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What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?

QURESH, Onaiza
SCHERER, Nathaniel
July 2020

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The question and the problem:

Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the COVID-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during COVID-19 and other recent pandemics, informing policy and practice during this crisis.

How can social protection responses to COVID-19 be made disability inclusive?

BANKS, Lena Morgon
HUNT, Xanthe
June 2020

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Question & problem

The COVID-19 pandemic and strategies essential for its containment are resulting in severe strains on economies, particularly in low- and middle-income countries (LMICs). These impacts will be felt most by groups already in or at risk of poverty, including the estimated 1 billion people with disabilities globally. Interventions to address the short- and long-term economic effects of the pandemic are urgently needed. Some countries have begun implementing or announced plans for interventions addressing the economic impacts of COVID-19, such as food assistance, emergency cash transfers, unemployment assistance or expansions to existing social protection programmes. As these programmes are developed, it is important to consider the extent to which their design and delivery is inclusive of people with disabilities. Failure to adequately include people with disabilities in this process will lead to widening inequalities.

Aid out of reach: A review of the access to humanitarian aid for women and men, girls and boys with disabilities affected by Cyclone Idai, Mozambique

BAART, Judith
WESTER, Mirian
2019

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The objective of this study is to generate empirical evidence on the barriers to accessing aid for women and men, girls and boys with disabilities in a post-Cyclone Idai context. By doing so, it also seeks to contribute to policy development for an inclusive humanitarian response in Mozambique

The research followed a qualitative design, using interviews and focus group discussions followed by inductive analysis to reveal dominant themes and stories. Data was collected in 30 in-depth interviews with women and men, girls and boys with disabilities and/or caregivers in communities (Beira), as well as in resettlement sites (Dondo).

What are the key considerations for including people with disabilities in COVID-19 hygiene promotion programmes?

WILBUR, Jane
HUNT, Xanthe
August 2019

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Question & problem

People with disabilities may be more likely to acquire COVID-19, and if infected may be more likely to experience serious symptoms, or die. Aside from those consequences of the pandemic related to morbidity and mortality, people with disabilities are often reliant on carers to aid with common daily tasks, and so social distancing measures may be unfeasible. Furthermore, safe water, sanitation and hygiene (WASH) services and facilities may be inaccessible to people with disabilities, and, in many settings, efforts to deliver services in a socially-distanced world have resulted in the roll out of digital or remote healthcare approaches which are sometimes not accessible or inclusive. One of the key interventions in response to the COVID-19 pandemic has been international attention, and improved funding, programming and media messaging in support of WASH. People with disabilities – who are most at risk of negative consequences of COVID-19 – most need access to such interventions. Yet, WASH access is considered to be one of the biggest challenges of daily life for many people with disabilities.

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

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

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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

 

 

Disability and inclusive education - A stocktake of education sector plans and GPE-funded grants

BANHAM, Louise
PAPAKOSTI, Elena
et al
March 2018

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This report was commissioned by the Global Partnership for Education’s Secretariat to take stock of how disability and inclusive education are included in education sector plans in 51 countries, including GPE-funded programs, such as education sector program implementation grants, program documents, implementation progress reports education sector analysis, if applicable, and other relevant GPE program documents.

This report documents progress and highlights the need to step up support to GPE partner countries on disability and inclusive education, to improve consideration of issues around disability and inclusion in education sector analysis and sector planning processes to better promote the achievement of GPE 2020 strategic goal 2, and to fulfill the transformative vision of Agenda 2030

Disability inclusive humanitarian response

ROHWERDER, Brigitte
December 2017

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"Disasters and armed conflicts can also increase the number of persons with disabilities as people acquire new impairments and/or experience a deterioration in existing impairments from injuries and/or limited access to health care and rehabilitation. For instance, a survey of Syrian refugees living in camps in Jordan and Lebanon found that 22 per cent had an impairment. However, accurate numbers can be hard to calculate due to lack of data disaggregation in humanitarian emergencies and differences in the way disability is defined and measured, while families may be reluctant to disclose disability due to fear of stigma and isolation. As a result, humanitarian programmes may inadequately document and consider the needs of persons with disabilities"

This short Operational Practice Paper from the Humanitarian Learning Centre offers lessons for disability inclusion in humanitarian response. 

Inclusive disaster risk reduction

LAFRENIERE, Annie
WALBAUM, Veronique
2017

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This policy paper defines the themes of inclusive disaster risk reduction and explains how these activities fit into the HI mandate. It also identifies the target population and defines modalities of intervention–standard expected outcomes, standard activities–as well as monitoring and evaluation indicators.

Rights to water and sanitation for people with disabilities in Madagascar

VEROMAMINIAINA, Edith
RANDRIANARISOA, Ridjanirainy
December 2016

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"This paper illustrates the experiences of the Platform For People with Disabilities (PFPH), working with the support of WaterAid, to highlight and address the gaps in the realisation of the rights of people with disabilities in Madagascar. The focus has been on engaging the government on the National Inclusion Plan for people with disabilities, which includes water, sanitation and hygiene (WASH). This pilot project was designed to increase access to safe WASH for people with disabilities through a human rights based approach. It focuses on strengthening the capacities of rights holders, as well as the capacity and the political will of duty bearers to fulfil their obligations towards the progressive realisation of rights. The project has strengthened the capacity of the PFPH to advocate for their rights and engage with government on all areas of their rights, although an increase in actual WASH provision is limited by the government’s lack of capacity and resources". 

7th RWSN Forum “Water for Everyone”, 7 ème Forum RWSN « L’eau pour tous » 29 Nov - 02 Dec 2016, Abidjan, Côte d’Ivoire

Sexual Abuse of Persons with Disabilities - Research

Rob Aley
et al
November 2016

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The aim of the research was to investigate the social, cultural and institutional factors which contribute to the high incidence of sexual abuse of persons with disabilities in East Africa and to identify interventions which could change detrimental attitudes, beliefs and practices which perpetuate this high incidence. The research is framed within the United Nations Convention on the Rights of Persons with Disability (UNCRPD), particularly articles 12, 13 and 16.

The study used a qualitative participatory action research approach and worked with local partner organisations and Ugandan and Kenyan field level researchers to collect data. Survivors of sexual abuse were not interviewed but instead the research investigated the understandings, beliefs and practices of a range of service providers and key responders who are involved in the prevention of and response to sexual abuse against persons with disabilities in their communities. Groups consulted included police, teachers, health-care workers, government administrators, faith and community organisations and traditional leaders, as well as persons with disabilities and their parents. Participatory workshops were run with a reference group of people with disabilities (with a range of impairments and experiences) and relevant specialists at the initial stage and during the participatory analysis process. After initial orientation and training the field researchers undertook a total of 52 individual interviews and 9 focus group discussions with a range of stakeholders.

The overall findings show that social attitudes and understanding of disability and sexuality in general are strong influencing factors on the risks that persons with disability face in relation to sexual abuse. Participants reported a range of harmful attitudes and beliefs about disability and about the needs and rights of persons with disabilities. It is very common for cases of abuse to go unreported and to be dealt with at the family or community level, rather than being viewed as a serious criminal matter which should be taken to the formal authorities. Many barriers exist, especially at community level which mean abuse does not get reported. Lack of awareness and knowledge, stigma and exclusion and poverty were key drivers of continuing abuse and survivors of abuse seldom get proper support. Guidelines, training and clear procedures for good practice in the various professions were generally weak or absent. Key recommendations were generated for both community level interventions and in relation to policy and training at regional and national levels. The practical implementation of some recommendations was undertaken.

Sexual Abuse of Persons with Disabilities - Research

ALEY, Rob
et al
November 2016

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Abstract
The aim of the research was to investigate the social, cultural and institutional factors which contribute to the high incidence of sexual abuse of persons with disabilities in East Africa and to identify interventions which could change detrimental attitudes, beliefs and practices which perpetuate this high incidence. The research is framed within the United Nations Convention on the Rights of Persons with Disability (UNCRPD), particularly articles 12, 13 and 16.

The study used a qualitative participatory action research approach and worked with local partner organisations and Ugandan and Kenyan field level researchers to collect data. Survivors of sexual abuse were not interviewed but instead the research investigated the understandings, beliefs and practices of a range of service providers and key responders who are involved in the prevention of and response to sexual abuse against persons with disabilities in their communities. Groups consulted included police, teachers, health-care workers, government administrators, faith and community organisations and traditional leaders, as well as persons with disabilities and their parents. Participatory workshops were run with a reference group of people with disabilities (with a range of impairments and experiences) and relevant specialists at the initial stage and during the participatory analysis process. After initial orientation and training the field researchers undertook a total of 52 individual interviews and 9 focus group discussions with a range of stakeholders.

The overall findings show that social attitudes and understanding of disability and sexuality in general are strong influencing factors on the risks that persons with disability face in relation to sexual abuse. Participants reported a range of harmful attitudes and beliefs about disability and about the needs and rights of persons with disabilities. It is very common for cases of abuse to go unreported and to be dealt with at the family or community level, rather than being viewed as a serious criminal matter which should be taken to the formal authorities. Many barriers exist, especially at community level which mean abuse does not get reported. Lack of awareness and knowledge, stigma and exclusion and poverty were key drivers of continuing abuse and survivors of abuse seldom get proper support. Guidelines, training and clear procedures for good practice in the various professions were generally weak or absent. Key recommendations were generated for both community level interventions and in relation to policy and training at regional and national levels. The practical implementation of some recommendations was undertaken.

Women and girls with disabilities. Committee on the Rights of Persons with Disabilities. General comment No. 3 (2016). Article 6.

OFFICE OF THE UNITED NATIONS HIGH COMMISSIONERS FOR HUMAN RIGHTS (OHCHR)
September 2016

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"International and national laws and policies on disability have historically neglected aspects related to women and girls with disabilities. In turn, laws and policies addressing women have traditionally ignored disability". "Article 6 serves as an interpretation tool to approach the responsibilities of States parties across the Convention, to promote, protect and fulfil the human rights of women and girls with disabilities, from a human rights-based approach and a development perspective". These general comments take the form of an introduction, normative content, states parties’ obligations, the interrelationship of article 6 with other articles of the Convention (perspectives of women with disabilities in CRPD provisions) and national implementation

Being a refugee in Turkey and western Europe: how it affects mental health and psychosocial wellbeing

JOURNAL OF MENTAL AND PSYCHOSOCIAL SUPPORT IN CONFLICT AFFECTED AREAS
September 2016

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"In this personal reflection, the author is a Syrian refugee who describes his experiences as a psychosocial worker in Syria and with refugees in Turkey and Greece. He highlights how women and children lack safety in the camps. The second section discusses how he became a refugee himself. Due to his experiences in Syria, he now finds himself in a difficult situation in the Netherlands, the county where he applied for asylum and has received a permit, but his ‘cry for help’ remains unheard and unrecognised by the (health) workers in the asylum centre."

Ensuring that no one is left behind. High-level political forum (HLPF) 2016 position paper by Persons with Disabilities.

INTERNATIONAL DISABILITY ALLIANCE (IDA)
2016

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This position paper states that "only by utilising the UN Convention on the Rights of Persons with Disabilities (CRPD) as a guiding framework in implementing the SDGs, will it be ensured that exclusion and inequality are not created or perpetuated". Proposals are made and background presented on the topics of: the unfinished work of the MDGs; realising, through an enabling environment, the full potential of persons with disabilities; working together to protect our planet; and reaching the farthest behind first

Disability framework : one year on : leaving no one behind

DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (DFID)
December 2015

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“The DFID vision is a world where no one is left behind. A world where people with disabilities have a voice, choice and control over the decisions that affect them. Where they participate in and benefit equitably from everyday life, everywhere. Our first Disability Framework was launched in December 2014. It focused on inspiring their colleagues to do more, with support from civil society partners…This updated Framework reflects lessons they have learned over the past year and outlines the next steps we will take as an organisation to deliver their vision”

Community-based rehabilitation in a post-soviet environment in Azerbaijan : where society meets ideology

BURCHELL, Gwen
2015

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This paper explores UAFA’s experience, since 2002, in working with Azerbaijani stakeholders to move from the medical approach to disability, propagated by the Soviet model of planning and implementation, to a social, community-based approach. The paper highlights the common misconceptions and how these can be overcome, including the policy gaps that challenge effective implementation.

 

The importance of creating and maintaining a core team is discussed, alongside the process that UAFA has developed for building up teams of CBR workers. Finally, the paper raises the issue of introducing outcomes-based evaluation in a society that has no such prior experience, followed by an account of the continual challenge faced by most programmes–namely, how to achieve sustainable funding.

 

 

Disability, CBR and Inclusive Development, Vol 26, No 3

Inter-agency and expert group on the sustainable development goal Indicators : tentative timeline, work plan and organization of work

INTER-AGENCY AND EXPERT GROUP ON THE SUSTAINABLE DEVELOPMENT GOAL INDICATORS
July 2015

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A brief guide on the prospective Sustainable Development Agenda from the Inter-Agency and Expert Group, giving a tentative outline as to the timescale that will be followed in the deliberation and creation of the Sustainable Development Goal (SDG) indicators. This guide begins with a table overview of this timescale and is then followed by a description on how the work within the group is to be aggregated and organised

Discussion papers on the theme of the high-level political forum on sustainable development, submitted by major groups and other stakeholders

UNITED NATIONS ECONOMIC AND SOCIAL COUNCIL
May 2015

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A compendium of papers from various stakeholders setting out “established and maintained effective coordination mechanisms” for the high-level discussions on sustainable development and the post-2015 development agenda

High-level political forum on sustainable development, Convened under the auspices of the Economic and Social Council, 26 June-8 July 2015

E/HLPF/2015/2

Disability and extreme poverty : recommendations from practitioners in Bangladesh

FREMLIN, Peter
April 2015

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This paper presents shared lessons from experts and organisations working on disability-inclusive poverty reduction in Bangladesh. It gives an overview of the situation of persons with disabilities in extreme poverty in Bangladesh, highlighting disability-specific challenges, and the gaps in institutional capacity to deal with these issues. Recommendations are provided on the need to identify persons with disabilities more clearly, introduce disability-focus to mainstream poverty reduction efforts, adopt measures to overcome disability specific challenges, and strengthen institutional capacity to work on disability issues

Inclusive disaster risk management : governments, communities and groups acting together

UNITED NATIONS (UN)
March 2015

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This Issue Brief, presented in advance of the United Nations (UN) Conference on Disaster Risk Reduction, outlines the UN position on the importance of developing more inclusive Disaster Risk Management (DRM) strategies. After initially outlining the importance of inclusivity, the paper goes on the present a number of key ways forward, including greater capacity development, greater understanding of risk, and the creation of innovative partnerships and institutional relationships

UN World Conference on Disaster Risk Reduction

14-18 March 2015

Sendai, Japan

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