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Assistive technology in Tajikistan: Situational analysis

WORLD HEALTH ORGANISATION (WHO). REGIONAL OFFICE FOR EUROPE
2019

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"This publication summarizes the current gaps, needs and opportunities for intervention in the field of assistive technology in Tajikistan. The situational analysis was conducted under the leadership of the Ministry of Health and Social Protection, Republic of Tajikistan and with technical support from the WHO Country Office, Tajikistan. It was undertaken in collaboration with different Government ministries and State agencies, development partners, United Nations agencies, nongovernmental organizations, disabled people’s organizations and users of assistive products. It adopted a realist synthesis approach, responsive to the unique social, cultural, economic and political circumstances in the country. The evaluation focuses on assistive technology policy and governance, service provision and the impact of assistive technology on the health and well-being of individual users and their families, with the aim of improving access to high-quality, affordable assistive products in Tajikistan.

 

200 persons with disabilities participated in a survey designed to collect information on self-reported need for assistive products, user experiences and barriers to access. An additional 11 focus groups made up of persons with disabilities and older adults held indepth discussions on assistive technology. The major providers of assistive technology (Government facilities, nongovernmental organizations, local producers) were also interviewed as part of the research"

Provision of wheelchairs in Tajikistan: Economic assessment of alternative options

WORLD HEALTH ORGANISATION (WHO). REGIONAL OFFICE FOR EUROPE
2019

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"This publication presents the results of a study on the economic aspects of various models for the provision of wheelchairs in Tajikistan. The study was conducted under the leadership of the Ministry of Health and Social Protection, Republic of Tajikistan and with technical support from the WHO Country Office, Tajikistan. The study was finalized in consultation with Tajik users of wheelchairs, the Ministry of Health and Social Protection and international experts on wheelchair production and provision, and made use of national and international evidence on the provision of wheelchairs to inform the analysis and develop evidence-based policy options. While the study focuses on the Tajik context and its aspirations to expand in-country production of wheelchairs, its approach and findings will also be of interest to other countries in a similar situation and to other interested stakeholders"

 

 

Disability, CBR & Inclusive Development, Volume 29, No.2, 2018 (Summer 2018)

July 2018

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Research articles are:

  • Lived Experience of Psychosocial Disability and Social Inclusion: A Participatory Photovoice Study in Rural India and Nepal
  • Barriers and Facilitators for Wheelchair Users in Bangladesh: A Participatory Action Research Project
  • A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia
  • Effect of Abacus Training on Numerical Ability of Students with Hearing Loss
  • Cross-Cultural Adaptation and Evaluation of Psychometric Properties of Persian Version of Supports Intensity Scale among Adults with Intellectual and Developmental Disabilities

Review:

  • Developmental Social Work for Promoting the Socioeconomic Participation of Persons with Disabilities: An Application of the Capability Approach
     

Brief reports:

  • Zero Rejection Policy in Admission of Children with Special Needs - Myth or Reality
  • Ujamaa and Universal Design: Developing Sustainable Tactile Curricular Materials in Rural Tanzania

Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

NOTE:
The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Wheelchair Service Provision Course

LOWE, Rachel
RAU, Barbara
2018

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This MOOC (Massive Open Online Course) aims to provide a basic theoretical understanding of wheelchair mobility and to develop an understanding of the theoretical principles, skills and knowledge underlying the management skills and knowledge in the management of wheelchair service delivery.  Starting on 3 September 2018 and lasting for 4 weeks, it will involve around 4-6 hours of work each week (depending on your learning style)

This course is aimed at Physiotherapy and Physical Therapy professionals, clinicians, students and assistants. It will introduce the role of the wheelchair in mobility, explore assessment and the roles of the multidisciplinary team in wheelchair service delivery, as well as provide a theoretical understanding of management techniques and related clinical considerations. It will not teach practical skills or lead to any clinical qualification. 

 

Fully accessible guide to flying with disabilities

2018

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A table is provided of the top 15 US airports giving notes on restrooms, pet relief areas, parking for people with disabilities and wheelchair services. Advantages of the use of specific credits cards by disabled people when travelling by plane in the USA are highlighted.

The 8 steps + : The role of community development organizations in providing holistic wheelchair services

ACCELERATING CORE COMPETANCIES FOR EFFECTIVE WHEELCHAIR SERVICE AND SUPPORT (ACCESS) PROJECT
October 2017

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This report suggests a “twin-track” approach based on the World Health Organization’s Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings, an eight-step process, and dedicated disability inclusion programming, the “plus.” By following this 8 Steps+ approach, community development organizations can provide appropriate wheelchairs and empower their constituencies to exercise their rights and fundamental freedoms.  

Physiotherapy care for adults with paraplegia due to traumatic cause: A review

GUPTA, Nalina
RAJA, Kavitha
October 2016

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Abstract

 

 

Purpose: This review aimed to identify the practice guidelines/ recommendations for physiotherapy management in acute /post-acute/ chronic/long-term phase of rehabilitation of clients with paraplegia due to traumatic causes.

 

Methods: Of the 120 articles retrieved, 26 met the inclusion criteria. After quality appraisal, 16 articles were included in the study. Data were extracted under the sub-headings: physiotherapy care in acute, chronic and long-term community stage; expected outcomes; effect of physical interventions; morbidities; wheelchair characteristics and standing.

 

Results: There is strong evidence in support of strength and fitness training, and gait training. Parameters of strength training (frequency, duration and intensity) vary. There is lack of evidence on passive movements, stretching, bed mobility, transfers and wheelchair propulsion. Preservation of upper limb functions is an important consideration in caring for clients with paraplegia.

 

Conclusion: Many areas of rehabilitation interventions remain inadequately explored and there is a need for high quality studies on rehabilitation protocols. Client preferences and feasibility are other areas that should be explored.

 

Limitations: The search criteria of articles in the English language or articles translated in English is a reason for this limitation. Articles related to advanced therapeutic interventions such as robot-assisted training, and transcranial electrical and magnetic stimulation were excluded from the study.

Google & Motivation collaboration

MOTIVATION
April 2016

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A 24 month collaboration between Google.org and Motivation to develop and test a model for using 3D printing to create customised postural support devices to enable wheelchairs to be adapted and fitted to the unique needs of the wheelchair user is announced. An integral part of the project is the piloting of a ‘Print Pod’ overseas, which will act as a temporary wheelchair clinic, kitted out with a 3D printer and raw material.

Assistive technology for children with disabilities: Creating opportunities for education, inclusion and participation. A discussion paper

BORG, Johann
et al
2015

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Based on evidence, examples (case studies), and a range of information the UNICEF-WHO discussion paper proposes a set of recommendations and actions to ensure every child with a disability has access to quality assistive technologies so that they can flourish and become productive members of society. Some recommended key actions are:

  • Estimate needs and map resources
  • Adopt legislation, policies and strategies
  • Provide funding and increase affordability
  • Set up assistive technology service provision systems
  • Ensure supply of quality assistive products
  • Train personnel
  • Establish partnerships

Surviving spinal cord injury in low income countries

ODEROD, Tone
August 2014

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Life expectancy and the situation of persons living with Spinal Cord Injury (SCI) in low income settings was explored. Mortality rates from injuries and challenges in daily lives of people with injuries from poorer economic backgrounds are were investigated and are compared with those with higher incomes. Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals.

There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges.

Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

The provision of wheeled mobility and positioning devices

GARTON, Francesca
June 2013

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This policy paper describes Handicap International’s mandate and values in operational terms as applied to the theme of provision of wheeled mobility and positioning devices. It presents the approaches and references for Handicap International’s actions, choices and commitments. It aims to ensure coherence in terms of practices whilst taking into account different contexts. Essentially this is a guidance document for programme staff which defines the topic and outlines the target populations, methods of intervention (expected results, activities) and indicators for monitoring and evaluation. This policy aims to ensure that all projects carried out by Handicap International programmes are consistent with the methods of intervention presented
PP 09

Wheelchair service training package : intermediate level (WSTP-I)

KHASNABIS, Chapal
MINES, Kylie
Eds
2013

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This wheelchair service training package is the second part of the WHO wheelchair service training package series and addresses the needs of people who have severe difficulties in walking and moving around and also having poor postural control. Special attention was given on the provision of appropriate wheelchairs for children who have poor postural control and are unable to sit upright independently. It is designed to support the training of personnel or volunteers to provide an appropriate manual wheelchair and cushion for children and adults who need additional postural support to sit upright
Note: A Trainers manual, Reference manual for participants, Participant’s workbook and Posters are available from the link above
Note: A DVD is available upon request which contains all the necessary forms and checklists; manuals and guides including the trainer’s manual; and sets of posters and presentations

International perspectives on spinal cord injury

BICKENBACH, Jerome
et al
Eds
2013

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This report assembles and summarizes information on spinal cord injury, in particular the epidemiology, services, interventions and policies that are relevant, together with the lived experience of people with spinal cord injury. It also provides recommendations for actions based on this evidence that are consistent with the aspirations for people with disabilities as expressed in the Convention on the Rights of Persons with Disabilities

The provision of wheeled mobility and positioning devices

GARTON, Francesca
URSEAU, Isabelle
July 2012

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This policy brief provides an overview of Handicap International’s 2012 policy paper on the provision of wheeled mobility and positioning devices (WP&MD) for people with disabilities
PP Brief No 9
Note: this policy should be read in conjunction with Handicap International’s rehabilitation policy paper which provides a broad framework for understanding the organization’s work on rehabilitation, including WP & MD

Wheelchair service training package : basic level (WSTP-B)

KHASNABIS, Chapal
MINES, Kylie
2012

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The main purpose of the training package is to develop the minimum skills and knowledge required by personnel involved in wheelchair service delivery. An important aim of the training package is to get it integrated into the regular paramedical/rehabilitation training programs such as physiotherapy, occupational therapy, prosthetics and orthotics, rehabilitation nursing
The package contains necessary forms and checklists, manuals and guides including trainer’s manual and set of posters and presentations. First click "Strat.pdf" which will come with four tabs - click tab "Manuals and guides" - open the Trainer’s manual to prepare yourself to deliver the training. Then click the "Timetable and sessions" tab to open the timetable. Click the hyperlinks of each session, which lead you to the exact slides and video location. The best way to deliver the training is to proceed through the lessons in sequential order respecting the timing allotted for each session as much as possible
Note: The whole training package is available on the Website for the training institutes and wheelchair service providers. It is recommended to download the complete package (requires 3 GB space)

Joint position paper on the provision of mobility devices in less resourced settings : a step towards implementation of the convention on the rights of persons with disabilities (CRPD) related to personal mobility

WORLD HEALTH ORGANIZATION (WHO)
UNITED STATES AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
2011

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"This joint position paper was developed in response to a meeting about personal mobility and mobility devices, held on 28-29 October 2009 at World Health Organization headquarters, Geneva, Switzerland. This paper aims to guide and support countries, especially those with limited resources, in the implementation of relevant articles of the CRPD associated with the provision of mobility devices"

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