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Lack of accessible transportation is considered a major barrier to education for children with disabilities—children already far less likely to attend school. While millions of children face challenges with getting to school, including long distances, poor roads, lack of transport and safety issues, these can be compounded for children with disabilities. Yet there is little data from low and middle-income countries on the nature and extent of this exclusion, or on attempted solutions. This paper explores some practical options for improving transport as part of providing inclusive education for children with disabilities in low income countries, as well applying concepts of transport-related social exclusion in such contexts. The paper reviews a project designed to improve sustainable transportation to school for children with disabilities in four districts in Mashonaland West Province, Zimbabwe. The most common solution was three wheel motorbikes (tricycles) with trailers. Whilst not been unproblematic, teachers, parents and the wider communities overwhelmingly agree that they have supported children with disabilities to attend school. Obviously tricycles are not the only component needed for an inclusive education system, but they are a start. The paper also highlights some crucial gaps in current approaches, key among which is the fact the most government departments work in silos. Whilst inclusive education is strongly supported by the Zimbabwean Government, there is a lack of joined up thinking between transport and education ministries. Without stronger collaboration across ministries children with disabilities will continue to experience avoidable barriers and transport-related social exclusion.

Lack of accessible transportation is considered a major barrier to education for children with disabilities—children already far less likely to attend school. While millions of children face challenges with getting to school, including long
distances, poor roads, lack of transport and safety issues, these can be compounded for children with disabilities. Yet there is little data from low and middle-income countries on the nature and extent of this exclusion, or on attempted solutions. This paper explores some practical options for improving transport as part of providing inclusive education for children with disabilities in low income countries, as well applying concepts of transport-related social exclusion in such contexts. The paper reviews a project designed to improve sustainable transportation to school for children with
disabilities in four districts in Mashonaland West Province, Zimbabwe. The most common solution was three wheel motorbikes (tricycles) with trailers. Whilst not been unproblematic, teachers, parents and the wider communities overwhelmingly agree that they have supported children with disabilities to attend school. Obviously tricycles are not the only component needed for an inclusive education system, but they are a start. The paper also highlights some crucial gaps in current approaches, key among which is the fact the most government departments work in silos. Whilst inclusive education is strongly supported by the Zimbabwean Government, there is a lack of joined up thinking between transport and education ministries. Without stronger collaboration across ministries children with disabilities will continue
to experience avoidable barriers and transport-related social exclusion. (author's abstract)

The difficulties faced by persons with disabilities throughout the displacement process contribute to their increased vulnerability. Adapted from the source document.

AbstractThis policy arena focuses on a significantly under‐represented subject in international development journals—disability. This is timely, as the United Nations Convention of the Rights of Persons with Disabilities recently came into force in May 2008. As a result, there is a growing awareness among policy‐makers and development practitioners of the need to comprehensively address disability issues in their core activities. Persons with disabilities have long been subjects of international aid, so why has there been so little focus on mainstreaming disability within international development, and so little attention to development within disability circles? This editorial, and the papers presented in the policy arena, draw out the key issues around these themes that emerged from a major conference—poverty, discrimination and lack of access—held in Addis Ababa, Ethiopia in May 2008 and looks at the trajectory of links between disability and development and asks what is the significance of convention and how will it take the field forward. Copyright © 2009 John Wiley & Sons, Ltd.

Background: Despite a global commitment to the right to education for persons with disabilities, little is known about how to achieve inclusive education in practice, particularly in low- and middle-income countries (LMICs), where the majority of the world's people with disabilities reside. Moreover, although exclusion from education is magnified by intersecting gender and socioeconomic inequalities, there is especially little knowledge regarding what approaches to inclusive education are effective amongst girls with disabilities living in resource-poor settings.Objectives: The objective of this article was to assess the impact of an inclusive education intervention led by a non-governmental organisation (NGO) on the educational attainment of girls with disabilities in the resource-poor Lakes region of Kenya.Method: A quasi-experimental design was employed, where the literacy and numeracy educational attainment of the intervention and control groups was compared over two time points a year apart (Time 1 and Time 2; total matched N = 353). During this period, activities pertaining to six core components of a holistic inclusive education model were implemented.Results: Relative to the control group, girls with disabilities in the intervention group reported a greater increase in literacy and numeracy attainment, adjusted for grade and level of functional difficulty.Conclusion: Findings suggest that the intervention was successful in engendering additional improvements in the educational attainment of girls with disabilities from the resource-poor Lakes region of Kenya. Results highlight both the applicability of NGO-led interventions in settings, where national implementation of inclusive education is constrained, and the potential of taking such interventions to scale.

Background: Disability and caste are two different forms of oppression; however, people of the Dalit caste in Nepal and people with disabilities commonly face similar types of marginalities. Dalit women with disabilities may experience double discrimination because of the intersectionality of disability and caste. This study examines whether the disability and caste identity of women together affects and compounds the utilization of maternal healthcare services. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire among a total of 354 Dalit and non-Dalit women, with and without a disability aged between 15–49 years. Maternal healthcare service utilization was assessed by antenatal care (ANC), health facility (HF) delivery, and postnatal care (PNC) during the last pregnancy. Logistic regression was performed to detect the predictors of service utilization and identify whether disability and caste were associated with service utilization. First, disability and caste were fitted separately in models. Secondly, the intersectionality of disability and caste was tested by inclusion of a disability*caste interaction term. Finally, the confounding effect of socio-demographic factors was investigated. Results: Out of surveyed women, 73% had 4+ ANC visits, 65% had HF delivery, and 29% had a PNC visit during their last pregnancy. Women with a disability had lower odds of HF delivery (OR 0.50, CI 0.30–0.84) and PNC (OR 0.47, CI 0.25–0.88) than women without a disability. Adjustment for women's age and household wealth explained associations in HF delivery by women with disabilities. There was no association between caste and service utilization. Disability overrode caste, and there was no other evidence of effect modification by women's caste status in the utilization. However, a weak interaction effect in the utilization of ANC services was found in the caste group by their education (OR 0.19, 95% CI 0.05–0.74). Conclusions: Disabled women—whether Dalit or non-Dalit—had lower rates of utilizing all maternal healthcare services than non-disabled women. Interestingly, Dalit women with disabilities were more likely to receive PNC than non-Dalit women with disabilities. Increasing equity in maternal healthcare service utilization requires that traditional approaches to service development and program intervention be re-examined and more nuanced interventions considered to ensure improved access and outcomes among all vulnerable groups.

Evidence suggests that people with disabilities are the most marginalised and vulnerable group within any population. However, little is known about the extent of inequality between people with and without disabilities in contexts where the majority of persons experience extreme poverty and hardship. This includes in Liberia, where very little is understood about the lives of disabled people in general. This study uses a multidimensional wellbeing framework to understand perceived relative inequality associated with disability by assessing several facets of wellbeing across and within households containing disabled members (N = 485) or households with no disabled members (N = 538) in Liberian communities (Total individuals surveyed, N = 2020). Statistical comparisons (adjusted for age, sex, education and wealth differences and clustered at the household, village and county level) reveal that disabled Liberians are managing similarly to non-disabled Liberians in terms of income and education, but experience many perceived relative inequalities including in life satisfaction, transport access, political participation and social inclusion. Our results further suggest that disability may lead to perceived relative inequality at the household level in terms of trust held in neighbours. However, they also show that being the head of a household may protect against perceived relative inequality in certain dimensions (e.g. healthcare and transport access, political participation) irrespective of disability status. Results are discussed in terms of practical implications for development efforts in Liberia and for disabled people in other low- and middle-income settings.

BACKGROUND: There has been little research on the impact of the 2014-2015 West African Ebola crisis on people with disabilities. This paper outlines the way in which the Ebola Virus Disease (EVD) outbreak in Liberia in 2015 highlighted existing inequalities and exclusion of people with disabilities and their households. METHODS: The results presented here are part of a larger ESRC/DFID-funded mixed methods research project in Liberia (2014-2017) which included a quantitative household survey undertaken in five counties, complemented by qualitative focus group discussions and interviews with people with disabilities and other key stakeholders. Uniquely, this research gathered information about people with disabilities' experience of the EVD outbreak, as well as additional socioeconomic and inclusion data, that compared their experience with non-disabled community members. RESULTS: Reflections by people with disabilities themselves show knowledge, preparation, and responses to the EVD epidemic was often markedly different among people with disabilities due to limited resources, lack of inclusion by many mainstream public health and medical interventions and pre-existing discrimination, marginalisation and exclusion. Interviews with other key stakeholder revealed a lack of awareness of disability issues or sufficient training to include this population systematically in both Ebola response activities and general health services. Key findings include the need to understand and mitigate direct and indirect health consequences of unequal responses to the epidemic, as well as the limited capacity of healthcare and social services to respond to people with disabilities. CONCLUSION: There are lessons to be learned from Ebola outbreak around inclusion of people with disabilities, relevant to the current COVID-19 pandemic. Now is the time to undertake measures to ensure that people with disabilities do not continue to be marginalised and excluded during global public health emergencies. SUPPLEMENTARY INFORMATION: The ...

There is a dearth of studies that have examined the attitudes of society toward people with intellectual disabilities (IDs) on a global scale. This study set out to gauge the extent to which ID continues to be stigmatized and to which initiatives are in place to increase their inclusion and tackle stigma around the globe. Data were collected using a web survey from 667 experts and organizations in the (intellectual) disability field pertaining to 88 countries and covering all world regions. Information about the study was disseminated by four multinational disability organizations, and the survey was available in five languages. Findings and responses indicated that the general public in many parts of the world broadly support the fundamental principle of inclusion of children and adults with IDs, yet negative attitudes persist. High levels of stigma and denial of fundamental rights still appeared a reality in many places. Initiatives to tackle stigma appeared patchy and least in evidence where they were most needed. In many parts of the world the life chances of people with IDs often appear still very poor, and support and advocacy almost entirely their families' responsibility. More needs to be done globally to reduce the stigma associated with ID and to promote active engagement and regular social interactions between persons with IDs and their fellow citizens without IDs.

Background. There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. Methods. We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103. Results. From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean). Twenty-two (88%) were cross sectional. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Low birth weight prevalence ranged from 25-39%. Only five (20%) included information on children with disabilities and reported prevalence from 8-75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9-72%; wasting from 0-27%; underweight from 7-79%; low BMI from 5-27%. Overweight/obesity ranged from 10-32% and small head circumference from 17-41%. The prevalence of HIV was from 2-23% and anemia from 3-90%. Skin conditions or infections ranged from 10-31% and parasites from 6-76%. Half the studies with dietary information found inadequate intake or diet diversity. Younger children were typically more malnourished than older children, with a few exceptions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. High risk of bias was found. Conclusions. This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. Micronutrient deficiencies and obesity were also prevalent. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development.

Background: There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. Methods: We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103. Results: From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean). Twenty-two (88%) were cross sectional. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Low birth weight prevalence ranged from 25-39%. Only five (20%) included information on children with disabilities and reported prevalence from 8-75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9-72%; wasting from 0-27%; underweight from 7-79%; low BMI from 5-27%. Overweight/obesity ranged from 10-32% and small head circumference from 17-41%. The prevalence of HIV was from 2-23% and anemia from 3-90%. Skin conditions or infections ranged from 10-31% and parasites from 6-76%. Half the studies with dietary information found inadequate intake or diet diversity. Younger children were typically more malnourished than older children, with a few exceptions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. High risk of bias was found. Conclusions: This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. Micronutrient deficiencies and obesity were also prevalent. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development.