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Accessible Sanitation in the Workplace – Important Considerations for Disability-Inclusive Employment in Nigeria and Bangladesh

Stephen Thompson
Rasak Adekoya
Utpal Mallick
Omojo Adaji
Abdur Rakib
Mark Carew
January 2022

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This paper explores the relationship between accessible sanitation and disability-inclusive employment in Bangladesh and Nigeria. Both countries have sanitation and hygiene challenges as well as disability-inclusive employment challenges, but the existing evidence on the intersection of these issues that is focused on Nigeria and Bangladesh is extremely limited. Building on the literature where this complex issue is addressed, this paper presents the findings of a qualitative pilot study undertaken in Nigeria and Bangladesh. It focuses on the need for toilets at work that are easy for people with disabilities to use in poor countries. These are sometimes called accessible toilets. Accessible sanitation is not regarded as a challenge that must be addressed by people with disabilities themselves, but as a challenge that must be addressed by many people working together – including governments, employers, and the community.

A disability inclusive response to COVID-19 - four lessons learned about including people with disabilities in humanitarian aid

MORRIS, Lisa
ELLIOTT, Chris
PIERI, Susan
September 2021

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Inclusive Futures played a crucial role in supporting some of the most marginalised people with disabilities in Bangladesh, Kenya, Nepal, Nigeria, and Tanzania during the COVID-19 pandemic. This paper summarises what we learned and it can be used to include people with disabilities in future programming, particularly in contexts at risk of crisis.

Learning Paper – Inclusive Sports for Development Project

NEUPANE, Sudarshan
JALAL, Faruk Ahmed
CHAKRABORTY, Ripon
Md. ISLAM, Shafiqul
PAUL, Ashok Kumar
Md. MUHIT, Mubdiul
April 2020

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Children with disabilities in Bangladesh have equal access to play, recreation and leisure, and sporting activities, including in the school system (contributing to enjoyment of article 30 5.d of UNCRPD).

Cost-effectiveness of a Community-based Rehabilitation Programme in Nepal

Vaughan, Kelsey
Thapa, Aradhana
2016

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Purpose: This study aimed to estimate the cost-effectiveness of a community- based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology to estimate the programme’s achievements and cost-effectiveness.

 

Methods: Financial records were reviewed to determine total expenditure during the period August 2011 - December 2013. Programme records which documented the physical, mental and social status of children and adults with a disability qualitatively before, during and after the intervention were used to determine a starting disability weight and improvement score, which was then converted into a change in disability weight. The disability weight and expected remaining lifespan of each person were used to estimate disability-adjusted life years (DALYs) averted by the intervention. The cost per DALY averted was estimated by dividing the total programme expenditure by the sum of DALYs averted over that same period.

 

Results: I2C cost 204,823 Euros to implement over the period August 2011- December 2013. In total, an estimated 1,065 DALYs were averted from the treatment and rehabilitation components. The cost per DALY averted was 192.34 Euros.

 

Conclusions and Implications: The methodology devised for the study was able to successfully estimate the cost-effectiveness of the I2C programme. Using WHO benchmarks, this programme can be considered highly cost-effective. Other organisations can assess the cost-effectiveness of their programmes by using the assessment improvement score and subsequent conversion to DALYs averted. However, while mental, physical and social gains have been captured, other benefits from I2C cannot be captured in the cost per DALY averted statistic. Further research is needed to develop methods for incorporating these harder-to- measure gains in cost-effectiveness studies with a single outcome measure like the DALY.

Participatory Monitoring of Community-Based Rehabilitation and other Disability- Inclusive Development Programmes: the Development of a Manual and Menu

Madden, Rosamond H
et al
2016

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Purpose: This paper describes a three-year research project leading to the development of the CBR Monitoring Manual and Menu (MM&M). The MM&M is a practical toolkit that meets the needs of CBR managers and stakeholders, and is consistent with the philosophy of CBR and community- based disability-inclusive development. It is designed to produce meaningful and locally useful information and data, based on international data standards where possible, to enable aggregation at regional, national and international levels.

 

Methods: Five complementary workstreams of research were carried out from 2011 to 2014: 1) literature review and analysis; 2) participatory action research with CBR stakeholders; 3) analysis and refinement of validity of concepts andstructures; 4) consultation and review; and 5) synthesis of results. This article documents the method and key results of each of the five workstreams, and the lessons learned along the way.

 

Results: The MM&M is now freely available on-line at thttp://sydney.edu. au/health-sciences/cdrp/projects/cbr-monitoring.shtml. Collaboration among members of the development team continues, chiefly via an on-line group to which new members have been welcomed.

 

Conclusion and Implications: At the time of writing, the MM&M is the only international monitoring product, known to the authors, that consciously sets out to reflect both a ‘bottom- up’ and ‘top-down’ perspective of monitoring information and data.To achieve this for a complex programme such as CBR, and to align with its principles, it was essential to use a multi-component and multi-stage strategy for tool development, involving a diverse multidisciplinary team including collaboration with CBR stakeholders.

Disability, poverty, and livelihoods guide : guidance from Trickle Up

SANSON, Jo
FELIX, Michael
November 2013

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"This guide is intended to encourage and assist organizations seeking to include people with disabilities in their economic strengthening and livelihood programs. It contains lessons for organizations that aim to move households out of poverty, [and] those that seek to economically and socially empower particularly vulnerable members of poor household"

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.

Sustainability Criteria for CBR Programmes – Two Case studies of Provincial Programmes in Vietnam

MIJNARENDS, Donja M
PHAM, D
SWAANS, Kees
VAN BRAKEL, W H
WRIGHT, Pamela
2011

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Purpose: This paper aims to explore the conditions needed for sustainable community based rehabilitation (CBR) programmes for persons with disabilities in Vietnam, and to identify the conditions and opportunities missing at present for the implementation of such programmes.

 

Method: Two CBR programmes in Vietnam, one medical based and one comprehensive (medical, educational, livelihood, social and empowerment), were evaluated for requirements and the current situation. Four factors were taken into account - human resources, organisational setting, social and political environment, and financing. Data were collected through interviews with programme managers and focus groups with stakeholders from provincial, district and communal levels, and with persons with disabilities. Persons with disabilities also completed a questionnaire to evaluate their satisfaction with the programme and their involvement in it.

 

Results: The conditions needed for a sustainable CBR programme were identified: availability of human resources, training, monitoring and evaluation, collaboration, commitment and financing. The conditions missing at present were: a stable pool of human resources (in both programmes), collaboration between sectors and with local authorities (in the medical programme), and knowledge about how to maintain financing (in both programmes). Persons with disabilities were more satisfied with their involvement in the comprehensive programme than in the medical programme. Stakeholders proposed opportunities to increase sustainability; highest priority was given to a collaboration plan (comprehensive CBR programme) and to involvement of other sectors in the CBR Steering Committee (medical CBR programme).

 

Conclusions: Few differences were found in conditions needed for sustainability of the medical and comprehensive programmes. The existence of disabled persons’ organisations (DPOs) seemed to be associated with the level of satisfaction persons with disabilities felt with their involvement in the programme.

 

Limitations: The People’s Committee was not involved in this research, although their input was perceived to be important. Generalisation of the results of this study should be done with caution because health system structures and organisational levels of CBR differ.

National institutional frameworks and human rights of persons with disabilities

DEPARTMENT FOR ECONOMIC AND SOCIAL AFFAIRS (DESA), UNITED NATIONS
August 2006

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This resource compares national disability institutions and frameworks in Australia, Sweden, India, Guatemala and the UK. It aims to: identify the core institutions concerned with disability rights and describe how they were established; review the legislative framework; and examine the organisational structure, mandates and activities of the states’ monitoring institution/s

Identifying disability issues related to poverty reduction : India country study

FOUNDATION FOR INTERNATIONAL TRAINING
2005

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This country report describes the situation of disabled people in India. It gives an overview about the country, reviews the legislation, describes disability organisations and development agencies and lays out the results of a participatory programme. In addition to this, the report analyses the connections between disability and poverty by reviewing the current programmes and showing the gaps. The recommendations of the report urge to pay special attention to activities in the fields of inclusion, participation, access and quality

Open source in developing countries

WEERAWARANA, Sanjiva
WEERATUNGA, Jivaka
2004

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This study discusses the history of open source, how open source works, and why developers contribute to open source. After examining open source markets and business models, it presents a strategy framework and strategy map for developing countries to go down the open source path. Finally, it presents a classification of the current status of developing countries in relation to its IT policy and infrastructure and how a donor agency can assist in exploiting open source to create value in the economy. A case study of Sri Lanka illustrares how the donor action plan, strategy implementation and strategy map all tie together

Disability, equality and human rights : a training manual for development and humanitarian organisations

HARRIS, Alison
ENFIELD, Sue
2003

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This manual is based on Oxfam's experience working with local disabled people's organisations before, during and after the recent crisis in Kosovo. Case studies from West Africa and South and East Asia also show how the principles and training can be translated to a wide range of political and social contexts. It suggests practical materials useful for trainers working in geographically isolated areas without access to sophisticated equipment. Most of the activities and exercises can be adapted for use in groups of people with a wide range of impairments and educational levels. The text is written in clear and simple language

Biwako millennium framework for action towards an inclusive, barrier-free and rights-based society for persons with disabilities in Asia and the Pacific

UNITED NATIONS ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC (UNESCAP)
January 2003

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Provides information on the Biwako Framework that was adopted in 2002. The document sets out a draft regional framework for action that provides regional policy recommendations for action by governments in the region and concerned stakeholders to achieve an inclusive, barrier-free and rights-based society for disabled people. The regional framework for action explicitly incorporates the millennium development goals and their relevant targets to ensure that concerns relating to disabled people become an integral part of efforts to achieve the goals

Understanding community approaches to handicap in development (CAHD)

KREFTING, Douglas
March 2001

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This document, part of the Handicap and Development Collection, introduces an expanded concept of community-based rehabilitation (CBR) called CAHD (community approaches to handicap in development). It is aimed at CBR planners, policy-makers and managers. CAHD aims to develop two-way relationships within communities to change attitudes so that community practices will include disabled persons and provide them with services and assistance

Communications framework for HIV/AIDS : a new direction

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
1999

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This framework, the product of a participatory research project on the use of communications for HIV prevention, finds conventional communications that focus on behaviour change limited in their scope and effectiveness. It questions the relationship between knowledge and behaviour, and the stress in ‘behaviour change’ communication on individual change. For sustainable change, the influence of a number of domains of social context need to be addressed, including: political and policy frameworks, gender, socio-economic status, spirituality and religion, and culture. It builds on these domains to create broad regional strategies for communications in Asia, Africa and Latin America and the Caribbean. Its suggestions for future national strategies combine interpersonal communication and mass media in key areas of HIV/AIDS prevention and care. It stipulates that participatory processes are central to designing and operationalising national strategies

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