Disability Action Plan Research Articles

Climate change and the right to health of people with disabilities

Climate change and the right to health of people with disabilities

Prevalence and determinants of hearing disability among older persons in Malaysia: Finding of National Health Morbidity Survey (NHMS) 2018.

An aging population is a potential burden for unprepared developing countries. Malaysia is foreseen to be an aging country by 2035. Thus, this study aimed to determine the prevalence and factors associated with hearing disability among older persons in Malaysia. Data from a nationwide survey implemented using a stratified cluster sampling design were analyzed. This study was carried out through face-to-face interviews and guided questionnaires. The questions were based on the Washington Group of Disability (WG) questionnaires, which produce multiple disability identifiers. Hearing disability is defined as at least one domain or question out of four questions coded as "A lot of difficulty" or "Cannot hear at all". The prevalence of hearing disability among older persons aged ≥60 years was 6.4% (95% CI 5.0-8.3), whereas 1.5% (95% CI 0.90, 2.50) older persons were reported to be using a hearing aid. The determinants of hearing disability are being male (aOR 2.67, 95% CI 1.94-3.66), being unemployed (retired, homemaker, unemployed; aOR 1.86, 95% CI 1.86-4.14) and had no formal education (aOR 18.25, 95% CI 4.18-79.55). Promoting healthy aging is important and crucial for Malaysia, in preparation toward an aging nation, as it could reduce the country's financial burden in the long term. Health-related agencies should promote health awareness and treatment centers in relation to hearing disability among older persons, as they should be educated and informed about healthcare choices availability, which is aligned with the Global Disability Action Plan 2014-2021. Geriatr Gerontol Int 2020; 20: 43-48.

An AHP – Based Assessment of Scenarios for Promoting Employment of People with Disabilities in Latvia

Abstract The employment of people with disabilities has multidimensional aspects - economic, social, legal, human rights, discrimination, psychological, ethical and responsibility aspects - with different actors involved representing various kinds of interests. The European Union Disability Action Plan and Strategy specifies the objective of promoting the employment of people with disabilities in the open labour market. The employment of such individuals is not only an economic issue, but also an issue of social inclusion, poverty reduction, equal opportunity and socially responsible employment. Effective and fair use of human resources for national economic development requires a variety of support mechanisms, including regulatory frameworks, the active involvement of local municipalities, and measures taken by state institutions. Because of the different issues and the various actors with different interests involved, an integrated way has to be considered to analyse the employment factors and employment opportunities for people with disabilities. The purpose of this study is to explore and substantiate the possible scenarios associated with promotion employment opportunities for people with disabilities in Latvia. The research methodology employed for this study is based on the Analytic Hierarchy Process, and expert interviews are used to analyse the interests of all involved parties, in order to determine the best possible scenarios as to how to stimulate employment for people with disabilities. As a result, three scenarios to promote the employment of people with disabilities were developed. Although the results showed slight differences between the three scenarios, experts believe that the optimal scenario for promoting the employment of people with disabilities is the one in which the EU participates.

It’s All in the Plan: A Document Analysis of Victorian Council and Public Library Disability Access and Inclusion Plans

ABSTRACTThe Victorian Government requires councils to create a disability action plan or discuss inclusion in their council plan. Disability action plans aim to reduce barriers in accessing goods, services or facilities and to reduce discrimination. With public libraries in Victoria being managed by councils either individually or in a corporation, these action plans have the potential to directly impact on the community via library services. Using qualitative and quantitative document analysis, a total of 31 Victorian councils or library corporation disability action plans were analysed to understand what these plans saw as the action areas for libraries working with people with a disability. It was found that definitions of disability in these action plans broadly matched with the wider disability and libraries literature, with most councils in Victoria having an online action plan but comparatively few library corporations having the same. Libraries were largely discussed in relation to six theme areas (Access; Certification; Collections; Programming; Technology; and Training). An overall summary indicates that libraries involvement in council disability action plans is less detailed than in some library corporation action plans.

STANDARDS OF QUALITY OF LIFE FOR PEOPLE WITH DISABILITIES IN THE EUROPEAN UNION’S POLICY

The image of disability in EU societies is changing. On the one hand, statistical data (global and European) indicate an increase in the number of people with disabilities. This is especially true for women, the elderly and the poor. On the other hand, numerous legislative and implementation activities are undertaken to implement the social model in the approach to disability issues. The effectiveness of social and economic policies in the EU member states is expressed by the quality of life of people with disabilities. The article presents the WHO global position on the disability problem and a brief comparative analysis of key statistical data characterising people with disabilities in the EU member states. The EU priorities regarding the standards of functioning of people with disabilities in the objective and subjective dimensions are discussed. The source of the EU’s strategy and activities are international documents: The Convention on the Rights of Persons with Disabilities of 2006 and the Council of Europe Disability Action Plan.

GLOBAL STANDARDS FOR PROSTHETICS AND ORTHOTICS

Over the past decade, essential documents and agreements have emerged to help improve the lives of people with physical disabilities. These include Convention on the Rights of Persons with Disabilities (CRPD), ratified by more than 170 countries, and the World Health Organization (WHO) global disability action plan. While the principles in these broad agreements can be applied to people who would benefit from assistive technology, specific service standards are required to operationalize the CRPD and WHO objectives. Therefore, WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), prepared global standards and an implementation manual to assist Member States in setting up, improving, or transforming their systems for delivering appropriate prosthetic and orthotic services.
 Article PDF Link:https://jps.library.utoronto.ca/index.php/cpoj/article/view/31371/23745
 How to cite: Lemaire ED, Supan T, Ortiz M. Global Standards for Prosthetics and Orthotics. Canadian Prosthetics & Orthotics Journal. Volume1, Issue2, No.3, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.31371

“Person with disabilities” and their “social determinants of health”- the neglected paradigm of public health

This study was conducted to aware the audience to be more concern about “person with disabilities” and their “social determinants of health” as an emerging area in public health. WHO mentioned, 15% of the global populations are suffering from some form of disabilities and the number is higher comparing the report of 1970s. Public health aim to prevent mortality, morbidity and disability in different sectors (Donald, Lollar & John, 2003). But its alarming that disability preventive program often neglected in public health programs. Even the link between diseases and disability is often overlooked in several cases like GBS, encephalitis, transverse myelitis etc. Reduced inflow and increased outflow of finance and social determinants of health impact negatively on the life of the person with disabilities. Continuous effort to improve the social determinants of health worked tremendously over the last few decades to improve the life of human being globally, which is unfortunately sometimes worked as predisposing factor to the increased number of disabilities. But effort to reduce burden of disability and to improve SDH is just negligible. The 67th World Health Assembly adopted a resolution endorsing the WHO global disability action plan 2014–2021: Better health for all people with disability. It reflects the major shift in global understanding and responses towards disability. It could be concluded that it’s the high time to look more precisely in this neglected area whiting various discourse of SDH which will be a big burden of the public health in coming days. More research is required to minimize number of disability as well the after math of disability.

Development of essential standards for the training of community rehabilitation workers in low resource settings

One of the objectives of the WHO Global Disability Action Plan 2014–2021 is to strengthen rehabilitation and Community Based Rehabilitation (CBR). In order to achieve this goal, the training of Community Rehabilitation Workers (CRW) is crucial. However, results of the last World CBR Congress show a lack of recognition of this professional group, looking at accountability and training with certificates. This is partially related to their wide range of skills and duties. In September 2017 a research protocol was conducted at community rehabilitation programmes in 6 low and middle income countries. It consisted of workshops with the management team (31 members) and CRW (78), field visits and Focus Group Discussions with the beneficiaries (182). The protocol looks at the needs of the beneficiaries, training received and activities carried out by CRW, and their support system. It uses an open question method, categorising and stratifying the responses according to their relative importance along the process. Training of CRW is inconsistent with the variety of interventions needed in the field, which leaves the users insecure. The needs of the beneficiaries are multifaceted, and activities carried out by CRW only partially reflect a needs based approach. Competencies regarding economic empowerment, disability specific issues, psychosocial support and inclusion are underadressed. Also, a mismatch was found between activities carried out most often and activities determined as most important. This research protocol identified gaps and priorities for the development of a standardised training content for CRW. We describe minimal standards that answer the needs of a person with a disability living in the community of a low resource country.

Global disability action plan 2014–2021 (GDAP): The way forward

An estimated 80% of persons with disability (PwD) live in low- and middle-income countries (LMICs), with significant burden of disease and subsequent disability. The WHO Global Disability Action Plan 2014–2021 (GDAP), provides a list of specific actions and metrics for the empowerment of PwD, including strengthening/extending rehabilitation, assistive-technology, support services, and community-based rehabilitation. The aim of this study was to identify potential barriers for implementation of the GDAP in LMICs. The Flying Faculty rehabilitation team from the Royal Melbourne Hospital, Australia conducted intensive workshops at medical/academic institutions in LMICs for healthcare professionals from various local Physical Medicine and Rehabilitation (PM&R) facilities. A modified Delphi method identified challenges for future implementation to address gaps identified. Despite differences in the healthcare system and practices in LMICs, the challenges reported in four countries, at both macro (governmental/policy makers) and micro levels (community/social/individual) were similar. Common strategies were implemented to address challenges: limited knowledge of disability services, PM&R workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Support of potential facilitators were: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research. Disability care and rehabilitation is an emerging priority in LMICs to address the needs of people with disability. The GDAP framework provides guidance to facilitate access and strengthen PM&R services.

White Book on Physical and Rehabilitation Medicine in Europe. Introductions, Executive Summary, and Methodology.

The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies (European Academy of Rehabilitation Medicine - EARM, European Society of PRM - ESPRM, European Union of Medical Specialists - PRM Section, European College of PRM-ECPRM served by the European Union of Medical Specialists-PRM Board) and constitutes the reference book for PRM physicians in Europe. It has now reached its third edition; the first was published in 1989 and the second in 2006/2007. The WB has multiple purposes, including providing a unifying framework for European countries, to inform decision-makers on European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public. The WB states the importance of PRM, a primary medical specialty that is present all over Europe, with a specific corpus disciplinae, a common background and history throughout Europe. PRM is internationally recognized and a partner of major international bodies, including the World Health Organization (WHO). PRM activities are strongly based on the documents of the United Nations (UN) and WHO, such as the Convention of the Rights of Persons with Disabilities (2006), the World Report on Disability (2011), the WHO Global Disability Action Plan 2014-2021 (2014) and the WHO initiative "Rehabilitation 2030: a call for action" (2017). The WB is organized in 4 sections, 11 chapters and some appendices. The WB starts with basic definitions and concepts of PRM and continues with why rehabilitation is needed by individuals and society. Rehabilitation focuses not only on health conditions but also on functioning. Accordingly, PRM is the medical specialty that strives to improve functioning of people with a health condition or experiencing disability. The fundamentals of PRM, the history of the PRM specialty, and the structure and activities of PRM organizations in Europe are presented, followed by a thorough presentation of the practice of PRM, i.e. knowledge and skills of PRM physicians, the clinical field of competence of PRM, the place of the PRM specialty in the healthcare system and society, education and continuous professional development of PRM physicians, specificities and challenges of science and research in PRM. The WB concludes with the way forward for the specialty: challenges and perspectives for the future of PRM.

Responding to the World Health Organization Global Disability Action Plan in Egypt: A Technical Consultancy to develop a National Disability, Health and Rehabilitation Plan.

A technical consultation to develop a National Disability, Health and Rehabilitation Plan (NDHRP) for Egypt was carried out in 2015. Its overall goal was to improve health, functioning, well-being, quality of life, and participation of persons with disability in Egypt by supporting the Ministry of Health and Population and other stakeholders to improve access to health services and strengthen health-related rehabilitation services for all persons in need. The methodological steps of the technical consultation were as follows: collecting and reviewing accessible documents and data; site visits to state institutions, health and rehabilitation services; discussions with relevant stakeholders in rehabilitation, including persons with disability; drafting recommendations based on the principles of the World Report on Disability and the World Health Organization Global Disability Action Plan and the information collected; discussion with stakeholders in a workshop; and preparation of a final report. The development of a NDHRP was successful and led to recommendations with a good level of consensus among stakeholders in Egypt. The authors hope that the NDHRP will lead to improved rehabilitation service provision, and health and quality of life of persons with disability and chronic health conditions living in Egypt.

Challenges and barriers for implementation of the World Health Organization Global Disability Action Plan in low- and middle- income countries

To identify potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Nigeria and compare these with other low- and middle-income countries. A rehabilitation team from the Royal Melbourne Hospital, Parkville, Australia, conducted intensive workshops at medical/academic institutions in Nigeria for healthcare professionals from various local Physical Medicine and Rehabilitation facilities. A modified Delphi method identified challenges for person with disability, using 3 GDAP objectives. Findings were compared with similar exercises in Madagascar, Pakistan and Mongolia. Despite differences in the healthcare system and practice, the challenges reported in Nigeria were similar to those in other 3 low- and middle-income countries, at both macro (governmental/policymakers) and micro levels (community/social/individual). Common challenges identified were: limited knowledge of disability services, limited Physical Medicine and Rehabilitation workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Common potential facilitators included: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research. Disability care is an emerging priority in low- and middle-income countries to address the needs of people with disability. The challenges identified in Nigeria are common to most low- and middle-income countries. The GDAP framework can facilitate access and strengthen Physical Medicine and Rehabilitation services.

World Health Organization Global Disability Action Plan: The Mongolian Perspective.

To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization (WHO) Global Disability Action Plan (GDAP). A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals (n = 77) from medical rehabilitation facilities (urban/rural, public/private) and non-governmental organizations. A modified Delphi method (interactive sessions, consensus agreement) identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure/human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.

Responding to the World Health Organization Gobal Disability Action Plan in Ukraine: Developing a National Disability, Health and Rehabilitation Plan.

In order to support the development of a National Disability, Health and Rehabilitation Plan (NDHRP) for Ukraine, a technical consultation was carried out by a Rehabilitation Advisory Team (RAT) of the International Society of Physical and Rehabilitation Medicine (ISPRM) in 2015. The consultation was based on assessment of the situation of persons with disabilities and the rehabilitation system in Ukraine. Recommendations for activities and projects to improve rehabilitation services within the healthcare system were developed and proposed. In order to reach consensus on the recommendations, dialogues were held with different stakeholders, including the Ministry of Public Health. The recommendations included: coordination of disability and rehabilitation policies within the Ministry of Public Health and among other involved ministries; translation and adaptation of international definitions of functioning, disability, and assessment tools into Ukrainian; data collection on the epidemiology of disability and the need for rehabilitation; implementation of health-related rehabilitation services; and implementation of international definitions and curricula of rehabilitation professions. The mission was regarded as successful and one year later a few changes had been adopted by the Ukrainian government. Further action based on this research is necessary. It will be important to track the changes and evaluate the results after an appropriate period of time.

Strengthening health-related rehabilitation services at national levels.

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

The Implementation Challenge and the Learning Health System for SCI Initiative.

The paper introduces the special issue by linking the International Spinal Cord Injury (InSCI) Community Survey study to the Learning Health System for SCI Initiative (LHS-SCI). The LHS-SCI was designed to respond to the implementation challenge of bringing about policy reform in light of the targeted policy recommendations of World Health Organization's International Perspectives on SCI report as well as the call for action of WHO's Global Disability Action Plan. The paper reviews the components of LHS-SCI relevant to internationally comparable information, a theory of change to guide for action, and the tools for evidence-informed policy. The interplay between persons, their health needs, and the societal response to those needs provides the foundation for the organization of the LHS-SCI Initiative. Moreover, as the other articles in this special issue describe in detail, the rationale, conceptualization, and study design of the InSCI study are also informed by the rationale, and mission, of the LHS for SCI Initiative. The LHS-SCI, and the implementation challenge that motivates it, is responsible for the design of the InSCI study and the overall mission of LHS-SCI to continuously improve the lived experience of people living with SCI around the world through an international evidence- and rights-informed research and policy reform effort.

The Cross-Cultural Societal Response to SCI: Health and Related Systems.

The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative aligned with the World Health Organization's (WHO) Global Disability Action Plan. Based on the outcomes of this initiative, countries will be able to shape their health systems to better respond to the needs of persons with SCI. This paper describes and compares the macroeconomic situation and societal response to SCI across 27 countries from all 6 WHO regions that will participate in the LHS-SCI initiative. A concurrent mixed-methods study was conducted to identify key indicators that describe the situation of persons with SCI, the general societal response, the health and rehabilitation system, and the experience for a SCI person after discharge from inpatient rehabilitation. A strong correlation was found between the efficiency of a healthcare system and the amount a country invests in health. Higher availability of resources does not necessarily imply that unrestricted access to the healthcare system is warranted. Variations in the health systems were found for various domains of the health and rehabilitation systems. The evaluation and comparative analysis of the societal response to SCI raise the awareness of the need of more standardized data to identify current needs and gaps in the quality and access to SCI-specific health system.

World Health Organisation Global Disability Action Plan 2014-2021: Challenges and perspectives for physical medicine and rehabilitation in Pakistan.

To provide an update on disability and outline potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Pakistan. A 6-day workshop at the Armed Forces Institute of Rehabilitation Medicine, Islamabad facilitated by rehabilitation staff from Royal Melbourne Hospital, Australia. Local healthcare professionals (n = 33) from medical rehabilitation facilities identified challenges in service provision, education and attitudes/approaches to people with disabilities, using consensus agreement for objectives listed in the GDAP. Respondents agreed on the following challenges in implementing the GDAP: shortage of skilled work-force, fragmented healthcare system, poor coordination between acute and subacute healthcare sectors, limited health services infrastructure and funding, lack of disability data, poor legislation, lack of guidelines and accreditation standards, limited awareness/knowledge of disability, socio-cultural perceptions and geo-topographical issues. The main facilitators included: need for governing/leadership bodies, engagement of healthcare professionals and institutions using a multi-sectoral approach, new partnerships and strategic collaboration, provision of financial and technical assistance, future policy direction, research and development. The barriers to implementing the GDAP identified here highlight the emerging priorities and challenges in the development of rehabilitation medicine and GDAP implementation in a developing country. The GDAP summary actions were useful planning tools to improve access and strengthen rehabilitation services.

Identifying Rehabilitation Workforce Strengths, Concerns and Needs: A Case Study from the Pacific Islands

Purpose: This exploratory case study was undertaken to inform capacity development of the rehabilitation workforce in member nations of the Pacific Islands Forum (PIF). Method: Participants at the 1st Pacific CBR Forum in June 2012 were key informants for this study. They comprised the disability focal points from government departments in each of the 14 countries, representatives of DPOs and disability service providers. The study was conducted in 3 phases: a template to gather data on rehabilitation workers; key informant interviews; and, stakeholder workshops to identify strengths and needs of the rehabilitation workforce in the Pacific. Results : The detailed case study findings suggest two critical drivers for rehabilitation health workforce development in the Pacific context. The first is leadership and commitment from government to serve rehabilitation needs in the community. The second is the urgent need to find alternative ways to service the demand for rehabilitation services as it is highly unlikely that the supply of specialist personnel will be adequate. Conclusions : A multi-sectoral view of health and social service systems is a key element for the development of a rehabilitation health workforce. The endorsement of the WHO Global Disability Action Plan by the World Health Assembly in 2014 further enhances the opportunity to work collaboratively across sectors in Pacific countries. Specialist personnel are and will remain in short supply. There is opportunity for the region to lead the development of alternate workforce mechanisms through the training and supply of skilled community-based rehabilitation personnel.

Designing Coastal Management Strategies for Populations with Distinct Needs: The Case of Learning Disabilities

The Disability Discrimination Act (1995, amended 2005), Equality Act (2010), EU Disability Action Plan (2003 –2010), and EU Disability Strategy (2010–2020) were designed to make equal opportunities a “reality.” As 16% of the EU population, is statutorily disabled there are considerable implications for beach management. Research examples of beach users include swimmers, anglers, etc. - but rarely people with learning disabilities (LD). This paper considered beach users with LD and their appreciation of three different coastal classifications in South Wales. Because of their disabilities, the research applied a participatory photo interpretation methodology (photovoice). A comparison of the LD ranking of beach issues was made with rankings provided by the general public at the same beaches. Results demonstrated some similarities between LD and general public coastal needs, but identified the need for specific considerations to be made by beach managers for LD users, including informed self-advocacy, use/application of signage, instructive access and a requirement for baseline information gathering. The research proposes an integrated coastal access model from which coastal management/gatekeepers can consider LD needs within coastal strategies. Finally, findings highlight the use of photovoice in coastal research projects and the need for innovative methodological considerations when researching certain groups.