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"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

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.

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.

 

Sightsavers' approach to making health services inclusive for everyone

Sightsavers
April 2019

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Sightsavers has produced a new film that sets out our work to make health care services accessible and inclusive for everyone. It focuses on our programmes in Bhopal, India and Nampula, Mozambique. This highlights how we work and share learnings globally, but also shows how programmes can be made locally relevant by working with partners with direct experience.

The film showcases some of the people who work hard to make our inclusive health programmes a success, from Sightsavers experts and government health workers to leaders of disabled people’s organisations.

To find out more our inclusive health work and how we are developing best practice in terms of inclusive health programmes, visit our website: https://www.sightsavers.org/disability/health/

Coordination between health and rehabilitation services in Bangladesh: Findings from 3 related studies

PRYOR, Wesley
MARELLA, Manjula
NGUYEN, Liem
SMITH, Fleur
JALAL, Faruk Ahmed
CHAKRABORTY, Ripon
HAQUE, Mazedul
MOSTOFA, Golam
HASAN, Rajib
April 2019

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The unmet need for rehabilitation is profound and is likely to worsen as population health shifts towards longer lives lived with more ill-health and disability. The WHO Global Action Plan on Disability and the Rehabilitation 2030 framework [1] call for quality evidence to inform targeted responses.
The intent of this work is to examine six IDSCs (Integrated Disability Service Centres) in detail but to use the results to inform new activities through the network of more than 100 Integrated Disability Service Centres, with potential to influence practice in other services. As such, results of this work have the potential to directly inform policy decisions concerning future investments in rehabilitation services in Bangladesh and bring awareness to key stakeholders on current challenges and potential solutions.

Research was conducted during March-October 2018 in Kurigram, Tangail, Manikgonj, Dhaka and Narsingdi districts of Bangladesh to map out the current trends and determinants of good coordination
between health and rehabilitation, emphasising quantitative measures of: timeliness, continuity, acceptability, availability and integration

3rd World Disability & Rehabilitation Conference (WDRC 2018) - Book of abstracts

O'CONNOR, Loren
Ed
November 2018

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The 3rd World Disability & Rehabilitation Conference 2018 was held from 12th and 13th November 2018 in Kuala Lumpur, Malaysia. People with disabilities and researchers, practitioners, policy makers, industry experts, university faculty and organizations along with advocates and volunteers working with people with disabilities participated and presented their original and unpublished results of conceptual, constructive, empirical, experimental, experiential or theoretical work through abstract and poster presentation. Total 33 participants presented their abstract and poster throughout this conference. The theme of WDRC 2018 was “Global advocacy and rights of people with disabilities”

Primary health care seeking behaviour of people with physical disabilities in Bangladesh: a cross-sectional study

TALUKDAR, Jhalok Ronjan
MAHMUD, Ilias
RASHID, Sabina
September 2018

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People with disabilities constitute about 10% of the total population of Bangladesh. They are more likely to experience poor health than those without disabilities. However, there is a lack of evidence on their primary health care (PHC) seeking behaviour for their general illness. The aim of this study was to understand the PHC seeking behaviour of people with physical disabilities (PWPDs), and to investigate the determinants of such behaviours. 282 PWPDs, aged ≥18 years, were studied using a structured questionnaire. Participants were recruited from the out-patient department of a rehabilitation centre in Dhaka between November and December 2014.

 

Archives of Public Health (2018) 76:43 

https://doi.org/10.1186/s13690-018-0293-1

 

Quality rehabilitation for all. Lessons learnt from integrating rehabilitation services in two general hospitals in Bangladesh

BAART, Judith
RAHMAN, Nafeesur
November 2017

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Working from the theory that integrating basic rehabilitation care within the health care system in Bangladesh, rather than as a stand-alone service, could greatly improve awareness of and access to rehabilitation services, CDD piloted setting up therapeutic care centres within hospitals. This report presents the lessons learned.

“We can also change” Piloting participatory research with persons with disabilities and older people in Bangladesh

BURNS, Danny
OSWALD, Katy
November 2014

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Sightsavers, HelpAge International, ADD International and Alzheimer’s Disease International worked together with the Institute of Development Studies (IDS) to bring the perspectives of those who live in poverty or who are highly marginalised into post-2015 policy making. The aim of the research was to understand better the experiences of social, political and economic exclusion of persons with disabilities and older people in Bangladesh from their own perspectives. Two groups (community and NGO) of peer researchers collected 70 stories from poor and/or excluded persons with disabilities and older people from each of the two sites: Bhashantek, an urban slum in Dhaka; and Cox’s Bazar, a rural area in southeast Bangladesh. From the stories collected and analysed in workshops, the peer researchers identified 13 priority areas that affect persons with disabilities and older people: accidents and disasters; livelihoods; access to education; medical treatment; family support; exclusion and mistreatment; superstition; access to services; mobility; marriage; land; rape and sexual abuse; the role of grassroots community-based organisations. Recommendations from the researchers are made in each area. The peer research programme was evaluated and guidelines for its use are provided.

Universal health coverage for inclusive and sustainable development. A synthesis of 11 country case studies.

MAEDA, Akiko
ARAUJO, Edson
CASHIN, Cheryl
HARRIS, Joseph
IKEGAMI, Naoki
REICH, Michael R.
et al
2014

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Universal health coverage (UHC) for inclusive and sustainable development synthesises the experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The UHC policies for each country are examined around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The path to UHC is specific to each country, but countries can benefit from experiences of others and avoid potential risks

Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

RAZZAK, A T M A
2013

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Purpose: The study aimed to explore the outcome of current practices in the treatment of persons with traumatic spinal cord injuries (TSCI) in Bangladesh, through the stages of rescue and first contact with physician, transportation to the tertiary hospital and intermediate admission.

 

Method: This observational study was conducted between June and August 2011, at the Centre for the Rehabilitation of the Paralysed (CRP), in Dhaka, Bangladesh. From the 113 persons with SCI admitted at CRP during this period, 56 persons with TSCI were selected. With the help of a questionnaire, data were collected from these persons or their attendants by trained staff, and also taken from hospital records. Data were processed and analysed by SPSS software version 16.

 

Results: The male-female ratio among the study participants was 5.25: 1, with a mean age of 33.02 years. 55.3% of them were paraplegic, while 44.7% were tetraplegic. About 70% of the injuries were complete according to ASIA impairment scale (AIS) during admission at CRP.

 

The most common causes of injury were falls (50%), followed by road traffic accidents (RTA) and carrying loads on the head. 74.8% of the injured persons had been rescued from the accident site by local people but only 16.1% had been transported by ambulance. The spine board had never been used. More than half of the injured received initial treatment only at a sub-district or district hospital where none of the requisite facilities were available.

 

While being transported from one hospital to the other, 10.7% experienced neurological deterioration of some sort. Significant statistical correlation was found between mode of transfer (P <0.03) and intermediate admission (P<0.001)with neurological deterioration.

 

Conclusions: There is an urgent need to implement pre-hospital trauma care in Bangladesh. Since resources and places for the rehabilitation of persons with TSCI are scarce, regional and national spinal injury centres should be established without delay.

 

Limitations: The study focussed only on a small sample of persons with TSCI undergoing treatment at a single centre.

Child-centred disaster risk reduction : building resilience through participation : lessons from Plan International

PLAN INTERNATIONAL
2010

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This report “presents the results and recommendations of a five-year programme and…includes a series of case studies illustrating how child-centred Disaster Risk Reduction (DRR) supports the delivery of the Hyogo Framework’s Priorities for Action, as well as the realisation of children’s rights to education, health and participation within disaster risk contexts…Child-centred Disaster Risk Reduction is an innovative approach to Disaster Risk Reduction (DRR) that fosters the agency of children and youth, in groups and as individuals, to work towards making their lives safer and their communities more resilient to disasters”

Annual review of HRH situation in Asia-Pacific region 2006-2007

DING Yang
TIAN Jiang
August 2008

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"This report reviews the Human Resources for Health (HRH) status in the targeted countries by mainly focusing on health education and training, distribution and retention of health workers, community health workers. Eighteen countries have been included in the report: Bangladesh; Cambodia; China; Fiji; India; Indonesia; Lao PDR; Myanmar; Nepal; Philippines; Papua New Guinea; Samoa; Sri Lanka; Thailand; Vietnam; Australia; New Zealand and Mongolia"

Successful leadership : country actions for maternal, newborn and child health

PARTNERSHIP FOR MATERNAL, NEWBORN AND CHILD HEALTH
2008

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This document provides country-specific summaries of actions taken on a national level to improve maternal and child health. The summaries do not provide a comprehensive assessment of the progress made by individual countries, but demonstrate the importance of five factors: 1. Successful political leadership (Thailand) 2. Sound health policies (Indonesia and Tanzania) 3. Effective financing (Mexico) 4. Strong health systems (Nepal and Senegal) 5. Action to achieve equity (Bangladesh and Chile). Each summary covers: progress on MDGs, supportive policies and interventions, outcome, and key lesson

WHO’s multi-country study on women’s health and domestic violence against women : summary report of initial results on prevalence, health outcomes and women's responses

WORLD HEALTH ORGANIZATION (WHO)
2005

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"Violence against women by an intimate partner is a major contributor to the ill-health of women. This study analyses data from 10 countries and sheds new light on the prevalence of violence against women in countries where few data were previously available. It also uncovers the forms and patterns of this violence across different countries and cultures, documenting the consequences of violence for women’s health. This information has important implications for prevention, care and mitigation... The high rates documented by the Study of sexual abuse experienced by girls and women are of great concern, especially in light of the HIV epidemic. Greater public awareness of this problem is needed and a strong public health response that focuses on preventing such violence from occurring in the first place...This study will help national authorities to design policies and programmes that begin to deal with the problem"

Monitoring the status of health equity in Bangladesh : the BHEW survey 2002

AHMED, Masud Syed
et al
2003

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BHEW (Bangladesh Health Equity Watch) is a Bangaldeshi initiative established to determine whether the health situation in the country is improving and if those improvements are equitable. This report produced by BRAC gives an account of its current findings. Equity in health is defined as 'the absence of systematic and potentially redemiable differences in one or more aspects of health across populations or population subgroups defined socially, economically, demographically or geographically'. For example, while child mortality in Bangladesh has decreased, it is not known whether the decline has been equal for all groups within the population, such as the difficult areas to reach usually inhabited by ethnic minorities. In addition to child mortality, the report also focuses on nutritional status of the population including young children, and utilisation and accessiblity of the health care services. The report finds that the health of the disadvantaged groups has not much improved since independence. The information given is targeted at policy makers and programme implementers

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