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Handicap National

Handicap National. December 5, 2011. HIV/AIDS andDisability: Community Based Rehabilitation as a Response. What Disability is.

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Handicap National

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  1. Handicap National December 5, 2011

  2. HIV/AIDS andDisability: Community Based Rehabilitation as a Response

  3. What Disability is • Disability is the umbrella term that refers to difficulties encountered in any or all three areas functioning: impairements, activity limitations, and participation restrictions. Thus, disability experience resulting from the interaction of health conditions, personal factors, and environmental factors varies greatly (WHO, and The World Bank, 2011). • “Disability” is defined as individuals with physical, sensory, intellectual, or mental health impairments that have a significant and long lasting effect on the individual’s daily life and activities (The World Bank/Yale University, 2004:4).

  4. Persons with Disabilities • Persons with disabilities are diverse and heterogeneous as a result. • This diversity encompasses the child born with a congential condition such as cerebral palsy or the youg soldier who loses his leg to a land-mine, or the middle-aged woman with severe arthritis, or the older person with dementia, among many others.

  5. Data of PwDs • Including Children with Disabilities, about 15% of the world population that is over a billion people were estimated to be living with disability (WHO and The World Bank, 2011:29). • Based on the WHO and The World Bank Report (2011), about 15 % of Ethiopian people are estimated to be living with disability.

  6. HIV/AIDS and Disability • PwDs are incorrectly believed to be sexually inactive. Thus, it is commonly considered that PwDs are not at high risk of HIV infection. It is also assumed that they are at less risk of violence or rape than their non-disabled peers. Risk factors for individuals with mental illness have received more attention. A growing literature indicates that individuals with disability are at equal or increased risk of exposure to all known risk factors (The World Bank/Yale University, 2004:3).

  7. Leading Risk Factors • PwDs are at significant risk of becoming HIV infected. All the following risk factors associated with HIV are increased for individuals with disabilities (The World Bank/Yale University, 2004:10). A.Poverty: It is generally recognized that persons with disabilities are the poorest members of the community. The World Bank estimates that individuals with disability may account for as many as one in five of the world’s poorest (The World Bank/Yale University, 2004:11).

  8. Risk Factors B Violence and Rape: Studies reveal that individuals with disability are up to three times more likely to be victims of physical abuse, sexual abuse, and rape. Most individuals with disability have little or no access to police, legal counsel, and courts for protection (The World Bank/Yale University, 2004:10). • Particularly women with disabilities are less likely to marry. If they marry, they are more likely to live in a series of unstable relationship which is full of risk of HIV infection.

  9. Risk Factors C . Lack of Access to education for PwDs • CwDs particularly are considered that they are not capable of learning. Schools are physically inaccessible. As a result, the global literacy rate for all individuals with disability may be as low as 3% and as low as 1% for disabled women.According to UNICEF, one-third of all street children are disabled (The World Bank/Yale University, 2004:10).

  10. Risk Factors D. Lack of information and resources to ensure ‘safer sex’ The general public considers individuals with disability as sexually inactive. • The existing HIV prevention formats are excluding rather. The absence of HIV prevention education materials prepared with Braille, audio materials, and other materials that are tailored to PwDs could also contribute to the risk of HIV infection as PwDs unable to make informed decisions as a result. And they less likely to have access to condoms or other prevention methods(The World Bank/Yale University, 2004:10).

  11. Risk Factors • Stigma • Stigma has been associated repeatedly with AIDS. Stigma has also been repeatedly associated with person disability. Individuals with disability who become HIV positive are doubly stigmatized (The World Bank/Yale University, 2004:12-13).

  12. What CBR is • Community-based Rehabilitation (CBR) is a strategy within community development for the rehabilitation, equalization of opportunities and social integration of all children and adults with disabilities (ILO, UNESCO and WHO , 1994). • Community-based rehabilitation (CBR) is a strategy for rehabilitation, equalization of opportunities, poverty reduction, and social inclusion of people with disabilities. Successful CBR is implemented through the combined efforts of PwDs, their families, organizations, and communities, and the relevant GO and NGO services (WHO, and The World Bank, 2011).

  13. Community-based Rehabilitation(CBR) • Inclusive development is essential for people with disabilities in the mainstream health, education, social, and employment sectors. The Convention on the Rights of Persons with Disabilities, Article 26, calls for “appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability and full inclusion and participation in all aspects of life...”(WHO, and The World Bank, 2011; WHO, 2010).

  14. CBR as a Response to HIV/AIDS • By and large, the more PwDs are Rehabilitated, have equal opportunities with non-disabled, the prevailed poverty is reduced, and socially included, they are likely to make informed discussions which could highly reduce the risk of HIV infection for HIV negative persons with disabilities. And reduce the risk of AIDS of previously HIV positive PwDs.

  15. CBR as a Response to HIV/AIDS • Community-based rehabilitation workers can provide HIV/AIDS Prevention, Care and Support services at community level if they are given necessry trainings in addition to rehabilitation services. CBR workers require a good understanding on: Peer Education and Communication Skill, HIV Counseling and Testing, Palliative Care Service Provision, and Income Generating Activities. Mainly, Sign Language Skill, and Skills of Reading & Writing with Braille.

  16. What CBR can Facilitate: • Develop Rehabilitation Plan and identify their pressing needs in consideration of their HIV status (goal oriented and inconsultation with the PwD); • Facilitate Referral and Provide Follow-up; Provide HIV related information regarding referral services to people with disabilities and their families, including location, possible benefits and potential costs. • Encourage people with disabilities and their families to express concerns and ask questions about referral services related to HIV/AIDS information, ART, CD4 Count, etc.. Help them to seek additional information if required. • Links can be made with other people in the community who experience similar problems and have benefited from the same or similar services.

  17. What CBR can Facilitate: • Link to self-help groups CBR program promote self-help groups where people with similar impairments and/or HIV status and similar rehabilitation needs come together to share information, ideas and experiences. • CBR program can encourage interactions between HIV+ PwDs and rehabilitation workers to enable mutual understanding and collaboration with a view to improve their quality of life.

  18. What CBR can Facilitate: • Develop and Distribute Resource Materials (Locate existing resource materials, Adapt materials , Translate Existing Materials, Distribute resource materials , and Create resource units) • Create Access to Assistive Devices (Mobility devices, Vision Devices, Hearing Devices, Communication Devices, and Cognitive Devices). • Access to Books written with brail and brail to write with.

  19. What CBR can Facilitate: • Mobilizing the community, CBR workers can create awareness to reduce the double burden that the HIV positive person with disabilities bear. • Closely follow up those HIV+ person with disabilities.

  20. Using the existing strategies to protect CwDs from HIV/AIDS • CBR works to reduce the incidence of abuse including sexual abuse on children with disabilities through different awareness raising programs • Incorporate issues related to HIV/AIDS in the rehabilitation counseling • CBR uses the cultural asset of the community like Coffee ceremonies as a forum of discussion on HIV/AIDS and Disability

  21. Using the existing strategies Continued • CBR serves as a bridge for children with disabilities in creating information accessibility on HIV/AIDS and other related diseases • CBR workers can play a significant role in creating children with disabilities friendly environment for discussion

  22. Using the existing strategies Continued • CBR can convince government and private sectors to produce advertisement or awareness raising events on HIV/AIDS that are accessible for person with disabilities in general and children with disabilities in particular • Train Traditional Birth Attendants (TBAs) on safe delivery , HIV/AIDS • Incorporate family planning in disability focused awareness programs

  23. CBR and Government structures • One of the main strategies of CBR is addressing the issue of disability through creating strong bondage with Government offices • CBR closely working with health offices • Capacitate health extension workers to include the issue of disability in the day to day activities

  24. CBR and Government structures continued • CBR closely working in scaling up the vaccination coverage where the program is implementing • CBR always ready to capacitate different government and non governmental organizations on prevention of disability and related issues including HIV/AIDS and Disability

  25. CBR and Government structures continued • Train health professionals in sign language and brail writing and reading • Train teachers on how to support children with special needs including children with disabilities • Organize and support Inclusive clubs in schools to incorporate the issue of disability and HIV/AIDS

  26. CBR with Community Based Organizations (CBOs) • To create the desired change in relation to disability and HIV/AIDS CBOs are one of the main target groups of CBR program • EDIR • Women associations • Youth Association • Elders • Famous people

  27. Rehabilitation as a Reduction of AIDS Particularly, closely follow up those HIV+PwDs would reduce the risk of AIDS. Provide them different services based on their pressing needs. Eyob, 17 years old, HIV + and physically impaired child is exercising on the parallel bar planted in his compound to prevent disability.

  28. Assistive Device for Better Vision

  29. Thank You

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