FOCUS ON – Addressing transport safety and accessibility for persons with disabilities | November 27, 2018
The intersection between health, disability and transport has significant challenges for persons with disabilities living in low- and middle-income countries, where road infrastructure is poor and travel unsafe. The Journey Access Tool (JAT) combines access and road safety audit approaches to identify barriers to transport on journeys taken by persons with disabilities. The Journey Access […]
The intersection between health, disability and transport has significant challenges for persons with disabilities living in low- and middle-income countries, where road infrastructure is poor and travel unsafe. The Journey Access Tool (JAT) combines access and road safety audit approaches to identify barriers to transport on journeys taken by persons with disabilities.
The Journey Access Tool
The priorities for development in low and middle income countries are set out in the Sustainable Development Goals (SDGs). There are several cross-cutting issues that are relevant across a number of the SDGs, and they emphasise the need to ensure access to health, education, employment and other services. A basic element of access is the availability of safe and accessible transport from home to health providers, schools, workplaces, shops and family members. The association between disability and poverty means that such accessibility cannot be achieved through door-to-door vehicle transportation by specialised vehicles, but must involve travelling on roads and paths, crossing roads that are sometimes heavily trafficked, and using the cheapest forms of public transport.
However, a common characteristic of low- and middle-income countries is inadequate provision of footpaths, and the poor condition and accessibility of the paths that exist, through poor maintenance, misuse, blockages and discontinuity. Heavily trafficked roads can be difficult to cross because motorists do not comply with traffic laws at marked crossings and a lack of crossing points. In addition to these identifiable problems, there is also a challenge in providing solutions that meet the widely varying needs of persons with disabilities, which are best understood by people with disability themselves.
A team at Queensland University of Technology (QUT), Australia developed a conceptual approach to addressing these issues in a manageable way that also incorporates direct engagement and feedback from persons with disabilities. The approach combines:
– access audits (such as those used in and around buildings and transport stops)
– and methods drawn from the road safety audit process (used extensively to assess the safety of road sections and intersections and to prioritise solutions).
The result was the Journey Access Tool (JAT), an illustrated checklist which is designed to be used for a personal ‘journey’ regularly taken by a person with a disability when they utilise services such as a hospital/clinic, employment or education, or seek general community access.
Formative evaluation of the JAT
The design of the JAT involved collaboration with Humanity & Inclusion and persons with disabilities in Cambodia, because it was intended to pilot the JAT in Cambodia in collaboration with HI. A formative evaluation was planned, based on the assumption that the JAT should fit the expectations of persons with disabilities (be acceptable) and be feasible for use in different settings (adoptable). The evaluation process was undertaken in Phnom Penh, Cambodia using an iterative process. The process involved initial consultation and three pilots undertaken with people from QUT, HI and people with disability. Participants were persons with disabilities, who were accompanied by assistants on a journey with a public transport component plus use of paths and roads between the public transport stops and destination. The checklists were used during the journey, photographs were taken, and focus groups involving the participants with disability and their assistants were held after each pilot. The results were integrated into JAT revisions. Rapid start of action, pronounced activity, high selectivity and lack of interaction with low-fat food— these are the best characteristics of Levitra. Probably that’s why most patients prefer Levitra over Sildenafil. Data from the new comparative study show a greater satisfaction with treatment results. Find out more advantages of Levitra at http://buylevitra.net/levitra-prescribed-online/.
Issues of terminology (such as terms for features of the built environment) were resolved early, as were process issues related to the length of time taken to complete the JAT. Interpersonal issues were more difficult to address, with assistants tending to exceed their role by being too helpful, recording their own comments rather than those of the people with disability. Use of the tool provided rich information on barriers to access that can form a basis for prioritisation and discussion with the local authorities responsible for paths, roads, public transport and traffic.
The JAT proved to be both acceptable and adoptable for persons with disabilities and other stakeholders, and the experience gained will facilitate adaptation of the tool to new settings including rural areas and other low and middle income countries. The tool has significant potential to shape and support advocacy for change and engagement with transport services and also health, education, employment and other services. It can be used as an advocacy tool for persons with disabilities, DPOs/NGOs and other stakeholder working with persons with disabilities.
King, Julie A., King, Mark J., Edwards, Niki, Hair, Sara A., Cheang, Sarim, Pearson, Anita, et al. (2018) Addressing transport safety and accessibility for people with a disability in developing countries: A formative evaluation of the Journey Access Tool in Cambodia. Global Health Action, 11(1), Article number: 1538658.