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Disability and HIV : a systematic review and a meta-analysis of the risk of HIV infection among adults with disabilities in Sub-Saharan Africa

DE BEAUDRAP, Pierre
MAC-SEING, Muriel
PASQUIER, Estelle
July 2014

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"More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02–1.69) overall; 1.16 (0.71–1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58–1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap"

 

AIDS Care : Psychological and Socio-medical Aspects of HIV/AIDS, Volume 26, Issue 12

DOI: 10.1080/09540121.2014.936820

 

With or without us? An audit of disability research in the southern African region

MCKENZIE, Judith
MJI, Gubela
GCAZA, Siphokazi
2014

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Background: Disability research in the global South has not received significant critical consideration as to how it can be used to challenge the oppression and marginalisation of people with disabilities in low-income and middle-income countries. The Southern Africa Federation of the Disabled (SAFOD) embarked on a programme to use research to influence policy and practice relating to people with disabilities in Southern Africa, and commissioned an audit on research expertise in the region. In this article, a research audit is reported on and situated in a framework of mancipatory research.

 

Objectives: This article sets out to describe a preliminary audit of disability research in the southern African region and to draw conclusions about the current state of disability research in the region and make recommendations.

 

Method: The research method entailed working with disability researchers in the ten SAFOD member countries and utilising African disability networks hosted on electronic media. Disability researchers working in the region completed 87 questionnaires, which were reviewed through a thematic analysis.

 

Results: The discussion of results provides a consideration of definitions of disability; the understanding of disability rights, research topics and methodologies; the participation of people with disabilities in research; and the challenges and opportunities for using research to inform disability activism.

 

Conclusion: The conclusion highlights critical issues for future research in the region, and considers how a disability researcher database can be used as a tool for disability organisations to prioritise research that serves a disability rights agenda.

 

Hidden victims of the Syria crisis : disabled, injured and older refugees

HELPAGE INTERNATIONAL
HANDICAP INTERNATIONAL
April 2014

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This report presents research undertaken to highlight the number and needs of Syrian refugees in Jordan and Lebanon living with impairment, injury and chronic disease – for the purposes of this study these groups are referred to as “people with specific needs”. Throughout the report specific consideration is given to the position of older people with specific needs. Due to access and security constraints it was not possible to collect data in Syria itself, however it is recognised that the needs of refugees identified in the following report will be reflected within Syria, and that in this more extreme humanitarian situation the issues outlined below demand further consideration and response

Caregiver’s Involvement in Early Intervention for Children with Communication Disorders

MALAR, G
SREEDEVI, N
SURESH, C
2014

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Purpose: Since very young people benefit from early identification of communication disorders, the primary caregivers (generally the parents) become the fulcrum of the intervention services provided. This article deals with the measures taken to empower caregivers, as part of the early intervention services offered at the All India Institute of Speech & Hearing (AIISH) in Mysore city in India, and the impact this has had on their wards’ progress.

 

Method: A survey was conducted among the caregivers of 205 clients who availed of early intervention services. Five-pronged data were collected, pertaining to family demographic details, early intervention measures for their children with communication disorders, type and intensity of caregiver empowerment measures provided along with early intervention services, resultant caregiver participation in the education and training of their wards, and the consequent development in children with communication disorders. The mutual influences among these factors were analysed using simple correlation measures.

 

Results: The findings revealed that informal, but continuous and consistent efforts to empower parents, such as counselling and guidance, had a better impact. Empowered caregivers in turn contributed towards the education and training of their children with communication disorders, resulting in improved development of their wards’ communication skills and academic achievements.

 

Conclusion: The evidence adds strength to recommendations that caregiver empowerment and participation need to become integral components of early intervention services for young children with special needs.

Presentation and Impact of Pain in Persons with Post-Polio Syndrome: A Cross-sectional Survey Study

SHETH, M S
GHOGHARI, B
VYAS, N J
2014

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Purpose: It is a common and well‐recognised phenomenon that functional deterioration occurs many years after people are affected by poliomyelitis infection. This study aims to determine the presentation of pain in subjects with post-polio syndrome (PPS) and also the correlation between severity of pain and interference in activities of daily living (ADL).

 

Method: A cross-sectional survey was conducted among 72 persons with PPS in Gujarat state in India. Each one was given a self-administered questionnaire which included an 11‐point Numeric pain rating scale (NRS) for intensity of pain, questions about site, duration and diurnal variation of pain, and an 11‐point Numeric pain rating scale for pain interference.

 

Results: The study showed that 17 persons (24%) had only joint pain, 28 (39%) had only muscular pain and 27 (37%) had both joint as well as muscular pain. The highest number of subjects or 34 persons (47%) had knee pain, followed by 24 (33%) with shoulder pain, 21% with hip and 19% with low back pain. Muscle pain was maximum in arm musculature, as reported by 33 persons (45%), followed by pain in leg and foot muscles among 25 (36%) and 17 (23%) persons, respectively. Maximum number of subjects or 31% had pain while working which was relieved by rest, while 28 % had pain which continued all day. 43% experienced more pain in winter while 57% had no seasonal variation in pain. 30 persons (42%) had severe pain, 26 had moderate pain and only 16 had mild pain. Mean pain intensity was 5.88 ±1.52. Interference in ADL on NRS was 4.72 ±2.70. Interference in ADL and pain intensity were found to be positively correlated with Pearson’s co-efficient r=0.6295(p<0.0001).

 

Conclusion: The majority of those who had recovered from polio experienced increased or new symptoms and problems in ADL, muscle pain, joint pain, and difficulties in walking.

The state of the world's children 2014 in numbers : every child counts

UNITED NATIONS CHILDREN’S FUND (UNICEF)
January 2014

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This report highlights the critical role data and monitoring play in realising children’s rights. It presents an updated compendium of statistics and data (which has been produced thirty years after the initial report) relating to the position of children throughout the world but particularly within the Global South. The data indicators cover a vast range: from demography, health and education, to rate of progression, child mortality, and disparities by household wealth. It emphasises that credible data, disseminated effectively and used correctly, make change possible to target interventions that help right the wrong of exclusion by identifying needs, supporting advocacy, gauging progress and holding duty bearers to account

Living with disability and disasters : UNISDR 2013 survey on living with disabilities and disasters : key findings

UNITED NATIONS OFFICE FOR DISASTER RISK REDUCTION (UNISDR)
2014

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This report discusses "the results of the first-ever UN global survey of persons living with disabilities (PWDs) on how they cope with disasters, illustrates why they die, or are injured, in disproportionate numbers in disasters. Survey responses from 5,717 persons from all over the world reveal that persons living with disabilities are rarely consulted about their needs in potential disaster situations." The report concludes with a number of recommendations for how to develop disaster risk reduction practises that include people with disabilities

DRR factsheet

UNITED NATIONS OFFICE DISASTER RISK REDUCTION (UNISDR)
UNITED NATIONS ENABLE
October 2013

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This resource presents the highlights from a UN global survey of persons living with disabilities on how they cope with disasters

A data revolution for disability-inclusive development

MITRA, Sophie
August 2013

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This article examines data collection and monitoring for disability-inclusive development. It discusses the need for a data revolution and the UN's Washington City Group on Disability Statistics’ questions as a measurement example
The Lancet Global Health, Early Online Publication

Spatial variation in the disability-poverty correlation : evidence from Vietnam

MONT, Daniel
NGUYEN, Cuong
August 2013

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"Poverty and disability are interrelated, but data that can disentangle the extent to which one causes the other is not available. However, data from Vietnam allows us to examine this interrelationship in a way not previously done. Using small area estimation techniques, we uncover three findings not yet reported in the literature. First, disability prevalence rates vary significantly within a county even at the district level. Second, the correlation between disability and poverty also varies at the district level. And most importantly, the strength of the correlation lessens based on district characteristics that can be affected by policy. Districts with better health care and infrastructure, such as roads and health services, show less of a link between disability and poverty, supporting the hypothesis that improvements in infrastructure and rehabilitation services can lessen the impact of disability on families with disabled members"
Working Paper Series, No 20

Disability prevalence among adults : estimates for 54 countries and progress towards a global estimate

MITRA, Sophie
SAMBAMOORTHI, Usha
July 2013

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This study estimated disability prevalence among adults at global, regional and country levels using internationally comparable disability data and measure. The authors conducted a retrospective analysis of data from the World Health Survey (WHS) (2002-2004) for nationally representative samples of civilian, non-institutionalized populations in 54 countries. A disability was measured as having at least one severe or extreme difficulty with bodily functions (seeing, concentrating) and activities (moving around, self-care) based on an individual’s self-reports
In the 54 countries under study, severe or extreme functional or activity difficulties are highly prevalent. For all countries, disability prevalence is estimated at 14% for all adults. Low and middle income countries have higher disability prevalence compared to high income countries. Among subgroups, disability prevalence stands at 12% among working age adults and 39% among the elderly. Women have higher prevalence than men.
Disability is found to be highly prevalent among adults, with an estimated global prevalence at 14%. Disability deserves enhanced policy attention and resources in public health and international development
Discussion Paper No: 2013-06, Forthcoming in Disability and Rehabilitation

Old age, disability and mental health : data issues for a post-2015 framework

SAMMAN, Emma
RODRIGUEZ-TAKEUCHI, L. K
May 2013

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"This Background Note focuses on inequalities associated with old age, disability and mental health. It argues that these should be considered salient sources of group-based difference, given the numbers of people affected, their marginalisation and vulnerability, and their relative neglect in international agreements to date. This note identifies a lack of data as a particular concern, but one that can be addressed through revisions to standard household surveys. To this end, the paper discusses the available data and their limitations, constraints to better data collection and efforts needed to adjust key international survey instruments -the World Bank’s Core Welfare Indicator Questionnaire (CWIQ) and Living Standards and Measurement Survey (LSMS), Macro International’s Demographic and Health Survey (DHS) and the UNICEF Multiple Indicator Cluster Survey (MICS)- to collect reliable data on these issues. It sets out technical adjustments that would enable these surveys to broaden their coverage, collect richer information and improve their identification of these three groups. It concludes by commenting on how measures to address the inequalities that affect these groups could be incorporated within a new post-2015 framework agreement"
ODI Background note

Challenges Faced by Malaysians with Disabilities in the World of Employment

TA, T L
LENG, K S
2013

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Purpose: This paper aims to explore and understand the challenges that are encountered by Malaysians with disabilities in the world of employment.

 

Method: A survey was undertaken in four Northern Malaysian states (Perlis, Kedah, Penang and Perak) to obtain the primary data. Two sets of questionnaires were formulated. The first questionnaire was addressed towards Malaysianpeople with disabilities, while the second one was for the employers. Descriptive statistics were used to explore, summarise and describe the data collected.

 

Results: This paper argues that integrating people with disabilities into the mainstream workforce should be the way forward, given that they are a pool of untapped human resources. Crucially, this study also highlights some of the key challenges faced by Malaysian people with disabilities, such as discrimination and exploitation at work.

 

Conclusions: This paper concludes that equal employment and training opportunities should be extended to Malaysian people with disabilities, in an effort to integrate them into the mainstream workforce. The existing Disability Act 2008 should be revised to address the challenges and issues highlighted in this paper.

Inclusive Education in Bangladesh: Are Pre-service Teachers Ready to Accept Students with Special Educational Needs in Regular Classes?

MALAK, M S
2013

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Purpose: The aim of this study was to examine pre-service special education (PSpE) teachers’ attitudes towards inclusive education (IE) for students with special educational needs (SEN) in Bangladesh.

 

Method: 100 PSpE teachers from a leading teacher education institute in Bangladesh were purposively sampled. A 20-item based survey questionnaire was used to measure participants’ attitudes. Items of the survey were developed from a literature review in which Attitudes Towards Inclusive Education Scale (ATIES) by Wilczenski (1992), Concern about Inclusive Education Scale (CIES) by Sharma and Desai (2002), and Interaction with Persons with a Disability (IPD) Scaled by Gething (1994) were considered as the key specialist resources. Both descriptive and inferential statistics were utilised in the analysis.

 

Results: The results revealed that while the PSpE teachers hold favourable attitudes towards students with SEN, they are concerned about some basic issues of inclusion. Practicum and close contact with children with SEN were found to be important variables which shaped the attitudes of the PSpE teachers. Implications of the findings are discussed and further suggestions are made as to how teacher education institutes may engage PSpE teachers more effectively with their programmes to promote better inclusive practices.

 

Conclusion: The study suggests that there is a need for providing PSpE teachers with experiential learning prior to school practicum.

Problem Behaviour and Academic Grade Level Performance of Adjudicated Children with Juvenile Delinquency

VENKATESAN, S
SWARNALATHA, G
2013

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Purpose: This paper attempted to profile the contemporary grade level academic performance as well as the frequency, spread and intensity of problem behaviour in relation to a few associated variables, of children adjudged as juvenile delinquents in India.

 

Method: A cross-sectional exploratory survey design was employed, with randomised convenience sampling of 66 inmates, between 9 and 18 years of age, from two representative Observation Homes. To ascertain their current grade levels, a criterion referenced ‘Grade Level Assessment Protocol’ was prepared exclusively for this study. Another standardised ‘Behaviour Assessment Scale for Indian Children with Mental Retardation, Part B’ was used to profile their problem behaviour.

 

Results: The contemporary academic performance results satisfy the conventional two-grade discrepancy criteria, usually postulated for identifying children with learning disabilities. Among the associated variables examined in this study, inmates who were booked under sections of the Indian Penal Code showed significantly greater academic grade discrepancy compared to the other children. Similarly, poorer academic performance, greater grade discrepancy, as well as higher frequency, spread and intensity of reported problem behaviour were found among children from intact family backgrounds, where parents were illiterates or educated below primary school level, and more among boys than girls, and among those in the 10-12 year age group.

 

Conclusions: While these are tentative findings, they call attention to the need for extensive research on the possible links between academic performance, under achievement and learning disabilities, and juvenile delinquency in this country.

A million voices : the world we want|A sustainable future with dignity for all

UNDG MILLENNIUM DEVELOPMENT GOALS TASK FORCE
2013

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"This report by the United Nations Development Group (UNDG) collects the perspectives on the 'world we want' from over 1 million people around the globe. For almost one year, people have engaged energetically in 88 national consultations, 11 thematic dialogues, and through the MY World global survey...The findings of this global conversation contain important messages for governments as they seek to agree on a new development agenda that can build on the successes of the Millennium Development Goals (MDGs)"

Impact of community-based rehabilitation on persons with different disabilities

DEEPAK, Sunil
BIGGERI, Mario
MAURO, Vincenzo
KUMAR, Jayanth
GRIFFO, Giampiero
2013

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There are some barriers that persons with different kinds of impairments commonly face, and there are also some impairment-specific barriers. Disaggregated data are needed to assess the impact of different CBR activities on different groups of persons with disabilities.

 

Purpose: This article assesses the impact of CBR on key variables linked to the five domains of the CBR Matrix, on 4 groups of persons with disabilities - visual, hearing and speech, physical and intellectual disabilities.

 

Method: A questionnaire survey was carried out involving 2,332 persons with disabilities, in a random stratified sample of villages covered by a CBR programme, in 9 sub-districts of Karnataka state (India) and in a control area. Data were collected pertaining to different activities in the lives of persons with disabilities. Through a participatory approach involving CBR workers and DPO representatives, some key indicators were identified to assess the impact of CBR on the five domains of the CBR Matrix - health, education, livelihood, social participation and empowerment.

 

Results: Among all the 4 groups of persons with disabilities, the CBR programme was found to have had a positive impact across all the five domains of the CBR Matrix. However, there was no uniform impact on different variables among the 4 groups; different groups of persons with disabilities benefited differently from different activities. Persons with physical disabilities seemed to benefit in more areas compared to persons in the other groups.

 

Conclusions: CBR programmes can have a positive impact on persons with visual, hearing and speech, physical and intellectual disabilities. Disaggregated data can help CBR programmes to identify groups of persons who benefit less from specific activities and adopt strategies to improve their participation.

 

 

Disability, CBR and Inclusive Development, Vol. 24, No. 4

Community volunteers : an asset for detecting and following up children with disabilities

INTERNATIONAL CENTER FOR EVIDENCE ON DISABILITY (ICED)
December 2012

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This video presents a  recording of a seminar held at the London School of Hygiene and Tropical Medicine (LSHTM) in November 2012.  The seminar explores the findings and recommendations from a four year CBM-funded project in Bangladesh and Pakistan to identify children with disabilities and connect them with appropriate rehabilitative services

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