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Systematic review of interventions for reducing stigma experienced by children with disabilities and their families in low and middle-income countries: state of the evidence.

SMYTHE, Tracey
ADELSON, Jaimie
POLACK, Sarah
March 2020

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A literature review was carried out to identify and assess the evidence for interventions to reduce stigma experienced by children with disabilities and their families in low and middle-income settings. A systematic review of seven databases (MEDLINE, EMBASE, Global Health, PsycINFO, Social Policy and Practice, CINAHL, IBSS) for articles published January 2000 to April 2018 was carried out. Data were extracted on study population, study design, intervention level(s) and target group, and type(s) of stigma addressed. A narrative approach was used to synthesise the results.

Twenty studies were included. The majority (65%) of interventions targeted enacted stigma (negative attitudes) and the most common intervention approach was education/training (63%). Over half (54%) of interventions were delivered at the organisational/ institutional level and only four studies targeted more than one social level. The most common disability targeted was epilepsy (50%) followed by intellectual impairment (20%). 

doi: 10.1111/tmi.13388

Trop Med Int Health. 2020 Mar

Estimated prevalence of disability and developmental delay among pre‐school children in rural Malawi: Findings from ‘Tikule Limodzi’, a cross‐sectional survey

MURPHY, Rachel
et al
January 2020

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This study measured and compared the prevalence of disability and developmental delay among children attending preschool centres in rural Malawi. A cross-sectional survey was conducted in 48 preschool centres in Thyolodistrict, Malawi. Data were collected from parents or guardians of 20 children per centre. Disability was ascertained using the Washington Group/UNICEF Child Functioning Module. Child development was measured using the language and social domains of the Malawi Development Assessment Tool. A total of 960 children were enrolled; 935 (97.4%) children were assessed for disability and 933 (97.2%) for developmental delay; 100 (10.7%) children were identified as having a disability

 

Child Care Health Dev. 2020;46:187–194.
https://doi.org/10.1111/cch.12741

Integrating geospatial data and measures of disability and wealth to assess inequalities in an eye health survey: An example from the Indian Sunderbans

MOHANTY, Soumya
et al
December 2019

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The Sunderbans are a group of delta islands that straddle the border between India and Bangladesh. For people living on the Indian side, health services are scarce and the terrain makes access to what is available difficult. In 2018, the international non-governmental organisation Sightsavers and their partners conducted a population-based survey of visual impairment and coverage of cataract and spectacle services, supplemented with tools to measure equity in eye health by wealth, disability, and geographical location. Two-stage cluster sampling was undertaken to randomly select 3868 individuals aged 40+ years, of whom 3410 were examined

 

Int J Environ Res Public Health. 2019 Dec; 16(23): 4869

doi: 10.3390/ijerph16234869

TT Tracker app aims to improve surgical outcomes and patient care

JENSEN, Kimberley
et al
November 2019

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Trichiasis (TT) operations are generally conducted in remote and resource-poor settings, which can make it difficult to follow-up and assess surgical outcomes. Sightsavers developed an Android-based mobile phone application, called the TT Tracker, which helps surgeons, assistants and supervisors to collect and analyse information about surgical outcomes and performance, and to determine when and where follow-up appointments are required. 

 

Community Eye Health. 2019; 31(104): 93.

Optimising the performance of frontline implementers engaged in the NTD programme in Nigeria: lessons for strengthening community health systems for universal health coverage

OLUWULE, A
et al
November 2019

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This research article focuses on optimising the performance of frontline implementers engaged with NTD programme delivery in Nigeria. Three broad themes are examined: technical support, social support and incentives

Qualitative data was collected through participatory stakeholder workshops. Eighteen problem-focused workshops and 20 solution-focussed workshops were held  in 12 selected local government areas (LGA) across two states in Nigeria, Ogun and Kaduna States

 

Human Resources for Health, 2019 Nov 1;17(1):79

doi: 10.1186/s12960-019-0419-8

Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan

MACLEOD, C K
October 2019

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To estimate the proportion of children with trachomatous inflammation—follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors. 

A random-effects hierarchical model was used to evaluate factors associated with TF and TT. Thirty-six IDP camps were represented in the survey data in which 1926 children aged 1–9 years were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1–9 years.

 

Transactions of The Royal Society of Tropical Medicine and Hygiene. 2019 Oct 11;113(10):599-609

DOI:10.1093/trstmh/trz042

India’s disability estimates: Limitations and way forward

RAKHI, Dandona
et al
September 2019

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With India preparing for the next decennial Census in 2021, disability estimates and data collection methodology between the Census 2011 and the most recent population-level survey for India and its states were compared, to highlight the issues to be addressed to improve robustness of the disability estimates in the upcoming Census.

 

Data from the Census 2011 and from two complementary nationally representative household surveys that covered all Indian states with the same methodology and survey instruments–the District-Level Household Survey-4 (DLHS-4, 2012–2013) and the Annual Health Surveys (AHS three rounds, 2010–11, 2011–12 and 2012–13) were used. Data from DLHS-4 and AHS 2012–13 round were pooled to generate estimates for the year 2012–13. Data collection methodology between the sources was compared, including the review of definitions of each type of disability. The overall, mental, visual, hearing, speech, and movement disability rate (DR) per 100,000 population were compared between the sources for India and for each state, and the percent difference in the respective rates was calculated
 

Estimating the intracluster correlation coefficient for trachomatous inflammation-follicular in population-based trachoma prevalence surveys: results from a meta-regression of 261 standardised pre-intervention surveys in Ethiopia, Mozambique, and Nigeria.

MACLEOD, Colin
et al
September 2019

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This study used a parametric bootstrap model to estimate intracluster correlation coefficient (ICC) for trachomatous inflammation-follicular (TF) in 1-9 year-olds, from 261 population-based trachoma prevalence surveys completed using standardised GTMP methodologies in Ethiopia, Mozambique, and Nigeria from 2012-2016.

Results from this study were used to draw up the most recent WHO 2018 recommendations on design effect (DE) estimates for sample size calculations for survey

 

American Journal of Epidemiology, 2019 Sep 11. pii: kwz196

doi: 10.1093/aje/kwz196

 

 

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: successes and challenges

SENYONJO, Laura
et al
September 2019

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In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. This paper outlines and reviews the adaptations made by Ghana between 2011 and 2016

Infectious Diseases of Poverty volume 8, Article number: 78 (2019)

Integrating face washing into a school-based, handwashing behavior change program to prevent trachoma in Turkana, Kenya

TIDWELL, James
et al
August 2019

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Trachoma is the leading infectious cause of blindness, and facial cleanliness has been associated with reduced odds of trachomatous inflammation and Chlamydia trachomatis infection.  This study reports on the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya

 

American Journal of Tropical Medicine and Hygiene. 2019 Oct;101(4):767-773

doi: 10.4269/ajtmh.19-0205.

Health economic evaluation in orthotics and prosthetics: a systematic review protocol

CLARKE, Leigh
DILLON, Michael
SHIEL, Alan
June 2019

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The aim of this systematic review is to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues and the extent to which the literature informs orthotic/prosthetic policy and investment decisions

 

Systematic Reviews volume 8, Article number: 152 (2019)

doi:10.1186/s13643-019-1066-9

 

 

People are neglected, not diseases: the relationship between disability and neglected tropical diseases

HAMILL, Claire Louise
et al
May 2019

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The affect of NTDs can contribute to poverty, illness, mental health and psychosocial, cognitive, intellectual and physical impairments, all of which can, in turn, result in disability through a multifaceted process upon which many other factors impinge. It is this complex and non-linear relationship between disability and NTDs that forms the basis of this review

 

Transactions of The Royal Society of Tropical Medicine and Hygiene 2019; 00: 1–6
doi:10.1093/trstmh/trz036

 

 

ClinFIT: ISPRM's Universal Functioning Information Tool based on the WHO's ICF

FRONTERA, Walter
et al
May 2019

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A short editorial reviews the development of ClinFit (“Clinical Functioning Information Tool”).  The expectation is that ClinFIT can be tailored to the needs of (1) rehabilitation service types along the continuum of care, (2) different patient populations across age groups and health conditions, and (3) low-, middle-, and high‑income countries

 

J Int Soc Phys Rehabil Med 2019;2:19-21

DOI: 10.4103/jisprm.jisprm_36_19

Access to social protection among people with disabilities: Evidence from Viet Nam

BANKS, Lena
et al
January 2019

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This study uses mixed methods to explore participation in disability‐targeted and non‐targeted social protection programmes in Viet Nam, particularly in the district of Cam Le. Following an overview of social protection in Viet Nam, and in addition to presenting quantitative measures of access, this article identifies challenges and facilitators to participation in social protection.

A mixed‐methods approach was used to evaluate the extent to which people with disabilities are accessing existing social protection programmes, including an evaluation of the effects of barriers and facilitators to access. First, a national policy analysis was conducted to provide an overview of available social protection entitlements, and how their design and implementation may affect access for people with disabilities. Second, qualitative and quantitative research was conducted in one district of Viet Nam to measure coverage and uptake of specific entitlements and to explore factors influencing access in greater depth.

 

International Social Security Review,Vol. 72, 1/2019
https://doi.org/10.1111/issr.12195

Expectations management; employer perspectives on opportunities for improved employment of persons with mental disabilities in Kenya

EBUENYI, Ikenna, D
et al
January 2019

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In Kenya, the employment rate for persons with disabilities is about 1% compared to 73.8% for the general population, and the situation is even worse for persons with mental disabilities. Persons with mental disabilities are often regarded as “mad”, and stand little or no chance of employment. An exploratory study was undertaken with employers and potential employers to understand factors that hinder or facilitate their employment and to gain insight into employers’ perceptions of mental disability.

A mixed method study design was adopted, including in-depth interviews (n = 10) and questionnaires (n = 158) with (potential) employers in Kenya to explore the barriers and facilitators of employment for persons with mental disabilities

 

Disability and Rehabilitation, https://doi.org/10.1080/09638288.2018.1534006

 

Community knowledge, attitude, and perceived stigma of leprosy amongst community members living in Dhanusha and Parsa districts of Southern Central Nepal

SINGH, Rakesh
SINGH, Babita
MAHATO, Sharika
January 2019

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The main objective of this study was to assess the knowledge, attitude and stigma of leprosy amongst the community members living in Dhanusha and Parsa districts of Southern Central Nepal. A total of 423 individuals were interviewed using a structured questionnaire in Dhanusha and Parsa districts. Data was analyzed using both descriptive (frequency, percentage, median) and statistical inferences.

Rating early child development outcome measurement tools for routine health programme use

BOGGS, Dorothy
et al
January 2019

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Background identification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). ECD measurement tools were systematically assessed for accuracy and feasibility for use in routine services in low income and middle-income countries (LMIC).

Building on World Bank and peer-reviewed literature reviews, available ECD measurement tools for children aged 0–3 years used in ≥1 LMIC were identified and matrixed according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering ≥3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations

Strengthening personal and family resilience: a literature review for the leprosy context

VAN'T NOORDENDE, Anna Tiny
KUIPERS, Kim
PEREIRA DSZ B
January 2019

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 A literature review was conducted to identify core elements of interventions to promote resilience in individuals and family members in the face of discrimination in the case of leprosy. A multi-phase adapted scoping review of English literature and a narrative review of the Portuguese language literature were carried out. Three main intervention focus areas in our review were identified: individual level, social/community level and system level.

 

Lepr Rev (2019) 90, 88–104

Unmet needs and use of assistive products in two districts of Bangladesh: Findings from a household survey

PRYOR, Wesley
NGUYEN, Liem
ISLAM, Qumrun Naher
JALAL, Faruk, Ahmed
MANJULA, Marella
December 2018

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Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs and unmet needs for AP, and current access patterns in Bangladesh. The ATA-N was incorporated in a Rapid Assessment of Disability (RAD), a population-based survey to estimate prevalence and correlates of disability. In each of two unions of Kurigram and Narsingdi districts, 60 clusters of 50 people each aged two years and older were selected using a two-staged cluster random sampling process, of whom, 4250 (59% Female; 41% Male) were adults, including 333 using AP. We estimate 7.1% of the studied population used any AP. AP use is positively associated with age and self-reported functional difficulty. The proportion of people using AP is higher for mobility than for sensory and cognitive difficulties. Of all people with any functional difficulty, 71% self-reported an unmet need for AP. Most products were home or self-made, at low cost, but provided benefits. Needs and unmet needs for AP are high, especially for people with greater functional difficulties. Assessing unmet needs for AP revealed important barriers to scale that can inform policy and practice.

Int. J. Environ. Res. Public Health 2018, 15(12), 2901;
doi:10.3390/ijerph15122901

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