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Prevalence, types, and combinations of multiple problems among recipients of work disability benefits

BRONGERS, Kor A
HOEKSTRA, Tialda
ROELOFS, Pepijn D D M
BROUWER, Sandra
2021

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Purpose: For persons on disability benefits who are facing multiple problems, active labour market poli- cies seem less successful. Besides health problems, these people perceive personal, social, and environ- mental problems. Since very little is known about these “non-medical” problems our aim was to explore the prevalence of clients experiencing multiple problems, the types and number of perceived problems, combinations of perceived problems, and associated characteristics in a group of work disability benefit recipients.

 

Methods: We performed a cross-sectional study, using self-reported data on perceived problems and socio-demographics, and register data from the Dutch Social Security Institute on diagnosed diseases and employment status. A convenient group of labour experts recruited eligible clients on work disability benefit.

 

Results: Of the 207 persons on work disability benefit, 87% perceived having multiple problems. Most reported problems were related to physical (76%) or mental (76%) health. Health problems most fre- quently occurred together with a mismatch in education, financial problems, or care for family members. Clients with lower education experienced significantly more problems than clients with an intermediate or high educational level.

 

Conclusions: Clients with multiple problems face severe and intertwined problems in different domains of life, and need tailored multi-actor work disability management.

How targeting mechanisms can identify people with disabilities for inclusion in social protection programmes

SAMMON, Elayn
CARRARO, Ludovico
COTE, Alexandre
ZEVENBERGEN, Stacey
HOLMES, Rebecca
March 2021

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Developed by Social Protection Approaches to COVID-19: Expert Advice (SPACE) in collaboration with the UNPRPD joint program on inclusive Social Protection, the UNPRPD global initiative on COVID 19 inclusive response and recovery, and Humanity & Inclusion.

The COVID-19 pandemic has demonstrated that countries which have disability identification mechanisms and registries already in place have been in a better position to provide fast relief and expand shock responsive support to persons with disabilities and their families. 

This guidance note includes:

  • Brief introduction to the definitions and terminology surrounding disability and the concept of inclusive social protection
  • Summary of the rationale for the inclusion of persons with disability in social protection programming
  • Examples for overcoming the challenges for outreach, identification, and registration, and needs assessment
  • Some country examples
  • Overall implications for future programming.

Action on COVID-19 Evidence on the Response of Disabled People’s Organisations during Pandemic

ADD International
October 2020

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In June 2020, ADD International conducted structured interviews with leaders from ten Disabled People’s Organisations (DPOs) which are participating in the Inclusion Works programme in three districts in Bangladesh to understand impact of and response to Covid-19 among DPOs.

 

Evidence from these interviews suggest that the economic impact of Covid-19 on persons with disabilities has been acute, and DPOs are taking critical action. DPOs are engaging with power holders to make relief, livelihood support and information accessible to persons with disabilities. DPOs are in touch with their members, but they face barriers in doing their work during this time, and more could be done to reach the most excluded.

The impact of Covid-19 on people with disabilities – emerging findings

ROHWERDER, Brigitte
THOMPSON, Stephen
WICKENDEN, Mary
WAKOKO, Eric
AKTER, Fatema
NJUNGI, Josephine
CHUBA-UZO, Shadrach
September 2020

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Emerging evidence suggests that people with disabilities are amongst the groups most affected by the COVID-19 pandemic in all aspects of their lives. In order to provide more systematic evidence, narrative interviews were conducted with a diverse group of 40 jobseekers with disabilities in Bangladesh, Kenya, Nigeria, and Uganda who are involved with the Inclusion Works programme. The first round of interviews were conducted in July and August 2020. Initial key findings are given.

 

Pivoting to inclusion : Leveraging lessons from the COVID-19 crisis for learners with disabilities

McCLAIN-NHALPO,Charlotte Vuyiswa
KULBIR SINGH,Ruchi
MARTIN,Anna Hill
et al
August 2020

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As governments respond to the Coronavirus 2019 (COVID-19) pandemic, the global community must ensure that persons with disabilities are included. This will require disability inclusion to be considered in all interconnected sectors; education, health, social protection, and inclusion from the planning stage all the way through to delivery and recovery efforts that are inclusive of all and are sufficiently differentiated to meet the specific needs of children with disabilities. The issues paper focuses on the following objectives: (1) addressing education, social needs, barriers, and issues for learners with disabilities at a global, regional, and country-level during the COVID-19 crisis; and (2) recommending practices for education and social inclusion, and reasonable accommodations utilizing the twin track approach and principles of universal design for learning.

Covid-19 Double Jeopardy for Persons with Disability

ADD International
August 2020

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SUMMARY

This report presents the findings from telephone interviews with 91 representatives from 15 Disabled People’s Organisation (DPO) partners in Bangladesh, to ask about the impact of the Covid-19 pandemic on persons with disabilities in Bangladesh.

The report finds that, in the Covid-19 pandemic, some persons with disabilities experience double jeopardy—not only are persons with disabilities disproportionately impacted by the pandemic, but they are also disproportionately excluded from protection and survival support.

Persons with disabilities report being disproportionately excluded from Covid-19 support. 63% of respondents report not receiving the same protection and survival support as others. Two-thirds of those who described their personal experiences reported supply shortage or diversion of essential food and medical supplies as reasons for why they had been excluded.

Relief that has been provided has not met need. Many respondents (84%) report that survival support does not meet their basic needs. Support received has mostly been food instead of cash. Some (17%) report difficulty in following Covid-19 advice, mostly because they cannot afford protection materials.

Persons with multiple disabilities are being left further behind. Respondents with multiple functional difficulties experience more exclusion than respondents with one functional difficulty. This finding of disproportionate exclusion is statistically significant and consistent with qualitative responses, which show that most of those that did report challenges in following received advice were persons with multiple functional difficulties. This strongly suggests that persons with multiple functional difficulties experience more barriers. Persons with multiple functional difficulties who were excluded tended to report difficulties in communicating, remembering, self-care and walking.

The economic impact of the pandemic is acute for persons with disabilities. On average, respondents report losing 65% of their income since the Covid-19 crisis began, which in absolute terms, after adjusting for purchase power parity, is the equivalent of moving from £167 to £58 in monthly earnings.

Some respondents report that they are skipping meals and going hungry. Anecdotal reports reveal that families are reverting to one main meal every two days, or two main meals every three days. Many are borrowing and relying on family support to meet their daily needs to survive, and some of those who already depended on family support have had that support reduced or withdrawn. On balance, future plans reflect a sense of precarity due to uncertainty, ranging from feelings of hope with specific plans to powerlessness with no plans.

Government can do more. Many respondents said government should prioritise persons with disabilities and provide more relief. Many voiced concerns about how relief was being distributed or stolen, and that it is not reaching those most in need. The majority of respondents said that NGOs and wealthy people should play a role in support efforts.

Disability Inclusive Development - Kenya Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Kenya?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Kenya. It will be helpful for anyone interested in disability inclusion in Kenya, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Disability Inclusive Development - Nepal Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nepal?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nepal. It will be helpful for anyone interested in disability inclusion in Nepal, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Disability Inclusive Development - Tanzania Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Tanzania?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Tanzania. It will be helpful for anyone interested in disability inclusion in Tanzania, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Disability Inclusive Development - Bangladesh Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Bangladesh?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Bangladesh. It will be helpful for anyone interested in disability inclusion in Bangladesh, especially in relation to stigma, employment, education, health, and humanitarian issues.

Disability Inclusive Development - Nigeria Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nigeria?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nigeria. It will be helpful for anyone interested in disability inclusion in Nigeria, especially in relation to stigma, employment, education, health, and humanitarian issues.

How can social protection responses to COVID-19 be made disability inclusive?

BANKS, Lena Morgon
HUNT, Xanthe
June 2020

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Question & problem

The COVID-19 pandemic and strategies essential for its containment are resulting in severe strains on economies, particularly in low- and middle-income countries (LMICs). These impacts will be felt most by groups already in or at risk of poverty, including the estimated 1 billion people with disabilities globally. Interventions to address the short- and long-term economic effects of the pandemic are urgently needed. Some countries have begun implementing or announced plans for interventions addressing the economic impacts of COVID-19, such as food assistance, emergency cash transfers, unemployment assistance or expansions to existing social protection programmes. As these programmes are developed, it is important to consider the extent to which their design and delivery is inclusive of people with disabilities. Failure to adequately include people with disabilities in this process will lead to widening inequalities.

COVID-19 at the intersection of gender and disability: Findings of a global human rights survey, March to April 2020

McRAE, Amanda
May 2020

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This report is based on the results of a global survey conducted in March and April 2020, targeted at the personal experiences of women, girls, non-binary, trans, and gender non-conforming persons with disabilities and COVID-19. This survey, which was intended to be primarily qualitative, asked respondents to provide narrative information about the following topics: access to health services, including sexual and reproductive health services; rationing of healthcare; personal safety and violence; access to support services to meet daily living needs; and access to education, employment, and other income. The results are based on 100 respondents. Recommendations are given.

Inclusion Counts: Disability Data Tracker. A data collection and advocacy guideline for Organisations of Persons with Disabilities. (Spotlight on adequate standard of living and social protection)

ADAMS, Lisa
2020

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This guideline is intended to be a tool for Organisations of Persons with Disabilities (OPDs) and their allies on how to advocate for the rights of persons with disabilities within the global development framework known as the Sustainable Development Goals (SDGs). The thematic focus of this guideline is on an adequate standard of living and social protection.

 

The guideline has three main parts:

  • Introduction and overview
  • Assessment tool to evaluate where your country or sub-national region is in terms of implementation of CRPD Article 28
  • Advocacy strategies to support implementation of CRPD Article 28 within the SDGs

 

The guideline also includes Annexes with further tools, resources and good practice case studies

Social insurance literacy: a scoping review on how to define and measure it

STAHL, Christian
KARLSSON, Elin A
SANDQVIST, Jan
HENSING, Gunnel
BROUWER, Sandra
FRIBERG, Emilie
MACEACHEN, Ellen
October 2019

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Purpose: Sickness insurance and workers’ compensation systems decide on peoples’ eligibility for benefits, and are commonly based on medical certificates and assessments of work ability. Systems differ in the extent to which they preserve clients’ dignity and right to fair assessments. In this article, we define a new concept for studying interactions between individuals and systems: social insurance literacy, which concerns how well people understand the different procedures and regulations in social insurance systems, and how well systems communicate with clients in order to help them understand the system.

 

Methods: The concept was defined through a scoping literature review of related concepts, a conceptual re-analysis in relation to the social insurance field, and a following workshop.

 

Results: Five related concepts were reviewed for definitions and operationalizations: health literacy, financial/economic literacy, legal capability/ability, social security literacy, and insurance literacy.

 

Conclusions: Social insurance literacy is defined as the extent to which individuals can obtain, understand and act on information in a social insurance system, related to the comprehensibility of the information provided by the system. This definition is rooted in theories from sociology, social medicine and public health. In the next step, a measure for the concept will be developed based on this review.

The concept of welfare technology in Swedish municipal eldercare

FRENNERT, Susanne
BAUDIN, Katarina
September 2019

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Purpose: An ageing population presents a challenge for municipal eldercare in Sweden due to difficulties recruiting staff and there being a strained economy. A strategy involving welfare technology is presented as one such solution. An important group to carry out this strategy involves those who work with welfare technology in municipal eldercare. In this paper we describe their perception of welfare technology, and the challenges and opportunities they perceive in utilizing it.

 

Methods: A self-administered online questionnaire was distributed to all Swedish municipalities and answered by 393 respondents. Analyses show that the respondents were representative of the different professions who work with welfare technology within municipal eldercare.

 

Results: Welfare technology was perceived as being more reliable and safer than humans with regards to supervisions and reminders. The respondents acknowledged factors that slowed down the implementation of welfare technology in municipal eldercare organizations, such as resistance to change, lack of finances, lack of supporting evidence, lack of infrastructure, high staff turnover, difficulties with procurement and uncertainties about responsibility and laws.

 

Conclusions: We found that the people who work with and make decisions about welfare technology in municipal eldercare organizations were generally very positive about the deployment and use of such technology, but there appear to be problems within municipal eldercare organizations to realize this vision. The lack of structured implementation processes and coherent evaluation models indicates inequality of the access to welfare technology and, as a result, even though Swedish eldercare is publicly funded, the availability of welfare technologies and their usage differ between municipalities.

How do we ensure that social protection assistance initiatives work for people with disabilities?

HUNT, Xanthe
August 2019

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Question & problem

Social protection systems and other financial assistance, including cash transfers and integrated benefits packages, may be important ways to facilitate the inclusion of people with disabilities in services and society. There is limited information, however, with regards to their impact in low- and middle-income settings. To understand how these programs work, it is important to recognise that there are disability-targeted entitlements, but people with disabilities may also be eligible for mainstream programmes aimed at other targeted groups, such as people of a certain socio-economic status. This evidence note summarises what is known about challenges faced by both of these types of initiatives, as well as evidence-based recommendations to strengthen them.

Labour Market Assessment - Inclusion Works Kenya

GESONGO, Mugita
BARAZA, Austen
July 2019

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This is a rapid assessment of the Kenyan labour market which was commissioned to understand how the labour market functions in Kenya within the context of disability. This assessment provided opportunity to validate existing data on employment of persons with disabilities thus generating a solid baseline on which to anchor the programme’s targets and assumptions.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Access to social protection among people with disabilities: Mixed methods research from Tanahun, Nepal

BANKS, Lena
et al
April 2019

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This study explores participation of people with disabilities in social protection programmes, with Tanahun District of Nepal as the study setting. This research uses mixed methods to assess coverage (through direct survey), how coverage varies amongst people with disabilities (e.g. by gender, impairment type), as well as challenges and facilitators to enrolling in or using relevant social protection programmes. This research benefits from a population-based study design and from the use of the Washington Group question sets

 

The European Journal of Development Research (2019) 31:929–956

https://doi.org/10.1057/s41287-019-0194-3

Feasibility of Family Group Conference to promote return-to-work of persons receiving work disability benefit

BRONGERS, Kor A
CORNELIUS, Bert
ROELOFS, Pepijn D D M
VAN DER KLINK, Jac J L
BROUWER, Sandra
April 2019

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Purpose: To investigate the feasibility of Family Group Conference for promoting return to work by clients receiving work disability benefits from the Social Security Institute in the Netherlands.

 

Methods: We conducted a mixed-method pre- post-intervention feasibility study, using questionnaires, semi-structured interviews and return to work plans drafted in Family Group Conferences. A convenient sample of Labour experts, Clients, and Facilitators was followed for a period of six months. Feasibility outcomes were demand, acceptability, implementation and limited efficacy of perceived mental health and level of participation.

 

Results: Fourteen labour experts and sixteen facilitators enrolled in the study. Of 28 eligible clients, nine (32%) participated in a Family Group Conference. About 78% of the Family Group Conferences were implemented as planned. Participant satisfaction about Family Group Conference was good (mean score 7). Perceived mental health and level of participation improved slightly during follow-up. Most actions in the return to work plans were work related. Most frequently chosen to take action was the participating client himself, supported by significant others in his or her social network. Six months after the Family Group Conference five participating clients returned to paid or voluntary work.

 

Conclusions: Family Group Conference seems a feasible intervention to promote return to work by clients on work disability benefit. Involvement of the social network may have added value to support the clients in this process. An effectiveness study to further develop and test Family Group Conferences is recommended.

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