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Pivoting to inclusion : Leveraging lessons from the COVID-19 crisis for learners with disabilities

McCLAIN-NHALPO,Charlotte Vuyiswa
KULBIR SINGH,Ruchi
MARTIN,Anna Hill
et al
August 2020

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As governments respond to the Coronavirus 2019 (COVID-19) pandemic, the global community must ensure that persons with disabilities are included. This will require disability inclusion to be considered in all interconnected sectors; education, health, social protection, and inclusion from the planning stage all the way through to delivery and recovery efforts that are inclusive of all and are sufficiently differentiated to meet the specific needs of children with disabilities. The issues paper focuses on the following objectives: (1) addressing education, social needs, barriers, and issues for learners with disabilities at a global, regional, and country-level during the COVID-19 crisis; and (2) recommending practices for education and social inclusion, and reasonable accommodations utilizing the twin track approach and principles of universal design for learning.

How can we measure disability in research related to the COVID-19 response?

MACTAGGART, Islay
KUPER, Hannah
August 2020

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There is growing evidence that COVID-19 is disproportionally impacting the lives of people with disabilities. This includes evidence of the increased risk of severe outcomes of contracting COVID-19 amongst people with existing health conditions, including many people with disabilities. It also includes a wide range of other potential impacts such as: reductions or disruptions in non-COVID-19 health or rehabilitation services, the effects of shielding on isolation and mental health, the implications of social distancing on people who require carer support, and the impact on poverty, participation and wellbeing due to disrupted disability-inclusive development programmes.

 

Measurement of disability in research has historically been contested and a number of different tools exist. Clear guidance is needed on how to determine which tool to use to understand the situation of people with disabilities in different settings, and plan responsive and inclusive COVID-19 programmes and policies to support their needs. Good quality, comparable data on disability is essential for tracking the impact of the COVID-19 pandemic, as well as prevention and mitigation interventions, amongst people with disabilities. Such evidence is also imperative for tracking progress towards the Sustainable Development Goals, and UNCRPD compliance.

 

This evidence brief synthesises findings from a scoping review of ICF-compatible tools to measure disability in population-based surveys with a focus on LMICs (2018), protocols and research outputs from seven population-based surveys of disability across Asia, Africa and the Pacific, secondary analyses of the South African Census, US National Health Interview Survey and three Demographic and Health Surveys, reflections from global stakeholders in disability measurement (including the UN Flagship Report on Disability), and evidence compiled for the upcoming Global Disability Research Massive Open Online Course at the London School of Hygiene & Tropical Medicine

Labour Force Survey (LFS) resources. The global reference for labour force survey design

INTERNATIONAL LABOUR ORGANISATION (ILO)
July 2020

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National labour force surveys (LFS) are the main source behind essential headline indicators of the labour market and the world of work. A wide range of economic and social policies, from monetary and fiscal policies to employment, decent work, vocational education and training, and a wide range of poverty reduction and social inclusion policies depend on labour force surveys as their main source of statistics for informed decision-making and monitoring.

To support countries in developing their national LFS, the ILO Department of Statistics maintains a set of model LFS resources to support PAPI and CAPI data collection. The ILO model LFS resources consolidate existing good survey practice and new approaches following evidence from ILO’s LFS testing programme to support the collection of work and labour market data, aligned with the latest international standards.

 

An add-on module has been introduced (July 2020) "Functional difficulties and barriers to employment" concerned with different barriers to labour market integration of persons with disabiliities.

Access to age-assistive technology: A resilience building measure for older people

HISCOCK, Diana
MALIK, Deepak
June 2020

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The intersection between age, gender and disability and the use of assistive technology (AT) by older people, in emergency response and as a tool for disaster risk reduction (DRR) is explored. The report shows that AT can have a positive impact on independence, vulnerability reduction and resilience building for older women and men in humanitarian crises. This report urges for sensitization and capacity building of humanitarian organizations for the inclusion and promotion of assistive product (AP) provision in humanitarian response and offers insight into key areas to enable AT provision to successfully meet the needs of older people.

 

The study employed primary research methods to gather both quantitative and qualitative information through a semi-structured survey with HelpAge programme beneficiaries in five countries: Bangladesh, Indonesia, Myanmar, Nepal and Pakistan. The survey incorporated the Washington Group short set of questions (WGQs), designed to identify people with functional difficulties in six core functional domains: mobility, vision, hearing, cognition, self-care and communication (Washington Group on Disability Statistics, 2016). The report also summarises secondary research including a literature review, information from rapid needs assessments carried out by HelpAge, and maps out relevant policy changes which have led to better recognition of the intersectionality and importance of AT for older men and women.

Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries

WALLACE, Sarah
MACTAGGART, Islay
MORGON BANKS, Lena
POLACK, Sarah
KUPER, Hannah
June 2020

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The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs).

A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties.

The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression

Ear and hearing survey handbook

WORLD HEALTH ORGANISATION (WHO)
May 2020

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This survey handbook provides guidance for planning and implementing hearing loss surveys, including information on possible data collection tools. The survey handbook aims to enable countries – particularly low- and middle-income countries – to gather data by planning and implementing population-based epidemiological surveys.

The main uses of data collected by such surveys are:

  • to provide an accurate picture of hearing loss prevalence in a given area, which could be a country or an area within the country (e.g. district or state);
  • to provide an overview of the most common probable causes of deafness and hearing loss in the study area;
  • assess global and regional prevalence and trends

 

Using this survey handbook for data collection will help to ensure comparability of data collected through studies conducted in different countries and by different investigators. This will facilitate the estimation of global prevalence and the examination of hearing loss trends over time.

Model disability survey of Afghanistan 2019

AKSEER SHINWARI, Nadia
AKSEER, Tabasum
KAMALA, Madhis
May 2020

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Led by The Asia Foundation (the Foundation) in Kabul, Afghanistan, the WHO’s and World Banks’ Model Disability Survey (MDS) was implemented in Afghanistan in 2019 to provide rigorous and current data for policy and action. Using an adapted MDS, the MDSA 2019 was designed and implemented to generate representative data at nationally and regionally representative levels.

 

A complex survey using multistage sampling was administered respectively to adult (18+ years) and child (2–17 years) populations; a total of 14,290 households were surveyed, representing 111,641 Afghans across the country. Separate survey tools were implemented for adults (157 questions) and children (53 questions). Three core tools were developed covering: 1) household characteristics; 2) adult disabilities (related to functioning, health conditions, personal assistance, assistive products and facilitators, health care utilization, well-being and empowerment); 3) child disabilities (related to functioning and health conditions)

Status of disability in Kenya: Statistics from the 2019 census

OWINE, Eastone
May 2020

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In August 2019 Kenya conducted its eighth Population and Housing Census. Data provided by the census is vital for the government, private sector and civil society to design and target disability-inclusive policies and programmes. Census data is also a critical input in the response to coronavirus, as it can support mapping of vulnerable communities and the distribution of funding to ensure public safety, health facilities, and social and economic protections for people with disabilities. In November 2019 and February 2020 a series of preliminary census reports were released by the Kenya National Bureau of Statistics (KNBS). These preliminary census reports provide summary tables of statistics drawn from the census data. An initial analysis of Kenya’s 2019 disability statistics using data sourced from these reports is presented

 

The 2019 census demonstrates the progress Kenya is making towards disability-inclusive data collection by integrating internationally comparable questions for identifying people with disabilities. This background paper provides a quantitative analysis of Kenya’s disability demographics, including disability prevalence rates at the national and subnational levels and by domain, and a critical appraisal of the factors that may have contributed to the results.

Rapid assessment of the socio-economic impact of COVID-19 on persons with disabilities in Viet Nam

HUONG, DAO THU
May 2020

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The objectives of the rapid assessment were to identify health and socio-economic challenges faced by persons with disabilities and their families during COVID-19 and formulate recommendations to the Government on COVID-19 disability-inclusive response and recovery. The rapid assessment was carried through a survey of persons with disabilities. A questionnaire was designed with inputs from OPDs, the Ministry of Labour, Invalids and Social Affairs and other UN agencies. The questionnaire included 29 questions, covering personal status, changes in personal income before and during COVID-19, employment situation, main challenges during COVID-19 including on health and socio-economic issues, coping mechanisms and main needs

Persons with disabilities must not bear the brunt of COVID-19 aftermath: Lessons from Ebola in Liberia (SDDirect COVID-19 pandemic blog series)

CAREW, Mark
May 2020

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The importance of ensuring persons with disabilities are not excluded as part of COVID-19 responses is explored.
Lessons learnt from the 2014-2017 Ebola outbreak in Liberia are discussed highlighting access to information, access to healthcare and the social impact. Research in Liberia combined surveys and interviews with people from households with a disabled person as well as those without, and included responses from 560 persons living in areas that had ‘many’ or ‘few’ cases of Ebola.

Assistive Technology Capacity Assessment (ATA-C) Survey Mongolia

Sunil Deepak
April 2020

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An Assistive Technology Capacity Assessment (ATA-C) survey in Mongolia in 2019. This survey was the first step in the effort to improve and strengthen the Assistive Technology (AT) services in the country, as part of the action following the resolution 71.8 of the World Health Assembly (WHA) in May 2018. WHO’s ATA-C survey has 4 questionnaires, these were translated and field tested in Mongolia. In collaboration with Tegsh Niigem, a Mongolian NGO, the major stakeholders involved in policy, acquisition, procurement, production and distribution of assistive products in the country were interviewed and compiled the WHO questionnaires. All together 47 persons were interviewed. This report presents the key findings from this survey.

Labour market date for persons with disabilities (i2i webinar)

EUROPEAN DEVELOPMENT FORUM
April 2020

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On April 22nd 2020, the European Disability Forum organised the fourth of a series of webinars about the Innovation to Inclusion project (also called i2i programme). 

Four speakers were invited to talk about Labour Market Data for persons with disabilities. After their presentation, there was some time for questions and answers.

 

  • Mark Carew (Leonard Cheshire) spoke briefly about i2i’s approach to disability data and how i2i supports a good quality collection of disability data.
  • Valentina Stoevska (Department of Statistics, International Labour Organisation) explained the objectives of the statistical data on the labour market characteristics of persons with disabilities. She talked about the use of Washington Group questions on the disability Labour Force Surveys. To conclude her presentation, Ms Stoevska briefly illustrated with some statistics the employment characteristics of persons with disabilities.
  • Robert Buluma (Governance, Peace and Security statistics of the Kenya National Bureau of Statistics) briefly provided some information on the development of a disability monograph.
  • Anderson Gitonga (United Disabled Persons of Kenya (UDPK)) spoke about the importance of the meaningful participation of persons with disabilities in data gathering and touched upon the technical working group that has been formed in Kenya.

Impact of COVID‐19 on people with disabilities and their families in Jordan, April 2020

HUMANITY & INCLUSION (HI)
April 2020

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The objective of the assessment is to understand the needs of people with disabilities and their families during the implementation of restrictions by the Government of Jordan in response to COVID‐19. The findings will provide insights for intervention planning at Humanity & Inclusion (HI) and evidence for advocacy effort with the local authority regarding support policies for vulnerable groups and movement permission for humanitarian aids.

HI conducted the assessment in April 2020 via phone survey with 942 households including 524 households having adults with disabilities and 418 households having children with disabilities. HI used purposive sampling to select the respondents from the currently active beneficiary dataset. Due to the large size of rehabilitation project, 93% of respondents were people with physical impairment. The results should be used as reference rather than representation for the needs of people with disabilities in Jordan.

 

The assessment findings are presented in two parts: Data at individual level and Data at household level.

No one left behind? Comparing poverty and deprivation between people with and without disabilities in the Maldives

BANKS, Lena Morgon
et al
March 2020

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This study estimates the prevalence of disability in the Maldives and compares indicators of poverty and living conditions between people with and without disabilities, using nationally-representative, population-based data (n = 5363). The prevalence of disability was estimated at 6.8%. Poverty and household living conditons, education, health, work and social participation were examined. Data were collected from July to August 2017 through a nationally-representative population-based survey with a nested case–control study

 

Sustainability 2020, 12, 2066 

https://doi.org/10.3390/su12052066

Disability and gender analysis toolkit

THOMSON, Teresa
et al
March 2020

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CBM’s Disability and Gender Analysis Toolkit has been developed to support staff, partners and allies in strengthening capacity to address systemic and deeply entrenched discriminatory practices and specifically to meet their Programme Quality Standards. It provides practical tools for stronger disability and gender analysis to inform planning, practice and systems. The toolkit provides practical assessment templates and guidance for individuals, organisations and programmes to identify strengths and gaps and to develop focussed action plans to improve practice.

Estimated prevalence of disability and developmental delay among pre‐school children in rural Malawi: Findings from ‘Tikule Limodzi’, a cross‐sectional survey

MURPHY, Rachel
et al
January 2020

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This study measured and compared the prevalence of disability and developmental delay among children attending preschool centres in rural Malawi. A cross-sectional survey was conducted in 48 preschool centres in Thyolodistrict, Malawi. Data were collected from parents or guardians of 20 children per centre. Disability was ascertained using the Washington Group/UNICEF Child Functioning Module. Child development was measured using the language and social domains of the Malawi Development Assessment Tool. A total of 960 children were enrolled; 935 (97.4%) children were assessed for disability and 933 (97.2%) for developmental delay; 100 (10.7%) children were identified as having a disability

 

Child Care Health Dev. 2020;46:187–194.
https://doi.org/10.1111/cch.12741

Prevalence of trachoma in Pakistan: Results of 42 population-based prevalence surveys from the Global Trachoma Mapping Project

KHAN, A A
et al
January 2020

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Previous phases of trachoma mapping in Pakistan completed baseline surveys in 38 districts. To help guide national trachoma elimination planning, this work was carried out to estimate trachoma prevalence in 43 suspected-endemic evaluation units (EUs) of 15 further districts. A population-based trachoma prevalence survey was planned for each EU. Two-stage cluster sampling was employed, using the systems and approaches of the Global Trachoma Mapping Project.

 

Ophthalmic Epidemiol. 2020 Apr;27(2):155-164

doi: 10.1080/09286586.2019.1708120

Disability measurement in household surveys : A guidebook for designing household survey questionnaires (English). LSMS guidebook.

TIBERTO, Marco
COSTA, Valentina
January 2020

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This Guidebook supports the implementation of the Washington Group Short Set (WG-SS) – a set of questions designed to identify (in a census or survey format) people with a disability – in multi-topic household surveys, towards improving the collection of disaggregated disability data. The first section presents an overview of the disability definitions in the sociopsychological literature, exploring how disability is defined and who is considered disabled. The second section looks at three different methods for capturing disability in multi-topic household surveys: the Washington Group (WG) question sets, the World Health Organization (WHO) survey instruments for disabilities, and the Demographic and Health Surveys (DHS) module on disabilities. The third section presents the six core WG-SS functional domains, ‘seeing’, ‘hearing’, ‘walking’, ‘cognition’, ‘selfcare’, and ‘communication’, that are intended for the general population five years of age and above. Finally, the Guidebook offers a series of recommendations for ensuring the improvement of disability data collection in multi-topic household survey.

Disability-inclusive disaster recovery (Disaster Recovery Guidance Series)

ROBINSON, Alex
2020

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This guidance note provides action-oriented direction for government officials and decision-makers with responsibility for post-disaster recovery and reconstruction. The guidance will enable the development of disability-inclusive planning and programming across sectors and government. The note is expected to be of interest to wider government and non-government actors, including disabled persons’ organizations (DPOs), concerned with inclusive recovery.

Integrating geospatial data and measures of disability and wealth to assess inequalities in an eye health survey: An example from the Indian Sunderbans

MOHANTY, Soumya
et al
December 2019

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The Sunderbans are a group of delta islands that straddle the border between India and Bangladesh. For people living on the Indian side, health services are scarce and the terrain makes access to what is available difficult. In 2018, the international non-governmental organisation Sightsavers and their partners conducted a population-based survey of visual impairment and coverage of cataract and spectacle services, supplemented with tools to measure equity in eye health by wealth, disability, and geographical location. Two-stage cluster sampling was undertaken to randomly select 3868 individuals aged 40+ years, of whom 3410 were examined

 

Int J Environ Res Public Health. 2019 Dec; 16(23): 4869

doi: 10.3390/ijerph16234869

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