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Disability inclusive Universal Healthcare

CENTRE FOR INCLUSIVE POLICY
March 2021

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The inclusion of direct medical costs, indirect medical costs and indirect costs incurred by people with disabilities into Universal Healthcare is discussed. The importance of including assistive devices, rehabilitation and extra transportation costs in the system is highlighted. Social protection measures are also highlighted.

Traffic crash injuries and disabilities : The burden on Indian society

WORLD BANK
February 2021

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Road crashes endanger the lives and livelihoods of millions of road users globally and in India.  The risk of a road crash in low-income countries is three times higher than compared to that in high-income countries. Not only does it lead to untold and unaccounted for suffering and loss for victims and their families, but also, it drains the GDP of countries by claiming millions of economically productive young lives6. While it is recognized that RTIs affect the developed and developing world in different ways, it also impacts poor households and disadvantaged sections of the population within developing countries differently. World Bank commissioned a survey-based assessment study in association with the Save LIFE Foundation (SLF) to determine such differential impacts more objectively in India. This study aims to capture the socioeconomic realities and nuances of road crashes at the sub-national level in India. It seeks to document inter-linkages between poverty, inequalities, road users, and road crash outcomes by analyzing data from four States in India, i.e., Uttar Pradesh, Bihar ,Tamil Nadu and Maharashtra. The four states have been selected on the basis of several criteria including demographic and geographical representation, magnitude of fatality burden and socio-economic parameters such as economic growth, poverty rate and social welfare. 

Breaking down barriers to travel. Championing disability inclusive and accessible travel

AYLING-SMITH, Verity
December 2020

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Inclusivity is a key element to exceptional travel experiences – enabling individuals all over the world to experience diverse countries, cultures and opportunities. Yet often, disability inclusion is not at the forefront of travel products and services.

This report will support travel providers to understand why disability inclusion matters to the industry whilst celebrating and learning from providers already striving to be more inclusive through their innovative practices

 

To gather stories and examples of best practice from within the travel industry, we developed a “Call for Case Studies” survey which was distributed to both Leonard Cheshire and Expedia Group’s networks. From these submissions, we selected examples which highlighted innovative practice and represented our key themes of the report

Training for the HandbikeBattle: an explorative analysis of training load and handcycling physical capacity in recreationally active wheelchair users

KOUWIJZER, Ingrid
VALENT, Linda J M
BENNEKOM, Coen A M van
HANDBIKEBATTLE group
POST, Marcel W M
WOUDE, Lucas H V Van Der
GROOT, Sonja de
November 2020

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Purpose: (1) to analyze training characteristics of recreationally active wheelchair users during handcycle training, and (2) to examine the associations between training load and change in physical capacity.

 

Methods: Former rehabilitation patients (N = 60) with health conditions such as spinal cord injury or amputation were included. Participants trained for five months. A handcycling/arm crank graded exercise test was performed before and after the training period. Outcomes: peak power output per kg (POpeak/kg) and peak oxygen uptake per kg (VO2peak/kg). Training load was defined as Training Impulse (TRIMP), which is rating of perceived exertion (sRPE) multiplied by duration of the session, in arbitrary units (AU). Training intensity distribution (TID) was also determined (time in zone 1, RPE ≤4; zone 2, RPE 5–6; zone 3, RPE ≥7).

 

Results: Multilevel regression analyses showed that TRIMPsRPE was not significantly associated with change in physical capacity. Time in zone 2 (RPE 5–6) was significantly associated with ΔVO2peak, %ΔVO2peak, ΔVO2peak/kg and %ΔVO2peak/kg.

 

Conclusion: Training at RPE 5–6 was the only determinant that was significantly associated with improvement in physical capacity. Additional controlled studies are necessary to demonstrate causality and gather more information about its usefulness, and optimal handcycle training regimes for recreationally active wheelchair users.

Inclusive design research in a pandemic: Working remotely in Ulaanbaatar, Mongolia

PATRICK, Michaela
NARANGEREL, Tamirkhuu
October 2020

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The Inclusive Infrastructure sub-programme of the AT2030 programme began in March 2020, right out the outset of the COVID-19 pandemic.

Over three years this part of the AT2030 programme will be conducting case studies in six cities on the current state of accessibility and inclusion of the built environment in each of those places. 

The first case study took place in Ulaanbaatar, Mongolia. In March 2020, research was about to begin, Mongolia closed its border as the Coronavirus pandemic escalated. This meant to travel to Ulaanbaatar to conduct research was not possible and new ways of working remotely had to be adopted.

Research was carried out by collaborating with a local team based in Ulaanbaatar: AIFO, an Italian NGO that has been working in Mongolia since 1993 and two Disabled Persons’ Organisations: ‘Universal Progress’ Independent Living Center and Tegsh Niigem.

Perspectives on working together, collaborating remotely and why this research is relevant to the country are shared.

Inclusive design and accessibility of the built environment in Ulaanbaatar, Mongolia

PATRICK, Michaela
McKINNON, Iain
AUSTIN, Vicki
September 2020

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This case study on inclusive infrastructure in Ulaanbaatar, Mongolia is the first part of a series of six global case studies. The series is being developed to understand global priorities for inclusive design within the Inclusive Infrastructure work of the AT2030 programme; to build evidence on the awareness, understanding, acceptance, application and experience of Inclusive Design and accessible environments globally, particularly in lower and middle-income countries

Smartphone apps for transportation by people with intellectual disabilities: are they really helpful in improving their mobility?

ALANAZI, Adel
2020

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Purpose

The paper undertakes a critical assessment of the use of smartphone apps for transportation by people with intellectual disabilities. Although apps for transportation such as Uber and Careem have been developed to assist people with disabilities and have numerous benefits, people with intellectual disabilities tend to encounter their own set of difficulties in accessing these apps.

 

Materials and method

This paper presents the research findings drawn from a focus group discussion conducted with nine people with moderate to mild intellectual disabilities in Riyadh, by using a qualitative study focussed on the interpretative paradigm.

 

Results

From the interview findings, some relevant themes were identified. These were: transportation issues encountered by people with intellectual disabilities, the extent and manner of the use of smartphone apps for transportation, the benefits enjoyed by those individuals in using smartphone apps for transportation and the difficulties encountered by them.

 

Conclusions

The paper also discusses the implications for practice and presents some useful recommendations, including the need for family support and government assistance.

Impact of lived experiences of people with disabilities in the built environment in South Africa

McKINNEY, Victor
AMOSUN, Seyi L.
August 2020

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Background: In spite of legislations and policies to ensure an inclusive society in South Africa for the accommodation of people with disabilities, there are reports that they still struggle to move freely within society.

 

Objectives: As part of a larger qualitative exploratory study on the preparation of undergraduate civil engineering students in a local university to contribute to the development of an inclusive society, this article seeks to understand the impact of the lived experiences of people with disabilities in their interaction with the built environment.

 

Method: Four persons with disabilities, considered to be knowledgeable about South African legislations relating to disability, were purposely selected to each share one specific experience whilst interacting with the built environment. The transcribed texts of the interviews were analysed by using the phenomenological–hermeneutic method.

 

Results: The participants exhibited strong desires to participate in society. However, the sense of loss of control and independence as they encountered challenges in the built environment changed the euphoria to disempowerment, rejection, anger and despondency. In spite of their experiences, participants expressed a commitment towards overcoming the challenges encountered in the broader interest of people with disabilities.

 

Conclusion: A deeper understanding of the impact of the experiences of people with disabilities when they participate within the built environment in South Africa revealed a broad spectrum of negative emotions, which may impact the quality of life and well-being of the participants.

 

 

African Journal of Disability, Vol 9, 2020

Disability Inclusive Development - Jordan Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Jordan?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Jordan. It will be helpful for anyone interested in disability inclusion in Jordan, especially in relation to stigma, employment, education, health, and humanitarian issues.

“Disability Is Not Weakness” Discrimination and barriers facing women and girls with disabilities in Afghanistan

GOSSMAN, Patricia
April 2020

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Everyday barriers that Afghan women and girls with disabilities face are described.  Decades of conflict have decimated government institutions and development efforts have failed to reach many communities most in need. Obtaining access to health care, education, and employment, along with other basic rights, is particularly difficult for Afghan women and girls with disabilities, who face both gender discrimination and stigma and barriers associated with their disability.

 

This report is based primarily on research by Human Rights Watch researchers from April 2018 through January 2020 in Kabul, Mazar-e Sharif, and Herat, Afghanistan. 23 interviews with women with disabilities and 3 interviews with family members of women and girls with disabilities were conducted. 14 healthcare and education professionals were interviewed, including representatives from the United Nations and international and local nongovernmental organizations providing services to persons with disabilities in Afghanistan

Required to be creative. Everyday ways for dealing with inaccessibility

WÄSTERFORS, David
2020

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Today’s society promises that people with disabilities can access anything, but in practice there are numerous obstacles, and the ways in which people deal with them can be easily missed or taken for granted by policy makers. This article draws on a project in which researchers ‘go along’ people with disabilities in Sweden who demonstrate and recount accessibility troubles in urban and digital settings. They display a set of mundane methods for managing inaccessibility: (a) using others, (b) making deals and establishing routines, (c) mimicking or piggybacking conventions, (d) debunking others’ accounts and performing local politics. The employment of these shared but tailored methods shows the difficulties to be accepted that people with disabilities still face, as well as the wide-ranging tension that exists between the grand rhetoric of inclusion and modest results. The tension implies that people with disabilities are required to be creative.

  • Declarations and policies often say that people with disabilities should have access to anything, but in practice this is not the case.
  • This study investigates what people with disabilities actually do when they have trouble accessing various places or resources. The results show their common and practical ways, and these ways are often taken for granted, overlapping, and combined.
  • People with disabilities ask others to support them when they face troubles to access places or resources, they make deals with important actors and they develop routines. They also observe, imitate and follow others’ actions, to pick out precisely those ways that suit their needs.
  • When people with disabilities find their ways in today’s society they also act with words. They argue against other people’s excuses or justifications for not providing access.
  • The study has found a lot of frustration among people with disabilities who get blocked, excluded or delayed. This gives them motives to engage in politics.

Building the inclusive city - Governance, access, and the urban transformation of Dubai

SANTIAGO PINEDA, Victor
2020

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This book is an anthropological urban study of the Emirate of Dubai, its institutions, and their evolution. It provides a contemporary history of disability in city planning from a non-Western perspective and explores the cultural context for its positioning. Three insights inform the author’s approach. First, disability research, much like other urban or social issues, must be situated in a particular place. Second, access and inclusion forms a key part of both local and global planning issues. Third, a 21st century planning education should take access and inclusion into consideration by applying a disability lens to the empirical, methodological, and theoretical advances of the field

Disability, mobility and transport in Low- and Middle-Income Countries: A thematic review

KETT, Maria
COLE, Ellie
TURNER, Jeff
January 2020

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This paper discusses issues affecting the transport and mobility needs of people with disabilities in middle- and low-income countries and how disability intersects with a range of other factors to impact on transport needs, use and engagement. The paper is intended to stimulate discussion and identify areas for further research, and identifies a number of key issues that are salient to discussions around equitable and inclusive transport provision, including patterns of transport use, behaviour and experiences, solutions and policy directions, measuring access and inclusion, policies and intersectionality. The paper also identifies gaps in knowledge and provision, barriers to addressing these gaps, and some possible solutions to overcoming these barriers. These include shifting the focus from access to inclusion, reconceptualising how ‘special’ transport might be provided, and most importantly listening to the voices and experiences of adults and children with disabilities. Despite lack of transport often being cited as a reason for lack of inclusion of people with disabilities, there is surprisingly little evidence which either quantifies this or translates what this lack of access means to people with disabilities in their daily lives in low- and middle-income countries.

 

Sustainability 2020, 12(2), 589

https://doi.org/10.3390/su12020589

Environmental Accessibility Assessment for People with Vision, Hearing and Speech Disabilities in Mongolia

BATDULAM, Tumenbayar
CHIMEDSUREN, Оchir
URANCHIMEG, Davaatseren
ENKHTSETSEG, Byambaa
2019

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Purpose: The main objective of this paper was to assess environmental accessibility for people with vision, hearing and speech disabilities in Mongolia, with particular focus on public buildings and public transportation.

 

Methods: A standardised internationally-used questionnaire, consisting of 29 questions, was used for the accessibility of public buildings assessment.  The questionnaire results were grouped into categories and descriptive statistics were obtained. To determine quality and accessibility to public transportation a standardised sheet, consisting of 51 questions from the internationally accepted SERVQUAL, was used. This model is commonly used for measurement of the discrepancies between actual performance and customer expectations.

 

Result: Assessment of public buildings in Mongolia revealed that they were moderately accessible for people with vision, hearing and speech disabilities. The assessment of public transportation found that the discrepancy between actual performance and customer expectation is the highest across all indicators for people with hearing and speech impairments.

 

Conclusion: The research findings indicated a strong need to pay closer attention to the current environmental unfriendliness and inaccessibility faced by people with vision, hearing and speech disabilities.

Safe and accessible public transport for all. Making SDG 11.2 a reality

HUMANITY & INCLUSION (HI)
INTERNATIONAL ASSOCIATION OF PUBLIC TRANSPORT (UITP)
May 2019

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The importance of addressing both safety and accessibility for inclusive urban mobility is discussed. 

Case studies provided are:

  • Accessible public transport for employment, Senegal
  • Training and ICT solutions, Kenya
  • Tuk Tuk drivers certified on accessibility, Laos
  • Designing Bus Rapid Transport (BRT) systems for accessibility, South Africa
  • Improving accessibility to transport, Brazil
  • Making public transport more inclusive with technology, Singapore
  • Taking efforts to be more inclusive, France
  • A model city for accessibility, Brazil
  • Prioritising accessibility, Czech Republic
  • Getting all residents and visitors to engage in all aspects of city life, Luxembourg
  • Communications training, Russia
  • Metro access audits, India

Recommendations are made to governments concerning strengthening poicy frameworks and removing barriers to accessible mobility

 

 

 

Accessibility of Public Buildings in Khulna, Bangladesh, for Wheelchair Users

FARZANA, Fawzia
2019

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Purpose: Physical accessibility is one of the fundamental rights of wheelchair users in order to ensure their integration into society. After Bangladesh ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) on November 30, 2007, there has been a paradigm shift in the government’s approach to ensure the welfare and rights of persons with disabilities through legislative and policy actions. This study assesses how accommodative the public buildings are for wheelchair users in Khulna, Bangladesh.

 

Method: All the public buildings in Khulna city - including government offices, public schools, colleges and universities, hospitals, libraries, post offices and court buildings -  were visited to assess the presence and suitability of facilities for wheelchair users, such as accessible parking, ramps, elevators, doors, and essential interior facilities like water closets and drinking-water fountains.  Bangladesh has no specific accessibility guidelines document, but accessibility requirements have been included in the Bangladesh National Building Code (BNBC) 2008. The study made its assessment using an abridged form of the Americans with Disabilities Act Accessibility Guidelines (ADAAG) and BNBC 2008.

 

Results: Only 6.7% (5) of the 75 public buildings were found suitable for wheelchair users. There is scope for modifications to be made in 28% (21) of the buildings which are currently unsuitable for wheelchair users.

 

Conclusion: The study revealed that public buildings are, in general, not very accommodative of wheelchair users. There is a need for modifications in infrastructure to ensure inclusive development of these individuals.

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