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Attitudes of health service providers: the perspective of Persons with Disabilities in the Kumasi Metropolis of Ghana

BADU, Eric
OPOKU, Maxwell P
APPIAH, Seth C Y
2016

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Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis.


Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics.


Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39).


Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.
 

Global strategy on human resources for health: Workforce 2030. DRAFT for the 69th World Health Assembly

World Health Organisation (WHO)
May 2016

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This report was presented to Member States at the World Health Assembly in May 2016 and is to be read in conjunction with A69/38: Draft global strategy on human resources for health: Workforce 2030. Report by the Secretariat. The vision of this work and report is to "Accelerate progress towards universal health coverage and the UN Sustainable Development Goals by ensuring equitable access to health workers within strengthened health systems". Objectives are "To optimise performance, quality and impact of the health workforce through evidence-informed policies on human resources for health, contributing to healthy lives and well-being, effective universal health coverage, resilience and strengthened health systems at all levels",  "To align investment in human resources for health with the current and future needs of the population and of health systems, taking account of labour market dynamics and education policies; to address shortages and improve distribution of health workers, so as to enable maximum improvements in health outcomes, social welfare, employment creation and economic growth", "To build the capacity of institutions at sub-national, national, regional and global levels for effective public policy stewardship, leadership and governance of actions on human resources for health" and "to strengthen data on human resources for health, for monitoring and ensuring accountability for the implementation of national and regional strategies, and the global strategy".  Global milestones by 2020 and 2030, policy options of Member States, responsibilities of the WHO Secretariat and recommendations to other stakeholders and international partners are discussed for each objective.

 

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. 

 

WHO : microcephaly and zika virus infection : questions and answers

COSTELLO, Anthony
February 2016

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Dr Anthony Costello, Director of WHO's Department of Maternal, Newborn, Child and Adolescent Health, answers some key questions on Microcephaly and Zika virus infection including concerning how a pregnant women would know if her baby is infected, what support would be needed if the child has Microcephaly and what steps can be taken to avoid being infected

Zika virus

HESPERIAN HEALTH GUIDES
February 2016

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A short introduction to the Zika virus and pregnancy. This resources details the signs of the Zika virus and the difference between Zika virus, dengue, chikungunya, or malaria are outlined. How the mosquito spreads the disease, the prevention of mosquito bites, ways in which communities can prevent mosquito illnesses and removal of mosquito breeding sites from around the house and community are also covered

 

Note: resource is available online and in downloadable pdf formats

Evaluation of the feasibility and acceptability of the ‘Care for Stroke’ intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke

SURESHKUMAR, K
MURTHY, G V S
NATARAJAN, S
GOENKA, S
KUPER, H
February 2016

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This study aimed to identify operational issues encountered by study participants in using the ‘Care for Stroke’ intervention and to evaluate the feasibility and acceptability of the intervention. ‘Care for Stroke’ is a smartphone-enabled, educational intervention for management of physical disabilities following stroke. It is delivered through a web-based, smartphone enabled application (app). It includes inputs from stroke rehabilitation experts in a digitised format. Sixty stroke survivors discharged from hospital in Chennai, South India, and their caregivers participated in the study. The preliminary intervention was field-tested with 30 stroke survivors for 2 weeks. The finalised intervention was provided to a further 30 stroke survivors to be used in their homes with support from their carers for 4 weeks. Field-testing identified operational difficulties related to connectivity, video-streaming, picture clarity, quality of videos, and functionality of the application. Assessment was carried out by direct observation and short interview questionnaires. 

 

 

Roads to inclusion, a tool for identifying progress in community-based rehabilitation projects

February 2016

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The roads to inclusion tool has been developed by ENABLEMENT (the Netherlands) and LIGHT FOR THE WORLD on the basis of an action research programme carried out in Burkina Faso, Ethiopia and North East India. Communities in two sites of each country were asked to define what inclusion meant to them and those definitions were used as a basis for developing this tool. LIGHT FOR THE WORLD and ENABLEMENT hope this tool will support CBR teams in assessing communities’ progress in becoming more inclusive of persons with disabilities and planning activities to further the inclusion process. It promotes reflection on changes related to inclusion rather than judging projects on the impact of their work, and is thus not a tool for impact evaluation or comparing inclusion between different countries and cultures. The tool can be used in a variety of contexts. We recommend adjusting it to fit your organisation’s needs and seeing it as an inspiration on how it could be done, not as a prescription on how it should be done

Success for Students and Nurses With Disabilities. A Call to Action for Nurse Educators

MARKS, Beth
McCULLOH, Karen
February 2016

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The identification and implementation of best practices by nurse educators in the USA to support the success of student nurses with disabilities are discussed. Requirements of The Americans With Disabilities Act Amendments Act (ADAAA) of 2008 and the Office of Federal Contract Compliance Programs (OFCCP) revisions to regulations implementing the nondiscrimination and affirmative action regulations of section 503 of the Rehabilitation Act of 1973, effective March 24, 2014 are described. Best practices for educating students with disabilities in nursing education are discussed. The Increased understanding of disability will promote greater diversity and inclusivity within the nursing profession, which will enhance patient care. Three case studies are provided: a student nurse with hearing difficulties having issues with "a code blue"; a student nurse wheelchair user; and student nurse with low vision requiring IT assistance 

Nurse Educator, Jan-Feb 2016, Vol. 41(1), pp.9-12. doi: 10.1097/NNE.0000000000000212

Discourses of service user involvement in meeting places in Norwegian community mental health care: a discourse analysis of staff accounts

YNNESDAL HAUGEN, Lill Susann
ENVY, Andreas
BORG, Marit
EKELAND, Tor-Johan
ANDERSSEN, Norman
2016

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In previous research, meeting places have been favourably addressed by service users, but they have also been contested as exclusionary. In this participatory explorative study, we sought to perform a contextual analysis of meeting places in Norway based on a discourse analysis of three focus group discussions with 15 staff members. We asked the following question: how do meeting-place employees discuss their concrete and abstract encounters with service users and their experiences? We focused on service user involvement, which was largely analysed as neoliberal consultation and responsibilisation. Service users were positioned as resisting responsibility trickling down and defending staffed meeting places. Social democratic discourse was identified in the gaps of neoliberal discourse, which is noteworthy given that Norway is a social democracy. This relates to global concerns about displacements of democracy. We suggest that meeting places appear to hold the potential for staff and service users to collaborate more democratically.

Strengthening community and primary health systems for tuberculosis. A consultation on childhood TB integration

UNICEF
2016

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An estimated one million children between the age of 0-14 fall ill with tuberculosis (TB) every year, over 67 million children are infected and might develop active disease at any time. In 2013, the WHO with key partners launched the Roadmap for Childhood TB, outlining ten key actions to improve outcomes for children affected by TB, including improved data, development of child-friendly tools for diagnosis and treatment, engagement of key stakeholders at all levels of the system, and the development of integrated family- and community-centred strategies to provide comprehensive and effective services at the community level. A consultation on childhood TB integration took place in New York on June 1 and 2, 2016 to stimulate further the dialogue. The meeting addressed 7 topics: perspectives on childhood TB; country discussions on integration; integrating childhood TB interventions into service delivery; an opportunity for TB risk assessment at the community level: TB/HIV adapted integrated community case management (iCCM); childhood TB integration at the national, district, and community level; and financing childhood TB integration 

UNICEF 2016-2030 Strategy for Health “at a glance”

UNICEF
2016

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This provides an overview of UNICEF’s 2016-2030 Strategy for Health which "aims to: end preventable maternal, newborn, and child deaths; and promote the health and development of all children. With the first goal, UNICEF commits to maintaining focus on the critical unmet needs related to maternal, newborn and under-5 survival. With the second, UNICEF highlights the importance of also looking beyond survival and addressing the health and development needs of older children and adolescents. The Strategy emphasises the importance of prioritising the needs of the most deprived children and promotes multi-sectoral approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts by encouraging risk-informed programming in all contexts"

CHILD AT RISK. The world’s most vulnerable children: who they are, where they live, and what puts them at risk

SOS CHILDREN'S VILLAGES INTERNATIONAL
2016

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An overview of the life situations and locations of the world’s most vulnerable children based on results from the SOS Children’s Villages Programme Monitoring Database is presented. Risk factors are outlined and the percentages of each factors are reported. The Child Vulnerability Index (CVI) is given for a large number of countries

UNICEF’S STRATEGY FOR HEALTH (2016-2030)

UNICEF
December 2015

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UNICEF envisions a world where no child dies from a preventable cause, and all children reach their full potential in health and well-being. To this end, UNICEF’s 2016-2030 Strategy for Health aims to:

 

- End preventable maternal, newborn, and child deaths

- Promote the health and development of all children

 

With the first goal, UNICEF commits to maintaining focus on the critical unmet needs related to maternal, newborn and under-5 survival. With the second, UNICEF highlights the importance of also looking beyond survival and addressing the health and development needs of older children and adolescents.

 

The Strategy emphasises the importance of prioritising the needs of the most deprived children and promotes multi-sectoral approaches to enhance child development and address underlying causes and determinants of poor health outcomes. It aims to shift UNICEF from vertical disease programmes to strengthening health systems and building resilience, including calling for better integration of humanitarian and development efforts by encouraging risk-informed programming in all contexts.

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

KRAMER-ROY, Debbie
2015

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Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be par- ticularly hard for people living with multiple disadvantage, such as disabled peo- ple from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participa- tory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these meth- ods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented.

Can households cope with health shocks in Vietnam?

MITRA, S
PALMER, M
MONT, D
GROCE, N
May 2015

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"This paper investigates the economic impact of health shocks on working-age adults in Vietnam during 2004-2008, using a fixed effects specification. Health shocks cover disability and morbidity and are measured by 'days unable to carry out regular activity', 'days in bed due to illness/injury', and 'hospitalization'. Overall, Vietnamese households are able to smooth total non-health expenditures in the short run in the face of a significant rise in out-of-pocket health expenditures. However, this is accomplished through vulnerability-enhancing mechanisms, especially in rural areas, including increased loans and asset sales and decreased education expenditures. Female-headed and rural households are found to be the least able to protect consumption. Results highlight the need to extend and deepen social protection and universal health coverage."

How rehabilitation can help people living with HIV in Sub-Saharan Africa : an evidence-informed tool for rehab providers

Canadian Working Group on HIV and Rehabilitation
University of Toronto
University of Zambia
March 2015

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The aim of this e-module (or pdf) is to enhance knowledge about HIV care among rehabilitation providers in Sub-Saharan Africa (SSA) to help address the needs of people living with HIV. The resource is divided into 5 sections: the role of rehabilitation in the context of HIV in SSA; what rehabilitation providers need to know about HIV in SSA; rehabilitation interventions that can help people living with HIV in SSA; what rehabilitation providers need to know about caring for children and youth living with HIV in SSA; concepts and tools for measuring rehabilitation outcomes in HIV in SSA. This current resource is a comprehensive adaptation of the 2014 Canadian e-Module for rehabilitation providers in Sub-Saharan Africa which was developed from "A Comprehensive Guide for the Care of Persons with HIV Disease (Module 7)", published by Health Canada and the Wellesley Central Hospital, Toronto, Canada, published in 1998.

A home-based rehabilitation intervention for people living with HIV and disability in a resource-poor community, KwaZulu-Natal : study protocol for a randomized controlled trial

COBBING, Saul
HANASS-HANCOCK, Jill
MYEZWA, Hellen
2015

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In this paper, the researchers develop a needs-based home-based rehabilitation programme for people living with HIV in order to improve their quality of life and functional ability. The study aims to  provide rehabilitation professionals and researchers with evidence that can be utilised to improve existing rehabilitation interventions for people living with HIV.

The paper outlines a randomised control trial to test the programme, to be conducted at a public hospital in KwaZulu-Natal, South Africa. The trial will assess the participants’ quality of life, perceived level of disability, functional ability and endurance

Trials 16:491

World report on ageing and health

WORLD HEALTH ORGANIZATION (WHO)
2015

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This report lays out framework for the development of new strategies to bring the right programmes, information, and services to an ageing international community. The report focuses on policy development, healthy ageing and health in old age, health systems and long – term care systems.  The report concludes by presenting a series of recommended next steps to realising the vision of a world that is more friendly to an ageing population

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”

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