The Human Development and Capability Association encourages researchers who share common interests to organize thematic groups. At present, sixteen thematic groups are active. If you are involved in a similar thematic group, or if you would like to start one, please read and complete the following document and hence contact us at info@hd-ca.org. Please know that the thematic groups currently work only in English.

This thematic group is a network of social scientists, physicians, public health practitioners, and philosophers interested in health and disability issues from a capability perspective. Through the past several conferences on the capability approach and now through our growing network of participants worldwide, group participants have begun to examine a number of issues at the nexus of health, disability and capability including, but not exclusive to, questions of social justice; resource allocation; HIV/AIDS and antiretroviral therapy; reproductive health; impairment, disability and special needs; health system financing and access; capabilities and functionings; responsibility; disability and poverty; aging; disability and income conversion; genetics; gender disparities and health; social determinants of health; and micro-credit participation and health.

If you would like to join this group and are not a HDCA member, please email jennifer.ruger@yale.edu.

Promising evidence, the insistent voices of consumers of mental health services, their families and advocates, and economic realities have focused U.S. behavioral health priorities on full community participation for people with complex, disabling psychiatric conditions. In this webinar, Mary Jane Alexander presented the methods, findings and outcomes of a five year grant to develop a research Center that applied the capabilities framework to public mental health using a Community Based Participatory Research CBPR approach.

The webinar focused on issues around the operationalisation of the capability approach for mental health research.

Judit Simon summarised the existing difficulties with outcome measurement in mental health economic evaluations and the potential advantages of the capability approach as opposed to the current gold standard QALY (quality-adjusted life year) approach. The applied example of the UK OCTET (Oxford Community Treatment order Evaluation Trial) study was presented where the capability profile of over 300 ‘revolving door’ mental health service users experiencing involuntary hospitalisation was measured using the OxCAP-MH (Oxford CAPabilities questionnaire-Mental Health). The contextual practicalities of instrument development were discussed together with the initial findings. Issues such as instrument generalisability, objective versus subjective capabilities, and the impacts of coercion, adaptation and altered perception have been considered further.

Paul Anand provided an overview of the capabilities measurement project. Paul argued that capabilities can be measured using survey data. Paul explained how some of the operationalisation and measurement issues have been overcome. To view his presentation, please use the "For more information" link below.

This webinar focused on the contribution that the capability approach could make to the problem of resource allocation in health care. Paula Lorgelly provided a review of the resource allocation problem from a health economics perspective. Three issues in a non-market system: efficiency and/or equity; who is the decision maker; and the criterion for making decisions, were discussed in the context of the capability approach. The use of capabilities would mean a move away from QALYs, and a move away from maximization of outcomes. There would be different roles for the expert (an independent observer) and the patient. The under specification of the approach may conflict with the use of generic instruments. Sridhar Venkatapuram similarly focused on the three principles often identified by the health economics discipline including effectiveness, efficiency, and equity, but discussed the issue from a social justice perspective. Effectiveness is often deferred to clinical researchers, and efficiency is the primary focus of health economics. The capabilities approach, on the other hand, identifies the non-healthcare determinants of health. It could be instrumental if applied in the governing of healthcare. Such an application of the capabilities approach to healthcare would mean the adherence to various principles under the primary concern for equity.

Dr Biggeri presented results on two impact evaluation studies of Community Based Rehabilitation (CBR) programs. CBR is a strategy within general community development for the rehabilitation, equalization of opportunities and social inclusion of all people with disabilities (WHO, 2004). This strategy promotes the rights of people with disabilities (PwD) to live as equal citizens within the community, to enjoy health and well being, to participate fully in educational, social, cultural, religious, economic and political activities(WHO, 2004). The objective of this presentation was twofold. The first was to explore different methodological alternatives on how to measure the impact of community-based programs. The second was to present the methods used and results in case studies in India (Karnataka) and Uganda (West-Nile). In both studies, the capability approach was used as a conceptual framework. In India, mixed methods were used. A survey of 2,600 PwDs was conducted and Propensity Score Matching techniques were used to evaluate program impact. In addition, Focus Group Discussions (FGDs) were conducted with treated and comparison groups. In Uganda, the impact evaluation was based mainly on participatory methods using structured FGDs at the community level. Results in both studies showed that CBR programs have a positive and significant impact on health, livelihood, social participation and empowerment for PWDs.

Any question about this webinar or the webinar series, please let me know.
Best wishes,
Sophie

Sophie Mitra, Ph.D
Assistant Professor
Department of Economics
Director, Social Justice and Policy Research Unit
Center for International Policy Studies
Fordham University
441 East Fordham Road
Bronx, NY 10458-9993
ph: 718-817-5337
fax: 718-817-3518
www.fordham.edu/economics/mitra