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Improving social inclusion and empowerment for people with disabilities in low- and middle-income countries: why does it matter and what works?

WHITE, Howard
SARAN, Ashrita
POLLOCK, Sarah
KUPER, Hannah
July 2018

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The aim of the Rapid Evidence Assessment (REA) is to provide an assessment of the effectiveness of interventions to improve social inclusion and empowerment for people with disabilities in low- and middle-income countries (LMICs). The studies included in this REA are taken from the Disability EGM prepared by the Campbell Collaboration for DFID under the auspices of the Centre for Excellence for Development Impact and Learning (CEDIL). Eligible studies included systematic reviews and impact evaluations published in English from 2000 onwards that assessed the effectiveness of interventions for people with disabilities in LMICs. The REA focused on studies identified by the EGM process that included ‘social inclusion’ or ‘empowerment’ as study outcomes and used the World Health Organization CBR matrix as a framework to categorise the different interventions and outcomes considered by the studies available. Evidence limitations and gaps were identified. 

There were 16 eligible primary studies, including studies conducted in 12 countries: Bangladesh (two studies), Brazil, Chile, China (two studies), Ethiopia, India (three studies), Kenya (two studies), Malaysia, Thailand, Turkey, Uganda, and Vietnam (two studies). Five of the studies concern interventions for people with physical or sensory impairments, nine for people with mental health or neurological conditions, and two for all disability types.

Disability stigma in developing countries

ROHWERDER, Brigitte
May 2018

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This K4D helpdesk report, commissioned by UK DFID, answers the question "What are the core drivers behind stereotypes, prejudice (including pity/shame etc), and harmful practices against persons with disabilities in developing countries and what promising strategies/pathways for addressing these drivers have been identified?" using desk research.

 

Across the world stereotypes, prejudice, and stigma contribute to the discrimination and exclusion experienced by people with disabilities and their families in all aspects of their lives. This rapid review looks at available evidence on the drivers of disability stigma in developing countries, and promising strategies for addressing these. Most of the available evidence uncovered by this rapid review comes from Sub-Saharan Africa, and is from a mix of academic and grey literature. Evidence gaps remain. The available literature has focused more on studying the victims of stigmatisation than the stigmatisers. 

Disability Equality: In Theory and Practice. Social Inclusion, volume 6, issue 1 (2018)

PRIESTLEY, Mark
WADDINGTON, Lisa
Eds
March 2018

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This special issue of this journal includes the following papers:

  • Achieving Disability Equality: Empowering Disabled People to Take the Lead
  • Dis-Equality: Exploring the Juxtaposition of Disability and Equality
  • Leveraging Employer Practices in Global Regulatory Frameworks to Improve Employment Outcomes for People with Disabilities
  • Equality of What? The Capability Approach and the Right to Education for Persons with Disabilities
  • Reasonable Accommodation as a Gateway to the Equal Enjoyment of Human Rights: From New York to Strasbourg
  • Disability, Access to Food and the UN CRPD: Navigating Discourses of Human Rights in the Netherlands
  • Rehabilitation as a Disability Equality Issue: A Conceptual Shift for Disability Studies?
  • Inclusions and Exclusions in Rural Tanzanian Primary Schools: Material Barriers, Teacher Agency and Disability Equality
  • Education, Work, and Motherhood in Low and Middle Income Countries: A Review of Equality Challenges and Opportunities for Women with Disabilities
  • Social Inclusion through Community Living: Current Situation, Advances and Gaps in Policy, Practice and Research


 

Do experiences and perceptions about quality of care differ among social groups in Nepal? A study of maternal healthcare experiences of women with and without disabilities, and Dalit and non-Dalit women

DEVKOTA, Hridaya Raj
MURRAY, Emily
CLARKE, Andrew
GROCE, Nora
December 2017

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Background
Suboptimal quality of care and disparities in services by healthcare providers are often reported in Nepal. Experience and perceptions about quality of care may differ according to women’s socio-cultural background, individual characteristics, their exposure and expectations. This study aimed to compare perceptions of the quality of maternal healthcare services between two groups that are consistently considered vulnerable, women with disabilities from both the non-Dalit population and Dalit population and their peers without disabilities from both non-Dalit and Dalit communities.

Methods
A cross-sectional survey was conducted among 343 total women that included women with disabilities, Dalits and non-Dalits. Women were recruited for interview, who were aged 15–49 years, had been pregnant within the last five years and who had used maternal care services in one of the public health facilities of Rupandehi district. A 20-item, Likert-type scale with four sub-scales or dimensions: ‘Health Facility’, ‘Healthcare Delivery’, ‘Inter-personal’ and ‘Access to Care’ was used to measure women’s perceptions of quality of care. Chi-square test and t test were used to compare groups and to assess differences in perceptions; and linear regression was applied to assess confounding effects of socio-demographic factors. The mean score was compared for each item and separately for each dimension.

PLoS ONE 12(12): e0188554
https://doi.org/10.1371/journal.pone.0188554

World Social Science Report 2016 | Challenging Inequalities: Pathways to a Just World

LEACH Melissa
GAVENTA, John
JUSTINO, Patricia
DENIS, Mathieu
November 2016

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Inequalities are multi-dimensional, multi-layered and cumulative. The Report makes clear that understanding and acting effectively upon inequalities requires looking beyond income and wealth disparities to capture their political, environmental, social, cultural, spatial, and knowledge features. Untangling such complexity is a challenge we must fully take on – if we are to develop policies and solutions that are feasible and sustainable.

 

The Report also emphasizes that the costs of inequalities are very high and borne by all – not just by the deprived and the excluded, but collectively, by current and future generations, in the form of heightened conflict and instability, economic and fiscal losses, environmental degradation, and political tensions. Reducing inequalities is thus everyone’s concern.

 

Countering inequalities requires robust knowledge – but knowledge alone is not enough. The challenge is to improve the connection between what we know and how we act: to mobilize the knowledge of the social and human sciences to inform policies, underpin decisions and enable wise and transparent management of the shift towards more equitable and inclusive societies. In this sense, investment in knowledge is a down-payment for informed change.

 

And in some respects, even the knowledge we have is not fully adequate. Social science research agendas equally require revisiting. The Report calls for a step change towards a research agenda that is interdisciplinary, multiscale and globally inclusive, creating pathways for transformative knowledge.

Social inclusion and mental health of children with physical disabilities in Gaza, Palestine

NASSER, Khaled
MACLACHLAN, Malcolm
MCVEIGH, Joanne
November 2016

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"Social inclusion of children with physical disabilities is essential for their mental health. The long-standing conflict and political instability in Palestine since 1948 has resulted in an unprecedented number of children with disabilities. This study aimed to assess social inclusion and mental health of children with physical disabilities in Palestine. Method: A mixed methods research design was used. The 12-item General Health Questionnaire and the Brief Assessment of Social Inclusion for Children with Disability (BASIC-D) were administered to 100 children with amputations, 12-18 years of age, in the Gaza Strip. Ten semi-structured interviews were also conducted with personnel working across civil society rehabilitation services in the area, particularly in services that focussed on the physical rehabilitation of children who had lost a limb"

Society at a Glance 2016 : OECD Social Indicators

OECD
November 2016

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Society at a Glance 2016 aims to address the growing demand for quantitative evidence on the social situation, its trends, and its possible drivers across OECD countries. One objective is to assess and compare social outcomes that are currently the focus of policy debates. Another is to provide an overview of societal responses, and how effective policy actions have been in furthering social development. This edition of Society at a Glance discusses policy actions in response to the situation of youth Neither in Employment, Education, nor Training (NEET). Indicators on youth are therefore a particular focus

DOI: http://dx.doi.org/10.1787/9789264261488-en

Innovations In Dementia

ROUTLEDGE, Martin
SANDERSON, Helen
BAILEY, Gill
October 2016

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This book offers concrete ideas and examples to those interested in driving a radically different approach to supporting people with dementia and their families. "We have explored a number of approaches with people who have been leading their development. We have been keen to look at both approaches that emerge from working directly to improve support for people with dementia and others that have different roots, but we think are potentially very transferable. None of the approaches is yet being used at any significant scale". Discussions and examples are all UK based. There is an introduction detailing current problems and issues with care and support for people with dementia. 10 approaches are described for housing and support, 4 concerned with enabling people to have good days and 7 associated with enabling people to connect with their community. 

World social science report, 2016 : Challenging inequalities; pathways to a just world

INTERNATIONAL SOCIAL SCIENCE COUNCIL
UNIVERSITY OF SUSSEX
INSTITUTE OF DEVELOPMENT STUDIES
September 2016

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This report focuses on the critical issues of inequalities and social justice and warns that unchecked inequalities could jeopardize the sustainability of economies, societies and communities, undermining efforts to achieve the Sustainable Development Goals (SDGs) by 2030. It highlights significant gaps in social science data about inequalities in different parts of the world and, to support progress towards more inclusive societies, calls for more robust research into the links between economic inequalities and disparities in areas such as gender, education and health. A short case study entitled "Consequences of inequality for persons with disabilities – experience of ADD International" is included.

Living in fear: experiences of hate crime and discrimination amongst people with learning disabilities and autism

BRADSHAW, Jill
RICHARDSON, Lisa
May 2016

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The views and experiences of people with learning disabilities and autism living within one UK unitary authority (Medway, Kent) were explored.  Aspects investigated were: how many people victimisation affects; who is affected by victimisation; what type of things happen to them; and the impact of victimisation on their quality of life.  The focus groups were: 7 groups with people with intellectual disability and autism (31 people); 4 groups with family and paid carers (33 people).  A survey was completed by: people with intellectual disabilities and autism (220 surveys) and family or paid carers (35 surveys).  27 individual interviews were carried out. 

The economic costs of exclusion and gains of inclusion of people with disabilities : evidence from low and middle income countries

BANKS, Lena Morgon
POLACK, Sarah
2015

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This report, formed of two parts, provides robust empirical basis to support the theorized disability-poverty link. The first section presents a systematic review of the literature on the relationship between disability and economic poverty. The second section explores the economic consequences of the exclusion and inclusion of people with disabilities in the areas of education, employment and health. The key pathways through which these economic costs may arise are discussed and studies that have attempted to quantify the financial impacts are reviewed

Mental illness, poverty and stigma in India : a case-control study

TRANI, J F
BAKHSHI, P
KUHLBERG, J
NARAYANAN, S S
VENKATARAMAN, H
MISHRA, N N
GROCE, N
JADHAV, S
DESHPANDE, S
January 2015

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The effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste was assessed. A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Conclusions: Public stigma and multidimensional poverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family.

The African report on children with disabilities : promising starts and persisting challenges

THE AFRICAN CHILD POLICY FORUM (ACPF)
December 2014

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This pan-African report describes and analyses the cultural, social, physical and other societal barriers preventing children with disabilities in Africa from realising their full human potential. It also describes the opportunities, initiatives and good practices that exist, that indicate the progress, albeit insufficient, that has been made towards realising the rights for children with disabilities in Africa. Recommendations and priorities for action are presented which promote inclusive and accessible laws, policies, and programmes for children with disabilities throughout Africa. The report is based on extensive research and evidence generated by the African Child Policy Forum (ACPF) and other institutions

Changing attitudes to child disability in Africa

THE LANCET
December 2014

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This brief editorial published in the Lancet highlights the situation of disabled children in Africa with reference to the 2014 publication of The African Report on Children with Disabilities by The African Child Policy Forum

 

The Lancet, Vol 384, No. 9959

Caring for people with intellectual disabilities in poor rural communities in Cambodia : experience from ADD International

CORDIER, Sylvie
October 2014

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This article explores the impact of ADD International’s project in Cambodia, which aimed to support communities to learn more about persons with intellectual disabilities and support them in their daily life. The article has a particular focus on how this work affected carers, the majority of whom are women

Gender & Development, 22:3

Moving from the margins: mainstreaming persons with disabilities in Pakistan

SURESH, Tricia
August 2014

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 This report examines the challenges, opportunities and policy issues affecting persons with disabilities in Pakistan. "The report makes strong recommendations for policymakers as well as the corporate sector and others. It advocates a comprehensive strategy through a gradual approach that includes policy intervention, awareness-raising and investment. The attitudinal, social and physical barriers faced by persons with disabilities in Pakistan also need to be challenged."

Social participation of diabetes and ex-leprosy patients in the Netherlands and patient preference for combined self-care groups

DE VRIES, Henry JC
DE GROOT, Roos
VAN BRAKEL, Wim H
August 2014

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This study compared the social constraints of diabetic patients and ex-leprosy patients and investigated combined self-care groups for ex-leprosy patients and diabetic patients. The physical complications and social problems in ex-leprosy and diabetic patients with neuropathy are similar. Despite the fact that diabetic patients preferred disease-specific, homogeneous self-care groups, the authors believe that the option of combined groups is a promising strategy. Therefore, further research is warranted into the acceptance and impact of self-care groups as a strategy to reduce social constraints by diseases causing neuropathy 

Frontiers in Medicine, Vol 1

Perceived needs related to social participation of people with leprosy-related disabilities and other people with disabilities in Cambodia : a qualitative study

HEEREN, Marie-Julie J
KY, Lai
VAN BRAKEL, Wim H
January 2014

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The objective of this study was to describe the similarities and differences in perceived needs related to social participation of persons with leprosy-related disabilities and other persons with disabilities in Cambodia, and to suggest key interventions to promote participation in the community. A cross-sectional study was completed by conducting a pilot-tested, face-to-face semi-structured interviews, with open and closed questions, and focus group discussions to investigate the perceived needs related to social and economic participation in the community. The study found that both groups of people with disabilities have similar needs to improve participation in social and economic life, and the authors suggest that it is best to form multi-disability self-help groups to empower all the affected people and help fight poverty

Disability, CBR & Inclusive Development Journal, Vol 25, No 3

Social relationships, sexuality and reproductive rights & persons with disabilities : international workshop report

DEEPAK, Sunil
et al
March 2013

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"This report presents an analysis and an overview of main issues in relation to social relationships, sexuality and reproductive rights that emerged from the different presentations and discussions during the workshop. Most of the discussions and presentations focused on difficulties, barriers and challenges. There were a few positive examples of activities that answer those challenges and overcome those barriers. There were also some ideas of what can be or should be done in this area" “"Going beyond the taboo areas in CBR" workshop, part 1
Agra, India
29 November 2012

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