A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Health
3.1.1. Infection, Treatment, and Death from COVID-19
3.1.2. Access to Public Health Information
3.1.3. Access to PPE and Infection Control Measures
3.1.4. Access to Regular Health Care and Medicines
3.1.5. Psychosocial Health
3.2. Access to Regular Services and Supports
3.3. Impact on Livelihoods
3.4. Access to Social Protection
3.5. Food Security and Emergency Supplies
3.6. Education
3.7. Experiences of Violence
3.8. Survey Methods and Methodological Implications
3.8.1. Sampling
3.8.2. Question Types and Survey Themes
3.8.3. Data Analysis
3.8.4. Other Methodological Features
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Fujii, K. Towards Disability Inclusive and Responsive Disasters and Emergency Response and Management through Promoting Accessibility. In Proceedings of the United Nations Expert Group Meeting on Building Inclusive Society and Development through Promoting ICT Accessibility: Emerging Issues and Trends, Tokyo, Japan, 19–21 April 2012. [Google Scholar]
- Baker, K. Disability Inclusion in Disaster Risk Reduction: Experiences of People with Disabilities in Vanuatu during and after Tropical Cyclone Pam and Recommendations for Humanitarian Agencies; Nossal Institute for Global Health, CBM Australia, Oxfam in Vanuatu, Vanuatu Society of People with Disabilities, Vanuatu Disability Promotion and Advocacy Association, Ministry of Justice and Community Services, Vanuatu National Disaster Risk Management Office: Melbourne, Australia, 2017. [Google Scholar]
- Bula, S.; Morgan, E.; Thomson, T. Pacific People with Disability Shaping the Agenda for Inclusive Humanitarian Action. Humanit. Exch. 2020, 78, 6–9. [Google Scholar]
- Llewellyn, G.; Dominey-Howes, D.; Villeneuve, M.; Lewis-Gargett, A. Disability and Disaster Risk Reduction/Emergency Preparedness: Scoping Review; Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney: Sydney, Australia, 2016. [Google Scholar]
- World Health Organisation. World Report on Disability; World Health Organisation: Geneva, Switzerland, 2011. [Google Scholar]
- Kuper, H.; Banks, L.M.; Bright, T.; Davey, C.; Shakespeare, T. Disability-inclusive COVID-19 response: What it is, why it is important and what we can learn from the United Kingdom´s response. Wellcome Open Res. 2020, 5, 79. [Google Scholar] [CrossRef]
- Paez, A. Grey literature: An important resource in systematic reviews. J. Evid. Based Med. 2017, 10, 233–240. [Google Scholar] [CrossRef] [PubMed]
- Cooke, A.; Smith, D.; Booth, A. Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis. Qual. Health Res. 2012, 22, 1435–1443. [Google Scholar] [CrossRef] [PubMed]
- Brennan, C. Disability Rights during the Pandemic: A Global Report on Findings of the COVID-19 Disability Rights Monitor. 2020. Available online: https://media.africaportal.org/documents/Disability-Rights-During-the-Pandemic-report-web.pdf (accessed on 8 September 2021).
- Stakeholder Group of Persons with Disabilities for Sustainable Development. The Experience of Persons with Disabilities with COVID-19: A Short Qualitative Research Study; Stakeholder Group of Persons with Disabilities for Sustainable Development: Geneva, Switzerland, 2020. [Google Scholar]
- Handicap International. Nepal COVID-19 Rapid Need Assessment Report; Humanity and Inclusion: Kathmandu, Nepal, 2020. [Google Scholar]
- National Federation of the Disabled Nepal. Impact of COVID-19 Pandemic and Lockdown on Persons with Disabilities; National Federation of the Disabled Nepal: Kathmandu, Nepal, 2020. [Google Scholar]
- ASB Disability Cluster. Survey for Messages and Information Dissemination on COVID-19 in the Community; Arbeiter-Samariter-Bund: Jogyakarta, Indonesia, 2020. [Google Scholar]
- World Blind Union. Amplifying Voices: Our Lives, Our Say; World Blind Union: Toronto, ON, Canada, 2020. [Google Scholar]
- UNDP Viet Nam. Rapid Assessment of the Socio-Economic Impact of COVID-19 on Persons with Disabilities in Vietnam; United Nations Development Programme: Hanoi, Vietnam, 2020. [Google Scholar]
- Hanna, R.; Olken, B. Current Results of Online Survey on Economic Impact of COVID-19- Results for People with Disabilities; J-PAL Southeast Asia: Jakarta, Indonesia, 2020. [Google Scholar]
- Save the Children International. Protect a Generation: The Impact of COVID-19 on Children´s Lives; Save the Children International: London, UK, 2020. [Google Scholar]
- YAKKUM. Impact of Covid-19 to PWD and Their Family; YAKKUM: Yogyakarta, Indonesia, 2020. [Google Scholar]
- Women Enabled International. COVID-19 at the Intersection of Gender and Disability: Findings of a Global Human Rights Survey; Women Enabled International: Washington DC, USA, 2020. [Google Scholar]
- Christensen, A.; Touch, G.; Cain, E.; Garbett, A. COVID-19: Violence Risk and Income Loss among Persons with Disabilities; ADD International: Frome, UK, 2020. [Google Scholar]
- DPO Network. People with Disability are Missing Out: The Financial Burden of COVID-19 on Families with Disability Across Indonesia; DPO Network: Bruxelles, Belgium, 2020. [Google Scholar]
- Hanson, C.; Bun, K.; Chou, L. Rapid Research Report: Impact of COVID-19 on Women Entrepreneurs with Disabilities in Cambodia; Agile Development Group: Phnom Penh, Cambodia, 2020. [Google Scholar]
- Aggarao, S.; Bernandino, B. Access of Filipinos with Disabilities to the Philippine Government Social Amelioration; Centre for Disease Preparedness: Manila, Philippines, 2020. [Google Scholar]
- World Bank Group. Pivoting to Inclusion: Leveraging Lessons from the COVID-19 Crisis for Learners with Disabilties; Agile Development Group: Phnom Penh, Cambodia, 2020. [Google Scholar]
- Rohwerder, B.; Thompson, S.; Wickenden, M.; Wakoko, E.; Akter, F.; Njungi, J.; Chuba-Uzo, S. The Impact of Covid-19 on People with Disabilities—Emerging Findings; London School of Hygiene and Tropical Medicine: London, UK, 2020. [Google Scholar]
- Abualghaib, O.; Groce, N.; Simeu, N.; Carew, M.T.; Mont, D. Making Visible the Invisible: Why Disability-Disaggregated Data is Vital to “Leave No-One Behind”. Sustainability 2019, 11, 3091. [Google Scholar] [CrossRef] [Green Version]
- Office for National Statistics. Updated Estimates of Coronavirus (COVID-19) Related Deaths by Disability Status, England: 24 January to 20 November 2020; Office for National Statistics: London, UK, 2021. [Google Scholar]
- Shapiro, J. COVID-19 Infections and Deaths are Higher among Those with Intellectual Disabilities. Available online: https://www.npr.org/2020/06/09/872401607/covid-19-infections-and-deaths-are-higher-among-those-with-intellectual-disabili (accessed on 8 September 2021).
- Bernard, E.; Weiss, S.; Stein, J.; Ulin, S.; D´Souza, C.; Salgat, A.; Panzer, K.; Riddering, A.; Edwards, P.; Meade, M.; et al. Assessing the Impact of COVID-19 on Persons with Disabilities: Development of a Novel Survey. Int. J. Public Health 2020, 65, 755–757. [Google Scholar] [CrossRef] [PubMed]
- Eetvelt, S.V.; Marella, M.; Logam, L.; Robinson, A. What does the Evidence Say? A Literature Review of the Evidence on Including People with Disabilities and Older People in Humanitarian response. Humanit. Exch. 2020, 78, 24–27. [Google Scholar]
- DID4all. COVID-19 & Disability Inclusion. Available online: https://www.did4all.com.au/ResourceTheme.aspx?9213ea00-9d1b-4407-9aa5-1a9f07491343 (accessed on 10 September 2021).
Countries | Organisation | Timing of Data Collection | Sample Size (n) | Participants | Comments on Methods | Summary of Key Findings |
---|---|---|---|---|---|---|
Bangladesh (also Kenya, Nigeria, Uganda) | London School of Hygiene and Tropical Medicine [25] | July and August 2020 | 40 (in all 4 countries, Bangladesh total unclear) | Jobseekers with disabilities | Narrative interviews (no further detail available) | Respondents reported experiencing psychological distress due to stress, social isolation, and limited access to health services. Underemployment, financial insecurities and lack of social protection resulting in food, medicine and hygiene equipment scarcity. Setbacks in completion of degrees delayed entry into the job market. Increase in gender-based violence recorded in all countries. |
Cambodia | Agile Development Group [22,25] | Unknown–before May 2020 | 19 | Female entrepreneurs with disabilities | Telephone interviews. | Seventy percent of respondents reported anxiety and nearly half were experiencing depression. Limited knowledge and skills in ICT meant women entrepreneurs with disabilities had limited ability to adapt their businesses to prosper under COVID-19 restrictions. |
Cambodia | ADD International (funded by DFAT) [20] | July–September 2020 | 87 members, 10 leaders | Disabled Person’s Organisations (DPO) members (80% female); DPO/Self-help group leaders | Telephone interviews. Purposive sampling. | Fifty-two percent of respondents reported losing more than half their monthly income during the pandemic. This disproportionately affected women and people with communication and self-care difficulties. Most respondents reported having a shortage of food. Respondents reported difficulties accessing pandemic supports on an equal basis to people without disabilities. Forty percent of respondents reported increased risk of violence, with economic distress a contributing factor. Up to 70% of respondents reported experiencing psychosocial distress. |
Indonesia | Arbeiter-Samariter-Bund (ASB), and a consortium of disability organisations [13] | 24–29 March 2020 | 221 | Both people with and without disabilities (32% had a disability) | Online survey, quantitative | Almost half of respondents reported COVID-19 information as difficult to understand. Nearly half experienced reductions in daily activity supports. Eighty percent of respondents experienced significant reductions in income. Almost half of respondents reported experiencing psychological distress. |
Indonesia | Harvard, MIT, and J-PAL SEA [16] | 13–15 April 2020 | 205 | People with disabilities | Online survey, quantitative. One of the few surveys that compares results to a mainstream population, to note where the experience of people with disabilities differs from others in the population. | One in four respondents reported an increase in personal protective practices during the pandemic. In line with the broader population, 24% said they practiced social distancing. People with disabilities experienced higher rates of income and employment loss than people without disabilities, in addition to gaps in social protection. Up to three quarters of households experienced food insecurity. |
Indonesia | YAKKUM (health service provider) [18] | Early April 2020 | 92 | People with psychosocial disabilities (59), people with other impairments (15), parents of children with cerebral palsy (17) | Not described | People with disabilities experienced significant barriers to accessing information. Deaf people reported challenges communicating due to mask wearing. Mainstream social media as well as social networks were the most common sources of COVID-19 information. Children with cerebral palsy experienced interruptions in therapeutic supports due to social distancing measures. Job losses and reduced household income were common with limited access to social protection. Respondents reported increased psychological distress and expressed fear of using health services and public amenities due to risk of infection. Children with disabilities found to have difficulties accessing and participating in remote learning activities. |
Indonesia | DPO Network in Indonesia (70 DPOs in total) [21] | 10–24 April 2020 | 1683 | People with disabilities | Online survey, quantitative | Most respondents reported reductions in employment and income. Ineligibility and lack of accessible information caused gaps in social protection coverage. |
Nepal | National Federation of the Disabled Nepal (umbrella body for 331 member organisations throughout the country) [12] | 12–22 April 2020 | 422 people with disabilities, 101 DPO leaders. | People with disabilities, DPO leaders | Telephone interview, quantitative. Purposive sampling possibly used. Sign-language interpretation available for deaf participants. | Gaps in knowledge reported around lockdown measures and how to prevent COVID-19 transmission. People with significant disabilities experienced greater barriers to accessing COVID-19 information. DPO leaders reported limited means of sharing information with people with disabilities. Nearly half of respondents reported limited access to PPE. Psychological distress and need for mental health supports were common during the pandemic. Few government isolation and quarantine facilities deemed to be accessible. |
Nepal | Humanity and Inclusion (INGO) [11] | 5–8 April 2020 | 686 | People with disabilities | Phone interview (incl proxy), quantitative | Gaps in knowledge around how to prevent COVID-19 transmission. Low understanding of COVID-10 protection and safety messages. People with significant disabilities had more difficulties accessing COVID-19 information. Almost a third of respondents had reduced access to usual services and supports. Twenty-seven percent of respondents reported interrupted access to medical and assistive services. Carers of women with disabilities were less likely to follow COVID-19 preventative measures than carers of men with disabilities. Seventy-six percent of respondents’ incomes were negatively affected, with 40 percent losing their income entirely. Four-in-ten reported food insecurity and most were unaware of food relief packages. |
Philippines | Centre for Disease Preparedness (NGO, that works with DPOs) [23] | 28 April to 2 May 2020 | 1313 | Persons with disabilities and without disabilities | Online survey, methods not clear in report | Loss of income led to unfulfilled basic needs, the foregoing of therapies, and an inability to purchase medication and assistive products. Most respondents were unable to access social protection and promised welfare benefits. |
Vietnam | UNDP, with support from DFAT, the Embassy of Ireland in Viet Nam and the Korea International Cooperation Agency (KOICA) [15] | 14–28 April 2020 | 986 | People with disabilities | Online survey, phone and face-to-face methods to maximise participation in rural/remote areas; quantitative | Seventy percent of respondents reported difficulties accessing healthcare. Respondents reported difficulties accessing PPE and expressed concern around being able to protect their own health during the pandemic. Thirty percent of respondents became unemployed and 28% experienced loss of income, with some falling below the poverty line. Gaps in social protection for people with disabilities, particularly those in informal and seasonal employment. Despite increased reliance on food and financial assistance, only 16 percent had received these. |
Global (data disaggregated for Asia and the Pacific) | Stakeholder Group of Persons with Disabilities for Sustainable Development [10] | 1 May to 5 June 2020 | 106 (28 from Asia and Pacific) | People with disabilities | Online interviews and focus group webinars; qualitative. Interviews conducted in six languages, and featured online captioning, and International Sign interpretation. | Rising cost of health services and medicine forced people with chronic health conditions to stop treatment. New triage policies and practices denied individuals access to medical treatment. Disability services in health facilities were deprioritised. In the Asia Pacific region, respondents reported decreases and cancellation of personal assistant services and higher reliance on informal supports. Minimal cases of COVID-19 and access to free testing reported in Pacific Islands countries. Some examples of inclusive health messaging but not in all countries, with limited access to sign language interpreters a major barrier. Many could not access financial supports and welfare benefits, in some cases due to falling outside eligibility criteria. Accessible information, disruptions in transportation, and communication barriers limited respondents’ access to PPE. Respondents reported increased violence from police. Reports of facilities and institutions closing suddenly, leaving some residents without care. |
Global | Seven disability organisations [9] | April–August 2020 | 2152 | People with disabilities; representatives from DPOs; policy makers; | Online survey with print versions available; Available in 25 different languages. Questions focus on policy responses at the national level. Lower participation from Asia and the Pacific | People living in institutions were not receiving adequate medical treatment for COVID-19. People with disabilities rely more on families for support due to limited access to regular services and supports. One third of respondents reported being unable to access food. Limited access to social services and more time spent at home caused increased family and domestic violence. |
Global | Women Enabled International [19] | March and April 2020 | 100 | Women, nonbinary (typically defined as a gender identities that are neither male nor female—outside the gender binary), trans, and gender non-confirming persons with disabilities | Online survey, qualitative. Respondents primarily from North America, little representation from Asia and the Pacific | Restrictions on movement a factor in one-in-three respondents losing access to usual disability supports and services as well as informal support from family and friends. Respondents experienced increased psychological distress and overall reductions in access to health services and assistive technology. Most respondents feared people with disabilities would be deprioritised in the rationing of healthcare. Fifty-seven percent of respondents experienced reductions in employment and income. |
Global | World Bank’s Inclusive Education Initiative (IEI) [24] | 12 March 2020 to 24 May 2020 | 3993 | Parents/caregivers of children with disabilities, teachers of children with disabilities, and persons with disabilities | Online survey, quantitative with open-ended response questions. Survey available in 5 languages. | Children with disabilities identified as particularly vulnerable to food scarcity and reduced access to medicine and disability supports. Humanitarian food distribution in rural areas were inadequate in meeting the needs of children with disabilities. Shift to remote learning disproportionately impacted on students with disabilities due to reliance on digital technologies. |
Global | World Blind Union [14] | Unknown. Published in August 2020 | 853 | People who are blind or partially sighted | Online survey, quantitative and open-ended questions; available in three languages. | New COVID-19 hygiene measures including PPE did not account for needs of blind or partially sighted people. Respondents reported increases in anxiety and depression. Top concerns of respondents during the pandemic were transportation and mobility as well as maintaining independence, autonomy, and dignity. Adults and children with disabilities alike experienced difficulties accessing and participating in remote learning and online work. Social and physical distancing regulations made accessing public amenities and performing community activities of daily living more difficult. |
Global | Save the Children [17] | Unknown. Published September 2020 | 17,565 parents and caregivers, 8069 children | Save the Children programme participants across 37 countries. % with disabilities not reported | Online survey, quantitative and qualitative. Limited reporting of the experiences of children with disabilities. | Children with disabilities had reduced access to healthcare, including medicine, as well as social protection during the pandemic. Report finds specific needs of children with disabilities are not reflected in national policies and practices around poverty reduction, and food and shelter provision. School closures are predicted to exacerbate barriers to learning. |
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Hillgrove, T.; Blyth, J.; Kiefel-Johnson, F.; Pryor, W. A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection. Int. J. Environ. Res. Public Health 2021, 18, 9701. https://doi.org/10.3390/ijerph18189701
Hillgrove T, Blyth J, Kiefel-Johnson F, Pryor W. A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection. International Journal of Environmental Research and Public Health. 2021; 18(18):9701. https://doi.org/10.3390/ijerph18189701
Chicago/Turabian StyleHillgrove, Tessa, Jen Blyth, Felix Kiefel-Johnson, and Wesley Pryor. 2021. "A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection" International Journal of Environmental Research and Public Health 18, no. 18: 9701. https://doi.org/10.3390/ijerph18189701