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Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

ADAKU, Alex
et al
September 2016

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Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom were, at the time of the research, in refugee settlements located throughout Uganda. A mental health and psychosocial support (MHPSS)​MHPSS needs and resource assessment was carried out in Rhino Camp refugee settlement in northern Uganda, between June and August 2014 following World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).

Integration of childhood tuberculosis into maternal and child health, HIV and nutrition services: A case study from Uganda

VERKUIJL, Sabine
et al
September 2016

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"Country case studies were conducted in Uganda and Malawi to document and analyse experiences and perspectives on childhood TB integration into other programmes at country level and related health system requirements. The aim was to inform the broader thinking about integration of childhood TB services. The Uganda case study identified and described different approaches to integration and unpacked the integration process. The perspective on TB integration of different relevant health actors at national and district level are described. The case study used a health systems approach and focused on the community and primary levels of the health system, paying attention to factors related to children of different ages in a lifecycle approach. The methodology for the case study included document review, consultations with key health actors at national and district level, a facility visit and a participatory workshop at national level. An analytical framework approach was used to investigate the extent of integration of childhood TB interventions in multiple dimensions. An assessment tool for the case studies was developed, summarising the assessment questions by theme, combining a number of existing tools and frameworks on health care integration in general and childhood TB and iCCM benchmarks"

An adult learning perspective on disability and microfinance: The case of Katureebe

NUWAGABA, Ephraim L
RULE, Peter N
2016

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Background: Despite Uganda’s progress in promoting affirmative action for persons with disabilities and its strategy of using microfinance to fight poverty, access to microfinance services by persons with disabilities is still problematic due to barriers, characterised by discrepancies between policies and practices. Regarding education, the affirmative action in favour of learners with disabilities has not translated into actual learning opportunities due to personal and environmental barriers.


Objectives: The study on which this article is based investigated the non-formal and informal adult learning practices regarding microfinance that persons with disabilities engaged in. This article seeks to illuminate the barriers that a person with a visual impairment encountered while learning about and engaging with microfinance and the strategies that he developed to overcome them.


Methods: This was a case study, framed within the social model of disability and critical research paradigm. Data were collected through in-depth interviews of a person with visual impairment and observations of the environment in which adult learning and engagement with Savings and Credit Cooperative Organisations (SACCOs) occurred.


Results: Findings indicate that the person with a visual disability faced barriers to learning about microfinance services. He experienced barriers in an integrated manner and developed strategies to overcome these barriers. The barriers and strategies are theorised using the social model of disability.


Conclusion: The case of a person with visual impairment suggests that persons with disabilities face multiple barriers regarding microfinance, including social, psychological and educational. However, his own agency and attitudes were also of importance as they influenced his learning. Viewing these barriers as blockades can lead to non-participation in learning and engagement with microfinance whereas viewing them as surmountable hurdles can potentially motivate participants to succeed in learning about and engaging with microfinance.

Early childhood development and child protection in emergencies

PLAN INTERNATIONAL
UNICEF
July 2016

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This purpose of this technical note is to support child protection in emergencies personnel to programme appropriately for 0 to 8-year-old children. It extends the basic content included in UNICEF’s Early Childhood Development in Emergencies: Integrated Programme Guide to help UNICEF staff and partners implement quality programmes in emergency settings. Preparedness key activities and response key activities are listed. Two case studies are presented: one from Uganda and the other from Syria.

Parental stress and support of parents of children with spina bifida in Uganda

BANNINK, Femke
IDRO, Richard
VAN HOVE, Geert
2016

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Background: Children with disabilities in Sub-Saharan Africa depend for a large part of their functioning on their parent or caregiver. This study explores parental stress and support of parents of children with spina bifida in Uganda.

 

Objectives: The study aimed to explore perceived stress and support of parents of children with spina bifida living in Uganda and the factors that influence them.

 

Methods: A total of 134 parents were interviewed. Focus group discussions were held with four parent support groups in four different regions within the country. The Vineland Adaptive Behaviour Scales, Daily Functioning Subscales and Parental Stress Index Short Form (PSI/SF) were administered to measure the child’s daily functioning level and parental stress levels.

 

Results: Parental stress was high in our study population with over half of the parents having a > 90% percentile score on the PSI/SF. Stress outcomes were related to the ability to walk (Spearman’s correlation coefficient [ρ] = −0.245), continence (ρ = −0.182), use of clean intermittent catheterisation (ρ = −0.181) and bowel management (ρ = −0.213), receiving rehabilitative care (ρ = −0.211), household income (ρ = −0.178), geographical region (ρ = −0.203) and having support from another parent in taking care of the child (ρ = −0.234). Linear regression showed parental stress was mostly explained by the child’s inability to walk (β = −0.248), practicing bowel management (β = −0.468) and having another adult to provide support in caring for the child (β = −0.228). Parents in northern Uganda had significantly higher scores compared to parents in other regions (Parental Distress, F = 5.467*; Parent–Child Dysfunctional Interaction, F = 8.815**; Difficult Child score, F = 10.489**).

 

Conclusion: Parents of children with spina bifida experience high levels of stress. To reduce this stress, rehabilitation services should focus on improving mobility. Advocacy to reduce stigmatisation and peer support networks also need to be strengthened and developed.

Disability and armed conflict: A quest for Africanising disability in Uganda

BUSINGE, Patrick
2016

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There are three key revelations from literature on disability and armed conflict in the Global South. First, though disability is a relative term, models from the Global North are widely used irrespective of indigenous knowledges and contexts. Second, though disability is caused by colonial and post-colonial inequalities such as poverty, disabled people are often forgotten in poverty reduction programmes. Third, while many countries experience armed conflict, little is known about its effects on disabled people living in contexts of armed conflict. This realisation led to the aims of this study which were to: i) investigate how disability is understood in the armed conflict setting of Uganda; ii) to understand the experiences of disabled people in armed conflict settings; and iii) examine ways of improving the experience of disabled people in the Global South. Using a critical, constructivist and grounded research methodology, the study revealed the nature of ‘African disabilities’ and the challenges faced by disabled people living in conflict settings: displacement, dehumanisation, rampant poverty and neo-colonialism. Disabled people experience rejection in their communities and invisibility in the provision of services. Using literature as a dialogue partner, this study concludes that the ways in which disabled people are treated runs counter to many African beliefs on what it means to be human and live in a community. Consequently, it proposes a theory which contains critical knowledge on how the Africanisation of disability could be thought of and brought about in conflict settings.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 1

Disability & the Global South (DGS), 2016, Vol. 3 No. 1

2016

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Articles include:

  • Disability and armed conflict: A quest for Africanising disability in Uganda
  • Disadvantage and disability: Experiences of people from refugee backgrounds with disability living in Australia
  • Tangible First Steps: Inclusion Committees as a Strategy to Create Inclusive Schools in Western Kenya
  • The Re-covering Self: a critique of the recovery-based approach in India’s mental health care
  • To what extent is Universal Design for Learning “universal”? A case study in township special needs schools in South Africa
  • Una Vida Sin Palabras?: Disability, Subalternity and the Sandinista Revolution

Training social facilitators in personalised social support: Trainers’ booklet

LAFRENIERE, Annie
RELANDEAU, Audrey
KIANI, Shirin
December 2015

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This booklet is the gateway for a training kit on personalised social support (PSS). The aim of this training course is to train social facilitators either in the personalised approach only, or in how to carry out a complete PSS process. The aim of this booklet is therefore to impart the methodological and educational components required to use the content of this training course to Handicap International’s (now Humanity and Inclusion) future PSS trainers. It therefore takes another look at the entire content of the PSS training course, explains the educational choices, presents the modules and other teaching tools created, and above all, provides advice/recommendations for future designers and trainers/facilitators on this theme. Throughout this booklet, internet links provide the reader with quick access to the content of training courses and other relevant resources

Deaf identities in a multicultural setting: The Ugandan context

MUGEERE, Anthony B
ATEKYEREZA, Peter
KIRUMIRA, Edward K
HOJER, Staffan
2015

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Often located far apart from each other, deaf and hearing impaired persons face a multiplicity of challenges that evolve around isolation, neglect and the deprivation of essential social services that affect their welfare and survival. Although it is evident that the number of persons born with or acquire hearing impairments in later stages of their lives is increasing in many developing countries, there is limited research on this population. The main objective of this article is to explore the identities and experiences of living as a person who is deaf in Uganda. Using data from semi-structured interviews with 42 deaf persons (aged 19–41) and three focus group discussions, the study findings show that beneath the more pragmatic identities documented in the United States and European discourses there is a matrix of ambiguous, often competing and manifold forms in Uganda that are not necessarily based on the deaf and deaf constructions. The results further show that the country’s cultural, religious and ethnic diversity is more of a restraint than an enabler to the aspirations of the deaf community. The study concludes that researchers and policy makers need to be cognisant of the unique issues underlying deaf epistemologies whilst implementing policy and programme initiatives that directly affect them. The upper case ‘D’ in the term deaf is a convention that has been used since the early 1970s to connote a ‘socially constructed visual culture’ or a linguistic, social and cultural minority group who use sign language as primary means of communication and identify with the deaf community, whereas the lower case ‘d’ in deaf refers to ‘the audio logical condition of hearing impairment’. However, in this article the lower case has been used consistently.

‘Ask us what we need’: Operationalizing Guidance on Disability Inclusion in Refugee and Displaced Persons Programs

PEARCE, Emma
2015

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Persons with disabilities remain one of the most vulnerable and socially excluded groups in any displaced community. Barriers to accessing humanitarian assistance programs increase their protection risks, including risk of violence, abuse and exploitation. Women’s Refugee Commission has been supporting the United Nations High Commissioner for Refugees and implementing partners to translate guidance on disability inclusion into practice at field levels through the provision of technical support to eight country operations. In the course of the project, WRC has consulted with over 600 persons with disabilities and care-givers and over 130 humanitarian actors in displacement contexts. Key protection concerns identified include a lack of participation in community decision making; stigma and discrimination of children and young persons with disabilities by their non-disabled peers; violence against persons with disabilities, including gender-based violence; lack of access to disabilityspecific health care; and unmet basic needs among families of persons with multiple impairments. Suggested strategies to further advance disability inclusion in humanitarian programming include: strengthening identification of protection risks and case management services for persons with disabilities; facilitating contextspecific action planning around key guidelines; and engaging the disability movement in advocacy on refugee issues.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 1

Beneath the rhetoric: Policy to reduce the mental health treatment gap in Africa

COOPER, Sara
2015

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In this paper I problematize knowledge on reducing the ‘gap’ in treatment produced by 14 national mental health policies in Africa. To contextualize this analysis, I begin with a historic-political account of the emergence of the notion of primary health care and its entanglement within decolonization forces of the 1960s. I unpack how and why this concept was subsequently atrophied, being stripped of its more revolutionary sentiments from the 1980s. Against this backdrop, I show how, although the 14 national mental health policies are saturated with the rhetoric of primary health care and associated concepts of community participation and ownership, in practice they tend to marginalize local meaning-systems and endorse a top-down framework heavily informed by colonial medicine. The policies thus end up reproducing many of the very Eurocentric assumptions that the original primary health care notion sought to transcend. More specifically, the paradigms of evidence-based research/practice and individualised human rights become the gatekeepers of knowledge. These two paradigms, which are deeply embedded within contemporary global mental health discourse, are legislating what are legitimate forms of knowing, and by extension, valid forms of care. I argue that a greater appreciation of the primary health care concept, in its earliest formulation, offers a potentially fruitful terrain of engagement for developing more contextually-embedded and epistemologically appropriate mental health policies in Africa. This in turn might help reduce the current ‘gap’ in mental health care treatment so many countries on the continent face.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

How disability studies and ecofeminist approaches shape research: exploring small-scale farmer perceptions of banana cultivation in the Lake Victoria region, Uganda

LEADBEATER, Bridget
2015

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This paper explores the complex intersections of race, gender and disability, whilst offering a critical reflection on how disability studies discourse and ecofeminist approaches together elucidate a subjectivity that is unique, distinct and influential in generating participatory action research knowledge. Reflection and insights are based on empirical work with small-scale farmers (mainly women) in the central region of Uganda carried out for a PhD study. The study aimed to illuminate the broad and complex livelihood experiences of domestic banana (staple crop) cultivators and their perceptions of bio-technological intervention in the form of banana tissue culture (TC) and the associated processes. Subjectivity between the researcher and respondents is a two-way process. As a researcher who is disabled woman using a wheelchair, working in the field required much adaptation physically and mentally. Equally, my disability shaped respondents’ perceptions of me as a person, a researcher as well as their responses. In fact, arguably, my disability facilitated unusual circumstances and opened up doors to sensitive questions, personal accounts and a mutual rapport between the farmers and myself. The influence of the disabled research subject fostered exceptional conditions to propagate inclusive investigative methods to represent ‘the lived experience’ of the farmer in a procedure not often applied in agricultural research.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

Disability & the Global South (DGS), 2015, Vol. 2 No. 3

2015

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Articles include:

  • Typhoon Haiyan One Year On: Disability, Poverty and Participation in the Philippines
  • Beneath the rhetoric: Policy to reduce the mental health treatment gap in Africa
  • Working within the tensions of disability and education in post-colonial Kenya: Toward a praxis of critical disability studies
  • How disability studies and ecofeminist approaches shape research: exploring small-scale farmer perceptions of banana cultivation in the Lake Victoria region, Uganda
  • Partnerships for Disability Research in Africa: Lessons Learned in Kinshasa, Democratic Republic of the Congo
  • Representation, Access and Contestation: Facebook and Vision Impairment in Jordan, India, and Peru

Equal basis 2014 : access and rights in 33 countries

BURKE, Megan
PERSI VICENTIC, Loren
December 2014

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This report presents research about efforts to meet the needs and uphold the rights of persons with disabilities in four thematic areas: health care, rehabilitation, work and employment, and accessibility and enabling environments. Research findings are drawn from the experiences of landmine and cluster munition survivors and other persons with similar needs in 33 countries experiencing armed conflict or emerging from armed conflict or political or economic transition. Findings are placed within the context of relevant articles of the Convention on the Rights of Persons with Disabilities and the World Report on Disability

The African report on violence against children

THE AFRICAN CHILD POLICY FORUM (ACPF)
September 2014

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This report reveals that Africa’s children are still subjected to levels of physical and emotional violence despite more than a decade of efforts by governments. The report “constitutes the most comprehensive study to date of the phenomenon in Africa and lays down the priorities for action at various levels that will be required to achieve better protection of children.  The report’s findings are principally informed by large scale surveys undertaken in Ethiopia, Kenya, Malawi, Mali, Morocco, Uganda, Zambia and Zimbabwe, and a review of more than 75 studies and reports. It reveals that a distinctive range of social, cultural and economic factors can combine to increase the risk of African children facing increased levels of physical and emotional violence in domestic settings, at schools, in institutions and in the workplace. These risks may be exacerbated in times of political upheaval and conflict, and girls are particularly vulnerable”

Disability inclusion : translating policy into practice in humanitarian action

PEARCE, Emma
March 2014

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This report “documents positive practices and ongoing challenges to promote disability inclusion across UNHCR’s and its partners’ work in multiple countries and multiple displacement contexts. The report provides lessons and recommendations for other organizations and the wider humanitarian community on engaging persons with disabilities at all levels of humanitarian work. It draws on consultations with over 700 displaced persons, including persons with disabilities, their families, and humanitarian staff, in eight countries”

Note: This report is also offered in plain text format

Disability : making CLTS fully inclusive

WILBUR, Jane
JONES, Hazel
2014

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This issue of Frontiers of CTLS (Community led total sanitation) focuses on “people with disabilities and particular needs for access to sanitation. There are many forms of disability, including mobility impairments, sensory impairments (affecting sight or hearing), chronic illness, impairments caused by older age or mental health issues.  People affected tend not to be present at triggering, to lack voice in the community, to have their needs overlooked, and may even be hidden by their families. This issue outlines the reality of the experiences of disabled people, the varied nature of their needs and how they can be met. It includes practical recommendations for people engaged in CLTS to make the different phases and processes of CLTS more inclusive”

Frontiers of CLTS : innovations and insights, Issue 03

A video and presentation is also available

Fact sheet : refugees with disabilities

WOMEN’S REFUGEE COMMISSION
2014

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This factsheet highlights the issue of disabilities among refugees and conflict-affected population. It emphasizes actions undertaken by the Women’s Refugee Commission (WRC) and highlights their next steps in disability inclusion

Note: Also available in easy read format

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