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Factors that influence doctors in the assessment of applicants for disability grant

TUMBO, JM
2014

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Background: A disability grant is the financial assistance given by the government to South African citizens and bona fide refugees who have debility that results in inability to work. Doctors in state hospitals and clinics are tasked with the duty of assessing applicants for this grant. Ideally, the assessment is done by an institutional committee consisting of a doctor, physiotherapist, social worker, occupational therapist and specialised nurses. However, this is not always the case because of a shortage of personnel, particularly in rural areas. A lack of clear guidelines for the assessment process has led to confusion and differences in the outcomes. This poses major problems for the doctors, as well as the applicants, who often are dependent on the grant for survival. The aim of this study was to explore the factors that influence doctors in the assessment of applicants for a disability grant.

 

Methods: A qualitative study using free attitude interviews was conducted amongst doctors involved in the assessment process in Limpopo province. Content analysis was used to identify themes from the interviews.

 

Results: The assessment process was not entirely objective and was influenced by subjective factors. These included the mood of the doctors, emotions such as anger and sympathy, and feelings of desperation. Perceptions by the doctors regarding abuse of the system, abuse of the grant, the inappropriateness of the task, lack of clear guidelines and the usefulness of the committees were important in decision making. The doctors’ personal life experiences were a major determinant of the outcome of the application.

 

Conclusion: The assessment of applicants for a disability grant is a subjective and emotional task. There is need for policy makers to appreciate the difficulties inherent in the current medicalised process. Demedicalisation of certain aspects of disability assessment and other social needs that doctors do not view as a purely clinical functions is necessary. In addition, there is a need for clear, uniform policy on and guidelines for the management of the grant, the role of the doctor has to be defined, healthcare practitioners must be trained in disability assessment, institutional committees should be established and intersectoral initiatives should be encouraged to address issues of poverty and dependence.

Victim assistance in the context of mines and explosive remnants of war

HOTTENTOT, Elke
July 2014

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This policy paper presents background information on victim assistance in the context of landmines and cluster munitions. It describes how it is rooted in two instruments of international humanitarian law and guided by the CRPD, and reviews the current situation in terms of Handicap International’s day-to-day interventions and outlines a vision of VA that is in line with their 2011 – 2015 strategy. Overall, it aims to contribute to a common position and coherent communication on VA among Handicap International staff, whether at the operational, advocacy, communication or campaigning level and to instigate new ways of operating in order to capitalize on the opportunity presented by VA at this point in time
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Included as excluded and excluded as included: minority language pupils in Norwegian inclusion policy

TORBJØRNSEN, Hilt Line
2014

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This article offers an analysis of four Norwegian policy documents on inclusion of minority language pupils. The main concepts of this policy will be reconstructed and re-described, applying Niklas Luhmann’s systems theory at different levels of the analysis. Luhmann’s theory about society as a conglomerate of self- referential social systems investigates how these systems construct meaning and what consequences these constructions have for inclusion and exclusion processes. This article will focus on the Norwegian educational policy towards minority language pupils, defined by the policy as pupils who have a different mother tongue than Norwegian and Sami language. It is argued that this inclusion policy is excluding in its social form, and that it exhibits an increased emphasis on education when it comes to inclusion in society. Re-descriptions based on logic of forms will show how binary distinctions such as ‘inclusion/ exclusion’, ‘majority language pupil/minority language pupil’ and ‘early intervention/wait and see’ emerge in the timespan of 2004–2012. Based on this, it is claimed that descriptions of inclusion and exclusion are mutually constituted in the policy, thus giving rise to the question of whether the policy goal – ‘full’ inclusion in society – is realisable. A paradox will be uncovered: minority language pupils are being included as excluded as well as excluded as included in the documents, displaying how inclusion and exclusion are two sides of the same coin. The strategy early intervention is introduced to remedy exclusions, thus converting the problem of inclusion into a problem of time.

Hidden victims of the Syria crisis : disabled, injured and older refugees

HELPAGE INTERNATIONAL
HANDICAP INTERNATIONAL
April 2014

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This report presents research undertaken to highlight the number and needs of Syrian refugees in Jordan and Lebanon living with impairment, injury and chronic disease – for the purposes of this study these groups are referred to as “people with specific needs”. Throughout the report specific consideration is given to the position of older people with specific needs. Due to access and security constraints it was not possible to collect data in Syria itself, however it is recognised that the needs of refugees identified in the following report will be reflected within Syria, and that in this more extreme humanitarian situation the issues outlined below demand further consideration and response

Research & humanities in medical education (RHiME)

DHALIWAL, Upreet
et al
March 2014

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Research and Humanities in Medical Education (RHiME) is an open access, peer-reviewed online journal with the vision to blend humanities with the sciences in medical education. It aims to encourage contributions from and discussion between teachers and students, doctors and patients, the sick and their care-providers, and between health policy makers and policy users

India’s Disability Policy – Analysis of Core Concepts of Human Rights

O'DOWD, J
MANNAN, H
MCVEIGH, J
2014

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Purpose: To analyse India’s National Policy for Persons with Disabilities (2006), using a Human Rights approach.

 

Method: A framework analysis was carried out using EquiFrame, which analyses policies for inclusion and quality of Core Concepts of Human Rights and inclusion of Vulnerable Groups.

 

Results: India’s National Policy for Persons with Disabilities scored 67% for Core Concept Coverage, 24% for Core Concept Quality and 42% for Vulnerable Group Coverage. This gave the policy an overall ranking of Low quality.

 

Conclusions: The current policy for persons living with disabilities in India would benefit from being updated to encompass the Core Concepts of Human Rights.

Send all my friends to school : a global campaign for education UK evaluation of UK’s aid to education for children with disabilities

NOCK, Stephen
DAVIS, Warren
Eds
2014

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This report reveals a major gap between DFID’s inclusive education policy and practice, with weak implementation, as a result of a lack of resources and capacity. GCE UK’s report highlights that there is an urgent need for a significant increase in policy attention and resources to address the major structural and social barriers that children with disabilities currently face in accessing education. It concludes by making key recommendations.  It finds that the issue needs much greater prioritisation within DFID, and that there is an urgent need for DFID to develop a systematic approach towards the issue, both directly within its education portfolio, and by mainstreaming the issue across other areas of DFID operations. It recommends that it is critical that DFID works to embed disability throughout its development programmes to achieve long-term change, even as governments change and key individuals move on

Childhood disability and malnutrition in Turkana Kenya : a summary report for stakeholders and policy

KISIA, James
et al
2014

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This study aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.   The report is intended for stakeholders to inform policy

Research summary : childhood disability and malnutrition in Turkana Kenya

KISIA, James
et al
2014

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This report summarises a study that aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.  The report is intended for stakeholders to inform policy 

Applied research on disability in Africa : the Maghreb and West Africa report

BENKIRANE, Wassila
ZOUHAIRI, Abdellah
2014

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“This literature review concerns the achievements of a project which started in 2014 and will last three years. The aim of this project is the dissemination and promotion of applied research results and disability to researchers and field stakeholders of the African continent (particularly to Disabled People Organizations), in order to increase knowledge on the situation of people with disabilities and the recommendations made to improve their social participation… The mapping of applied research in West African countries shows the exclusion related to the environment, which lacks the school, health, and sports infrastructure required to promote their [people with disabilities] rights. We will mainly deal with the issue of exclusion and its multidimensional aspect in West Africa, as well as the institutional efforts to set up development plans for people with disabilities in these regions”

Facilitating disability inclusion in poverty reduction processes: Group consensus perspectives from disability stakeholders in Uganda, Malawi, Ethiopia, and Sierra Leone

MACLACHLAN, Malcolm
MJI, Gubela
CHATAIKA, Tsitsi
WAZAKILI, Margaret
DUBE, Andrew K
MULUMBA, Moses
MASSAH, Boniface
WAKENE, Dagnachew
KALLON, Frank
MAUGHAN, Marcella
2014

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This paper addresses the challenge of how to get disability on the development agenda in four African countries. We explored perceptions of what initiatives would most help in achieving disability inclusion in Poverty Reduction Strategy Papers (PRSPs), and identified factors that can either promote or hinder these initiatives. Stakeholders from Disabled People’s Organisations (DPOs), other civil society organisations (CSOs), development agencies, researchers and government ministries, participated in the Nominal Group Technique and Force Field Analysis procedures across Malawi, Ethiopia, Uganda and Sierra Leone. While each country had specific contextual factors, common ideas for promoting greater disability inclusion in PRSPs focused on policy action, the need for a stronger evidence-base, mechanisms for directly influencing the PRSP process, as well as strengthening central government and DPOs’ capacity in this regard. Common facilitators for these actions were seen as the existence of a national disability umbrella body, disability-specific legislation, named Ministries for Disability, ratification of the UN Convention on the Rights of Persons with Disabilities (UNCRPD), and the fact that disability was already mentioned (albeit inadequately) in some PRSPs. Common inhibitors included negative attitudes towards disability, poor capacity in DPOs and government ministries, poor policy implementation, little ‘domestication’ of the UNCRPD, little political will or consultation with people with disabilities, as well as aggregating disability with other vulnerable groups, a lack of research in the area and poor coordination between DPOs.

 

Disability and the Global South (DGS), 2014, Vol. 1 No. 1

Youth with disabilities in law and civil society: Exclusion and inclusion in public policy and NGO networks in Cambodia and Indonesia

MEYERS, Stephen
KARR, Valerie
PINEDA, Victor
2014

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Youth with disabilities, as a subgroup of both persons with disabilities and of youth, are often left out of both legislation and advocacy networks. One step towards addressing the needs of youth with disabilities is to look at their inclusion in both the law and civil society in various national contexts. This article, which is descriptive in nature, presents research findings from an analysis of public policy and legislation and qualitative data drawn from interviews, focus group discussions, and site visits conducted on civil society organizations working in Phnom Penh, Cambodia and Jakarta, Indonesia. Data was collected during two separate research visits in the Spring and Summer of 2011 as a part of a larger study measuring youth empowerment. Key findings indicate that youth with disabilities are underrepresented in both mainstream youth and mainstream disability advocacy organizations and networks and are rarely mentioned in either youth or disability laws. This has left young women and men with disabilities in a particularly vulnerable place, often without the means of advancing their interests nor the specification of how new rights or public initiatives should address their transition to adulthood.

 

Disability and the Global South (DGS), 2014, Vol. 1 No. 1

Globalizing psychiatry and the case of ‘vanishing’ alternatives in a neo- colonial state

DAVAR, Bhargavi
2014

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Analysing ‘modernity’ in India is a complex exercise, as the movement of the ‘modern’ is locally determined and may be non-linear at different sites and contexts. General medicine and psychiatry are illustrative of the difference in how ‘patienthood’ has been historically constructed, with each wave of ‘modernisation’ changing the subjecthood of the ‘mentally ill’. Unlike the public health sector in India, the mental health sector is driven by the ‘mental asylum’ archetype, continuing through late colonial times into contemporary science in refurbished designs. A related set of changes also concomitantly happened in the domain of indigenous healing, with each epistemic shift pushing this domain to the margins of knowledge and healing practice. The paper is set against the time period covering 1850s until recently (2014).

 

Disability and the Global South, 2014, Vol. 1 No. 2

Nonparametric estimation of a compensating variation : the cost of disability

HANCOCK, Ruth
MORCIANO, Marcello
PUDNEY, Stephen
December 2013

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This paper proposes a nonparametric matching approach to estimation of implicit costs based on the compensating variation (CV) principle. The paper aims to introduce the matching approach, compare its properties with those of the conventional indirect parametric approach, and demonstrate its application in an important policy area. The authors apply the method to estimate the additional personal costs experienced by disabled older people in Great Britain, finding that those costs are substantial, averaging in the range £48-61 a week, compared with the mean level of state disability benefit (£28) or total public support (£47) received. Estimated costs rise strongly with the severity of disability. The authors compare the nonparametric approach with the standard parametric method, finding that the latter tends to generate large overestimates unless conditions are ideal, and recommend the nonparametric approach

ISER Working Paper Series, No. 2013-26

Sustainable development in an ageing world : a call to UN member states on the development agenda beyond 2015

HELPAGE INTERNATIONAL
AARP OFFICE OF INTERNATIONAL AFFAIRS
INTERNATIONAL FEDERATION ON AGING
September 2013

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This paper responds to UN discourse and highlights that the post-2015 development framework should be inclusive of older people along with others and address the rights and needs of people of all ages. It provides recommendations to the UN Member States with regard to ageing and the post 2015 agenda

Policy implementation in wheelchair service delivery in a rural South African setting

VISAGIE, Surona
SCHEFFLER, Elsje
SCHNEIDER, Marguerite
2013

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Background: Wheelchairs allow users to realise basic human rights and improved quality of life. South African and international documents guide rehabilitation service delivery and thus the provision of wheelchairs. Evidence indicates that rehabilitation policy implementation gaps exist in rural South Africa.

 

Objectives: The aim of this article was to explore the extent to which wheelchair service delivery in a rural, remote area of South Africa was aligned with the South African National Guidelines on Provision of Assistive Devices, The United Nations Convention on the Rights of Persons with Disabilities and The World Health Organization Guidelines on Provision of Wheelchairs in Less-Resourced Settings.

 

Method: Qualitative methods were used. Data were collected through semi-structured interviews with 22 participants who were identified through purposive sampling. Content analysis of data was preformed around the construct of wheelchair service delivery.

 

Results: Study findings identified gaps between the guiding documents and wheelchair service delivery. Areas where gaps were identified included service aspects such as referral, assessment, prescription, user and provider training, follow up, maintenance and repair as well as management aspects such as staff support, budget and monitoring. Positive findings related to individual assessments, enthusiastic and caring staff and the provision of wheelchairs at no cost.

 

Conclusion: The gaps in policy implementation can have a negative impact on users and the service provider. Inappropriate or no wheelchairs limit user function, participation and quality of life. In addition, an inappropriate wheelchair will have a shorter lifespan, requiring frequent repairs and replacements with cost implications for the service provider.

Parent peer advocacy, information and refusing disability discourses

BELL, M
FITZGERALD, R
LEGGE, M
2013

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Parent peer advocacy is a distinct type of empowering relationship practised in Parent to Parent New Zealand that shares experiential knowledge gained from raising a child with disability, chronic illness or special needs and draws on both partnership and participation ideals of support. This support organisation matches families with impairment, illness and genetic difference in light of issues they encounter as families with disability. In this paper we discuss disabling historical contexts countered by the provision of information as advocacy, ambivalence towards difference in the organisation, and the rise in prospective parents seeking parent peer support. These thematic areas allow us to create an analytical framework to be used in the next phase of an empirical study with Parent to Parent New Zealand.

Exploring Knowledge and Attitudes towards HIV/AIDS among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.

 

Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.

 

Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.

 

Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.

What are the impacts of approaches to increase the accessibility to education for people with a disability across developed and developing countries and what is known about the cost-effectiveness of different approaches?

BAKHSHI, Parul
KETT, Maria
OLIVER, Kathryn
June 2013

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This study presents a mapping of existing evidence that provides information about the impact of initiatives that provide education for children with disabilities, and also identifies any studies that provide an analysis about the cost-effectiveness of existing initiatives. It is useful for policymakers, researchers, practitioners, parents of children with disabilities and the children themselves

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