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Human Rights, Social Inclusion and Health Equity in International Donors' Policies

Eide, A H
Amin, M
MacLachlan, M
Mannan, H
Schneider, M
2013

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Background: Health policies have the potential to be important instruments in achieving equity in health. A framework – EquiFrame - for assessing the extent to which health policies promote equity was used to perform an equity audit of the health policies of three international aid organizations.

 

Objective: To assess the extent to which social inclusion and human rights feature in the health policies of DFID (UK), Irish Aid, and NORAD (Norway).

 

Method: EquiFrame provides a tool for analyzing equity and quality of health policies with regards to social inclusion and human rights. Each health policy was analyzed with regards to the frequency and content of a predefined set ofVulnerable Groups and Core Concepts.

 

Results: The three policies vary but are all relatively weak with regards to social inclusion and human rights issues as defined in EquiFrame. The needs and rights of vulnerable groups for adequate health services are largely not addressed.

 

Conclusion: In order to enhance a social inclusion and human rights perspective that will promote equity in health through more equitable health policies, it is suggested that EquiFrame can be used to guide the revision and development of the health policies of international organizations, aid agencies and bilateral donors in the future.

 

Limitations: Analyses are limited to “policy on the books” and does not measure how effectively vulnerable groups are included in mainstream health policy work.

Attitudes of Students towards Peers with Disability in an Inclusive School in Nigeria

OLALEYE, A
OGUNDELE, O
DEJI, S
AJAYI, O
OLALEYE, O
ADEYANJU, T
2012

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Purpose: The majority of children and young people with disabilities live in developing countries where they face inequalities in education and other opportunities. Negative attitudes constitute one of the major barriers to thedevelopment of their potential.

 

This study aimed to describe the attitudes of students without disability towards their peers with disability, and to assess the role that gender and interpersonal contact play in shaping these attitudes.

 

Method: A cross-sectional study involving 107 students was carried out at an inclusive secondary school located in a peri-urban area in South Western Nigeria.

 

Participants were recruited from a group of 118 students in the three junior classes and senior class one (JSS 1 to SSS 1). A semi-structured questionnaire containing items on the “Chedoke-McMaster Attitudes Towards Children with Handicaps (CATCH) scale”, which elicits responses on a Likert scale numbered 0 to 4 (0-strongly disagree, 4-strongly agree), was administered. Data analysis was done using Stata version 12. Descriptive analysis was carried out and association between variables was determined using independent two-tailed t-tests.

 

Results: The Cronbach’s alpha coefficient of the scale was 0.83. The attitudes of students in the school were generally positive (M = 22.55, SD = 3.79). Female students had higher total scores (M = 24.76, SD = 2.78) than their male contemporaries (M = 19.84, SD = 3.05), t (103) = 8.55, p = .000. Having a friend/relative with a disability was associated with more positive attitudes among female students.

 

Conclusions: In this inclusive setting, the attitudes of students towards their peers with disability were generally positive. Since interpersonal contact was associated with positive attitudes towards students with disabilities, interventions should be directed towards promoting interpersonal relationships in order to build an integrated society.

 

The Role of Community Health Workers in the Mongolian CBR Programme

COMO, E
BATDULAM, T
2012

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Purpose: This article aims to present the role of community health workers in the implementation of a comprehensive CBR Programme in rural Mongolia, and to explore the main challenges that arise in this specific geographical and socio-economic context.

 

Methods: Qualitative data were collected through semi-structured interviews with CBR workers from three selected provinces; short meetings and interviews with respective provincial level CBR coordinators complemented the information acquired. Additionally, a workshop with national level CBR stakeholders was carried out in order to review and discuss the findings.

 

Results: The study highlighted a number of practical barriers (including long distances and lack of transportation, low population density, and harsh climate conditions) which constrain the work of community health workers in the areas studied. In relation to disability, the study shed light on the difficulties found by community workers in shifting from a medical approach to disability to a new approach that emphasizes prevention and rehabilitation. Exploring interviewees’ experience in the five areas of CBR (health, education, livelihood, social, empowerment) the authors found that working in the areas other than health is perceived as difficult due to insufficient training as well as objective contextual barriers.

 

Conclusions: Despite many challenges, CBR represents a significant improvement for disability action in rural Mongolia. In this context, the local community health workers are well suited and willing to act as CBR workers; nonetheless, more training and some tailoring work to adapt the Programme to the context is needed if all potential results are to be achieved.

 

Limitations: This study did not include direct observation of CBR activities or consultation of beneficiaries and other stakeholders. Their involvement and consultation would certainly improve the understanding of all the issues raised.

A Low-intensity Approach for Early Intervention and Detection of Childhood Disability in Central Java: Long-term Findings and Implications for “Inclusive Development”

KUIPERS, P
MARATMO, J
2012

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Purpose: This paper describes a qualitative follow-up study, conducted eight years after completion of a low-intensity early intervention and detection of childhood disability project in Central Java, Indonesia. The original project sought to increase the level of skills and engagement of existing community health volunteers, for the support of children with disabilities. This follow- up study explored long-term outcomes and implications for the inclusive development approach.

 

Method: Semi-structured interviews were conducted with 18 of the original volunteers. Interview notes were translated and thematically categorised.

 

Results: While the study was qualitative and descriptive, results indicate that despite the low intensity of the project, some early detection and prevention activities were still going on eight years later.

 

Conclusions: The study suggests that a low-intensity initiative such as this, which is closely aligned with the goals of a government department, may indeed achieve some ongoing change by extending the focus of the department towardsdisability-related concerns.

 

Implications: Implications are drawn for the emerging area of “inclusive development”, which similarly seeks to promote change in mainstream services for the benefit of people with disabilities.

The Community Based Rehabilitation Programme of the University of the Philippines Manila, College of Allied Medical Professions

MAGALLONA, M L M
DATANGEL, J P
2012

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Purpose: This paper reports the process of development of a CBR programme by UP Manila College of Allied Medical Professions, and its impact on the stakeholders: persons with disabilities, students and alumni, CBR workers, local leaders and the agencies involved in the programme.

 

Method: The impact of the programme was assessed through interviews, questionnaires, focus group discussions and review of secondary data and records.

 

Results: The programme results show that the condition of persons with disabilities has improved and there has been a remarkable change in their knowledge, attitudes and skills. The positive attitudes, skills and values of students were enhanced, and the CBR programme was a “character builder” for them as rehabilitation professionals. The CBR workers who participated in the programme learnt to appreciate the potential of persons with disabilities and to accept their limitations. Another key result was the pledge by local leaders to sustain CBR in their own villages.

 

Conclusions: The students and alumni reported that the CBR programme should be replicated for nation-building. The different stakeholders reported that it helped improve the quality of life of people with disabilities and contributed to community development.

Practical lessons from four projects on disability-inclusive development programming

COE, Sue
WAPLING, Lorraine
2010

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This article considers early lessons learned from the inclusion of disabled people, based on socially inclusive principles, in World Vision programming work in Angola, Armenia, Cambodia, and Senegal. Externally led reviews and evaluations conducted between July 2007 and April 2008 drew out seven key lessons. In summary: the substantial effect of stakeholders’ attitudes on practical implementation; the importance of authentic consultation with a range of disabled people; appropriate budgetary considerations; and a need for caution regarding livelihoods work.

Access to mainstream microfinance services for persons with disabilities : lessons learned from Uganda

BWIRE, Flavia Nakabuye
MUKASA, George
MERSLAND, Roy
2009

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This article reports from a pilot project in Uganda where the aim is to enable persons with disabilities to have access to mainstream microfinance services. Several lessons have already been learned: 1) entrepreneurs with disabilities are an untapped market opportunity for Micro Finance Institutions (MFIs); 2) to influence MFIs it is important to understand their business model and team up with key actors from the industry; 3) persons with disabilities are often misinformed about MFIs' terms and services and don't know how to tap these opportunities. Gradually a change in attitudes in MFIs and Disabled Peoples Organizations (DPOs) is observed. All MFIs participating in the project now report an increase in the number of clients with disabilities served. This is happening without the use of any economic incentives.

Inclusive information and communication technologies for people with disabilities

SIMPSON, Jennifer
2009

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Information and Communications Technology (ICT) has the potential both to enhance access for people with disabilities and to contribute to creating barriers. What we now call the digital divide actually began long before the introduction of computers — barriers have existed and still exist today with telephones, television, the Internet and other information technology. It is important to remember that people with disabilities have many different accessibility needs and that there are different ways to make technology accessible and that new accessibility needs emerge as technology changes. This paper looks at the state of accessibility policy in the U.S. in several technology infrastructures that may provide some lessons and directions for increasing inclusive information and communication technologies worldwide. For instance, if the many provisions involving technology in the UN Convention on the Rights of Persons with Disabilities are to have real and substantive meaning, policy and implementation at the infrastructure level must occur.

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