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Access to age-assistive technology: A resilience building measure for older people

HISCOCK, Diana
MALIK, Deepak
June 2020

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The intersection between age, gender and disability and the use of assistive technology (AT) by older people, in emergency response and as a tool for disaster risk reduction (DRR) is explored. The report shows that AT can have a positive impact on independence, vulnerability reduction and resilience building for older women and men in humanitarian crises. This report urges for sensitization and capacity building of humanitarian organizations for the inclusion and promotion of assistive product (AP) provision in humanitarian response and offers insight into key areas to enable AT provision to successfully meet the needs of older people.

 

The study employed primary research methods to gather both quantitative and qualitative information through a semi-structured survey with HelpAge programme beneficiaries in five countries: Bangladesh, Indonesia, Myanmar, Nepal and Pakistan. The survey incorporated the Washington Group short set of questions (WGQs), designed to identify people with functional difficulties in six core functional domains: mobility, vision, hearing, cognition, self-care and communication (Washington Group on Disability Statistics, 2016). The report also summarises secondary research including a literature review, information from rapid needs assessments carried out by HelpAge, and maps out relevant policy changes which have led to better recognition of the intersectionality and importance of AT for older men and women.

Pre-Primary and Primary Inclusive Education for Tanzania (PPPIET) – Foundation Phase : Report on Participatory Research to Inform Design of New Inclusive Education Model in Tanzania

JUDGE, Emma
June 2020

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The Disability Inclusive Development (DID) consortium, a UK Department for International Development (DFID) funded initiative, is working together on the Pre-Primary and Primary Inclusive Education in Tanzania (PPPIET) programme whose ultimate goal is to foster quality sustainable inclusive education for all children with disabilities at scale across Tanzania in mainstream pre-primary and primary government schools. To achieve this, it aims to support collective, coordinated systems change by establishing an agreed common model of basic inclusive pre-primary and primary education in mainstream government schools, and galvanising significant progress in spreading its systematic implementation for all children with disabilities across Tanzania. 

 

This task requires the cooperation of government, civil society and Disabled People’s Organisations (DPOs) to achieve real change.  No single organisation or government department can achieve inclusive education on its own. Pooling the skills and resources and exchanging learnings to achieve quality inclusive education of children can help all involved. Working together will build collective commitment and action, not just amongst DID consortium members but also across government, donors, education actors and the private sector. 

 

Part of this process was to conduct a participatory field research to gather evidence on the current provision of support services needed for inclusive education and identify gaps that need to be filled in the future. The exercise also served to identify key challenges that need addressing to facilitate the removal of legal, policy, systemic, physical, communication and language, social, financial and attitudinal barriers. The findings from the research were intended to identify the priority components that need addressing in the design of an inclusive education design model and the drivers of accountability, i.e. the agencies/stakeholders responsible for implementing the required system changes.

 

Summary of key findings

The Government of Tanzania has continually demonstrated its support and commitment to inclusive education evidenced by the many comprehensive policies for inclusive education, including the National Inclusive Education Strategy (NSIE) 2018 – 2021.  Through these policies, it is actively working to improve the educational environment but the journey is long and requires significant system changes for the policies to be effectively implemented, which needs collaboration, cooperation, planning, and strategic resourcing across multiple ministries, NGOs, DPOs, and the private sector. 

 

To achieve inclusive education, a rights-based approach to education needs to be adopted, focusing on identifying and removing the barriers to access and quality learning for every child, including appropriate infrastructure changes in schools, changing attitudes, and providing additional support to girls and boys with disabilities through learning support assistants.  There also needs to be a fundamental shift towards child-centred pedagogy in teacher training and curriculum development to meet the needs of all learners, including having a mandatory module on inclusive education in all teacher training curricula.  Over time, this will help develop teachers’ confidence and positive attitudes towards teaching children with disabilities and achieve impact at scale.  Strengthening the capacities of all teachers, improving classroom management, increasing awareness about inclusive education for all stakeholders, and improving access to screening and early identification, health, rehabilitation services, and affordable assistive devices are all contributing factors to achieving inclusive education in Tanzania.

 

Systems change to improve learning and support for children with disabilities takes time and requires a significant investment of resources and budget allocation by government and service providers.  However, inclusive education can be cost-effective compared with the cost of segregation and special schools, particularly where ministries work together to ensure a more ‘strategic allocation of existing funds, promoting universal design and co-operation agreements among multiple ministries’.   Developing partnerships with the private sector to improve the physical infrastructure of schools and access to affordable assistive devices can also help reduce the cost of inclusion.

 

Inclusive education is a cross-cutting issue that requires the commitment and accountability of multiple stakeholders across government ministries to ensure its effective implementation.  This includes the MOEST, MOHCDGEC, MOFP, the Prime Minister’s Office (PMO) and the President's Office, Regional Administration and Local Government (PORALG). 

 

It is anticipated that to achieve successful implementation and scaling up of the model design for inclusive education, there will need to be a systematic and phased approach to implementing the recommendations in this report over the short, medium and long term.  It is acknowledged that this process will take considerable time to implement and can only be successfully achieved over a period of years with the support and increased understanding of all stakeholders.  There is no quick-fix solution to inclusive education.  It requires changing long-established systems and adjusting services, including health and education, training, and attitudes.  There is also no financial short cut. 

 

However, while some recommendations require significant investment, others can be achieved in the current context without significant monetary investment.  For example, changing the curriculum for all teacher training to ensure inclusive education is included as a standard module will help transform the approach of teachers and the inclusion of children with disabilities in learning.  Raising awareness of inclusive education for all stakeholders, including policy-makers and implementers will also help increase understanding of the long-term system changes required and reduce stigma and discrimination.  Inclusive education can only be achieved in an inclusive society and it needs collective effort from the government, parents, community, and all stakeholders for effective implementation.

Inclusion of persons with disabilities in Covid-19 response and recovery: seven steps to implementing the IASC Guidelines

PALMER, Tom
June 2020

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A brief overview of the Inter-Agency Standing Committee (IASC) Guidelines on inclusion of persons with disabilities in humanitarian action is given. Key points of the Humanitarian Policy Group (HPG) roundtable meeting (Mar 2020) are summarised, along with their implications for practice during the Covid-19 response. These are: accessible formats; learning and evidence; tools; training; coordination and partnerships; strategies for organisational change and accountability.

Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries

WALLACE, Sarah
MACTAGGART, Islay
MORGON BANKS, Lena
POLACK, Sarah
KUPER, Hannah
June 2020

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The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs).

A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties.

The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression

Guidance Note 4, TV and Radio Learning

McGEOWN, Julia
BOISSEAU, Sandra
BOHAN-JACQUOT, Sandrine
June 2020

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This guidance is part of a series to provide support during the Covid-19 crisis. The guidance notes include #1- Inclusive Digital learning #2 - Teacher resources and #3 Home support. #4 TV and Radio Learning #5Return to school.

 

A pictorial based summary of the top 10 tips is provided followed by explanation of the resources and more information about top tips, with hyperlinks of relevant resources.

Disability inclusion, COVID-19 and adaptations to the DFID Ghana LEAP 2 programme 43

WAPLING, Lorraine
MEANEY-DAVIS, Jessie
June 2020

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This short paper provides an overview of disability inclusion considerations for adaptations to Ghana’s Livelihood Empowerment Against Poverty (LEAP) 2 social protection programme during the COVID-19 pandemic. It includes considerations for changing the payment mechanism from cash payments to mobile money as well as the necessary communications and monitoring of beneficiary feedback and safeguarding during the pandemic. The attached annex provides detailed considerations of the benefits, risks and mitigations for specific programme adaptations.

HLPF 2020: "Will the SDGs still be relevant after the pandemic for persons with disabilities?

INTERNATIONAL DISABILITY ALLIANCE (IDA)
June 2020

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In the framework of the 2020 High-level Political Forum, the event provided a platform for governments championing disability-inclusive sustainable development. Governments were able to share the measures that they have and will carry out to ensure that the “leave no one behind” and “reach the furthest behind first” will still be achievable despite all the challenges caused by the pandemic. The event also featured diverse testimonies from persons with disabilities, in particular underrepresented groups, sharing their experiences and requests with world leaders in order to rebuild a more disability-inclusive future

Learning Needs Assessment Report: Skills for impact - Rohingya Humanitarian crisis response, Bangladesh Local Humanitarian Aid Workers

AHSANUL ISLAM, Suman
et al
June 2020

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The Rohingya humanitarian crisis response in Cox’s Bazar (CXB) is a fairly new and complex experience for the humanitarian aid workers in Bangladesh. Aid workers are responsible for responding effectively in a very demanding context and acquire certain skills and competencies to adapt to the extreme workload. Since the current response in CXB began in 2017, local humanitarian aid workers (LHAWs) have gathered tremendous amount of learnings and experiences.

 

The objective of this LNA is to outline the knowledge, skills, capacity gaps and learning needs of LHAWs working in CXB. 

 

This LNA focuses on understanding LHAWs’ skills, knowledge and behaviour - both operational & technical. It analyses individuals' ability to contribute and implement response plans and respond effectively to the humanitarian crisis. Analysis focuses on understanding LHAWs’ capacity in addressing the needs of specific beneficiary groups such as children, women & girls, people with disability (PwD), elderly and people with chronic health issues. Quantitative and qualitative data was collected in November 2019.

 

COVID-19 outcomes among people with intellectual and developmental disability living in residential group homes in New York State

LANDES, Scott D.
TURK, Margaret A.
FORMICA, Margaret K.
McDONALD, Katherine E.
STEVENS, J. Dalton
June 2020

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In order to investigate whether people with intellectual and developmental disabilities (IDD) are at higher risk of severe outcomes from COVID-19, the COVID-19 outcomes among people with IDD living in residential groups homes in the state of New York and the general population of New York State were compared. Data for people with IDD are from a coalition of organizations providing over half of the residential services for the state of New York, and from the New York State Department of Health. Analysis describes COVID-19 case rates, case-fatality, and mortality among people with IDD living inresidential group homes and New York State through May 28, 2020

 

Disability and Health Journal, https://doi.org/10.1016/j.dhjo.2020.100969

 

Accountability, feedback & complaints mechanisms in humanitarian responses to migration

KAHN, Clea
June 2020

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This guidance aims to give humanitarian actors a guidance for developing their accountability mechanisms in the context of mixed migration, with a focus on complaints and feedback mechanisms. Excellent guidance already exists on how to implement feedback and complaint mechanisms in humanitarian contexts, and this is not intended to replace or duplicate those. It should be read as a supplement, to provide additional reflection for humanitarian actors working in migration contexts.

The development of this guidance was based on a review of existing literature, including research studies, guidelines and training materials. More than 30 interviews were conducted with representatives of more than 20 organisations working in Africa, the Americas, the Middle East and Europe. Particular support was received from Start Network’s MERF member organisations.

Considering the disability related extra costs in social protection

MONT, Daniel
COTE, Alexandre
et al
June 2020

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This paper tackles several critical elements required for social protection systems and programs to adequately consider disability related extra costs. In the first part, it will explain the diversity of disability related costs. The second part will present current methods to assess and measure disability related costs and the issues they raise. The last part will present how social protection systems can take into account and tackle those different disability related costs.

 

This background paper is a part of a series produced in the frame of a project led by ILO and UNICEF in close collaboration with the International Disability Alliance (IDA) and supported by the UN Partnership on the Rights of Persons with Disabilities. It has been co-financed by Leonard Cheshire in the frame of the DFID funded I2I project. The UNPRPD project aims at developing practical guidance for countries, development agencies and DPOs for reforms towards inclusive social protection systems fostering empowerment of persons with disabilities across the life cycle. The papers summarize key issues and present policy recommendations and proposal to build inclusive social protection systems supporting empowerment and participation of persons with disabilities across the life cycle

Addressing barriers to employment for people with disabilities: evidence and lessons learned. Disability Inclusion Helpdesk Research Report No. 41

MEANIE-DAVIS, Jessie
COE, Sue
June 2020

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This work was carried out to answer the query: “What is the evidence available on interventions that effectively address the barriers to people with disabilities accessing and maintaining employment (decent work) in the agriculture and manufacturing sectors in low and middle income countries?”.

This paper provides an overview of findings from evaluations, research, and case studies on programmes that seek to address barriers to employment for people with disabilities in low and middle income countries (LMICs). There is extremely limited evidence available on this subject, particularly from mainstream agriculture, livelihoods and employment programmes. Almost all of the evidence available is from programmes with a specific focus on disability inclusion. Due to the lack of evidence available from interventions specifically focused on employment in the agriculture and manufacturing sectors, the scope of this query was expanded to include evidence from employment programmes that are not specific to one sector

This rapid evidence review identified three common programme approaches that seek to address different combinations of these barriers by working with different stakeholder groups: Single intervention approaches; Supply and demand approaches; and Systems approaches.

Fragmented yet together: the disability movement in Sierra Leone

VAN DEN BRINK, Amélie
ELBERS, Willem
IBRAHIM, Aisha Fofana
2020

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The on-going struggles of disability movements worldwide have been examined from multiple perspectives. As of yet, however, research into this topic has largely overlooked experiences on the African continent. This article seeks to address this gap by presenting a case study of the disability movement in Sierra Leone, West Africa. The study finds that on the one hand the Sierra Leonean disability movement is fragmented (referring to the tendency of groups to work individually as opposed to operating in a collective manner), thus limiting synergy. Three main ‘centrifugal’ forces underlying fragmentation are identified: resource scarcity, impairment specific interests and capacity differences between impairment types. On the other hand, the movement somehow manages to survive and even achieve modest successes. The research shows that interdependence, shared experiences of marginalization, and a clear identification of the ‘other’ have a unifying effect.

  • The disability movement in Sierra Leone is fragmented, meaning it struggles to formulate a unified position and act collectively, yet somehow survives and even manages to achieve some successes;
  • The fragmentation is fueled by competition between groups, a hierarchy between impairment types and interests that are impairment specific.
  • The movement is kept together by mutual dependence to achieve key goals and raise funds, shared experiences of marginalization and negative experiences with ‘outsiders’.
  • The research offers recommendations to disability groups and donors to mitigate fragmenting forces while strengthening unifying forces.

Loneliness in life stories by people with disabilities

TARVAINEN, Merja
2020

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This study investigates loneliness in life stories by people with disabilities. By approaching loneliness from a relational perspective, this study attempts to illustrate how loneliness and disability are intertwined in the life course. The research question was as follows: How do people with disabilities understand loneliness in their life stories? Life story data ‘Life of Disabled Persons in Finland 2013–2014’ was analysed with a narrative life course approach. Loneliness was narrated in accordance with normative life course expectations. People with disabilities narrated loneliness as unbelonging in childhood, disjointed youth and disaffiliation to normative institutions in adulthood. This study suggests that relation between loneliness and disability concern the conditions of inclusion that is the conditions of living and telling.

  • Loneliness involves both unwanted emotions and social isolation. 
  • In many societies, both loneliness and disability bear a stigma. This so-called double stigma affects the lives of people with disabilities.
  • This study explores loneliness and disability in life stories by people with disabilities in Finland from a life course perspective. Although scholars have widely studied loneliness in Finland, they have not studied loneliness in people with disabilities in any great depth.
  • Loneliness in life stories by people with disabilities was narrated in relation to a sense of bodily difference and occurred as a disconnection from a socially ‘standard’ life course. Loneliness was located within three main phases: childhood, youth and adulthood. Negative attitudes towards disability feed social isolation and emotional loneliness.
  • Further research on disability and loneliness throughout the life course as well as more discussion about the conditions of inclusion and the emotional patterns of social relations are needed.

Multifaceted interventions for supporting community participation among adults with disabilities

GROSS, Judith
MONROE-GULICK, Amalia
DAVIDSON-GIBBS, Debbie
NYE, Chad
June 2020

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This Campbell systematic review and meta-analysis examines the impact of multifaceted interventions on community participation outcomes for adults with disabilities, and aims to find effective components of the interventions. The review summarizes the findings from 15 reports of multifaceted interventions in five countries.

Included studies employ at least two interventions designed to address two or more participant characteristics (e.g., skill enhancement, behavior/attitude change) and/or environmental characteristics (e.g., participant interactions with people, places, or things) resulting in outcomes that provide direct access to the community (e.g., competitive employment, adult learning, housing) or are a dimension of community participation (e.g., self-determination, quality of life, social networking).

 

Campbell Systematic Reviews. 2020; 16:e1092.

https://doi. org/10.1002/cl2.1092.

Significant challenges when introducing care robots in Swedish elder care

JOHANSSON-PAJALA, Rose-Marie
GUSTAFSSON, Christine
2020

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Introduction: 

Care robots are machines, operating partly or completely autonomously, that are intended to assist older people and their caregivers. Care robots are seen as one part of the solution to the aging population, allowing fewer professional caregivers to provide the necessary assistance and care. Despite the potential benefits, the dissemination of care robots, and welfare technology in general, is limited in Swedish elder care.

 

Purpose: 

To explore the challenges of introducing welfare technology, particularly care robots, in elder care.

 

Materials and methods:

 Twenty-one individual interviews with key actors at the societal level, analysed by thematic analysis.

 

Results: 

The challenges, from the societal actors’ perspectives, were related to; the beliefs in technology, attitudes, ethics, collaboration, and the need for knowledge and skills regarding care robots (individual and group challenges). Challenges of a national character were: national governance, infrastructure, laws and regulations, economics, and procurement (systemic and societal challenges). In addition, the necessary preconditions for successful introduction were revealed as: the utility of the technology, implementation, evaluation and safety, security, and integrity (preconditional challenges).

 

Conclusions: 

The introduction of care robots in elder care services seems to be more challenging than that of welfare technology in general, given the context and prevailing attitudes and preconceptions about robotics. Significant challenges need to be managed, at all levels of the society, before care robots can become an integral part of daily care and assist older people and their caregivers in activities and rehabilitation.

Aesthetics and the perceived stigma of assistive technology for visual impairment

DOS SANTOS, Aline Darc Piculo
FERRARI, Ana Lya Moya
MEDOLA, Fausto Orsi
SANDNES, Frode Eika
2020

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Purpose: 

The aim of this study was to identify factors that influence the perceived stigma of two assistive devices for visual impairment, namely the white cane and smart glasses.

 

Method: 

Face-to-face semi-structured interviews with eight European students were conducted to probe their experiences and knowledge related to disability, assistive technology, visual impairment, as well as handheld and wearable devices.

 

Results: 

Close relationships with disabled people seems to have a positive influence on participants perceptions about stigma, disability, and assistive technology. Academic background seems to not have any influence. The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device.

 

Conclusion: 

Device without negative symbolism but with modern aesthetics (smart glasses) were positively accepted by the participants than the device with traditional aesthetics and symbolisms of visual impairment (white cane). Designers should, therefore, consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment.

Introduction: disability, partnership, and family across time and space

VIKSTRÖM, Lotta
SHAH, Sonali
JANSSENS, Angélique
2020

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Notions of family life and romantic partnership, like notions of disability, have been culturally constructed and socially produced over historical time, and our understandings of these notions are being continually challenged and re-negotiated across time and space. Policies, institutions, and cultural practices across the globe have brought about changes to the construction of the family and to the rights and inclusion of disabled people in private and public life. This special issue brings together a collection of studies from different countries and time periods to explore the interplay between disability, romantic partnerships, and family life across the individual lifetime and between generations. With this interdisciplinary collection, we seek to merge disability research and research on family and partnerships through a life course lens. This offers unique insights and opportunities to interconnect his- torical and cultural location and changing social institutions with individual and family experiences. This introduction presents the eight studies in the collection and discusses them within a life course frame that views disabled people’s roles as partners, spouses, and members of a family. In so doing, it engages in an analysis of (dis)similarities concerning how family dynamics, romantic relationships, and disability have developed over time and in different spaces.

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