Category: Policy and Policy Development

Inclusive healthcare practice

Almost everyone finds themselves in hospital at some time whether as a patient or a visitor. Consequently, we are talking about the whole of our diverse population. But how well is diversity, equity and inclusion considered in healthcare practice? If the statistics are anything to go by, we are not doing well. Marginalised groups experience poorer health outcomes. The conditions in which people live – referred to as the “social determinants of health” – are the main reason for this.

Thirteen people were involved in devising 12 Tips for Inclusive Practice in Healthcare Settings.

A man in a white hospital shirt is wearing a blue face mask and has a stethoscope around his neck. He is looking into the camera and is posing with a thumbs up sign.

Appropriate terminology is a major feature in the list of 12 tips. Non-judgmental factual terms are preferred. Labels such as “obese” or “schizophrenic” can imply blame or non-compliance. And some patients will want to use non-binary gender terms when referring to themselves. Using the person’s preferred terms is recommended in all situations as these can vary. For example some people say they are autistic and others will say they have autism. Then there are people with multiple identities (intersectionality).

The 12 Tips for Inclusive Practice

Here is a brief outline of the the 12 tips.

Tip 1: Beware of assumptions and stereotypes: An individual might have multiple diverse characteristics. In the absence of early information it is easy to assume some things by default. A wheelchair user might conjure up assumptions about the health and ability to make decisions. A person accompanying a patient may be assumed to be a partner or family member.

Tip 2: Replace labels with appropriate terminology: The main point here is to keep up to date with best-practice terminology. For example, guidelines for preferred language for First Nations people is shifting and evolving. Some terms considered derogatory are now embraced by some (queer, autistic).

Tip 3: Use inclusive language: words can exclude and “other” people when they deemed to be different to oneself.

Tip 4: Ensure inclusive physical spaces: Accommodating physical, sensory and cognitive needs improves patient experience. Inclusive design goes beyond legislated minimum access requirements for buildings. For example gowns, furniture, and blood pressure cuffs, should accommodate all sizes.

Tip 5: Inclusive signage and symbols: A rainbow flag or First Nations flag will make people feel welcome. However, the use of these signs needs to be accompanied by inclusive care to avoid disappointment.

Tip 6: Appropriate communication methods: This is where body language and auditory input come into play. Not everyone processes these cues well and sometimes information is better put in writing.

Tip 7: Adopt a Strengths-Based Approach: This approach avoids stereotyping and acknowledges patients’ capacity for resilience and builds on their strengths.

Tips 8 – 12 focus on the health system and healthcare delivery and encourages health workers to advocate for improvements.

The title of the Australian open access article is Inclusive Practice in Healthcare Settings.

Abstract

This paper outlines practical tips for inclusive healthcare practice and service delivery, covering diversity aspects and intersectionality. A team with wide-ranging lived experiences from a national public health association’s diversity, equity, and inclusion group compiled the tips, which were reiteratively discussed and refined. The final twelve tips were selected for practical and broad applicability.

The twelve chosen tips are: (a) beware of assumptions and stereotypes, (b) replace labels with appropriate terminology, (c) use inclusive language, (d) ensure inclusivity in physical space, (e) use inclusive signage, (f) ensure appropriate communication methods, (g) adopt a strength-based approach, (h) ensure inclusivity in research, (i) expand the scope of inclusive healthcare delivery, (j) advocate for inclusivity, (k) self-educate on diversity in all its forms, and (l) build individual and institutional commitments.

The twelve tips are applicable across many aspects of diversity. They provide a practical guide for all healthcare workers and students to improve practices. These tips guide healthcare facilities and workers in improving patient-centered care, especially for those who are often overlooked in mainstream service provision.

The 12 tips for inclusive healthcare with five underpinning concepts: diversity, equity, inclusion, intersectionality, strengths based approach.

Law schools and universal design

Aerial view of a large public library with long desks around a central console. Law schools teach law and introduce the values that students take into the legal profession. Unless law schools embrace universal design, they will continue to be inequitable and pose barriers to people who might be good lawyers. This is the basis of an article by Matthew Timko where he says the place to introduce universal design is through law libraries.

Timko says the law library is the ideal testing ground for changes that assist student comprehension and testing. Beginning with the library services, the value of universal design will gradually become apparent to all stakeholders. From there it will enter the legal academy, legal education process and legal profession.

Timko uses the 7 Principles of Universal design as the framework for his proposition. This shows how flexibly the principles can be applied. He then discusses the role of disability legislation in the United States and the supports available. 

Photo of the sign on the grey stone building of The Royal Courts of Justice. Ethical and professional standards provide another opportunity to support individuals. Timko argues that most accommodations pose menial burdens on institutions but provide great benefit to individuals. However, they need to be provided as a general rule, not just when they are asked for. This is the underlying tenet of universal design for learning. 

The article goes into more detail about the role of legislation and how it should apply to law schools. In the conclusion, Timko states:

“Universal design offers the key to not only increased access to legal education and legal knowledge but also a more fundamental shift in the perceptions and thinking that have plagued disability laws and design habits over the last 30 years.”

The types of universal design features discussed can be introduced into the law library gradually and in cost-effective ways. 

The title of the article is, Applying Universal Design in the Legal Academy. 

From the editor

I was invited to participate in a question and answer interview for the Law Society Journal with Features Editor, Avril Janks. I was encouraged to find that universal design has entered the realms of the legal profession and happy to participate. 

We discussed universal design broadly and then how it might be implemented in legal workplaces. Universal design can be applied to the office design, office systems, and employment practice. So plenty of scope for the profession to be more inclusive. If you want to read the article published in the March 2023 edition, contact journal@lawsociety.com.au 

Jane Bringolf

8-Inclusion needs to prevent discrimination

The 7 Principles and the 8 Goals of universal design have their roots in the built environment and people with disability. We have moved on since their inception to thinking about including other marginalised groups. With this thinking comes intersectionality where an individual can be a member of more than one of those groups. For example, a female refugee with a disability.

The 8-Inclusion Needs framework sits alongside the classic 7 Principles and the practical 8 Goals of universal design. Together they provide a more holistic view of the real lives of people.

A human head shape with a montage of photos of many different people.

The framework seeks to provide a new perspective for shifting the focus from a list of identities to addressing the needs of all people. As such it provides a guide for inclusive designs and interventions that eliminate discrimination. It also provides another perspective on the amorphous term “diversity”.

The 8-Inclusion Needs of All People framework

The results of the literature review formed the basis of the 8-Inclusion Needs framework. Briefly, they are:

1. Access – Ensuring all people can see and hear, or understand via alternatives, what is being communicated; and physically access or use what is being provided.
2. Space – Ensuring there is a space provided that allows all people to feel, and are, safe to do what they need to do.
3. Opportunity – Ensuring all people are provided opportunity to fulfil their potential.
4. Representation – Ensuring all people can contribute and are equally heard and valued.
5. Allowance – Ensuring allowances are made without judgement to accommodate the specific needs of all people.
6. Language – Ensuring the choice of words or language consider the specific needs of all people.
7. Respect – Ensuring the history, identity, and beliefs of all people are respectfully considered.
8. Support – Ensuring additional support is provided to enable all people to achieve desired outcomes.

Individual identities – a list

Identities included in the analysis of research on the lived-experience of underrepresented identities:

    • Gender
    • Race/ethnicity
    • Socio-economic status/class
    • Indigenous
    • LGBTQI+
    • Disability
    • Religion
    • Age
    • Immigrant
    • Illness (physical or mental)
    • Refugee
    • Veteran
    • Neurodiversity

The title of the article is, The 8-Inclusion Needs of All People: A proposed Framework to Address Intersectionality in Efforts to Prevent Discrimination. Published in the International Journal of Social Science Research and Review.

From the abstract

This paper begins by highlighting the current state of inclusion, and then reviews research on the application of intersectionality to address discrimination.

The literature review includes an overview of existing models designed to assist the application of intersectionality in reducing discrimination.

An analysis of research was carried out on the discrimination on 13 individual identities and 5 intersectional identities. A new framework called the 8-Inclusion Needs of All People is based on 8 common themes.

The framework is illustrated with recommendations for application in government and policy making, the law, advocacy work, and in organizations. This goal is to provide a useful framework for expediting social justice and equitable outcomes for all people.

Global roadmap for healthy longevity

When we use the phrase “design for all ages” it usually means “let’s include older people as well”. How did they get left out in the first place? The concepts underpinning universal design aim to overcome this division of ages. Many research articles address the issues, but community attitudes are slow to change. The Global Roadmap for Healthy Longevity is yet another publication promoting the need to be (older) age-friendly. It takes a global view with case studies and recommendations. 

Chapter 5 of the roadmap focuses on physical environment enablers. These include housing, public space and infrastructure, transportation, climate change and digital access. There’s very little new information in this chapter, but it brings together international research for useful recommendations.

A circle of six different coloured rings each with a key actor for an all of society approach to healthy longevity.
Six key areas of collaboration are needed.

Collaboration is needed at all levels including non government and local community organisations, the private sector, researchers and families. 

One of the key recommendations is taking a universal design approach and involving people in design processes. There is more emphasis on communities getting involved in the solutions. Strategic action plans for ageing societies exist in many countries, but few are heeded. That’s because they are viewed as being for a single sector or age group. Therefore collective action is needed. 

The Global Roadmap for Healthy Longevity is not just about older people. It recognises that all ages need to be considered, for younger people will eventually get older. It is a comprehensive publication. Here is a sample of findings from Chapter five. 

Housing

“Finding 5-1: Housing that encourages independence, social integration, and mobility is a key factor in older adults’ ability to realize healthy longevity, but the availability and affordability of this type of housing are limited, especially for those with limited financial resources.”

Walkability

“Finding 5-3: Intentionally designed public spaces and built environments can play an important role in influencing healthy longevity. Creating opportunities for mobility, walkability, access to green space, and social engagement can enhance the lives of older people and reduce mortality and morbidity.”

Finding 5-4: Public infrastructure, such as sidewalks, bike lanes, and well-lit streets, can influence the usability of an area and adults’ perception of safety.”

Transportation

“Finding 5-5: Safe and accessible transportation options can give older adults the opportunity to enjoy independent mobility around their community instead of avoiding social activities and becoming isolated and lonely.”

Information and communications technology

“Finding 5-6: Access to broadband internet is integral to many aspects of society. Low-income and rural households are especially likely to lack broadband access, which greatly influences their equitable access to other resources and their ability to work remotely and stay connected to social networks.”

Global Roadmap for Healthy Longevity is published by National Academies of Sciences, Engineering, and Medicine. 2022. Global Roadmap for Healthy Longevity. Washington, DC: The National Academies Press. https://doi.org/10.17226/26144. The full publication is available for download. 

 

Our Streets: Dangerous by Design

The Dangerous by Design report from Smart Growth America has some interesting statistics about road deaths. This 2022 report differs from previous reports because it captures the behaviours of people during a pandemic. People walked more and drove less, but there were more road deaths. The report examines why.

“Seeing driving go down while deaths went up should call into question the long-held belief that traffic fatalities are inextricably linked to the amount of driving.”

Front cover of Dangerous by Design Report.

Conventional wisdom among policymakers and transportation professionals is that traffic fatalities are inextricably linked to the amount of driving. But the decrease in driving during the pandemic meant less congestion and a significant increase in speeds. Therefore more people were killed. Consequently, speed is the key factor.

Smart Growth America claims that too many transportation agencies and decision makers have been “asleep at the switch”. Their incremental changes to improve safety have not made any positive difference overall.

Those in power, “will have to unwind the deeply embedded, invisible yet powerful emphasis on speed, which is completely incompatible with safety.”

Two ambulance officers push a patient into the ambulance.

The Dangerous by Design 2022 report has several recommendations in terms of policy and design. The guest supplements provide practical experience and add depth to the report. The bottom line of the report is that we have to choose between speed and safety.

Walking and wheeling

The report has a sidebar about “walking” and inclusive language. Of course, some people cannot walk and that is why the term “pedestrian” is used throughout. People using mobility devices are considered pedestrians. However, they are not separated from people using other devices such as skateboards. Consequently, data are difficult to assess in terms of people with disability.

An engineer’s perspective

Charles Marohn writes in a guest supplement that engineers start the process by using the values of their profession. They don’t stop to consider their values might be questioned by others. It’s about standard practice. He says no-one asks questions about speed in proposed road and street designs. Engineers might claim they are not in control of how fast people drive, but Marohn questions this “excuse”. He believes they have a duty to consider it.

Accessible and inclusive cities: case study

The research team with the Mayor (standing).
Bunbury research group

Talking about universal design is all very well, but it takes collective action to make it happen. Collective action for accessible and inclusive cities requires everyone to get on board and work together. And “everyone” means governments at all levels, urban planners and designers, construction companies, contractors and tradespeople. Everyone also means citizens and this is where co-design methods come in. 

Two case studies form the basis of a research paper on two regional centres in Australia. One is in Geelong in Victoria and the other in Bunbury, Western Australia. The authors describe the collaborative and action oriented process in both studies. 

A note of caution. Many local governments have little power over developments that not funded by them limiting what they can achieve. Private and commercial developers can legally challenge any requirements beyond the building codes. 

Recommendations for both centres emerged from the research process. The key recommendation is to use a co-design and co-research process. The authors take a universal design to the whole process and recommendations. They also call for enhanced standards including mandating co-design. 

The title of the paper is, Accessible and Inclusive Cities: Exposing Design and Leadership Challenges for Bunbury and Geelong. It is open access. 

Two of the authors, Adam Johnson and Hing-Wah Chau, were speakers at the 4th Australian Universal Design Conference. Papers were published by Griffith University.  

From the abstract

This article compares research identifying the systemic barriers to disability access and inclusion in two regional Australian cities. We discuss some of the leadership and design challenges that government and industry need to address to embed universal design principles within urban planning, development.

In Geelong, Victoria, the disability community sought a more holistic and consultative approach to addressing access and inclusion. Systems‐thinking was used to generate recommendations for action around improving universal design regulations and  community attitudes to disability. This included access to information, accessible housing, partnerships, and employment of people with disability.

In Bunbury, Western Australia, a similar project analysed systemic factors affecting universal design at a local government level. Recommendations for implementing universal design included staff training, policies and procedures, best practice benchmarks, technical support and engagement in co‐design.

Universal design and local government

Three children, each a wheelchair user, are enjoying the spinner in the playground: a universal design.
Children enjoying the spinner in the playground

Here is an earlier paper from Adam Johnson who used Bunbury in Western Australia as a case study for his presentation at the UD2021 Australian Universal Design Conference. Bunbury set itself an aim, and a challenge, to be the “Most Accessible Regional City in Australia”. Adam explained how he used participatory action research (PAR) methods to meet Bunbury’s challenge. Universal design in local government means involving the people who are the subject of the research. In this case, people with disability and older people. 

PAR has three principles: 

    • The people most affected by the research problem should participate in ways that allow them to share control over the research process
    • The research should lead to some tangible action within the immediate context
    • The process should demonstrate rigour and integrity. 

Adam recruited 11 co-researchers to work with him: 6 people with disability, 3 family carers, and 2 support workers.

Local government is where the ‘rubber hits the road’. Local government is best placed to work with residents and understand the context of where they live, and it means they can be innovative with solutions tailored to local needs. 

The research project had a positive impact:

– Greater alignment between policies and practices at the City of Bunbury with universal design.
– Co design panel created informing many current infrastructure projects.
– Universal design standards adopted.
– Staff and contractors trained in Universal Design.
– $100,000 per annum allocated for auditing and retrofitting

The project was undertaken with a three year industry engagement scholarship with Edith Cowan University. The title of Adam’s presentation is, Universal design in local government: Participatory action research findings. 

 

The Metaverse: inclusive and accessible?

The concept of the Metaverse is a continuous online 3D universe that combines multiple virtual spaces. It’s the next step on from the internet. It means users can work, meet, game and socialize in these 3D spaces. We are not quite there yet, but some platforms have metaverse-like elements. Video games and Virtual Reality are two examples. So, we need to keep a careful watch on developments to make sure the Metaverse is inclusive and accessible.

Another term for the Metaverse is digital immersive environments. It sounds science fiction, but this fiction is becoming a fact. Someone is designing these environments, but are they considering equity, diversity and inclusion? Zallio and Clarkson decided to tackle this issue and did some research on where the industry is heading.

Several companies are involved in the development of digital immersive environments. So before they get too far in development it’s important to define some principles for the design of a good Metaverse. Zallio and Clarkson came up with ten principles that embrace inclusion, diversity, equity, accessibility and safety.

10 Principles for designing a good Metaverse

  1. is open and accessible
  2. is honest and understandable
  3. is safe and secure
  4. is driven by social equity and inclusion
  5. is sustainable
  6. values privacy, ethics and integrity
  7. guarantees data protection and ownership
  8. empowers diversity through self-expression
  9. innovates responsibly
  10. complements the physical world
A young woman is wearing a pair of virtual reality goggles and looking towards the sky.

Their paper is insightful and provides some important areas for discussion and research. We need developers to consider the essentials of inclusion, diversity and accessibility. Zallio and Clarkson advise that designers can learn from the past to reduce pitfalls in the future. As the Sustainable Development Goals say, “leave no-one behind”.

Diagram showing the 10 principles for designing a good Metaverse.

The title of the paper is Designing the Metaverse: A study on Inclusion, Diversity, Equity, Accessibility and Safety for digital immersive environments.

Synopsis of the paper

1. The Metaverse appears as the next big opportunity in the consumer electronics scenario.

2. Several companies are involved with its development.

3. It is extremely important to define principles and practices to design a good Metaverse.

4. Qualitative research pointed out to challenges and opportunities to design a safe, inclusive, accessible Metaverse that guarantees equity and diversity.

5. Ten principles for designing a good Metaverse embrace inclusion, diversity, equity, accessibility and safety.

From the abstract

The Metaverse is shaping a new way for people interact and socialise. By 2026 a quarter of the population will spend at least an hour a day in the Metaverse. This requires consideration of challenges and opportunities that will influence the design of the Metaverse.

A study was carried out with industry experts to explore the social impact of the Metaverse through the lens of Inclusion, Diversity, Equity, Accessibility and Safety (IDEAS). The goal was to identify directions business has to undertake.

The results indicated the nature of future research questions and analysis to define a first manifesto for Inclusion, Diversity, Equity, Accessibility and Safety in the Metaverse.

This manifesto is a starting point to develop a narrative, brainstorm questions and eventually provide answers for designing a Metaverse as a place for people that does not substitute the physical world but complements it.

Caring cities are inclusive cities

Care is both a need and a service, but it is also a social value that helps qualify how services, assistance, and support are provided. The value of care aims to keep people feeling safe and maintains their dignity. And caring cities are inclusive cities. A policy paper for the World Summit of LoA narrow pedestrian street with market stalls and shops. A caring city is an inclusive city.cal and Regional Leaders at local government level proposes some thoughts on this.

A city that cares fulfils its human rights obligations as well as the needs and aspirations of everyone. Places and spaces should be available, acceptable, accessible, and affordable for everyone. This means city and community ecosystems need a new social contract to be caring. This contract should involve collaboration and be based on respect for people and the environment. 

The policy paper discusses the challenges and sets some recommendations for local and regional governments and some points on taking local action. This paper will be of interest to policy makers in all levels of government. 

Enabling Environments for Local Action

“The responsibility for caring extends across all of government. Local and regional governments need to be supported and enabled to make the necessary transformations in favour of caring systems. To this end, this paper recommends taking the following actions at the national level:

a. Enact adequate, inclusive regulatory and policy frameworks establishing the basis for green, sustainable, and accessible public services and infrastructure

b. Sustain adequate transfer and allocation of financial resources to strengthen local-level technical capacity and enable efficient implementation.

c. Establish the legal foundations to institutionalize meaningful participatory and multi-level governance that considers the whole of society, moving past political alliances and promoting government accountability at all levels.”

Joint way forward

Governments at all levels need to share responsibility for creating caring systems by collaborating with communities. The policy paper recommends establishing strong partnerships and collaboration to enable social change. Here are some of the key points: 

        • Care is a human right and a public good and universal access to it
        • Establishing collaborative platforms and social dialogue
        • Challenging the gendered division of labour of paid and unpaid care work
        • Respect for local and indigenous knowledge
        • Accessible and ethical information management

The title of the policy paper is Caring Systems and was presented at the UCLG World Congress and Summit of World Leaders held October 2022 in Korea.

UCLG = United Cities and Local Government.

Public toilets and cultural conflict

When you gotta go, you gotta go and it doesn’t matter who you are or how you identify. Historically, the use of public toilets has been studied from four different and separate perspectives. These are gender, public health, ergonomics, and the spaces people like between themselves and others. Public opinion plays a role and this makes the creation of inclusive public toilets a site of cultural conflict.

Standard toilet block in a rural area signed as Ladies and Gents.

Trans* rights are getting more attention these days and public toilets seem to be an area where public opinion plays a big part. But the trans population is not the only group that has trouble with toilet rooms.

Public toilets have been around for more than 2000 years. They are both public and intimate places at the same time. This gives rise to an emotional response to our need to eliminate and dispose of our waste. We care who we share this public yet intimate space with.

Steinfeld, Thibodeaux and Klaiman have taken up the issues with a view to solving issues by design. That is, to make these public amenities more inclusive. In doing so, it might provide some insights into making other public facilities more inclusive. The title of their research paper is, Public Restrooms: A Site of Cultural Conflict.

The research paper outlines a literature review and the qualitative research methods. The aim is to identify strategies for inclusive restroom design that is acceptable to the US population generally.

From the conclusions

The researchers note that in many parts of North America, any attempt to depart from the conventional binary women/men design will be politicised. Hence they can expect little, if any change. The conventional euro-centric gender segregated restroom is a reflection of a culture that supports a rigid idea of gender identity. Unfortunately, it neglects the realities of diverse needs.

Supporters of trans access to restrooms have focused on changing laws. However, laws do not address the whole problem. They can still face violence and abuse. The design of public toilets needs to be addressed too.

On orange door with a sign saying Unisex Toilet and baby change with icons to match.

A simple strategy for improving trans access is re-signing single user restrooms to be “all-gender”. It is an good initial first step because trans and cisgender people with additional needs can use these restrooms.

From the abstract

Public restrooms have become the major locus of conflict over trans rights. But this is only the latest manifestation of cultural conflicts related to restrooms. Historically, the restroom has been studied through four aligned, but separate, lenses: gender studies, public health, ergonomics, and proxemics.

These four lenses are both interdependent and intersectional. A review of literature paints a picture of how this conflict represents the gulf between embedded cultural values and the lived experience of a diverse population. We hypothesize that there is strong consensus on what people desire in toilet rooms, particularly regarding safety, hygiene, and privacy. However, these desires conflict with a cultural legacy based on hetero-normative values.

This hypothesis was tested through a review of research and preliminary findings from a survey that targets the intersections of gender identity, public health, ergonomics, and boundary regulation. This research leads to a holistic picture of the public restroom and situates the contemporary conflict as the result of polarized public opinion.

Demographics and ideology play an important role in forming opinions. While the public restroom is the main focus, this research improves our understanding about the larger issues. How might our built environment adapt in response to a more nuanced view of gender? How might urban spatial practices serve as catalysts for social change.

*Note that the term “trans” is used to encompass a wide range of gender identities including transgender, intersex, gender non-conforming and others.

World Cup: Accessible by Design

Major sporting events offer great opportunities to design and build inclusive infrastructure and services. The FIFA World Cup in Qatar is no exception. The Accessible by Design: Building a legacy of inclusion report sets out Qatar’s challenges and solutions.

The aim is to “ensure stadia and the entire experience, inside and outside the stadium, are fully accessible to all. This includes designing and planning for accessible hotels, transportation, tourist attractions and more”.

The policy recommendations in the report “provide solid and practical guidelines to design and redesign cities that are equally accessible to all”.

Front cover of Accessible by Design report.

Qatar has worked with organisations representing people with disability to meet their pledge to deliver the most accessible World Cup to date. This means both inside and outside the stadia – hotels, transportation, and tourist attractions. The aim is to leave a lasting legacy and a national priority for greater accessibility across Qatar.

Report and recommendations

The report is in four sections with an executive summary with a focus on urban design and the FIFA World Cup event. The first section discusses the prevalence of and disadvantages for people with disability. Five levels of accessible and inclusive urban design are presented based on the UN’s Economic and Social Affairs work.

The second section relates specifically to the World Cup with diagrams and explanations of how Qatar will achieve its aims. The third section is about what to expect at the tournament. With eight stadia all within a relatively close proximity to each other. That means fans can see more than one match in a day.

The fourth section has conclusions and policy recommendations. At the end of the tournament it will be necessary to check the experiences of people with disability. And also, whether the tournament left a lasting legacy of service and behavioural change.

The report closes with six policy recommendations. Similarly to the London Olympic and Paralympic Games, setting up an authority to continue the work is one of them. There is not much new in the report for countries that have policies on access and inclusion. However, it is good to see their aims and objectives set out in the report. While people with disability are being considered, we know that there are some other groups who remain on the outside.

The report is published by WISH and draws on the WISH 2022 Forum on Accessible Design and Health recently held in Doha.