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COVID-19, Amplifying Voices: Our Lives, Our Say: Learning from COVID-19 through the experiences of blind and partially sighted persons across the world

ZAYED, Yana
et al
August 2020

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The World Blind Union (WBU) conducted a study to examine the extent to which COVID-19 pandemic has exposed some deep structural inequalities in society. Data gathered from the study is evidencing that persons with disabilities, older persons, and persons from lower socioeconomic status backgrounds are among those hardest hit by the pandemic. While this report puts a spotlight on the voices of blind and partially sighted persons, many of the experiences shared strongly resonate with numerous other studies that are also highlighting how marginalised groups have been affected by this crisis. Through this report, WBU hopes to raise awareness on the specifics of what those challenges have meant in reality for its constituents, as well as shed light on what have been effective resilience strategies for them. The study was made possible with the support of CBM Global

To understand the situation of our constituents, the World Blind Union (WBU) conducted a global survey in collaboration with key stakeholders. In April 2020, the WBU launched an open online survey for seven weeks in Spanish, French and English, seeking information from blind and partially sighted persons on how COVID-19 was impacting their day to day life. 853 people participated in the survey. The respondents expressed in their own words how their lives had been and continue to be impacted by the coronavirus pandemic. This report is a compilation of those voices. It depicts the ways in which COVID-19 response measures taken by state and non-state actors have created additional barriers and challenges for blind and partially sighted people. It also includes powerful testimonies on how people have shown resilience in the face of adversity.

 

 

Delivering trauma and rehabilitation interventions to women and children in conflict settings: a systematic review

JAIN, Reena P
METEKE, Sarah
GAFFEY, Michelle F
et al
May 2020

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In recent years, more than 120 million people each year have needed urgent humanitarian assistance and protection. Armed conflict has profoundly negative consequences in communities. Destruction of civilian infrastructure impacts access to basic health services and complicates widespread emergency responses. The number of conflicts occurring is increasing, lasting longer and affecting more people today than a decade ago. The number of children living in conflict zones has been steadily increasing since the year 2000, increasing the need for health services and resources. This review systematically synthesised the indexed and grey literature reporting on the delivery of trauma and rehabilitation interventions for conflict-affected populations.

A systematic search of literature published from 1 January 1990 to 31 March 2018 was conducted across several databases. Eligible publications reported on women and children in low and middle-income countries. Included publications provided information on the delivery of interventions for trauma, sustained injuries or rehabilitation in conflict-affected populations. A total of 81 publications met the inclusion criteria, and were included in the review.

 

BMJ Global Health 2020;5:e001980

http://dx.doi.org/10.1136/bmjgh-2019-001980

Access to basic needs and health care for Malawian prosthetic and orthotic users with lower limb physical disabilities: a cross-sectional study

MAGNUSSON, Lina
FINYE, Clifford
ENSTEDT, Catrin
May 2020

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Purpose: To investigate access to basic human rights such as health, a standard of living adequate for health, education, work, marrying and establishing a family, and voting for prosthetic and orthotic users with lower limb disabilities in Malawi.

 

Materials and methods: A cross-sectional design and a questionnaire were used to collect data from 83 participants.

 

Results: Most participants reported their overall physical and mental health as good (60 [72%] and 50 [60%], respectively) and said they could access medical care (69 [83%]). Fifty (60%) participants had access to food, 72 (87%) had access to basic water, and 55 (66%) lived in housing adequate for their health. Most participants had studied in school (74 [89%]) but only 27 (33%) of the participants were working. Forty-three (52%) were married and 53 (64%) had children. Seventy-six (92%) participants could vote if they wished.

 

Conclusions: Rurality and high costs of transport and medication increase the barriers to accessing several basic human rights for people with lower limb physical disabilities. Interventions to target these barriers and increase access to secondary school, employment, and income could improve health equity for people with physical disabilities in Malawi and similar contexts.

Coronavirus (COVID-19): Evidence Collection

EVIDENCE AID
2020

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The COVID-19 (Coronavirus) pandemic is leading to a rapidly expanding and evolving literature. Evidence Aid is preparing summaries of relevant research, which are available below in English with links to translations in other languages. 

 

  • Clinical characterization and management
  • Epidemiology
  • Ethical considerations
  • Health systems and services
  • Infection prevention and control, including health care workers’ protection
  • Public health interventions
  • Research & Development: Therapeutics and Vaccines
  • Social science in the response

MAANASI - A sustained, innovative, integrated mental healthcare model in South India

JAYARAM, Geetha
GOUD, Ramakrishna
CHANDRAN, Souhas
PRADEEP, Johnson
2019

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Studies in low and middle-income countries (LMICs) point to a significant association of common mental disorders with female gender, low education, and poverty. Depression and anxiety are frequently complicated by lack of disease awareness and non-adherence, the absence of care and provider resources, low value given to mental health by policy-makers, stigma, and discrimination towards the mentally ill. This paper aims to show that female village leaders/ community health and outreach workers (CHWs) can be used to overcome the lack of psychiatric resources for treatment of common mental disorders in rural areas.

A multidisciplinary team was set up to evaluate and treat potential clients in the villages. A program of care delivery was planned, developed and implemented by: (a) targeting indigent women in the region; (b) integrating mental health care with primary care; (c) making care affordable and accessible by training local women as CHWs with ongoing continued supervision; and (d) sustaining the program long-term.   Indigenous CHWs served as a link between the centre and the community. They received hands-on training, ongoing supervision, and an abridged but focused training module to identify common mental disorders, help treatment compliance, networking, illness literacy and community support by outreach workers. They used assessment tools translated into the local language, and conducted focus groups and client training programs. 

As a result, mental healthcare was provided to clients from as many as 150 villages in South India. Currently the services are utilized on a regular basis by about 50 villages around the central project site. The current active caseload of registered clients is 1930.  Empowerment of treated clients is the final outcome, assisting them in self-employment. 

Rural mental healthcare must be culturally congruent, and must integrate primary care and local CHWs for success. Training, supervision, ongoing teaching of CHWs, on-site resident medical officers, research and outreach are essential to continued success over two decades.

 

Disability, CBR & Inclusive Development, [S.l.], v. 30, n. 2, p. 104-113, Oct. 2019

 

 

Disability and vocational rehabilitation in rural settings

HARLEY, Debra
et al
2018

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A graduate student textbook offered in 39 chapters, each with different authors and subjects. Abstracts, test questions and citations are freely available on-line. Full text is charged for. The book surveys rehabilitation and vocational programs aiding persons with disabilities in remote and developing areas in the U.S. and abroad. Contributors discuss longstanding challenges to these communities, most notably economic and environmental obstacles and ongoing barriers to service delivery, as well as their resilience and strengths. Considerations are largely of the US but there is a chapter on each of Asia and Pacific region, Australasia, Canada, Mexico, India, Turkey, Colombia and the UK. 

 

Community stakeholders’ perspectives on the role of occupational therapy in primary healthcare: Implications for practice

NAIDOO, Deshini
Van WYK, Jacqueline
JOUBER, Robin
2017

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Background: Primary healthcare (PHC) is central to increased access and transformation in South African healthcare. There is limited literature about services required by occupational therapists in PHC. Despite policy being in place, the implementation of services at grassroots level does not always occur adequately.

 

Objectives: This study aimed at gaining an understanding of the challenges of being disabled and the services required by occupational therapists (OTs) in rural communities in order to better inform the occupational therapy (OT) training curriculum. 

 

Method: An exploratory, descriptive qualitative design was implemented using purposive sampling to recruit 23 community healthcare workers from the uGu district. Snowball sampling was used to recruit 37 members of the uGu community, which included people with disability (PWD) and caregivers of PWDs. Audio-recorded focus groups and semi-structured interviews were used to collect data, which were thematically analysed. Ethical approval was obtained from the Biomedical and Research Ethics Committee of the University of KwaZulu-Natal (BE248/14).


Results: Two main themes emerged namely: firstly, the challenges faced by the disabled community and secondly appropriate opportunities for intervention in PHC. A snapshot of the social and physical inaccessibility challenges experienced by the community was created. Challenges included physical and sexual abuse, discrimination and marginalisation. Community-based rehabilitation and ideas for health promotion and prevention were identified as possible strategies for OT intervention.
Conclusion: The understanding of the intervention required by OT in PHC was enhanced through obtaining the views of various stakeholders’ on the role. This study highlighted the gaps in community-based services that OTs should offer in this context.
 

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

BIBHAV Acharya
et al
January 2017

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Abstract

Background

Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation.

Partnerships network

We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community.

Conclusions

We propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal.

Inclusive disaster risk reduction

LAFRENIERE, Annie
WALBAUM, Veronique
2017

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This policy paper defines the themes of inclusive disaster risk reduction and explains how these activities fit into the HI mandate. It also identifies the target population and defines modalities of intervention–standard expected outcomes, standard activities–as well as monitoring and evaluation indicators.

Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines

WEINTRAUB, Ana Cecilia Andrade de Moraes
et al
November 2016

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"In response to the Typhoon Haiyan in the Philippines, Médecins Sans Frontières-Operational Centre Brussels (MSF-OCB) decided to concentrate its efforts in the severely affected area of Guiuan and its four surrounding municipalities. The MSF-OCB intervention included a comprehensive approach to mental health, including care for people with pre-existing and post-disaster severe mental disorders. Based on this experience of providing MH care in the first five months after Typhoon Haiyan, we report on the monthly volume of MH activities and beneficiaries; sociodemographic and care seeking characteristics of beneficiaries receiving MH counselling/care, stratified by the severity of their condition; profile and outcomes of patients with severe mental disorders; prescribing practice of psychotropic medication; and main factors facilitating the identification and management of individuals with severe mental disorders"

International Health, Vol.8, No.5, pp. 336-344

Doi: 10.1093/inthealth/ihw032

The promise and the reality: a mental health workforce perspective on technology-enhanced youth mental health service delivery

ORLOWSKI, Simone
LAWN, Sharon
MATTHEWS, Ben
et al
October 2016

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Digital technologies show promise for reversing poor engagement of youth (16–24 years) with mental health services. In particular, mobile and internet based applications with communication capabilities can augment face-to-face mental health service provision. Results of in-depth qualitative data drawn from various stakeholders involved in provision of youth mental health services in one Australian rural region are described. Data were obtained using focus groups and semi-structured interviews with regional youth mental health clinicians, youth workers and support/management staff and analysed via inductive thematic analysis. Six main themes were identified: young people in a digital age, personal connection, power and vulnerability, professional identity, individual factors and organisational legitimacy. 

 

DOI: 10.1186/s12913-016-1790-y

Being a refugee in Turkey and western Europe: how it affects mental health and psychosocial wellbeing

JOURNAL OF MENTAL AND PSYCHOSOCIAL SUPPORT IN CONFLICT AFFECTED AREAS
September 2016

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"In this personal reflection, the author is a Syrian refugee who describes his experiences as a psychosocial worker in Syria and with refugees in Turkey and Greece. He highlights how women and children lack safety in the camps. The second section discusses how he became a refugee himself. Due to his experiences in Syria, he now finds himself in a difficult situation in the Netherlands, the county where he applied for asylum and has received a permit, but his ‘cry for help’ remains unheard and unrecognised by the (health) workers in the asylum centre."

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).

Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis

MCVEIGH, Joanne
MACLACHLAN, Malcolm
GILMORE Brynne
MACLEAN Chiedza
EIDE, Arne H.
MANNAN Hasheem
GEISER Priscille
DUTTINE Anthony
MJI Gubela
MACAULIFFE Eilish
SPRUNT Beth
AMIN Mutamad
NORMAND Charles
et al
August 2016

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General principles requiring contextual adaptation regarding optimal policy related governance of health related rehabilitation in less resourced settings were developed from a literature review and realistic synthesis. A systematic review of literature published since 2003 was carried out. Multiple reviewers selected articles for inclusion in the realistic synthesis.  A Delphi survey of expert stakeholders refined and triangulated findings from the realist synthesis. Context mechanism outcome pattern configurations (CMOCs) were identified from the literature and then developed into statements for the Delphi survey, whereby 18 expert stakeholders refined these statements to achieve consensus on recommendations for policy related governance of health related rehabilitation. Several broad principles emerged throughout formulation of recommendations: participation of persons with disabilities in policy processes; collection of disaggregated disability statistics; explicit promotion in policies of access to services for all subgroups of persons with disabilities and service-users; robust inter-sectoral coordination; and ‘institutionalising’ programmes.

 

 

Assessment of Rehabilitation Capacity in Ghana

Christian, Asare
et al
2016

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Purpose: This study describes a cross-sectional assessment of infrastructure, human resources, and types of rehabilitation interventions provided in a sample of healthcare facilities in Ghana. The objectives were to (a) develop and pilot a questionnaire assessing rehabilitation capacity in LMICs, and (b) provide initial data regarding available rehabilitation care in rural Ghana.

 

Methods: Data was collected from a sample of rehabilitation workers at 9 facilities, comprised of 5 regional and 4 district hospitals, located in seven of the ten geographical regions of Ghana. Participants completed a modified version of the World Health Organisation's Tool for Situational Analysis to Assess Emergency and Essential Surgical Care, adapted to reflect core indicators of rehabilitation infrastructure. Participating facilities were mailed questionnaires and agreed to subsequent site visits from the first author.

 

Results: There were several limitations associated with basic rehabilitation infrastructure. Consistent with previous research, significant human resources limitations were observed as hospital-based rehabilitation services were primarily rendered by 20 physiotherapists and 21 physiotherapy assistants across the 9 participating sites. No rehabilitation physicians were identified at any of the surveyed facilities. With regard to therapeutic interventions, management of musculoskeletal impairments was generally consistent with current evidence- based practices, whereas rehabilitative approaches for neurologic conditions were limited to physical rather than sensory-motor modalities.

 

Conclusions: For the first time there is study data which details the rehabilitation infrastructure, human resources, and interventions in Ghana. This study furthers the field through the adaptation and initial piloting of a rehabilitation assessment instrument that can be used in LMIC contexts.

 

Limitations: The questionnaire used for the study was modified from the questionnaire for assessing surgical care in resource poor countries, and has not yet been validated. Since the study was conducted in a convenience sample of rehabilitation/physiotherapy centres in Ghana, generalisability may be limited.

Interventions for children affected by armed conflict: a systematic review of mental health and psychosocial support in low- and middle-income countries

JORDANS, Mark. J. D.
PIGOTT, Hugo
TOL, Wietse A
January 2016

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Over one billion children under the age of 18 live in countries affected by armed conflict. This systematic review replicates an earlier study, aiming to provide a comprehensive update of the most current developments in interventions for children affected by armed conflict. For the period 2009– 2015, a total of 1538 records were collected. Twenty-four studies met the inclusion criteria, and the included interventions involve data from 4858 children. Two types of analysis were conducted. First, for an account of intervention descriptions, thematic analysis was used to summarise themes, with a specific focus on cultural adaptations. Second, all evaluation studies reporting quantitative data were categorised into level of evidence (1 = randomized controlled trials, all types; 2 = quasi-experimental design and controlled studies; 3 = non-controlled design; 4 = case studies) 

Current Psychiatry Reports, vol 18 (9), doi:10.1007/s11920-015-0648-z

Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq : a randomized household cluster survey

LAFTA, Riyadh
et al
August 2015

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“The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad.” The quantitative study shows the methodology used in the collection of data, the findings discovered through evaluation of the data gathered, and interpretation of how to best use those findings to serve specific populations”

 

 PLOS ONE, 10(8)

Malawi : DoDMA exploring indigenous knowledge on disasters

KAZEMBE, Ida
May 2015

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This article contains an interview with Mulder Mkutumula, Mitigation Officer at the Department of Disaster Management Affairs in Malawi. Mr. Mkutumula discusses the importance of raising awareness and understanding of disaster risk reduction in Malawi, especially in the context of the 2015 floods

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