A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection

Abstract

Introduction: People with disabilities are disproportionately impacted by disasters, including health emergencies, and responses are not always inclusive or accessible. Disability-inclusive response and recovery efforts require rapid, contextually relevant data, but little was known about either the experience of people with disabilities in the first phase of the COVID-19 pandemic, or how rapid needs assessments were conducted. Methods: We reviewed the available results from rapid assessments of impacts of COVID-19 on people with disabilities in low- and middle-income countries in Asia and the Pacific. Rapid assessment methods and questions were examined to describe the current approaches and synthesise results. Results: Seventeen surveys met the inclusion criteria. The findings suggest that people with disabilities experienced less access to health, education, and social services and increased violence. The most rapid assessments were conducted by or with disabled person’s organisations (DPOs). The rapid assessment methods were varied, resulting in heterogeneous data between contexts. Efforts to standardise data collection in disability surveys are not reflected in practice. Conclusions: Persons with disabilities were disproportionately impacted by the ‘first wave’ of the COVID-19 pandemic. Despite complex implementation challenges and methodological limitations, persons with disabilities have led efforts to provide evidence to inform disability-inclusive pandemic responses.

Describing adolescents with disabilities’ experiences of COVID-19 and other humanitarian emergencies in low- and middle-income countries: a scoping review

“…There is potential for clinicians and practitioners to conduct research with adolescents with disabilities enabling their unique experiences to be integrated in policies and programmes. The effects of the pandemic and humanitarian emergencies were different across different contexts, and there is a need to develop the capacity of local organisations to conduct rigorous research which can inform local and international responses [ 2 ].…”

“…For example, people with disabilities routinely experience discrimination. This means that they are often denied equitable access to resources, services and opportunities for personal development, which results in lower levels of education and higher levels of poverty than in people without disabilities [ 4 , 5 ] During humanitarian disasters, rapid assessments have shown that people with disabilities experienced worse access to health, education, and social services, and increased violence in comparison with people without disabilities [ 2 , 3 ]. These inequalities are driven by pre-existing socio-economic and political processes that structure hierarchical power relations and stratify society on the basis of gender, disability, age etc [ 1 ].…”

Promoting equity in health emergencies through health systems strengthening: lessons learned from disability inclusion in the COVID-19 pandemic

“…Third, persons with disabilities may face new or worsening health conditions as lockdowns, physical distancing requirements and prioritization of health services disrupt access to regular health check-ups, medication, assistive devices, psychosocial support, rehabilitation [ 9 , 23 , 24 ], as well as assistant and home support services [ 25 ], which are critical to their independence and autonomy. COVID-19 and the public health measures enacted have also added to the psychosocial stress experienced by persons with disabilities [ 9 , 15 , 23 , 26 – 28 ], and there is a growing body of evidence about how isolation due to physical distancing and movement restrictions has exacerbated the risk of violence against persons with disabilities [ 9 , 23 , 29 ], especially women, girls, transgender and non-binary persons with disabilities [ 30 , 31 ]. Lastly, already more likely to live in poverty [ 32 ], persons with disabilities are facing job losses, reduced household income, and in some countries, food insecurity during the COVID-19 pandemic [ 9 , 24 , 33 ], with some studies demonstrating greater economic impacts compared to those without disabilities [ 9 , 23 , 34 , 35 ] – all of which are determinants of health and well-being.…”

“…COVID-19 and the public health measures enacted have also added to the psychosocial stress experienced by persons with disabilities [ 9 , 15 , 23 , 26 – 28 ], and there is a growing body of evidence about how isolation due to physical distancing and movement restrictions has exacerbated the risk of violence against persons with disabilities [ 9 , 23 , 29 ], especially women, girls, transgender and non-binary persons with disabilities [ 30 , 31 ]. Lastly, already more likely to live in poverty [ 32 ], persons with disabilities are facing job losses, reduced household income, and in some countries, food insecurity during the COVID-19 pandemic [ 9 , 24 , 33 ], with some studies demonstrating greater economic impacts compared to those without disabilities [ 9 , 23 , 34 , 35 ] – all of which are determinants of health and well-being.…”

“…Expanding on the first area relating to data, there is a distinct gap in empirical evidence on the health inequities faced by persons with disabilities in low- to middle-income countries in the COVID-19 pandemic, and a need to strengthen disability data collection and analysis, not only to inform health emergency policies and programs, but also to feed into health systems strengthening efforts. For example, the Coronavirus Disability Survey (COV-DIS) has been used in the USA to assesses the impact of the COVID-19 pandemic on persons with disabilities in domains of general and psychological health, activities of daily living, financial resources, and information and transportation access [ 53 , 54 ], with some authors suggesting that it “could help improve the evidence for ongoing response and recovery during this emergency” [ 9 ]. However, a more inclusive and intersectional approach could be to include disability as one of many variables considered in health emergency data collection, allowing for disaggregated analysis of the risks factors faced by different groups and informing responses accordingly [ 11 ].…”