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The missing billion - Access to health services for 1 billion people with disabilities

KUPER, Hannah
HEYDT, Phyllis
July 2019

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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC (Universal Health Care) and SDG 3 cannot be attained without better health services for the one billion people with disabilities. 

Health and healthcare are critical issues for people with disabilities. People with disabilities often need specialized medical care related to the underlying health condition or impairment (e.g., physiotherapy, hearing aids). They also need general healthcare services like anyone else (e.g., vaccinations, antenatal care). On average, those with disabilities are more vulnerable to poor health, because of their higher levels of poverty and exclusion, and through secondary conditions and co-morbidities. People with disabilities therefore may require higher levels of prevention, diagnosis, and treatment services. However, health services are often lower quality, not affordable, and inaccessible for people with disabilities. In many situations these barriers are even more significant for women with disabilities, compared to men with disabilities.

Reimagining the workplace: disability and inclusive employment

LEONARD CHESHIRE
February 2019

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This UK based report examines the challenges and barriers facing disabled people throughout their working journey, as well as considering solutions to some of the key issues. Through our own research survey and interviews we look at the impact on disabled people where they cannot access adequate support as well as what works in improving their employment prospects

 

Topics discussed include: conditions of employment; preparing for work; falling out of work; and the performance of government based programmes.

 

ComRes interviewed in 2018 online 1,647 disabled adults in the UK, aged between 18 and 65, and in 2017 they interviewed 1,609 disabled adults. ComRes interviewed 503 UK line managers responsible for or involved in the recruitment process in 2018 and in 2017.  Between 1 December 2018 – 20 January 2019, Leonard Cheshire conducted in-depth telephone interviews with seven disabled people of working age about their experiences of employment. 

 

Recommendations are made throughout.

Provision of wheelchairs in Tajikistan: Economic assessment of alternative options

WORLD HEALTH ORGANISATION (WHO). REGIONAL OFFICE FOR EUROPE
2019

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"This publication presents the results of a study on the economic aspects of various models for the provision of wheelchairs in Tajikistan. The study was conducted under the leadership of the Ministry of Health and Social Protection, Republic of Tajikistan and with technical support from the WHO Country Office, Tajikistan. The study was finalized in consultation with Tajik users of wheelchairs, the Ministry of Health and Social Protection and international experts on wheelchair production and provision, and made use of national and international evidence on the provision of wheelchairs to inform the analysis and develop evidence-based policy options. While the study focuses on the Tajik context and its aspirations to expand in-country production of wheelchairs, its approach and findings will also be of interest to other countries in a similar situation and to other interested stakeholders"

 

 

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.

Resource book on Disability Inclusion

LIGHT FOR THE WORLD
2017

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This is a resource book on disability inclusive practices. Within this book a variety of resources has been brought together that are relevant for disability inclusion. This is of particular interest for persons working in (development) organisations who would like to ensure that their projects and programmes are inclusive of persons with disabilities.

This book consists of four parts:

Core concepts
How To Pages
Resource Listing
Trainer-facilitator’s Guide

The book relies heavily on the experiences and practices of inclusion developed by different organisations to which the authors are indebted, and they have tried to make reference to the sources wherever possible. In addition, they have drawn on their experiences as programme managers and disability inclusion advisors.

These materials may be used for non-commercial purposes, with proper references to all authors and sources involved. Should you use this resource book in your training or other work, please let us know via lab@light-for-the-world.org.

Making microfinance accessible to persons with disabilities: awareness and attitudes among Indian microfinance institutions

GUPTA, Vin
May 2014

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This research focuses on three stakeholders: Microfinance Institutions (MFIs), Persons with Disabilities (PWD), and non-disabled clients. It attempts to highlight the following:

  • Understanding of MFIs about disability, their perceptions of persons with disabilities, and their preparedness to include them as potential clients
  • Concerns and apprehensions of PWD to becoming potential MFI clients
  • Views of non-disabled clients on including PWD in their groups

The study investigates the knowledge and the perceptions about disability among each stakeholder group and attempts to elucidate how that impacts the ability of PWD to access microfinance services. Four microfinance institutions of different geographic areas were studied. The survey inolved 1,000 people of whom 57 were disabled. 

The labour market for human resources for health in low and middle-income countries

SCHEFFLER, Richard
BRUCKNER, Tim
SPETZ, Joanne
July 2012

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This paper provides an introduction to the terms and tools of labour market analysis and connects these labour market principles to real-world case studies from LMIC. Three examples are provided of issues: workforce shortage in Thailand; unfilled posts in Kenya; and ghost workers in Rwanda. The labour market for health workers is considered and an integrated framework is provided. The technical structure and dynamics of the health worker market is discussed and applied to the first two examples. Task shifting, health worker performance and health worker productivity are also discussed.

Human Resources for Health Observer, No. 11

Good governance handbook

BULLIVANT, Dr. John
et al
March 2012

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"This document has been designed to provide some key principles of good governance that can aid decision making at board level in healthcare providers. The guide builds on previous best practice guidance whilst recognising the major impact of the current changes to the NHS architecture. It is intended to be of interest to existing NHS boards, emerging Clinical Commissioning Groups and Health and Wellbeing Boards and those responsible for managing governance systems and processes within healthcare"

Disability in the workplace : employers' organizations and business networks

INTERNATIONAL LABOUR OFFICE (ILO)
2011

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This paper is "a compilation of 12 case studies of employers’ organizations and business networks, describing their activities related to disability and employment. The publication is intended for employers’ organizations and other representative business organizations, companies, workers’ organizations, ILO staff, people with disabilities, and others interested in learning about the inclusion of disabled people in the workplace. It contributes to the knowledge sharing activities of the ILO Global Business and Disability Network"
Working Paper No 6

Disability in the workplace : company practices

INTERNATIONAL LABOUR OFFICE (ILO)
2010

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This paper is "a compilation of 25 company profiles, which describes how companies address hiring and retention, products and services and corporate social responsibility (CSR) from the perspective of disability. The publication is for companies, employers’ organizations and other representative business organizations, workers’ organizations, ILO staff, people with disabilities, and others interested in learning about company practices as it relates to disability. It is one of the first knowledge sharing initiatives of the ILO Global Business and Disability Network"
Working Paper No 3

Guarantee funds for small enterprises : a manual for guarantee fund managers

DEELEN, Linda
MOLENAAR, Klaas
2004

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This manual presents practical information about guarantee funds aimed at small entrepreneurs, highlighting that guarantee funds play a vital part in the recovery of a weak economy. It provides an introduction and useful information such as types of guarantee fund models and monitoring information. This resource is useful for guarantee fund managers in developing countries

The world health report 2001. Mental health : new understanding, new hope

WORLD HEALTH ORGANIZATION (WHO)
October 2001

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This report raises awareness of the global burden of mental and neurological disorders, and its cost in human, social and economic terms. It also aims to dismantle the barriers which prevent millions of sufferers of mental and neurological disorders from receiving the treatment they need and deserve. The report describes how mental health problems can be solved (eg. by drug therapy, psycho-social rehabilitation and psychotherapy, vocational rehabilitation, housing), and gives examples of the effectiveness of these treatments for a wide range of mental disorders

Strategic issues in preventing cataract blindness in developing countries

Ellwein, L B
Kupfer, C
1995

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Cataract blindness is a public health problem of major proportions in developing countries. Intracapsular cataract extraction with aphakic spectacles has been the standard surgical technique for restoring sight. Because of image magnification in the operated eye, however, the result in unilaterally blind patients is less than satisfactory. Fortunately, with the availability of low-cost intraocular lenses ( IOL) and ophthalmologists trained in extracapsular surgery, it is now practical to intervene successfully in the unilateral case. The need for increased attention on the quality of the visual outcome is only one of three important strategic issues in cataract blindness control. The existing high prevalence of cataract blindness in developing countries and an increasing cataract incidence due to an aging population require substantial increases in surgical volume. The third issue relates to cost. If significant increases in surgical volume and quality of outcomes are to be realised without an increased need for external funding, service delivery must be made more efficient. The expansion of IOL surgery for unilateral blindness is a favourable trend in ensuring financial sustainability of delivery systems; patients can be operated on while still economically productive and able to pay rather than waiting for bilateral blindness and a less favourable economic and social impact. It the quality, volume, and cost issues are to be successfully addressed, operational and structural changes to eye care delivery systems are necessary. These changes can be effected through training, technology introduction, management of facilities, social marketing, organizational partnerships, and evaluation. With improved understanding of the critical factors in successful models their widespread replication will be facilitated.

ILO global business and disability network

INTERNATIONAL LABOUR OFFICE (ILO)

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The ILO Global Business and Disability Network is a network of multinational entreprises, employers' organizations, business networks and disabled persons' organizations who share the conviction that people with disabilities have talents and skills that can enhance virtually any business. The Network wishes to foster the development of a workforce culture that is respectful and inclusive; promoting the hiring, retention and professional development of people with disabilities. The Network's mission is to raise business awareness about the positive relationship between the inclusion of people with disabilities in the workplace and business success. We serve companies of all sizes and markets by encouraging knowledge-sharing and joint activities thus building disability expertise, facilitating the development of national networks and promoting the business and human rights cases for disability inclusion in the workplace.

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