Resources search

“Everything is Totally Uncertain Right Now”: People with Disabilities’ Experiences of the COVID-19 Pandemic in Bangladesh

SHAW, Jackie
AKTER, Fatema
ROHWERDER, Brigitte
WICKENDEN, Mary
THOMPSON, Stephen
June 2021

Expand view

The COVID-19 pandemic is deepening pre-existing inequalities. Emerging research suggests that people with disabilities across the world have experienced various rights violations and been disproportionality affected by the health, economic and social impacts of the COVID-19 pandemic and the responses to it. The aim of this research was to explore how people with disabilities, who often are excluded from research, have experienced the evolving COVID-19 pandemic. In order to better understand how it has affected jobseekers with disabilities, in-depth qualitative research was conducted as part of the Inclusion Works programme in Bangladesh.

Views and Experiences of People with Intellectual Disabilities to Improve Access to Assistive Technology: Perspectives from India

BOOT, F H
GHOSH, R
DINSMORE, J G
MACLACHLAN, M
2021

Expand view

Purpose: People with intellectual disabilities are deeply affected by health inequity, which is also reflected in their access to and use of assistive technology (AT). Including the perspectives of adults with intellectual disabilities and their caregivers, together with the views of local health professionals, suppliers of AT and policy-makers, this paper aims to provide an overview of factors influencing access to AT and its use by people with intellectual disabilities in Bangalore, a southern region of India.

 

Method: Face-to-face interviews were conducted with 15 adults with intellectual disabilities (ranging from mild to profound) and their caregivers, and with 16 providers of AT. This helped to gain insight into the current use, needs, knowledge, awareness, access, customisation, funding, follow-up, social inclusion, stigma and policies around AT and intellectual disability.

 

Results: Access to AT was facilitated by community fieldworkers and services to reach out and identify people with intellectual disabilities. Important barriers were stigma, and lack of knowledge and awareness among parents. Factorsrelated to continued use were the substantial dependence on the care system to use AT, and the importance of AT training and instructions for the user and the care system.

 

Conclusion and Implications: The barriers and facilitators related to AT for people with intellectual disabilities differ from other populations in need. The findings of this study can be used to inform and adjust country policies and frameworks whose aim is to improve access to AT and enhance the participation of people with intellectual disabilities within their communities.

Training of Mid-Level Rehabilitation Workers for Community-Based Rehabilitation Programmes

GHOSH, R
PALANIVELU, V
TEBBUTT, E
DEEPAK, S
2021

Expand view

Purpose: There is a lack of trained rehabilitation professionals, especially in the small towns and rural areas of low and middle income countries. In India, a cadre of mid-level rehabilitation workers, the Rehabilitation Therapy Assistants (RTAs), are being trained by Mobility India, a Non-Governmental Organisation (NGO). This paper aims to assess impact of their training and experiences after the training.

 

Method: Data were collected from 3 different initiatives connected with the trained RTAs: an impact assessment of their training; interviews with RTAs during an evaluation; and a survey of 188 RTAs trained between 2002 and 2019.

 

Results: RTAs were shown to have good skills to provide rehabilitation interventions in the field and are appreciated by clients and other stakeholders. Most of the RTAs work for NGOs in CBR programmes, and in private hospitals and clinics. There does not seem to be a role for them in government services in most countries. The number of trained RTAs remains small in spite of the large needs. This may be due to lack of an accreditation system for RTAs and the low priority given to rehabilitation services in general in some countries.

 

Conclusions: The results provide useful information to strengthen RTA training courses. Training RTAs to provide rehabilitation services in smaller towns and rural areas of low and middle income countries can have a good impact through CBR programmes. However, this impact remains circumscribed to small areas where NGOs are active. Changes are needed in health systems for the inclusion of mid-level rehabilitation workers in primary health care services.

Dimensions of invisibility: insights into the daily realities of persons with disabilities living in rural communities in India

GUPTA, Shivani
DE WITTE, Luc P
MEERSHOEK, Agnes
2020

Expand view

Persons with disabilities in rural India do not have the opportunity to lead a self-determined life and be included in their community as required by the convention on the rights of persons with disabilities. To investigate their experience of living everyday life and the amount of agency they are able to exercise, in-depth interviews were undertaken. The Capability Approach (CA) was used to ana- lyse the situation that was seen in terms of outcome of the interplay between internal and external factors resulting in loss of agency. The results show that the dependency they experience due to lack of adequate support to undertake activities and being completely dependent on the family places them in a vicious circle of ‘self-worthlessness’. Reducing the dependency disabled people face and chang- ing perceptions of the community towards disability may break this circle.

At the Margins of Society: Disability Rights and Inclusion in 1980s Singapore

ZHUANG, Kuansong Victor
2020

Expand view

A new era focused on the inclusion of disabled people in society has emerged in recent years around the world. The emergence of this particular discourse of inclusion can be traced to the 1980s, when disabled people worldwide gathered in Singapore to form Disabled Peoples’ International (DPI) and adopted a language of the social model of disability to challenge their exclusion in society. This paper examines the responses of disabled people in Singapore in the decade in and around the formation of DPI. As the social model and disability rights took hold in Singapore, disabled people in Singapore began to advocate for their equal participation in society. In mapping some of the contestations in the 1980s, I expose the logics prevailing in society and how disabled people in Singapore argued for their inclusion in society as well as its implications for our understanding of inclusion in Singapore today.

 

Disability & the Global South (DGS), 2020, Vol. 7 No. 1

Disability at a Glance 2019: Investing in accessibility in Asia and the Pacific — Strategic approaches to achieving disability-inclusive sustainable development

TATA, Srinivas
et al
December 2019

Expand view

This report lays out foundational concepts and terminologies related to disability and accessibility, and outlines the tools and approaches for successful investment in accessibility. Furthermore, it identifies drivers and added values of investment, and analyses the status of disability-inclusive development and accessibility investment across Asia and the Pacific. Finally, it provides recommendations to governments across key areas of focus to ensure that societies are built to be sustainable and inclusive.

Case studies from Australia, the Republic of Korea and India are presented.

Community-Based Rehabilitation programming for sex(uality), sexual abuse prevention, and sexual and reproductive health: A scoping review

SCHINDELER, Tamara Lee
ALDERSEY, Heather
2019

Expand view

Purpose: The United Nations Convention on the Rights of Persons with Disabilities aims to protect the human rights and dignity of all people with disabilities. In low-and middle-income countries (LMICs), one way this goal is pursued is through Community-Based Rehabilitation (CBR), a strategy to support the full and equal participation of people with disabilities. In spite of policy and community-based interventions, people with disabilities continue to experience inequities in many areas of life - one of these being their sexual and reproductive health (SRH) rights. This scoping review explored the literature to understand how CBR programming has supported sex(uality), sexual abuse prevention, and SRH for people with disabilities.

 

Methods: Arksey and O’Malley’s (2007) framework was used to identify relevant studies in academic and grey literature. This included six databases, the WHO website, and five Regional CBR Network websites. Relevant studies were selected using criteria and data was charted to examine the quantity, variation, and nature of CBR interventions.

 

Results: Fifteen studies were identified. The majority were implemented in Africa; targeted all people with disabilities, regardless of gender, age, or type of disability; and frequently focussed on the topic of HIV/AIDS.  The interventions were most commonly designed to educate people with disabilities on issues of sex(uality), sexual abuse prevention, or SRH.

 

Conclusion: A number of studies discussed CBR programmes that aim to support sex(uality), sexual abuse prevention and SRH for people with disabilities, yet gaps were identified that indicate that certain populations and topics are being overlooked by CBR interventions.

 

Implications: CBR practitioners can focus on filling the gaps identified in this review through future programming. Further action must concentrate on implementing a variety of CBR Matrix strategies to address comprehensive issues related to sex(uality), sexual abuse prevention, or SRH.

 

 

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

Good practices for the implementation of the CRPD in Indonesia (2015-2017) - Making it Work

HANDICAP INTERNATIONAL
WIDJAYA, Hartaning
2018

Expand view

In Indonesia, the Advocacy for Change project aimed to increase the effective participation of people with disabilities in inclusive development efforts at the local level, and promote their participation in development at the national level. Specifically, the Advocacy for Change project sought to improve and monitor the people with disabilities' access to local government processes and existing social services.

Six case studies are presented:

  • Community Based Forum as Community Public Space (The culture is the key)
  • Building the Foundation of Inclusion with Sendangadi Village Government
  • WKCP (Cerebral Palsy Family Association) Health Initiative for Health Budgeting Advocacy
  • Citizen Based Forum as a Common Space to Encourage the Government to Build a Disability-Friendly Village in Mata Air Village, Kupang Tengah Sub- district, Kupang District
  • Inclusion of Disabled Persons in Noelbaki Village Women's Forum 
  • The role of disabled people organization in participation of development with Bappeda Kupang Municipality

 

Access to Services and Barriers faced by People with Disabilities: A Quantitative Survey

GRILLS, Nathan
SINGH, Lawrence
PANT, Hira
VARGHESE, Jubin
MURTHY, GVS
HOQ, Monsurul
MARELLA, Manjula
2017

Expand view

Purpose: In low- and middle-income countries, reliable and disaggregated disability data on prevalence, participation and barriers is often not available. This study aimed to estimate disability prevalence, determine associated socio-demographic factors and compare access in the community between people with and without disability in Dehradun district of Uttarakhand, India, using the Rapid Assessment of Disability Survey.

 

Methods: A cross-sectional population-based survey was conducted on a sample of 2431 adults, selected using a two-stage cluster randomised sampling technique. The survey comprised an interviewer-administered household survey and an individual survey measuring disability, wellbeing and participation.  For each person with disability, an age and sex-matched control (without disability) was selected. In addition to prevalence, the difference in participation and barriers faced by people with and without disability were analysed.

 

Results and Conclusions: The prevalence of disability was 6.8% (95% CI 5.8-7.8) with significant associations with age, sex, economic status, education and employment. Psychosocial distress (4.8%) and mobility impairment (2.7%) were the most common disabilities identified. The study showed that people with disabilities had significantly less access to services than those without disability, and the barriers reported most often were lack of information, transport and physical inaccessibility.

Making disability rights real in southeast Asia: Implementation of the UN Convention on the Rights of Persons with Disabilities in ASEAN

COGBURN, Derrick
KEMPIN REUTER, Tina
March 2017

Expand view

This edited collection evaluates national implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD) across all 10 countries of the Association of Southeast Asian Nations (ASEAN) region. Working with interdisciplinary and country-specific research teams, the book presents case studies of CRPD implementation across Southeast Asia, including detailing the factors that influenced each country to ratify the CRPD; the focal point structure of implementation; the independent mechanism established to monitor implementation; and civil society organizations’ involvement.

The book also evaluates the implications of CRPD implementation for human rights and development in ASEAN, including the degree of institutionalized support for persons with disabilities; the development objectives of the CRPD against the strategic objectives of the ASEAN community; and the way these developments compare with those in other countries and regions

Human rights and disability: A manual for national human rights institutions

CROWTHER, Neil
QUINN, Gerard
REKAS, Abigail
March 2017

Expand view

(Updated Dec 2018)

This Manual is designed to provide practical guidance for national human rights institutions (NHRIs) that are actively working to advance the human rights of persons with disabilities, as well as those NHRIs that are seeking to strengthen their efforts in this area. This Manual provides practical guidance and recommendations about how the role and functions of NHRIs can be directed to provide better protection for persons with disabilities, to promote greater awareness and respect for their rights, and to monitor the progress made and obstacles encountered in advancing their rights.

There are three parts to the manual.

  • Part I: The concepts - the human rights framing of disability
  • Part II: The law - international human rights law and disability (CRPD and others)
  • Part III: The practice - what NHRIs can do to contribute to the process of change

 

 

Cost-effectiveness of a Community-based Rehabilitation Programme in Nepal

Vaughan, Kelsey
Thapa, Aradhana
2016

Expand view

Purpose: This study aimed to estimate the cost-effectiveness of a community- based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology to estimate the programme’s achievements and cost-effectiveness.

 

Methods: Financial records were reviewed to determine total expenditure during the period August 2011 - December 2013. Programme records which documented the physical, mental and social status of children and adults with a disability qualitatively before, during and after the intervention were used to determine a starting disability weight and improvement score, which was then converted into a change in disability weight. The disability weight and expected remaining lifespan of each person were used to estimate disability-adjusted life years (DALYs) averted by the intervention. The cost per DALY averted was estimated by dividing the total programme expenditure by the sum of DALYs averted over that same period.

 

Results: I2C cost 204,823 Euros to implement over the period August 2011- December 2013. In total, an estimated 1,065 DALYs were averted from the treatment and rehabilitation components. The cost per DALY averted was 192.34 Euros.

 

Conclusions and Implications: The methodology devised for the study was able to successfully estimate the cost-effectiveness of the I2C programme. Using WHO benchmarks, this programme can be considered highly cost-effective. Other organisations can assess the cost-effectiveness of their programmes by using the assessment improvement score and subsequent conversion to DALYs averted. However, while mental, physical and social gains have been captured, other benefits from I2C cannot be captured in the cost per DALY averted statistic. Further research is needed to develop methods for incorporating these harder-to- measure gains in cost-effectiveness studies with a single outcome measure like the DALY.

China’s Mental Health Law: Analysis of Core Concepts of Human Rights and Inclusion of Vulnerable Groups

Hussey, Meghan Marie
Mannan, Hasheem
2016

Expand view

Purpose: The aim of this research is to assess China’s first Mental Health Law in terms of Core Concepts of Human Rights and equitable coverage of Vulnerable Groups.

 

Methods: The EquiFrame analytical tool provided the framework for evaluation of the inclusion of Core Concepts of Human Rights as well as Vulnerable Groups in the Law.

 

Results: China’s Mental Health Law scored 83% for Core Concept coverage, with a Core Concept Quality score of 76%. The Law had a 42% score for Vulnerable Groups coverage. This gave the Law an overall score of “Moderate” in terms of Human Rights coverage.

 

Conclusions: China’s Mental Health Law is a landmark document providing the country’s first ever legal framework for mental health. While the Law scores high on level commitment in Core Concepts of Human Rights, the potential for equitable protection would be enhanced by increased inclusion of Vulnerable Groups.

 

Limitations: Further analyses of health and social policies in the People’s Republic of China from a Human Rights perspective would provide a deeper understanding of the Law in context.

Understanding the Lives of Caregivers of Children with Cerebral Palsy in rural Bangladesh: Use of Mixed Methods

Zuurmond, Maria A
Mahmud, Ilias
Polack, Sarah
Evans, Jenny
2015

Expand view

Cerebral palsy is the most prevalent health condition linked to childhood disability in Bangladesh, yet support and rehabilitation for this group is limited. Understanding the impact of cerebral palsy at family level is important forthe development of appropriate interventions.

 

Purpose: This study aims to explore the impact on the lives of caregivers of children with cerebral palsy.

 

Methods: The study used mixed methods. The PedsQLTMFamily Impact Questionnaire Module was administered to the main caregivers in 135 families with a child with cerebral palsy and 150 families that did not have a child with a disability, from the same villages. In-depth interviews and observations were undertaken with 10 families, and 2 focus group discussions were conducted with representatives from 14 parent/caregiver groups. The project was conducted from April 2011- April 2013. Data collection was from September 2011- Dec 2012.

 

Results: The mean overall and sub-scale PedsQLTM scores were significantly poorer (p<0.001) for caregivers of a child with cerebral palsy compared to scores from families that did not have a child with disability. Caregivers reported high levels of stress, anxiety, isolation, stigma, physical tiredness, and lack of time to complete everyday tasks. Knowledge and understanding about cerebral palsy was generally low.

 

Conclusion: This study demonstrates the particular vulnerability of families of children with disabilities in resource-limited settings. It reveals the extent of the impact on the caregivers. Interventions therefore need to be holistic, addressing the well-being and empowerment of caregivers as well as children.

Typhoon Haiyan one year on: Disability, poverty and participation in the Philippines

COBLEY, David
2015

Expand view

This article explores the relationship between disability, poverty and participation in the aftermath of Super Typhoon Haiyan, which struck the Philippines on 8th November 2013, based on field research conducted at the time of Haiyan’s first anniversary. Fieldwork included interviews exploring disabled people’s experiences, their priorities and the challenges facing them in the year since Haiyan. The analysis, which draws on a three-level typology of participation and Sen’s (1999) capability perspective, concludes that disabled people have the potential to participate as active agents in disaster planning and recovery processes, both individually and collectively, at various levels. Furthermore, supporting disabled people to participate effectively, through flexible approaches, capacity building and the forging of pro-poor alliances, can reduce poverty in capability terms, as well as raising awareness of the largely untapped potential of disabled people to contribute to the shaping of more inclusive societies.

 

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

ESCAP Guide on Disability Indicators for the Incheon Strategy

UNITED NATIONS ECONOMIC AND SOCIAL COMMISSION FOR ASIA AND THE PACIFIC (ESCAP) SOCIAL DEVELOPMENT DIVISION
December 2014

Expand view

The Incheon Strategy to “Make the Right Real” for Persons with Disabilities in Asia and the Pacific provides the Asian and Pacific region, and the world, with the first set of regionally agreed disability-inclusive development goals. The Incheon Strategy goals cover a range of development areas from poverty reduction and employment to political participation, accessibility, social protection, education, gender equality, disaster risk reduction, data collection, CRPD ratification and international cooperation.

To ensure that the 10 goals are successfully met, the Strategy identifies 27 targets as well as 62 related indicators for monitoring and evaluating the implementation of the 10 goals. These targets and indicators are essential for developing practical implementation strategies, ensuring success and identifying areas where significant challenges remain. Goal 8 of the Incheon Strategy accords particular priority to data collection, calling for improvement of the reliability and comparability of disability data across countries in the region. Member States, in target 8B, have specifically committed to establishing a baseline with reliable statistics by the midpoint of the Asian and Pacific Decade of Persons with Disabilities in 2017, as a source of tracking progress towards the achievement of the Incheon Goals.

The ESCAP Guide on Disability Indicators for the Incheon Strategy aims to guide data collection and generation by ESCAP member States through providing them with relevant methodologies and tools to construct and use the 62 indicators of the Incheon Strategy, in order to monitor the achievement of the 10 disability-inclusive development goals.

Violence Against Persons with Disabilities in Bidar District, India

DEEPAK, S
KUMAR, J
SANTOSH, B
GORNALLI, S
MANIKAPPA, P
VYJANTHA, U
GIRIYAPPA, R
2014

Expand view

Violence and sexual violence against persons with disabilities at community level are serious issues. Though CBR programmes and DPOs are expected to prevent violence and offer support to the victims, there is very little informationabout their role in this regard.

 

Purpose: This research aimed to assess the level of violence and sexual violence experienced by DPO members, and the role played by CBR programmes in preventing it.

 

Method: The study involved a non-random consecutive sample of 146 persons with disabilities from 3 sub-districts of Bidar district in Karnataka, India. Using a structured questionnaire, interviews were conducted by a group of trained DPO members and CBR workers, many of whom had personal experience of violence. The data was entered using Epi-Info and then converted into spreadsheet Tables for analysis.

 

Results: 58% of the sample reported having experienced violence and 14% reported experiences of sexual violence during the previous 12 months. Girls and women reported higher levels of violence at different age groups. Male children and young adults reported having experienced more violence, including sexual violence, than older men. The research did not provide conclusive evidence that participation in the CBR and DPO activities played a protective role.

 

Conclusions: Violence and sexual violence against persons with disabilities are serious problems. More research on the subject, in terms of roles of CBR programmes and DPOs, is needed.

India’s Disability Policy – Analysis of Core Concepts of Human Rights

O'DOWD, J
MANNAN, H
MCVEIGH, J
2014

Expand view

Purpose: To analyse India’s National Policy for Persons with Disabilities (2006), using a Human Rights approach.

 

Method: A framework analysis was carried out using EquiFrame, which analyses policies for inclusion and quality of Core Concepts of Human Rights and inclusion of Vulnerable Groups.

 

Results: India’s National Policy for Persons with Disabilities scored 67% for Core Concept Coverage, 24% for Core Concept Quality and 42% for Vulnerable Group Coverage. This gave the policy an overall ranking of Low quality.

 

Conclusions: The current policy for persons living with disabilities in India would benefit from being updated to encompass the Core Concepts of Human Rights.

Youth with disabilities in law and civil society: Exclusion and inclusion in public policy and NGO networks in Cambodia and Indonesia

MEYERS, Stephen
KARR, Valerie
PINEDA, Victor
2014

Expand view

Youth with disabilities, as a subgroup of both persons with disabilities and of youth, are often left out of both legislation and advocacy networks. One step towards addressing the needs of youth with disabilities is to look at their inclusion in both the law and civil society in various national contexts. This article, which is descriptive in nature, presents research findings from an analysis of public policy and legislation and qualitative data drawn from interviews, focus group discussions, and site visits conducted on civil society organizations working in Phnom Penh, Cambodia and Jakarta, Indonesia. Data was collected during two separate research visits in the Spring and Summer of 2011 as a part of a larger study measuring youth empowerment. Key findings indicate that youth with disabilities are underrepresented in both mainstream youth and mainstream disability advocacy organizations and networks and are rarely mentioned in either youth or disability laws. This has left young women and men with disabilities in a particularly vulnerable place, often without the means of advancing their interests nor the specification of how new rights or public initiatives should address their transition to adulthood.

 

Disability and the Global South (DGS), 2014, Vol. 1 No. 1

Pages

E-bulletin