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Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

NOTE:
The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Managing epidemics - Key facts about major deadly diseases

WORLD HEALTH ORGANISATION (WHO)
2018

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The manual is structured in three parts.

  • Part One “Epidemics of the 21st century” provides vital insights on the main features of the 21st century upsurge and the indispensable elements to manage them.
  • Part Two “Be in the know. 10 key facts about 15 deadly diseases” contains key information about 15 diseases (Ebola Virus Disease, Lassa Fever, Crimean-Congo haemorrhagic fever, Yellow Fever, Zika, Chikungunya, Avian and Other Zoonotic Influenza, Seasonal Influenza, Pandemic Influenza, Middle East Respiratory Syndrome, Cholera, Monkeypox, Plague, Leptospirosis and Meningococcal Meningitis). This section provides tips on the interventions required to respond to epidemics of all these diseases.
  • Part Three “Tool boxes” gives an overview and summarized guidance on some other important topics, including: the role of WHO, the International Coordinating Group, laboratory diagnosis and shipment of infectious diseases substances, and vector control.

 

The handbook enables the three levels of WHO – its Headquarters, Regional Offices and Country Offices to work efficiently together by building the foundations of a shared conceptual and thinking framework, which includes common terminology. 

Strengthening environmental sustainability and inclusion in health and other development programs. Practical guidance for environmental sustainability, accessibility, gender, safeguarding and disaster risk reduction

CBM
2018

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The purpose of this booklet is to promote discussion and innovation for strengthening environmental sustainability and inclusion in health and other development activities. The case studies and checklists are designed to foster creative thinking and the ongoing gathering of evidence related to these topics. The booklet will be useful to anyone seeking high quality outcomes from health and other development programs. The information was first compiled for CBM’s engagement in the General Assembly of the International Agency for the Prevention of Blindness 2016, however will be useful for advancing sustainable development with inclusion in any context.

The case sutdies are: Environmental Sustainability in Eye Health, Caritas Takeo Eye Hospital (CTEH), Cambodia; and  Strengthening Accessibility and Inclusion in Eye Health. UMC Kissy Eye Hospital, Freetown, Sierra Leone, West Africa

Global AgeWatch Insights. The right to health for older people, the right to be counted

ALBONE, Rachel
et al
2018

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This report considers the progress being made to achieve older people's right to health amid the global drive towards universal health coverage. It explores how older people are currently accessing health services and what changes need to be made to improve on this. It considers the role of data in driving and informing changes to health systems and the services they deliver. Data must be collected with and about older people to ensure adequate evidence for service design and delivery that is targeted and appropriate. This report explores the adequacy of current data systems and collection mechanisms and how, alongside health systems, they must be adapted in an ageing world. 

 

This report is supported by 12 country profiles (for Argentina, Colombia, El Salvador, Kenya, Lebanon, Moldova, Myanmar, Pakistan, Serbia, Tanzania, Vietnam and Zimbabwe; see Appendix 1). These provide national information on trends in the physical and mental health status of older people, and population-level information on access to UHC. The profiles are supplemented by data mapping, showing the national data available on older people’s health in the 12 profile countries, and revealing the data gaps. The data mapping results are available at www.GlobalAgeWatch.org.

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.

Sexual assault advice - Booklet for Kenya

ALEY, Rob Aley - Advantage Africa
et al
November 2017

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This simple guide has been written to support victims of
sexual abuse and their families in Kenya to know their rights and
to understand what services are available to them. The
booklet is also a useful source of summary information for
duty bearers in the community (e.g. village elders, faith
groups, Assistant Chiefs and CBOs) as well as formal
service providers such as hospitals and the police.

The Journal of Mental Health Training, Education and Practice, vol.12, no.4 Special Issue - Mental health pathways for people with intellectual disabilities: the education, training and practice implications

CHARNOCK, David
WRIGHT, Nicola
Eds
November 2017

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"This special edition aims to address some of the complexities and challenges faced in mainstream mental health services in three ways. First, to highlight the specific needs of people with intellectual disabilities and mental health problems. Second, to promote the importance of interdisciplinary working and learning in relation to mental wellbeing and intellectual disability, showcasing innovative approaches to care and finally, to offer a voice to specialists from intellectual disability practice and research to foster practical and conceptual thinking in relation to this group of service users"

There is a freely accessible editorial and there are six papers:

  • People with intellectual disabilities accessing mainstream mental health services: some facts, features and professional considerations
  • Psychiatry and intellectual disabilities: navigating complexity and context
  • Development and dissemination of a core competency framework
  • Mental health staff views on improving burnout and mental toughness
  • Using wordless books to support clinical consultations
  • Actors with intellectual disabilities in mental health simulation training

Full articles are not free.

Inclusive and integrated mother, newborn and child health programming: Beyond mortality

OLCHINI, Davide
November 2017

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This policy paper describes the operational terms of Handicap International’s mandate and values as applied to Mother, Neonatal and Child Health (MNCH). Presenting the approaches and references underpinning Handicap International’s actions, choices and commitments, its purpose is to ensure consistency across its practices while taking account of different contexts. Intended as a document to guide programme staff, the paper defines the topic, describes the target populations and sets out the methods of intervention (activities and expected results) and the indicators used to monitor and evaluate. It also aims to ensure that Handicap International programmes implement all projects in accordance with the presented methods of intervention

 

The SDGs focus on a broader scope of activities and are thus slowly but surely shifting from mortality to address in a more comprehensive manner the well-being and achievement of maximum potential for children and adolescents. With a robust component in sexual and reproductive health, this represents a significant frame of reference for Handicap International’s work in MNCH as it has paved the way for integrating MNCH-related impairments into existing health services. The framework of the SDGs provides a clear vision of the importance of multi-sectorial interventions, which encompass the limit of vertically-organised health systems centred on curative aspects, to offer a more integrated and preventive package of interventions that include chronic conditions, impairments and health for all. After many years of implementing MNCH projects, Handicap International is well-positioned and firmly established as a major player in this process.

Childhood disability in Malaysia: a study of knowledge, attitudes and practices

MOORE, Katie
BEDFORD, Juliet
November 2017

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This study was carried out to assess the knowledge, attitudes and practices of society towards children with disabilities, the children themselves, and their peers in Malaysia. The study took place in Selangor, Kelantan, Sabah and Sarawak. There were 756 total respondents/participants including government ministries, community members, service providers, care givers and children and adolescents both with and without disabilities. 

Quality rehabilitation for all. Lessons learnt from integrating rehabilitation services in two general hospitals in Bangladesh

BAART, Judith
RAHMAN, Nafeesur
November 2017

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Working from the theory that integrating basic rehabilitation care within the health care system in Bangladesh, rather than as a stand-alone service, could greatly improve awareness of and access to rehabilitation services, CDD piloted setting up therapeutic care centres within hospitals. This report presents the lessons learned.

Access to health care in an age of austerity: disabled people’s unmet needs in Greece

ROTAROU, Elena S
SAKELLARIOU, Dikaios
2017

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Since late 2009, Greece has been dealing with the effects of a debt crisis. The neoliberal principles embedded in the three structural adjustment programmes that the country accepted have required radical cuts in health care funding, which in turn have led to widening inequalities in health. This article focuses on access to health care for people with disabilities in Greece in the context of these structural adjustments. We investigate possible differences in unmet health care needs between people with and without disabilities, using de-identified cross-sectional data from the European Health Interview Survey. The sample included 5400 community- dwelling men and women aged 15 years and over. The results of the logistic regressions showed that people with disabilities report higher unmet health care needs, with cost, transportation, and long waiting lists being significant barriers; experience of all barriers was positively associated with low socio- economic status. These findings suggest that a section of the population who may have higher health care needs face greater barriers in accessing services. Austerity policies impact on access to health care in both direct and indirect ways, producing long-term disadvantage for disabled people. Social policies and comprehensive anti-discrimination legislation might help to address some of the barriers this population faces.

Mental health assessments in refugees and asylum seekers: evaluation of a tablet-assisted screening software

MORINA, Naser
et al
October 2017

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Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface.

Conflict and Health 2017 11:18

https://doi.org/10.1186/s13031-017-0120-2

Ensuring universal access to eye health in urban slums in the Global South: the case of Bhopal (India).

PREGEL, Andrea
et al
October 2017

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In the context of its Urban Eye Health Programme in Bhopal (India), Sightsavers launched a pilot approach aimed at developing an Inclusive Eye Health (IEH) model and IEH Minimum Standards.

Accessibility audits were conducted in a tertiary eye hospital and four primary vision centres located within urban slums, addressing the accessibility of physical infrastructures, communication and service provision. The collection and analysis of disaggregated data inform the inclusion strategy and provide a baseline to measure the impact of service provision. Trainings of eye health staff and sensitisation of decision makers on accessibility, universal design, disability and gender inclusion are organised on a regular basis.

A referral network is being built to ensure participation of women, people with disabilities and other marginalised groups, explore barriers at demand level, and guarantee wider access to eye care in the community. Finally, advocacy interventions will be developed to raise awareness in the community and mainstream disability and gender inclusion within the public health sector.

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.
 

Community health workers lensed through a South African backdrop of two peri-urban communities in KwaZulu-Natal

WHITE, Meghan S.
GOVENDER, Pragashnie
LISTER, Helga E.
2017

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Background: As the South African government re-engineers primary healthcare (PHC), the need for additional information on stakeholders involved in the process has emerged. Of these are community health workers (CHWs), who have been identified as central to PHC success.


Objectives: To profile the current CHWs within KwaDabeka and Clermont in KwaZulu-Natal, to describe their roles and to explore the barriers and enablers influencing their service delivery.


Method: A convergent mixed methods design was employed with a sample of CHWs with the use of a survey (n = 53) and two focus groups (n = 10) and semi-structured interviews with four ward councillors (n = 4). Data were analysed statistically and thematically.


Results: The profile of CHWs reflected only women with a mixed age range and a majority of 59% who had not completed formal schooling. General work experience as a CHW varied. There were diverse opinions expressed towards the CHW role which related to their job title and identity, supervision, remuneration, growth pathways and psychological and emotional issues. Whilst the National Community Health Worker Profile Framework was established for the CHW programme, there are several factors lacking in the current CHW programme such as a formal growth pathway or formal training to align the CHWs with the National Qualifications Framework.


Conclusion: The study findings are essential for the monitoring and evaluation as well as development and refinement of policies that will assist in ensuring adequate rollout of PHC with CHWs.

Postpartum Depression: Signs and Resources for Help

Nursing@Georgetown
July 2017

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This resource provides insights into the symptoms of postpartum depression and how to support a loved one with PPD. Also included in the article are insights on how to find providers and community groups that offer free resources. Readers can also learn what to do in crisis situations to ensure that important preventative measures are taken when needed.

Healthcare provider's attitude towards disability and experience of women with disabilities in the use of maternal healthcare service in rural Nepal

DEVKOTA, Hridaya Raj
KETT, Maria
GROCE, Nora
MURRAY, Emily
June 2017

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BACKGROUND:
Women with disabilities are less likely to receive maternal healthcare services compared to women without disabilities. While few studies have reviewed healthcare experience of women with disabilities, no studies have been conducted to understand provider's attitude towards disability in Nepal, yet the attitude and behaviour of healthcare providers may have a significant influence on aspects of care and the use of service by women with disabilities. This study examines healthcare provider's attitudes towards disability and explores the experience of women with disabilities in maternal healthcare service utilization during pregnancy and childbirth.

METHOD:
The study used mixed method approach. An attitude survey was conducted among 396 healthcare providers currently working in public health facilities in Rupandehi district of Nepal. For additional insight, eighteen in-depth interviews with women with disabilities who used maternal healthcare services in a healthcare facility within the study district in their last pregnancy were undertaken. The Attitude Towards Disabled Persons (ATDP) scale score was used to measure the attitudes of healthcare providers. For quantitative data, univariate and multivariate analysis using ANOVA was used to understand the association between outcome and independent variables and qualitative analysis generated and described themes.

Reproductive Health, 2017

Gendered experiences of physical restraint on locked wards for women

FISH, Rebecca
HATTON, Chris
2017

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Physical restraint is used in inpatient services for people with intellectual disabilities as a way of holding a person to avoid injury. This article uses data from an ethnographic study in a locked unit in the north of England to explore women’s experiences of physical restraint using a feminist disability studies analysis. Data consists of field notes as well as interviews with 16 of the women who had experienced restraint, and 10 staff who worked with them. The women gave insights into the gendered phenomenon of restraint in light of their past experiences of violence. The authors argue that restraint is used with women to encourage passivity at times when more relational and therapeutic methods could be used. The article offers recommendations for alternative strategies that services can encourage.

Evaluation of disability-inclusive development at UNDP

INDEPENDENT EVALUATION OFFICE OF THE UNITED NATIONS DEVELOPMENT PROGRAM
March 2017

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The Independent Evaluation Office (IEO) presents its evaluation of disability-inclusive development at the United Nations Development Programme (UNDP). This work was carried out in 2016 and analyses UNDP’s contribution to disability-inclusive development during the period 2008-2016, which corresponds to the current and past UNDP strategic plans, and to the period within which the UN Convention on the Rights of Persons with Disabilities has been in force. The work of UNDP was considered through the four key principles of the CRPD, namely nondiscrimination, participation and inclusion, accessibility and accountability. Eleven country office visits were made and 337 people interviewed. Key findings (24) are provided, conclusions made and future strategic planning put forward.

 

Report available in summary (32 p) or in full. Video also available (51 min).

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