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The missing billion - Access to health services for 1 billion people with disabilities

KUPER, Hannah
HEYDT, Phyllis
July 2019

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One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC (Universal Health Care) and SDG 3 cannot be attained without better health services for the one billion people with disabilities. 

Health and healthcare are critical issues for people with disabilities. People with disabilities often need specialized medical care related to the underlying health condition or impairment (e.g., physiotherapy, hearing aids). They also need general healthcare services like anyone else (e.g., vaccinations, antenatal care). On average, those with disabilities are more vulnerable to poor health, because of their higher levels of poverty and exclusion, and through secondary conditions and co-morbidities. People with disabilities therefore may require higher levels of prevention, diagnosis, and treatment services. However, health services are often lower quality, not affordable, and inaccessible for people with disabilities. In many situations these barriers are even more significant for women with disabilities, compared to men with disabilities.

Hearing aid systems in low-resource settings (Community Ear & Hearing Health, vol.15, no.19, 2018)

RICARD, Paddy
Ed
2018

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Articles in this issue are:

  • Hearing aid systems in low-resource settings
  • How hearing aids work and how to take care of them
  • The impact of hearing aid use in low and middle-income countries
  • Barriers to the use of hearing aid systems in low-and middle-income countries
  • Beyond devices: what to consider when providing hearing aids in LMICs
  • Improving access to hearing care and hearing rehabilitation in the Philippines
     

Disability-inclusive social protection in Vietnam: A national overview with a case study from Cam Le district

BANKS, Lena M
et al
2018

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Social protection programmes are increasingly being adopted in low- and middle-income countries as a set of strategies for poverty reduction, improving livelihoods and decreasing inequality. Due to high levels of poverty and social exclusion, people with disabilities – who comprise upwards of 15% of the global population – have been identified as a key target group for inclusion in social protection, in both international guidelines and in national strategies. However, there is currently a lack of evidence on whether these programmes are adequately reaching and meeting the needs of people with disabilities.

The aim of this research was to assess the extent to which social protection systems in Nepal and Vietnam address the needs of people with disabilities. This research uses a mixed methods approach, combining a national policy analysis with district-level qualitative and quantitative studies in each country.

Disability-inclusive social protection research in Nepal: A national overview with a case study from Tanahun district

BANKS, Lena M
et al
2018

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Social protection programmes are increasingly being adopted in low- and middle-income countries as a set of strategies for poverty reduction, improving livelihoods and decreasing inequality. Due to high levels of poverty and social exclusion, people with disabilities – who comprise upwards of 15% of the global population – have been identified as a key target group for inclusion in social protection, in both international guidelines and in national strategies. However, there is currently a lack of evidence on whether these programmes are adequately reaching and meeting the needs of people with disabilities.

The aim of this research was to assess the extent to which social protection systems in Nepal and Vietnam address the needs of people with disabilities. This research uses a mixed methods approach, combining a national policy analysis with district-level qualitative and quantitative studies in each country

Guatemala National Disability Study ENDIS 2016 Report

DONICIO Carlos
GRECH Shaun
Islay MACTAGGART
Jonathan NABER
Dr Ana Rafaela SALAZAR DE BARRIOS
Gonna ROTA,
Sarah POLLACK
April 2017

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The Guatemala National Disability Study (ENDIS 2016) was undertaken to address a need for up to date reliable data on disability in Guatemala.

Through a population based survey:

* To estimate the national disability prevalence among adults and children in Guatemala, and to provide regional estimates for 5 broad regions

* To disaggregate the prevalence of disability in Guatemala by age, sex, type of functional limitation and socio-economic status

* To explore the impact of disability on: poverty, quality of life, participation, health and opportunities to go to school and to work amongst children and adults respectively

Through a qualitative study:

* To explore cultural, ideological, and social interpretations and responses to disability; provide insight into the disability and poverty relationship; and examine social, political, and economic dimensions operating within this relationship.

Evaluating the impact of a community–based parent training programme for children with cerebral palsy in Ghana

ZUURMOND, Maria
et al
January 2017

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"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".

Protect us! Inclusion of children with disabilities in child protection

Hannah Kuper
Morgon Banks
Susan Kelly
Nambusi Kyegombe
Karen Devries
June 2016

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Children with disabilities experience very high levels of violence, according to this research from Plan International and the London School of Hygiene and Tropical Medicine. The new study carried out in Uganda and Malawi provides valuable insights into the lives of children with disabilities. Key findings include: 

- Girls and boys with disabilities experience extremely high levels of violence: 84% of children with disabilities surveyed reported having experienced some form of violence at school in the previous week.
- Girls with disabilities were more likely to report emotional and sexual violence than girls without disabilities.
- Children with disabilities find it difficult to access community-based child protection mechanisms, due to a range of barriers including environmental barriers, social barriers and institutional barriers.

This extremely important piece of research shows that if we don’t explicitly include, we exclude. In line with the aspiration of the Sustainable Development Goals to “leave no one behind” and with the UN Convention on the Rights of Persons with Disabilities, we therefore call upon Plan International and all other development actors to work together to stop the widespread violence against boys and girls with disabilities, and take concrete steps to include them in child protection mechanisms.

Disability and social protection forum

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
April 2015

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This webpage presents useful information and materials from a forum held at London School of Hygiene and Tropical Medicine about disability and social protection. Session one set the scene on disability and social protection, and session two focused on the priorities and opportunities to build on the evidence on social protection and disability. Related summaries, audiovisuals and powerpoints are provided from the Forum

Disability and Social Protection Discussion Forum

London, UK

26 March 2015

The economic costs of exclusion and gains of inclusion of people with disabilities : evidence from low and middle income countries

BANKS, Lena Morgon
POLACK, Sarah
2015

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This report, formed of two parts, provides robust empirical basis to support the theorized disability-poverty link. The first section presents a systematic review of the literature on the relationship between disability and economic poverty. The second section explores the economic consequences of the exclusion and inclusion of people with disabilities in the areas of education, employment and health. The key pathways through which these economic costs may arise are discussed and studies that have attempted to quantify the financial impacts are reviewed

The Telengana disability study : summary report

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents a summary of the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in India, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in Telengana State, India

The north west Cameroon disability study

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

The north west Cameroon disability study : summary report

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents a summary of the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in Cameroon, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in north west Cameroon

Building the evidence base in disability : research summary

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This research summary of presents the aims, methods and key findings from two disability studies in Cameroon and India. The studies developed a comprehensive population-based survey methodology that is compatible with the International Classification of Functioning (ICF), and explored the inter-relationship between the components of this framework

The Telengana disability study : India

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
December 2014

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This report presents the findings of a study that developed and tested a best-practice population-based survey methodology to estimate the prevalence of disability in children and adults in India, and compared the extent to which people with and without disabilities access key mainstream services and opportunities including health, education and livelihoods in Telengana State, India

The Malawi key informant child disability project

TATARYN, Myroslava
et al
August 2014

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“The aim of this study was to use the KIM to estimate the prevalence of moderate/severe physical, sensory and intellectual impairments and epilepsy among children in two districts (Ntcheu and Thyolo) in Malawi. The Key Informant Method (KIM) is a novel method for generating these data. KIM focuses on training community volunteers to identify local children who may have disabilities, who are then screened by medical professionals and referred on for appropriate health and rehabilitation interventions. Consequently, the method offers an alternative to population-based surveys of disability in children, which can be costly and time consuming”

The Malawi key informant child disability project : summary report

TATARYN, Myroslava
et al
August 2014

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This report provides a summary of research project conducted by the International Centre for Evidence in Disability at the London School of Hygiene and Tropical Medicine and the University of Malawi. The study used the Key Informant Method (KIM) to estimate the prevalence of moderate/severe physical, sensory and intellectual impairments and epilepsy among children in two districts (Ntcheu and Thyolo) in Malawi. This report presents summary of the study’s background information, aims and objectives, key findings, conclusions and recommendations

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

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