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Sightsavers' approach to making health services inclusive for everyone

Sightsavers
April 2019

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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

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A short overview is given of MAANASI project in southern India reporting how 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. The Maanasi clinic has an active caseload of 1900+ patients, and the CHWs have logged hundreds of visits, over 2 decades, to provide outreach and teaching to hundreds of households

 

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

https://doi.org/10.5463/dcid.v30i2.851

 

 

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.

Standard school eye health guidelines for low and middle-income countries

GILBERT, Clare
MINTO, Hasan
MORJARIA, Priya
KHAN, Imran
February 2018

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The purpose of these best practice guidelines is to provide direction to those planning and implementing eye health initiatives for schools, including policy makers, health care and educational authorities, health planners, eye care delivery organizations and professionals, in partnership with teachers, parents and children. In situations where resources for eye health are limited, decisions need to be made to ensure that programs not only address public health problems but are also implemented in a way that is effective, efficient and, wherever possible, sustainable. Systems for monitoring and plans for evaluation should also be developed at the outset. These practice guidelines provide an excellent learning resource for a module on school eye health that can be incorporated in optometry and ophthalmology residency curricula.  A section highlights some of the challenges in current school eye health initiatives and provides a framework in which school eye health is integrated into school health programs. Case studies are provided to emphasise the integrated approach and a 15-step approach, from situation analysis to monitoring and evaluation, is suggested. Practical recommendations for implementation are provided, including information on the equipment and technology required

 

This evidence-based document is based on best practice guidelines initially developed through a joint collaboration between Sightsavers International, the London School of Hygiene and Tropical Medicine and the Brien Holden Vision Institute

Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
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.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own 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. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

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

Evaluating the impact of a community–based parent training programme for children with cerebral palsy in Ghana

ZUURMOND, Maria
et al
January 2017

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"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".

Problem Management Plus (PM+) Individual psychological help for adults impaired by distress in communities exposed to adversity

WORLD HEALTH ORGANIZATION
2016

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With this manual, the World Health Organization (WHO) is responding to requests from colleagues around the world who seek guidance on psychological interventions for people exposed to adversity.

The manual describes a scalable psychological intervention called Problem Management Plus (PM+) for adults impaired by distress in communities who are exposed to adversity. Aspects of Cognitive Behavioural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists. To ensure maximum use, the intervention is developed in such a way that it can help people with depression, anxiety and stress, whether or not exposure to adversity has caused these problems. It can be applied to improve aspects of mental health and psychosocial well-being no matter how severe people’s problems are.

Living in hell : how people with mental health conditions in Indonesia are treated

HUMAN RIGHTS WATCH (HRW)
March 2016

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This report examines the abuses—including pasung—that persons with psychosocial disabilities face in the community, mental hospitals, and various other institutions in Indonesia, including stigma, arbitrary and prolonged detention, involuntary treatment, and physical and sexual violence. It also examines the government’s shortcomings in addressing these problems.

Based on research across the Indonesian islands of Java and Sumatra, Human Rights Watch documented 175 cases of persons with psychosocial disabilities in pasung or who were recently rescued from pasung. 

 

Capturing the difference we make. Community-based rehabilitation indicators manual

WORLD HEALTH ORGANIZATION
2015

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"WHO and the International Disability and Development Consortium (IDDC) have worked together to develop the indicators presented in this manual that capture the difference CBR makes in the lives of people with disabilities in the communities where it is implemented. This manual presents these (base and supplementary) indicators and provides simple guidance on collecting the data needed to inform them. The indicators have been developed to show the difference between people living with a disability and their families and those without disabilities in relation to the information reported in the indicators. This comparability provides valuable information to CBR managers, donors and government agencies alike, which can be used to guide decision-making, support advocacy and improve accountability. Further, the ability of the indicators to provide a comparison of the populations of persons with disability to persons without disability aligns with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that persons with disability have equal rights to those without disabilities." 

Capturing the difference we make : community-based rehabilitation indicators manual

WORLD HEALTH ORGANIZATION (WHO)
2015

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This manual presents indicators that "capture the difference (Community-Based Rehabilitation) CBR makes in the lives of people with disabilities in the communities where it is implemented. This manual presents these (base and supplementary) indicators and provides simple guidance on collecting the data needed to inform them. The indicators have been developed to show the difference between people living with a disability and their families and those without disabilities in relation to the information reported in the indicators. This comparability provides valuable information to CBR managers, donors and government agencies alike, which can be used to guide decision-making, support advocacy and improve accountability. Further, the ability of the indicators to provide a comparison of the populations of persons with disability to persons without disability aligns with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that persons with disability have equal rights to those without disabilities...this manual serves to standardize the monitoring of differences made by in the lives of people with disabilities and their families, making it possible to compare the difference CBR makes across areas and countries. This manual aligns with the WHO Global Disability Action Plan 2014–2021, and may also be used to monitor other development plans in an easy and efficient way”

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

Inclusion through community based rehabilitation : lessons learned in Burkina Faso, Ethiopia & Mozambique 2009 - 2011

LIGHT FOR THE WORLD
2012

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"The LIGHT FOR THE WORLD Community Based Rehabilitation (CBR) Framework brought together 14 CBR projects in Ethiopia, Burkina Faso and Mozambique between 2009 and 2011 to share experiences and learning. This report reflects the experiences of the projects during this period and the lessons learned that can provide invaluable learning for other CBR projects. It also provides a useful record of the projects’ activities and outcomes, and enables future planning"

Packages of care for epilepsy in low- and middle-income countries

MBUBA, Caroline K
NEWTON, Charles R
October 2009

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This article focuses on the management of epilepsy in low- and middle-income countries and recommends a package of care - a combination of interventions aimed at improving the recognition and management of conditions to achieve optimal outcomes - for epilepsy, that is sustainable

Integrating gender into HIV/AIDS programmes in the health sector : tool to improve responsiveness to women’s needs

AMIN, Avni
et al
2009

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The purpose of this operational tool is to: raise awareness of how gender inequalities affect women’s access to and experience of HIV and AIDS programmes and services; and offer practical actions on how to address or integrate gender into specific types of HIV and AIDS programmes and services. The vulnerability of women, their risk of HIV infection and the impact of the epidemic on them are heightened by many factors, including: the low status accorded to women in many societies, their lack of rights, their lack of access to and control over economic resources, the violence perpetrated against them, the norms related to women’s sexuality, and women’s lack of access to information about HIV. This tool is primary aimed at primarily programme managers and health-care providers involved in setting up, implementing or evaluating HIV and AIDS programmes

The influence of HIV/AIDS on community-based rehabilitation in Dar es Salaam, Tanzania

BOYCE, William
COTE, Laurence
January 2009

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This paper examines the impact of HIV and AIDS on community-based rehabilitation (CBR) in Dar es Salaam, Tanzania. Over a three-month period, observational sessions and individual interviews were conducted with caregivers of children with disabilities, CBR workers and managers. Among the findings was a significant decrease in CBR activities in families affected by HIV and AIDS. It is recommended that further integration of CBR work with general health development initiatives might improve this situation

Shifting the paradigm in social service provision : making quality services accessible for people with disabilities in south east Europe

CHIRIACESCU, Diana
December 2008

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This report examines the ways in which policies and practices evolve in the social services sector in South East Europe, as well as the impact of this change process on the lives of people with disabilities. It aims to identify the main stakes, priorities and steps forward that should be undertaken in order to modernise this sector in an effective and sustainable way

School-centred HIV and AIDS care and support in Southern Africa : technical consulation report

BOLER, Tania
JOHNSSON, Emily
February 2008

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This report maps out the various activities in school-based HIV treatment, care and support that are being undertaken in Southern Africa, as a response to the changing needs of teachers, students and local communities. It highlights successful factors and common challenges and suggests five broad principles that help provide a comprehensive response to treatment, care and support,and reinforce prevention messages

The right to live in the community : making it happen for people with intellectual disabilities in Bosnia and Herzegovina, Montenegro, Serbia and Kosovo

ADAMS, Lisa
2008

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This report concerns the situation of people with intellectual disabilities in Bosnia and Herzegovina, Croatia, Kosovo under UN Security Council Resolution 1244, Montenegro and Serbia. It describes how five organisations working in the region have successfully developed innovative services to support people with intellectual disabilities to live in their communities as equal citizens. The aim of this report is to highlight the importance of developing a range of client-focused, community-based services as alternatives to institutionalisation; demonstrate that such services can successfully be developed in the region; identify barriers to the development of such services; and make recommendations on how to address such barriers

The essentials of antiretroviral therapy for health care and program managers

HOPE, Ruth
ISRAEL, Ellen
April 2007

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This book provides health care workers and mangers with information and practical guidance relating to antiretroviral therapies (ART). It also considers wider care and treatment issues such as; opportunistic infections, the integration of ART with antenatal and midwifery services, the particular needs of children and young people, support relating to nutrition, spiritual needs, psycho-social and economic issues. In addition, the need for community level support to help with adherence to treatment and address stigma and discrimination are also considered, as is end-of-life care for people whose disease does not respond to treatment

The care economy : gender and the silent AIDS crisis in Southern Africa

URDANG, Stephanie
March 2006

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This article considers the impact of AIDS on women’s roles and responsibilities within the household ‘care economy’. In particular, it emphasises that all interventions aimed at reversing the AIDS epidemic need to take into account the excessive work-load that members of the household, usually women, shoulder in responding to the needs of sick family members. Most notably, gender equality and care economy issues need to be identified by development programmes. There is also a need to implement policies that focus on issues such as treatment, prevention, education, economic empowerment and violence against women. The article argues that unless the care economy and the relations of gender inequality within the household are included in the design, implementation, monitoring and evaluation of such interventions, results will be compromised

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