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Prevalence of disabilities and health care access by disability status and type among adults — United States, 2016

OKORO, Catherine
et al
August 2018

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In 2013, based on questions to assess five disability types (i.e., vision, cognition, mobility, self-care, and independent living), one in five U.S. adults reported a disability.

In 2016, using the U.S. Department of Health and Human Services six-question set, one in four (61 million) U.S. adults reported any disability; nearly 6% reported hearing disability. Adults with disabilities, particularly those aged 18–44 and 45–64 years, experienced disparities in health care access by disability type.

 

MMWR Morb Mortal Wkly Rep 2018;67:882–887

DOI: http://dx.doi.org/10.15585/mmwr.mm6732a3

Improving social inclusion and empowerment for people with disabilities in low- and middle-income countries: why does it matter and what works?

WHITE, Howard
SARAN, Ashrita
POLLOCK, Sarah
KUPER, Hannah
July 2018

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The aim of the Rapid Evidence Assessment (REA) is to provide an assessment of the effectiveness of interventions to improve social inclusion and empowerment for people with disabilities in low- and middle-income countries (LMICs). The studies included in this REA are taken from the Disability EGM prepared by the Campbell Collaboration for DFID under the auspices of the Centre for Excellence for Development Impact and Learning (CEDIL). Eligible studies included systematic reviews and impact evaluations published in English from 2000 onwards that assessed the effectiveness of interventions for people with disabilities in LMICs. The REA focused on studies identified by the EGM process that included ‘social inclusion’ or ‘empowerment’ as study outcomes and used the World Health Organization CBR matrix as a framework to categorise the different interventions and outcomes considered by the studies available. Evidence limitations and gaps were identified. 

There were 16 eligible primary studies, including studies conducted in 12 countries: Bangladesh (two studies), Brazil, Chile, China (two studies), Ethiopia, India (three studies), Kenya (two studies), Malaysia, Thailand, Turkey, Uganda, and Vietnam (two studies). Five of the studies concern interventions for people with physical or sensory impairments, nine for people with mental health or neurological conditions, and two for all disability types.

Improving educational outcomes for people with disabilities in low and middle-income countries: why does it matter and what works?

KUPER, Hannah
SARAN, Ashrita
WHITE, Howard
July 2018

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The studies included in this Rapid Evidence Assessment (REA) are taken from the Disability Evidence and Gap Map (EGM) prepared by the Campbell Collaboration for the UK Department for International Development (DFID) under the auspices of the Centre for Excellence for Development Impact and Learning (CEDIL). Eligible studies included systematic reviews and impact evaluations published in English from 2000 onwards that assessed the effectiveness of interventions for people with disabilities in LMICs. Qualitative studies, process evaluations, and non-impact evaluations (e.g. crosssectional surveys) were not eligible for inclusion. Quality grading was applied to the literature, so that assessment could be made of where there was strong evidence and where evidence was limited or missing. The studies were grouped by education sub-outcomes related to different stages in education across the life course; that is: early intervention, primary education, secondary education, non-formal education, and lifelong learning. 

 

There were 24 eligible individual studies, including studies conducted in the Middle East (10), Asia (7), and Africa (5), one from Latin America, as well as one multicountry study

Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

The disability data portal

July 2018

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The Disability Data Portal provides a snapshot of the data globally available on people with disabilities in 40 countries. The portal also identifies where there are gaps in the current body of data. 

The portal was designed for the Global Disability Summit, held on 24 July 2018, and focusses on data relating to four thematic areas: inclusive education, stigma and discrimination, technology and innovation, and economic empowerment. 

The portal presents key development indicators relevant to the Summit themes, mostly drawn from the Sustainable Development Goals (SDGs), along with others relevant to the UN Convention on the Rights of Persons with Disabilities (CRPD)

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

Young persons with disabilities: Global study on ending gender-based violence, and realising sexual and reproductive health and rights

McCLOSKEY, Megan
MEYERS, Stephen
July 2018

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This study provides an analysis on the situation of young persons with disabilities concerning discrimination and gender-based violence, including the impact on their sexual and reproductive health and rights. It also provides an assessment of legal, policy and programming developments and specific good practices in service delivery as well as best-standard prevention and protection measures. Finally, policy and programming recommendations are provided to assist in greater promotion of the rights of young persons with disabilities, with a particular emphasis on preventing and responding to gender-based violence, and realizing sexual and reproductive health and rights.

Situation of persons with disabilities in Lebanon.

COMBAZ, Emilie
July 2018

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This K4D helpdesk report identifies information since 2013 concerning:

  • data on the state of persons with disabilities in Lebanon
  • assessments of laws on the rights of persons with disabilities in Lebanon
  • analyses of the political, social, cultural, and economic context for persons with disabilities in Lebanon

Issues particular to persons with disabilities amongst Syrian refugees within these aspects are identified where possible.

The state of knowledge and gaps are discussed. 

Removing barriers - The path towards inclusive access. Disability assessment among Syrian refugees in Jordan and Lebanon. Jordan report

ASAI, Yahoko
et al
July 2018

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Humanity & Inclusion (HI) and iMMAP conducted a study concerning with the lack of disability data in the Syria crisis context,  which aimed to:

  • Provide statistically reliable prevalence of disability as well as disability disaggregated data indicators on access to services.
  • Increase understanding of the situation of Syrian refugees with disabilities and their households, compared to their peers without disabilities, in relation to the access to services including education, and key barriers experienced in accessing these services.
  • Recommend inclusive actions to be prioritized by humanitarian actors.

The study conducted a literature review, quantitative data collection as well as qualitative data collection. Quantitative data was collected from 6,381 persons of randomly sampled 1,159 households in Azraq and Zaatari camps and Irbid between October 2017 and January 2018. Twenty-five Key Informant Interviews (KIIs) and 3 Focus Group Discussions (FGDs) were also conducted between November 2017 and January 2018 to elicit deeper insights on the educational situation of children with and without disabilities

Removing barriers - The path towards inclusive access. Disability assessment among Syrian refugees in Jordan and Lebanon. Lebanon report

ASAI, Yahoko
et al
July 2018

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Humanity & Inclusion (HI) and iMMAP conducted a study concerned with the lack of disability data in the Syria crisis context,  which aimed to:

  • Provide statistically reliable prevalence of disability as well as disability disaggregated data indicators on access to services.
  • Increase understanding of the situation of Syrian refugees with disabilities and their households, compared to their peers without disabilities, in relation to the access to services including education, and key barriers experienced in accessing these services.
  • Recommend inclusive actions to be prioritized by humanitarian actors.

The study conducted a literature review, quantitative data collection as well as qualitative data collection. Quantitative data was collected from 2,495 persons of randomly sampled 506 households in the urban setting in Bar Elias as well as Informal Tented Settlements (ITS) in Bar Elias and Arsal in December 2017. Fourteen Key Informant Interviews (KII) were also conducted in December 2017 to elicit deeper insights on the educational situation of children with and without disabilities.

Women with disabilities, HIV and sexual violence: Data tell us they are still left behind

HUMANITY & INCLUSION (HI)
July 2018

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This leaflet intends to underline the existence of intersectional factors of vulnerability amongst Women with Disabilities with respect to HIV/AIDS and sexual violence in Burkina Faso and Guinea Bissau. The figures presented here are taken from two studies carried out in Burkina Faso and Guinea Bissau in 2017. In Burkina Faso, 28,667 people were interviewed in total, among whom 978 identified themselves as persons with disabilities (using the Washington Group Short Set of Questions). For the biobehavioral study in Guinea Bissau, 17,110 people were interviewed in total, among whom 1,147 identified themselves as persons with disabilities

Scaling up inclusive approaches for marginalised and vulnerable people. K4D emerging issues report

CARTER, Becky
JOSHI, Anu
REMME, Michelle
July 2018

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This rapid review summarises the evidence on how to scale up inclusive approaches to complex social change. It looks at how to design scalable inclusive change interventions, as well as how to plan and manage the scale-up process. Focusing on interventions with the aim of reaching the most marginalised and transform social norms, it covers programmes aiming to deliver inclusive outcomes for women and girls (with a particular focus on preventing violence against women and girls) and persons with disabilities. To date, many interventions seeking to change harmful gender and disability norms have been implemented as small-scale projects. There are limited experiences of scale-up and fewer evaluations of these experiences. However, there are some documented case studies as well as emerging analysis that draw out lessons learned. From this evidence base, this rapid desk review identifies eight critical issues commonly highlighted as important considerations when scaling up inclusive change interventions:

1. Opportunities for systemic approach, including integrating political and community-level scale-up, and coordinating across multiple sectors and stakeholders

2. Political support for scale-up

3. Strategic choices: balancing reach, speed, cost, quality, equity, and sustainability

4. Catalysing change: tipping points, diffusion effects, and local champions

5. Locally grounded, participatory, and adaptive approaches

6. Long-term approaches with funding models to match

7. Cost-effective and financially feasible scale-up strategies

8. Measuring impact and sustainability.

 

Scale-up pathways are discussed including: horizontal, vertical, functional and organisational.

A number of case studies are given.

Explosive hazards: another fear for the population in Mosul. Factsheet July 2018.

HUMANITY & INCLUSION (HI)
July 2018

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This paper draws on data gathered by Handicap International (HI) on explosive hazard incidents and related casualties that happened after Mosul was retaken, and demonstrates the dire need for scaling-up humanitarian mine action, specifically risk education, technical and non-technical survey, hazard marking, clearance, and victim assistance activities in Iraq

Adolescents with disabilities: Enhancing resilience and delivering inclusive development

JONES, Nicola
PRESLER-MARSHALL, Elizabeth
STAVROPOLULOU, Maria
July 2018

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This report takes stock of evidence from LMICs, drawing on findings from a thematic evidence review combined with emerging findings from the Gender and Adolescence: Global Evidence (GAGE) survey and qualitative research baseline studies in Bangladesh, Ethiopia, Jordan and Palestine. These interviews involved more than 6,000 adolescents and their caregivers – including approximately 600 girls and boys with physical, visual, hearing or intellectual impairments, alongside service providers and policy actors. The report draws attention to the multiple and intersecting capabilities that need to be supported in order for adolescents with disabilities in LMICs to reach their full potential. It goes beyond a focus on their access to education and health services, and also considers their rights to psychosocial wellbeing, protection from violence, mobility and opportunities to participate within their communities, as well the skills, assets and support they need to become economically independent once they transition into adulthood. 

Disability in humanitarian context: A case study from Iraq

HUMANITY & INCLUSION (HI)
June 2018

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This brief presents and addresses some of the challenges that prevent internally displaced persons with disabilities and other vulnerable population groups (elderly, injured persons, pregnant women, etc.) in camp settings from accessing humanitarian services in Iraq and impede on the development of an inclusive humanitarian response. Examples drawn from Handicap International’s experience working in Iraq with persons with disabilities and vulnerable population groups further illustrate those challenges. The recommendations to the humanitarian community provided in this brief aim at improving the protection of persons with disabilities and their inclusion in the humanitarian response

Bridging the Gap: Examining disability and development in four African countries. The case for equitable education

GROCE, Nora
et al
June 2018

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Over the course of a three-year project the Leonard Cheshire Research Centre worked with research teams in four countries: Kenya, Sierra Leone, Uganda and Zambia to better understand the relationship between disability and development in each country across four domains: education, health, labour markets and social protection. This mixed methods research used a range of interrelated components, including policy and secondary data analysis, a household survey of 4,839 households (13,597 adults and 10,756 children), 55 focus group discussions and 112 key informant interviews across the four countries. 

 

This report explores key findings in relation to education. Key findings discussed include school attendance, cost of education, inability to learn and gap in educational attainment.

Disability inclusion and accountability framework

McCLAIN-NHLAPO, Charlotte
et al
June 2018

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The main objective of the Disability Inclusion and Accountability Framework is to support the mainstreaming of disability in World Bank activities. It lays out a road map for (a) including disability in the Bank's policies, operations and analytical work, and (b) building internal capacity for supporting clients in implementing disability-inclusive development programs. The primary target audience of the Framework is Bank staff but it is also relevant to the Bank's client countries, development partners and persons with disabilities. The framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities: nondiscrimination and equality, accessibility, inclusion and participation, and partnership and collaboration. 

 

The appendices to this framework highlight key areas in which the Bank can have a significant impact on the inclusion, empowerment, and full participation of persons with disabilities. These areas include transport, urban development, disaster risk management, education, social protection, jobs and employment, information and communication technology, water sector operations, and health care. 


Report No. 126977
 

Exploring the links between water, sanitation and hygiene and disability; Results from a case-control study in Guatemala

KUPER, Hannah
et al
June 2018

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A case-control study was conducted, nested within a national survey. The study included 707 people with disabilities, and 465 age- and sex-matched controls without disabilities. Participants reported on WASH access at the household and individual level. A sub-set of 121 cases and 104 controls completed a newly designed, in-depth WASH questionnaire.

Monitoring employment rights of people with disabilities in Kathmandu, Nepal, Holistic report 2018

PRASAI, Sagar
PANT, Aashish
June 2018

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This report presents the results of a monitoring project on the employment situation of persons with disabilities in Nepal. This study is part of a larger initiative called the DRPI AWARE (Asian Workplace Approach that Respects Equality) project. The project is a collaborative five-year initiative that is altering the perspective on employment of persons with disabilities in Nepal as well as India, and Bangladesh. DRPI methodology has been adapted to specifically target the monitoring of Article 27 – Right to Work and Employment of the CRPD. Participants with disabilities have focused specifically on the issues and statistics surrounding disability and employment. In each of the three monitoring sites (Hyderabad, Dhaka, Kathmandu), Monitors used an interview and focus group guide to capture a specialized data set and analyze violations of the right to work and employment. The interview and focus group guides were designed to capture various components of the employment process; including experiences of people with disabilities while job searching, during the interview process, during the training process, and on the job. People with disabilities themselves carried out the data collection, analyzed the data, and wrote this monitoring report ensuring these activities were by people with disabilities, for people with disabilities. Monitoring results have been used to identify barriers to employment, which will help direct actions for increasing sustainable employment for persons with disabilities. The module developed during this project may be used in other regions.

Monitoring employment rights of people with disabilities in Kathmandu, Nepal, Holistic report 2018

PRASAI, Sagar
PANT, Aashish
June 2018

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This report presents the results of a monitoring project on the employment situation of persons with disabilities in Nepal. The report is one step toward a comprehensive evaluation of Nepal’s constitutional, legal and policy framework. Findings scrutinise the country’s implementation of laws and policies based on the daily life experiences of persons with disabilities. These experiences are used to assess the level of rights violations, the reasons behind those violations, and possible solutions. This holistic report offers an in-depth analysis of the life circumstances for persons with disabilities, with a specific focus on employment. The analysis has been conducted in relation to fundamental human rights principles of dignity, autonomy, participation, inclusion and accessibility, non-discrimination and equality and respect for difference. The report highlights the degree of implementation of the constitution, laws, policies and programs, enacted to protect and advance the human rights, and specifically the employment rights, of persons with disabilities. The report also highlights the experiences of persons with disabilities with reflection of societal attitudes. 

This study is part of a larger initiative called the DRPI AWARE (Asian Workplace Approach that Respects Equality) project. In each of the three monitoring sites (Hyderabad, Dhaka, Kathmandu), monitors used an interview and focus group guide to capture a specialized data set and analyze violations of the right to work and employment.

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