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Assessment of Rehabilitation Capacity in Ghana

Christian, Asare
et al
2016

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Purpose: This study describes a cross-sectional assessment of infrastructure, human resources, and types of rehabilitation interventions provided in a sample of healthcare facilities in Ghana. The objectives were to (a) develop and pilot a questionnaire assessing rehabilitation capacity in LMICs, and (b) provide initial data regarding available rehabilitation care in rural Ghana.

 

Methods: Data was collected from a sample of rehabilitation workers at 9 facilities, comprised of 5 regional and 4 district hospitals, located in seven of the ten geographical regions of Ghana. Participants completed a modified version of the World Health Organisation's Tool for Situational Analysis to Assess Emergency and Essential Surgical Care, adapted to reflect core indicators of rehabilitation infrastructure. Participating facilities were mailed questionnaires and agreed to subsequent site visits from the first author.

 

Results: There were several limitations associated with basic rehabilitation infrastructure. Consistent with previous research, significant human resources limitations were observed as hospital-based rehabilitation services were primarily rendered by 20 physiotherapists and 21 physiotherapy assistants across the 9 participating sites. No rehabilitation physicians were identified at any of the surveyed facilities. With regard to therapeutic interventions, management of musculoskeletal impairments was generally consistent with current evidence- based practices, whereas rehabilitative approaches for neurologic conditions were limited to physical rather than sensory-motor modalities.

 

Conclusions: For the first time there is study data which details the rehabilitation infrastructure, human resources, and interventions in Ghana. This study furthers the field through the adaptation and initial piloting of a rehabilitation assessment instrument that can be used in LMIC contexts.

 

Limitations: The questionnaire used for the study was modified from the questionnaire for assessing surgical care in resource poor countries, and has not yet been validated. Since the study was conducted in a convenience sample of rehabilitation/physiotherapy centres in Ghana, generalisability may be limited.

Mental Health Innovation Network (MHIN)

May 2016

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MHIN is a network  for the global mental health community to  communicate and share knowledge, experiences and resources to improve the quality and coverage of care. Provides searchable innovations and resources. The community area hosts blogs, podcasts, webinars and forums.

Global strategy on human resources for health: Workforce 2030. DRAFT for the 69th World Health Assembly

World Health Organisation (WHO)
May 2016

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This report was presented to Member States at the World Health Assembly in May 2016 and is to be read in conjunction with A69/38: Draft global strategy on human resources for health: Workforce 2030. Report by the Secretariat. The vision of this work and report is to "Accelerate progress towards universal health coverage and the UN Sustainable Development Goals by ensuring equitable access to health workers within strengthened health systems". Objectives are "To optimise performance, quality and impact of the health workforce through evidence-informed policies on human resources for health, contributing to healthy lives and well-being, effective universal health coverage, resilience and strengthened health systems at all levels",  "To align investment in human resources for health with the current and future needs of the population and of health systems, taking account of labour market dynamics and education policies; to address shortages and improve distribution of health workers, so as to enable maximum improvements in health outcomes, social welfare, employment creation and economic growth", "To build the capacity of institutions at sub-national, national, regional and global levels for effective public policy stewardship, leadership and governance of actions on human resources for health" and "to strengthen data on human resources for health, for monitoring and ensuring accountability for the implementation of national and regional strategies, and the global strategy".  Global milestones by 2020 and 2030, policy options of Member States, responsibilities of the WHO Secretariat and recommendations to other stakeholders and international partners are discussed for each objective.

 

Mental health funding and the SDGs What now and who pays?

MACKENZIE, Jessica
KESNER, Christie
May 2016

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"This report provides an overview of who is currently funding mental health and who isn’t, but could be. It is a synthesis of research previously conducted in this field and analyses both existing and new funders. It highlights how little information there is on what donors are spending on mental health globally, what types of activities are funded and why funding mental health delivers a variety of benefits, and it suggests how to frame the issue to encourage more investment".

Priority assistive products list

WORLD HEALTH ORGANISATION (WHO)
May 2016

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The Priority Assistive Products List (APL) aspires to follow in the footsteps of the WHO Model List of Essential Medicines, which creates awareness among the public, mobilises resources and stimulates competition. The Priority Assistive Products List is similarly intended to be a catalyst in promoting access to assistive technology. It is not a restrictive list but aims to provide each Member State with a model from which to develop a National priority assistive products list. 

The List includes hearing aids, wheelchairs, communication aids, spectacles, artificial limbs, pill organizers, memory aids and other essential items for many older people and people with disabilities to be able to live a healthy, productive and dignified life.

The APL is part of the Global Cooperation on Assistive Technology (GATE)

Living in hell : how people with mental health conditions in Indonesia are treated

HUMAN RIGHTS WATCH (HRW)
March 2016

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This report examines the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

Living in hell : abuses against people with psychosocial disabilities in Indonesia

HUMAN RIGHTS WATCH (HRW)
March 2016

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This article with a video is related to a report examining the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

How CBM Australia supports engagement with government for disability inclusion and prevention

CBM AUSTRALIA
March 2016

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CBM Australia engages both directly and indirectly with governments. Indirectly, CBM Australia supports other organisations, for instance disabled people’s organisations or civil society organisations to engage with governments. This report looks at the different ways that CBM partners seek influence government and promote sustainability. It considers the different roles and relevance of activism, advocacy, service delivery and advisory approaches.

 

The cases in this report were identified and gathered through semi-structured interviews with CBM’s Program Officers, Technical Advisors, regional/country office and project staff in-country, as well as drawing on reports and evaluations. The report starts with a section explaining the four different approaches to working with government, followed by a brief introduction to each approach, highlighting what CBM are doing and the key lessons learned. Each section is followed by case studies giving more detailed insight into how CBM are engaging, key achievements, challenges and the lessons learned. Fifteen case studies covering key projects from CBM Australia’s International Programs and the Inclusive Development Team are described in this report.

Emergence and structuring of support groups for people living with mental health problems in Togo, Madagascar, Lebanon and South Sudan

CALVOT Thomas,
PEGON Guillaume
February 2016

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"Based on an ethnographic type baseline study conducted on four support groups for people living with mental health problems, evolving in various contexts (prisons, hospitals, refugee camps and mental health centres) in Madagascar, Lebanon, South Sudan and Togo, this study identifies four dynamics contributing to the emergence and the structuring of these groups: survive, get medical care, get organised, advocate." 

Health financing country diagnostic: a foundation for national strategy development

MCINTYRE, Diane
KUTZIN, Joseph
2016

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Health systems’ analysis is not an exact science in the sense that it is not a case of calculating an indicator and comparing that to a target that is set in stone. Instead, the analysis rests on describing elements of the existing system and critically assessing this on the basis of a clear understanding of health financing policy, the objectives associated with UHC, and relevant comparisons with and lessons from other countries. The paper attempts to provide guidance on how this can be done by highlighting the key issues that should be considered and some of the specific questions that should be addressed. It is not intended to provide a strict chapter-bychapter outline for a system assessment, but instead to foster and guide a systematic approach to the analysis of the health financing system. The health financing country diagnostic is written for Ministries of Health, advisors and others actors responsible for developing and implementing health financing policies, and provides step-by-step guidance on how to undertake a situation analysis of a country’s health financing system. Topics considered include: key contextual factors that influence health financing policy and attainment of policy goals; overview of health expenditure patterns; review of health financing arrangements; analysis UHC goals and intermediate objectives; and overall assessment - priorities for health financing reform.

Public financing for health in Africa: from Abuja to the SDGs

BARROY, Helene
VAN DE MAELE, Nathalie
MUSANGO, Laurent
HSU, Justine
et al
2016

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"This report takes stock of the main public financing for health trends over the past fifteen years in the African region, and highlights opportunities for accelerated progress toward universal health coverage (UHC) based on better-informed budget planning and utilization decisions. The report presents new evidence on the critical role played by domestic public financial management systems on the level, effectiveness and quality of public spending on health in Africa. It argues that these systems should be reconsidered if countries are to move towards UHCCountry experience in reforming public finance systems to support progress towards UHC indicates that success depends on more than simply increasing the level of public budgets. Rather, it requires appropriately targeted health budget allocations, complete execution of health’s public budgets, and improved efficiency in the use of public resources for health.

The report is composed of three sections. The first section is articulated around three policy highlights: aligning budget resources and health priorities; closing the gap between health budget allocation and expenditure; and maximizing UHC performance with the money available. Section 2 is dedicated to providing detailed health financing information on countries, and includes 48 country profiles focused on key health financing trends. The last section includes information on progress towards the development of health financing strategies in the region, as well as regional and country benchmarks on key health financing indicators"

WHO/HIS/HGF/Tech.Report/16.2

Strengthening community and primary health systems for tuberculosis. A consultation on childhood TB integration

UNICEF
2016

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An estimated one million children between the age of 0-14 fall ill with tuberculosis (TB) every year, over 67 million children are infected and might develop active disease at any time. In 2013, the WHO with key partners launched the Roadmap for Childhood TB, outlining ten key actions to improve outcomes for children affected by TB, including improved data, development of child-friendly tools for diagnosis and treatment, engagement of key stakeholders at all levels of the system, and the development of integrated family- and community-centred strategies to provide comprehensive and effective services at the community level. A consultation on childhood TB integration took place in New York on June 1 and 2, 2016 to stimulate further the dialogue. The meeting addressed 7 topics: perspectives on childhood TB; country discussions on integration; integrating childhood TB interventions into service delivery; an opportunity for TB risk assessment at the community level: TB/HIV adapted integrated community case management (iCCM); childhood TB integration at the national, district, and community level; and financing childhood TB integration 

UNICEF 2016-2030 Strategy for Health “at a glance”

UNICEF
2016

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This provides an overview of UNICEF’s 2016-2030 Strategy for Health which "aims to: end preventable maternal, newborn, and child deaths; and promote the health and development of all children. With the first goal, UNICEF commits to maintaining focus on the critical unmet needs related to maternal, newborn and under-5 survival. With the second, UNICEF highlights the importance of also looking beyond survival and addressing the health and development needs of older children and adolescents. The Strategy emphasises the importance of prioritising the needs of the most deprived children and promotes multi-sectoral approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts by encouraging risk-informed programming in all contexts"

Interventions for children affected by armed conflict: a systematic review of mental health and psychosocial support in low- and middle-income countries

JORDANS, Mark. J. D.
PIGOTT, Hugo
TOL, Wietse A
January 2016

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Over one billion children under the age of 18 live in countries affected by armed conflict. This systematic review replicates an earlier study, aiming to provide a comprehensive update of the most current developments in interventions for children affected by armed conflict. For the period 2009– 2015, a total of 1538 records were collected. Twenty-four studies met the inclusion criteria, and the included interventions involve data from 4858 children. Two types of analysis were conducted. First, for an account of intervention descriptions, thematic analysis was used to summarise themes, with a specific focus on cultural adaptations. Second, all evaluation studies reporting quantitative data were categorised into level of evidence (1 = randomized controlled trials, all types; 2 = quasi-experimental design and controlled studies; 3 = non-controlled design; 4 = case studies) 

Current Psychiatry Reports, vol 18 (9), doi:10.1007/s11920-015-0648-z

Hear my voice: old age and disability are not a curse. A community-based participatory study gathering the lived experiences of persons with disabilities and older people in Tanzania

MRISHO, Mwifadhi
FAKIH, Bakar
GREENWOOD, Margo
STEFF, Marion
2016

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Community based participatory research (CBPR) was used to provide evidence on the specific nature and experiences of persons with disabilities and older people from their own perspectives in Tanzania, through the lens of social, political, economic and cultural inclusion. The aim was to strengthen efforts to provide services for and improve the lives of people living in the rural and urban settings of Nachingwea and Kibaha Urban Municipal Council. Twenty-nine peer researchers (nine persons with disabilities, 10 older people and 10 Tanzanian Non-Governmental Organisation (NGO) members working in these communities) were involved in the study. A total of 106 stories were collected. Eight priority areas emerged and were chosen by peer researchers for further discussion in groups: access to education and quality learning; access to health services; issues fed back from NGOs; poverty relating to income and dependence; attitudes towards witchcraft and albinism; relationship difficulties and marriage breakdowns; sexual violence and gender issues; poor treatment from family
 

The medical inadmissibility of intellectual disability: A postcolonial reading of Canadian immigration systems

SPAGNUOLO, Natalie
2016

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This article builds upon existing critiques of Canada’s immigration system by focusing on the medical inadmissibility of young people labelled with intellectual disabilities. In considering how the Canadian state regulates applications for permanent residency, it explores discourses and practices of citizenship which invoke mutually-constituting identity markers such as disability and race. A close reading of case studies involving family applicants, demonstrates how immigration policies and legal systems frame the needs of young people labelled with intellectual or ‘profound’ disabilities as a burden to Canadian society. Individuals who were initially denied admission to Canada due to their diagnostic label, experience disability-related discrimination in different ways depending on the role of their perceived racial, gender, and class identities, among others. The individuals considered in this study navigate intersectional identities and ableist legal systems in their efforts to resist discrimination and win a review of their residency applications. This analysis will show that applicants are forced to work through the logic of medical assessment processes to favourably position their children within impairment hierarchies which rank intellectual disability as ‘too disabled’ to be admissible.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 2

The Re-covering Self: a critique of the recovery-based approach in India’s mental health care

BAYETTI, Clement
JADHAV, Sushrut
JAIN, Sumeet
2016

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This paper critiques recent initiatives for deploying the Recovery Model in the Indian sub-continent. It traces the history and growth of the model, and questions its applicability for mental health care in the Indian sub-continent. The authors argue that mental health professionals in this region are at the crossroads of a familiar past: either to uncritically import and apply a Euro-American 'recovery' model or reconfigure its fundamental premise such that it is embraced by the majority Indian population. The paper proposes a fundamental re-thinking of existing culturally incongruent 'Recovery Models' before application in India’s public mental health and clinic settings. More crucially, policy makers, clinicians and researchers need to reconsider the local validity of what constitutes 'recovery' for the very people who place their trust in State mental health services. This critical reappraisal, together with essential culturally-sensitive research, is germane to prevent yet again the deployment of culture-blind programmes and practices. Addressing these uncontested issues has profound implications for public mental health in the Global South.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 1

UNICEF’S STRATEGY FOR HEALTH (2016-2030)

UNICEF
December 2015

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UNICEF envisions a world where no child dies from a preventable cause, and all children reach their full potential in health and well-being. To this end, UNICEF’s 2016-2030 Strategy for Health aims to:

 

- End preventable maternal, newborn, and child deaths

- Promote the health and development of all children

 

With the first goal, UNICEF commits to maintaining focus on the critical unmet needs related to maternal, newborn and under-5 survival. With the second, UNICEF highlights the importance of also looking beyond survival and addressing the health and development needs of older children and adolescents.

 

The Strategy emphasises the importance of prioritising the needs of the most deprived children and promotes multi-sectoral approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts by encouraging risk-informed programming in all contexts.

Interventions to improve the labour market situation of adults with physical and/or sensory disabilities in low and middle-income countries : a systematic review

TIPNEY, Janice
et al
November 2015

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This systematic review analyses the methodology, collection, and results of fourteen individual studies that examined the effectiveness of fifteen different intervention methods to assist students with disabilities in low and middle income countries to improve the labour market situation

Campbell Systematic Reviews 2015:20

 

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