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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

Disability Data Lab learning paper: a practical guide to disability data

JENKINSON, Astrid
et al
December 2019

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The Bond Disability and Development Group (DDG) has commissioned this learning paper to summarise discussions which took place at the DDG’s Data Lab workshop, held in London on 22 October 2019, and to be used as a reference document going forward. This first workshop focused on why organisations need to collect disability data; what tools are available and practical ways in which these can be used. This learning paper provides a summary of these discussions and can act as a guide and reference tool for organisations looking to be more inclusive in their programming, generally, and in their data collection practices, specifically. A number of case studies and numerous resource references are provided.

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

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.

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

Realising children's right to social protection in Middle East and North Africa. A compendium of UNICEF's contribution's

ARCHIBALD, Edward
January 2019

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This Compendium documents the broad range of UNICEF’s social protection interventions in MENA from 2014-2017. 
 

The Compendium includes 20 case studies detailing UNICEF’s contributions in the MENA region across the following five Action Areas

 

  • Evidence and Advocacy (Algeria, Egypt, Iraq, Iran, Lebanon, Yemen, Morocco)
  • Policies, coordinating and financing (Djibouti, Morocco)
  • Cash transfer programming and systems strengthening (Egypt, Jordan, Tunisia)
  • Cash plus interventions and social work (Iraq, State of Palestine (highlights children with disabilities), Yemen)
  • Social protection in fragile and humanitarian contexts/settings (Yemen, Lebanon, Jordan, Syria). The Syrian programme was "Reaching children with complex disabilities through cash transfers and case management"

 

 

 

Creating an inclusive school environment

DOUGLAS, Susan
Ed
2019

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This publication draws together research and learning from around the world, in papers which highlight the need for inclusive education and some of the steps being taken to implement it. 

The settings brought to life here reveal the work of teachers, leaders and policy makers in geographically and culturally diverse situations. In each of the chapters we see the challenges they face and the significant efforts they make to ensure access to, and engagement with, a quality education for all children. The collection includes 15 case studies:

 

Special educational needs and disability section:

  • Teaching for All: mainstreaming inclusive education in South Africa
  • Successful inclusive education starts with teachers: what have we learned? A multi-country case study
  • Teaching English as a second language to the visually impaired in disadvantaged contexts: a case study from Chiapas, Mexico
  • The Theatre of the Classroom

Displaced populations section

  • Teaching on the run: safe learning spaces for internally displaced persons
  • Developing resilience through English language teaching in youth centres across Iraq
  • Capacity building for inclusive classrooms: the Living Together training
  • Integrating Syrian refugee children and their parents into Lebanese early education systems

Gender and inclusion in the classroom section

  • A gender equality and social inclusion approach to teaching and learning: lessons from the Girls’ Education Challenge
  • Teacher development and gender equality in five Nigerian states
  • Creating gender-inclusive schools in Turkey: the ETCEP project in action
  • Education, English language, and girls’ development: exploring gender-responsive policies and practices in Nepal

Minority ethnic groups in the classroom

  • Social inclusion and the role of English language education: making a transition from school to higher education in India
  • Storytelling for diverse voices
  • Inclusive education in marginalised contexts: the San and Ovahimba learners in Namibia

 

Blast injuries. The impact of explosive weapons on children in conflict

DENSELOW, James
SALARKIA, Keyan
EDWARDS, Jess
2019

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This report covers children's exposure to blasts, children's unique vulnerability to blast injury (head, torso, burns and long term effects) and why children are exposed to blast.

Across five of the deadliest conflicts for children in 2017, an estimated 72% of child casualties were due to blasts. Using UN data for Afghanistan, Yemen, Syria, Nigeria and Iraq we can see that of the 7,364 children killed or maimed in conflict in 2017, at least 5,322 were linked to blasts.

Paediatric blast injury field manual

THE PAEDIATRIC BLAST INJURY PARTNERSHIP
2019

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The Field Manual has been created to provide technical guidance for those with medical training.  It enables the user to adapt their knowledge to the treatment of severely injured children.  It has paediatric-specific sections on:

  • Pre-hospital care and transport
  • Damage control resuscitation, surgery and intensive care
  • Surgery (thoraco-abdominal, limb, burns)
  • Neurological injury
  • Ward care
  • Rehabilitation
  • Psychosocial support
  • Ethics and safeguarding

The Manual is also intended for use by anyone who is required to plan for the treatment of severely injured children, so they can see the resources, training and equipment that is required in a medical facility likely to receive blast injured children.

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

Enabling Education Review Issue 8 - 2019: Family involvement in inclusive education

CORCORAN, Su
LEWIS, Ingrid
Eds
2019

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Articles in this issue include:

Working together to advocate for our children in Trinidad and Tobago

The inclusion of deaf children in Malaysia: parental support and advocacy

Family-mediated intervention to support inclusion in Bulgaria

Creating inclusivity and diversity through a parent support group in Kolkata, India 

The positive impact of family involvement in inclusive education, Tetouan, Morocco

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

Removing barriers - The path towards inclusive access. Disability assessment among Syrian refugees in Jordan and Lebanon. Jordan report

ASAI, Yahoko
et al
July 2018

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Humanity & Inclusion (HI) and iMMAP conducted a study concerning with the lack of disability data in the Syria crisis context,  which aimed to:

  • Provide statistically reliable prevalence of disability as well as disability disaggregated data indicators on access to services.
  • Increase understanding of the situation of Syrian refugees with disabilities and their households, compared to their peers without disabilities, in relation to the access to services including education, and key barriers experienced in accessing these services.
  • Recommend inclusive actions to be prioritized by humanitarian actors.

The study conducted a literature review, quantitative data collection as well as qualitative data collection. Quantitative data was collected from 6,381 persons of randomly sampled 1,159 households in Azraq and Zaatari camps and Irbid between October 2017 and January 2018. Twenty-five Key Informant Interviews (KIIs) and 3 Focus Group Discussions (FGDs) were also conducted between November 2017 and January 2018 to elicit deeper insights on the educational situation of children with and without disabilities

Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

Inclusive urban mobility and getting to school safely in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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For teenagers in developing countries, there is no greater threat to life than road traffic crashes: road crashes are the leading cause of preventable death of youth aged 15 to 29 years, and the second cause for those aged 5 to 14 years.(6) The risks are even higher for children with disabilities, who are also more exposed to non-fatal injuries from road crashes.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility and road safety challenges discussed include: safe crossing points over roads and collective transport (particularly buses). 

 

Two case studies are provided: Safer access to school for disabled students in Kenya; and School access and pedestrian safety improvements in Democratic Republic of Congo

 

Recommendations for improvements in policies and actions are given under the headings:

  • 1. Strengthening the policy and financial framework for safe and inclusive mobility, based on evidence and through participative processes
  • 2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Learning From Experience: Guidelines for locally sourced and cost-effective strategies for hygiene at home for people with high support needs.

World Vision/CBM Australia
May 2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HYGIENE AT HOME FOR PEOPLE WITH HIGH SUPPORT NEEDS
This document is one of two developed in the Jaffna District and describes strategies that used to assist households and individuals in hygiene tasks at home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka.

NOTE: The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

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