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Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

Disability inclusion in climate change programming in the Middle East

KETT, Maria
MEANEY-DAVIS, Jessie
January 2021

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This document provides guidance on how to incorporate disability inclusion within climate change programming in Iraq, Jordan, Lebanon, Occupied Palestinian Territories (OPTs), Syria, Turkey and Yemen. It is intended to inform the UK's Foreign, Commonwealth and Development Office’s (FCDO) climate change programming in the Middle East and North Africa (MENA) region. 

Disability inclusion annual report 2020

UNITED NATIONS RELIEF AND WORKS AGENCY (UNRWA)
December 2020

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The number of Palestine refugees registered by UNRWA recently grew to 5.7 million (from 5.5 million in 2019) in all its five field of operations in Jordan, Lebanon, Syria, Gaza and the West Bank. Among them are Palestine refugees with disabilities, who have long-term impairments, which in interactions with attitudinal, institutional, and environmental barriers prevent their full and effective participation on an equal basis with others in society. Persons with disabilities constitute an estimated 15 per cent of the global population1, and may constitute a higher percentage in humanitarian contexts, such as Syria, the West Bank and Gaza, in particular, which are UNRWA fields of operations.

 

The main actions undertaken in 2020 discussed in the report are:

  • targeted and disability-specific services for persons with disabilities
  • disability inclusion through programmes
  • inter-agency coordination
  • international protection advocacy

The Rights of Persons with Disabilities Amid COVID-19

UNITED NATIONS HUMAN RIGHTS
Ministry of Social Development
Independent Commission for Human Rights
June 2020

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This document make specific recommendations on support and protection to be provided to persons with disabilities during the COVID-19 response, and to ensure that appropriate measures are in place to maintain their active participation as well as to avoid discrimination at all levels against them

COVID-19 in humanitarian contexts: no excuses to leave persons with disabilities behind! Evidence from HI's operations in humanitarian settings

HUMANITY & INCLUSION (HI)
June 2020

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This collection and review of evidence aims to illustrate how the COVID-19 crisis triggers disproportionate risks and barriers for men, women, boys and girls with disabilities living in humanitarian settings. It highlights recommendations for humanitarian actors, to enhance inclusive action, aligned with existing guidance and learnings on disability inclusion. It is based on evidence, including testimonies, collected by HI programs in 19 countries of intervention. Special efforts were made to reflect the voices of persons with different types of disabilities, genders and ages, residing in different geographical areas and living circumstances, including refugee and internally displaced persons’ settlements and host communities.

 

Evidence has been collected through primary data collection among HI teams and partners, working in countries impacted by the COVID-19 pandemic in April/May 2020. Data was extracted from assessments conducted by HI and partners in Bangladesh, Egypt, Haïti, Indonesia, Philippines, Jordan, Lebanon, Somaliland and Togo. Testimonies from affected communities, staff and partners were collected in Kenya, Myanmar, Pakistan, Palestine, Philippines, Somaliland, South Sudan, Rwanda, Thailand, Uganda and Yemen.

 

Disability inclusion annual report 2019

UNITED NATIONS RELIEF AND WORKS AGENCY FOR PALESTINE REFUGEES IN THE NEAR EAST
December 2019

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United Nations Relief and Works Agency (UNRWA) adopts a twin-track approach to ensure the full inclusion of Palestine refugees with disabilities. This entails ‘disability mainstreaming’, whereby all UNRWA programmes and services are universally designed to ensure that they are usable by and/or reach beneficiaries with disabilities, coupled with the provision of ‘targeted/tailored interventions’. During 2019, UNRWA implemented the following activities to address the specific needs of Palestine refugees with disabilities:

  • Direct Specialized Services for Persons with Disabilities
  • Disability Inclusion through Programmes
  • International Cooperation

Geneva Academy briefing on Disability and armed conflict 2019

PRIDDY, Alice
April 2019

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This publication brings attention to the devastating impact conflict has on persons with disabilities and, crucially, highlights that many of the key international humanitarian law (IHL) provisions that serve to minimize the impact of armed conflict – such as the proportionality assessment and advanced effective warnings – are not being applied in a disability inclusive manner, resulting in persons with disabilities being killed, seriously injured or left behind as families flee armed attacks.

 

Research methods included a combination of: desk research; structured interviews with persons with disabilities and their representative organizations, NGOs and humanitarian personnel; and field workshops through which feedback was sought on discrete issues. 

 

The project focused on the situation of persons with disabilities in five states experiencing different levels of armed conflict or its aftermath (the DRC, Colombia, Palestine, Ukraine and Vietnam). These states were selected because they are all States Parties to the CRPD, and they represent a diverse range of regions and cultures, differing types of conflicts (including the involvement of ANSAs), different stages of conflict or post-conflict situations, differing levels of economic development and varying levels of international assistance

Women and girls with disabilities. Needs of survivors of gender based violence and services offered to them

BURGHAL, Waseem
March 2019

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This study on GBV among women and girls with disabilities was conducted by UNFPA (United Nations Population Fund) with the support of Denmark in the context of the GBV Sub-Cluster Strategy 2018-2020. It was based on a needs analysis and mapping of services offered to women and girls with disabilities aged 15 and older who are survivors of gender-based violence (GBV) in the West Bank and Gaza Strip, particularly in view of the poor protection, care and social services available to women survivors of violence. Its objective was to map the available services; analyze major gaps and challenges related to service delivery; identify roles and responsibilities of stakeholders and service providers, including stakeholder coordination, legislation and policies, capacity, prevention and response services, the referral process and accountability; as well as to make recommendations and propose interventions to address the weaknesses in the protection system for women and girls with disabilities in Palestine.

Realising children's right to social protection in Middle East and North Africa. A compendium of UNICEF's contribution's

ARCHIBALD, Edward
January 2019

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This Compendium documents the broad range of UNICEF’s social protection interventions in MENA from 2014-2017. 
 

The Compendium includes 20 case studies detailing UNICEF’s contributions in the MENA region across the following five Action Areas

 

  • Evidence and Advocacy (Algeria, Egypt, Iraq, Iran, Lebanon, Yemen, Morocco)
  • Policies, coordinating and financing (Djibouti, Morocco)
  • Cash transfer programming and systems strengthening (Egypt, Jordan, Tunisia)
  • Cash plus interventions and social work (Iraq, State of Palestine (highlights children with disabilities), Yemen)
  • Social protection in fragile and humanitarian contexts/settings (Yemen, Lebanon, Jordan, Syria). The Syrian programme was "Reaching children with complex disabilities through cash transfers and case management"

 

 

 

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

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. 

Psychosocial disability in the Middle East

BOLTON. Laura
May 2018

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A K4 helpdesk report, commissioned by DFID (UK), provides a rapid review of literature to provide best estimates of psychosocial disability in specific countries in the Middle East.

Topics discussed include:

Prevalence and different forms of mental health conditions and psychosocial disability

Factors influencing prevalence

Differences across demographics

Provision for those with psychosocial disabilities

Psychosocial disabilities in the Middle East. K4D Helpdesk Report.

BOLTON, Laura
May 2018

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This desk based review reports on the then current best estimates of psychosocial disability in the following countries in the Middle East and North Africa: Lebanon, Jordan, Occupied Palestinian Territories (OPTs), Iraq, Syria and Yemen. Factors influencing prevalence of psychosocial disability in each of these countries, and whether conflict was an important factor were considered. Prevalent forms of psychosocial disability and how might they differ by country were reviewed. How prevalence and form of psychosocial disability differ across the following demographic characteristics: gender, age, religion, ethnic group was addressed. The state of provision, both state and non-state, for those with psychosocial disabilities in these countries, and variation of eligibility and access to provision/services across demographics (e.g. age, gender, religion or ethnic group) were also considered.

Inclusion for all: Research case study June 2018: Occupied Palestinian Territories

CAPPER, Sarah
El ZOKM, Norah
2018

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The Inclusion for All program, funded by the Norwegian Agency for Development Cooperation (NORAD) and implemented by Save the Children and its partners, seeks to increase the access of children with disabilities (CwD) to quality education and to strengthen child rights in the Occupied Palestinian Territories (OPT). The program works with children, parents, teachers, counselors, and principals at 30 public, UNRWA, and private schools in the West Bank, Jerusalem, and Gaza, since 2015. In addition, the program supports full inclusion of CwD in education and child rights governance through extracurricular activities run by a host of partner organizations and promotes policies and mechanisms that support such inclusion and child rights. This review of the Inclusion for All program, completed between February and May 2018, utilizes previously-collected quantitative data, in addition to data from focus group discussions and interviews with children, parents, teachers, counselors, principals, policymakers, and program implementers and observations of program activities.

The implications of ensuring equal access and inclusion of persons with intellectual disabilities and mental health issues in disaster risk reduction and humanitarian action. A rapid literature review conducted for NAD by EENET

EENET
December 2017

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This literature review seeks to gain a better understanding of the particular challenges faced by people with intellectual disabilities and those with mental health issues in Palestine and the refugee settings in Lebanon. An overview of the Palestine and Lebanon contexts is presented. Mental health and intellectual disability in situations of risk and the disproportionate impacts are discussed.  Access to and inclusion in disaster risk reduction (DRR) and humanitarian response are also discussed.

Social inclusion and mental health of children with physical disabilities in Gaza, Palestine

NASSER, Khaled
MACLACHLAN, Malcolm
MCVEIGH, Joanne
2016

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Purpose: Social inclusion of children with physical disabilities is essential for their mental health. The long-standing conflict and political instability in Palestine since 1948 has resulted in an unprecedented number of children with disabilities. This study aimed to assess social inclusion and mental health of children with physical disabilities in Palestine.

 

Method: A mixed methods research design was used. The 12-item General Health Questionnaire and a Social Inclusion Questionnaire were administered to 100 children with amputations, 12-18 years of age, in the Gaza Strip. Ten semi-structured interviews were also conducted with personnel working across civil society rehabilitation services in the area, particularly in services that focussed on the physical rehabilitation of children who had lost a limb.

 

Results: Quantitative findings indicated that 88% of children’s disabilities were caused by war-related incidents. While the sample of children showed on average relatively low levels of psychological distress, males reported feeling more socially included and having better mental health than did females. Furthermore, there was a strong positive correlation between mental health and social inclusion, and a moderate positive correlation between psychological distress and social inclusion. The qualitative data identified different factors that hinder social inclusion, mainly: political instability; under-resourced disability organisations; lack of coordinated efforts; and negative societal attitudes towards disability.

 

Conclusion: A new questionnaire for social inclusion was developed, which can now be used as a tool to assess social inclusion in similar contexts; as well as a culturally-adapted form of the General Health Questionnaire-12 to assess mental health. There is a clear need for service-providers to move beyond a medical model of care to one that embraces community-based rehabilitation and the realisation of rights, in order to promote the social inclusion and mental health of children with disabilities in Palestinian society.

Enabling education review, issue 4

ENABLING EDUCATION NETWORK
December 2015

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This newsletter contains a variety of articles about inclusive education in several countries around the world. The topics focus mostly on funding, managing and sustaining inclusive education; engaging and empowering beneficiaries in finding solutions; facilitating parental and child involvement and early childhood education

Enabling Education Review, issue 4

Disability under occupation : at the congruence between conflict, religion, & society in Palestine

RASHID, Omar
January 2015

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A dissertation on the Palestinian experience of disability under Israeli territorial occupation. The following key research questions were considered under this dissertation. "First, to locate the perceptions of disability among the disabled in the occupied territories of Palestine, in light of their religious affiliation. Second, to investigate the realities of the disabled within Palestine; and third, to enquire as to whether there had been any differences in the perceptions of disabilities and the realities of those who were injured in conflict, and those who were born with impairment" These questions were answered through a hybrid-methods system of research, with a mix of qualitative and quantitative methods being used

 

Dissertation submitted in part fulfilment of the requirements for a Masters degree at the University of Birmingham

The user has given permission for the original dissertation document to be uploaded to be reproduced and made publicly available on the Source website

Equal right, equal opportunity – Inclusive education for children with disabilities

WALKER, Jo
2013

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This report synthesises current evidence on the policy responses which can help bring down the common barriers faced by disabled children in gaining a quality education, across seven inter-dependent strategies – from the family, local communities and national government, through to the international community. 

 

The strategies are: create appropriate legislative frameworks, and set out ambitious national plans for inclusion; provide the capacity, resources and leadership to implement ambitious national plans on inclusion; improve data on disability and education, and build accountability for action; make schools and classrooms accessible and relevant for all; ensure there are enough appropriately trained teachers for all; challenge attitudes which reinforce and sustain discrimination; create an enabling environment to support inclusive education, including through cross-sectoral policies and strategies that reduce exclusion.

 

Actions to be taken by national governments to achieve these strategies are presented.

 

Case studies in India, Italy, Ethopia, Bolivia, Bangladesh, Mozambique, Gambia, Burkino Faso and Palestine are provided.

 

 

Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey

EL ESSI, K
EL-SHAFIE, J M
AL HAWAMDAH, Z
ZAQOUT, S I
2012

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Shoulder pain among paraplegic persons has negative effects on their lives. The prevalence of shoulder pain among persons with spinal cord injury (SCI) varies from 30% to 70% in different studies and may be related to repetitive use of the shoulder during self-care and wheelchair-related activities.

 

Purpose: This study focused on the prevalence of shoulder pain and examined its effects on activities of daily living and social participation, and on functional, work and recreational or athletic activities. It also aimed to detect the degree ofsatisfaction with shoulder functioning in wheelchair users who were paraplegic due to spinal cord injury, in the Gaza strip.

 

Methods: Cross sectional study design was used to collect data from 80 persons with paraplegia, post rehabilitation, who were still using manual wheelchairs (MWC) for ambulation. After giving informed consent, the selected persons were interviewed directly in their homes, and filled questionnaires which included demographic data, Wheelchair User’s Shoulder Pain Index (WUSPI) and Shoulder Rating Questionnaire (SRQ).

 

Results: The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Sixty four percent from among the study sample mentioned that they had no limitation in shoulder-using ability during daily personal and household activities, while the rest experienced different degrees of limitation. Seventy-four percent reported no limitation during recreational or athletic activities, while the rest (26%) agreed that pain has variably limited their participation in these activities. Fourteen percent from the sample rated the overall degree of satisfaction with their shoulder functioning as fair, and the rest rated their satisfaction from good to excellent.

 

Conclusion: Shoulder pain, ranging from mild to severe, was highly prevalent among SCI paraplegics who use MWCs during their usual activities, and other activities which involve wheelchair propulsion. About two- thirds of the subjectsreported no limitation in shoulder use during daily personal and household activities and in recreational or athletic activities.

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