Nossal Institute for Global Health and Australia-India Institute, University of Melbourne, Level 5, 333 Exhibition Street, Melbourne, 3000, Australia.
Australia India Institute, University of Melbourne, 147-149 Barry Street, Carlton, VIC, 3053, Australia.
BMC Public Health. 2020 Jan 31;20(1):145. doi: 10.1186/s12889-020-8192-0.
Disabled People's Organisations (DPOs) are the mainstay of disability responses worldwide. Yet there is no quantitative data assessing their effectiveness in low-and middle-income countries (LMICs). The aim of this study was to measure the effectiveness of DPOs as a low-cost intervention to improve well-being and access to services and facilities for people with disabilities.
We undertook a cluster randomised intervention control trial across 39 distinct rural villages in Uttarakhand State, North India. A total of 527 participants were included from 39 villages: 302 people from 20 villages were assigned to the intervention arm and 225 from 19 villages were assigned to the control group. Over a 2-year period, people with disabilities were facilitated to form DPOs with regular home visits. Participants were also given financial support for public events and exposure visits to other DPOs. Seven domains were used to measure access and participation.
DPO formation had improved participation in community consultations (OR 2.57, 95% CI 1.4 to 4.72), social activities (OR 2.46, 95% CI 1.38 to 4.38), DPOs (OR 14.78, 95% CI 1.43 to 152.43), access to toilet facilities (OR 3.89, 95% CI 1.31 to 11.57), rehabilitation (OR 6.83, 95% CI 2.4 to 19.42) and Government social welfare services (OR 4.82, 95% CI 2.35 to 9.91) in intervention when compared to the control. People who were part of a DPO had an improvement in having their opinion heard (OR 1.94, 95% CI 1.16 to 3.24) and being able to make friends (OR 1.63, 95% CI 1 to 2.65) compared to those who were not part of a DPO. All other well-being variables had little evidence despite greater improvement in the DPO intervention group.
This is the first randomised control trial to demonstrate that DPOs in LMICs are effective at improving participation, access and well-being. This study supports the ongoing role of DPOs in activities related to disability inclusion and disability services. This study also suggests that supporting the establishment, facilitation and strengthening of DPOs is a cost-effective intervention and role that non-governmental organisations (NGOs) can play.
ISRCTN36867362, 9th Oct 2019 (retrospectively registered).
残疾人组织（DPO）是全球残疾应对的主要力量。然而，在中低收入国家（LMIC），没有评估其有效性的定量数据。本研究旨在衡量 DPO 作为一种低成本干预措施的有效性，以改善残疾人的幸福感以及获得服务和设施的机会。
我们在印度北部北阿坎德邦的 39 个不同的农村村庄进行了一项集群随机干预对照试验。共有 527 名参与者来自 39 个村庄：20 个村庄的 302 人被分配到干预组，19 个村庄的 225 人被分配到对照组。在两年的时间里，残疾人通过定期家访被协助成立 DPO。参与者还获得了公共活动的资金支持和对其他 DPO 的参观机会。使用七个领域来衡量准入和参与情况。
DPO 的成立改善了社区咨询（OR 2.57，95%CI 1.4 至 4.72）、社会活动（OR 2.46，95%CI 1.38 至 4.38）、DPO （OR 14.78，95%CI 1.43 至 152.43）、获得厕所设施（OR 3.89，95%CI 1.31 至 11.57）、康复（OR 6.83，95%CI 2.4 至 19.42）和政府社会福利服务（OR 4.82，95%CI 2.35 至 9.91）方面的参与，与对照组相比。与未加入 DPO 的人相比，加入 DPO 的人发表意见（OR 1.94，95%CI 1.16 至 3.24）和交朋友（OR 1.63，95%CI 1 至 2.65）的机会有所增加。尽管 DPO 干预组的情况有所改善，但所有其他幸福感变量都几乎没有证据。
这是第一项随机对照试验，证明了中低收入国家的 DPO 能够有效提高参与度、准入机会和幸福感。这项研究支持 DPO 在残疾包容和残疾服务相关活动中的持续作用。这项研究还表明，支持 DPO 的建立、促进和加强是一种具有成本效益的干预措施，非政府组织（NGO）可以发挥作用。
ISRCTN36867362，2019 年 10 月 9 日（追溯注册）。
