Resources search

Training of Mid-Level Rehabilitation Workers for Community-Based Rehabilitation Programmes

GHOSH, R
PALANIVELU, V
TEBBUTT, E
DEEPAK, S
2021

Expand view

Purpose: There is a lack of trained rehabilitation professionals, especially in the small towns and rural areas of low and middle income countries. In India, a cadre of mid-level rehabilitation workers, the Rehabilitation Therapy Assistants (RTAs), are being trained by Mobility India, a Non-Governmental Organisation (NGO). This paper aims to assess impact of their training and experiences after the training.

 

Method: Data were collected from 3 different initiatives connected with the trained RTAs: an impact assessment of their training; interviews with RTAs during an evaluation; and a survey of 188 RTAs trained between 2002 and 2019.

 

Results: RTAs were shown to have good skills to provide rehabilitation interventions in the field and are appreciated by clients and other stakeholders. Most of the RTAs work for NGOs in CBR programmes, and in private hospitals and clinics. There does not seem to be a role for them in government services in most countries. The number of trained RTAs remains small in spite of the large needs. This may be due to lack of an accreditation system for RTAs and the low priority given to rehabilitation services in general in some countries.

 

Conclusions: The results provide useful information to strengthen RTA training courses. Training RTAs to provide rehabilitation services in smaller towns and rural areas of low and middle income countries can have a good impact through CBR programmes. However, this impact remains circumscribed to small areas where NGOs are active. Changes are needed in health systems for the inclusion of mid-level rehabilitation workers in primary health care services.

NOTHING ABOUT US WITHOUT US! Cooperation with organisations of persons with disabilities in community programmes A learning guide

LIGHT FOR THE WORLD
June 2019

Expand view

Good practices of DPO (Organisations of Persons with Disabilities) involvement in Light for the World programmes are analysed and successful ways of supporting DPO empowerment are reported. The paper is based on interviews and focus group discussions with organisations of persons with disabilities (DPOs), other project partners and Light for the World programme colleagues in Bolivia, Ethiopia, Mozambique, Northeast India and South Sudan

Sightsavers' approach to making health services inclusive for everyone

Sightsavers
April 2019

Expand view

Sightsavers has produced a new film that sets out our work to make health care services accessible and inclusive for everyone. It focuses on our programmes in Bhopal, India and Nampula, Mozambique. This highlights how we work and share learnings globally, but also shows how programmes can be made locally relevant by working with partners with direct experience.

The film showcases some of the people who work hard to make our inclusive health programmes a success, from Sightsavers experts and government health workers to leaders of disabled people’s organisations.

To find out more our inclusive health work and how we are developing best practice in terms of inclusive health programmes, visit our website: https://www.sightsavers.org/disability/health/

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

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

Expand view

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

 

 

Kerala - Post disaster needs assessment - Floods and landslides - August 2018

October 2018

Expand view

Between June 1 and August 18, 2018, Kerala experienced the worst floods ever since 1924. The torrential rains triggered several landslides and forced the release of excess water from 37 dams across the state, aggravating the flood impact. Nearly 341 landslides were reported from 10 districts. The devastating floods and landslides affected 5.4 million people, displaced 1.4 million people, and took 433 lives. The Government reports that 1,259 out of 1,664 villages spread across the state’s 14 districts were affected.  The floods and landslides caused extensive damage to house, roads, railways, bridges, power supplies, communications networks, and other infrastructure; washed away crops and livestock. The Post Disaster Needs Assessment (PDNA) conducted by the UN under the leadership of the Government of Kerala estimates the total Recovery needs to be at USD 4.4 billion.

 

The PDNA is the global methodology developed by the UN, the World Bank and the European Union to assess damage and loss in the wake of disaster and to recommend the recovery needs and strategies. In all, 76 experts from 10 UN agencies and European Union across 13 sectors collaborated to develop the report in 20 days. The UN agencies included, UNDP, UNICEF, UNESCO, UN Women, UNFPA, UNEP, WHO, WFP, ILO and FAO.

 

An inclusive and people centred approach is a pillar of the policy framework for recovery and the effects on people with disabilities are briefly assessed. Over 8,600 PWDs are reported to have been impacted by this disaster

 

Everybody Matters: Good practices for inclusion of people with disabilities in sexual and reproductive health and rights programmes

Van SLOBBE, Caroline
November 2017

Expand view

This publication provides introductory chapters from two activists who work to create better opportunities for people with disabilities in Nigeria and India. Subsequently, the challenges that organisations worldwide have encountered whilst improving the access to and knowledge of sexual and reproductive health and rights for people with disabilities are presented. Ways in which they managed to find solutions and the results achieved are reviewed. Some cases show the importance of a more personal approach whilst others emphasise the advantage of changing systems and policies. Different regions, types of disabilities and various SRHR-topics are reflected in these stories. All cases provide lessons learnt that contribute to a set of recommendations for improved responses. The closing chapter highlights the challenges, solutions, and ambitions that are presented and lead up to a concise overview of recommendations.  

Good practice examples include:

A shift in SRH programming (Nepal)

Breaking Barriers with performance art (Kenya)

Her Body, Her Rights (Ethiopia)

People with disabilities leading the way (Israel Family Planning Association)

Best Wishes for safe motherhood (Nepal)

It’s my body! (Bangladesh)

Calling a spade a spade (Netherlands)

Four joining forces (Colombia)

Change agents with a disability (Zimbabwe)

Tito’s privacy and rights (Argentina)

Sign language for service providers (Kenya)

Global Report on the participation of organisations of persons with disabilities (DPOs) in VNR Processes

INTERNATIONAL DISABILITY ALLIANCE
2017

Expand view

Within the Stakeholder Group of Persons with Disabilities, a working group was created on the Voluntary National Reviews (VNRs) aimed at raising awareness among Organisations of Persons with Disabilities (DPOs) to engage with their governments in the national consultation processes on SDG implementation, with particular focus on the 2017 44 volunteering countries. The VNR working group are compiling an outcome document reflecting the work that DPOs carried out at the national, regional and global levels. A comprehensive report – called the Global Report on DPO Participation in VNR Processes – will be issued in draft form prior to the HLPF and will be updated afterward with concrete findings. 

The report will showcase the national level DPO work carried out in different regions as well as best practices and challenges, and will serve as a case study for Member States. It will additionally be useful for DPOs as a model to engage with their government. The case study will feature the volunteering countries of Denmark, Italy, Sweden, Nigeria, Togo, Kenya, Ethiopia, Argentina, El Salvador, Peru, Guatemala, Indonesia, Bangladesh, India and Jordan.

Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

Expand view

The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Equal measures 2030: Policymakers survey

EQUAL MEASURES 2030
2017

Expand view

This report gives interim findings from results of a survey of 109 policymakers in five countries (Indonesia, India, Kenya, Senegal and Colombia), and seeks to shed light on:

  • How do policymakers perceive progress on gender equality in their countries?
  • What most needs to change in order to improve gender equality?
  • What data and evidence do they rely on to make their decisions?
  • How confident are they in their understanding of the major challenges affecting girls and women in their countries?

 

These findings will contribute to debates about data-driven decision making on gender equality, and raise attention to the gaps in accessible, reliable and relevant data and evidence needed to reach the SDGs by 2030.

Toolkit for understanding and challenging leprosy related stigma for Civil Society Organisations in India

JOY, Anish
et al
2017

Expand view

This toolkit is intended primarily for use by CSO's at the community level in India for use with field workers and local governments for challenging stigma and discrimination against people affected by leprosy/disabilities. The toolkit uses simple activities and pictures and is based on a participatory approach which requires active involvement of the group being trained. There are 6 modules:

What is leprosy

What is stigma

How we stigmatise others

How it feels to be stigmatised

Understanding human rights

Action towards inclusion

There are 10 appendices providing supporting information for the toolkit  

Enabling education review, issue 4

ENABLING EDUCATION NETWORK
December 2015

Expand view

This newsletter contains a variety of articles about inclusive education in several countries around the world. The topics focus mostly on funding, managing and sustaining inclusive education; engaging and empowering beneficiaries in finding solutions; facilitating parental and child involvement and early childhood education

Enabling Education Review, issue 4

Prosthetics & orthotics impact assessment : India and Bangladesh

COCHRANE, Helen
ROSARIO, Demetria
SINGH, Anil
GHOSH, Ritu
June 2015

Expand view

Mobility India is the only International Society for Prosthetics and Orthotics​ (ISPO) recognised program in India offering training for ISPO Category II single discipline. From 2002 to the time of the study Mobility India enrolled two hundred and twenty-one students. This study was conducted in association with ISPO’s USAID funded programme: ‘Rehabilitation of physically disabled people in developing countries’. Activities included: field visits to India and Bangladesh, interviewing Ministry officials, Heads of Clinical Services and Heads of Prosthetic and Orthotic Departments;  a partial audit of graduate clinical skills and competencies and determining the professional development needs of graduates in selected South-East Asian countries; and listening to service users, hearing stories of how services had directly impacted upon their lives. Services in India and Pakistan are outlined and 22 recommendations to help to further develop prosthetic and orthotic services are provided.

The Development of a New Quality of Life Questionnaire for Children with Hearing Loss - The Impact of Hearing Loss on Children (IHL-C): Field Testing and Psychometric Evaluation

Raj, Lavanya J
Pitchai, Swarnakumari
2015

Expand view

Purpose: To report the development of user-defined, multidimensional, psychometrically sound Quality of Life questionnaires – Impact of Hearing Loss on Children – IHL-C 69 and Brief IHL-C for children with hearing loss, in two languages -Tamil and English.

 

Methods: 421 problem statements from previous qualitative studies were reduced to a 220-item questionnaire with 7 domains (educational implications, social integration, psycho-social well-being, speech, language and communication, family relationships, leisure time activities and general functioning). After field testing, the domain of leisure time activities was dropped, resulting in a 103-item self-administered questionnaire with 6 domains. This 103-item questionnaire was translated from Tamil to English, and self-administered by children with hearing loss (11-18 years of age) in Special schools (n=100) and Integrated schools (n=100), as well as by normal controls in Integrated schools (n=200). Standard methods were used for item reduction and to evaluate psychometric properties.

 

Results: Psychometric item reduction produced the 69-item IHL-C69 (long version) and 48- item Brief IHL-C (brief version) questionnaires. Psychometric evaluation showed that all the domains of both the questionnaires had good acceptability, high internal consistency (alpha >0.80; intrinsic validity >0.80) and test-retest reliability (0.86).The questionnaires significantly distinguished between the children with hearing loss and the normal controls. The domains of both the questionnaires showed moderate evidence of convergent validity, and discriminant validity derived through hypotheses testing showed mixed results. The translation validity was also determined.

 

Conclusion: The IHL-C 69 and Brief IHL-C are reliable and valid user-defined, multidimensional questionnaires, available for the first time in both Tamil and English languagesin Tamil Nadu, India. Designed to analyse the impact of hearing loss and to determine the quality of life of children with hearing loss, the questionnaires could be used to prioritise the goals for rehabilitation intervention for these children.

‘Ask us what we need’: Operationalizing Guidance on Disability Inclusion in Refugee and Displaced Persons Programs

PEARCE, Emma
2015

Expand view

Persons with disabilities remain one of the most vulnerable and socially excluded groups in any displaced community. Barriers to accessing humanitarian assistance programs increase their protection risks, including risk of violence, abuse and exploitation. Women’s Refugee Commission has been supporting the United Nations High Commissioner for Refugees and implementing partners to translate guidance on disability inclusion into practice at field levels through the provision of technical support to eight country operations. In the course of the project, WRC has consulted with over 600 persons with disabilities and care-givers and over 130 humanitarian actors in displacement contexts. Key protection concerns identified include a lack of participation in community decision making; stigma and discrimination of children and young persons with disabilities by their non-disabled peers; violence against persons with disabilities, including gender-based violence; lack of access to disabilityspecific health care; and unmet basic needs among families of persons with multiple impairments. Suggested strategies to further advance disability inclusion in humanitarian programming include: strengthening identification of protection risks and case management services for persons with disabilities; facilitating contextspecific action planning around key guidelines; and engaging the disability movement in advocacy on refugee issues.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 1

Disability disaggregation of data : baseline report

JOLLEY, Emma
THIVILLIER, Pauline
SMITH, Fred
December 2014

Expand view

“This baseline report contains information on the initial steps (prior to the start of data collection) undertaken to include disaggregation of data by disability in two projects in Tanzania and India. The report includes information on project selection, development of an Monitoring and Evaluation (M&E) plan, adaptation of data collection tools and training of Country Office staff, partners and data collectors. This baseline also captures the knowledge, attitudes and practices of programme managers, decision makers and data collectors around disability, the availability of data, and the experiences of Sightsavers’ implementing staff”

Note: The user has given permission for the uploaded document to be reproduced and made publicly available on the Source website

Violence Against Persons with Disabilities in Bidar District, India

DEEPAK, S
KUMAR, J
SANTOSH, B
GORNALLI, S
MANIKAPPA, P
VYJANTHA, U
GIRIYAPPA, R
2014

Expand view

Violence and sexual violence against persons with disabilities at community level are serious issues. Though CBR programmes and DPOs are expected to prevent violence and offer support to the victims, there is very little informationabout their role in this regard.

 

Purpose: This research aimed to assess the level of violence and sexual violence experienced by DPO members, and the role played by CBR programmes in preventing it.

 

Method: The study involved a non-random consecutive sample of 146 persons with disabilities from 3 sub-districts of Bidar district in Karnataka, India. Using a structured questionnaire, interviews were conducted by a group of trained DPO members and CBR workers, many of whom had personal experience of violence. The data was entered using Epi-Info and then converted into spreadsheet Tables for analysis.

 

Results: 58% of the sample reported having experienced violence and 14% reported experiences of sexual violence during the previous 12 months. Girls and women reported higher levels of violence at different age groups. Male children and young adults reported having experienced more violence, including sexual violence, than older men. The research did not provide conclusive evidence that participation in the CBR and DPO activities played a protective role.

 

Conclusions: Violence and sexual violence against persons with disabilities are serious problems. More research on the subject, in terms of roles of CBR programmes and DPOs, is needed.

Making microfinance accessible to persons with disabilities: awareness and attitudes among Indian microfinance institutions

GUPTA, Vin
May 2014

Expand view

This research focuses on three stakeholders: Microfinance Institutions (MFIs), Persons with Disabilities (PWD), and non-disabled clients. It attempts to highlight the following:

  • Understanding of MFIs about disability, their perceptions of persons with disabilities, and their preparedness to include them as potential clients
  • Concerns and apprehensions of PWD to becoming potential MFI clients
  • Views of non-disabled clients on including PWD in their groups

The study investigates the knowledge and the perceptions about disability among each stakeholder group and attempts to elucidate how that impacts the ability of PWD to access microfinance services. Four microfinance institutions of different geographic areas were studied. The survey inolved 1,000 people of whom 57 were disabled. 

Disability inclusion : translating policy into practice in humanitarian action

PEARCE, Emma
March 2014

Expand view

This report “documents positive practices and ongoing challenges to promote disability inclusion across UNHCR’s and its partners’ work in multiple countries and multiple displacement contexts. The report provides lessons and recommendations for other organizations and the wider humanitarian community on engaging persons with disabilities at all levels of humanitarian work. It draws on consultations with over 700 displaced persons, including persons with disabilities, their families, and humanitarian staff, in eight countries”

Note: This report is also offered in plain text format

Mapping report of physical rehabilitation services in Afghanistan, Bangladesh, Odisha (India) and Sri Lanka

AXELSSON, Charlotte
2014

Expand view

This report presents a mapping (situational analysis) of the physical rehabilitation sector in the three countries and the Odisha state in India completed as part of Handicap International’s three year regional program in South Asia “Towards Disability Inclusive Development through a Strengthened Rehabilitation Sector in South Asia”. The aim of this mapping is improve the availability of information on the physical rehabilitation sector and to have an overview of the needs and unmet needs for physical rehabilitation

Fact sheet : refugees with disabilities

WOMEN’S REFUGEE COMMISSION
2014

Expand view

This factsheet highlights the issue of disabilities among refugees and conflict-affected population. It emphasizes actions undertaken by the Women’s Refugee Commission (WRC) and highlights their next steps in disability inclusion

Note: Also available in easy read format

Pages

E-bulletin