Resources search

Purpose: The aim of this study was to review peer-reviewed literature on the roles and functions of Disabled Peoples’ Organisations (DPOs) in low and middle-income countries, and their outputs and outcomes for people with disabilities.

Method: Online databases were searched without date or language limiters (Medline, CINAHL, Scopus, Embase and Cochrane), using a combination of two key word search strategies. Eleven studies were selected for inclusion in this review on the basis of predetermined inclusion and exclusion criteria. Included studies underwent quality assessment using the Critical Appraisal Skills Programme (CASP) and Downs and Black’s criteria for quality assessment. Data for thematic analysis was then grouped under the broad themes of: participation and factors that facilitate participation; development of partnerships and connections; and self-development and self-help.

Results: There was some evidence within the included studies to suggest that DPOs can produce significant, positive outcomes for persons with disability in terms of factors such as employment rates, access to microfinance and bank loans, accessibility of housing, acquisition of orthopaedic devices, involvement in civil society, development of friendships and networks, and participation in training programmes. Although the studies under review largely did not investigate the long-term impact of the reported DPO functions and outputs, some of the short-term outputs may be considered proximal indicators of outcomes such as increased empowerment and wellbeing.

Conclusion: The 11 studies in this review suggested that DPOs can be effective in achieving their stated aims of promoting wellbeing, participation and rights of people with disabilities in low and middle- income countries.

A short review of the literature was carried out which derived some specific recommendations with regards to the needs of people with disabilities in cash transfer programming in the braod categories of: appropriate beneficiary targeting and assessment; accessibility of training and sensitisation materials; physical and sensorial access to markets, vendors and distributions points (including ATM); access to activities in cash for work; accessibility of technology; access to lost goods and services

In her report, the Special Rapporteur provides an overview of the activities undertaken in 2016, as well as a thematic study on access to support by persons with disabilities. The study includes guidance for States on how to ensure the provision of different forms of rights-based support and assistance for persons with disabilities, in consultation with them. In preparing the study, the Special Rapporteur convened a regional expert consultation in Addis Ababa in September 2016 and analysed the responses to a questionnaire sent to Member States, national human rights institutions, agencies of the United Nations system, civil society organisations and persons with disabilities and their representative organisations. As at 5 December 2016, she had received 114 responses. 

This study investigated the environment’s role in community reintegration amongst persons with experience of stroke. Focus group discussions with 29 individuals recruited from community stroke clubs in Scotland revealed that stroke influenced a person’s perceptions, experience, use and enjoyment of the environment. Multiple specific (e.g. theatres, cafes) and more general (out-of-the- home) environments appeared capable of supporting community reintegration, providing settings in which individuals were able and willing to interact with others and participate in various functional, social and recreational activities. The article reflects on the study’s implications for policy and practice.

Abstract
The aim of the research was to investigate the social, cultural and institutional factors which contribute to the high incidence of sexual abuse of persons with disabilities in East Africa and to identify interventions which could change detrimental attitudes, beliefs and practices which perpetuate this high incidence. The research is framed within the United Nations Convention on the Rights of Persons with Disability (UNCRPD), particularly articles 12, 13 and 16.

The study used a qualitative participatory action research approach and worked with local partner organisations and Ugandan and Kenyan field level researchers to collect data. Survivors of sexual abuse were not interviewed but instead the research investigated the understandings, beliefs and practices of a range of service providers and key responders who are involved in the prevention of and response to sexual abuse against persons with disabilities in their communities. Groups consulted included police, teachers, health-care workers, government administrators, faith and community organisations and traditional leaders, as well as persons with disabilities and their parents. Participatory workshops were run with a reference group of people with disabilities (with a range of impairments and experiences) and relevant specialists at the initial stage and during the participatory analysis process. After initial orientation and training the field researchers undertook a total of 52 individual interviews and 9 focus group discussions with a range of stakeholders.

The overall findings show that social attitudes and understanding of disability and sexuality in general are strong influencing factors on the risks that persons with disability face in relation to sexual abuse. Participants reported a range of harmful attitudes and beliefs about disability and about the needs and rights of persons with disabilities. It is very common for cases of abuse to go unreported and to be dealt with at the family or community level, rather than being viewed as a serious criminal matter which should be taken to the formal authorities. Many barriers exist, especially at community level which mean abuse does not get reported. Lack of awareness and knowledge, stigma and exclusion and poverty were key drivers of continuing abuse and survivors of abuse seldom get proper support. Guidelines, training and clear procedures for good practice in the various professions were generally weak or absent. Key recommendations were generated for both community level interventions and in relation to policy and training at regional and national levels. The practical implementation of some recommendations was undertaken.

This Guidance was developed by the Convention on Cluster Munitions Coordinators for 2016 and 2017 on Victim Assistance (Australia, Chile and Italy) and Cooperation and Assistance (Austria, Iraq and Australia), with technical support from Handicap International, through funding provided by the Government of Australia. The Coordinators collected the range of good practices and national examples of effective implementation of an integrated approach presented in the Guidance. The dual imperatives of this integrated approach are to: (1) ensure that as long as specific victim assistance efforts are implemented, they act as a catalyst to improve the inclusion and well being of survivors, other persons with disabilities, indirect victims and other vulnerable groups; and (2) ensure that broader efforts actually do reach the survivors and indirect victims amongst the beneficiaries.

Purpose: This study assesses the factors that influence the wellbeing of caregivers and their children with a disability, in a rural and an urban site in Ghana. The wellbeing of parents, not surprisingly, influences the wellbeing of their children. A better understanding of the role and challenges faced by parents in caring for their child with a disability will help to improve existing services and support for children with disability.

Methods: Twenty-five parents of children with different disabilities participated in a PhotoVoice study. Photographs taken by parents, to show the challenges they experienced in childcare, were explained and discussed during focus group discussions. The Cantril Ladder was used to discuss subjective wellbeing.

Results: The photographs and discussions with parents indicated that the extensive time spent on their child, the child’s poor health status, and lack of educational opportunities had a negative influence on the wellbeing of both parent and child. Parents struggle to earn an income to provide for a child with disability. This often causes them to sink into (even deeper) poverty, and further increases the challenge to provide the (specific) care that a child with disability needs.

Conclusions and Implications: If governments, non-governmental organisations and community-based organisations want to contribute to the wellbeing of children with disability, they should be aware of the immediate context of the child, namely the family, and of the specific needs of the parents. Since the wellbeing of parents can affect the wellbeing of the child, and a child with disability may often cause further poverty in the family, relieving parents from some of the demands of childcare could help them to generate income, to the ultimate benefit of the entire family. Organisations working for children with a disability should actively involve parents of these children in designing and implementing interventions.

Background

Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs.

Methods

We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review.

Results

Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors.

Conclusions

This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.