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Disability prevalence-context matters: A descriptive community-based survey

MAART, Soraya
AMOSUN, Seyi
JELSMA, Jennifer
August 2019

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Background: There is increasing interest in the collection of globally comparable disability data. Context may influence not only the rates but also the nature of disability, thus locally collected data may be of greater use in service delivery planning than national surveys.

 

Objectives: The objective of this article was to explore the extent to which two areas, both under-resourced but geographically and socially distinct, differed in terms of the prevalence and patterns of disability.

 

Method: A cross-sectional descriptive survey design was utilised, using stratified cluster sampling in two under-resourced communities in the Western Cape, South Africa. Nyanga is an informal urban settlement in Cape Town and Oudtshoorn is a semi-rural town. The Washington Group Short Set of questions was used to identify persons with disabilities (PWD), and a self-developed questionnaire obtained socio-demographic information.

 

Results: The overall prevalence of disability was 9.7% (confidence intervals [CIs] 9.7–9.8) and the proportion of PWD was significantly different between the two sites (Chi-Sq = 129.5, p < 0.001). In the urban area, the prevalence rate of any disability was 13.1% (CIs 12.0–14.3) with 0.3% (CIs 0.1–0.6) reporting inability to perform any function at all. In contrast, the semi-rural community had a lower overall prevalence rate of 6.8% (CIs 6.0% – 7.8%) but a higher rate of those unable to perform any function: 1% (CIs 0.07–1.4). Disability was associated with gender, age, unemployment and lower income status in both areas.

 

Conclusion: Deprived areas tend to show higher disability prevalence rates than the National Census estimates. However, the discrepancy in prevalence and patterns of disability between the two under-resourced areas indicates the need for locally specific data when planning health interventions.

 

 

African Journal of Disability, Vol 8, 2019

Success in Africa: People with disabilities share their stories

SHAKESPEARE, Tom
MUGEERE, Anthony
NYARIKI, Emily
SIMBAYA, Joseph
2019

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Background: Whereas most narratives of disability in sub-Saharan Africa stress barriers and exclusion, Africans with disabilities appear to show resilience and some appear to achieve success. In order to promote inclusion in development efforts, there is a need to challenge narratives of failure.

 

Objectives: To gather life histories of people with disabilities in three sub-Saharan African countries (Kenya, Uganda and Sierra Leone) who have achieved economic success in their lives and to analyse factors that explain how this success has been achieved.

 

Methods: Qualitative research study of economic success involving life history interviews with 105 participants with disabilities from both urban and rural settings recruited through disabled people’s organisations and non-governmental organisation partners, framework analysis of transcripts to chart success and success factors.

 

Results: Participants had faced barriers in education, employment and family life. They had largely surmounted these barriers to achieve success on an equal basis with others. They were working in private and public sectors and were self-employed farmers, shopkeepers and craftspeople.

 

Conclusion: The findings of this study suggest that, given the right support, disabled people can achieve economic success, with the implication being that investment in education or training of disabled people can be productive and should be part of overall development efforts for economic reasons, not solely to achieve social justice goals.

 

 

African Journal of Disability, Vol 8, 2019

Disabled people’s organisations and the disability movement: Perspectives from Burkina Faso

BEZZINA, Lara
April 2019

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Background: In Burkina Faso, the disability movement is rather weak, both in terms of funding and staffing – its range does not extend far outside the capital city and is largely dependent on international non-governmental organisations (INGOs). Despite the huge number of grassroots disabled people’s organisations (DPOs), many of these organisations do not function beyond the occasional meeting and celebration of the International Day of Persons with Disabilities. The reasons for this are various, including dependency on external funding (such as from international organisations), lack of access to resources, being dependent on voluntary members, and lack of organisation.

 

Objectives: This article looks at the functioning of – and politics governing – DPOs in Burkina Faso, their significance in the lives of people with disabilities and the challenges they encounter.

 

Method: This article is based on research findings obtained through interviews conducted with people with disabilities, as well as INGOs working with people with disabilities and state authorities in Burkina Faso.

 

Results: Evidence suggests that the farther people with disabilities are from the capital, the lesser are their chances of being heard and of being involved in decision-making. However, DPOs offer a haven for many, offering people with disabilities solace in meeting other members and finding a sense of belonging in these associations. Others give importance to the role of DPOs in raising awareness and human rights advocacy.

 

Conclusion: Finally, the article raises the question as to what the future of DPOs in Burkina Faso might entail.

 

 

African Journal of Disability, Vol 8, 2019

Insights from ASEAN hometown improvement project: Towards improved practice

Asia-Pacific Development Center on Disability (APCD)
2019

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The ASEAN Hometown Improvement Project, aimed to tackle challenges emerging from urbanization and the rise of the ageing population in the ASEAN region by attempting timely and relevant improvements to disability inclusive ‘hometowns’. 

 

Three approaches were utilized:

1) Promotion of an inclusive business through capacity building of persons with disabilities

2) Promotion of accessibility features in the community and other public places, as well as to information, communication, and transportation

3) Promotion of cooperation with government sector via discussions to find solutions to improve the livelihood of persons with disabilities

 

The sections, arranged per country in alphabetical order, contain the following: Hometown Improvement Project description and backgrounder; Capacity Building Workshop details; Key Partners and Stakeholders; Training Results; Challenges; Framework for Good Practice; and Way Forward and include:

  • Cambodia: Phnom Penh Center for Independent Living's Bakery by Persons with Disabilities
  • Indonesia: Batik Design and Marketing Management at Kampung Peduli
  • Malaysia: Branding and Marketing Management for Bakery and Handicraft by Persons with Disabilities at CBR Semenyih
  • Myanmar: Mushroom Production by Persons with Disabilities with Shwe Minn Tha Foundation
  • Phillipines: Sustainable Inclusive Urban Micro-Gardening and Community-Based Cooperative at Barangay 177
  • Thailand: Earthworm Casting and Cactus Farming at Farm D
  • Vietnam: Fermented Dry Bamboo Waste Fertilizer at Bamboo Dana Co. Ltd

 

 

A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia

TAY, Ee Lin
WONG, Chee Piau
2018

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Purpose: Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.

 

Method: A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.

 

Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.

 

Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.

Anticipated Barriers to Implementation of Community-Based Rehabilitation in Ribeirão Preto, Brazil

FIORATI, Regina Celia
CARRETTA, Regina Y Dakuzaku
JOAQUIM, Karine Pereira
PLACERES, Aline Ferreira
JESUS, Tiago Silva
2018

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Purpose: Disability is a global health and a global development concern. To address both issues, a community-based rehabilitation (CBR) approach is increasingly recommended to meet a spectrum of needs, especially for people with disabilities. It is first necessary to understand the perceptions of local, frontline providers, in order to design effective measures for implementing CBR programmes. This paper aimed to understand the conceptions of Primary Healthcare Providers (PHPs) - serving a sub-urban, socially-vulnerable territory in Brazil - about: 1) disability, 2) rehabilitation, and 3) the possible local implementation of a CBR strategy, including any anticipated barriers.

 

Method: Cross-sectional, exploratory qualitative research was based on focus groups conducted between 2013 and 2016. It involved a total of 78 PHPs serving the western region of the Ribeirão Preto municipality in São Paulo, Brazil. Data analysis was based on Habermas’ critical hermeneutics approach.

 

Results: PHPs understood disability mostly within the biomedical paradigm. Similarly, the predominant conception of rehabilitation was focussed on enabling individuals’ capacity, more than their environment. For local CBR implementation, the barriers that were anticipated were: 1) difficulties in managing and running action across sectors, and 2) the broader socio-political environment that hardly empowers civil society and is affected by power differentials.

 

Conclusion and Implications: While local PHPs identified important CBR implementation barriers which are contextual in nature, the predominant conceptions of disability and rehabilitation (i.e., biomedical, impairments-based) also act as a barrier. Contextual and cognitive barriers must both be addressed when envisioning a local CBR implementation

Making cities inclusive: safe mobility for persons with disabilities in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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A policy brief concerning safe and inclusive urban mobility is presented. Safe and inclusive mobility is not currently a universally recognised concept in international human rights instruments and development framework. The relationship of various global legal & policy frameworks with safe and inclusive urban mobility is discussed including:

  • The UN Convention on the Rights of Persons with Disabilities
  • The 2030 Sustainable Development Goals
  • The New Urban Agenda
  • The UN Road Safety Decade of Action

Recommendations for improved policies and actions are made:

  • Recommendation 1: Recognise safe and inclusive mobility as a transversal issue for realising the Sustainable Development Goals and human rights
  • Recommendation 2: Agree strong political and financial commitments to improve the safety of roads with a focus on vulnerable road users
  • Recommendation 3: Provide safe and accessible urban mobility infrastructures applying universal design approach, all along the mobility chain
  • Recommendation 4: Enhance participatory and evidence-based policy-making for a better governance of road safety, mobility management and urban planning

Inclusive urban mobility and road safety in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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Between 20 to 50 million people worldwide suffer non-fatal injuries in road crashes every year; around 1.25 million are killed. Unsafe roads also represent a major factor of social exclusion, especially for ‘vulnerable road users’. These include notably pedestrians, persons with disabilities, cyclists and children. They represent 46% of road casualties. Persons with disabilities are at higher risk of sustaining injuries from road crashes.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility and road safety challenges discussed include: safe crossing points over roads; signage and information; collective transport (particularly buses); road design and layout, poor road markings or signposts and the lack of street lighting.

 

Case histories provided are: Engaging government and DPOs to improve safe and inclusive mobility in Burkina Faso; and  Data, road safety and urban mobility in Vientiane, Laos

 

Recommendations for improvements in policies and actions are given under the headings: 

1. Strengthening the policy and financial framework for safe and inclusive mobility action, based on evidence and through participative processes

2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Inclusive urban mobility and getting to school safely in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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For teenagers in developing countries, there is no greater threat to life than road traffic crashes: road crashes are the leading cause of preventable death of youth aged 15 to 29 years, and the second cause for those aged 5 to 14 years.(6) The risks are even higher for children with disabilities, who are also more exposed to non-fatal injuries from road crashes.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility and road safety challenges discussed include: safe crossing points over roads and collective transport (particularly buses). 

 

Two case studies are provided: Safer access to school for disabled students in Kenya; and School access and pedestrian safety improvements in Democratic Republic of Congo

 

Recommendations for improvements in policies and actions are given under the headings:

  • 1. Strengthening the policy and financial framework for safe and inclusive mobility, based on evidence and through participative processes
  • 2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Inclusive urban mobility and getting to work safely in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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The lack of safe and accessible roads in many cities in developing countries impacts negatively on employment opportunities for persons with disabilities. Between 20 to 50 million people worldwide suffer non-fatal injuries in road crashes every year; around 1.25 million are killed. Unsafe roads also represent a major factor of social exclusion, especially for ‘vulnerable road users’. These include notably pedestrians, persons with disabilities, cyclists and children. They represent 46% of road casualties. Persons with disabilities are at higher risk of sustaining injuries from road crashes.

 

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility and road safety challenges discussed include: safe crossing points over roads; signage and information; collective transport (particularly buses); accessing buildings such as offices or retail and driving with a disability.

 

Case histories provided are: Accessible transport as part of an inclusive jobs program in Senegal; and Modified vehicles and driving licenses for drivers with disabilities in Vietnam

 

Recommendations for improvements in policies and actions are given under the headings: 

1. Strengthening the policy and financial framework for safe and inclusive mobility action, based on evidence and through participative processes

2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Inclusive and safe urban mobility and Disaster Risk Management in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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Disabled people are disproportionately affected by disasters owing to mobility difficulties in evacuation, lack of access to information or services and discrimination. When disasters occur, constraining external factors, such as unsafe roads and lack of accessible pedestrian and transport routes, create additional difficulties for coping with the situation. Developing cities vulnerable to disasters also are likely to have a greater proportion of the population with a disability, due to past injuries.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility challenges relating to disasters discussed include: inaccessible disaster shelters, inaccessible means of evacuation and lack of information.

 

Case histories provided are: Building back better in Haiti; a focus on inclusive access and mobility; and Improving universal accessibility in Kathmandu, Nepal

 

Recommendations for improvements in policies and actions are given under the headings: 

1. Strengthening the policy and financial framework for safe and inclusive mobility action, based on evidence and through participative processes

2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Promoting rights of people with disabilities in Indonesia (UN Partnership to Promote the Rights of Persons with Disabilities / UNPRPD) - Special edition, ILO Jakarta newsletter

ILO Jakarta
February 2018

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One of the first implementing countries of the UNPRPD was Indonesia. In Indonesia the project was jointly implemented between the ILO, WHO and UNESCO, in partnership with the national entities such as the Association of Indonesian Municipalities (APEKSI) and various disability rights non-governmental organizations (NGOs).

 

The newsletter has items on: 

  • Towards inclusive cities - Fourteen mayors across Indonesia signed the Charter of the Network of Indonesian Mayors for Inclusive Cities in Indonesia during the UN-sponsored High-Level Meeting of Mayors for Inclusive Cities
  • Towards inclusive employment - Mojokerto city in East Java is the first city in the country to conduct an inclusive job fair at the district level. The first two-day inclusive job fair was organized in 2014 and it has become an annual event
  • Employment assessments for people iwth disabilities - In collaboration with the University of Indonesia, the ILO conducted a study on Mapping Persons with Disabilities in Indonesia. The study reveals that there is an urgent need to increase the labour-force participation of people with disabilities
  • Rapid Assessment on Employment for Persons with Disabilities

 

Cross-sectional Survey to Assess Prevalence of Disability and Access to Services in Albay Province, The Philippines

HODGE, Marcus
BOLINAS, Amable
JAUCIAN, Erlynn
BONEO, Rebecca
SCHAPIRA, Allan
VILLANUEVA, Mary Mediatrix V
2017

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Aim:  A cluster randomized cross-sectional survey to assess the prevalence of disability and access to support services was conducted in Albay Province, the Philippines in April 2016.

 

Method:  The population-based survey methodologies developed by the Washington Group of the United Nations Statistical Commission and UNICEF were utilized.  A sample of 70 barangays (the 3rd level administrative division in the Philippines) was selected as clusters, with probability proportional to size, and 30 households were selected randomly in each barangay to be surveyed.

 

Results:  The estimated prevalence of disability using the standard criteria of the Washington Group and UNICEF among children (2-17 years old) was 2.0% and for adults (≥18 years old) it was 6.5%.  The estimated prevalence of disability was higher in rural than in urban areas.  Deficiencies in the performance of existing services were identified; access by children with disabilities to support services was lowest in rural highland and rural plain barangays.

 

Conclusions: There was a large unmet demand for support services addressing the needs of persons with disabilities in Albay Province, especially in rural highland areas.  Persons with disabilities were disadvantaged in access to education and employment; many had not been educated in their basic rights.

 

Implications:  To identify, educate and fully support persons with disabilities, community-based rehabilitation (CBR), health and other rehabilitation services must communicate effectively with each other, their current work should be mapped and analysed, their comparative strengths identified, and their future work coordinated.  It is a priority to educate persons with disabilities and their families about their rights, and facilitate their access to support services; this requires increased investment in communication targeting persons with disabilities and the communities, especially rural.  Providers caring for persons with disabilities need to work in partnership to identify unreached persons with disabilities.  Prevalence surveys, with stronger focus on the profiles and performance of CBR and related services, would add to the evidence-base to improve the quality and coverage of services for persons with disabilities.

Ensuring universal access to eye health in urban slums in the Global South: the case of Bhopal (India).

PREGEL, Andrea
et al
October 2017

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In the context of its Urban Eye Health Programme in Bhopal (India), Sightsavers launched a pilot approach aimed at developing an Inclusive Eye Health (IEH) model and IEH Minimum Standards.

Accessibility audits were conducted in a tertiary eye hospital and four primary vision centres located within urban slums, addressing the accessibility of physical infrastructures, communication and service provision. The collection and analysis of disaggregated data inform the inclusion strategy and provide a baseline to measure the impact of service provision. Trainings of eye health staff and sensitisation of decision makers on accessibility, universal design, disability and gender inclusion are organised on a regular basis.

A referral network is being built to ensure participation of women, people with disabilities and other marginalised groups, explore barriers at demand level, and guarantee wider access to eye care in the community. Finally, advocacy interventions will be developed to raise awareness in the community and mainstream disability and gender inclusion within the public health sector.

Psychological well-being of adolescents with physical disabilities in Zimbabwean inclusive community settings: An exploratory study

MPOFU, Jabulani
SEFOTHO, Maximus M.
MAREE, Jacobus G.
2017

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Background: The purpose of this study was to explore the psychological well-being of adolescents with physical disabilities living in inclusive community settings of Makonde Urban in Zimbabwe. An inclusive community is one that aims to remove exclusionary practices within the community and promote community systems that accept all people irrespective of their difference. Inclusive communities on their own are not uniquely designed for people with disabilities, but most developing countries have adopted them as a basic strategy to influence and enhance psychological well-being of people with disabilities.


Methods: A constructivist lived experience perspective underpinned this research, in which multiple case studies were used to interact with the participants on inclusion and psychological well-being of adolescents with physical disabilities. Purposive sampling was used to select 14 participants (9 males and 5 females). Data were collected through face-to-face interviews and transcribed verbatim. Four themes emerged from the thematic analysis of data sources.


Results: It was found that participants who were adolescents with physical disabilities living in inclusive community settings of Makonde Urban in Zimbabwe were having high levels of autonomy and choice, purpose in life, positive relations with others and good personal growth and self-acceptance.


Conclusion: The findings of this study should enable inclusive communities’ policy-makers and researchers to better understand the psychological well-being of adolescents with physical disabilities living in inclusive communities.

Enabling inclusive cities - Tool kit for inclusive urban development

LINDFIELD, Michael
SINGRU, Ramola Naik
2017

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This Inclusive Cities Tool Kit presents an integrated approach to inclusive urban development (IUD).

 

This tool kit presents concepts and strategies for addressing technical and institutional challenges related to shelter, infrastructure, transport, climate change, and disaster risk management. Chapter 1 presents an IUD framework that sets out the underlying principles of accessibility, affordability, resilience, and sustainability for an integrated approach to IUD investments. It outlines the process for undertaking an inclusive urban assessment. Chapter 2 sets out a toolbox that includes assessment methodologies, implementation tool kits, and other resources for each step in the process. The tools are designed to mesh across three phases of the development of an inclusive urban redevelopment project—the initial data gathering, the assessment and options development, and the prioritization of preferred options.

 

This tool kit has been prepared for ADB staff and other stakeholders to engage in IUD programming and implementation as an integral component of the ADB lending programs in DMCs. It is a guide to assist staff in supporting city governments in DMCs to prepare and implement IUD plans. The tool kit is intended as a practical guide for mayors, local government officials, sector specialists, planners, and other decision makers involved in project programming and design of urban infrastructure projects in cities

Supporting Parents in Caring for Children with Disability in Ghana

BESTEN, Joyce den
CORNIELJE, Marije Tebogo
CORNIELJE, Huib
BOTWEY, David Norden
2016

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Purpose: This study assesses the factors that influence the wellbeing of caregivers and their children with a disability, in a rural and an urban site in Ghana. The wellbeing of parents, not surprisingly, influences the wellbeing of their children. A better understanding of the role and challenges faced by parents in caring for their child with a disability will help to improve existing services and support for children with disability.

 

Methods: Twenty-five parents of children with different disabilities participated in a PhotoVoice study. Photographs taken by parents, to show the challenges they experienced in childcare, were explained and discussed during focus group discussions. The Cantril Ladder was used to discuss subjective wellbeing.

 

Results: The photographs and discussions with parents indicated that the extensive time spent on their child, the child’s poor health status, and lack of educational opportunities had a negative influence on the wellbeing of both parent and child. Parents struggle to earn an income to provide for a child with disability. This often causes them to sink into (even deeper) poverty, and further increases the challenge to provide the (specific) care that a child with disability needs.

 

Conclusions and Implications: If governments, non-governmental organisations and community-based organisations want to contribute to the wellbeing of children with disability, they should be aware of the immediate context of the child, namely the family, and of the specific needs of the parents. Since the wellbeing of parents can affect the wellbeing of the child, and a child with disability may often cause further poverty in the family, relieving parents from some of the demands of childcare could help them to generate income, to the ultimate benefit of the entire family. Organisations working for children with a disability should actively involve parents of these children in designing and implementing interventions.

Good practices of accessible urban development - Making urban environment inclusive and fully accessible to ALL

August 2016

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About 6.25 billion people, 15 per cent of them persons with disabilities, are expected to be living in urban centres by 2050. Urbanisation has the potential to be an engineer for achieving sustainable and inclusive development for all. The current lack of environmental accessibility faced by people with disabilities, in particular in many cities in the world, presents a major challenge. As the international community prepares for the Third Global Conference on Housing and Sustainable Urban Development (Habitat III), which will take place in Quito, Ecuador, in October 2016, it is an apt and a strategic opportunity to promote an accessible and inclusive Urban Agenda.

This report is a compendium of promising initiatives and good practices that have emerged in recent yeas successfully promoting accessibility and inclusion of persons with disabilities, their rights, aspiration and contributions in the contexts of urban development. It countains findings and recommendations which were adopted at a UN expert group meeting, that may be helpful in informing the ongoing Habitat III discourses, the development of the New Urban Agenda as well as in furthering accessible and inclusive urban development 

Disability considerations for infrastructure programmes

AGARWAL, Anjlee
STEELE, Andre
March 2016

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This study identifies and summarises evidence of the impact of non-accessible infrastructure on people with disabilities. It makes recommendations on how to incorporate the principals of universal access into all infrastructure projects. This document should be read in combination with the DFID (UK Department for International Development)​ Disability Framework “Leaving No One behind” (2014), which sets out how DFID promotes inclusion of people living with disabilities in all its programmes. Topics covered include: rationale for inclusive infrastructure; best practices in project planning, engineering design; monitoring and evaluation processes; inclusive design in planning and policy; mainstreaming disability considerations into infrastructure programmes and policy decisions; linking disabilities with cross cutting agendas. 

The right to adequate housing for persons with disabilities living in cities

UNITED NATIONS HABITAT
2015

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“This study reviews the literature on the meaning and impact of the right to adequate housing for persons with disabilities in cities. It uses the foundational framework of the International Covenant on Economic, Social and Cultural Rights (ICESCR), and demonstrates how the Convention on the Rights of Persons with Disabilities (CRPD) provides a new understanding of this complex right”

 

Adequate Housing Series

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