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How can the health of people with disabilities in humanitarian camps be supported during the COVID-19 pandemic? - Evidence brief

HUNT, Xanthe
2020

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More than 10% of the world’s 35 million displaced people are people with disabilities. People with disabilities and their families are at significant risk of discrimination, stigma, violence, and marginalisation, and get little access to adequate services in humanitarian camps. Disabled people are frequently sidelined during health sector planning in humanitarian camps, and healthcare access is a particular challenge. The COVID-19 pandemic, and measures necessary for its containment, pose a particular threat and challenge in humanitarian settings. Containment measures such as mass ‘stay-at-home' orders, social distancing, self-isolation and quarantine are often unsuitable for, or difficult to implement in, camp settings. People in humanitarian camps, then, need special consideration within the COVID-19 response. However, among people in humanitarian camps, people with disabilities are particularly vulnerable to being left behind or overlooked in COVID-19 planning and programming. Their double vulnerability as refugees and disabled people warrants special consideration.

 

Evidence in considered and recommendations provided.

How can we promote the inclusion of people with disabilities in programme design? - Evidence brief

QURESHI, Onaiza
2020

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In order to fully encapsulate the principles of ‘Nothing About Us without Us’ within development efforts, a strong knowledge base from programmes worldwide is needed to identify effective ways to promote the meaningful inclusion of people with disabilities in the design and delivery of programmes.

Development programmes need to move beyond passive consultations and seek meaningful engagement from people with disabilities from the early stages of programming right till the end so that the solutions and lessons learned are inclusive and representative for people with disabilities worldwide.

How do we improve access to healthcare for people with disabilities?

HUNT, Xanthe
August 2019

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Gaining access to healthcare is often a challenge for people with disabilities in low- and middle-income countries. Part of this has to do with a general dearth of healthcare services in low-resource settings. But part of this difficulty has to do with structural, attitudinal, economic and social barriers to participation and healthcare which affect people with disabilities more than people without disabilities. This lack of access to healthcare is a problem because, in general, people with disabilities may need to access healthcare more frequently than people without disabilities. Full and equitable access to quality healthcare is a human right, and an important imperative of the global agenda. This evidence brief summarises what we know about how to improve access to healthcare for people with disabilities in low-resource settings.

What interventions are effective to support home-based carers?

HUNT, Xanthe
August 2019

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Question & problem

Many people with disabilities require the assistance of other people in order to go about their daily lives. In high-income countries, home-based carers are professional or para-professional workers who provide assistance to people with disabilities, in their homes. They are often well-trained, and remunerated for their services. However, individuals with disabilities in many low- and middle-income countries (LMIC) predominantly live with their family, and receive home-based care from family members. There are some stresses associated with giving care to others, and these include burnout, compassion fatigue, and an array of emotional and social consequences related to the caring role. The carers, too, need care. This evidence brief summarises what we know about how to support home-based carers, taking into consideration that these people, in LMIC, are often untrained, unpaid family members of the person for whom they are caring.

How do we ensure that children with disabilities are not bullied in school?

HUNT, Xanthe
August 2019

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Question & problem

Students with disabilities are bullied more often than their typically developing peers. Students in schools for children with disabilities may be victimized more often than students with disabilities in inclusive settings. Being bullied, which can take forms which are physical, verbal, indirect (relational, emotional, or social), and/or sexual, is associated with negative academic, social, and psychological outcomes for the victim. This evidence brief summarises what we know about how to prevent bullying of children with disabilities.

What works to improve educational outcomes of children with disabilities in school?

HUNT, Xanthe
August 2019

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Question & problem

For people with disabilities, a major determinant of social and economic outcomes in adulthood, is access to, and the adequacy of, education in childhood and adolescence. Yet, children with disabilities are less likely to be enrolled in, or complete, school. Further, there are substantial gaps in the evidence regarding what works to improve educational outcomes of children with disabilities in school. Educational outcomes, here include academic achievement, pass rates, and grade completion. Many studies measure child behaviour and proxy or distal outcomes in response to various interventions, but not actually how children with disabilities do in these domains. This is particularly the case in LMIC, where there is a dearth data about the effects of educational policies and practices on child educational outcomes.

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.

How do we provide mental health support to children with psychosocial disabilities in school?

QURESH, Onaiza
August 2019

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Question & problem

It is estimated that approximately 10-20% of children, adolescents and young people (under the age of 18) worldwide have a disabling mental health condition. Approximately two-thirds of the global youth population goes to school for a significant proportion of the day. The idea of delivering mental health support in the setting has gained prominence as a way to increase the coverage and accessibility of mental health support for children. While there is a wealth of evidence around school mental health approaches in HIC, there is limited information with regards to their impact in low- and middle-income settings. This evidence brief explores what has worked for the delivery of school mental health initiatives in diverse settings, as well as evidence-based recommendations to strengthen them.

What are the key considerations for including people with disabilities in COVID-19 hygiene promotion programmes?

WILBUR, Jane
HUNT, Xanthe
August 2019

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Question & problem

People with disabilities may be more likely to acquire COVID-19, and if infected may be more likely to experience serious symptoms, or die. Aside from those consequences of the pandemic related to morbidity and mortality, people with disabilities are often reliant on carers to aid with common daily tasks, and so social distancing measures may be unfeasible. Furthermore, safe water, sanitation and hygiene (WASH) services and facilities may be inaccessible to people with disabilities, and, in many settings, efforts to deliver services in a socially-distanced world have resulted in the roll out of digital or remote healthcare approaches which are sometimes not accessible or inclusive. One of the key interventions in response to the COVID-19 pandemic has been international attention, and improved funding, programming and media messaging in support of WASH. People with disabilities – who are most at risk of negative consequences of COVID-19 – most need access to such interventions. Yet, WASH access is considered to be one of the biggest challenges of daily life for many people with disabilities.

Disability Inclusion Helpdesk Report No: 15 : Mental health and psychosocial support (MHPSS) in Syria: concepts, reality and effectiveness of interventions

LEE, Harri
ZIVERI, Davide
PFEFFER, Lauriane
July 2019

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Summaries on the findings from the following queries:

Define mental health and psychosocial support (MHPSS) and intended outcomes of these interventions (at the global level).

What is the evidence on the nature of the problem and the scale of need for MHPSS services in Syria?

What is the evidence on effectiveness of MHPSS interventions in Syria?

Physical Disability, Rights and Stigma in Ghana: A Review of Literature

GRISCHOW, Jeff
MFOAFO-M’CARTHY, Magnus
VERMEYDEN, Anne
CAMMAERT, Jessica
2019

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Purpose: This is a survey of peer-reviewed articles focussed on the causes and consequences of stigma towards persons with physical disability in Ghana.

 

Method: After a systematic search of the online databases EBSCOhost, ProQuest, PubMEd and Web of Science for peer-reviewed articles on disability in Ghana, 26 articles were chosen for critical review.  The three main selection criteria were: the articles had to be peer-reviewed, they had to be based on interviews with Ghanaians in the field, and they had to discuss stigma and human rights.  For analysis, the content of the articles was grouped under two sections: major themes (human rights, causes of stigma, consequences of stigma) and policy recommendations (economics, medical services/healthcare, affirmative action, attitudes and awareness-raising, inclusion of cultural beliefs).

 

Results:   This review found that most of the studies attribute stigma to negative attitudes towards Ghanaians with disability, and many highlight beliefs among Ghanaians that disability is caused by spiritual and supernatural forces. The consequences, according to most authors, are social, economic and political exclusion. Policy recommendations include improving government policy, increasing funding for disability programmes, changing public attitudes, and paying attention to Ghanaian culture and tradition in designing disability interventions. While these are valid points, the authors of this paper are of the opinion that the literature also suffers from lack of a deep understanding of the historical and socio-cultural roots of supernatural beliefs in Ghana.

 

Conclusion: The 26 studies discussed in this review show that since 2006 very good work has been produced on disability in Ghana, especially by Ghanaian disability scholars.

 

It is hypothesised, however, that a full understanding of disability and stigma in Ghana must be based on deeper research into the roots of the beliefs that drive stigma.  Future work therefore should focus on deepening the analysis of cultural beliefs towards disability in Ghana, in order to understand fully the roots of culturally-based disability stigma. More research into the economic causes and consequences of disability is also recommended, without which a full analysis of cultural stigma will not be possible.

Training Needs of Community-based Rehabilitation Workers for the Effective Implementation of CBR Programmes

VUUREN, Julia Mary Jansen-van
ALDERSEY, Heather Michelle
2019

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Purpose: This review investigates the training needs of Community-Based Rehabilitation (CBR) workers that would enable them to effectively facilitate CBR programmes. Emphasis was placed on identifying: (a) the skills that CBR workers require (b) the training currently available for them, and (c) the gaps in current training.

 

Method: A scoping review was conducted using on-line database searches (Medline, Embase, Cinahl, PsycInfo, Global Health) for English articles from 2006 onwards. A combination of keywords related to CBR, personnel, and training were applied. Hand searches of reference lists and the DCID journal were also conducted. Grey literature related to training, from the World Health Organisation (WHO), CBR Regional Networks and organisations affiliated with CBR were included as secondary data. Thirty-three articles and thirty-five sources from the grey literature were included. Data was organised under the three objectives outlined above – i.e., required skills, available training and training gaps.

 

Results: CBR workers represent a diverse group requiring a broad range of skills. A new cadre of mid-level workers is also necessary to effectively implement the CBR guidelines. There is currently no standardised training for CBR workers and training varies widely, depending on context. CBR workers require further training in various clinical, social, management, communication, and cultural competence skills across the spectrum of the CBR Matrix, and specifically in empowering persons with disabilities and facilitating community development. They also need to develop critical reasoning, creativity, and compassion.

 

Conclusion: A standardised approach to training CBR workers would be beneficial to ensure basic standards and quality services, to allow meaningful comparison and evaluation across contexts, to recognise the role of mid-level CBR workers, and to strengthen the workforce. Further research is required to determine minimal competencies, define the roles of various CBR workers, and evaluate the effectiveness of training.

Impact of parenting a child with cerebral palsy on the quality of life of parents: A systematic review of literature

RAMANANDI, Vivek H
PARMAR, Trupti Rudra
PANCHAL, Juhi Kalpesh
PRABHAKAR, M M
et al
2019

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Purpose: The implications of parenting a child with cerebral palsy (CP) are multifaceted, as parents have to cope with their child’s functional limitations and specific needs, and prepare for the possibility of long-term dependence. There has been significant research on the consequences of managing these parenting tasks. This article reviews the literature on the effects of parenting children with CP, and summarises the related factors.

 

Methods: A systematic search of online databases was conducted and, based on the reference lists of selected articles, further studies were identified. Thirty-six articles that met the inclusion criteria were analysed.

 

Conclusion & Implication: Parents of children with CP were found to have lower quality of life, associated with high levels of stress and depression, due to factors such as child behaviour and cognitive problems, low caregiver self-efficacy and low social support. The implications of these findings in relation to the planning and development of interventions addressing the family as a whole are discussed. The aim is to enhance parents’ competence and resources so that they are better able to cope with the demands of parenting their children.

 

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Association between social factors and performance during Functional Capacity Evaluations: a systematic review

ANSUATEGUI ECHEITA, Jone
VAN HOLLAND, Berry J
GROSS, Douglas P
KOOL, Jan
OESCH, Peter
TRIPPOLINI, Maurizio
RENEMAN, Michiel F
March 2018

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Purpose: Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults.

 

Materials and methods: A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor’s association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods.

 

Results: Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner’s fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied.

 

Conclusions: Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance.

Disability inclusive elections in Africa: a systematic review of published and unpublished literature

VIRENDRAKUMAR, Bhavisha
JOLLEY, Emma
BADU, Eric
SCHMIDT, Elena
2018

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The United Nations Convention on the Rights of Persons with Disabilities underscores the equal right of persons with disabilities to participate in political life. However, in Africa they are often unable to exercise their right to vote. This study sought to systematically review available evidence on inclusive elections in Africa. Findings showed that although most African countries ratified disability-focused legislation and proclaimed equal opportunities, the implementation of the legislation varies across the continent. Barriers to political participation can occur at any electoral stage and can be broadly categorised into three groups: lack of education and financial resources; stigma and negative social attitudes; and inaccessible physical infrastructure.

Analysis of Bibliography on Specific Learning Disability in India

VENKATESAN, S
2017

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Aim: This study attempts a comprehensive qualitative and quantitative analysis of un-annotated bibliographic listing of books and citations compiled on specific learning disability published by researchers in India.

 

Method: An online and offline survey covering ISSN journals and ISBN marked books available in print or electronic media was compiled, coded, categorized, and classified by title, theme, year, journals, and names of author/s.

 

Results: The bibliographic search yielded 450 research articles drawn from 196 national and international journals of Indian origin and 29 book titles on the topic of learning disability and/or its equivalents covering themes related to their nature-characteristic (N: 184; 40.89%), therapy-intervention (N: 115; 25.56%), causes-correlates (N: 57; 12.67%), screening-assessment-identification (N: 52; 11.56 %), and epidemiology-prevalence (N: 42; 9.33%).  A decade wise timeline analysis shows an increasing trend in the quantum of publications on learning disability by almost four times from the base years of <=1990s to the contemporary period, along with corresponding shift in the increased use of the term ‘learning disability’ in preference for other older terms (p:<0.05).  

 

Conclusion: On the whole, there seems to be much unused information available about learning disabilities in the country, which now lies widely scattered.

 

Limitations & Recommendation: Although no claim is made that the bibliographic listing is all inclusive, it is recommended that the first step is to have an information gathering mechanism, creation of a dynamic repository, or archival system with retrieval systems in place for prospective researchers on a subject matter of great importance  within the country. 

The development and evaluation of content validity of the Zambia Spina Bifida Functional Measure: Preliminary studies

MWESHI, Margaret M.
AMOSUN, Seyi L.
SHILALUKEY-NGOMA, Mary P.
MUNALULA-NKANDU, Esther
KAFAAR, Zuhayr
2017

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Background: Very little is known on outcome measures for children with spina bifida (SB) in Zambia. If rehabilitation professionals managing children with SB in Zambia and other parts of sub-Saharan Africa are to instigate measuring outcomes routinely, a tool has to be made available. The main objective of this study was to develop an appropriate and culturally sensitive instrument for evaluating the impact of the interventions on children with SB in Zambia.


Methods: A mixed design method was used for the study. Domains were identified retrospectively and confirmation was done through a systematic review study. Items were generated through semi-structured interviews and focus group discussions. Qualitative data were downloaded, translated into English, transcribed verbatim and presented. These were then placed into categories of the main domains of care deductively through the process of manifest content analysis. Descriptive statistics, alpha coefficient and index of content validity were calculated using SPSS.


Results: Self-care, mobility and social function were identified as main domains, while participation and communication were sub-domains. A total of 100 statements were generated and 78 items were selected deductively. An alpha coefficient of 0.98 was computed and experts judged the items.


Conclusions: The new functional measure with an acceptable level of content validity titled Zambia Spina Bifida Functional Measure (ZSBFM) was developed. It was designed to evaluate effectiveness of interventions given to children with SB from the age of 6 months to 5 years. Psychometric properties of reliability and construct validity were tested and are reported in another study.

No One Left Behind: A review of social protection and disability at the World Bank

KARR, Valerie L
VAN EDEMA, Ashley
SIMS, Jacob
BRUSEGAARD, Callie
2017

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The 2030 Agenda for Sustainable Development cites poverty eradication as both the ‘greatest global challenge’ and an ‘indispensable requirement’ for sustainable development (UN, 2015). Unfortunately, the path between discourse and practice is rarely clear. This is especially true for the estimated one billion people with disabilities around the globe who face barriers and challenges to inclusion in mainstream development efforts; and for whom disability-specific projects and interventions are far and few between. This paper responds to the lack of available data focused on tracking the inclusion of persons with disabilities in mainstream poverty reduction efforts. It reports on work by a multidisciplinary research team in developing and piloting a methodology measuring disability inclusive investments in the World Bank’s active portfolio. The paper focuses specifically on the World Bank’s social protection portfolio, aligned with SDG 1 (End Poverty), and outlines a methodology for analysing project-level documentation, using key word searches, and codes aligned with the Sustainable Development Goals to determine the inclusion of persons with disabilities. Findings indicate that only a small percentage, 5%, of the World Bank’s active social protection portfolio explicitly include persons with disabilities as target beneficiaries. It goes on to argue that this dearth in disability inclusive development efforts exposes a vital need to systematically include the needs of this population in the planning for, provision of, and assessment of development assistance efforts. The paper concludes with a set of recommendations for ensuring future projects are inclusive from program development and implementation through to assessment of outcomes.

 

Disability & the Global South (DGS), 2017, Vol. 4 No. 1

Disability and social protection programmes in low- and middle-income countries: a systematic review

BANKS, Lena Morgon
MEAKLE, Rachel
MACTAGGART, Islay
et al
2016

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“This paper systematically reviews the evidence on whether persons with disabilities in low- and middle-income countries are adequately included in social protection programmes, and assesses the financial and non-financial impacts of participation. Overall, we found that access to social protection appears to fall far below need. Benefits from participation are mostly limited to maintaining minimum living standards and do not appear to fulfil the potential of long-term individual and societal social and economic development. However, the most notable finding of this review is that there is a dearth of high-quality, robust evidence in this area, indicating a need for further research.”

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