The Health of People with Disabilities in Humanitarian Settings During the Covid-19 Pandemic

People with disabilities are at a higher risk of poor health outcomes and face barriers to accessing health services, which may be exacerbated in humanitarian settings and during the Covid-19 pandemic. This scoping review explores how best to protect the health of people with disabilities in humanitarian contexts during the Covid-19 response. Forty-eight articles across the peerreviewed and grey literature were identified. Key challenges include a lack of accessibility of mainstream Covid-19 prevention and response measures, disruptions to routine care pathways for people with disabilities, and double discrimination based on disability and displaced status. Specific priority areas include continuity of basic and specialised services, prioritisation of women and children with disabilities, the need to adapt mainstream recommendations for the Covid-19 response to be disability- and humanitarian-setting inclusive, and strengthening data systems

Building minds for an uncertain future? Nurturing care in early childhood is more important than ever

Recent innovations including the launch of powerful artificial intelligence (AI) tools such as ChatGPT provide a glimpse into a very different future where machines increasingly take on tasks that were previously considered the preserve of humans. What these large language models and their successors mean for the near future of work remains uncertain, yet it is increasingly clear that these changes will be radical. Whole cadres of workers will work with, or be replaced by, machines. The prediction in 2017 that nearly 60% of all occupations are automatable, already looks potentially out of date.1 Contrary to early predictions, even some highly skilled jobs in law, journalism and medicine may disappear entirely and machines may also play increasing roles in child development and healthcare.2 Moreover, these technological shifts will occur against the backdrop of vast disruptions due to climate change and a breakdown of the planetary health systems on which human beings rely; changes likely to precipitate or exacerbate conflicts and displacement.

Predictors of negative beliefs toward the sexual rights and perceived sexual healthcare needs of people with physical disabilities in South Africa

Background: Although sexuality is a ubiquitous human need, recent empirical research has shown that people without disabilities attribute fewer sexual rights and perceive sexual healthcare to benefit fewer people with disabilities, compared to non-disabled people. Within a global context, such misperceptions have tangible, deleterious consequences for people with disabilities (e.g., exclusion from sexual healthcare), creating an urgent need for effective strategies to change misperceptions. Methods: To lay the groundwork for developing such strategies, we examined predictors of the recognition of sexual rights of people with physical disabilities within the South African context, derived from three key social psychological literatures (prejudice, social dominance orientation and intergroup contact), as well as the relationship between sexual rights and beliefs about sexual healthcare. Data were obtained through a cross-sectional survey, given to non-disabled South Africans (N = 1989). Results: Findings indicated that lack of recognition of the sexual rights for physically disabled people predicted less positive beliefs about the benefits of sexual healthcare. In turn, high levels of prejudice (both cognitive and affective) toward disabled sexuality predicted less recognition of their sexual rights, while prejudice (both forms) was predicted by prior contact with disabled people and possessing a social dominance orientation (cognitive prejudice only). Evidence was also obtained for an indirect relationship of contact and social dominance orientation on sexual healthcare beliefs through prejudice, although these effects were extremely small. Conclusion: Results are discussed in terms of their implications for rehabilitation, as well as national-level strategies to tackle negative perceptions of disabled sexuality, particularly in contexts affected by HIV.Implications for rehabilitation Findings demonstrate an empirical link between prejudice toward disabled sexuality, lack of recognition of sexual rights and viewing sexual healthcare of less benefit for disabled people. Consequently, there is need for increased attention to these dimensions within the rehabilitative context. Contact with disabled people, including dedicated interventions, is unlikely to meaningfully impact beliefs about the benefits of sexual healthcare

PROTOCOL: Effectiveness of interventions for improving social inclusion outcomes for people with disabilities in low‐ and middle‐income countries: A systematic review

The objectives of this review are to: (1) examine the effectiveness of interventions for improving social inclusion outcomes for people with disabilities (physical, visual, hearing, intellectual or mental health conditions) in low- and middle-income countries (LMICs); and (2) to critically appraise the confidence in study finding of the included studies. Key questions include: (1) Are interventions to improve social inclusion outcomes for people with disabilities in LMICs effective, and what is the quality of evidence base? (2) What types of intervention, or intervention design features, are most effective in improving social inclusion outcomes for people with disabilities in LMICs? (3) Which interventions appear most effective for different categories of disability? (4) What are the barriers to people with disabilities participating in interventions to improve their social inclusion outcomes? And what factors facilitate participation in, and the success of, such interventions?

Are children with disabilities more likely to be malnourished than children without disabilities? Evidence from the Multiple Indicator Cluster Surveys in 30 countries

Introduction A key Sustainable Development Goal target is to eliminate all forms of malnutrition. Existing evidence suggests children with disabilities are at greater risks of malnutrition, exclusion from nutrition programmes and mortality from severe acute malnutrition than children without disabilities. However, there is limited evidence on the nutritional outcomes of children with disabilities in large-scale global health surveys. Methods We analysed Multiple Indicator Cluster Survey data from 30 low and middle-income countries to compare nutritional outcomes for children aged 2–4 years with and without disabilities. We estimated the adjusted prevalence ratios for stunting, wasting and underweight comparing children with and without disabilities by country and sex, using quasi-Poisson models with robust SEs. We accounted for the complex survey design, wealth quintile, location and age in the analyses. We meta-analysed these results to create an overall estimate for each of these outcomes. Results Our analyses included 229 621 children aged 2–4 across 30 countries, including 15 071 children with disabilities (6.6%). Overall, children with disabilities were more likely to be stunted (adjusted risk ratio (aRR) 1.16, 95% CI 1.11 to 1.20), wasted (aRR 1.28, 95% CI 1.18 to 1.39) and underweight (aRR 1.33, 95% CI 1.17, 1.51) than children without disabilities. These patterns were observed in both girls and boys with disabilities, compared with those without. Conclusion Children with disabilities are significantly more likely to experience all forms of malnutrition, making it critical to accelerate efforts to improve disability inclusion within nutrition programmes. Ending all forms of malnutrition will not be achievable without a focus on disability

Impairment, socialization and embodiment: The sexual oppression of people with physical disabilities

People with disabilities face multiple forms of social exclusion, discrimination, and oppression, including in the domain of sex and sexuality. From a critical psychoanalytic viewpoint, social responses to persons with impairments are strongly unconsciously mediated, and often dominated by projections based on archaic anxieties about dependency, vulnerability, and shame. Where disability meets sexuality, these defenses may be more prominent still, resulting, for one example, in the prejudiced myth that people with disabilities are disinterested in, or not capable of, sex. Using this theoretical stance, this paper examines how the developmental role of family and societal influences on the social constructions of sexuality and disability are internalized, resisted, and negotiated by two South Africans with physical disabilities. Data are drawn from interview material elicited via photovoice methodology. The interview narratives and photographic images are used to explore how sexual oppression may be internalized, creating intra-psychic barriers to inclusion for this already structurally disadvantaged group

PROTOCOL: Effectiveness of interventions for improving livelihood outcomes for people with disabilities in low‐ and middle‐income countries: A systematic review

The objectives of this review are to answer the following research questions: (1) What is the effect size of the effectiveness of interventions to improve livelihood outcomes for people with disabilities in low- and middle-income countries (LMICs), and what is the quality of the evidence base? (2) What works to improve livelihood outcomes for people with disabilities in LMICs? (3) Which interventions appear most effective for different categories of disability? (4) What are the barriers and facilitators to the improvement of livelihood outcomes to people with disabilities?

(Re)presenting the self: Questions raised by a photovoice project with people with physical disabilities in South Africa

Photovoice is presented here as an emancipatory, participatory research method with the potential to put minority subjects in charge of their own representation. Drawing on research with disabled people conducted in South Africa, we argue that the meaning of images is often hostage to interpretations which reify untruths about the subject. We consider how photovoice projects may give rise to images that perpetuate the subjugation of their subjects, but could also facilitate an emancipatory politics of self-representation through photography, constituting a challenge and not only the discursive regimes and ideologies which underlie dominant aesthetics

Dating persons with physical disabilities: The perceptions of South Africans without disabilities

There is good reason to believe that the attitudes of persons without disability towards dating a person with a physical disability might be unfavourable. However, in general, and in the Global South in particular, there is a dearth of research in this area. This study sought to take the first step in addressing this lack of enquiry, by surveying the attitudes of a general population sample in South Africa towards dating people with physical disabilities, using a vignette. Data from 1,723 survey respondents were analysed thematically. Findings reveal largely negative attitudes towards people with physical disabilities. Respondents without disability perceived numerous barriers to dating a person with a physical disability, including social stigma, anxiety, and concerns about the burden of care they believed such a relationship would place upon them. However, there was some evidence to suggest that some positive attitudes do exist, and a few respondents were open to dating a person with physical disabilities. Findings contribute to a nuancing and expanding of the ‘myth of asexuality’ among physically disabled people by showing that people with physical disabilities are actively desexualised by persons without disability. Future research is needed to explore how the inclusive attitudes, of which we did find evidence here, can be further cultivated