What are the key considerations for including people with disabilities in COVID-19 hygiene promotion programmes?
People with disabilities may be more likely to acquire COVID-19, and if infected may be more likely to experience serious symptoms, or die. Aside from those consequences of the pandemic related to morbidity and mortality, people with disabilities are often reliant on carers to aid with common daily tasks, and so social distancing measures may be unfeasible. Furthermore, safe water, sanitation and hygiene (WASH) services and facilities may be inaccessible to people with disabilities, and, in many settings, efforts to deliver services in a socially-distanced world have resulted in the roll out of digital or remote healthcare approaches which are sometimes not accessible or inclusive. One of the key interventions in response to the COVID-19 pandemic has been international attention, and improved funding, programming and media messaging in support of WASH. People with disabilities – who are most at risk of negative consequences of COVID-19 – most need access to such interventions. Yet, WASH access is considered to be one of the biggest challenges of daily life for many people with disabilities.
- Programme designers should conduct a rapid review of WASH-related challenges
- Disability-inclusion is a key consideration when designing COVID-19 WASH programmes
- People with all types of disabilities must be engaged at all stages of COVID-19 programming
- Assistance needs to be provided to people with disabilities and carers
- All WASH facilities and services need to be designed with accessibility and inclusion in mind
- Apply a gender lens to disability inclusive WASH COVID-19 responses
- Train WASH practitioners and healthcare workers on disability inclusive WASH
- Learn from and document experiences to inform disability inclusive programming and policies
What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?
Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the Covid-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during Covid-19 and other recent pandemics, informing policy and practice during this crisis.
- A multi-sectoral approach is needed to address mental health issues
- Service provision needs to be sustainable and feasible
- Interventions must be adapted to meet the constantly changing demands of a novel health crisis
- Need for rigorous research on appropriate and effective service provision
- Strong communication campaigns are essential to support wellbeing and reduce disinformation
How can social protection responses to COVID-19 be made disability inclusive?
The COVID-19 pandemic and strategies essential for its containment are resulting in severe strains on economies, particularly in low- and middle-income countries (LMICs). These impacts will be felt most by groups already in or at risk of poverty, including the estimated 1 billion people with disabilities globally. Interventions to address the short- and long-term economic effects of the pandemic are urgently needed. Some countries have begun implementing or announced plans for interventions addressing the economic impacts of COVID-19, such as food assistance, emergency cash transfers, unemployment assistance or expansions to existing social protection programmes. As these programmes are developed, it is important to consider the extent to which their design and delivery is inclusive of people with disabilities. Failure to adequately include people with disabilities in this process will lead to widening inequalities.
- Livelihood & Social Protection
- Eligibility criteria should be reviewed to avoid the widespread exclusion of people with disabilities in need of support during COVID-19.
- Application procedures and facilities for social protection and relief interventions must be accessible to people with all types of disabilities.
- Mechanisms for delivering social protection and other must be accessible and support the agency of people with disabilities
- The content of COVID-19 economic responses must be relevant to people with disabilities and adequate to meet their needs.
- Social protection should be coordinated with other sectors and actors to develop complementary interventions
How can we measure disability in research related to the COVID-19 response?
There is growing evidence that COVID-19 is disproportionally impacting the lives of people with disabilities. This includes evidence of the increased risk of severe outcomes of contracting COVID-19 amongst people with existing health conditions, including many people with disabilities. It also includes a wide range of other potential impacts such as: reductions or disruptions in non-COVID-19 health or rehabilitation services, the effects of shielding on isolation and mental health, the implications of social distancing on people who require carer support, and the impact on poverty, participation and wellbeing due to disrupted disability-inclusive development programmes.
Measurement of disability in research has historically been contested and a number of different tools exist. Clear guidance is needed on how to determine which tool to use to understand the situation of people with disabilities in different settings, and plan responsive and inclusive COVID-19 programmes and policies to support their needs. Good quality, comparable data on disability is essential for tracking the impact of the COVID-19 pandemic, as well as prevention and mitigation interventions, amongst people with disabilities. Such evidence is also imperative for tracking progress towards the Sustainable Development Goals, and UNCRPD compliance.
- Use the Washington Group Enhanced Short Set (WGES), supplemented by other tools as relevant
- Dedicate sufficient resources to translation and training
- Follow guidance to analyse, disaggregate, interpret and present data
- Where insufficient resources exist to embed the WGES, consider alternatives but invest in pilot testing first
- Include assessment of impairments or health conditions depending on the research question and resource availability
- Invest in further research to strengthen identification tools for people with disabilities
How can the health of people with disabilities in humanitarian camps be supported during the COVID-19 pandemic?
More than 10% of the world’s 35 million displaced people are people with disabilities. People with disabilities and their families are at significant risk of discrimination, stigma, violence, and marginalisation, and get little access to adequate services in humanitarian camps. Disabled people are frequently sidelined during health sector planning in humanitarian camps, and healthcare access is a particular challenge. The COVID-19 pandemic, and measures necessary for its containment, pose a particular threat and challenge in humanitarian settings. Containment measures such as mass ‘stay-at-home' orders, social distancing, self-isolation and quarantine are often unsuitable for, or difficult to implement in, camp settings. People in humanitarian camps, then, need special consideration within the COVID-19 response. However, among people in humanitarian camps, people with disabilities are particularly vulnerable to being left behind or overlooked in COVID-19 planning and programming. Their double vulnerability as refugees and disabled people warrants special consideration.
- Learn from prior research on barriers faced by people with disabilities in humanitarian camps, to inform an inclusive COVID-19 response
- Ensure the continuity of basic and specialised services for people with disabilities in camps.
- Women and children with disabilities need specific consideration during the COVID-19 response in camps.
- Mainstream recommendations for the containment of COVID-19 in camps need to be adapted to be disability inclusive.
- A targeted approach “targeted shielding”, could ensure that people with disabilities are specifically catered for in containment measures.
The World Bank. COVID-19 Makes Handwashing Facilities and Promotion More Critical Than Ever (2020)
Water for Women & CBM Australia. Disability inclusion and COVID-19: Guidance for WASH delivery Guidance for Water for Women Fund implementing partners (2020)