Addressing Poverty throughDisability Inclusive Development

8 Partner Case Studies

CBM is supported by Australian Aid

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OVERVIEW

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Thisbookletshowswhatdisabilityinclusive developmentforpovertyalleviationlookslikein arangeofsettingsandwithdifferentchallengesthrougheightcasestudiesofprojectsfundedbyCBMAustraliathroughtheAustralianGovernmentNGOCooperationProgram(ANCP).

Disability inclusive development actively includes people with disability and their families in development processes and programs. The disability inclusive approach to poverty reduction recognises that including people with disabilities creates more accessible and inclusive communities and results in more successful and sustainable development for all.1

Thecasestudiesprovideanhonestreflectionontheinclusionofpeoplewithdisabilitiesandtheirfamilies indevelopmentinitiativeswiththeaimofbringingsustainedpovertyalleviation.Successes,challengesandlessonsfromeachoftheseeightpartnerorganisationsareshared. It is hopedthese casestudieswillinspirenewideasandencouragereflectiononourownpractice.

Todevelopthisbooklet,alargenumberofcasestudieswerecollectedfromCBM’spartnersglobally.CBMwaslookingforprojectexamplesthatdemonstratesuccessfuloruniquepracticesthateffectivelycontributetopovertyreductionthroughdisabilityinclusivedevelopment.Ofthese,eightprojectswereselectedaskeycasestudies.Eachcasestudywasthendevelopedthroughthereviewofprojectdocumentsincludingprojectplans,narrativereportsandprojectmonitoringreports.Thedeskreviewwascomplementedwithin-depthdiscussionswithprojectpartnerstaffwhowereabletoensuretheiraccuracy.

1 AusAID, 2008, ‘Development for all: Towards a disability-inclusive Australian aidprogram 2009-2014’

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RESOURCES

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Thereare many resources available tohelp organisations implementdisabilityinclusivedevelopment.Asastartingpoint,thekeyreferencematerialsthatCBMrecommendsare:

WorldHealthOrganisationCBRGuidelines,2010

InclusionMadeEasy:

AQuickProgramGuidetoDisabilityandDevelopment,2012

TheUNConventionontheRightsofPersonswithDisabilities

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©2013CBMAustralia

Wewelcomeanyfeedbackorcomplaintsmadebycalling1800678069(FREECall)orvisitingcbm.org.au.

Allmaterialissubjecttocopyright;however,articlesandphotographsmaybereproducedwithpermissionfromCBMAustralia.

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Varsha runs her own beauty salon after training through the BPA Project.

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CONTENTS

The cycle of poverty and disabilityPage 3

Key factors for effective disability inclusive developmentPage 4

Case study snapshotPage 5

Effectiveinclusivedevelopmentinpractice-analysisoffivefactorsacrosscasestudiesPage 6

ChallengesPage 8

AcronymlistPage 9

LeadingchangewithlocalpartnersinBangladeshPage 10

Amatrixofchange–inclusioninIndiaPage 16

PuttingdisabilityontheagendainCambodiaPage 21

Breakingbarrierstoinclusion–rehabilitationandeducationinEthiopiaPage 26

Breakingchainsofdiscrimination–mentalillnessinNigeriaPage 31

LocalownershipcreatessustainabilityinthePhilippinesPage 36

VillageleaderspavethewaytowardsinclusioninIndiaPage 41

NetworksbreakbarriersinCameroonPage 46

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A group of classmates from a school in Gujarat, India, which now has 18 students with a disability

enrolled and attending class.

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THE CYCLE OF POVERTY AND DISABILITY

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Oftheworld’ssevenbillionpeople,15percenthaveadisability–thatmeansoveronebillionpeopleface thechallengesofdisabilityeveryday.2Peoplewithdisabilitiesexistineverysocietyandplayanimportantroleineverydaylife,bringingdiversityandabilitiestotheircommunities.

Eightypercentofpeoplewithdisabilitieslivein developingcountries.3Oftenthismeanstheyare confrontedwithaseverelackofaccesstoeducation,healthcare,employment,decisionmakingpowerandparticipationincommunitylife.Inmanycommunitiesthesestrugglesarecompoundedbydiscrimination,socialexclusionandhumanrightsabuses.

CBM’sexperienceofworkinginpoorcommunitieshasshownthatpovertyanddisabilitygohandinhand: peoplewithdisabilitiestendtobethepoorestofthepoor,andpeoplelivinginpovertyarefarmoreatriskofacquiringadisabilityintheirlifetime.Thismakes peoplewithdisabilitiesthepoorest,mostexcludedpopulationindevelopingcountriestoday.

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2World Health Organisation & World Bank. (2011).

World ReportonDisability,Geneva:World HealthOrganization,p.7.

3UnitedNationsEnable.(2006).FactsheetonPersonswithDisabilities-August2006.Retrieved14August2013from

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KEY FACTORS FOR EFFECTIVE DISABILITY INCLUSIVE DEVELOPMENT

Whileeffectivedisabilityinclusivedevelopmentlooksdifferentineachsetting,projectscanhavemanythingsincommon.Fivekeyfactorsforeffectivedisabilityinclusivedevelopmentareshownacrosstheeightcasestudies.These factorsarehighlightedas aframeworktolearn fromandenablereflection.The fivefactorsare:

1.Empoweringpeoplewithdisabilitiestoadvocatefortheirrights

Theseinitiativesseektobuildthecapacityandselfconfidenceofpeoplewithdisabilitiesandtheirfamiliestoorganisethemselvestolobbyandadvocateforchangeandmakeinformeddecisionsabouttheirneeds.

2.Advocacy to build awareness of and support for disability inclusion

Advocacyandawarenessraisingactivitiesaimtochallengethenegativeattitudestowardspeoplewithdisabilities,raiseawarenessofrightsandbuildgovernmentandcommunitysupportforinclusionofpeoplewithdisabilities.

3.Building capacity of governments, institutions and service providers to implement disability inclusive approaches

Ifpeoplewithdisabilitiesaretobemeaningfullyincludedinmainstreamdevelopmentprogramsandcommunityactivities,itiscrucialthatgovernments,institutionsandserviceprovidershavetheknowledgeandskillstoadapttheirprogramsaccordingly.Thisfactoremphasisestheimportanceofbuildingthecapacityofotherstoimplementdisabilityinclusiveapproaches.

4.Provision of disability specific supports and services to enable participation of people with disabilities in the community

Thisfactorreferstotheprovisionofrehabilitation,assistivedevicesandmedicalservicestoassistpeoplewithdisabilitiestoimprovetheirleveloffunctioningandreachtheirmaximumpotential.

5.Working together with government and networking with other community based organisations for coordinated, sustainable projects

Developingpartnershipswithotherorganisationsisvitaltoensureacoordinatedandeffectiveapproachtodisabilityinclusion.Thisfactorconsidershowdifferentorganisationsworkinpartnershiptominimiseduplicationandmaximisetheuseofexistinglocalresources.

Inclusive self help group in Gujarat, India

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CASESTUDYSNAPSHOT

Case Study Name / Organisation / Location / Factors for effective disability inclusive development highlighted in the case study
Empowering people with disabilities to advocate for their rights / Advocacy to build awareness of and support for disability inclusion / Building capacity of government, institutions and service providers to implement disability inclusive approaches / Provision of disability specific supports and services to enable participation of people with disabilities in community / Working together with government and networking with other community based organisations for coordinated, sustainable projects
Leading change with local partners in Bangladesh / Centre for Disability in Development (CDD) / BANGLADESH / x / x / x
Amatrixofchange–inclusioninIndia / MobilityIndia / INDIA / x / x
PuttingdisabilityontheagendainCambodia / CambodianDevelopmentMissionfor Disability(CDMD) / CAMBODIA / x / x
Breakingbarrierstoinclusion–rehabilitationand educationinEthiopia / RehabilitationandPreventionInitiativeAgainstDisability(RAPID) / ETHIOPIA / x / x
Breakingchainsofdiscrimination–mentalillness inNigeria / AmaudoCommunity Mental HealthProgram / NIGERIA / x / x
Localownershipcreatessustainabilityinthe Philippines / NORFILFoundation / PHILIPPINES / x / x
Villageleaderspavethewaytowardsinclusionin India / BlindPeople’sAssociation(BPA) / INDIA / x / x
NetworksbreakbarriersinCameroon / CameroonBaptistConvention(CBC) / CAMEROON / x / x / x

ORGANISATIONLOCATI

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EFFECTIVE INCLUSIVE DEVELOPMENT IN PRACTICE ANALYSIS OF FIVE FACTORS ACROSS CASE STUDIES

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1.Empoweringpeoplewithdisabilitiestoadvocatefortheirrights

Projectsadoptarangeofstrategiestoempowerpeoplewithdisabilitiestoadvocatefortheirrights.

Acommonapproachistostrengthenselfhelpgroupstoestablishthemselvesasaplacewherepeoplewithdisabilitiescancometogetherformutualsupportandbuildacollectivevoicefordisabilityinclusionintheir communities.

Eachcasestudytookadifferentapproachtotheestablishmentofselfhelpgroups.Forinstance,theBlindPeople’sAssociation(BPA)invitedallcommunitymemberstojointheirselfhelpgroups,notjustpeoplewithdisabilities.Thisinclusiveapproachhelpedtopreventfurthersegregationofpeoplewithdisabilitieswithintheircommunitiesandprovidedaplatformforwholecommunitiestocometogethertoidentifyandaddresschallengestopovertyalleviation.

TheCentreforDisabilityinDevelopment(CDD)hasanalternativeapproach;insteadofestablishingselfhelpgroupsdirectly,CDDinvestsitstimeandresourcesinrightsandadvocacytrainingforpeoplewithdisabilities.Then,afterthetrainingiscomplete,theysupportpeoplewithdisabilitiestoestablishtheir ownselfhelpgroupsintheirowncommunity.Thisapproachincreaseslocalownershipofthegroupsandensureseachnewgrouphasastrongfocusonadvocacyrightfromthebeginning.

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2.Advocacy to build awareness of and support for disability inclusion

Mostcasestudiesdemonstratetheimportanceofadvocacyandawarenessraisingingainingorbuildingongovernmentsupportfordisabilityinclusionandchangingfamilyandcommunityattitudestowardspeoplewithdisabilities.Inprojectswhereadvocacyisnotastrongcomponent,governmentownershipandinvolvementtendstobeweaker,whichcancompromisetheproject’spotentialsustainability.

Acommonobservationacrossthecasestudiesisthatgovernmentagenciesandcommunitymembersrespondverypositivelytoadvocacymessagesfromapersonwithadisabilityorfromsomeone,suchasafamilymember,affectedbydisability.Thisapproachshowshowpowerfulandinfluentialpersonalstoriesofexclusionanddiscriminationcanbe.Thecasestudiesalsoshowthatconsistent,repetitivemessagestargetingthegovernmentatnational,provincialandlocallevelssupportthesuccessofadvocacyinitiatives.

A local self help group undergoes training.

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3.Building capacity of governments, institutions and service providers to implement disability inclusive approaches

Whileall the case studies show somelevel ofadvocacy,onlysomeorganisationscombinetheiradvocacyeffortswithcapacitybuildingofgovernments,institutionsandserviceproviderstoimplementdisabilityinclusiveapproaches.TheCameroon BaptistChurch (CBC)uses mediatoimprovecommunityawarenessoftherightofchildrenwithdisabilitiestoattendschoolandadvocatestothegovernmenttoprioritiseeducationforchildrenwithdisabilities.Theprojectsimultaneouslyprovidesintensivetrainingtoteachersonstrategiesforsupportingchildrenwithdisabilitiesanddevelopsresourcestohelptheprocess.

CombiningeducationandadvocacyeffortshassimilarlyprovedtobeeffectiveinEthiopia.TheRehabilitationand Prevention Initiative againstDisability(RAPID)sendsfieldworkerstomeet withschoolprincipalsandteacherstoadvocatefordisabilityinclusion.Theireffortsresultedintheprovisionoftrainingtodevelopteachingstrategiesandtheestablishmentofschooldisabilityawarenessclubs.

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4.Provision of disability specific supports and services to enable participation of people with disabilities in the community

Eachprojectworkstoproviderehabilitation,medicalservices andprovision ofassistive devices,eitherdirectlyorthroughreferralstootherservices. Theprojectsthatweremosteffectiveincludedacombinationofthetwoapproaches;theywouldprovidesomelocal,reliablerehabilitationsupportandreferpeopletootherspecialistservicesforfurthermedicalinterventionorassistivedevices.Gettingthisbalancerightisimportant;implementingalargerangeofrehabilitationservicesoftenincreasesthecostoftheprojectandcanreducesustainability,whereasrelyingexclusivelyonreferralscanbelimitedbytheavailabilityofservicesinlocalcommunities.

Therearealsootherfactorsthatmaketheprovisionofrehabilitationaneffectivestrategyfordisabilityinclusivedevelopment.SomeorganisationssuchasMobilityIndiaandNORFILFoundationfocusontrainingparentsorcommunitymemberstoprovidehomebasedrehabilitation.Thishelpstoincreasethesustainabilityofrehabilitationsupportandincreases effectivenessas rehabilitationexercisescanbeconductedinbetweenvisitsbyfieldworkers.Someprojectsalsoproviderehabilitationsupportaspartofabroadrangeofcommunityactivitiesthatsimultaneouslyaimtoimprovecommunityattitudesandcreateanenvironmentwherepeoplewithdisabilitiesarevaluedandrespected.

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5.Working together with government and networking with other community based organisations for coordinated, sustainable projects

Allofthecasestudiesshowtheimportanceofdevelopingstrongrelationshipswithotherorganisationsandimplementingpartnerstoimprovetheoveralleffectivenessofeachproject.Mostpartnersfoundthatestablishingclearrolesandresponsibilities,signingformalpartnershipagreementsandworkingwithestablishedpartnersoveranextendedperiodoftimehashelpedmaketheserelationshipssuccessfulandlonglasting.

Networksareparticularlyimportantfortheprovisionofrehabilitation,medicalservicesandassistivedevices.BPAinGujarat,India,establisheddistrictinformationcentressothatcommunitymembershadonecentralinformationhub.Herecommunitymemberscanbeintroducedtoawiderangeofotherorganisationsworkingtosupportpeoplewithdisabilities.Thisapproachensuresthereisabroadrangeofassistanceavailableforpeoplewithdisabilities.

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CHALLENGES

Whilethecasestudieseachshowtremendousprogresstowardsdisabilityinclusivecommunitiesseekingequitabledevelopmentoutcomesforall,itis importanttounderstandandrecognisethechallengestoassistustoimproveourinitiatives.Anumberofcommonchallengesappearacrossthecasestudies.Eachprojectadoptsavarietyofstrategiestorespondtotheseissueswithvaryingdegreesofsuccess.

Sustainability

Organisationsappliedarangeoftechniquestoimprovesustainability.Someorganisationsestablishedcommunitybasedrehabilitation(CBR)committeesandconductedadvocacyactivities;othersfocusedtheir effortsonbuildingrelationshipswiththegovernmentandimprovingthecapacityofpartnerorganisations.Despitetheseefforts,thecasestudiesstillshowsustainabilityisasignificantchallenge,particularlyin gainingacommitmentfromgovernmenttodirectlycontinueprojectimplementationorcontributefinanciallytoitscontinuation.

Amongtheorganisationsthatachievedthegreatestcommitmentfromgovernment,anumberofcommonfactorsemerge.Ifthegovernmentwasinvolvedasakeystakeholderattheplanningphaseoftheprojectandthencontinueditsinvolvementthroughoutimplementation,itsdedicationtotheprojectwasheightened.Itseemstheearlierand greaterrole governmentsplay,thestrongertheiroverallcommitmenttoseetheprojectsucceed.

Theuseoffieldworkers,bothpaidandvoluntary,isalsoseentoinfluencethesustainabilityofprojects.Whilerelyingonvolunteersreducesimplementationandfuturefundingcosts,thecasestudiesshowitcanbedifficulttomaintainmotivation.NORFILFoundationshowshowtrainingandbuildingthecapacityofcommunityvolunteerscanencourageengagement andimprovetheirabilityinalongertermrole.

UsingCBRcommitteeswasastrategyemployedbyRAPID andtheCambodianDevelopmentMissionforDisability(CDMD).Thecommitteeswereestablishedtoincreaseawarenessoftheimportanceofdisabilityinclusionamongstlocalstakeholdersand,inthecaseofCDMD,resultedinanumberofcommunecouncilsgivinggreaterprioritytodisabilityinclusion.WhiletheCBRcommitteeshavethepotentialtoincreasesustainability,furthersupportfromthegovernmentisgenerallyneededtostrengthentheinfluenceofthecommitteesbeyondtheboundaryofthecommunity.

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Involvement of people with disabilities

Themajorityoforganisationsrecognisetheimportanceofparticipationofpeoplewithdisabilitiesinallaspectsoftheproject.However,achievingthisinpracticeisoftenachallenge.Allorganisationsconsultedpeoplewithdisabilitiesortheirfamiliesduringtheplanninganddesignphaseoftheirproject.Severalorganisationsusedfocusgroups.Others(suchasCBC, CDMD andCDD) gavepeople withdisabilitiestheopportunitytoplayamoreactiveroleindesigningprojectactivities.However,eachofthesecasestudieshighlightsthedifficultyinincludingchildrenwithdisabilities,peoplewithintellectualimpairmentsandpeoplewithmentalhealthproblemsinthedevelopmentandimplementationofprojects.Thiswasidentifiedformanyoftheorganisationsasanareathatrequiresimprovement.

CBC,CDMD andRAPID show great successinincludingpeoplewithdisabilitiesinstakeholdercommitteesorCBRcommittees.Thishelpstoensurethattheirvoiceandviewpointcaninfluencethedirectionofinitiatives.MobilityIndia,CDD,CDMDandBPAallwentastepfurtherandemployedpeoplewithdisabilitiesorrecruitedthemascommunityvolunteers.Ineachcase,thepartnerswitnessedsignificantchange,bothtothecommunitieswherepeoplewithdisabilitieswereabletoworkandshowtheirvalue,andintheselfconfidenceofpeoplewithdisabilities.

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Supply and demand

While referringtoexistingservicescan significantlyreducethecostsofimplementation,inmostcasesorganisationsfoundexistingserviceswerenotabletocopewiththeadditionaldemandcreatedbytheirprojects.Thishighlightspartners’successinraisingawareness.Mostpartnerssoughttoaddressthechallengeofincreaseddemandbyincreasingadvocacyeffortstothegovernmenttoleverageadditionalfundingforrehabilitationservices.

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ACRONYM LIST

BPABlind People’s Association
CBCCameroon Baptist Convention
CBRCommunity Based Rehabilitation
CDCCommunity Disability Committees
CDDCentre for Disability in Development
CDMDCambodian Development Mission for Disability
CECCommunity Education Centres
DPODisabled People’s Organisation
MHAPMental Health Awareness Program
NGONon Government Organisation
RAPIDRehabilitation and Prevention Initiative Against Disability
SEEPDSocio-Economic Empowerment of Persons with Disabilities

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CASESTUDYFROMTHECENTREFORDISABILITYINDEVELOPMENT(CDD)

LESSON1

Workingthroughlocalpartnersbasedincommunitiesmeansthereisstrongersupportonthegroundinthecommunitiesthatneedit.

LESSON2

Whenevaluatingatraining program,itisimportanttolooknotonlyatwhoattendedthetraining,butalsowhocouldnotattendthetraining.

TheCentre forDisabilityinDevelopment(CDD)foundwomenwithdisabilitieswerenotaswellrepresentedasmenwithdisabilities.In response, CDDdivided thetrainingprogramintotwoblocksoftimetohelpwomenandmen balancefamilyandeconomicresponsibilitiesathomeandencourageparticipation.Thisalsomeanttheygainedconfidencefromthefirstblock(10days)toreturnforthesecond(17days).

LEADING CHANGE WITH LOCAL PARTNERS IN BANGLADESH

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DisabilityinBangladesh

Itisestimatedthatsome16millionpeoplearelivingwithadisabilityinBangladesh.1Withlittleawarenessofdisabilitythroughoutthecountry,especiallyinruralareas,theeffectsuponqualityoflifearemarked. Studiesshowdisabilitynegativelyimpactsmarriages,andtheabilitytogainaneducationandemployment,2whicharecrucialinthefightagainstpoverty.

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2Mitra,Sophie,Posarac,AleksandraVick,BrandonC,‘Disabilityandpovertyindevelopingcountries:Asnapshot fromtheWorldHealthSurvey’(April2011). World BankSocialProtectionWorkingPaperNo.1109.Accessat:ssrn.com/sol3/papers.cfm?abstract_id=1908128

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Zolekha(centre)meetingwithothermembersoftheselfhelpgrouptheyformedfollowingtrainingthroughCDD’sproject.

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CDD’sapproachtodisabilityinclusivedevelopment

TheCentreforDisabilityinDevelopment(CDD)establishedthePromotionofHumanRightsofPersonswithDisabilitiesinBangladeshprojecttodevelopcapacitybuildingresourcesandbuildtheleadershipqualitiesofpeoplewithdisabilities.Theprojectseekstoensurepeoplewithdisabilitiesnotonlyparticipateinbutalsoleaddevelopmentinitiatives.

Theprojectisimplementedinpartnershipwithtwelvepartnerorganisations (fourDPOsororganizationsledbypeoplewithdisabilitiesandeightmainstreamdevelopmentNGOs)locatedintendistricts.CDDundertakethemajorityoftraining,resource development,nationalleveladvocacyandlobbyingin Dhaka.

Partnersfocusonworkingatthelocalcommunityleveltohelpdeterminetheneedsandprioritiesofpeoplewithdisabilitiesandwhattypeofcapacitybuildingis neededtoempowerpeoplewithdisabilitiestobecomeleaders.

Theprojectalsofocusesontherapeuticrehabilitation,referralsandprovisionofassistivedevicestoincreasethefunctionalcapacityandmobilityrangeofpeoplewithdisabilities.Alloftheseactivitiesaredevelopedtosupporttheinclusionofpeoplewithdisabilitiesandempowerthemtoactasleadersandrightsagents.

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The General Secretary of Notun Jibon self help group in Gaibandha, Bangladesh.

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Howis the project implemented?

In each new area, CDD spends time listening to theexperiencesoflocalpeoplewithdisabilities,their familiesandanylocalorganisationsthatworkwithpeoplewithdisabilities.

This learningisused tohelp plantheproject. Ineacharea,CDDseekstopartnerwithalocalorganisationthathasundergonesomepriordisabilityinclusiontrainingwithCDD.

Onceselectedasapartner,thelocalorganisationthenreceivesadditionaltrainingaboutdisabilityrightsandinclusion,actionplanning,advocacyandcampaigning,genderandchildprotection.Eachpartnerissupportedtoemploytwofulltimestaffmembers(whichmustincludeawomanandapersonwitha disability),tofulfiltherolesofacommunitydisabilityrehabilitationofficerandacommunitymobiliser.Thecommunitymobiliserworkstocreateadisabilityfriendlyattitudewithinthecommunityandsupportstherehabilitationofficertoestablishcommunitybasedselfhelpgroups.

Thepartnerisaskedtoidentifyandinvitepeoplewithdisabilitiesfromtheirlocalcommunitytoattendaday leadershiptraining.Thistraining isrunbyCDDinDhakaandaimstobuildthecapacityofpeoplewithdisabilitiestobecomeleadersandadvocatefortheirrights.ThelocalpartnerassiststheparticipantstotraveltoDhakatoattendthe trainingprogram,andthenworkswiththemupontheirreturntoestablishselfhelpgroupsofpeoplewithdisabilitiesandeducatethecommunityaboutdisabilityinclusion.Thepartneralsohelpssetupanapexbody,withtworepresentativesfromeachselfhelpgroupintheprojectarea.Thekeypurposeoftheapexbodyis toensureacoordinatedapproachtolocaladvocacywork.

CDDoverseesadvocacyactivitiesatthelocal,districtandnationallevels. Theyidentify thekey issuesforpeoplewithdisabilitiesthroughdiscussionswithpartners,selfhelpgroupsandapexbodies,andworkwithpartnerstoorganiseadvocacyeventswithspeakers who have adisability.

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PROGRESSTOWARDSINCLUSION

  • Selfhelpgroupmembersnowmeetwithlocalgovernmentrepresentativesandinteractwithothercommunitymembers.
  • Localgovernmentshaveincreasedthebudgetallocatedtoschemesforpeoplewithdisabilities.
  • Self helpgroupmeetingsarenowheldingovernmentoffices.
  • Someselfhelpgroupshavestartedto seeencouragingchangesintheattitudesofgovernmentwiththeconstructionofpublichousingforpeoplewithdisabilities.
  • Followingadvocacyefforts,fiveacresofgovernmentlandwasallottedtooneselfhelpgroup.Thegrouphasusedthelandtocultivatevegetablesandsharestheprofitsamongthegroup.
  • Projectstaffhavenoticedasignificantchangeintheconfidenceofpeoplewithdisabilities.Peoplewithdisabilitiesarestandingupforthemselvesandfightingfortheirrightstobeupheld.Communitymemberscallpeoplewithdisabilitiesbytheirnamesinsteadoftauntingthemwithoffensivenames

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Whatismosteffective?

Insteadofdirectlyimplementingprojects,CDDbuildsthecapacityofexistingorganisationstosupportpeoplewithdisabilities.Byactingasafacilitator,CDDleveragestheirstrongrelationshipswithpartnerorganisationsandcommunitiestocreatelastingchangewheredisabilityinclusionbecomesapriorityforalldevelopmentefforts.Thisapproachiseffectivebecauseitutilisesthecredibilitylocalorganisationshavewithintheircommunitieswhileprovidingmuchneededonthegroundsupporttopeoplewithdisabilities.ItalsomeansCDDcanfocusontrainingmoreorganisationstobecomedisabilityinclusiveastheirenergyisspentoncapacitybuildingratherthanprojectimplementation.

Byoverseeingandguidingpartnersandorganisationsinsteadofdirectlyimplementingprojects,CDDisabletoinvesttimeindevelopingthespecificresourcesrequiredfordisabilityinclusionthatcanbeusedconsistentlyacrosstrainingprogramsandfornationallevel advocacy andlobbying. Theseresourcesareusedbytheselfmanagedselfhelpgroupstoensuretheyhavetherightsupporttoleadtheirowninitiatives andcontinuetoberunbythepeopletheyexisttosupport.This‘handsoff’approachiseffectiveinbuildingleadershipskills,empoweringpeoplewithdisabilitiestoadvocatefortheirownrightscollectively.Importantly,itgivesthegroupmembersastrongsenseofcontrolandownershipoverthedirectionoftheiractivities.

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Whatarethechallenges?

  • Itisdifficulttoincludepeoplewithalltypesofdisabilitiesintheselfhelpgroups,particularlythosewithhearing,speechorintellectualimpairments,aslocallydevelopedsignlanguageislimitedtobasicvocabulary.CDDhopestoaddressthisissuebyprovidingbasictrainingonsignlanguagetoselfhelpgroupmembers.CDDalsoplanstoconductexposurevisitstogetherwithpartnerorganisationstolearnnewstrategiesfocusedonincludingpeoplewithintellectualdisabilitiesandmentalillness.
  • The28-dayleadershiptrainingprogram,undertakeninoneblockinDhaka,wastoolongforsomepeoplewithdisabilitiestobeawayfromhome,particularlyforwomenwhohadfamilyresponsibilities.Asaresult,theprojectadaptedthetrainingintotwomodules.Thishasenabledmorewomentoattend.
  • Inrural areas there are noadequateservicestoproviderehabilitation.Thisisparticularlyanissueforsomemedicalortherapeuticinterventionsthatneedtobeprovidedfrequentlysuchasphysiotherapyorspeechtherapy.CDDisseekingtoaddressthisissuebylobbyingtheMinistryofHealthtoextendservicesintounreacheddistrictsandbydevelopingareferraldirectorytohelpfieldworkersmakeappropriatereferrals.
  • Transportforselfhelpgroupmemberstoattendmeetingsandeventsiscostly,particularlyforrepresentativesoftheapexbodieswhooftenneedtotravellongdistances.Ratherthancoveringthesecostsinthelongterm,CDDisworkingwithselfhelp groupstodevelopstrategiestomeetthesecostsinternally.

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Inclusivedevelopmentinpractice

Theprojecthighlightsthreekeyfactorsforeffectiveinclusivedevelopment:

1.Empoweringpeoplewithdisabilitiestoadvocatefortheirrights

Throughtheapexbodies,CDDfocusesonprovidingopportunitiesforpeoplewithdisabilitiestodirectlyvoicetheirconcernstogovernmentofficials,policymakersandinstitutions,ratherthanalwaysspeaking ontheirbehalf.CDDhasfoundthatpolicymakers respondmorepositivelywhentheydirectlyinteractwithpeoplewithdisabilities.

2.Provision of disability specific support and services to enable participation of people with disabilities in the community

Whilemany organisations have started selfhelp groupsinBangladesh,CDDistakingadifferentapproachbytrainingpeoplewithdisabilitiestostarttheirownselfhelpgroupswiththeirownobjectives.Indoingso,CDDisincreasingthecapacityofpeoplewithdisabilitiesasleaders,andimprovingtheownershipandsustainabilityofthegroups.

3.Working together with government andnetworkingwithothercommunitybasedorganizations forcoordinated,sustainableprojects

Insteadofdirectlyimplementingactivities,CDDisworkinginpartnershipwithstrong,establishedlocalorganisations ineachcommunity.Theseorganisationsareknowninthecommunitiestheyworkinandhaveongoingrelationshipswithcommunitymembers. Importantly,theorganisationsarealreadyoperatinginthecommunityandwillcontinuetoimplementtheir projects,withimprovedcapacity,afterCDD’strainingiscomplete.

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Learning and reflection

Howisyourprojectbuildingthecapacityofpeoplewithdisabilitiestoadvocatefortheirownrights?Howcouldyoubettersupportpeoplewithdisabilitiestodirectlyadvocatefortheirownrights?

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Howdoesyourprojectensurethatpeoplewithalltypesofdisabilitiesareconsidered,targetedandincluded?Doyouconsiderbarriersbeyonddisabilitysuchasgender?

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______

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A meeting of the Songram self help group in Gaibandha, Bangladesh

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CASE STUDY FROM MOBILITY INDIA

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LESSON1

MobilityIndiahasfounditis importanttofirstestablishselfhelpgroupsthatarefocusedonbuildingselfconfidenceand empowerment.Then,oncetherearestronggroupdynamics,livelihoodoradvocacyactivitiescanbeintroduced.

LESSON 2

CommunityEducationCentresnotonlyoffereducationalopportunitiesforchildrenwithdisabilitiesbutalsoafriendlyandsafeenvironmenttointeractwithotherchildrenandstrengthensocialskills.

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A MATRIX OF CHANGE – INCLUSION IN INDIA

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The cycle of poverty and disability in India

Disabilityisbothacauseandconsequenceofpoverty.InIndia this is seen inthe slums of Bangalore andinrural areas where accesstoadequatehealthservicesisweak.Withapopulationofoveronebillionpeople,therearemanydisadvantagedgroupsacrossIndia,yetpeoplewithdisabilitiesareoftenthemostvulnerable andexcluded.Withchildrenturnedawayfromschoolandadultsunabletoattainemployment,itisthestigmaassociatedwithdisabilitythattruly‘disables’people.AlthoughtheIndianattitudetodisabilityis slowlychanging,discriminationstillpreventspeoplewithdisabilitiesfromhavingequalopportunitiesandfullparticipationincommunitylife.

PROGRESSTOWARDSINCLUSION

Threepeoplewithdisabilitiesandtwofamilymembershavebeenelectedtothepanchayat(localgovernment).

  • Disabilityhasbecomeanimportantagendaitemin panchayatmeetings,withpeoplewithdisabilitiesbeinginvitedtospeakandsharetheirviews.
  • ApproximatelyhalfofallpeoplewithdisabilitiesidentifiedinAnekal(the project area) arenowmembersofselfhelpgroups.
  • Peoplewithdisabilitiesaretreatedmorelikeequalmembersofthecommunityandareinvitedtosocialfunctionssuchasweddingsandhousingceremonies

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  • Thecooperativesociety inAnekalhas developedapartnershipwithalocalcompanytoassemblepens, andisreceivingamanagementfeetocoordinatetheirassembly.Asaresult,52peoplewithdisabilitiesnowhavearegularincome.
  • Mostlocalgovernmentoffices,courts,policestationsandlocalschoolsintheprojectareashavebeenadaptedtobemorephysicallyaccessible.Someschoolshaveevenpaintedmuralsontheirwalls promotinginclusionofpeoplewithdisabilities.

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The Anekal CBR program’s approach

MobilityIndiaisanindependentdisabilityanddevelopmentorganisationthatfocusesonsupportingpeoplewithdisabilitiesthroughrehabilitationservicesandpovertyalleviationwiththegoalofachievinganinclusivecommunity.MobilityIndialeadsacommunity-basedrehabilitation(CBR)projectinAnekal,Bangalore,thatsupportspeoplewithdisabilities,workingacrossallfivedomainsoftheCBRmatrix:health,education,social,empowermentandlivelihood.

Health

Toaddressthelimitedqualityandsupplyofaidsandappliancesavailablethroughthegovernment,MobilityIndiahasestablisheditsownphysicalrehabilitationworkshop(prosthetics,orthotics,assistivedevicesand therapy services)in BangaloreCity. TheprojectinAnekalprovideshomebasedrehabilitationandreferspatientstotheserviceinBangalorewhenextrasupportisneeded.

Education

ChildrenwithdisabilitiesinIndiaareapproximatelyfiveandahalftimesmorelikelytobeoutofschoolthanother children their age.1Thismeans increasingaccesstoeducationisakeypriorityfortheproject.To increasedemand foreducation, awareness raisingactivitiessuchasstreetplaysareusedtoshowparentsthebenefitsofenrollingtheirchildrenwithdisabilitiesinschool.Atthesametime,theprojectisreducingbarrierstoeducationwithintheclassroombyprovidingtrainingondisabilityinclusiontoteachers,schooldevelopmentcommitteesandlocal governmentauthorities.

TheprojectalsoestablishesCommunityEducationCentres(CECs)atthevillagelevelthatarestaffedbyvolunteertutorsfromthecommunity.CECsaredesignedtosupportchildrenwithdisabilitieswhomaynotreceiveaneffectiveeducationsolelythroughamainstreamschool.Theyalsoprovideanopportunityforchildrenwithdisabilitiestogettoknowotherchildrenintheirvillageandengagewiththeminplayandlearning.

Social

Children’sparliamentsareapopularwayofenablingchildrenfrommarginalisedcommunitiestohaveavoiceinissuesthataffecttheirlives.Childrenareelectedasministersinareassuchaseducationandhealthandaresetthetaskofdevelopinganactionplan toaddressissuesraised intheirgroup.InAnekal,MobilityIndiaworkswithotherdevelopmentorganisationstoensurechildrenwithandwithoutdisabilitiescantakepartinthechildren’sparliamentmeetingsanddiscussissuesimportanttothemandtheirvillage.

Empowerment

TofosteranenvironmentofmutualsupportandencouragementtheprojectestablishedselfhelpgroupsincommunitiesacrossAnekal.Thegroupsreceiveinformationaboutrelevantgovernmentschemesandtrainingonleadershipandhuman rights,partakeinrecreationalandculturalactivities,andconductawarenessraisingactivitiestochangecommunityattitudes.Onceestablished,Mobility IndiasupportstheselfhelpgroupstosetupDisabledPeople’sOrganisations(DPOs).TheDPOsaretrainedinallaspectsoftheCBRprogram,withtheintentionthattheywillruntheCBRprograminthefuture.AfederatedDPOhasbeenestablished,withrepresentativesfromeachDPO.Itworkstoprovideaunitedvoicepromotingtherightsofpeoplewithdisabilities.

Livelihood

InAnekal,Mobility Indiaassists representatives acrossmultipleselfhelpgroupstoestablishacooperativesociety.Eachindividualselfhelpgroupmembercanchoosetopayasmallfeetobecomeashareholder

inthecooperative.ThesefundsareusedtoprovidelowinterestloanstoselfhelpgroupmembersandalsocontributetowardspaymentoftheCBRprojectmanagers.Thecooperative(originallytrainedbyMobilityIndia)providesbusinessskillstrainingandmentoringtoallloanapplicants.

1Singal,N.‘EducationofchildrenwithdisabilitiesinIndia.’BackgroundpaperfortheEducationofAllGlobalMonitoringReport,2010,p.8.

How is the Anekal CBR program implemented?

TheCBR program isimplementedinAnekalthroughanetworkoffieldworkersselectedfromlocalcommunities.Wherepossible,peoplewithdisabilitiesarerecruitedforthesepositionstoencourageownershipandselfadvocacyandto increasecommunityunderstandingoftheirabilitiesinapowerfulway.Oncepeoplewithdisabilitiesareidentifiedandassessedinthecommunity,anindividualrehabilitationplanisdeveloped.TheplanlooksatrehabilitationacrossallfivedomainsofCBRtosupporttheindividualtoparticipateandflourishin communitylife.

What is most effective?

MobilityIndia’scomprehensiveCBRapproachensuresallaspectsofdisabilityinclusionareconsidered.

Peoplewithdisabilitiesreceivehomebasedtherapyandassistivedevicesasneeded,whilefieldworkerssupportpeoplewithdisabilitiestoformselfhelp groupsandadvocatewithschools,employersandcommunitymemberstoincreasetheirparticipation inthecommunityandtheeconomy.Thesuccessoftheseindividualapproachesishowtheycomplementeachother:noapproachisaseffectivewithouttheother.ThiscomprehensivemethodofrehabilitationiscoordinatedbyateamoftherapistsandCBRworkerswhoworktogethertodevelopindividualinterventionplans.

Beyondindividualplans,theprojecthasbeensuccessfulonawidercommunityscalethroughchildren’sparliaments.Childrenwithdisabilitiesarestartingtoraiseissuesofconcernandthesearebeingaddressedbyotherchildren.Forexample,atonechildren’sparliamentinruralBangalore,awheelchairusernotedshewashavingdifficultyattendingschoolbecausetheroadwasnotaccessible.Thechildren’sparliamentraisedthisissuewiththelocalgovernmentwhichagreedtoimprovetheroad.Attheinstitutionallevel, largely due to the work of the Anekal DPO andselfhelpgroups,disabilityhasbecomeanimportantagendaiteminpanchayat(localgovernment)meetings,wherepeoplewithdisabilitiesarenowinvitedtospeakandsharetheirviews.

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What are the challenges?

  • Initiallysomecommunitieswereresistanttotheproject’ssupport;theywereletdowninthepastbyotherNGOsanddidnottrustthatMobilityIndiawouldfulfiltheircommitments.Oversixmonthstheprojectteambuiltrapportandconfidencewithinthecommunitytogainthetrustoflocalpeopleandencouragedtheirparticipationintheproject’sactivities.
  • TheestablishmentofMobilityIndia’sownphysicalrehabilitationaidsandappliancesworkshop,whilemeetingtheimmediateneedofpeoplewithdisabilitiesforqualityassistivedevices,hasnotbeensuccessfulinencouragingthegovernmenttoincreaseitsownsupplyorimprovethequalityoftheassistivedevicesitprovidestoitsconstituents.ThisraisesachallengeforthelongtermsustainabilityofprovisionofaidsandappliancesinBangaloreandacrossIndia.
  • Thetrainingoffieldworkersandprovisionofrehabilitation services is expensive and hinders thesustainabilityoftheprogram.BybuildingstrongnetworkswithlocalhospitalsandincreasingthecapacityoflocalDPOsandthecooperativesociety,itishopedtheworkoftheprojectwillcontinuelongafterthefundingperiod.

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Employees of Mobility India (women with disabilities) making prosthetic feet.

A meeting of the Kozhipalaya village Community Education Centre group.

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Inclusive development in practice

TheAnekalprojecthighlightstwokeyfactorsforeffectiveinclusivedevelopment:

1.Empowering people with disabilities to advocate for their rights

MobilityIndiatakesatwo-stepapproachtoempowerment.Thefirststepisthroughselfhelpgroups;wheretheyseektobuildtheselfconfidenceofpeoplewithadisabilityandaddressotherissuesexperiencedasaresultofyearsofdiscriminationandexclusion.Itisthroughthissupportmechanismthatpeoplewithdisabilitiescometorecognisetheyshouldhave thesamerightsasothersinthe community.ThenextstepissupportingpeoplewithdisabilitiestojoinDPOs where they can undertake and lead advocacyworkaboutissuesthatconcernthemandtheircommunityonagranderscale.

2.Provision of disability specific supports and services to enable participation of people with disabilities in the community

MobilityIndiahasestablishedandoperatesalargemedicalrehabilitationserviceinBangalorethatresourcesCBRprogramsacrosstheregion.ThisservicewasestablishedtosupportMobilityIndia’sbeliefthatbyimprovingpeople’sfunctionalabilities,peoplearemoreabletoactivelyparticipateintheircommunities.

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Learning and reflection

Ifyourorganisationdoesnotdirectlyproviderehabilitationservicesorassistivedevices,howcanyoumakesurepeoplewithdisabilitiesstillreceivethetypeofcomprehensivesupporthighlightedinthiscasestudy?

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MobilityIndiaimplementsthefivecomponentsofCBR.WhymightitbeimportanttoaddressallfiveaspectsofCBR?Howcouldyourorganisationutilisethisapproach?

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IfyourorganisationhasdevelopedasuccessfulapproachtoCBR,howcouldyousupportotherorganisationstoimplementasimilarapproach?

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CASE STUDY FROM CAMBODIAN DEVELOPMENT MISSION FOR DISABILTY (CDMD)

LESSON1

Ensuringpeoplewithdisabilitiesareactiveparticipantsinprojectimplementationnotonlyprovidesopportunitiestoimproveselfconfidence,butalsochallengescommunityperceptionsaboutthecontributionspeoplewithdisabilitiescanmakeintheircommunity.

LESSON2

EstablishingCommunityDisability Committees(CDCs)withinfluential communitymembersiskeytocreatingchangeatboththecommunityandgovernmentlevel.

PUTTING DISABILITY ON THE AGENDA INCAMBODIA

DisabilityinCambodia

Whiledatacanvaryconsiderably,Cambodiaisestimatedtohaveoneofthehighestratesofdisabilityforadevelopingcountry,1withmorethanhalfamillionpeople2 livingwithdisability,one-fifthofwhomhaveamputations.3Peoplewithdisabilitieshaveverylimitedaccesstoappropriatetreatment,rehabilitationservicesandvocationaltraining.Thismakesitincrediblydifficultforpeoplewithdisabilitiestoparticipatefullyandequallyincommunitylife.

1PolicyProject_Cambodia.pdf

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CDMD’sapproachtodisabilityinclusivedevelopment

TheCambodianDevelopmentMissionforDisability (CDMD) hasalonghistoryofprovidingrehabilitationandsupportingpeoplewithdisabilitiesinCambodia.In2009,thelossofamajorfundingsourceasaresultoftheglobalfinancialcrisisledCDMDtore-evaluateitsprogramdesign.CDMD’snewapproachwastoadoptamorecomprehensive,rights-basedapproachtodisabilityinclusion.Thenewapproachmeantthefocusshiftedfromjustprovidingrehabilitationtoworkingwithcommunities,partnersandthegovernmenttoencouragedisabilityinclusion.

Todesigntheproject,CDMDfacilitatedaworkshopwithstafffromCDMD,peoplewithdisabilitiesandtheirfamilies,disabilityorganisationsandrepresentativesfromthegovernment.Together,theydiscussedthechallengesfacingpeoplewithdisabilitiesinCambodiaanddevelopedstrategiestosupporttheseissues.ItwasthesefindingsthatguidedCDMD’sapproachtodisabilityinclusivedevelopment.

PROGRESSTOWARDSINCLUSION

  • In the two & a half years of project implementation over 800 people with disabilities or their family members have taken part in vocational training
  • Ofthesepeople,almost95percentcontinuetoworkinthatvocationalfieldtoday.
  • Morethan1100peoplewithdisabilitiesreceivedalivelihood loan in the past two & a half years.Closeto all loans have been repaid or partially repaid.
  • The2012evaluationfoundthatpeoplewithdisabilitieslivinginthefiveprovinceswhereCDMD works are now generally living in thesameconditionsas,orbetterconditionsthan,peoplewithoutdisabilities.
  • TheCambodianMinistryofSocialAffairs,VeteransandYouthRehabilitation isso impressedbythechangescreatedbyselfhelpgroupsandCommunityDisabilityCommittees,theyaredevelopingnationalstandardsandguidelinestopromotetheircreationinallcommunes.
  • Thirty-threecommunecouncilshaveagreedtoincludedisabilityissuesintheirdevelopmentplans.

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Howis the project implemented?

Communitylevel:Today,theprojecthasapproximately150communityvolunteers(ofwhich23arepeoplewithdisabilities)whoraiseawarenessofdisability,identifypeoplewithdisabilitiesandassistpeoplewithdisabilitiestoaccesseducationandhealthcareandearnanincome.Communitysupervisors,manyofwhomwerefieldworkerswithCDMDpriortotheprogramredesign,supporttheestablishmentofselfhelpgroups.Thesegroupsprovideaspacewithincommunitieswherepeoplewithdisabilitiescancometogethertoshareexperiences,learnadvocacytechniquesandcommunicationskills,andworktogethertoearnanincomethroughseedgrants.

Governmentlevel:EstablishingstronglinkswiththegovernmentiscrucialtoensureasustainableapproachtodisabilityinclusivedevelopmentinCambodia.Atthecommunelevel(thisisthethirdleveloforganisationinCambodia;nationalthendistrictthencommune)CDMDworkswithlocalgovernmenttoestablishCommunityDisabilityCommittees(CDCs).Thesecommitteeshavefivemembers:apersonwithadisability,arepresentativefromthehealthcentre,aschoolmaster/teacher,areligiousleader,andamemberofthecommunecouncil.Withtrainingsupportfromthecommunitysupervisors,theCDCsdevelopactionplanstowardsdisabilityinclusivepracticesandadvocatetoCommuneCouncilstodevelopdisabilityinclusivecommunedevelopmentplans.Thereligiousleaderinthegroupconductsawarenessraisingactivitiestoreducestigmaanddiscriminationwithinthecommunity.

Workingtogether:The36establishedCDCsworkwiththenetworkofcommunityvolunteers.Forexample,ifamemberofthecommunityrequiresawheelchairtheymayapproachtheCDC,whowillthenworkwithacommunityvolunteertosourcethewheelchairorreferthemontoaservice where wheelchairsareavailable

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Whatismosteffective?

CDMDstrivestoensuredisabilityisontheagendaatboththecommunityandnationallevel.Thishashelpedmorechildrenwithdisabilitiestoattendschoolandhasreducedstigmawithincommunities,enablingpeoplewithdisabilitiestoparticipateincommunitylife.

Beyondthechangesseeninthecommunity,oneofthesuccessesofCDMD’sworkisthewaytheyengagepeoplewithdisabilitiestodelivertheirwork.Over15percentofCDMDcommunityvolunteers haveadisability.Molikaisonesuchvolunteer;atfive years ofage Molikawas referredby CDMD forsurgerytoimprovehisvisionimpairment.Althoughthesurgerywasnotsuccessful,MolikahasmaintainedanongoingrelationshipwithCDMDsincethen.Today,at24 years ofage, heis anactive communityvolunteer withCDMDandrolemodelforpeoplewithdisabilities.Afterreceivingtraining,hetookonthecommunityvolunteerroleasanopportunitytochallengethemisconceptionthatpeoplewithdisabilitiescan’tdoanything.Hesawitasachancetosupportothersin thewayCDMDsupportedhim.

Molika’sstoryshowshowCDMDstrivestofindpositiveoutcomesforpeoplewithdisabilities.Byensuringactiveparticipationinprojectimplementation,CDMDisimprovingtheselfconfidenceofpeoplewithdisabilitiesandhelpingchallengecommunityperceptionstherebyreapingstrongbenefitsfortheindividualandthewidercommunity.

Producing hammocks as an income generation activity.

What are the challenges?

  • CDMDhasfoundthehighlevelsofpovertyin Cambodiamakeitdifficultforvolunteerstospendsignificanttimeundertakingunpaidwork.Tohelp motivate andmaintainvolunteers,CDMDpays asmall perdiemtocovertransportcostsandonemealforeachdayspentvolunteering.
  • WhileCDMDtakesstepstoactivelyinvolvepeoplewithdisabilitiesintheimplementationoftheproject,themajorityofpeoplewithdisabilitiesinvolvedarevisuallyimpairedorhaveminorphysicalimpairments.CDMDhasspecialistskillssupportingthevisuallyimpaired,yetisfocusedonwideningitsreachtosupportpeoplewitharangeofdisabilitiesandhigh supportneeds.ThischallengeisalsoseeninthegenderbreakdownofCDCs:CDMDencouragesequalnumbersofwomenandmen,yetonly15percentofCDCmembersarewomen.
  • OneofthesuccessesofCDMD’sworkistheprogresstheyhavemadeinsupportingschoolstobemorephysicallyaccessible.HoweverCDMDdoesn’tyethavethecapacitytoworkwithteacherstoimprovetheirskillsforteachingchildrenwithdisabilities.Insome cases,childrenhave beenplacedin mainstreamschoolswithouttherelevantsupporttoensuretheyreceiveagoodqualityeducation.CDMDislinkingupwithinclusiveeducationNGOstoplacechildrenwithdisabilitiesinschoolswheretheyhavetheappropriatesupport.
  • SustainabilityisanongoingchallengeforCDMD. Despitebuildingstrongrelationshipswiththegovernment,CDMDhasfounditdifficulttosecureongoinggovernmentfunding.Withoutthissupport,coststosupporttheCDCsandcommunityvolunteers willnotbemetbeyondthelifeoftheproject.Inresponse,CDMDwillengageinmoretargetedadvocacywithnationallevelbodiesinthenextphaseoftheproject.

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Inclusivedevelopmentinpractice

CDMDhighlightstwokeyfactorsforeffectiveinclusivedevelopmentinitswork:

1.Empoweringpeoplewithdisabilitiestoadvocatefortheirrights

CDMDadoptsstrategiesthatseektoempowerpeoplewithdisabilitiestoadvocatefortheirrightsandgainskillsthatenablethemtohavegreatercontrolovertheirlives.AsofJuly2012,CDMDhadestablished105selfhelpgroupswith7to15memberseach.Selfhelpgroupshavedevelopedadvocacyskills,receivedsmallloansforlivelihoodactivities,networkedwithlocalgovernmentsandparticipatedincommunityactivities.Whilethisisastrongfoundation,the2012evaluationnotesthatadditionalcapacitybuildingwillberequiredfortheselfhelpgroupstofunctionindependentlyofCDMD.

CDMDalsoworkswithexistingDisabledPeople’sOrganisations(DPOs)operatingatthedistrictlevel,andplanstobuildthecapacityoftheseorganisationstosetupselfhelpgroups,ratherthandoingthisdirectly.DPOshavereceivedtraininginrights,projectcyclemanagement,proposalandreportwritinganddisabilitylaw.Theyareaimingtoadvocatetogovernmentforinclusiveeducationandinclusionofdisabilityissuesincommunedevelopmentplans.CDMDisdevelopingapartnershipwiththenationallevelDPO,CambodianDisabledPeople’sOrganisation,whichwillbeimportanttoincreasesustainabilityandavoidduplicationofefforts.

2.Working togetherwithgovernmentandnetworkingwithothercommunitybasedorganisationsforcoordinated,sustainableprojects

CDMDclearlyshowsthebenefitsofworkingcloselywithgovernmentministriesandotherorganisations.Throughbuildingrelationshipsatalllevelsofgovernment,CDMDhasbuiltstrongsupportforitsactivitieswithintheMinistryofSocialAffairs,VeteransandYouthRehabilitation.TheMinistryrecognisesCDMDasanimportantpartnerandrecommendsthatselfhelpgroupsandCDCsbepromotedinallcommunes.Unfortunately,thissupportfromgovernmenthasnotyetresultedinafinancialcontributiontowardstheproject.

Atthelocallevel,establishingtheCDCshasprovedtobeasuccessfulstrategyfordisabilityinclusion.With someinitialtrainingondisabilityinclusion,CDCshavebegunaddressingbarrierstoinclusionwithintheirlocalcommunities.StrategicallyselectingmembersofCDCswhoareinfluentialwithinthecommunityhashelpedtomakethesecommitteeseffective. Whathasresultedisasmallnetworkofchampionswithineachcommunewhocanadvocatefordisabilityinclusionwithintheirownspheresofinfluence.Withsomeadditionalsupport,theCDCshavepotentialtobecomesustainablestructuresfordisabilityinclusionat the local level.

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Learning and reflection

HowcouldCDMDworkwithandsupportawiderrangeofpeoplewithdisabilitieswithvaryingsupportneeds?

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Haveyoudevelopedarelationshipwithlocalandnationalgovernment?Howisyourprojectlinkinginwithgovernmentplansandpriorities?

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CASE STUDY FROM REHABILITATION & PREVENTION INITIATIVE AGAINST DISABILITY (RAPID)

LESSON1

The quality of theRehabilitation and Prevention InitiativeAgainstDisability(RAPID)programisreliantontheskillsandknowledgeoftheCBRfield workers.To maintainahighstandard,itiscrucialfieldworkersreceivetrainingandongoingmentoring.

LESSON 2

EmpoweringDisabledPeople’sOrganisations(DPOs),parents’groupsandindividualstoadvocateforthemselveswas themosteffectivewaytochangecommunityattitudestowardspeoplewithdisabilities.

BREAKING BARRIERS TO INCLUSION – REHABILITATION AND EDUCATION IN ETHIOPIA

PROGRESSTOWARDSINCLUSION

  • During 2012 activities to raise awareness of the causes and prevention of disabilities reached over 51,000 community members.
  • Projectstaffestimatethatupto80percentofpeoplearenowawareofdisabilityissuesandrecognisetheabilitiesofpeoplewithdisabilities.
  • Between2006and2009almost900childrenwithdisabilitiesreceivedhomebasedrehabilitation.In2012,392childrenwithdisabilitiesreceivedrehabilitationservices.
  • In2012,736peoplewerereferredformedicaltreatment.
  • During2012,468peopleweresupportedtoreceiveassistiveandmobilitydevices.
  • 210peoplecommencedincomegenerationbusinessesduring2012.
  • Allparentswithaloaninterviewedduringa2009evaluationreportedearningabetterincome.
  • Increasednumbersofpeoplewithdisabilitiesareparticipatingindecisionmakingprocesses.
  • Accessibilityofhealthcentreshasimprovedwithsignlanguagetrainingsostaffcancommunicatewithdeafpeople.
  • Healthcentresareprovidingfreetreatmentforpeoplewithdisabilities.
  • Agovernmentfundedbusnowprovidestransporttorehabilitationservices.

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The cycle of poverty and disability in Ethiopia

InEthiopiadisabilityiscommonlyassociatedwithacurse. Thereforepeoplewith disabilitiesareregularlyexcludedfromEthiopiansocietyanddiscriminatedagainst by theirfamilies andcommunities. Therearecloseto5.3millionpeoplewithdisabilitiesinEthiopiaandonly0.7percenthavehistoricallyhadaccesstoeducationalservices.1

1Agegnehu,Etenesh.2000.‘InclusionofCWD:situationalanalysisofEthiopia.’InternationalSpecialEducationCongress2000.papers_a/agegnehu_1.htm

RAPID’s approach to disability inclusive development

RecognisingtheextremechallengesfacingpeoplewithdisabilitiesinEthiopia,theRehabilitationandPreventionInitiativeAgainstDisability(RAPID)beganestablishingcommunitybasedrehabilitation(CBR)programsfrom2005.TheCBRprogramsaredesignedtochangenegativecommunityattitudesandsupportchildrenandyouthwithdisabilitiestoparticipateandcontributeasequalmembersoftheircommunityandeconomy.Today,theCBRprogramshavereachedover450,000peopleinAdama,Assela,DeraandIteyawithCBRactivities.

Changeathome:RAPID’sCBRprogramsfocusonchildrenunder15yearsofagewithdisabilities,sosupportisoftenprovidedtofamiliesintheirhomes.InAdama,22localfieldworkersweretrainedtohelpfamilieslearnaboutandunderstanddisability.Thefieldworkersconductrehabilitationinhomes,referchildrenformedicaltreatmentandprovideassistivedevicestosupportchildrentoparticipateintheircommunity.Someparentsaregivenloansandtrainingtohelpthemearnasustainableincomeandsupporttheirchildrentogotoschool.

Changeatschool:Openingschooldoorstochildrenwithdisabilitiesisonesteptowardsgaininganeducation,butensuringtheyhavetherightfacilities,areacceptedandcanthriveatschoolisanother.AtAdama No.2Elementary,oneoftheschoolswhereRAPIDisworking,specialclassesareprovidedforstudentswithdisabilitieswheretheylearntouseBraille, signlanguageandotherskillstopreparethemfortransitionintomainstreamclassrooms.Teachersaretaughttorespondtotheneedsofstudents,infrastructureisinplacetosupportstudentswithadisabilityandadisabilityclubisrunforallstudents,aimingtobuildunderstandingandacceptance.Now,whenchildrenwithdisabilitiesarereadytomoveintomainstreamclassrooms,theyarewelcomedwiththerightsupport.Inadditiontoschools,RAPIDalsosupportsinclusivepracticesforlivelihoodprograms,healthservices,hospitalsandlocalgovernment.

Changeinthecommunity:Withfieldworkerssupportingchangeinthehomesofchildrenwithdisabilitiesandteachersembracingdisabilityinclusioninschools,itisimportantthatdisabilityisrecognisedinthewidercommunity.RAPIDhasfoundthemosteffectivewaytochangecommunityattitudestowardspeoplewithdisabilitiesistofocuseffortsontrainingandempoweringDPOs,parents’groupsandindividualstoadvocateforthemselves.Ineachcommunitywheretheprojectisrun,aCBRcommitteeissetupwithparentsofchildrenwithdisabilities,governmentrepresentativesandlocalmembersofDPOs.Togethertheyworktoensuredisabilityisonthecommunityagendaandthatpeoplewithdisabilitieshaveavoiceindecisionmaking.

How is RAPID implemented?

RAPID commencesCBRworkineachnewtown byaskinglocalstakeholderstoidentifythegreatestbarrierstotheinclusionofchildrenandyouthwithdisabilitiesintheircommunity.Theprojectfocusesonfourkeyelementstoachievegreaterinclusionofchildrenandyouthwithdisabilities:

  1. Provisionofcomprehensivephysicalrehabilitationservicestocaterforthepoorestchildrenandyouthwithdisabilities.
  1. Developmentandimplementationofinitiativestoensureschoolsareinclusiveofchildrenandyouthwithdisabilities.
  1. Deliveryofawareness raisingactivitiestohelpthecommunitylearnaboutthecausesandeffectsofdisability,andtoadvocatefortheimplementationofexistinggovernmentpoliciesregardingdisabilityissues.
  1. Creatingopportunitiesforyouthwithdisabilitiesandtheirfamiliestoaccesslivelihoodandmainstreamfinancialresourceopportunities.

Inresponse totheseelements,RAPIDlooksatestablishingandsupportingin-homerehabilitationatthesametimeasnetworkingwithmainstreaminstitutionsandmedicalservicesfortheinclusionofchildrenandyouthwithdisabilities.

What is most effective?

Aleadingstrengthoftheprogramisthequalityoftrainingforfieldworkerswhosupportfamilieswithrehabilitationinhomes.Eachfieldworkerparticipatesinaninitialsixweeksoftrainingonhowtoidentifydisability,developindividualrehabilitationplans,trainparentsondisabilitymanagementskillsandconductawarenessactivities.RAPID’sfieldworkersengageincontinuallearning,meetingmonthlytosharechallengesandsuccesses.

The referral system across Adama and Addis AbabalinksCBRprograms,hospitals,medicalclinics,schoolsandtraininginstitutionsthatareinclusiveofchildrenandyouthwithdisabilities.Thisincludescost-sharingarrangementswithsomeserviceproviderstohelp make rehabilitationmoreaffordable. The referralsystem ensuresthat fieldworkershave avariety ofreferraloptionsandthattheprogramcanbeproactiveineducatingmedicalprofessionalsandcommunitymembersaboutreferralmechanisms,helpingtoensuresustainability.

RAPID’sapproachtoachievinginclusiveeducationisdesignedtoprovideinformaleducationthroughfieldworkersatthesametimeasworkingwith15 elementaryschoolstoimproveaccessforchildrenwithdisabilities.RAPIDfieldworkersmeetwithschoolprincipalsandteacherstoadvocatefordisabilityinclusion,providetraininginteachingstrategiesandofferassistanceinestablishingschooldisabilityawarenessclubs.Activitiesundertakenbythedisabilityawarenessclubsincludetheatreondisabilityinclusion,discussionsanddebatesaboutinclusion,andorganisingcelebrationstorecognisepeoplewithdisabilities.RAPID’sapproachtoinclusiveeducationsupportschildrenwithdisabilitiestodevelopfoundationskillstoeasetheirtransitionintoaschoolthatismoreequippedtoprovideaninclusivelearningenvironment.

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What are the challenges?

  • While thereferral systemis costeffective,RAPID’sdecisiontorefrainfromprovidingservicesdirectlymeansthatfieldworkersarereliantuponexistingservices,which are notalways adequate. Someservicesarelocatedalongdistancefromprojectareas,whichcanleadtoadditionalaccommodationandtransportcosts.
  • Itcantaketimeforparentstoconfidentlyapplythephysiotherapyanddisabilitymanagementtechniques. Inresponse,thefieldworkersnowsupporttheparentswithadditionalvisitsandtraining.
  • Theprojectfacesdifficultiesinvolvingchildrenwithdisabilities,especiallyyoungchildrenandthosewithhighsupportneeds,inprojectplanningandimplementation.Inresponse, RAPIDisdevelopingstrategiesforchildren’sinvolvementthroughparticipatoryplanningprocessesalongsidetheirparentsandhasstartedtoinvolvechildreninthedevelopmentoftheirownrehabilitationplans.

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A mother carrying out daily therapy with her child, as trained by a field worker.

Children with and without disabilities at school together.

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Inclusive development in practice

RAPID’sapproachhighlightstwokeyfactorsforeffectiveinclusivedevelopment:

1.Provision of disability specific supports and services to enable participation of people with disabilities in the community

RAPIDrecognisesthatphysicalrehabilitationandprovisionofassistivedevicesarevitalstepstoenableinclusionofyouthandchildrenwithdisabilitiesintheircommunities.Byprovidingdisabilityspecificsupport,astrongreferralsystemandserviceswithinawiderCBRdisabilityinclusionprogram,RAPIDismakingprogresstowardsgenuineinclusionandmeaningfulparticipationforchildrenandyouthwithdisabilities.

2.Advocacytobuildawarenessofandsupportfordisabilityinclusion

RAPID’sworkwithschoolsisagoodexampleofhowutilisinganumberofstrategiescanincreaseawarenessandremovebarriersblockingdisabilityinclusion.Bysupportingparentgroups,teachersandDPOstoincludechildrenandyouthwithdisabilities,andempoweringindividualstoadvocateforthemselvesaccordingtotheirownpriorities,theprojectisstrengtheningthevoiceofpeoplewithdisabilitiesacrossthecommunity.

Learning and reflection

Howcouldchildrenwithdisabilitiesbemoreactivelyinvolvedinprojectplanningandimplementation?

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HowcouldRAPIDworktowardsimprovingthequalityofexistingserviceprovidersinthereferralnetwork?

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CASESTUDYFROMAMAUDOCOMMUNITYMENTALHEALTHPROGRAM

LESSON1

Buildingaprojectwithinexistinggovernmentsystemscanresultinmoresustainable change. However,to ensureprojectsareinclusive,theseactivitiesmustbecoupledwithstrongadvocacywiththegovernmenttoensurepeoplewithdisabilitieshaveopportunitiestofulfillprojectimplementationroles.

LESSON 2

Making timetoraiseawarenessatthebeginningoftheprojectandharnessthesupportofcommunityleadersandmembersofthegovernmenthelpstocreateastrongsenseofcommunityownership.

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BREAKING CHAINS OF DISCRIMINATION –

MENTAL ILLNESS IN NIGERIA

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Mental illness in Nigeria

InNigeriastigmatowardsthosewithmentalillnessisastrongbarriertoinclusionandachallengeforcommunities.Atalocallevel,thereislittleknownabout mental illness. As a resultviews of mentalillnessare oftenfuelled by myths.In many Nigeriancommunitiesitisbelievedmentalillnessiscausedbywitchcraftoristheresultofdivinepunishment.Consequentlycommunitieshavebeenknowntochain peoplewithmentalillnessorhidefamilymembers affectedbymentalillnessasaresultofthestigma.1

1Ukpong,DIAbasiubong,F.‘Stigmatisingattitudestowardsthementallyill:AsurveyinaNigerianuniversityteaching hospital’,SouthAfricanJournalofPsychiatry,

Vol16,No.2,2010.

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The Mental Health Awareness Program’s approach to disability inclusive development

TheAmaudo Community MentalHealth Program istheonlycommunitybasedmentalhealthserviceinsoutheasternNigeria.Theprojectprovidesaccessible,affordableandprofessionalcaretopeoplewithmentalillnessthroughanetworkofclinicsanddirectlytohomes.Theprojectfoundeducatingcommunitiesandchallengingtraditionalbeliefsaboutmentalillnessisanessentialpartofsupportingpeoplewithmentalillness.

Aspartoftheprogram,theMentalHealthAwarenessProgram(MHAP)wasdevelopedtoeducatecommunityworkersandfamiliesandprovidethemwiththetoolsandknowledgetosupportpeoplewithmentalillnessintheircommunity.MHAPisafive-yearprogramdeliveredtothefourstateswheretheCommunityMentalHealthProgramoperates.

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PROGRESSTOWARDSINCLUSION

  • The MHAPhasledtosignificant increasesinthenumberofreferralstotheCommunityMentalHealthProgram.
  • Villagehealthworkershavereportedpowerfulexamplesofworkingwithfamiliestoreleasepeopleaffected bymentalillnessfromchains andsupport themtoreceivementalhealthcare.
  • Villagehealthworkershavecarriedoutawarenessraisingactivitiesinchurches, mosques,schoolsandcommunitymeetings.
  • Childrenwithepilepsywhowereinitiallyexcludedfromschoolsarenowreturningandtheattitudesofteachersandclassmatesarechanging.
  • Some villagehealthworkershavefoundthatpeopleincommunitiesareapproachingthemforadviceaboutmentalhealth.

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How is MHAP implemented?

Recognisingthataccesstogoodhealthcareisanimportantfirststeptowardscommunityinclusion,theprojectarrangestrainingforcommunitypsychiatricnursesandothergovernmenthealthprofessionals.Once trained,theydeliverawarenessandeducationprogramsaboutmentalillnessandhumanrightstovillagehealthworkerswhodirectlysupportpeopleaffectedbymentalillnessintheircommunities. Ineacharea thegovernment recruits 15voluntaryvillagehealthworkerstosupportapproximately200,000people.Thevillagehealthworkerslearnpositivemessagesaboutmentalhealthandadviceonhowtoidentify,referandsupportpeoplewithamentalillness in the community. In raising awareness aboutmentalillnessandencouragingthosewithmental healthproblemstoattendCMHPclinics,thevillagehealthworkersarehelpingtochangecommunitybeliefsandpreventdiscrimination.

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Whatismosteffective?

Inthesixmonthsleadinguptotheproject’sstartinanewarea,communitiesareheavilyinvolvedinthedevelopmentoftheproject.Thismeansmeetingwithinfluentialcommunitymembersandgovernmentofficialstosharetheimportanceofmentalhealth. Bythetimetheprojectofficiallylaunchesineachcommunity,thecommunitypsychiatricnurses,othergovernmenthealthstaffand15villagehealthworkershavealreadyattendedtraining,keycommunitymembersaresupportiveoftheprojectandthereisastrongsenseofcommunityownership.

MrOmo is a village health worker for the MHAP. Inhissparetimehevisitsthetraditionalleadersinlocalvillagestoexplainhisroleandprovideinformationaboutmentalillness,supportservicesandtheimportanceofcommunityinclusion.Eachvillagehealthworkermaintainsacloserelationshipwithapsychiatricnurse,andMrOmoisnoexception.Hehasastrongrelationshipwiththecommunitypsychiatricnurse,whosupportshim,andherequeststheirsupportwhenhehasanyquestions.

MrOmofoundthatasmorepeopleaccessmentalhealthcarethecommunityhasbecomemoresupportiveastheycanseetheresultsforthemselves.PeoplearenowstartingtoapproachMrOmofromothercommunitiesbecausetheyhaveheardabouthisworkandarehopefulthatmentalhealthproblemscanbetreated.Thisisanimportantfirststepinstartingtochangecommunityattitudesandincreaseparticipationofpeoplewithmentalillnessinthecommunity.

Villagehealthworkersdomuchmorethanprovidereferral services; theyalso help peoplewith mentalillnesstake partincommunitylife.Theyencourage familyreconciliationandvisitschoolsandworkplaceswherepeoplewithmentalillnessarenolongerabletoattend.Inthesehomes,schoolsandworkplacesthey teachpeopleaboutthechallengesofmentalillnessandtheimportanceofdisabilityinclusivepractices.Thiscomponentoftheprojectisavitalsteptowardsreintegratingpeoplewithdisabilitieswhohaveexperienceddiscrimination.

TheMHAPmonitoringprocessesareintegratedintotheexistingCommunityMentalHealthProgram’smonitoringwherepossible.Amonitoringandevaluationteamisestablishedatthebeginningofeachperiodofvillagehealthworkertrainingwiththeaimofreviewingattendance,contentandthequalityoftraining.Thisteamconductspre-andpost-trainingteststoassessthechangeinattitudeandknowledgeofthevillagehealthworkers.Information,includingthenumberofreferralsmadetoclinicsandawarenessraisingactivitiesinthecommunity,isalsocollectedbycommunitypsychiatricnursesfromeachvillagehealthworker.

Community Mental Health Program nurse and field workers.

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What are the challenges?

  • Oneofthekeychallengesfortheprojectisthatmentalillnessisoftennotapriorityforstateandlocalgovernments.Asaresult,gaininggovernmentsupporttakesconsiderabletimeandeffort.Althoughtherearemanybenefitstohavinggovernmentstaffsupporttheproject,highstaffturnoveratlocalgovernmentlevelhasimpactedthereachoftheproject.
  • Communitypsychiatricnursesprovide‘refresher’trainingsessionsforvillagehealthworkerseverysixmonths.However,ithasstillproveddifficulttomaintainvillagehealthworkermotivation.Tohelp fosterapositiveworkingenvironmenttheprojectprovidesincentivestocoverthecostsoftransportandhasintroducedaprizeforvillagehealthworkerswhohavethehighestnumberofsuccessfulreferralsintheirlocal governmentarea.
  • Althoughpeoplewithdisabilities(primarilymental illness)aredirectbeneficiariesoftheprojectandwereinvolvedintheprojectdesign,theyhavenotbeengiventheopportunitytohelpimplementactivitiesandcreatechangeintheircommunity.Theprojectwillcontinuetoadvocatetothegovernmenttoconsiderselectingpeoplewithdisabilitiesasvillagehealthworkers.
  • AkeycomponentofMHAPistoestablishselfhelp groupsineachlocalgovernmentareatobringpeoplewithmentalillnesstogetherforpeersupportandtoundertakeadvocacyactivities.Yetnotmanypeoplehavecomeforwardtojointhegroups.Thisislikelytobebecauseofthestigmaassociatedwithmental illness.Activeparticipationinaselfhelpgroupmayresultindiscriminationagainstthemortheirfamilymembers.

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Community Mental Health Clinic

Psychiatric nurse

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Inclusive development in practice

TheAmaudoMHAPhighlightstwokeyfactorsforeffectiveinclusivedevelopment:

1.Advocacytobuildawarenessofandsupportfordisabilityinclusion

Beforeworkinginnewlocalgovernmentareas,projectstaffspendsixmonthsbuildingawarenessandsupportfortheproject.Thisincludesmeetingwithgovernmentofficials,theprimaryhealthcaredirector,localchiefsandreligiousgroupstosharetheimportanceoftheproject.Thishelpseachcommunityunderstandmentalhealthandfeelpartoftheproject.Itisalsoacrucialsteptoensurecommunitypsychiatricnurses,villagehealthworkersandothergovernmenthealthstaffaretrainedandreadytostartworkwhentheprojectlaunchesintheircommunity.

2.Working togetherwith governmentandotherserviceprovidersforcoordinated,sustainableprojects

TheMHAPworkscloselywiththegovernmentintwoways:itislinkedwithexistinggovernmentservicesandissupportedbygovernmentstaff.TheMHAPworkstostrengthenexistingservicesthegovernmentisalreadycommittedtoproviding.Thisapproachhelpstobuildthelongevityoftheservicesofferedforpeoplewithmentalillness.Intermsofstaff,ratherthanemployingnewprojectstafftheprojectutilisesexistinggovernmentstaffsuchascommunitypsychiatricnursestoimplementtheproject.Governmentsystemsareused to recruit, trainand supervise village healthworkers.Bybuildingtheprojectintothegovernmenthealthstructure,theservicesforpeoplewithmentalillnessremaintheresponsibilityofthegovernment,arenotdependentondonorfundingandhaveagreaterlikelihoodofcontinuingbeyondthetimeframeoftheproject.

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Learning and reflection

Howdoesyourorganisationmanagethedifficultiesofprojectimplementationinanenvironmentwherestigmaanddiscriminationarewidespread?

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WhatmorecouldtheMHAPdotoensurepeoplewithmentalillnessareinvolvedintheimplementationoftheproject?

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Whattechniquescouldtheyusetosupportandencouragepeoplewithmentalillnesstoparticipateinselfhelp groups?

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CASESTUDYFROMNORFILFOUNDATION

LESSON1

Workingwithlocalgovernmentbyassistingandequippingthemtoimplementservicesandsupportforpeoplewithdisabilitiesachievesstronglocalownershipoftheprogram.

LESSON 2

Changetakestime–itisimportanttodedicateenough timetobuildthecapacityofparentsinsteadofrushingtobuildlargesupportgroups.Parents’Associationsneedtofirstequipparentstobettersupporttheirownchildren,thengraduallyintroduceparentstowidernetworkssuchassupportgroups.

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LOCAL OWNERSHIP CREATES SUSTAINABILITY IN THE PHILIPPINES

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ThecycleofpovertyanddisabilityinthePhilippines

DisabilityisagrowingconcernindevelopingcountrieslikethePhilippineswherediscriminationandprejudicepresentmajorchallengesforpeoplewithdisabilities,especiallyinpovertyaffectedareas.IntheprovinceofBatangas,where2.2millionpeoplelive,peoplewithdisabilitiesareamongstthepoorestinthecommunity.Theyareoftenmarginalisedfrommainstreamsocietyandlackaccesstohealthcareandrehabilitation.

Forchildrenwithdisabilitiesthelikelihoodofgoingtoschoolisextremelyslim,withonlyafewschoolsintheprovinceacceptingchildrenwithdisabilitiesandveryfewspecialeducationclasses.Thecascadingimpactofthisisseeninthelimitedopportunitiespeoplewithdisabilitieshavetoaccessskillstrainingandemployment.Thereisalsothelostincomeopportunityforparentswhoneedtostayathometocarefortheirchildrenwithdisabilities,furtherexacerbatingpoverty.

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PROGRESS TOWARDS INCLUSION

  • Ownershipofcommunitybasedrehabilitation(CBR)activitieshasincreasedsubstantiallyatbothprovincialandmunicipallevels.
  • Localgovernmentunitsarenowroutinelyplanningtomeettheneedsofpeoplewithdisabilitiesintheircommunitiesandbudgetingfortheseactivities.
  • Ordinances have beenpassed within thelocalgovernmentunitsfortheestablishmentofspecialclassesinmainstreamschools,resultinginover400childrenwithdisabilitiesattendingmainstreamschoolsintheBatangasProvincein2011.
  • Physicalaccessibilitylawsconcerningpublicinfrastructurehavebeenpassed.
  • Somelocalgovernmentunitshaveorganisedlivelihoodtrainingforpeoplewithdisabilities,orhavearrangedforpeoplewithdisabilitiestobeincludedinmainstreamlivelihoodprograms.
  • In2011,theprovincialgovernmentledanannualreflectionthatshowedthegovernment’sreadiness tolead theCBR activitiesinBatangas.
  • AKAPINBatangan(parentassociation)hasover2000membersandisactivelysupportingthe19 municipallevelparentgroups.
  • AKAPINBatanganisreceivinggovernmentfundingandisseenbygovernment as a key partner in implementing disability related initiatives.

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NORFIL Foundation’s approach to disability inclusive development

NORFIL Foundationis anon-governmentorganisationbasedinthePhilippinesfocusedontheneedsofchildrenandyoungpeoplewithdisabilitiesandtheirfamilies.In2002,NORFILdesignedtheBatangas communitybasedrehabilitation(CBR)projecttoaddressthesocietalbarrierspreventingtheinclusionofchildrenwithdisabilitiesasequalmembersintheircommunity.

Theinitialfocusoftheprojectwasonprovidinghome-basededucationandrehabilitationservicesforchildrenwithdisabilitiesandhelpingpreparechildrentoattenddaycareandmainstreamschools.Inaddition,theprojectestablishedaparents’association,AKAPINBatangan,whichencouragedparentsofchildrenwithdisabilitiestoformsupportgroups.

TheprovisionoftheseimportantinitiativesheavilyreliedonNORFILFoundation.Asaresult,theaimofthenextphaseoftheprojectwastoensuremechanismsareinplacetosupportthecontinuationofthe CBR project after NORFIL Foundation phasesout. Withthisaiminmind,NORFILFoundationisworkingtostrengthenthecapacityoflocalgovernmentunitsandtheAKAPINBatanganparents’associationby:

  • LobbyingfortheestablishmentofaCommitteeforDisabilityAffairstooverseetheimplementationofprogramsandservicesforpeoplewithdisabilitiesatthelocalgovernmentunitlevel.
  • Strengtheningtheparents’association,AKAPINBatangan,andtherelationshipbetweentheassociationandlocalgovernmentunits.
  • Trainingadditionalgovernmentvolunteerstoextendtheprovisionofrehabilitationservices

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Disability inclusion training for students in a local school.

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How is the project implemented?

ToeasethehandoverofCBRactivities,NORFILFoundation’sfirstpriorityistoincreaselocalgovernmentownershipofCBRactivities.Todothis,NORFILFoundationlobbiesforandsupportstheestablishmentofaCommitteeforDisabilityAffairstooverseethe CBRactivities in eachlocal governmentunitwithintheBatangasProvince.

Establishment:Eachcommitteeissetupwith15 members,includingrepresentativesfromgovernmentlineagencies(inareassuchashealth,socialservicesandeducation),registeredNGOs,civilsocietyorganisations,DisabledPeople’sOrganisationsandselfhelpgroups.

Monitoring:InthePhilippinesthecommitteesaredesignedasthecoordinatingandmonitoringarmofthelocalgovernmentunitsfortheimplementationofdisabilityrelatedinitiatives.Theyformulatelocalpolicies,draftordinancesfortheapprovalofthelegislativeassemblyand ensure localgovernmentdevelopmentplansareinclusiveofpeoplewithdisabilities.

Capacitybuilding:NORFILFoundation,throughAKAPINBatangan,worksalongsidethecommitteestoimprovethecapacityofgovernmentlineagenciestoimplementdisabilityinclusiveprograms.AnAKAPINBatanganrepresentativeattendseverycommitteemeetingtosupportthelocalgovernmentunittoachieveitsCBRcommitments.Forexample, whenonecommitteewassuccessfulinhavinganordinancepassedtoincludechildrenwithdisabilitiesinmainstream schools,AKAPINBatangantrainedteachersandprovidedtechnicaladvicetomainstreamschoolsonhowbesttoincludechildrenwithdisabilities.

NORFIL Foundation alsofocuses onbuilding thecapacityofAKAPINBatanganandstrengtheningitsrelationshipwithlocalgovernmentunitstoincreasesustainability. NORFILFoundationsupported AKAPINBatangantobecomearegisteredorganisation,conducted awareness raising sessionsonCBR,trained25AKAPINBatanganofficersasCBRtrainers,andtrainedparentstobecomevolunteerpeercounsellors.NORFILFoundationalsoassisted AKAPINBatangantoestablish19 parent groups(oneineachlocalgovernmentunit)toextendAKAPINBatangan’smembershipbaseandincreaseitspresencewithinmunicipalitiesanditsconnectionwithlocalgovernmentunits.Theparents’groupsmeetmonthlyandaretrainedinadvocacyandtheprovisionofrehabilitationinthehome.

Alloftheseactivitiesrelyonarangeofcommunityvolunteerstoimplementcommunitybasedactivities.

AsNORFILFoundationphasesoutofBatangas itisimportantthattheexistingvolunteersandnetworksestablishedinthegovernmentstructuresarestrengthened.Forexample,NORFILFoundation,throughAKAPINBatanganmembers,providedtrainingondisabilityinclusiontovolunteercommunityhealthworkers,nutritionscholarsanddaycareworkers.Thecommunityvolunteersweretrainedtoidentifypeoplewithdisabilities,referthemtoservicesandincludepeoplewithdisabilitiesintheirregularcommunityworkandresponsibilities.

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What is most effective?

EstablishingandsupportingtheCommitteesforDisabilityAffairswithintheexistinggovernmentstructurestotakeoverprimaryresponsibilityforcoordinatingCBRactivitiesineachlocalgovernmentareahasenabledthesmoothphaseoutofNORFILFoundationfromtheBatangasProvince.Thisincludeddevelopingacounterpartschemewiththelocalgovernmentstohelpinitiallysharecostsandlimitdependencyonprojectfunding.Forexample,NORFILFoundationpaidfortheprovisionofepilepsymedicationforoneyearonly;thenextyearitwas includedinthegovernmentbudget.Thishelpedtoremindthegovernmentthatresponsibilityforsupportingpeoplewithadisabilityshouldsitwithin thecommunityandbeanongoingpriorityoflocalgovernmentunits.

StructuringtheCommitteesforDisabilityAffairssorepresentativesfrom AKAPIN parents’groupsareincludedasmembersineachcommitteehasalsobeeneffectiveinholdingthecommitteestoaccountandensuringthatdisabilityinclusionisconsideredinthegovernment’sannualinvestmentplans.

In preparation forthe phase out,NORFIL Foundationgraduallyimplementedfeweractivitiesdirectly,andprimarilyfocusedonprovidingtechnicaladviceandsupporttolocalgovernmentunitsandAKAPINBatanganwhenrequired.