed to reach many communities most in need. Obtaining access to health care, education, and employment, along with other basic rights, is particularly difficult for Afghan women and girls with disabilities, who face both gender discrimination and stigma and barriers associated with their disability.

 

This report is based primarily on research by Human Rights Watch researchers from April 2018 through January 2020 in Kabul, Mazar-e Sharif, and Herat, Afghanistan. 23 interviews with women with disabilities and 3 interviews with family members of women and girls with disabilities were conducted. 14 healthcare and education professionals were interviewed, including representatives from the United Nations and international and local nongovernmental organizations providing services to persons with disabilities in Afghanistan

Barriers Faced by Young Adults with Disabilities in Ulaanbaatar, Mongolia Report of a Community-Based Emancipatory Disability Research (CB-EDR)

Sunil Deepak
February 2020

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An Emancipatory Disability Research in Mongolia was carried out as part of a project aimed at promoting independent living among young adults with disabilities living in the national capital Ulaanbaatar (UB). It was focused on young adults with disabilities living in the 9 districts of UB and was seen as a part of the process which provides information and skills to persons for independent living. It was based on the social model of disability - it looked at the different ways in which the society creates disabling barriers which block or make difficult the participation of persons with disabilities in the different domains of life. The idea of conducting the emancipatory research came from an interaction between some Mongolian DPOs and Tegsh Niigem, a Mongolian NGO active in the areas of rehabilitation, who then asked AIFO-Italy for technical support to conduct it. EDR in Mongolia was implemented through a new approach called a “Community-Based Emancipatory Disability Research” (CB-EDR). A group of young persons with different disabilities were identified as volunteer-researchers by their DPOs, trained and then supported to carry out research in 12 broad areas which they had identified, over a period of 18 months. The researchers, individually or in small groups, carried out research on one theme at a time by collecting information about it from the field. They met periodically to share and discuss the findings of their research and to build a common understanding about the key issues related to the selected theme, and what could they do to overcome the barriers they had identified.

Disability Inclusion Helpdesk Report No: 17 : Mobile phone technology for disability-inclusive agricultural development: findings from an evidence review and webinar

AHLENBÄCK, Veronica
LEE, Harri
COE, Sue
February 2020

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Summaries on the findings from the following queries:

A rapid evidence review on best practice in addressing disability and including people with disabilities in agricultural development programming, including mobile agriculture.

An online webinar bringing together practitioners in the mobile agriculture and disability inclusion space highlighting barriers, emerging practice and gaps.

Required to be creative. Everyday ways for dealing with inaccessibility

WÄSTERFORS, David
2020

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Today’s society promises that people with disabilities can access anything, but in practice there are numerous obstacles, and the ways in which people deal with them can be easily missed or taken for granted by policy makers. This article draws on a project in which researchers ‘go along’ people with disabilities in Sweden who demonstrate and recount accessibility troubles in urban and digital settings. They display a set of mundane methods for managing inaccessibility: (a) using others, (b) making deals and establishing routines, (c) mimicking or piggybacking conventions, (d) debunking others’ accounts and performing local politics. The employment of these shared but tailored methods shows the difficulties to be accepted that people with disabilities still face, as well as the wide-ranging tension that exists between the grand rhetoric of inclusion and modest results. The tension implies that people with disabilities are required to be creative.

  • Declarations and policies often say that people with disabilities should have access to anything, but in practice this is not the case.
  • This study investigates what people with disabilities actually do when they have trouble accessing various places or resources. The results show their common and practical ways, and these ways are often taken for granted, overlapping, and combined.
  • People with disabilities ask others to support them when they face troubles to access places or resources, they make deals with important actors and they develop routines. They also observe, imitate and follow others’ actions, to pick out precisely those ways that suit their needs.
  • When people with disabilities find their ways in today’s society they also act with words. They argue against other people’s excuses or justifications for not providing access.
  • The study has found a lot of frustration among people with disabilities who get blocked, excluded or delayed. This gives them motives to engage in politics.

Disability, mobility and transport in Low- and Middle-Income Countries: A thematic review

KETT, Maria
COLE, Ellie
TURNER, Jeff
January 2020

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This paper discusses issues affecting the transport and mobility needs of people with disabilities in middle- and low-income countries and how disability intersects with a range of other factors to impact on transport needs, use and engagement. The paper is intended to stimulate discussion and identify areas for further research, and identifies a number of key issues that are salient to discussions around equitable and inclusive transport provision, including patterns of transport use, behaviour and experiences, solutions and policy directions, measuring access and inclusion, policies and intersectionality. The paper also identifies gaps in knowledge and provision, barriers to addressing these gaps, and some possible solutions to overcoming these barriers. These include shifting the focus from access to inclusion, reconceptualising how ‘special’ transport might be provided, and most importantly listening to the voices and experiences of adults and children with disabilities. Despite lack of transport often being cited as a reason for lack of inclusion of people with disabilities, there is surprisingly little evidence which either quantifies this or translates what this lack of access means to people with disabilities in their daily lives in low- and middle-income countries.

 

Sustainability 2020, 12(2), 589

https://doi.org/10.3390/su12020589

Persons with disabilities in a just transition to a low-carbon economy

HASAN, Maria
November 2019

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Implementing a just transition to a low-carbon economy that aims to leave no one behind will require a context-specific and locally determined mix of legal standards, social protection, skills development and attitudinal transformation that create an enabling environment for green jobs to perpetuate and decent work opportunities for persons with disabilities to proliferate. If done right, a just transition towards environmentally sustainable economies and societies for all can contribute to the goals of achieving social justice, decent work, social inclusion and the eradication of poverty. At this unique time that climate action is accelerating and the transition to green economies has started to take form, a just transition - that is inherently disability-inclusive - represents a unique opportunity to shape a future that works for all.

 

Topics discussed include: Persons with disabilities in a world of work confronted by climate change; Understanding the future of the world of work; Existing frameworks to guide action; An inclusive transition to a low-carbon economy; Key recommendations

Exploring barriers to physical activity of patients at the internal medicine and surgical wards: a retrospective analysis of continuously collected data

KOENDERS, Niek
WEENK, Mariska
VAN DE BELT, Tom H
VAN GOOR, Harry
HOOGEBOOM, Thomas J
BREDIE, Sebastian J H
November 2019

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Purpose: To analyse physical activity of patients during their hospital stay and to explore the relationship between physical activity and barriers to physical activity.

 

Methods: This was a secondary analysis of physical activity data for patients admitted to the internal medicine and surgical wards. Physical activity data, collected with a wireless patch sensor, was operationalized as time spent lying, sitting/standing, and walking. Barriers to physical activity included patients’ pain levels, the use of urinary catheters, intravenous tubing, oxygen lines, drains, and level of dependence. Regression analysis explored the relationship between physical activity and barriers to physical activity.

 

Results: Physical activity data were collected in 39 patients (aged 27–88, mean 54 years) during hospital stay. Patients were admitted for a median of 10 d (interquartile range [IQR]: 7–15 d). These patients were lying for a median of 12.1 h (7.6–17.7), sitting/standing 11.8 h (6.3–15.7), and walking 0.1 h (0–0.3) per day. Time lying during the day related to pain levels (β = 0.4 h per unit increase in pain, p < 0.01) and drain use (β = 3.1 h, p < 0.01).

 

Conclusions: Patients spent the most time during the hospital stay lying in bed. Improved pain management and decreased drain use may be worth exploring to increase inpatient physical activity.

Disability & inclusion survey, Wau PoC AA

INSTITUTE OF MIGRATION (IOM)
HUMANITY & INCLUSION
CCCM CLUSTER
October 2019

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The International Organization for Migration's Displacement Tracking Matrix (10M DTM) and Humanity & Inclusion (HI) joined efforts to undertake an assessment of the level of access to services and the barriers faced by persons with disabilities within Wau Protection of Civilian Adjacent Area site (PoC AA or PoC site). The study, based on data collected in February 2019, aims to improve the knowledge base available to the humanitarian community about access to services by persons with disabilities living in the PoC site. It provides a quantitative estimate of the prevalence of disabilities among the IDP population and an assessment of the barriers faced by persons with disabilities in accessing humanitarian services across sectors. It also seeks to empower persons with disability living within the PoC site, giving them the opportunity to express their concerns and preferences with regards to possible solutions and targeted interventions.

A university’s response to people with disabilities in Worcester, Western Cape

MÜLLER, Jana V.
NED, Lieketseng
BOSHOFF, Hananja
October 2019

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Background: The call for institutions of higher education to foster interaction with communities and ensure training is responsive to the needs of communities is well documented. In 2011, Stellenbosch University collaborated with the Worcester community to identify the needs of people with disabilities within the community. How the university was engaging with these identified needs through student training still needed to be determined.

 

Objectives: This study describes the engagement process of reciprocity and responsivity in aligning needs identified by persons with disability to four undergraduate allied health student training programmes in Worcester, Western Cape.

 

Method: A single case study using the participatory action research appraisal methods explored how undergraduate student service learning was responding to 21 needs previously identified in 2011 alongside persons with disability allowing for comprehensive feedback and a collaborative and coordinated response.

 

Results: Students’ service learning activities addressed 14 of the 21 needs. Further collaborative dialogue resulted in re-grouping the needs into six themes accompanied by a planned collaborative response by both community and student learning to address all 21 needs previously identified.

 

Conclusion: Undergraduate students’ service learning in communities has the potential to meet community identified needs especially when participatory action research strategies are implemented. Reciprocity exists when university and community co-engage to construct, reflect and adjust responsive service learning. This has the potential to create a collaborative environment and process in which trust, accountability, inclusion and communication is possible between the university and the community.

 

 

African Journal of Disability, Vol 8, 2019

Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana

PAULUS-MOKGACHANE, Thato M.M.
VISAGIE, Surona J.
MJI, Gubele
September 2019

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Background: People with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.

 

Objective: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.

 

Methods: A quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.

 

Results: The male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.

 

Conclusion: Primary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.

 

 

African Journal of Disability, Vol 8, 2019

Experiences of primary caregivers of children with cerebral palsy across the trajectory of diagnoses in Ghana

KYEREMATENG, Joana D.A
EDUSEI, Anthony
DOGBE, Joslin A.
OPUKU, Maxwell P.
NKETSIA, William
HAMMOND, Chrales
AFRIYIE, Sally A.
September 2019

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Background: Cerebral palsy (CP) is a non-progressive disorder of posture or movement caused by a lesion to the developing brain that results in functional limitations. The diagnosis of CP can vary from one child to another, causing family stress because of vague and unknown outcomes of the disorder. Although there are negative attitudes in Ghanaian societies towards primary caregivers and children with disabilities, fewer attempts have been made to understand their experiences.

 

Objectives: The main aim of this study was to explore the experiences of primary caregivers across the trajectory of the diagnosis (before, during and after) of CP in the setting of a tertiary hospital.

 

Method: Using Social Capital Theory as framework, 40 primary caregivers of children with CP, who were receiving treatment at a major referral hospital in Ghana, were interviewed about their experiences before, during and after diagnosis.

 

Results: The results that emerged from the thematic analysis were discussed as follows: experiences before diagnosis, experiences during the diagnosis and experiences after the diagnosis. Particularly, participants discussed their inability to access essential services such as education for their children with CP.

 

Conclusion: In light of systemic challenges faced by participants and their children with CP, the need for health policymakers to prioritise the public education about CP, promoting the well-being of caregivers and other implications of the study have been discussed.

 

 

African Journal of Disability, Vol 8, 2019

Barriers and Facilitators to Community Ambulation in Maharashtra, India: Perception of Individuals with Stroke

SHAIKH, Atiya A
ATRE, Janhavi Jagdish
2019

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Purpose: The study aimed to understand the self-perceived environmental barriers/ facilitators to community ambulation among stroke survivors in Maharashtra State, India.

 

Method: The Facilitators and Barriers Survey /Mobility Questionnaire (FABS/M) was used to collect information from a convenience sample of 50 individuals with stroke. Data was analysed using descriptive statistics in Statistical Package for Social Sciences (SPSS) 22.00.

 

Results: Curbs, gravel surfaces, rain, noise, and crowd were marked as barriers by 56%, 58%, 52%, 36% and 50% of the participants, respectively. Ramps, elevators, and flat surfaces were reported as facilitators by 42%, 70% and 82% of the participants, respectively. Participants also mentioned the absence of automatic doors and escalators in community areas (92% and 88%), specialised exercise equipment, handrails and specialised bathroom equipment at home (92%, 50% and 52%), and inaccessibility to public places (50%), as barriers to easy mobility. 

 

Conclusions: To enhance community mobility of individuals with stroke, environmental barriers should be reduced and facilitators should be enhanced. The marked absence of facilitators in the environment should be rectified and appropriate steps should be taken to enhance ambulation. 

 

Limitations of the study are the small sample size. Factors like balance, economic status, physical activity of the stroke individuals and severity of stroke were also not considered.

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