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Musculoskeletal impairment among Syrian refugees living in Sultanbeyli, Turkey: prevalence, cause, diagnosis and need for related services and assistive products

BOGGS, Dorothy
ATIJOSAN-AYODELE, Oluwarantim
YONSO, Hisem
et al
April 2021

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Epidemiological data on musculoskeletal impairment (MSI) and related service and assistive product (AP) needs for displaced populations are lacking. This study aimed to estimate the prevalence, aetiology, and specific MSI diagnosis and the need for related services and APs among Syrian refugees living in Sultanbeyli, a district in Istanbul, Turkey.

A population-based survey used probability proportionate to size and compact segment sampling to select 80 clusters (‘street’) of 50 individuals (aged 2+), for total sample size of approximately 4000 participants. An updated version of the Rapid Assessment of MSI tool (RAM) was used to screen all participants using six questions. Any participant who screened positive underwent a standardised examination by a physiotherapist to assess the presence, aetiology, severity and specific diagnosis of MSI and an assessment of need for related services and APs.

 

Conflict and Health volume 15, Article number: 29 (2021)

https://doi.org/10.1186/s13031-021-00362-9

Disability inclusion annual report 2020

UNITED NATIONS RELIEF AND WORKS AGENCY (UNRWA)
December 2020

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The number of Palestine refugees registered by UNRWA recently grew to 5.7 million (from 5.5 million in 2019) in all its five field of operations in Jordan, Lebanon, Syria, Gaza and the West Bank. Among them are Palestine refugees with disabilities, who have long-term impairments, which in interactions with attitudinal, institutional, and environmental barriers prevent their full and effective participation on an equal basis with others in society. Persons with disabilities constitute an estimated 15 per cent of the global population1, and may constitute a higher percentage in humanitarian contexts, such as Syria, the West Bank and Gaza, in particular, which are UNRWA fields of operations.

 

The main actions undertaken in 2020 discussed in the report are:

  • targeted and disability-specific services for persons with disabilities
  • disability inclusion through programmes
  • inter-agency coordination
  • international protection advocacy

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 inclusion annual report 2019

UNITED NATIONS RELIEF AND WORKS AGENCY FOR PALESTINE REFUGEES IN THE NEAR EAST
December 2019

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United Nations Relief and Works Agency (UNRWA) adopts a twin-track approach to ensure the full inclusion of Palestine refugees with disabilities. This entails ‘disability mainstreaming’, whereby all UNRWA programmes and services are universally designed to ensure that they are usable by and/or reach beneficiaries with disabilities, coupled with the provision of ‘targeted/tailored interventions’. During 2019, UNRWA implemented the following activities to address the specific needs of Palestine refugees with disabilities:

  • Direct Specialized Services for Persons with Disabilities
  • Disability Inclusion through Programmes
  • International Cooperation

Disability Inclusion Helpdesk Report No: 15 : Mental health and psychosocial support (MHPSS) in Syria: concepts, reality and effectiveness of interventions

LEE, Harri
ZIVERI, Davide
PFEFFER, Lauriane
July 2019

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Summaries on the findings from the following queries:

Define mental health and psychosocial support (MHPSS) and intended outcomes of these interventions (at the global level).

What is the evidence on the nature of the problem and the scale of need for MHPSS services in Syria?

What is the evidence on effectiveness of MHPSS interventions in Syria?

Disability, CBR & Inclusive Development (DCID), 2019, Vol. 30 No, 2

2019

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Research articles are:

  • Stereotypes about Adults with Learning Disabilities: Are Professionals a Cut Above the Rest?
  • Perceptions of Primary Caregivers about Causes and Risk Factors of Cerebral Palsy in Ashanti Region, Ghana
  • Changes in Social Participation of Persons Affected by Leprosy, Before and After Multidrug Therapy, in an Endemic State in Eastern India
  • Users’ Satisfaction with Assistive Devices in Afghanistan
  • Perceived Benefits and Barriers to Exercise among Physically Active and Non-Active Elderly People

Brief reports are:

  • The GRID Network: A Community of Practice for Disability Inclusive Development
  • A Preliminary Report of the Audiological Profile of Hearing Impaired Pupils in Inclusive Schools in Lagos State, Nigeria

An experiential report is given:

  • MAANASI - A Sustained, Innovative, Integrated Mental Healthcare Model in South India

 

Disability in Gaza: policy, barriers to inclusion and a mapping of interventions (Disability Inclusion Helpdesk Report No.12)

LEE, Harri
ABU ALGHAIB, Ola
LAURICIANO, Rabeca
May 2019

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This report presents key findings from a practical ‘know-how’ query, which included a rapid review of key literature as well as a small set of key informant interviews (KIIs) to help fill gaps and supplement online evidence. This query is based on a rapid review of the available literature to provide a brief overview of the barriers people with disabilities face in Gaza in terms of access to basic services, jobs and social inclusion/participation (Section 2), and the policy framework in Gaza in relation to the rights of people with disabilities(Section 3). The main body of this query comprises a mapping of existing interventions for people with disabilities in Gaza and an analysis of the trends and gaps in programming (Section 4)

Emergency trauma response to the Gaza mass demonstrations 2018–2019. A one-year review of trauma data and the humanitarian consequences

OLIM, Nelson
HALIMAH, Sarah
Eds
May 2019

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The specific goals of this publication are first, to conduct an analysis of 1 year of conflict related trauma in Gaza; second, to highlight the role of the Health Cluster partners, including the World Health Organization (WHO) as the cluster lead agency, in supporting the local health system; and third, to document success stories, challenges and lessons learnt

Disability, CBR & Inclusive Development (DCID), 2019, Vol. 30 No. 1

2019

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Research articles are:

  • Community-Based Rehabilitation Programming for Sex(uality), Sexual Abuse Prevention, and Sexual and Reproductive Health: A Scoping Review
  • Access to Social Organisations, Utilisation of Civil Facilities and Participation in Empowerment Groups by People with Disabilities in Amravati district, Maharashtra
  • The Arabic Version of Trinity Amputation and Prosthetic Experience Scale - Revised (TAPES-R) for Lower Limb Amputees: Reliability and Validity
  • Impact of Parenting a Child with Cerebral Palsy on the Quality of Life of Parents: A Systematic Review of Literature

Reviews:

  • Uzbekistan: Case for Inclusion
  • Physical Therapy for Diabetic Peripheral Neuropathy: A Narrative Review

Brief report:

  • Exploring the Experiences of Students with Visual Impairments at the University of Botswana

The waiting list. Addressing the immediate and long-term needs of victims of explosive weapons in Syria

O'REILLY, Claire
et al
2019

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This report looks at the challenges linked to the use of explosive weapons in the Syrian context for the provision of adequate immediate assistance and to plan for mid- to long-term assistance to the victims of explosive violence, to ensure their full recovery and inclusion into society. It is based on data and testimonies collected from humanitarian agencies, actors and patients across all areas of control in Syria. The testimony of Farah, a Syrian girl injured during the bombing of her school, and of her mother, is shared throughout the report to illustrate the challenges faced by victims. 

This report was compiled from June to August 2019 and relies on multiple sources, including review of both gray and academic literature, published and unpublished data from INGOs working in Syria response, firsthand interviews with patients and Syrian humanitarians working both inside Syria and from cross-border locations, and expatriate staff from INGOs and UN agencies. Interviews were conducted at a distance during June and July 2019 with 12 individuals, among which: 2 patients; 3 mine action operators; 4 medical staff, and 3 humanitarian workers 

The Arabic version of Trinity Amputation and Prosthetic Experience Scale - Revised (TAPES-R) for lower limb amputees: Reliability and validity

MASSARWEH, Reem
SOBUH, Mohammad
2019

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Purpose: Despite the importance of the evaluation process in lower limb prosthetic rehabilitation, prostheses are rarely evaluated properly in the Arab world. This is partly due to the absence of any suitable Arabic evaluative tool. The aim of this study is to translate TAPES-R (a standardised evaluative questionnaire) into Arabic and to investigate its psychometric properties on lower limb amputees. Such a tool would ultimately be of benefit for clinical follow-up and research purposes.

 

Method: International standards were followed for the forward- and back-translation of the TAPES-R questionnaire. A sample of 111 Arabic-speaking volunteers with lower limb amputation completed the translated version of the questionnaire. The responses were then statistically analysed using factor analysis and Cronbach’s α to assess the content and construct validity, and internal consistency (reliability) respectively.

 

Results: Factor analysis showed that the questionnaire’s items (included in the analysis) can be divided into three distinct dimensions as was originally suggested. The distribution of the items within the three dimensions is comparable with the original questionnaire. All three parts of TAPES-R showed high reliability; where Cronbach’s α were .892, .894, and .873 respectively.

 

Conclusion: This study found that the Arabic version of TAPES-R represents a valid and reliable tool.

 

Limitations: The questionnaire is designed to be emailed or posted, but the majority of the amputee population in Jordan did not have these services, so direct contact with each participant was necessary.

 

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Users’ satisfaction with assistive devices in Afghanistan

MOHAPATRA, Bikram Keshari
2019

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Purpose: The objective of this study was to assess users’ satisfaction and effectiveness of assistive devices in four regions of Afghanistan, namely Mazar-e-Sharif, Ghazni, Jalalabad and Taloqan.

 

Method: A random sample of 785 users, who were provided with 874 mobility and assistive devices in four regional prosthetic and orthotic workshops of the Swedish Committee for Afghanistan (SCA), participated in the study.

 

Results: The study revealed that the majority of the participants rated the assistive devices as very useful. While 45% of respondents even described them as excellent, 49% expressed a good level of satisfaction with the services they received at treatment centres. Similarly, the majority of respondents (67%) mentioned a maximum level of improvement, while 15% claimed to have witnessed some improvement in their physical condition. Fitting, comfort, and ease of use, along with durability, weight and appearance were rated as the most important factors of assistive devices. On the other hand, slow service and limited access to maintenance and repair facilities were identified as reasons for dissatisfaction.

 

Conclusion: The study provided continuous and valuable information to rehabilitation professionals regarding device effectiveness and satisfaction. The findings also recommended a stronger focus on comfort and usefulness of mobility and assistive devices. Lastly, the study suggested that lack of local device-repair service needs to be addressed by rehabilitation professionals. 

Psychosocial disability in the Middle East

BOLTON. Laura
May 2018

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A K4 helpdesk report, commissioned by DFID (UK), provides a rapid review of literature to provide best estimates of psychosocial disability in specific countries in the Middle East.

Topics discussed include:

Prevalence and different forms of mental health conditions and psychosocial disability

Factors influencing prevalence

Differences across demographics

Provision for those with psychosocial disabilities

An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan

Darawsheh, Wesam B
2018

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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.

 

Method: This was a mixed-methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data was analysed using SPSS Version 22.0. Qualitative data was analysed through thematic content analysis and open coding to identify emergent themes.

 

Results:  40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.

 

Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.

 

Implications: This study was inclusive of all types of disability.  Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings. 

Disability, CBR and inclusive development (DCID), 2016, Vol. 27 No. 4

2016

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Titles of research articles in this issue of the journal are:

  • Social Inclusion and Mental Health of Children with Physical Disabilities in Gaza, Palestine
  • CBR Workers' Training Needs for People with Communication Disability
  • Educational Concerns of Students with Hearing Impairment in Secondary and Higher Secondary Classes in Mumbai, India
  • Advocacy Campaign for the Rights of People with Disabilities: A Participatory Action Research within a Community-based Rehabilitation Project in Vangani, Maharashtra
  • Effectiveness of Role Play and Bibliotherapy in Attitude Change of Primary School Pupils towards Learners with Special Needs in Nigeria

Reviews

  • Disability Data Collection in Community-based Rehabilitation

Brief reports

  • Differences in Malaria Prevention between Children with and without a Disability in the Upper East Region of Ghana
  • Demographic Profile of Spinal Cord Injury (SCI): A Hospital-based Prospective study in Bangladesh

Social inclusion and mental health of children with physical disabilities in Gaza, Palestine

NASSER, Khaled
MACLACHLAN, Malcolm
MCVEIGH, Joanne
2016

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Purpose: Social inclusion of children with physical disabilities is essential for their mental health. The long-standing conflict and political instability in Palestine since 1948 has resulted in an unprecedented number of children with disabilities. This study aimed to assess social inclusion and mental health of children with physical disabilities in Palestine.

 

Method: A mixed methods research design was used. The 12-item General Health Questionnaire and a Social Inclusion Questionnaire were administered to 100 children with amputations, 12-18 years of age, in the Gaza Strip. Ten semi-structured interviews were also conducted with personnel working across civil society rehabilitation services in the area, particularly in services that focussed on the physical rehabilitation of children who had lost a limb.

 

Results: Quantitative findings indicated that 88% of children’s disabilities were caused by war-related incidents. While the sample of children showed on average relatively low levels of psychological distress, males reported feeling more socially included and having better mental health than did females. Furthermore, there was a strong positive correlation between mental health and social inclusion, and a moderate positive correlation between psychological distress and social inclusion. The qualitative data identified different factors that hinder social inclusion, mainly: political instability; under-resourced disability organisations; lack of coordinated efforts; and negative societal attitudes towards disability.

 

Conclusion: A new questionnaire for social inclusion was developed, which can now be used as a tool to assess social inclusion in similar contexts; as well as a culturally-adapted form of the General Health Questionnaire-12 to assess mental health. There is a clear need for service-providers to move beyond a medical model of care to one that embraces community-based rehabilitation and the realisation of rights, in order to promote the social inclusion and mental health of children with disabilities in Palestinian society.

The challenges of disability in Pakistan : listening to the voices of mothers

ALI, Rabia
RAFIQUE, Sana
November 2015

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“This study was conducted with the aim to explore the experiences of mothers in dealing with children having disabilities in Rawalpindi, Pakistan. Through random sampling method 154 mothers of physically handicapped children studying in pre-schools and primary schools were selected as respondents…The data highlights that the disability of the children had been unexpected for all the mothers who participated in this research. The mothers reported to have been shocked (56%) and apprehended about the future of the children (41%)… The data demonstrates that measures taken by mothers to facilitate their children included seeking help from internet and engaging with support groups and friends”

European Scientific Journal, Vol.11

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

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