Hannah Kuper

Hannah Kuper
London School of Hygiene and Tropical Medicine | LSHTM · International Centre for Evidence in Disability

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453
Publications
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Introduction
Skills and Expertise

Publications

Publications (453)
Article
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It is well established that access to preventative care, such as breast or cervical cancer screening, can reduce morbidity and mortality. Certain groups may be missed out of these healthcare services, such as women with disabilities, as they face many access barriers due to underlying inequalities and negative attitudes. However, the data have not...
Article
Background : This study explores the acceptability and feasibility of the use of two different Participatory Visual Methods (Participatory Video and Digital Storytelling) in gathering information on the experiences and perspectives of carers of children with Congenital Zika Syndrome within Colombia. Methods : Participatory Video was used to assess...
Article
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Background:People with disabilities—more than a billion people worldwide—arefrequently excluded from livelihood opportunities, including employment, socialprotection, and access to finance. Interventions are therefore needed to improvelivelihood outcomes for people with disabilities, such as improving access to financialcapital (e.g., social protec...
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Background The aim of this paper is to estimate the economic burden of children with congenital Zika Syndrome (CZS) in Brazil over 5–10 years. Methods We conducted a modelling study based on data collected in a case–control study in Brazil, including children with CZS (cases) and typically developing children (controls), born in 2015 and 2016. In...
Article
The purpose of this article is to analyse the circumstances in which the National Health Policy for Persons with Disabilities (PNSPCD) came into place in 2002, and factors supporting or impeding its implementation from 2002 to 2018. The analysis was based on the Comprehensive Policy Analysis Model proposed by Walt and Gilson, and focussed on unders...
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Background: On average, people with disabilities have greater healthcare needs, yet face a range of barriers in accessing care. Objectives: Our objectives were to explore the experiences of people with disabilities in accessing care and identify opportunities for the health system to be designed for inclusion in Zimbabwe. Methods: In-depth qualit...
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Background: People with disabilities are at higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes. Additionally, measures to mitigate COVID-19 transmission have impacted health service provision and access, which may particularly disadvantage people with disabilities. Objectives: To explore the perspectives and experiences of people...
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Disability-targeted cash transfers are increasingly used by governments in low- and middle-income countries as a tool to address poverty and exclusion among people with disabilities. However, in many settings, accurate estimates of coverage and an understanding of factors affecting uptake are needed for effective delivery. This study explores cover...
Preprint
Introduction Dementia is an important and growing issue in sub-Saharan Africa, but epidemiological data are lacking. Risk factors may differ from other regions due to high stroke incidence and HIV prevalence. Understanding the epidemiology of cognition in older adults in Africa is crucial for informing public health strategies to improve the lives...
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Abstract: This study analyses the use of the self-reported Washington Group (WG) question sets as a first stage screening to identify people with clinical impairments, service and assistive product (AP) referral needs using different cut-off levels in four functional domains (vision, hearing, mobility and cognition). Secondary data analysis was und...
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Provision of inclusive services and reaching marginalised groups are crucial to achieving the UNAIDS 95-95-95 targets by 2030. However, people with disabilities are often left behind. This gap in HIV care provision is important because more than 1 billion people worldwide have disabilities, including a quarter of people living with HIV. The associa...
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This article uses a socio-anthropological framework to explore the stigmas around interactions with children born with congenital Zika syndrome caused by the Zika virus epidemic in two Brazilian municipalities. Semi-structured interviews were conducted with parents and other relatives. We reflected on the search for meaning when having a baby with...
Article
Background : This study explores the acceptability and feasibility of the use of two different Participatory Visual Methods (Participatory Video and Digital Storytelling) in gathering information on the experiences and perspectives of carers of children with Congenital Zika Syndrome within Colombia. Methods : Participatory Video was used to assess...
Preprint
Introduction: There is little evidence on the impact of livelihood interventions amongst people with disabilities. Effective programmes are critical for reducing the heightened risk of poverty and unemployment facing persons with disabilities. STAR + is a skills development and job placement programme targeted to out-of-school youth with disabiliti...
Article
Background: The 2015-16 Zika epidemic resulted in thousands of children born with congenital Zika syndrome (CZS). In Brazil, gaps in the health system often caused parents to be left with insufficient information and support. Consequently, we developed and piloted Juntos - a participatory support programme which aims to improve knowledge, capacitie...
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The Brazilian government launched the National Health Policy for People with Disabilities (PNSPD) in 2002 to address this inequality. PNSPD has six areas of focus: quality of life, impairment prevention, comprehensive health care, organization and functioning of health services, information mechanisms, and training of human resources. The aim of th...
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The likelihood of a newborn child dying before their fifth birthday (under-5 mortality rate) is universally acknowledged as a reflection of the social, economic, health, and environmental conditions in which children (and the rest of society) live, but little is known about the likelihood of a newborn child having a lifelong disability before their...
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Background The majority of children with sensory impairments live in low- and middle-income countries. More studies of hearing and vision impairment prevalence are needed, in order to generate more accurate estimates of trends in sensory impairments. This study aimed to estimate the prevalence and describe the characteristics of hearing and vision...
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Limited evidence on the design and implementation of social protection programmes for people with disabilities in low‐ and middle‐income countries constrains understanding of how their impacts could be improved. The Disability Allowance programme in the Maldives is a non means‐tested, monthly cash transfer targeting people with disabilities. Using...
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Introduction: Mobile health (m-health) has the potential to improve access and uptake of health services globally. Noncommunicable diseases such as hearing loss have seen increasing use of m-health approaches to improve access, scalability, penetration, quality, and convenience of health services. This scoping review describes published research in...
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Background Musculoskeletal impairment (MSI) in children is an under-recognised public health challenge. Although preventable, road injuries and other traumas continue to cause significant impairments to children worldwide. The study aimed to use the Key Informant Method (KIM) to assess prevalence and causes of MSI in children in two districts in Ma...
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The objectives of this review are to answer the following research questions: (1) What is the nature of the interventions used to support education for people with disabilities? (2) What is the size and quality of the evidence base of the effectiveness of interventions to improve educational outcomes for people with disabilities in low- and middle-...
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To meet the Sustainable Development Goals target of ending poverty “in all its forms”, it is critical to monitor progress towards poverty alleviation, including amongst people with disabilities. This research used data from a population-based nested case control studies (n=667) and compares monetary and multidimensional poverty levels amongst peopl...
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Background People with learning disabilities are at substantially increased risk of COVID-19 mortality, but evidence on risks of COVID-19 mortality for disabled people more generally is limited. We aimed to use population-level data to estimate the association between self-reported disability and death involving COVID-19 during the first two waves...
Article
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The objectives of this review are to answer the following research questions: (1) What is the effect size of the effectiveness of interventions to improve livelihood outcomes for people with disabilities in low‐ and middle‐income countries (LMICs), and what is the quality of the evidence base? (2) What works to improve livelihood outcomes for peopl...
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The objectives of this review are to: (1) examine the effectiveness of interventions for improving social inclusion outcomes for people with disabilities (physical, visual, hearing, intellectual or mental health conditions) in low‐ and middle‐income countries (LMICs); and (2) to critically appraise the confidence in study finding of the included st...
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The Washington Group (WG) tools capture self-reported functional limitations, ranging from 6 domains in the Short Set (SS) to 11 in the Extended Set (ESF). Prevalence estimates can vary considerably on account of differences between modules and the different applications of them. We compare prevalence estimates by WG module, threshold, application...
Article
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve und...
Article
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This paper describes the components of the Bishesta campaign: a behaviour change intervention for menstrual hygiene management (MHM), targeting young people with intellectual impairments, and their carers in Nepal. The campaign uses two fictitious characters: Bishesta (a young person with an intellectual impairment) and Perana (her carer), and cons...
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Purpose This study assesses the inclusion of disability in Nepal’s policy and guidance relevant to water, sanitation and hygiene (WASH), and menstrual hygiene management (MHM) in comparison to gender. We investigated both policy formulation and implementation, using the Kavrepalanchok district as a case study. Materials and methods We used the Equ...
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This analysis of surveys from six low- and middle-income countries (LMICs) aimed to (i) estimate the prevalence of disability among older adults and (ii) compare experiences and participation in key life areas among older people with and without disabilities which may show vulnerability during the COVID-19 pandemic. Data were analysed from district...
Article
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Background: The Zika epidemic highlighted gaps in health and social care services for parents of children with developmental disabilities. We aimed to evaluate the feasibility of a 10-week support group, ‘Juntos’, as a community-based intervention for parents of children with congenital Zika syndrome (CZS) in Colombia. Methods: Two facilitators del...
Preprint
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Objectives: To assess the association between self-reported disability and deaths involving COVID-19 among adults in England. Design: Cohort study of >29 million adults using data from the Office for National Statistics Public Health Data Asset. Setting: People living in private households or communal establishments (including care homes) in Englan...
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Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Hea...
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Purpose This study aimed to describe and compare the performance of two screening protocols used for preschool hearing screening in resource-constrained settings. Method Secondary data analysis was done to determine the performance of two protocols implemented during a preschool hearing screening program using mobile health technology in South Afr...
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Objective Examine how disability status among adolescents is associated with the following domains of personal well-being: schooling, livelihoods, health, violence and psychosocial well-being. It is hypothesised that adolescents with a disability will have greater deficits in these areas of well-being compared with their healthier counterparts. De...
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Background Epidemiological data on musculoskeletal impairment (MSI) and related service and assistive product (AP) needs for displaced populations are lacking. This study aimed to estimate the prevalence, aetiology, and specific MSI diagnosis and the need for related services and APs among Syrian refugees living in Sultanbeyli, a district in Istanb...
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Background : Children with congenital Zika syndrome (CZS) have a wide range of additional healthcare needs. This study aimed to estimate the direct costs of CZS from the health provider and family perspectives, and the indirect costs for families, in two Brazilian states: Rio de Janeiro and Pernambuco. Methods: A case-control study was undertaken b...
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Globally, people with disabilities are disproportionally affected by poverty. Social protection policies, including cash transfers, are key strategies to address poverty “in all its forms”, but it is currently unclear how such programmes affect people with disabilities. This study examines differences in the impact of the Lesotho Child Grant Progra...
Article
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Background Menstrual hygiene management (MHM) is a recognised public health, social and educational issue, which must be achieved to allow the realisation of human rights. People with disabilities are likely to experience layers of discrimination when they are menstruating, but little evidence exists. Methods The study aims to investigate barriers...
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Abstract Objective The COVID-19 pandemic has placed health care workers under psychological stress. Previous reviews show a high prevalence of mental disorders among health care workers, but these need updating and inclusion of studies written in Chinese. The aim of this systematic review and meta-analysis was to provide updated prevalence estimate...
Article
Importance More than 1 billion people worldwide have vision impairment or blindness from potentially preventable or correctable causes. Quality of life, an important measure of physical, emotional, and social well-being, appears to be negatively associated with vision impairment, and increasingly, ophthalmic interventions are being assessed for the...
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If Sustainable Developmental Goal 3 and Universal Health Coverage are to be achieved, functioning is a third health indicator which must be assessed and integrated into global health population-based metrics alongside mortality and morbidity. In this paper, we define functioning according to the International Classification of Functioning, Disabili...
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Em 2015, houve um aumento de casos de más-formações congênitas entre recém-nascidos no Brasil associado ao vírus Zika, com repercussões sociais e econômicas para as famílias. O objetivo deste estudo foi estimar a prevalência de gasto catastrófico para famílias de crianças com síndrome congênita do vírus Zika (SCZ) grave, leve/moderada em comparação...
Article
Background: The 2015-2016 Zika virus outbreak in Brazil was unprecedented and resulted in the birth of more than 3,000 children with congenital Zika syndrome (CZS). These children experience multiple complex health conditions and have limited services to support them and their family's needs. Program development and piloting: An existing family...
Article
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve und...
Article
Full-text available
The congenital Zika syndrome (CZS) epidemic in Brazil turned the spotlight on many other factors beyond illness, such as poverty, gender, and inequalities in health care. Women were the emblematic subjects in this study, not only because Zika virus is a vertical transmission disease, but also because women—in Brazil and elsewhere—typically represen...
Article
OBJECTIVES: To estimate population need and coverage for distance glasses, hearing aids and wheelchairs in India and Cameroon, and to explore the relationship between assistive product (AP) need measured through self-report and clinical impairment assessment. METHODS: Population-based surveys of approximately 4000 people each were conducted in Mah...
Article
Background: Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve und...
Article
Full-text available
Disability-inclusive development is important because there are a billion people with disabilities, and they often fall behind in income, education, health, and wellbeing. More and better evidence is needed on the effectiveness of how development interventions include and target people with disabilities. This review outlines some of the methodologi...
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Methods: Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eligible studies were identified. Results: Findings suggest that the people with disabilities' choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types...
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Background The Zika virus outbreak in Brazil (2015–2016) affected thousands of children who were born with Congenital Zika Syndrome (CZS). Families play an important role in their care of children with complex needs, yet their knowledge, experience and skills are rarely harnessed in existing interventions to best support these families. Objective...
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In the last two decades, the global community has made significant progress in saving the lives of children <5 y of age. However, these advances are failing to help all children to thrive, especially children with disabilities. Most early child development research has focussed on the impact of biological and psychosocial factors on the developing...
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Objectives We investigated whether self-reported disability was associated with mortality in adults in rural Malawi. Setting Karonga Health and Demographic Surveillance Site (HDSS), Northern Malawi. Participants All adults aged 18 and over residing in the HDSS were eligible to participate. During annual censuses in 2014 and 2015, participants wer...
Article
The one billion people living with disabilities globally already face a heightened risk of poverty, which will likely be exacerbated by the COVID-19 pandemic unless interventions to address its economic impacts are disability-inclusive. This paper draws on the literature on disability, poverty and social protection in low- and middle-income countri...
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Introduction Vision impairment and eye disease are major global health concerns and have been associated with increased morbidity and mortality, and lower quality of life. Quality of life, whether generic, vision-specific or disease-specific, is an important measure of the impact of eye health on people’s daily activities, well-being and visual fun...
Article
Objective To systematically review the evidence for effectiveness of rehabilitation interventions in people who are visually impaired, living in low- and middle-income countries. Methods Fifteen databases and the grey literature were searched up until February 2020; papers were identified according to eligibility criteria, and assessed for risk of...