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Part 2: The feasibility of utilising photovoice method and the World Health Organization Quality of Life instrument in evaluating the Community-Based Rehabilitation programme in Namibia: A pilot study

SHUMBA, Tonderai W.
MOODLEY, Indres
2018

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Background: Evaluation of Community-Based Rehabilitation (CBR) programmes in Namibia has been primarily quantitative, focusing mainly on outputs, including numbers of persons with disabilities served, referrals made and activities implemented. Little or no evidence is available on experiences and quality of life of persons with disabilities, despite the CBR programme being operational for more than 20 years. The 2011 World Report on Disability recommended the use of appropriate tools to fill the research gap by integrating the experiences of persons with disabilities and their quality of life.

 

Objectives: The overall objective of the larger cohort study is to develop a monitoring and evaluation tool that can measure and integrate the experiences of persons with disabilities and their quality of life within the context of the CBR Programme in Namibia.

 

Method: An adapted photovoice process was conducted with six purposively selected participants over a period of 1 month. The World Health Organization Community-Based Rehabilitation (WHO CBR) Matrix was used to identify the themes and subthemes. Participants were requested to complete the World Health Organization Quality of Life (abbreviated version) (WHOQOL-BREF) instrument at the end of the photovoice process to determine their quality of life.

 

Results: Administering the WHOQOL-BREF instrument at the end of the photovoice process measured both the quality of life of persons with disabilities and at the same time indicated the convergence and divergence in the two data collection methods. The study demonstrated a stronger convergence than divergence of the two methods. A feasibility criterion was mapped for future studies.

 

Conclusion: This study demonstrated that photovoice is a flexible method that can be used with a variety of disabilities and has the potential of being combined with the WHOQOL-BREF assessment form. A larger cohort study may consider implementing photovoice and WHOQOL-BREF on multiple study sites and be able to compare results, considering geographical and demographic variables. The feasibility of utilising each method alone and in combination offered valuable insights on future conceptual framing of CBR programme evaluation. This conceptual framing will allow CBR practitioners to appreciate how these two methods contribute to a rigorous process of CBR programme evaluation.

Association between social factors and performance during Functional Capacity Evaluations: a systematic review

ANSUATEGUI ECHEITA, Jone
VAN HOLLAND, Berry J
GROSS, Douglas P
KOOL, Jan
OESCH, Peter
TRIPPOLINI, Maurizio
RENEMAN, Michiel F
March 2018

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Purpose: Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults.

 

Materials and methods: A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor’s association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods.

 

Results: Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner’s fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied.

 

Conclusions: Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance.

Standard school eye health guidelines for low and middle-income countries

GILBERT, Clare
MINTO, Hasan
MORJARIA, Priya
KHAN, Imran
February 2018

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The purpose of these best practice guidelines is to provide direction to those planning and implementing eye health initiatives for schools, including policy makers, health care and educational authorities, health planners, eye care delivery organizations and professionals, in partnership with teachers, parents and children. In situations where resources for eye health are limited, decisions need to be made to ensure that programs not only address public health problems but are also implemented in a way that is effective, efficient and, wherever possible, sustainable. Systems for monitoring and plans for evaluation should also be developed at the outset. These practice guidelines provide an excellent learning resource for a module on school eye health that can be incorporated in optometry and ophthalmology residency curricula.  A section highlights some of the challenges in current school eye health initiatives and provides a framework in which school eye health is integrated into school health programs. Case studies are provided to emphasise the integrated approach and a 15-step approach, from situation analysis to monitoring and evaluation, is suggested. Practical recommendations for implementation are provided, including information on the equipment and technology required

 

This evidence-based document is based on best practice guidelines initially developed through a joint collaboration between Sightsavers International, the London School of Hygiene and Tropical Medicine and the Brien Holden Vision Institute

Tensions and unity in the struggle for citizenship: Swedish disability rights activists claim ‘Full Participation! Now!’

SÉPULCHRE, Marie
2018

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This article analyses the claims of contemporary disability rights activists mobilising in a context where de facto second- class citizenship co-exists with legal and political declarations about the rights of disabled people. As an empirical case, it focuses on the blog ‘Full Participation.Now’, which was initiated by disability rights activists in Sweden. Drawing upon citizenship research, the article points to the tensions and dilemmas featuring the bloggers’ demand for participation and equality, as well as the challenges relative to their struggle. Although the bloggers formulate contrasting arguments, the article highlights that the activists share a common aspiration for ‘full citizenship’.

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

WORLD VISION
CBM Australia
2018

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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.

GEM report summary on disabilities and education

UNESCO
2018

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In support of the run-up to the 2020 GEM Report on inclusion and education, this paper contains summarised content related to disabilities and education in previous Global Education Monitoring (GEM) Reports since 2010. Reports cited from 2010 and 2015 monitored countries in the Global South. The GEM Report started monitoring countries in the Global North from the 2016 Report onwards only.

 

Topics covered include: compliance monitoring; the role of civil society organisations; lack of data; marginalisation; data on primary school attendance; intersection with other disadvantages; different education related challenges; and ten education policies to counteract marginalisation.

Global education monitoring report, 2019: migration, displacement and education: building bridges, not walls

UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION (UNESCO)
et al
2018

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“The 2019 GEM Report continues its assessment of progress towards Sustainable Development Goal 4 (SDG 4) on education and its ten targets, as well as other related education targets in the SDG agenda.


Its main focus is on the theme of migration and displacement. It presents evidence on the implications of different types of migration and displacement for education systems but also the impact that reforming education curricula and approaches to pedagogy and teacher preparation can have on addressing the challenges and opportunities posed by migration and displacement. It gives voice to experiences in host and home communities.


With the help of case studies, it illustrates approaches which work and could be scaled up. In this way, it aims to be a tool for practitioners. It will make the case for investing in education of good quality in rural areas suffering from depopulation and in slum areas suffering from large population inflows; in countries with high rates of emigration and those with high rates of immigration; in short-term refugee emergencies and in protracted crises. Its analysis, conclusions and recommendations advance the aims of SDG 4 and its call to leave no one behind.”

INCLUDE US! Good practices in the inclusion of persons with disabilities in Myanmar

HUMANITY & INCLUSION (HI)
2018

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In 2015, Humanity & Inclusion HI began the project: “Empowering persons with disabilities to contribute to equal access to basic social services and local policymaking processes in under-resourced areas of Ayeyarwady and Mandalay”. The project supported Disabled Peoples Organizations and other civil society groups to participate in the development of inclusive regional policies and programmes, and to promote good practices contributing to greater access to services for persons with disabilities. An aim was also to document, publish and disseminate these good practices throughout Myanmar, increasing awareness and understanding in order to sensitise people to disability inclusion and influence policy change. Rather than focusing on what is not working, this report seeks to shift attention to what has worked locally and how it could be replicated in other parts of the country, providing constructive, practical recommendations to decision-makers, service providers and other community groups in Myanmar. The report is related to two projects. The second is “Advocacy for Change: Fostering protection and rights of men and women with disabilities in Myanmar”. 

 

There are global recommendations. There are seven good practices:

  • Related to education:  Case Study I: Promoting Inclusion of children with disabilities in Middle Schools of Ayartaw. Case Study II: How the development of the teacher training promotes inclusion of all children in education
  • Related to economic life: Case Study III: How partnerships between private companies and organizations of people with disabilities can improve access to employment and vocational training
  • Related to social/community life: Case Study IV: Giving the Myanmar Deaf Community access to information.  Case Study V: How parental advocacy can make a difference
  • Related to political life: Case Study VI: Community advocacy in obtaining the National Registration Card. Case Study VII: Supporting people with disabilities to participate in Myanmar elections

 

Disability & the Global South (DGS), 2018, Vol. 5 No. 1

2018

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Articles include:

  • Inclusive Education in the global South? A Colombian perspective: ‘When you look towards the past, you see children with disabilities, and if you look towards the future, what you see is diverse learners
  • Services for people with Communication Disabilities in Uganda: supporting a new Speech and Language Therapy profession
  • Frida Kahlo and Pendular Disability Identity: A Textual Examination of El Diario de Frida Kahlo
  • Health Information-Seeking Behaviour of Visually Impaired Persons in Ibadan Metropolis, Nigeria
  • Online Collective Identities for Autism: The Perspective of Brazilian Parents
  • Transnationalizing Disability Policy in Embedded Cultural-Cognitive Worldviews: the Case of Sub-Saharan Africa
  • Portrayal of Disabled People in the Kuwaiti Media

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

MARSHALL, Julie
WICKENDEN, Mary
2018

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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

Online collective identities for autism: The perspective of Brazilian parents

ANTUNES, Debora
DHOEST, Alexander
2018

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The importance of online communities for parents of people with disabilities has been discussed by many scholars in the fields of Digital and Disability Studies, showing, for instance, the importance of social support and the formation of social ties. In order to contribute to this scholarship, this paper explores how collective identity models are built and circulated by parents of autistic people in one of the biggest Brazilian online communities about the subject, ‘Sou autista… conheça o meu mundo’ (I am autistic…get to know my world). The results were obtained through a digital ethnography, based on participant observation and an exchange of information with the members of the community studied. Based on the data collected, the study concludes that the collective identity models that circulate in this community can be grouped into legitimising, resistant, and project identities, as postulated by Castells (2010). The different views reflect how parents see autism and represent the ways it is treated in Brazilian society.

 

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

Portrayal of disabled people in the Kuwaiti media

ALENAIZI, Hussain Mohammed
2018

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This paper explores the views of 10 participants on how the Kuwaiti media represents disabled people. Participants expressed their views through focus groups and interviews. The findings show that, generally, disabled people in Kuwait are shown in a negative light in the media. The media depicts disabled people as ‘pitiable’, ‘violent’, ‘sinister’, ‘tragic’, and as a ‘tool of ridicule’. The findings, however, witness some positive examples of media representation regarding how some TV shows portray deaf people in a positive light. On the other hand, the study suggests that learning disabled people are the most negatively depicted group in Kuwaiti society. There are also indications of implicit endorsement or internalisation by the participants of views of disabled people as ‘extraordinary’ despite the presence of their impairments. The study concludes that it is more important that the media shows the everyday lives of disabled people before showing their abilities and achievements.

 

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

Pacific regional consultation – IASC guidelines on inclusion of persons with disabilities in humanitarian action

DOMINIK, Georgia
January 2018

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The Pacific Disability Forum (PDF), in partnership with the Inter-Agency Standing Committee (IASC) Task Team on Inclusion of Persons with Disabilities in Humanitarian Action and the International Disability Alliance (co-chair of the Task Team), held a regional multi-stakeholder consultation for the Pacific in Nadi, Fiji from 24 – 25 January 2018.

The workshop was the first in a series of regional consultations which will support the development of the IASC Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action (“the Guidelines”). 

The Guidelines will assist humanitarian actors, governments, affected communities and organizations of persons with disabilities to coordinate, plan, implement, monitor and evaluate essential actions that foster the effectiveness, appropriateness and efficiency of humanitarian action, resulting in the full and effective participation and inclusion of persons with disabilities and changing practice across all sectors and in all phases of humanitarian action. 

Defying the barriers

KHONDKAR, Laila
HAQUE, Reazul Md
January 2018

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Research summaries, case studies and process documentation from “Inclusive Protection and Empowerment Project for Children with Disabilities (IPEP)” are presented.  The aim of the project was to build resilience and capacity among children with disabilities and to create a violence-free community for them. The project ran in five districts of Bangladesh i.e. Sylhet, Dhaka, Barishal, Rangpur and Gaibandha from 2014- 2017. 

 

The research topics were:

  • Understanding the Vulnerabilities of Children with Disabilities Living in both Government-run and Private Residential Institutions
  • The Vulnerabilities of Children with Disabilities from Low-income Households
  • Social Protection Schemes Relevant to Children with Disabilities and their Families 

 

Introduction to Disabled Refugees Welcome project

INDEPENDENT LIVING INSTITUTE
January 2018

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Disabled Refugees Welcome (DRW) is a 3-year project run by Independent Living Institute (ILI) and it's main goal is to develop methods that will improve the conditions for the reception of disabled newcomers in Sweden. 

 

Project worker Julius Ntobuah shares his experiences as an asylum seeker with disability in Sweden and his commitment for better reception of newcomers with functional disabilities.

The nation’s body: disability and deviance in the writings of Adolf Hitler

BENGTSSON, Staffan
2018

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This article takes its starting point in the Nazi ideology as it appears in the writings of Adolf Hitler, and discusses how disability and the body can be understood in the context of Mein Kampf. The article underlines how disability and bodily infirmities, alongside race, featured significantly in Hitler’s demagogic message. Although the overall image of disability was related to a sense of threat – and a culture gone wrong – Mein Kampf also contains a mixed interpretation of disability as a phenomenon, in which different and opposing disability narratives took part in the construction and the image of the body as a national property.

Disability inclusive humanitarian response

ROHWERDER, Brigitte
December 2017

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"Disasters and armed conflicts can also increase the number of persons with disabilities as people acquire new impairments and/or experience a deterioration in existing impairments from injuries and/or limited access to health care and rehabilitation. For instance, a survey of Syrian refugees living in camps in Jordan and Lebanon found that 22 per cent had an impairment. However, accurate numbers can be hard to calculate due to lack of data disaggregation in humanitarian emergencies and differences in the way disability is defined and measured, while families may be reluctant to disclose disability due to fear of stigma and isolation. As a result, humanitarian programmes may inadequately document and consider the needs of persons with disabilities"

This short Operational Practice Paper from the Humanitarian Learning Centre offers lessons for disability inclusion in humanitarian response. 

Inclusive and integrated mother, newborn and child health programming: Beyond mortality

OLCHINI, Davide
November 2017

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This policy paper describes the operational terms of Handicap International’s mandate and values as applied to Mother, Neonatal and Child Health (MNCH). Presenting the approaches and references underpinning Handicap International’s actions, choices and commitments, its purpose is to ensure consistency across its practices while taking account of different contexts. Intended as a document to guide programme staff, the paper defines the topic, describes the target populations and sets out the methods of intervention (activities and expected results) and the indicators used to monitor and evaluate. It also aims to ensure that Handicap International programmes implement all projects in accordance with the presented methods of intervention

 

The SDGs focus on a broader scope of activities and are thus slowly but surely shifting from mortality to address in a more comprehensive manner the well-being and achievement of maximum potential for children and adolescents. With a robust component in sexual and reproductive health, this represents a significant frame of reference for Handicap International’s work in MNCH as it has paved the way for integrating MNCH-related impairments into existing health services. The framework of the SDGs provides a clear vision of the importance of multi-sectorial interventions, which encompass the limit of vertically-organised health systems centred on curative aspects, to offer a more integrated and preventive package of interventions that include chronic conditions, impairments and health for all. After many years of implementing MNCH projects, Handicap International is well-positioned and firmly established as a major player in this process.

Towards inclusion. A guide for organisations and practitioners

VAN EK, Vera
SCHOT, Sander
November 2017

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Inclusive development is about creating societies that value and enfranchise all marginalised groups. It is often not difficult to open up development projects to persons from these marginalised groups. But it does take time before organisations are willing and able to fully commit to inclusion.

Towards Inclusion aims to support organisations who wish to commit to an inclusive approach. It establishes the rationale for inclusion and provides technical advice and tools for putting theory into practice. It is intended to be used as a reference during organisational development, as well as a tool to support good practice in implementation.

If you are looking to support a (development) organisation in the process of becoming an inclusive organisation, then Towards Inclusion is for you

This guide consists of three parts. The first part guides the reader through the process of assessing whether or not the organization is ready to change towards becoming a more inclusive organization. The second part introduces the ACAP framework, which sets up a way of approaching inclusion via focus on the areas: Access, Communication, Attitude and Participation. It then demonstrates how the framework can be applied to projects and programmes. The third part provides guidelines for the people who will guide organizations through the process of change towards becoming inclusive of persons from marginalized groups

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