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

Author

Listed:
  • Jane Wilbur

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
    Contributed equally to this work.)

  • Tess Bright

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
    Contributed equally to this work.)

  • Thérèse Mahon

    (WaterAid, London SE11 5JD, UK)

  • Shaffa Hameed

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK)

  • Belen Torondel

    (Environmental Health Group, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK)

  • Wakisa Mulwafu

    (Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi)

  • Hannah Kuper

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK)

  • Sarah Polack

    (International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK)

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.

Suggested Citation

  • Jane Wilbur & Tess Bright & Thérèse Mahon & Shaffa Hameed & Belen Torondel & Wakisa Mulwafu & Hannah Kuper & Sarah Polack, 2018. "Developing Behaviour Change Interventions for Improving Access to Health and Hygiene for People with Disabilities: Two Case Studies from Nepal and Malawi," IJERPH, MDPI, vol. 15(12), pages 1-21, December.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:12:p:2746-:d:188062
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    References listed on IDEAS

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    1. Valentina Iemmi & Karl Blanchet & Lorna J. Gibson & K. Suresh Kumar & Santosh Rath & Sally Hartley & Gudlavalleti V. S. Murthy & Vikram Patel & Joerg Weber & Hannah Kuper, 2016. "Community-based rehabilitation for people with physical and mental disabilities in low- and middle-income countries: a systematic review and meta-analysis," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 8(3), pages 368-387, July.
    2. Laura Asher & Abebaw Fekadu & Charlotte Hanlon & Gemechu Mideksa & Julian Eaton & Vikram Patel & Mary J De Silva, 2015. "Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    3. Arne H Eide & Hasheem Mannan & Mustafa Khogali & Gert van Rooy & Leslie Swartz & Alister Munthali & Karl-Gerhard Hem & Malcolm MacLachlan & Karin Dyrstad, 2015. "Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    4. Lena Morgon Banks & Hannah Kuper & Sarah Polack, 2017. "Poverty and disability in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-19, December.
    5. Tess Bright & Sarah Wallace & Hannah Kuper, 2018. "A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries," IJERPH, MDPI, vol. 15(10), pages 1-34, October.
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    Cited by:

    1. Jane Wilbur & Thérèse Mahon & Belen Torondel & Shaffa Hameed & Hannah Kuper, 2019. "Feasibility Study of a Menstrual Hygiene Management Intervention for People with Intellectual Impairments and Their Carers in Nepal," IJERPH, MDPI, vol. 16(19), pages 1-14, October.
    2. Antonia Baum & Wakisa Mulwafu & Mwanaisha Phiri & Sarah Polack & Tess Bright, 2019. "An Intervention to Improve Uptake of Referrals for Children with Ear Disease or Hearing Loss in Thyolo District, Malawi: Acceptability and Feasibility," IJERPH, MDPI, vol. 16(17), pages 1-16, August.
    3. Yaroslava Robles-Bykbaev & Christian Oyola-Flores & Vladimir Espartaco Robles-Bykbaev & Martín López-Nores & Paola Ingavélez-Guerra & José Juan Pazos-Arias & Fernando Pesántez-Avilés & Manuel Ramos-Ca, 2019. "A Bespoke Social Network for Deaf Women in Ecuador to Access Information on Sexual and Reproductive Health," IJERPH, MDPI, vol. 16(20), pages 1-17, October.
    4. Maria Zuurmond & Islay Mactaggart & Nanda Kannuri & Gudlavalleti Murthy & Joseph Enyegue Oye & Sarah Polack, 2019. "Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India," IJERPH, MDPI, vol. 16(7), pages 1-14, March.

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