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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.

Every learner matters: Unpacking the learning crisis for children with disabilities

McCLAIN-NHLAPO, Charlotte
et al
June 2019

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This paper was developed by the World Bank in partnership with Leonard Cheshire and Inclusion International. It is an attempt to add knowledge to the current understanding of the importance of learning achievements, with a focus on children with disabilities. While the premise is that inclusive education refers to the inclusion of all children, the focus of this paper is on children with disabilities.

The aim of the paper is to:

  • Provide an evidence-based review of educational participation of children with disabilities.
  • Establish a case for focusing on learning achievements for students with disabilities.
  • Take stock of current mechanisms of measurement of learning outcomes and review their inclusivity.
  • Explore evidence of practice and systems which promote disability-inclusive learning for all. 

Four case studies are provided - from Pakistan, South Africa, Canada and UK.

Leaving no-one behind: Building inclusive social protection systems for persons with disabilities

KIDD, Stephen
et al
February 2019

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How to make social protection systems and schemes more inclusive of persons with disabilities is examined. Social protection can play a key role in empowering persons with disabilities by addressing the additional costs they face, yet the majority of persons with disabilities are currently excluded from schemes.

The report identifies a wide range of barriers persons with disabilities experience in accessing social protection to be overcome. It calls for better data on disability, disability-specific and old age pension schemes and expanded coverage; adapting communications about social protection schemes; and improving disability assessment mechanisms. The research underpinning the report comprised involved a review of the literature, an analysis of household survey datasets, and consultations with key stakeholders and persons with disabilities in seven low- and middle-income countries: Brazil, India, Kenya, Mauritius, Rwanda, South Africa and Zambia.

Topics covered include:

  • Types of social protection schemes for persons with disabilities
  • Levels of investment in social protection for persons with disabilities
  • Coverage of persons with disabilities by social protection
  • Impacts of social protection on persons with disabilities
  • Barriers to accessing social protection and measures to address them
  • Links between social protection schemes and other public services

Leaving no-one behind: Building inclusive social protection systems for persons with disabilities

KIDD, Stephen
et al
February 2019

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This report identifies a wide range of barriers persons with disabilities experience in accessing social protection to be overcome. It calls for better data on disability, disability-specific and old age pension schemes and expanded coverage; adapting communications about social protection schemes; and improving disability assessment mechanisms. The project involved a review of the literature, an analysis of household survey datasets, and consultations with key stakeholders and persons with disabilities in seven low- and middle-income countries: Brazil, India, Kenya, Mauritius, Rwanda, South Africa and Zambia.

Disability and nutrition programming: evidence and learning (Disability Inclusion Helpdesk Report No. 6)

HOLDEN, Jenny
CORBY, Nick
February 2019

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This document provides a rapid review of the evidence on approaches to ensuring people with disabilities are reached through nutrition programming, focusing on children, adolescents, and women of reproductive age in low and middle-income countries (LMICs). The purpose of this review is to support DFID advisers and partners designing and implementing programmes with nutrition components to ensure they are more inclusive of people with disabilities. After outlining the methodology in Section 2, Section 3 includes an overview of available evidence on what works to ensure nutrition programming reaches people with disabilities, as well as an assessment of the strength of the evidence, and highlighting key research gaps. Section 4 provides a summary on factors affecting access for people with disabilities, and Section 5 concludes by drawing a series of considerations for policy and programming to ensure that people with disabilities are not left behind when it comes to government-led and development partner-led programmes to tackle malnutrition. Case studies of approaches are included in annex 1 to give further insights on promising practices and key learnings

Zero Project Report 2019: Independent living and political participation

FEMBEK, Michael
January 2019

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The Zero Project Report 2019 focuses on Article 19 (Living independently and being included in the community) and Article 29 (Participation in political and public life) of the UN CPRD, as well as related topics such as Article 12 (Equal recognition before the law) and Article 13 (Access to justice)

For 2019 the Zero Project selected 66 Innovative Practices and 10 Innovative Policies from 41 countries that positively impact the rights of persons with disabilities in their ability to live more independently and to take part in political life

 

This Report is composed of five main sections, summarizing the annual research, followed by an Annex:

• Executive Summary, including background information on this year’s research topic and the Zero Project methodology

• Innovative Polices and Practices: Fact Sheets and Life Stories

• Description of the Zero Project–Impact Transfer programme

• Description of EU-grant-funded TOPHOUSE projects

• A summary of this Report in easy language

• An Annex listing all Zero Project network members active in 2018–2019

The Zero Project Report is also available on the Zero Project Website in an accessible pdf format.

 

Shaping health systems to include people with disabilities. K4D emerging issues report

DEAN, Laura
et al
November 2018

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People with disabilities are at a heightened risk of communicable and non-communicable diseases and these diseases can cause debility and disability. Health needs of these people often extend beyond requiring continual longterm medical support to addressing broader social inequities. Key areas that are likely to be critical in re-orientating health systems from a biomedical approach towards inclusive health systems that are more responsive to the needs of people with debility and disability in low and middle-income countries (LMICs) are offered in this report and cover the following:

 

  • 1. Nothing about us without us: prioritising person-centred health systems
  • 2. Responding to issues of access in mainstreaming disability within health systems
  • 3. Ensuring the provision of specialised services
  • 4. Community based rehabilitation 
  • 5. Improving the collection and use of disability related data against modified legal and policy frameworks
  • 6. Partnerships are paramount
  • 7. Financing and social protection 

Case studies are provided from Sudan, India, Liberia, Uganda and Nigeria

Young persons with disabilities: Global study on ending gender-based violence, and realising sexual and reproductive health and rights

McCLOSKEY, Megan
MEYERS, Stephen
July 2018

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This study provides an analysis on the situation of young persons with disabilities concerning discrimination and gender-based violence, including the impact on their sexual and reproductive health and rights. It also provides an assessment of legal, policy and programming developments and specific good practices in service delivery as well as best-standard prevention and protection measures. Finally, policy and programming recommendations are provided to assist in greater promotion of the rights of young persons with disabilities, with a particular emphasis on preventing and responding to gender-based violence, and realizing sexual and reproductive health and rights.

Disability inclusion in disaster risk management - Promising practices and opportunities for enhanced engagements

GUERNSEY, Katherine
SCHERRER, Valerie
April 2018

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Disaster risk management aims to address vulnerability in order to reduce risk and therefore needs to consider the full range of vulnerability drivers, including those that affect persons with disabilities. This report presents the results of comprehensive review of the state of practice in disability-inclusive Disaster risk management (DRM) undertaken by GFDRR (Global Facility for Disaster Reduction and Recovery). The report is intended to help World Bank staff incorporate persons with disabilities and a disability perspective into their ongoing DRM work. The report will also be of interest to other development actors and stakeholders working on DRM.

Good practice guide: embedding inclusion of older people and people with disabilities in humanitarian policy and practice Lessons learnt from the ADCAP programme

AKERKAR, Supriya
BHARDWAJ, Rhea
2018

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This guide shares good practices and challenges that have emerged through the experience of the Age and Disability Capacity Programme (ADCAP) implementing partners, in embedding inclusion of older people and people with disabilities within their humanitarian policies and practices. All mainstream and specialist organisations engaged in humanitarian responses can learn and benefit from this experience. This guide complements the ‘Humanitarian inclusion standards for older people and people with disabilities’ (see Appendix 4), by documenting practices that will help humanitarian organisations to systematically include older people and people with disabilities.

Nine change themes that reflect successful inclusion practices emerging from the ADCAP experience are presented. Each theme includes analysis — using examples of action from ADCAP implementing organisations, a set of good practice action points, and case studies detailing how change was brought about in different implementing organisations

Labour market inclusion of people with disabilities: Paper presented at the 1st Meeting of the G20 Employment Working Group

INTERNATIONAL LABOUR ORGANISATION (ILO)
ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT (OECD)
February 2018

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A common understanding of how to approach the employment of persons with disabilities in a way that respects social justice, human rights and decent work as a key element of more inclusive economies and societies is sought. Having the employment of persons with disabilities on the G20 agenda is also a reflection of the increased attention to the rights of persons with disabilities both at a national as well as at an international level. The contribution focuses on one particular group of people with disabilities, namely those who may have been born with disabilities or may have developed some during their lives, but either way have remaining work capacities and are at working age. 

Employment-to-population ratio statistics for persons with and without disabilities are provided for some of the G20 countries. Economic and social determinants of low employment rates of people with disabilities are discussed.

 

Policies across G20 countries for the labour market inclusion of persons with disabilities are discussed

  • demand side - promoting disability inclusion within the private and public sector
  • supply side - ensuring that persons with disabilities have the skills as demanded by the labour market
  • making the environment more enabling 
  • mental health as a special challenge
  • measurement and quality data to inform evidence-based policies

 

GEM report summary on disabilities and education

UNESCO
2018

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In support of the run-up to the 2020 GEM Report on inclusion and education, this paper contains summarised content related to disabilities and education in previous Global Education Monitoring (GEM) Reports since 2010. Reports cited from 2010 and 2015 monitored countries in the Global South. The GEM Report started monitoring countries in the Global North from the 2016 Report onwards only.

 

Topics covered include: compliance monitoring; the role of civil society organisations; lack of data; marginalisation; data on primary school attendance; intersection with other disadvantages; different education related challenges; and ten education policies to counteract marginalisation.

Global education monitoring report, 2019: migration, displacement and education: building bridges, not walls

UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION (UNESCO)
et al
2018

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“The 2019 GEM Report continues its assessment of progress towards Sustainable Development Goal 4 (SDG 4) on education and its ten targets, as well as other related education targets in the SDG agenda.


Its main focus is on the theme of migration and displacement. It presents evidence on the implications of different types of migration and displacement for education systems but also the impact that reforming education curricula and approaches to pedagogy and teacher preparation can have on addressing the challenges and opportunities posed by migration and displacement. It gives voice to experiences in host and home communities.


With the help of case studies, it illustrates approaches which work and could be scaled up. In this way, it aims to be a tool for practitioners. It will make the case for investing in education of good quality in rural areas suffering from depopulation and in slum areas suffering from large population inflows; in countries with high rates of emigration and those with high rates of immigration; in short-term refugee emergencies and in protracted crises. Its analysis, conclusions and recommendations advance the aims of SDG 4 and its call to leave no one behind.”

Towards inclusion. A guide for organisations and practitioners

VAN EK, Vera
SCHOT, Sander
November 2017

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Inclusive development is about creating societies that value and enfranchise all marginalised groups. It is often not difficult to open up development projects to persons from these marginalised groups. But it does take time before organisations are willing and able to fully commit to inclusion.

Towards Inclusion aims to support organisations who wish to commit to an inclusive approach. It establishes the rationale for inclusion and provides technical advice and tools for putting theory into practice. It is intended to be used as a reference during organisational development, as well as a tool to support good practice in implementation.

If you are looking to support a (development) organisation in the process of becoming an inclusive organisation, then Towards Inclusion is for you

This guide consists of three parts. The first part guides the reader through the process of assessing whether or not the organization is ready to change towards becoming a more inclusive organization. The second part introduces the ACAP framework, which sets up a way of approaching inclusion via focus on the areas: Access, Communication, Attitude and Participation. It then demonstrates how the framework can be applied to projects and programmes. The third part provides guidelines for the people who will guide organizations through the process of change towards becoming inclusive of persons from marginalized groups

Disability and HIV

UNAIDS
August 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care. Globally, it is estimated that 1 billion people (15% of the world’s population) have a disability. Of those aged over 15 years, approximately 110–190 million (2.2–3.8%) experience significant disabilities. Disability is increasing in prevalence due to ageing populations, trauma, accidents and the increase in chronic health conditions, including HIV. Persistent discrimination against and exclusion of people with disabilities, in particular women and girls with disabilities, increases their vulnerability, including their risk of HIV infection.
 

Still left behind: Pathways to inclusive education for girls with disabilities

ABU AL-GHAIB, Ola
ANDRAE, Karen
GONDWE, Rachel
LEONARD CHESHIRE DISABILITY
June 2017

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This progress review aims to: provide a synthesis of the understanding of the additional barriers that girls with disabilities face in education; highlight effective or promising approaches and programmes addressing these barriers, including policies and legislation; point to gaps in evidence; and provide recommendations on a way forward. An internet search of relevant grey and academic literature on gender-responsive inclusive education was carried out. A search of websites of (inter) national non-governmental organisations, donors, and research institutions on the subject of gender-responsive inclusive education was conducted. In addition, requests for information on gender-responsive inclusive education interventions were submitted to platforms such as the Pelican Initiative and the Gender and Development Network UK. Subsequent referral to contact persons was followed up via email and phone with requests for sharing of studies, evaluations, progress reports, and other relevant documents of interventions.

Support and guidance for the report provided by UN Girls’ Education Initiative (UNGEI)

DFID data disaggregation action plan - Better data for better lives

UK DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (DFID)
UK AID
January 2017

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This action plan sets out the steps that the UK Department for International Development (DFID) will take to promote, provide and make use of their own development and humanitarian programme data which can be disaggregated on the basis of sex, age, disability status and geography (in the short term). It also has the objective to build the culture within DFID on disaggregated data, and to work with others to change the international development system on disaggregated data. A review is scheduled for 2020. Working with partners, influencing, capacity building and management information, research, analysis and reporting are outlined. Trailblazer country programmes with Bangladesh, Nepal, Zimbabwe and Rwanda are reported.

Zero Project report 2017. Employment work and vocational education & training

FEMBAK, Michael
et al
January 2017

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The results of the Zero Project Survey 2016–2017 consisting of 21 questions with a particular focus this year on employment and vocational and educational training are presented. After five years of Social Indicator research, for the first time data trends are published as well as comparisons between world regions. The Social Indicators section also includes analysis of data availability on youth employment with regards to Sustainable Development Goal (SDG) 8, and of the “data gap” of persons with disabilities living in institutions. 56 Innovative Practices have been selected, and 13 common solutions and “threads” have been identified.  11 Innovative Policies have been selected, and 13 ways to create a significant impact have been identified.

 

Mental health and human rights : Report of the United Nations High Commissioner for Human Rights

OFFICE OF THE HIGH COMMISIONER FOR HUMAN RIGHTS
January 2017

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"The present report, mandated by the Human Rights Council in resolution 32/18, identifies some of the major challenges faced by users of mental health services, persons with mental health conditions and persons with psychosocial disabilities. These include stigma and discrimination, violations of economic, social and other rights and the denial of autonomy and legal capacity.

In the report, the High Commissioner recommends a number of policy shifts, which would support the full realisation of the human rights of those populations, such as the systematic inclusion of human rights in policy and the recognition of the individual’s autonomy, agency and dignity. Such changes cover measures to improve the quality of mental health service delivery, to put an end to involuntary treatment and institutionalisation and to create a legal and policy environment that is conducive to the realisation of the human rights of persons with mental health conditions and psychosocial disabilities"

A/HRC/34/32

Human Rights Council, Thirty-fourth session, 27 February-24 March 2017

Disability and HIV

UNAIDS
January 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care.

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