This review examines the potential implications of not addressing mental health and psychosocial support (MHPSS) needs resulting from conflict throughout the life course, including on longer term mental and physical health, communities and families (including intergenerational effects), and overall human development (including education and participation in the workforce).
This article looks at literature focussing on the benefits and costs of disability inclusion for a wide range of stakeholders. Included are the perspectives of persons with a disability, households, employers, education and health service providers and governments.
The primary objective of this study is to estimate the expenditure in primary (outpatient) care incurred by leprosy patients in two different health system settings in India. The secondary objective is to compare the effect of the health systems on consumer behaviour and practices.
The study followed a cross-sectional design, where a cohort from the Union Territory of DNH (an administrative division ruled directly by the federal government) was compared with a cohort from Umbergaon block of Valsad district, Gujarat, India. A block is the smallest administrative unit under a district. The cohorts were leprosy cases detected between April 2015 and March, 2016. A sample of 120 participants from each group was selected randomly. In the financial year of 2015–16, DNH reported 425 and Umbergaon reported 287 cases.
A household survey was conducted between June and October, 2016 by means of a structured questionnaire collecting data on patient demographics, HH socioeconomic status, accessibility of health services, treatment seeking history and OPD expenditure. Respondents were asked to report on the last three OPD visits, either in a public or private facility, in the last 6 months.
The costs were categorized as direct and indirect expenditure. The direct part included the expenditure on consultation, investigations and medicines & supplies. The indirect part constituted expenditure on transport, food, and days lost during illness of the patient and attendant
PLOS Neglected Tropical Diseases, January 4, 2018
There has been a growing interest in disability and poverty on the international research and policy stages. Poverty assessments for persons with disabilities may be affected by the experience of extra costs associated with a disability.
This article provides a systematized review of the global literature on the direct costs associated with living with a disability at the individual or household level.
We searched three databases for peer-reviewed journal articles that estimated extra costs associated with disability: Econlit, SocIndex and PubMed.
We found 20 such studies conducted in 10 countries. These studies were predominantly from high-income countries. Although studies were heterogeneous (e.g., in terms of disability measures and cost methodologies), estimated costs were sizeable and some patterns were consistent across studies. Costs varied according to the severity of disability, life cycle and household composition. Highest costs were observed among persons with severe disabilities, and among persons with disabilities living alone or in small sized households.
Disability and Health Journal
Volume 10, Issue 4, October 2017, Pages 475-484
This Campbell Collaboration systematic review assesses the effectiveness and cost-effectiveness of community-based rehabilitation (CBR) for people with physical and mental disabilities in low- and middle-income countries, and/or their family, their carers, and their community. This review identified 15 studies that assessed the impact of community-based rehabilitation on the lives of people with disabilities and their carers in low- and middle-income countries. The studies included in the review used different types of community-based rehabilitation interventions and targeted different types of physical (stroke, arthritis, chronic obstructive pulmonary disease) and mental disabilities (schizophrenia, dementia, intellectual impairment). The authors conclude that the evidence on the effectiveness of CBR for people with disabilities in low- and middle-income countries suggests that CBR may be effective in improving the clinical outcomes and enhancing functioning and quality of life of the person with disabilities and his/her carer and recommend future studies will need to adopt better study designs, will need to focus on broader clients group, and to include economic evaluations
Campbell Systematic Reviews 2015:15
This report, formed of two parts, provides robust empirical basis to support the theorized disability-poverty link. The first section presents a systematic review of the literature on the relationship between disability and economic poverty. The second section explores the economic consequences of the exclusion and inclusion of people with disabilities in the areas of education, employment and health. The key pathways through which these economic costs may arise are discussed and studies that have attempted to quantify the financial impacts are reviewed
This report provides a summary of the full report which “explores the potential pathways through which exclusion of people with disabilities may generate economic costs to individuals, their families and societies at large. Additionally, potential economic gains that may be realised through inclusion are investigated”
This study presents a mapping of existing evidence that provides information about the impact of initiatives that provide education for children with disabilities, and also identifies any studies that provide an analysis about the cost-effectiveness of existing initiatives. It is useful for policymakers, researchers, practitioners, parents of children with disabilities and the children themselves
This video presents a recording of a seminar held at the London School of Hygiene and Tropical Medicine (LSHTM) in November 2012. The seminar explores the findings and recommendations from a four year CBM-funded project in Bangladesh and Pakistan to identify children with disabilities and connect them with appropriate rehabilitative services
This report highlights the benefits of employing people with disabilities in Australia
This report estimates the increase in economic output that could be achieved by increasing employment outcomes for people with disabilities…The economic modelling presented in this report suggests that closing the gap between labour market participation rates and unemployment rates for people with and without disabilities by one-third would result in a cumulative $43 billion increase in Australia’s GDP over the next decade in real dollar terms. The modelling also suggests that GDP will be around 0.85% higher over the longer term, which is equivalent to an increase in GDP in 2011 of $12 billion.
The policy and program mechanisms for achieving these outcomes are not explicitly addressed in this report, nor does it address the costs associated with achieving an increase in employment participation. Rather, the aim of this report is to present the potential benefits associated with increasing employment participation for people with disabilities and provide a reference point for future policy discussion
This briefing note presents information about the cost and benefits of inclusive design of school latrines. It is useful for anyone interested in the inclusive design of school latrines
WEDC Briefing Note 1
"This report investigates tools and methods for assessing aid efficiency. It explains concepts of efficiency and efficiency analysis and presents a catalogue of 15 methods that can be used to assess the efficiency of aid interventions. Each method is described and characterised. Several general observations and recommendations conclude the report"
BMZ Evaluation Working Papers
"This report sets out the statistics, evidence and experiences needed to launch a more forceful response to the growing threat posed by noncommunicable diseases. While advice and recommendations are universally relevant, the report gives particular attention to conditions in low- and middle-income countries, which now bear nearly 80% of the burden from diseases like cardiovascular disease, diabetes, cancer and chronic respiratory diseases. The health consequences of the worldwide epidemic of obesity are also addressed"
This report provides a global picture of the economic impact of Alzheimer's disease and dementia. "The report includes an estimate of the worldwide cost of dementia, including direct medical costs, direct non-medical costs and costs of informal (family) care. The estimates are broken down by world region and include analysis of the differences between low and high income countries. The report also contains important policy recommendations and makes clear to key decision-makers that doing nothing is not an option"
This report presents evidence that diabetes is a global epidemic. It contains comprehensive information in the following sections: What is diabetes?; The Global Burden; Regional Overviews; Diabetes and Development; Linking Local to Global; Resources and Solutions; References; Additional Resources. This report is useful for health professionals, scientists, economists, policy-makers, and national and international agencies
This report presents the findings of an evidence review investigating the costs, benefits and effectiveness of advocacy support for disabled people in the UK. The review examines the following four situations where disabled people are particularly at risk of losing choice and control over their lives: during transition to adulthood; when the children of disabled parents are subject to safeguarding procedures; when entry to residential care is a possibility; and when disabled people are victims or alleged perpetrators of anti-social behaviour. The executive summary, report and an easy to read version are available in downloadable pdf format. A framework for research on costs and benefits of independent advocacy is also provided. Audio and braille versions of the executive summary, the full report and the framework for research are available on request
"Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and opportunities to achieving universal coverage and access with limited resources. The purpose of this study was to systematically review the quality of existing cost-effectiveness evidence and discuss implications for future research and strategies to prevent disability in leprosy and other disabling conditions"
PLoS One, Vol 4, Issue 2
Cost-effectiveness analysis is used to evaluate medical interventions worldwide, in both developed and developing countries. This book provides process-specific instruction in a concise, structured format to provide a robust working knowledge of common methods and techniques. Each chapter includes real-world examples and tips that highlight key information. Calculations concerning disability life adjusted years are covered. The third edition contains new discussion on meta-analysis and advanced modelling techniques and a long worked example.
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