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Preventing lifelong impairment: Access to clubfoot treatment in low and middle income countries

CLINTON HEALTH ACCESS INITIATIVE (CHAI)
July 2021

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Congenital talipes equinovarus (CTEV), commonly known as clubfoot is one of the most common congenital conditions, affecting 1 in 800 births. Left untreated, it can lead to life-long impairment, impacting participation in society, education, and employment. Most children with clubfoot can be successfully treated with the Ponseti method, a low-cost, cost-effective, and minimally invasive treatment protocol. Despite progress, less than 1 in 5 children born with clubfoot in low- and middle-income countries (LMICs) currently receive treatment

Clubfoot services require coordination and leadership between different departments within health ministries. Both are often missing

 

Disability inclusive Universal Healthcare

CENTRE FOR INCLUSIVE POLICY
March 2021

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The inclusion of direct medical costs, indirect medical costs and indirect costs incurred by people with disabilities into Universal Healthcare is discussed. The importance of including assistive devices, rehabilitation and extra transportation costs in the system is highlighted. Social protection measures are also highlighted.

What are the most effective strategies for strengthening health systems for disability inclusive development? - Evidence brief

MACTAGGART, Islay
February 2021

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Health system strengthening refers to initiatives that improve one or more functions of health systems, leading to better health. There is a large body of evidence on what works to strengthen health systems in low- and middle-income countries (LMICs), much of which is aligned to the World Health Organization (WHO) health system building blocks (service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership/governance). Despite the fact that some people with disabilities have additional health needs, and many face additional barriers to accessing healthcare, inclusion of people with disabilities is largely missing from this evidence base. Separately, a smaller evidence base exists on increasing the effectiveness of specific health-related services targeting people with disabilities, such as health-related Community Based Rehabilitation (CBR), rehabilitation services more broadly, and mental health services. This second evidence base is less closely aligned to the building blocks. Reviewing these outputs in parallel goes some way towards identifying effective strategies for strengthening health systems for disability inclusive development.

World Report on Hearing

WORLD HEALTH ORGANISATION (WHO)
2021

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The World Report on Hearing (WRH) has been developed in response to the World Health Assembly resolution (WHA70.13), adopted in 2017 as a means of providing guidance for Member States to integrate ear and hearing care into their national health plans.

Based on the best available evidence, this report presents epidemiological and financial data on hearing loss; outlines available cost-effective solutions and sets the way forward through ‘Integrated people-centered ear and hearing care’ (IPC-EHC). The report proposes a set of key H.E.A.R.I.N.G. interventions that must be delivered through a strengthened health system to realize the vision of IPC-EHC. 

The WRH was developed in collaboration with experts and stakeholders in the field of ear and hearing care who informed the report’s strategic direction and ensured that it reflects a range of cultural contexts and approaches to hearing care. The report is global in its reach while keeping a special focus on low- and middle-income countries, where the number of people with hearing loss is not matched by the availability of services and resources.

COVID-19 in humanitarian contexts: no excuses to leave persons with disabilities behind! Evidence from HI's operations in humanitarian settings

HUMANITY & INCLUSION (HI)
June 2020

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This collection and review of evidence aims to illustrate how the COVID-19 crisis triggers disproportionate risks and barriers for men, women, boys and girls with disabilities living in humanitarian settings. It highlights recommendations for humanitarian actors, to enhance inclusive action, aligned with existing guidance and learnings on disability inclusion. It is based on evidence, including testimonies, collected by HI programs in 19 countries of intervention. Special efforts were made to reflect the voices of persons with different types of disabilities, genders and ages, residing in different geographical areas and living circumstances, including refugee and internally displaced persons’ settlements and host communities.

 

Evidence has been collected through primary data collection among HI teams and partners, working in countries impacted by the COVID-19 pandemic in April/May 2020. Data was extracted from assessments conducted by HI and partners in Bangladesh, Egypt, Haïti, Indonesia, Philippines, Jordan, Lebanon, Somaliland and Togo. Testimonies from affected communities, staff and partners were collected in Kenya, Myanmar, Pakistan, Palestine, Philippines, Somaliland, South Sudan, Rwanda, Thailand, Uganda and Yemen.

 

Assistive technology use and provision during COVID19: Results from a rapid global survey

SMITH, Emma M
HERNANDEZ, Maria Luisa Toro
EBUENYI, Ikenna D
SYURINA, Elena V
BARBARESCHI, Giulia
BEST, Krista L
DANEMAYER, Jamie
OLDFREY, Ben
IBRAHIM, Nuha
HOLLOWAY, Catherine
MacLACHLAN, Malcolm
June 2020

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The coronavirus disease 2019 (COVID-19) pandemic has impacted all segments of society, but it has posed particular challenges for the inclusion of persons with disabilities, those with chronic illness and older people regarding their participation in daily life. These groups often benefit from assistive technology (AT) and so it is important to understand how use of AT may be affected by or may help to mitigate the impacts of COVID-19. The objectives of this study were to explore the how AT use and provision have been affected during the initial stages of the COVID-19 pandemic, and how AT policies and systems may be made more resilient based on lessons learned during this global crisis.

This study was a rapid, international online qualitative survey in the 6 United Nations (UN) languages (English, French, Spanish, Russian, Arabic, Mandarin Chinese) facilitated by extant World Health Organization (WHO) and International Disability Alliance networks. Themes and subthemes of the qualitative responses were identified using Braun and Clarke's 6-phase analysis.

 


International Journal of Health Policy and Management. 2022 Jun 1;11(6):747-756

doi: 10.34172/ijhpm.2020.210.

 

Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review

JAIN, Reena P
METEKE, Sarah
GAFFEY, Michelle F
et al
May 2020

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In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations.

A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations. A total of 81 publications met the inclusion criteria, and were included in the review.

 

BMJ Global Health 2020;5:e001980

http://dx.doi.org/10.1136/bmjgh-2019-001980

How to Cope With Being Short Of Breath

April 2020

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People with lung problems often feel short of breath. Many daily tasks can make you breathless, such as walking, getting dressed or doing jobs around the house. Being breathless can make you panic or feel frightened. When you learn how to control your breathing these feelings will not trouble you as much and you will be able to do more. When you are breathless, do not panic. Your breathing will settle.
 

Policy brief: Access to assistive technology

WORLD HEALTH ORGANISATION (WHO)
2020

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This brief is for policy-makers in any ministry involved in designing assistive technology policies and programmes (such as ministries of health, finance and social welfare), especially those involved in designing universal health coverage programmes. It is also relevant for all stakeholders working in these areas. The brief highlights key challenges in ensuring equitable access to high-quality, affordable assistive technology and suggests actions to improve access within universal health coverage or any other national health/welfare programme.

Rehabilitation in health systems: guide for action

WORLD HEALTH ORGANISATION (WHO)
May 2019

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There is great variation across countries regarding the rehabilitation needs of the population, characteristics of the health system and the challenges that face rehabilitation. For this reason, it is important for each country to identify their own priorities and develop a rehabilitation strategic plan. A rehabilitation strategic plan should seek to increase the accessibility, quality and outcomes of rehabilitation.

To assist countries to develop a comprehensive, coherent and beneficial strategic plan, WHO has developed Rehabilitation in health systems: guide for action. This resource leads governments through a four-phase process of (1) situation assessment; (2) strategic planning; (3) development of monitoring, evaluation and review processes; and (4) implementation of the strategic plan. This process utilizes health system strengthening practices with a focus on rehabilitation.

The Rehabilitation in health systems: guide for action provides practical help that directs governments through the four phases and twelve steps. The process can take place at national or subnational level. Typically phases 1 to 3 occur over a 12-month period, while phase 4 occurs over the period of the strategic plan, around 5 years. The four phases and accompanying guidance are outlined below

Paediatric blast injury field manual

THE PAEDIATRIC BLAST INJURY PARTNERSHIP
2019

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The Field Manual has been created to provide technical guidance for those with medical training.  It enables the user to adapt their knowledge to the treatment of severely injured children.  It has paediatric-specific sections on:

  • Pre-hospital care and transport
  • Damage control resuscitation, surgery and intensive care
  • Surgery (thoraco-abdominal, limb, burns)
  • Neurological injury
  • Ward care
  • Rehabilitation
  • Psychosocial support
  • Ethics and safeguarding

The Manual is also intended for use by anyone who is required to plan for the treatment of severely injured children, so they can see the resources, training and equipment that is required in a medical facility likely to receive blast injured children.

Shaping health systems to include people with disabilities. K4D emerging issues report

DEAN, Laura
et al
November 2018

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People with disabilities are at a heightened risk of communicable and non-communicable diseases and these diseases can cause debility and disability. Health needs of these people often extend beyond requiring continual longterm medical support to addressing broader social inequities. Key areas that are likely to be critical in re-orientating health systems from a biomedical approach towards inclusive health systems that are more responsive to the needs of people with debility and disability in low and middle-income countries (LMICs) are offered in this report and cover the following:

 

  • 1. Nothing about us without us: prioritising person-centred health systems
  • 2. Responding to issues of access in mainstreaming disability within health systems
  • 3. Ensuring the provision of specialised services
  • 4. Community based rehabilitation 
  • 5. Improving the collection and use of disability related data against modified legal and policy frameworks
  • 6. Partnerships are paramount
  • 7. Financing and social protection 

Case studies are provided from Sudan, India, Liberia, Uganda and Nigeria

Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST)

SKEMPES, Dimitrios
et al
October 2018

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The process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities is described.  A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. Fifty-six individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. Forty-one participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by a select number of participants.

 

Globalization and Health (2018) 14:96
https://doi.org/10.1186/s12992-018-0410-5

Where there is no psychiatrist A mental health care manual

PATEL, Vikram
HANLON, Charlotte
March 2018

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This is a practical manual about mental health care, aimed at community health workers, primary care nurses, social workers and primary care doctors, particularly in low resource settings. It describes more than 30 clinical problems associated with mental illness, using a problem-solving approach to guide the reader through their assessment and management. It addresses the lack of understanding of mental health among many health workers. Mental health issues as they arise in specific contexts are described - in refugee camps, in school health programmes, as well as in mental health promotion. The final section helps the reader to personalise for a particular location, for example, by entering local information on voluntary agencies, the names and costs of medicines and words in the local language for symptoms.

 

This product is an update of the first edition 2003. It is also available as Open Access.

Hearing aid systems in low-resource settings (Community Ear & Hearing Health, vol.15, no.19, 2018)

RICARD, Paddy
Ed
2018

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Articles in this issue are:

  • Hearing aid systems in low-resource settings
  • How hearing aids work and how to take care of them
  • The impact of hearing aid use in low and middle-income countries
  • Barriers to the use of hearing aid systems in low-and middle-income countries
  • Beyond devices: what to consider when providing hearing aids in LMICs
  • Improving access to hearing care and hearing rehabilitation in the Philippines
     

Landmine Monitor 2017

INTERNATIONAL CAMPAIGN TO BAN LANDMINES – CLUSTER MUNITION COALITION (ICBL-CMC)
December 2017

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Landmine Monitor 2017 provides a global overview of the landmine situation. Chapters on developments in specific countries and other areas are available in online Country Profiles on the website.

Landmine Monitor covers mine ban policy, use, production, trade, and stockpiling in every country in the world, and also includes information on contamination, clearance, casualties, victim assistance, and support for mine action. The report focuses on calendar year 2016, with information included up to November 2017 when possible.

The Victim Assistance section covers: assessing the needs; frameworks for assistance; enhancing plans and policies; inclusion and active participation of mine victims; availability of and accessibility to services (medical care, rehabilitation including prosthetics; socioeconomic inclusion; education, pyschosocial support); guaranteeing rights in an age- and gender-sensitive manner; communicating objectives and reporting improvements; legal frameworks and new laws.

Disability and HIV

UNAIDS
August 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care. Globally, it is estimated that 1 billion people (15% of the world’s population) have a disability. Of those aged over 15 years, approximately 110–190 million (2.2–3.8%) experience significant disabilities. Disability is increasing in prevalence due to ageing populations, trauma, accidents and the increase in chronic health conditions, including HIV. Persistent discrimination against and exclusion of people with disabilities, in particular women and girls with disabilities, increases their vulnerability, including their risk of HIV infection.
 

Rehabilitation in health systems

WORLD HEALTH ORGANISATION (WHO)
2017

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This document provides evidence-based, expert-informed recommendations and good practice statements to support health systems and stakeholders in strengthening and extending high-quality rehabilitation services so that they can better respond to the needs of populations. The recommendations are intended for government leaders and health policy-makers and are also relevant for sectors such as workforce and training. The recommendations and good practice statements may also be useful for people involved in rehabilitation research, service delivery, financing and assistive products, including professional organisations, academic institutions, civil society and nongovernmental and international organisations. The recommendations focus solely on rehabilitation in the context of health systems. They address the elements of service delivery and financing specifically. The recommendations were developed according to standard WHO procedures, detailed in the WHO handbook for guideline development

Disability and HIV

UNAIDS
January 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care.

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