The first phase of the Disability KaR programme (KaR 1), funded by the UK's department for International Development (DFID), was launched in 2000 and lasted for two years. Its main focus was on healthcare technology.

An evaluation report commissioned in 2002, recommended that a second phase should focus more on disability as a human rights issue in development.

Although a number of healthcare technology projects continued to be supported, the main emphasis of the second phase of the Disability KaR Programme, managed by the Overseas Development Group at the University of East Anglia (UEA) and Healthlink Worldwide, shifted to issues of disability, poverty and development. With this change came the more direct involvement of disabled people's organisations in both the UK and the South.

Below is more information on the activities of the first KaR programme.

To read more about the current Disability KaR programme see the Programme overview section.

Main activities KaR 1 September 2000 - 2003
The main activities of KaR1 involved administering an open competition for project proposals linking UK institutions to parallel institutions in developing countries.
A total of 18 projects were identified that either:

• developed a new technology;
• adopted a newly-developed technology; or
• contributed to the wider use of a successful technology.

The project eligibility was decided by a Programme Advisory Group. This group consisted of: specialists in disability and healthcare technology, representatives from DFID and the World Health Organization (WHO), and managers from Healthlink Worldwide and GIC Ltd.

Studies and conclusions
As well as programme newsletters, KaR1 produced a learning publication that pulled together the lessons learned from this phase. The programme also commissioned a significant study from the Overseas Development Group at the University of East Anglia (UEA). This study, entitled Perspectives on Disability, Poverty and Technology

• considered the interaction between disability, poverty and technology, with a particular focus on providing recommendations for the second phase of the program; and
• commented on the wider issues of disability and development as addressed in and by DFID.

Among the conclusions of this study were that the programme should:

• focus on all aspects of disability, not just technology; and
  
• establish a balance between projects selected through competition and commissioned work.

The lessons learned from of the 17 projects are available in PDF format at the end of this page.

Full details of the original projects from the first phase of the programme can be found on the website; www.kar-dht.org

Lessons Learned
Below is a summary of the lessons learned from each KaR1 project and a paper on the round-table discussion. They are available in PDF format.

KaR1 disability projects 2000-2003

1. Research into the extent and impact of uncorrected vision (D1) Ghana and India (PDF 34 KB)
Adaptive Eyecare Ltd, UK
This project was a first phase of research into the extent and consequence of uncorrected vision in developing countries. The research led to further studies to persuade policy makers that investing in vision correction pays significant social, educational and economic dividends.

2. An appropriate, low-cost mechanical Braille writer (D2) Cambodia (PDF 34 KB)
Development Technology Workshop, UK
Project to improve a low-cost mechanical Braille writer, to enhance access to communication thereby, reducing the detrimental effects of blindness and visual impairment on poor people.

3. Promoting good practice on disability internationally (D3) Worldwide (PDF 39 KB)
Healthlink Worldwide, UK
There is a real need for practical initiatives that improve disabled people’s lives. This project documented learning from published and unpublished disability literature to make it available to those working on disability issues in developing countriies.

4. Field-testing the Access Portfolio (D4) Sri Lanka and Uganda (PDF 43 KB)
Institute of Child Health, UK
Project to improve early identification of impairments in children, with the aim of enabling children with moderate or mild disabilities to participate more in their communities.

5. Evaluating the impact of a community-based rehabilitation intervention (D5) Kilifi district, Kenya (PDF 40 KB)
Institute of Child Health, UK and Kenya Medical Research Institute, Kenya
Specialist services for children with communication problems in low-income rural areas like Kilifi are almost non-existent. This project aimed to increase knowledge about appropriate interventions in order to evaluate strategies to help this vulnerable group.

6. Prefabrication of knee-ankle-foot orthoses (D6) India (PDF 60 KB)
Jaipur Limb Campaign, UK and Mobility India, India
The design of metal callipers has not changed in over 100 years. Plastic knee-ankle-foot orthoses (KAFOs) are a lightweight, user-friendly alternative, and this project designed a system for their rapid, easy, low-cost mass production.

7. WorldMade wheelchairs (D7) 20 countries worldwide (PDF 108 KB)
Motivation Charitable Trust, UK
There is a huge demand for appropriate, low-cost wheelchairs and associated services in developing countries. This project saw industrial designers developing a simple chair design and looking at the potential for financing, with the long-term objective of creating a global wheelchair distribution network.

8. Wheelchair Technologists' Training Course (D8) Moshi, Tanzania (PDF 55 KB)
Motivation Charitable Trust, UK
Wheelchair technologists are trained to build up African capacity to design, produce and maintain wheelchairs locally.

9. Capacity building in community-based rehabilitation (D9) Kenya (PDF 41 KB)
VSO, UK
The prevalence and impact of negative attitudes towards disabled children can prevent them from participating fully in society. Building on previous work, this project introduced a CBR approach into 10 districts in Kenya, to help parents, families and communities increase understanding and provide for the needs of the children.

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KaR1 healthcare technology projects 2000-2003

10. Developing the Essential Healthcare Technology Package (HCT1) South Africa and Mozambique (PDF 24 KB)
African Federation for Technology in Healthcare
This project aimed to integrate two tools developed in response to an extensive audit of healthcare technology management. The tools facilitate healthcare technology-related decision making, planning and managemnt.

11. Health information systems, processes and technologies (HTC2) Malawi
Baobab Health Partnership Inc, USA (PDF 63 KB)
Absence of reliable data makes it difficult to plan improvements in healthcare. In response, at Lilongwe Hospital in Malawi a computer-based health information system was developed and evaluated.

12. Maintaining medical equipment in developing countries (HTC3) Gambia
ECHO International Health Services, UK (PDF 52 KB)
In 1997 a WHO report concluded that there was a major and urgent need to address equipment maintenance in developing countries. ECHO has been looking at how this problem can be tackled through fostering a culture of maintenance for medical equipment.

13. The Global Knowledge Network Project (HTC4) Worldwide
GIC Ltd, UK (PDF 30 KB)
Improving access to and availability of information related to healthcare technology is vital to improve the healthcare delivered in developing countries. In response, this project produced an indexed knowledge database and undertook a survey of healthcare delivery institutions to identify areas of need.

14. Establishing the International Centre for Healthcare Technology Management (HCT5) South Africa and worldwide (PDF 33 KB)
International Federation for Medical and Biological Engineering, South Africa
This web-based international resource centre supports healthcare technology management activities such as networking and acts as a reference resource for healthcare practitioners.

15. Controlling malaria and trypanosomiasis with insecticide-treated cattle (HCT6) Ethiopia (PDF 46 KB)
University of Greenwich, Natural Resources Institute, UK
Local livestock owners in Ethiopia identify trypanosomiasis in cattle and malaria in humans as the diseases that most impair their health and livelihoods. This project tested the approach that insecticide-treated cattle can help break the transmission cycle of malaria, never been tested in sub-Saharan Africa before.

16. Production and distribution of electronic training materia (HCT7) Worldwide (PDF 41 KB)
Teaching Aids at Low Cost (TALC), UK
CD-ROM technology has become an important way of increasing the availability of health information. This project aimed to increase the efficiency, reach and impact of health information dissemination to health workers in developing countries.


17. Practical healthcare technology management procedure guides (HCT8) Worldwide (PDF 35 KB)
Ziken International, UK
Health service providers greatly benefit from written materials on procedures such as planning, procurement, operation, maintenance and training. However, in developing countries these materials are often unavailable. This project saw the first phase in producing a series of generic and practical healthcare technology guides help staff in the daily management of equipment.

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KaR1 Round-table discussions, April-November 2002 (P2)

Between April and November 2002 Healthlink Worldwide and GIC Ltd held the first two in a series of round-table discussions in London as part of the KaR programme. The aim of the discussions was to:

• raise the profile of the programme, particularly among those working in disability;
• share learning from individual KaR projects and related activities; and
• discuss important issues in the fields of disability and healthcare technology

At each discussion one or more organisations gave presentations about work they were doing. Participants then discussed issues raised by these presentations, and broader issues related to the round-tables theme >>more information on KaR 1 Round-table discussions (PDF 56 KB)