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Int. J. Environ. Res. Public Health 2018, 15(12), 2746; https://doi.org/10.3390/ijerph15122746

Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi

1
International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
2
WaterAid, London SE11 5JD, UK
3
Environmental Health Group, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
4
Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
Contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 27 September 2018 / Revised: 22 November 2018 / Accepted: 24 November 2018 / Published: 5 December 2018
(This article belongs to the Special Issue Disability and Global Health)
Full-Text   |   PDF [2029 KB, uploaded 5 December 2018]   |  

Abstract

Limited evidence exists about how to design interventions to improve access to health care for people with disabilities in low and middle-income countries (LMICs). This paper documents the development of two behaviour change interventions. Case study one outlines the design of an intervention to improve uptake of referral for ear and hearing services for children in Malawi. Case study two describes the design of an intervention to improve menstrual hygiene management for people with intellectual impairments in Nepal. Both followed existing approaches—Medical Research Council Guidance for developing and evaluating complex interventions and Behaviour Centred Design. The purpose is to demonstrate how these frameworks can be applied, to document the interventions developed, and encourage further initiatives to advance health services targeting people with disabilities. Important components of the intervention design process were: (1) systematic reviews and formative research ensure that interventions designed are relevant to current discourse, practice and context; (2) people with disabilities and their family/carers must be at the heart of the process; (3) applying the theory of change approach and testing it helps understand links between inputs and required behaviour change, as well as ensuring that the interventions are relevant to local contexts; (4) involving creative experts may lead to the development of more engaging and appealing interventions. Further evidence is needed on the effectiveness of these types of interventions for people with disabilities to ensure that no one is left behind. View Full-Text
Keywords: people with disabilities; access to health care; developing countries; menstrual hygiene management; hearing loss; hearing impairment; intellectual impairment; carers people with disabilities; access to health care; developing countries; menstrual hygiene management; hearing loss; hearing impairment; intellectual impairment; carers
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Wilbur, J.; Bright, T.; Mahon, T.; Hameed, S.; Torondel, B.; Mulwafu, W.; Kuper, H.; Polack, S. Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi. Int. J. Environ. Res. Public Health 2018, 15, 2746.

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