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Human Rights, Social Inclusion and Health Equity in International Donors' Policies

Eide, A H
Amin, M
MacLachlan, M
Mannan, H
Schneider, M
2013

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Background: Health policies have the potential to be important instruments in achieving equity in health. A framework – EquiFrame - for assessing the extent to which health policies promote equity was used to perform an equity audit of the health policies of three international aid organizations.

 

Objective: To assess the extent to which social inclusion and human rights feature in the health policies of DFID (UK), Irish Aid, and NORAD (Norway).

 

Method: EquiFrame provides a tool for analyzing equity and quality of health policies with regards to social inclusion and human rights. Each health policy was analyzed with regards to the frequency and content of a predefined set ofVulnerable Groups and Core Concepts.

 

Results: The three policies vary but are all relatively weak with regards to social inclusion and human rights issues as defined in EquiFrame. The needs and rights of vulnerable groups for adequate health services are largely not addressed.

 

Conclusion: In order to enhance a social inclusion and human rights perspective that will promote equity in health through more equitable health policies, it is suggested that EquiFrame can be used to guide the revision and development of the health policies of international organizations, aid agencies and bilateral donors in the future.

 

Limitations: Analyses are limited to “policy on the books” and does not measure how effectively vulnerable groups are included in mainstream health policy work.

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.

A manual for CBR planners

THOMAS, Maya
THOMAS, M J
Eds
2003

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This manual for community-based rehabilitation planners has 13 sections and contains a very useful overview of the history of CBR with valuable introductory reading for newcomers to the field. The subsequent six sections cover planning, needs assessment and include suggestions of how to understand local communities and encourage community participation in CBR programmes. The final six sections are concerned with programme management issues; for example, as organising self-help groups, training personnel for CBR, and the sustainability of projects including evaluation and management of change

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