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Missing millions: How older people with disabilities are excluded from humanitarian response

SHEPPARD, Phillip
POLACK, Sarah
McGIVERN, Madeleine
July 2018

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The aim of this study was to explore the experiences of older people with disabilities across a range of humanitarian settings, considering:

  • whether older people with disabilities have additional needs and challenges accessing humanitarian assistance and protection
  • what factors facilitate or limit access by older people with disabilities to humanitarian assistance and protection
  • to what extent is humanitarian response inclusive of older people with disabilities

A systematic literature review of published studies was conducted. Key online humanitarian guidelines were explored to review how far they explicitly address older people with disabilities. Data from six population-based disability surveys comparing the living situation of older people with and without disabilities were analysed. These included databases from two crises-affected populations in Haiti (post-earthquake) and Palestine. Data from four non-humanitarian settings was also reviewed to explore more broadly the situation for older people with disabilities – India, Guatemala, Cameroon and Nepal. Interviews were held with older people with disabilities, members of their families and local key informants in two conflict-affected populations in Ndutu and Mtendeli refugee camps in Western Tanzania, and Donetsk and Luhansk regions of Eastern Ukraine to find out about their experiences. Staff of five international agencies working in humanitarian response were also interviewed. 

 

Findings highlight particular issues facing older people with disabilities in humanitarian crises: more risk escaping from danger;  barriers to accessing social protection and work; barriers to accessing health and rehabilitation services; barriers to accessing food and other essentials; unsuitable housing and poor living conditions;  insecurity and discrimination; threats to dignity and independence; social isolation and loneliness; risks to mental health; and missing from humanitarian response.

 

A table brings together the findings from the different components of the research to show the needs, risks, barriers and enablers for older people with disabilities identified in the research. Recommendations are provided to humanitarian donors, policy makers and practitioners

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

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

ASAI, Yahoko
et al
July 2018

Expand view

Humanity & Inclusion (HI) and iMMAP conducted a study concerned 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 2,495 persons of randomly sampled 506 households in the urban setting in Bar Elias as well as Informal Tented Settlements (ITS) in Bar Elias and Arsal in December 2017. Fourteen Key Informant Interviews (KII) were also conducted in December 2017 to elicit deeper insights on the educational situation of children with and without disabilities.

Including children with disabilities in humanitarian action

UNICEF
July 2017

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"The purpose of Including Children with Disabilities in Humanitarian Action is to strengthen the inclusion of children and women with disabilities, and their families, in emergency preparedness, response and early recovery, and recovery and reconstruction. This series of booklets provides insight into the situation of children with disabilities in humanitarian contexts, highlights the ways in which they are excluded from humanitarian action, and offers practical actions and tips to better include children and adolescents with disabilities in all stages of humanitarian action. The booklets were created in response to UNICEF colleagues in the field expressing a need for a practical resource to guide their work. The information and recommendations are based on evidence and good practices gathered from literature and field staff experiences. The six booklets on how to include children and adolescents with disabilities in humanitarian programmes are as follows: 1) general guidance; 2) child protection; 3) education; 4) health and HIV/AIDS; 5) nutrition; 6) water, sanitation and hygiene (WASH)".

General guidance available July 2017. Others to follow.

In addition to the PDF versions in English, Arabic and French, the guidance is also available in a range of accessible formats, including EPUB, a Braille-ready file and accessible HTML formats. 

The guidance was developed in collaboration with Handicap International.

Humanitarian Hands on Tool (HHoT)

CBM
2017

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The CBM smartphone app 'Humanitarian Hands-on Tool' (HHoT) provides step-by-step guidance on how to implement an inclusive emergency response. With disability-inclusive humanitarian action broken down into individual task cards, which explain the basic 'how-to' details in simple language and images, this web-based tool and downloadable mobile app aims to become the ‘go-to’ field resource for all agencies planning humanitarian work that leaves no-one behind

For every child, a fair chance : the promise of equity

UNITED NATIONS CHILDREN’S FUND (UNICEF)
November 2015

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“UNICEF’s commitment to equity – giving a fair chance in life to every child, everywhere, especially the most disadvantaged – is built on the conviction that it is right in principle and evidence that it is right in practice. This report makes the case for closing persistent gaps in equity…” The report identifies a number of persistent gaps in equity for children, ranging from health to nutrition, to social inclusion. The report concludes by making recommendations to close gaps in equity worldwide as well as projecting progress in achieving equity by 2030

Abandoned by the state : violence, neglect, and isolation for children with disabilities in Russian orphanages

MAZZARINO, Andrea
September 2014

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This report presents the situation of violence, neglect, and isolation for children with disabilities in Russian orphanages.  The report is based on visits by Human Rights Watch researchers to 10 orphanages in 6 regions of Russia, as well as on more than 200 interviews with parents, children, and young people currently and formerly living in institutions in these regions in addition to 2 other regions of Russia. It finds that many children and young people with disabilities who have lived in state orphanages suffered serious abuse and neglect on the part of institution staff that impedes their development. The report presents the background of the current situation and its detailed findings. and makes recommendations to key Russian stakeholders to ensure protection of the rights of children with disabilities in Russia and to comply with its international human rights obligations

Note: Easy read version is available from the web link

Childhood disability and malnutrition in Turkana Kenya : a summary report for stakeholders and policy

KISIA, James
et al
2014

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This study aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.   The report is intended for stakeholders to inform policy

Research summary : childhood disability and malnutrition in Turkana Kenya

KISIA, James
et al
2014

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This report summarises a study that aimed to assess whether children with disabilities were included within humanitarian and food security response programmes and whether there was an association between disability and malnutrition. The fieldwork was conducted in 2013 in the Turkana region of Kenya, a region repeatedly classified as experiencing a humanitarian emergency, and used both qualitative and quantitative methods. The key finding of the report is that children with disabilities are more likely to be malnourished and the key recommendations are that children with disabilities should be targeted in food aid and food assistance programmes, and that further efforts are needed to include children with disabilities in education.  The report is intended for stakeholders to inform policy 

Inequalities relating to health and the life course : disability, mental Illness and older age

SAMMAN, Emma
RODRIGUEZ-TACKEUCHI, Laura
November 2012

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"Issues related to early childhood feature prominently in the MDG framework (as do malnutrition, HIV status and malaria), and data collection in these areas is fairly advanced. Other sources of inequality are notable by their virtual absence - among these, older age, disability and mental illness, although these issues each appear to affect sizeable numbers of particularly vulnerable people throughout the world. A clear obstacle to ‘mainstreaming’ these sources of inequality in a new post-2015 agreement is the widespread lack of nationally representative internationally comparable data. This could arise from definitional or technical issues (what to measure and/or how), operational issues (e.g., resource or capacity constraints), attitudinal issues (relating to stigma) and/or lack of demand from data users. Greater attention is needed to explore these constraints and how they might be overcome. To this end, this paper discusses currently available data and its limitations, constraints to better data collection and efforts needed to adjust key international survey instruments- the World Bank’s Core Welfare Indicator Questionnaire (CWIQ) and Living Standards and Measurement Survey (LSMS), Macro International’s Demographic and Health Survey (DHS) and the UNICEF Multiple Indicator Cluster Survey (MICS) - to collect reliable data on these sources of inequality, alongside other household indicators"
Note: Accepted under the "Addressing Inequalities" Global Thematic Consultation - Call for Proposals for Background Papers, Oct 2012

Disabilities among refugees and conflict-affected populations

WOMEN'S COMMISSION FOR REFUGEE WOMEN AND CHILDREN
June 2008

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"This report is the culmination of a six-month project...to address the rights and needs of displaced persons with disabilities, with a particular focus on women (including older women), children and youth. Based on field research in five refugee situations, as well as global desk research, the Women’s Commission sought to map existing services for displaced persons with disabilities, identify gaps and good practices and make recommendations on how to improve services, protection and participation for displaced persons with disabilities"

Strong foundations : early childhood care and education. Education for all monitoring report 2007

United Nations Educational, Scientific And Cultural Organization (UNESCO)
2006

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"This global monitoring report focuses on the first Education for All goal, which calls upon countries to expand and improve early childhood care and education - a holistic package encompassing care, health and nutrition in addition to education. Disadvantaged children stand to benefit the most, yet too few developing countries, and too few donor agencies, have made early childhood a priority." Additional features on the CD-ROM: 1. The report in ten questions 2. Highlights and overview of the 2007 report 3. 2007 summary report 4. Background research papers commissioned for the report 5. Over 90 country profiles on early childhood care and education

Disability, inclusion and development : key information resources

SOURCE INTERNATIONAL INFORMATION SUPPORT CENTRE
December 2005

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This directory of information resources pulls together over 300 of the most practical and useful books, reports, videos, CD-ROMs and websites on disability. It is aimed at organisations working with disabled people in developing countries. Organised thematically, It covers a wide range of issues including human rights, gender, poverty and mainstreaming, as well as planning and management of disability programmes and service delivery relating to children, community-based rehabilitation, mental health and HIV and AIDS. The directory provides a quick reference listing of information resources with clear abstracts and details of distributors and websites, while the CD-ROM contains many published and un-published full-text documents, as well as links to websites for those who can access the Internet. The index of publishers and distributors will be especially useful to resource centres and information services which collect and manage information on disability and development

UN Millennium Project 2005 : who's got the power? Transforming health systems for women and children. Task Force on Child Health and Maternal Health

FREEDMAN, Lynn P
et al
2005

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This report has been produced by the Task Force on Child Health and Maternal Health. It identifies technical interventions needed to address the problems of high rates of maternal mortality, continued child deaths due to preventable illnesses, unmet need for sexual and reproductive health services, and weak and fragile health systems. The report also asserts that policymakers must act now to change the fundamental societal dynamics that currently prevent those most in need from accessing quality health care

Introducing the gender perspective in national essential drug programmes

BISILLIAT, Jeanne
February 2001

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The objective of this document is to provide a conceptual framework to explain the situation of women and men with regard to health and drugs, and to encourage policy makers and programme managers to adopt a gender-sensitive approach. The document draws on and quotes theoretical anthropological literature, and the English version is a relatively poor translation of the French original

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