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Torture in healthcare settings : reflections on the Special Rapporteur on torture's 2013 thematic report

ANTI-TORTURE INITIAITIVE
February 2014

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This resource is a collection of articles focused upon the treatment of people with psycho-social disabilities in health-care settings, particularly with regard to torture, abuse and ill-treatment, and reflecting on the Special Rapporteur on Torture’s 2013 thematic report.

It brings together contributions by more than thirty international experts in response to the United Nations Special Rapporteur on Torture Juan E. Méndez’s thematic report, providing insights into essential topics and highlighting issues at the forefront of the intersecting medical, legal, and policy fields. It supports a commitment to tackling the challenges that continue to arise in promoting and protecting the human rights of persons in diverse healthcare settings globally

Evolution of community physiotherapy in India

RAJAN, Pavithra
2014

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Despite the urgent need for physiotherapy services for underprivileged communities, Community Physiotherapy is not a sought-after specialisation in India. Physiotherapists tend to serve in institutions rather than at community level, as a result of which this field of healthcare has stagnated. This article, based on an interview with one of the country’s eminent community physiotherapists, gives a first person account of the evolution of community physiotherapy in India and provides qualitative inputs to deal with the prevalent issues. While the need for services has increased, there has been no matching growth in the pool of physiotherapists willing to work in the community. Several recommendations have been made, including changes in approach to community physiotherapy by both physiotherapists as well as community organisations in India.

Compendium of accessible WASH technologies

JONES, Hazel
WILBUR, Jane
2014

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This compendium of accessible WASH technologies is designed for use by staff, such as health workers and community volunteers, working directly with communities in rural areas of sub-Saharan Africa. A few examples of technologies are presented that families can adapt to suit their needs and budgets with many more options possible. Most of the ideas are geared towards disabled and older people, but are suitable for anyone who may have difficulty using standard facilities, such as pregnant women, children and people who are ill. The main focus is on household facilities, although some ideas might be useful for institutional facilities as well

Inclusive disaster risk management : a framework and toolkit

FERRETTI, Silva
KHAMIS, Marion
2014

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This framework and toolkit have been designed to support practitioners in challenging and deepening inclusiveness in their work. They have been designed in simple language, so the resource should be easy to adapt for the use of field staff as a complement to existing manuals and operational resources on DRM. The practical framework contains the following sections:introduction, framework for inclusive DRM, levels of achievements, and assessing inclusiveness, using the framework for,  annexes and Q&A. Throughout the resource, related resources and checklists are provided and the toolbox features cartoons, tools catalogue, learning pills, case studies, poster and 4D lenses. These resources are useful for practitioners who want to develop an understanding of inclusive DRM framework and to learn how to practically assess inclusiveness in in ongoing DRM situations

Mental Health Care, Diagnosis, and the Medicalization of Social Problems in Ukraine

YANKOVSKYY, Shelly
2014

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This paper focuses on cultural issues associated with reforms of the mental health system in Ukraine. Specifically, the paper will explore the adoption of the International Classification of Diseases (ICD-10), with its heavy focus on biomedical definitions of health and illness, and the applicability of applying this model cross-culturally. Using first hand ethnographic data with psychiatrists, social workers and advocates, as well as patients or ‘bolnoi’ (bolnoi translates literally as ‘an ill person’) of psychiatric services, I argue that ‘mental illness’ is not always, or solely, biological, but also culturally shaped, and therefore a ‘one-size-fits-all’ approach to mental health becomes problematic. I follow this argument with a discussion of how social problems more generally come to be redefined in Ukraine as medical in nature, where issues such as gender relations, alcoholism, poverty and environmental disasters are subject to medicalization. Here ‘symptoms of oppression’ or ‘distress’ are diagnosed within a psychiatric framework and become ‘symptoms of illness’, to be treated within the biomedical arena. This redefinition places the responsibility for larger societal issues on the individual and ignores the social and environmental underpinnings of suffering - a dynamic that was also operative in the Soviet system. I argue that the growing popularity of the medicalization of behavior coupled with its relationship with the pharmaceutical industry is thus a moral issue, and one with harmful results.

 

Disability and the Global South, 2014, Vol. 1 No. 2

Manual on disability inclusive community-based disaster risk management

MALTESER INTERNATIONAL INCLUSIVE DRR ADVISOR AND PROJECT TEAM IN VIETNAM
et al
December 2013

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"This manual provides specific tips and recommendations on how to include people with disabilities in community-based disaster risk management (CBDRM) work; these tips are applicable to other socially marginalized groups such as illiterate people or ethnic minorities"

Spinal cord injury

WORLD HEALTH ORGANIZATION (WHO)
November 2013

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WHO factsheet on spinal cord Injury (SCI) presents key facts related to spinal cord injury (SCI).  It includes the following details: background information; prevalence; demographic trends; mortality; the health, economic and social consequences of SCI; prevention; improving care and overcoming barriers; and WHO response

Fact sheet N°384

An evidence review of research on health interventions in humanitarian crises

BLANCHET, Karl
et al
November 2013

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This report presents a review of the evidence base of public health interventions in humanitarian crises by assessing the quantity and quality of intervention studies, rather than measuring the actual effectiveness of the intervention itself.  It notes an increase in quality and volume of evidence on health interventions in humanitarian crises and recognises that evidence remains too limited, particularly for gender-based violence (GBV) and water, sanitation and hygiene (WASH). This report identifies a number of common needs across all areas, namely more evidence for the effectiveness of systems and delivery, better developed research methods, and more evidence on dispersed, urban and rural populations, on ensuring continuity of care and measuring and addressing health care needs in middle-income settings (particularly NCDs)

Note: Use links on the left hand side of the webpage to access either the full report, the executive summary, or the individual chapters arranged by health topic

Spatial variation in the disability-poverty correlation : evidence from Vietnam

MONT, Daniel
NGUYEN, Cuong
August 2013

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"Poverty and disability are interrelated, but data that can disentangle the extent to which one causes the other is not available. However, data from Vietnam allows us to examine this interrelationship in a way not previously done. Using small area estimation techniques, we uncover three findings not yet reported in the literature. First, disability prevalence rates vary significantly within a county even at the district level. Second, the correlation between disability and poverty also varies at the district level. And most importantly, the strength of the correlation lessens based on district characteristics that can be affected by policy. Districts with better health care and infrastructure, such as roads and health services, show less of a link between disability and poverty, supporting the hypothesis that improvements in infrastructure and rehabilitation services can lessen the impact of disability on families with disabled members"
Working Paper Series, No 20

Community-based rehabilitation (CBR) and persons with intellectual disabilities : international workshop report

SUNIL, Deepak
Ed
March 2013

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This report presents a summary of the main issues and conclusions from a CBR and persons with intellectual disabilities workshop. The workshop’s four sessions included "a session on health care needs led by Alaa Sebeh; a session on inclusive education led by Katharina Pfortner; a session on livelihoods and economic independence led by Philipa Bragman; and lastly, a session on social participation and empowerment led by Kathy Al Ju’beh." At the end of the workshop the participants agreed to establish an electronic group/network on CBR and intellectual disabilities. All presentations can be accessed from the website in pdf format
"CBR and Persons with Intellectual Disabilities"
Agra, India
24-25 November 2012

A Framework for Healthcare Provision to Children with Intellectual Disability

NUJUM, Z T
ANILKUMAR, T
VIJAYAKUMAR, K
ANISH, T
MOOSAN, H
2013

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Purpose: The Kudumbashree mission, an initiative of the Government of Kerala state in India, has collaborated with Local Self Governments to set up ‘Buds’, a special school system for individuals with intellectual disability. The objectives of this study were to evaluate the structure and functioning of ‘Buds’ schools, to identify the healthcare needs of the students, and to conceptualise a framework for healthcare provision.

 

Method: A cross-sectional survey was conducted among 202 children at 11 registered ‘Buds’ schools in Kerala. A multidisciplinary team consisting of a psychiatrist, public health personnel and a social worker from the Medical Colleges of Kerala, visited the institutions. Data collection consisted of abstraction from medical records, interviews with parents, and clinical assessment and prescription of intervention by the specialists concerned. A pre-tested semi- structured questionnaire was used for every child. Using both quantitative and qualitative techniques, the public health personnel in the team evaluated the structure and functioning of the schools.

 

Results: The most commonly associated condition was epilepsy, seen in 11.9% of the children, while 28.2% had behavioural problems. The medicines needed were mainly anti-epileptics and drugs for behavioural problems. Interventions for self help and social skill training were also among the important requirements. The infrastructure and other facilities were poor in many schools, with the average student to teacher ratio at 14:1. While these institutions were well utilised, functioning was good only in 27.2% of the schools. Healthcare services and visits by healthcare personnel were far from adequate. This study proposes a framework in which the Medical Colleges and Health Services can function together to deliver healthcare services to children at these schools, with linkages from the District Mental Health Programme (DMHP).

 

Conclusion and Recommendation: Evidence that these schools are well utilised indicates a need to propagate this initiative in other areas of the state, country and other countries. However, improvements in infrastructure, human resources and other logistics are required. Besides, the healthcare needs of these children have to be addressed. A comprehensive healthcare programme through the existing system, using a multidisciplinary approach, needs to be developed.

Disability and diversity

INTERNATIONAL CENTRE FOR EYE HEALTH
2013

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This resource provides practical advice for eye care professionals in low and middle income countries on how to how to make eye care inclusive and accessible and engage with people with different impairments
Community Eye Health Journal, Vol 26, No 81

Getting to know cerebral palsy|Working with parent groups : a training resource for facilitators, parents, caregivers, and persons with cerebral palsy

INTERNATIONAL CENTRE FOR EVIDENCE IN DISABILITY (ICED)
et al
2013

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This manual aims to increase knowledge and skills in caring for a child with cerebral palsy. Research highlighted the significant needs of the caregivers, and how they can gain a huge amount of support from meeting with each other in an understanding environment. The manual is divided into 11 modules and promotes a participatory learning approach with an emphasis on the empowerment of parents and caregivers. It provides an opportunity for parents to organise themselves and to consider strategies at the community level to address some of the issues which affect them and their child
Note: An online community that aims to support practitioners share their learning and experiences around the parent training manual is available from the weblink. Members can share questions and perspectives, news items and resources with eachother via email or through a community website

Maternal and new-born care practices among disabled women, and their attendance in community groups in rural Makwanpur, Nepal

LEONARD CHESHIRE DISABILITY AND INCLUSIVE DEVELOPMENT CENTRE
2013

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This paper presents qualitative and quantitative research that describes the type and severity of disability of married women in the study area, describes their participation in community groups and analyses associations between maternal and new-born care behaviours and disability. Health workers and field researchers were also interviewed about their experience with disabled women in rural Makwanpur
Cross-cutting Disability Research Programme, Background Paper: 01

Responding to intimate partner violence and sexual violence against women : WHO clinical and policy guidelines

WORLD HEALTH ORGANIZATION (WHO)
2013

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"The guidelines aim to raise awareness of violence against women among health-care providers and policy-makers, so that they better understand the need for an appropriate health-sector response. They provide standards that can form the basis for national guidelines, and for integrating these issues into health-care provider education...The guidelines are based on systematic reviews of the evidence, and cover: identification and clinical care for intimate partner violence; clinical care for sexual assault; training relating to intimate partner violence and sexual assault against women; policy and programmatic approaches to delivering services; mandatory reporting of intimate partner violence"

Responding to intimate partner violence and sexual violence against women : summary

WORLD HEALTH ORGANIZATION (WHO)
2013

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"This document summarizes ‘Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines’, the World Health Organization (WHO), 2013 publication, developed by an international group of experts following a thorough review of evidence. It contains evidence-based recommendations for the introduction of policies into health services and programmes to improve responses within the health sector to violence against women. Each recommendation is classified as either "strong" or "conditional", on the basis of the generalizability of benefit across different communities and cultures, the needs and preferences of women to access services, as well as taking into consideration the level of human and other resources that would be required"
WHO/RHR/13.10

International perspectives on spinal cord injury

BICKENBACH, Jerome
et al
Eds
2013

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This report assembles and summarizes information on spinal cord injury, in particular the epidemiology, services, interventions and policies that are relevant, together with the lived experience of people with spinal cord injury. It also provides recommendations for actions based on this evidence that are consistent with the aspirations for people with disabilities as expressed in the Convention on the Rights of Persons with Disabilities

Gender inclusion for social resilience : a key factor in disaster risk reduction

POURNIK, Milad
CHUNG, Jaeeun
MILLER, Barbara
December 2012

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"This report offers a brief review of the concept of social resilience, especially in relation to natural disasters and with specific attention to women and girls as victims of disasters and active participants in disaster prevention and response. It next provides a summary of a conference that took place at the George Washington University's Elliott School of International Affairs on October 11, 2012, marking the United Nations International Day for Disaster Reduction and its 2012 theme, Women & Girls: The inVisible Source of Resilience. Last, it summarizes how social resilience can create more secure societies in a changing world"

Global Gender Program, Occasional Paper #2

Common European guidelines on the transition from institutional to community based care|Guidance on implementing and supporting a sustained transition from institutional care to family-based and community-based alternatives for children, persons with dis

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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These guidelines "provide practical advice about how to make a sustained transition from institutional care to family-based and community based alternatives for individuals currently living in institutions and those living in the community, often without adequate support. The Guidelines are aimed primarily at policy and decision makers in the European Union and the neighbouring countries with responsibility for the provision of care and support services for children, people with disabilities and their families, people with mental health problems and older people"

Toolkit on the use of European Union funds for the transition from institutional to community based care

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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This toolkit "aims to explain how European Union funds can support national, regional and local authorities in designing and implementing structural reforms aimed at facilitating the development of quality family-based and community-based alternatives to institutional care. It addresses primarily the desk officers of the European Commission, managing authorities, intermediate bodies, monitoring committees and project promoters in the EU Member States and in acceding, candidate and potential candidate countries; and any other donors investing in services for children, people with disabilities, people with mental health problems or older people"

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