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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

Strengthening the knowledge and information systems of the urban poor : policy paper

SCHILDERMAN, Theo
April 2002

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This brief policy paper summarises the findings of a research project that focused on the information needs of the urban poor, and the information sources they access. The study found that the main sources of information were social networks, key informants, and infomediaries. It ends with six suggestions for development agencies seeking to share their knowledge and information with the urban poor

Strengthening the knowledge and information systems of the urban poor

SCHILDERMAN, Theo
March 2002

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Presents the findings of a research project that focused on the information needs of the urban poor, and the information sources they access. The study found that the main sources of information were social networks, key informants, and infomediaries. It considers the role of information and communication technologies (ICTs), and impact assessment methods. It ends with suggestions for development agencies seeking to share their knowledge and information with the urban poor

Enhancing accessibility for people with disabilities living in urban areas

VENTER, C
et al
2002

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People with disabilities constitute a significant proportion of the poor in developing countries. If internationally agreed targets on reducing poverty are to be reached, it is critical that specific measures be taken to reduce the societal discrimination and isolation that people with disabilities continue to face. Transport is an important issue. This paper aims to further the understanding of the mobility and access issues experienced by people with disabilities in developing countries and to identify specific steps that can be taken to start addressing problems; produce a compendium of guidelines that can be used by government authorities, advocacy groups and agencies to improve the access to transport. The investigation into mobility needs was conducted in five case study countries: India, Malawi, Mexico, Mozambique and South Africa

Can ICTs help the urban poor access information and knowledge to support their livelihoods?

SCHILDERMAN, Theo
2001

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This paper is based on a research project undertaken by ITDG and funded by DFID in to the knowledge and information systems of the urban poor. Using an action research approach, the research team found that the urban poor do require knowledge and information to improve their livelihoods, but there are gaps in what is offered; that social networks are the biggest information source, followed by key informants; that a wide range of 'infomediaries' supplies information, but again their are gaps; and that although there are a number of cases of strengthening the knowledge and information systems of the urban poor, ICTs are not yet playing a major role here

Spatial patterns of leprosy in an urban area of central Brazil

MARTELLI, C M T
et al
1995

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Reported is the spatial variation of leprosy in an urban area of Brazil and its correlation with socioeconomic indicators. From November 1991 to October 1992 a total of 752 newly diagnosed leprosy patients who were attending all outpatient clinics in Golania city, central Brazil, were indentified. A database of leprosy cases was set up linking patients' addresses to 64 urban districts. Leprosy cases were detected in 86 of the districts and three risk strata were identified. The highest risk area for leprosy was in the outskirts of the city and detection rates increased on moving from more developed to poorer areas. The risk of detecting leprosy cases was 5.3-fold greater (95CL: 3.8-7.4) in the outskirst of the town than in the central zone.
Discussed are the methodological issues related to leprosy case ascertainment, completeness and reliability of information, and the interpretation of the spatial distribution of leprosy per unti area. High lighted also are the lack of deprosy control activities in primary health care units and the usefulness of geographical analysis in planning health services.

Child friendly cities initiative

UNITED NATIONS CHILDREN'S FUND (UNICEF)

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This website is a knowledge base for the global Child Friendly Cities (CFC) Initiative. It contains the CFC Database, which collects information on the role played by local governance systems in the areas of child rights, child participation and services for children; a CFC toolkit, which offers a definition of a CFC, examples of good practice and successful methods from around the world, a framework for action and key references

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