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SOUTH SUDAN. Protection Analysis Update. Protection risks facing persons with disabilities and older persons

GLOBAL PROTECTION CLUSTER, UNHCR
October 2023

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This South Sudan Protection Analysis Update places a thematic focus on protection risks facing persons with disabilities and older persons.

The most recent census reported that 5% of the population in South Sudan, or approximately 424,000 people, were living with a disability. However, the current number is likely to be much higher, possibly reaching 1.2 million people, or 16% of the population, according to the global estimate. Data in South Sudan also suggests a rapid increase in the number of older persons each year, mounting to 5.1% of total population with this percentage expected to continue to steadily increase.

People with disabilities and older people in South Sudan are often excluded and face multiple challenges in accessing essential services and protection. Decades of civil war have increased the number of older people and persons with disabilities who are being left behind as they are unable to flee due to chronic health conditions and mobility impairments. People who have managed to flee the violence are often faced with barriers accessing protection and health services. Therefore, older people with and without disabilities in South Sudan face higher risks and greater challenges in getting the necessary humanitarian assistance.

Using a community-based participatory research (CBPR) approach to explore economic empowerment for youth with disabilities in rural Uganda

GREENWOOD, Margo
BECHANGE, Stevens
EMONG, Paul
KYOSABA, Winnie
NSSAJA, David
THE PEERS RESEARCHER TEAM
August 2023

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This paper presents findings from a community-based participatory study exploring the lived experiences and key livelihood changes post-intervention of a vocational skills training for young people with disabilities in rural Uganda. Twenty-four youth with disabilities (13 female, 11 male) who had previously taken the vocational training were trained to become peer researchers and conducted 72 in-depth interviews with a more recent cohort of youth with disabilities. 

 

Social Sciences & Humanities Open, Volume 8, Issue 1, 2023, 100647

https://doi.org/10.1016/j.ssaho.2023.100647

Repair strategies for assistive technology in low resource settings

OLDFREY, Ben
HOLLOWAY, Cathy
WALKER, Julian
McCORMACK, STEVEN
DEERE, Bernadette
KENNEY, Laurence
SSEKITOLEKO, Robert
ACKERS, Helen
MIODOWNIK, Mark
July 2023

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Purpose: To  investigate the  practices of  repair that  exist for  users of  mobility assistive products in  low resource settings, as  well  as  the  psychosocial impact that  the  repair, or  non-repair, of  these devices has on users’ lives.

Materials and Methods: This article collates data on repair practices and the responses from participants on  the  topic of  repair from studies conducted by  the  authors across four  different low  resource settings in  Kenya, Uganda, Sierra Leone, and  Indonesia. This  data was  then analyzed to  identify the  common themes found across geographies

 

DISABILITY AND REHABILITATION: ASSISTIVE TECHNOLOGY

https://doi.org/10.1080/17483107.2023.2236142 

Prevention against emerging infectious diseases: An Opportunity for Inclusive Health. Understanding the behavioural and social drivers (BeSD) of COVID-19 vaccination among persons with disabilities in Internally Displaced camps in Somalia/Somaliland

ZIVERI, Davide
ABDULLAHI, Hawaa
July 2023

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In close collaboration with the World Health Organization, Humanity & Inclusion adapted and piloted WHO’s behavioural and social drivers (BeSD) of vaccination tools to understand and analyze the perception of COVID-19 vaccines as well as the barriers and drivers of immunization among persons with disabilities in a humanitarian setting in Somalia/Somaliland. This study was funded by the Universal Health Coverage and Life Course (UHL) division of the Immunization, Vaccines and Biologicals (IVB) department of the World Health Organization, Geneva. Humanity & Inclusion also carried out a Risk Communication and Community Engagement (RCCE) project, contributing to the inquiry phase described in this report, to foster the right to health as well as access to COVID-19 vaccination in Somalia/Somaliland, funded by the Center for Disaster Philanthropy.

 

RS I FP I 44

Experiences of lower limb prosthesis users in Kenya: a qualitative study to understand motivation to use and satisfaction with prosthetic outcomes

MATTICK, Kate
OLDFREY, Ben
DONOVAN-HALL, Maggie
MAGOMERE, Grace
GAKUNGA, Joseph
HOLLOWAY, Catherine
December 2022

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An estimated 1.5 million people undergo limb amputation each year [1]. Low- and middle-income countries (LMICs) are projected to have a rapid increase in people living with an amputation in the coming years due to prevalence of non-communicable disease, trauma and conflict. This paper explores the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting.

This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied.

 

Disability and Rehabilitation Volume 45, 2023 - Issue 26

https://doi.org/10.1080/09638288.2022.2152875

Cost analysis of 3D printing services implementation into public services to produce orthoses: An Ugandan case-study

NIZET, Alicia
BRUS, Aude
December 2022

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3D printing is a new technology and there is a need for producing evidence to justify and demonstrate its associated costs and benefits. Humanity and Inclusion has been implementing an innovative 3D printing project in Uganda, in the Omugo Refugee Settlement, to address the unmet rehabilitation needs of people with disabilities (PETRA Project) since November 2018. This project is implemented in collaboration with the public hospital of the Arua District (Arua Regional Referral Hospital). 

 

This study aims to calculate implementation and running costs of 3D printing services to produce orthoses in a public service (here ARRH), in addition to traditional services, in a developing context.

Specific objectives:

To define and detail all phases of the patient pathway for the 3D printed orthosis provision(from patients’ identification to orthoses delivery);

To evaluate costs of the 3D printed orthosis procurement (from patients’ identification to orthoses delivery) based on lifetime of digital material;

To give a better understanding on how to implement such a digital service in a public health structure.

 

The results of this study will allow HI, other organisations, States or potential donor to enrich their decisions on the implementation of 3D-printed orthoses production in their context of intervention - embedded in addition to traditional services or in remote areas where there is no traditional services.

 

Hypotheses, choices and data are based on the information collected through multiple sources and methodologies (desk review, semi-structured interviews, surveys, workshop, and literature review) and are specific to the context of Arua, Uganda. To calculate all the costs related to the service that produces and delivers 3D-printed orthoses, a matrix has been created.

Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

Evaluating the use of a thermoplastic socket in Kenya: A pilot study

BARBARESCHI, Giulia
TEERLINK, Wesley
NJUGUNA, Josepg Gakunga
MUSUNGU, Purity
KIRINO, Mary Dama
HOLLOWAY, Catherine
October 2022

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Many people with amputations who live in low-resourced settings struggle to access the workshops where qualified prosthetists provide appropriate care. Novel technologies such as the thermoplastic Confidence Socket are emerging, which could help facilitate easier access to prosthetic services. The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket. This is a longitudinal repeated-measures design study.

 

Prosthet Orthot Int. 2022 Oct; 46(5): 532–537.

Published online 2022 Mar 25. doi: 10.1097/PXR.0000000000000130

Inclusive Design and Accessibility of the Built Environment in Nairobi, Kenya

PATRICK, M
MULDOWNEY, A
KILIMANJARO BLIND TRUST AFRICA
TANUI, G
BUKACHI, V
CAMPBELL CLAUSE, J
McKINNON, I
October 2022

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

This case study, funded through UK aid AT2030 programme, explores the current situation of inclusive and accessible environments for people with disabilities living in Nairobi. The research findings detailed in this report describe the current challenges and opportunities for embedding inclusive design in Nairobi’s future, providing priority recommendations and forward-thinking next steps.

The research took place in three phases between July 2021 and January 2022, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk research and interviews, phase 2 captured the lived experience of people with disabilities utilising interviews, photo diaries and co-design activities. Phase 3 then synthesised findings, running multiple workshops to create actions towards inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life, poverty, transport, housing, sanitation, public spaces and recreational activities. Quotes from participants are interwoven into this report, and strengthen the concluding actions towards inclusion.

 

Inclusive Futures: Using social behaviour change to promote disability inclusion in development programmes

Inclusive Futures
Sightsavers
August 2022

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This brief focuses on the use of social behaviour change (SBC) in the Inclusive Futures programme. It includes an introduction to social behaviour change, followed by three examples of how it is being used in our Inclusive Futures work. These examples reflect emerging findings and our approaches as we go forward. The brief is designed to:
•Explain what SBC is and what it can be useful for – particularly when addressing disability stigma and discrimination
•Present examples of how SBC can be used in different ways to support disability inclusion in development programmes

Mainstreaming disability inclusive employment in international development

Mary Wickenden
Philip Mader
Stephen Thompson
Jackie Shaw
July 2022

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People with disabilities are under-represented in the global workforce, and this problem is often particularly acute inthe‘global south’. This is an editorial to a special issue that seeks to provide new perspectives on why this is the case. We deliberately wanted to place this collection in the Journal of International Development as a core development publication, rather than in a disability specific one, because we think it is important to ‘mainstream’ disability within development so that the international community can develop an increased understanding and awareness of disability dilemmas. The challenges faced by disabled people need to be tackled as part of all development thinking and programming.

Capability-sensitive principles for assistive technology to support young graduates with disabilities in Bangladesh and Kenya into employment

MORRIS, Lisa-Dione
ALGHAIB, Ola Abu
NORTHRIDGE, James
July 2022

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Owing to increased inclusion of young people with disabilities into the private sector in Bangladesh and Kenya, there is an urgent need to find alternative ways to support young graduates with a disability in the workplace with assistive technology solutions. The aim of the paper is to identify barriers for private workplace sectors to use assistive technology to support young graduates seeking, maintaining and retaining employment. This qualitative study adopted the research onion design of Saunders et al. Data were collected usinginterviews and focus group discussions and analysed using thematic analysis. The findings reveal that barriers are linked to seven key person-centred capability themes: the dream, external factors, internal factors, assistive technology vision,strategic design priorities and gaps and assistive actions.

 

Journal of International Development, Volume 34, No. 5

Early detection tools for children with developmental delays and disabilities in the Middle East and North Africa

UNITED NATIONS CHILDREN'S FUND (UNICEF)
June 2022

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This technical brief was developed to support specialists in countries of the Middle East and North Africa (MENA) region to select which early detection tools best fit their needs and context by comparing various tools that have been used in theregion and lessons learned in using and adapting those tools to local contexts.

Disability inclusive employment in urban Malawi: A multi-perspective interview study

REMNANT, Jennifer
WANGGREN, Lena
HUQUE, Sarah
SANG, Katherine
KACHALI, Limbani
RICHARDS, James
June 2022

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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and oftenreactive nature of non-governmental organisation (NGO ) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.

 

Journal of International Development, Volume 34, Issue 5

https://doi.org/10.1002/jid.3678

From disability budget commitments to budget execution in Kenya: Matching disability approved allocations to actual spending and performance

Development Initiatives
May 2022

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This paper builds on previous analyses conducted by DI on disability budgeting. In this paper, we match budget commitments to implementation; first by mapping the extent to which disability-relevant budget implementation information is accessible, then by analysing financial and non-financial performance in Kenya over the financial years 2016/17 to 2020/21. We have analysed disability budget implementation in five counties (Baringo, Bungoma, Busia, Kakamega, and Vihiga) and two national sectors (Education and Social Protection).

Towards a disability-inclusive humanitarian response in South Sudan?

FUNKE, Carolyn
DIJKZEUL, Dennis
February 2022

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The Inter-Agency Standing Committee (IASC) Guidelines on the Inclusion of Persons with Disabilities in Humanitarian Action (2019) set out four ‘must do’ actions to identify and respond to the needs and rights of persons with disabilities. This study investigates how humanitarian organizations implement the four ‘must do’ actions in South Sudan. It shows that mainstream and inclusion-focused organizations actively promote their implementation to make disability inclusion an integral part of humanitarian action, investing heavily in capacity-building and awareness-raising at all levels of the response. Nevertheless, serious gaps and challenges to disability inclusion remain. 

Using radio drama to tackle disability discrimination in Nigeria

BBC Media Action
Inclusive Futures
February 2022

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As part of the Inclusive Futures programme, BBC Media Action produced a radio drama, Story Story, and accompanying social media content, to tackle stigma and discrimination around disability in Nigeria. This content was broadcast from November 2020 to November 2021 through local radio partners in six states – Enugu, Federal Capital Territory (FCT), Kano, Kaduna, Kogi and Lagos.

This briefing draws on a literature review and key insights from BBC Media Action’s mixed-methods evaluation of the drama conducted in June and July 2021.

Unemployment in women with psychosocial disabilities during the COVID-19 pandemic: Lessons from Tana River County, Kenya

IBUENYI, Ikenna D.
GITONGA, Isaiah
TELE, Albert
SUYRINA, Elena
February 2022

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In low-income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID-19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context-sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio-economic empowerment and inclusion.

 

Journal of International Development, volume 34, issue 5

https://doi.org/10.1002/jid.3638

Social protection for disability in Kenya and Uganda - synthesis report

Development Initiatives
January 2022

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In 2021, Development Initiatives analysed how existing social protection programmes benefit persons with disabilities in Uganda and Kenya and associated challenges. The two country reports synthesised in this report interrogate policy frameworks, existing social protection schemes and institutional setups, and track public investment towards disability-specific and mainstream social protection programmes. 

Accessible Sanitation in the Workplace – Important Considerations for Disability-Inclusive Employment in Nigeria and Bangladesh

Stephen Thompson
Rasak Adekoya
Utpal Mallick
Omojo Adaji
Abdur Rakib
Mark Carew
January 2022

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This paper explores the relationship between accessible sanitation and disability-inclusive employment in Bangladesh and Nigeria. Both countries have sanitation and hygiene challenges as well as disability-inclusive employment challenges, but the existing evidence on the intersection of these issues that is focused on Nigeria and Bangladesh is extremely limited. Building on the literature where this complex issue is addressed, this paper presents the findings of a qualitative pilot study undertaken in Nigeria and Bangladesh. It focuses on the need for toilets at work that are easy for people with disabilities to use in poor countries. These are sometimes called accessible toilets. Accessible sanitation is not regarded as a challenge that must be addressed by people with disabilities themselves, but as a challenge that must be addressed by many people working together – including governments, employers, and the community.

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