Executive summary
- Study objectives, methods and approach: This study of the impact of the Nepal earthquake of 25 April, 2015, aims to understand the impact factors leading to the exclusion of older people and persons with disabilities from humanitarian action, barriers to their inclusion, and the extent to which their skills and knowledge were utilised to promote inclusive humanitarian action and, using this understanding, to formulate a set of recommendations for promoting inclusion. These recommendations will be used to sensitise the broader humanitarian community to the need for inclusive disaster risk management practices in future emergency responses which pay attention to factors such as gender, age, disability and ethnicity, and build upon the capacities of older people and persons with disabilities.
A cross-sectional survey of older people and both adult and older persons with disabilities in seven severely affected districts was conducted eight months after the April 2015 earthquake. The sample size for both the older people and the persons with disabilities was estimated using the 2011 census data published by Central Bureau of Statistics, Government of Nepal. Of the 1,515 total respondents in the study sites, 1,142 were older people and 373 were persons with disabilities (206 older people with disabilities and 167 adults with disabilities). The estimated margin of error was 2.5%.
Analysis of the results intended to identify the proportion of older people and persons with disabilities disposed to post-traumatic stress disorder (PTSD), or anxiety, or depression, as well as to know how they perceived the overall social support they received from family, friends, kin, and society. The prevalence of probable PTSD, anxiety, or depression and risk factors predisposing a respondent to develop these conditions were analysed using R-statistical software. The probable factors, both impact and protective, contributing to the traumatic situation were estimated by employing a ‘multivariate logistic model’.
The Hopkins Symptoms Checklist-25 was used to screen the probable anxiety and depression disorders. The checklist consisted 25 items: 10 for anxiety and 15 for depression, with scores ranging from 1 (not at all) to 4 (extremely). The reference period for symptoms was the month before the survey was undertaken. A mean score above 1.75 was considered to predict a clinical diagnosis of anxiety and depression disorders across different cultures. The Perceived Social Support Scale was used to measure the level of social support experienced by earthquake survivors. It consisted 12 items with scores ranging from 1 (strongly disagree) to 7 (strongly agree).
Qualitative methodology applied both review of secondary data as well as analysis of primary data through participatory approaches, mostly covered impact factors, good practices, challenges, and cross cutting issues namely gender and ethnicity. A total of 14 focus group discussions and 56 key informant interviews were carried out to capture the qualitative impression.