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Disability Models - UNICEF Mozambique

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Disability Models - UNICEF Mozambique Powered By Docstoc
					       Children with Disabilities
HRBA, Equity and Inclusive Development
  Challenges & Opportunities for UNICEF
   WHO ARE THE
‘BENEFICIARIES’ OF
  DEVELOPMENT?




                      AND WHO
                      ARE THE
                     EXCLUDED?
      Convention on the Rights of Persons with Disabilities

                             Article 1 - Purpose
    To promote, protect and ensure the full and equal enjoyment of all 
    human rights and fundamental freedoms by all persons with 
    disabilities, and to promote respect for their inherent dignity.
   

     Persons with disabilities include those who have  long-
      term physical, mental, intellectual or sensory 
      impairments which in interaction with various
      barriers may hinder their full and effective
      participation in society on an equal basis with others.

        CRPD                                       Optional Protocol
        •153 signatories                           •90 signatories
        •110 ratifications                         •63 ratifications
                  UNICEF’s Mandate

UNICEF’s mission statement:
-priority to the most disadvantaged children;
-identifies CWD as being among the most disadvantaged 
;
-requiring special protection.

CRC, together with CRPD and CEDAW:
 


- UNICEF foundation to uphold the civil, cultural, 
economic, political, and social rights of all girls, boys and 
women in the world, including those with disabilities. 
          The CRPD institutes:
     - PERSON(S) WITH DISABILITIES

               Also Correct:
•individual(s) with disability or disabilities
   •people with disabilities or disability

      Disabled People also acceptable.
                                                I will kill you
                                                so you stop
                                                  suffering

Disabilities as:

- Will of God/test from God
- Divine punishment 
- More humane to end “life of pain/suffering”




               People with disabilities considered:

               •inferior, useless, dependent
               •A burden to society, live on charity, lower social status
               •Families hide them out of shame
               •Objects of pity, humiliated in relationships with others
  Problem belongs to individual: disability results directly 
  from impairment of the person.

 Disability considered only a  
  health problem, medical issue                   EMPLOYMENT

                                      We will rehabilitate
                                       you so you can
 Solutions decided by               overcome all barriers

  "experts”, based on diagnosis
 Focus in elimination or cure 
   of  disability, “normalization”
(includes pre-natal genetic 
   testing & selective abortion)
 People with disabilities are part of society and inclusion must 
  be promoted (health, education, training, work…)

 Independent living movement is born

 PwD are organized, 
get stronger

 Sectors of society, 
especially “disability 
professionals”, 
see this as cause to 
worry
MEDICAL MODEL
He cannot vote
because he is
disabled.




                 SOCIAL MODEL
                 He cannot vote because the
                 stairs prevent him from
                 reaching the ballot box.




            From MEDICAL to SOCIAL model
 The main issue is in society rather than in the individual
 Recognizes that disability is a 
     part of society
 More comprehensive and 
     global. Considers:
    - Civil and political rights
     (voting, freedom of expression 
     )
    - Economic, social and cultural 
     rights (health, education ...)
    - PwD and their families 
     reclaim their place as 
     PERSONS, with rights and 
            Equal opportunities
     duties. full participation
           and
        in political and social life.
           IMPAIREMENT & DISABILITY

Anyone at any time can acquire an IMPAIRMENT of any 
kind and can become permanently or temporarily 
DISABLED.  Impairment relates to the way people function 
in their environment and in society. 
 

It may be present from birth or it may develop during a 
lifetime, through malnutrition or disease, accident, violence 
or abuse, or environmental conditions.  As people age, so 
too does the possibility of acquiring a visual, hearing, 
physical or other type of impairment.
 

Different kind of IMPAIRMENTS may generate different 
kinds and levels of FUNCTIONING LIMITATIONS but, if we 
can eliminate barriers in society, these limitations may not 
necessarily become a DISABILITY.
           IMPAIREMENT & DISABILITY

Whether an individual will be considered “disabled”
is strongly related to the enabling or disabling
environments that surround that specific person,
including society’s attitudes and social norms.  
 
If barriers are eliminated and there is positive interaction
between the person and the broader environment, so 
there will be greater opportunities for personal 
empowerment, social participation and inclusion.  
If the individual may not be able to overcome the existing 
societal barriers, even with support and specific 
accommodations, this interaction will reinforce stigma, 
discrimination and lead to disempowerment and
exclusion.
 Equity issue becomes clear when
                    1+1= minus 2

                    Gender + disability
                   Minorities + disability
                  Indigenous + disability
                     Race + disability
                   Refugees + disability
                   Orphans + disability
                    Poverty + disability
      and other associations, including all of the above 


INVISIBILITY – STIGMA - EXCLUSION
most excluded are the ones with multiple factors combined
         Equity = Equal Opportunities

To guarantee a fair
  selection, all will
have the same exact
 test – climb up on
      that tree.




 Functioning Diversity           Environment
HOW IS DISABILITY DEFINED AFTER THE CRPD?




    Interaction between persons with different
                levels of functioning
                         and
     an environment that does not take those
          differences into consideration.

Disability= Functioning limitation x Environment
 Note: we are using “functioning limitation” as a synonym of “impairment”. 
Environment Impact in the relation
between disability and functioning


     FL 1 x E 0 => 0 Disability
     FL 5 x E 0 => 0 Disability
     FL 1 x E 1 = 1 Disability
     FL 5 x E 5 = 25 Disability


               FL: FUNCTIONING LIMITATION
               E: ENVIRONMENT
   Disability is part of each and every individual’s life cycle




Beyond the typical areas of impairments (physical, sensory,
 intellectual and mental), people in general face ‘disabling’
   conditions in a society that is unprepared for diversity.
 Every day, new causes of disability…
Advances in medicine         HIV-AIDS survivors =
= higher life expectancy.
People living with AIDS potentially living with disability
associated with, or as consequence of, medication.

                                 Also, PwD at risk of
                                 contracting STI, HIV-Aids
                                 due to greater vulnerability
                                 to sexual abuse, and lack of
                                 access to information,
                                 communication and services.
 This could be the SAME person at
   different times of their life

Why not make life
 easier for all?
            INCLUSIVE DESIGN




None of
them
would be
able to
open that
door…
    INCLUSIVE DESIGN
A HUMAN-CENTERED DESIGN
 Inclusive & Sustainable Public Policies
All principles, actions and components should be
conceived under an inclusive approach, from
design to implementation.

Persons with
disabilities
should be
visible and
actively engage
in all phases
            It is estimated that the
additional costs to bring inclusive access to
 infrastructure is lower than 1% in the stage
          of designing and planning
                Poverty & Disability
   WHO/WB estimate approximately 15 percent of world’s 
population has a disability. This translates into over a million
people, at least 200 million being children with disabilities
   (CWD), 80% of them living in developing countries.
Vicious cycle between poverty and disability




      Poverty not only from economic perspective,                             
                    Causes of Impairments
       About 80% of disabilities have causes associated to poverty.
An estimated 130 million people globally acquired a disability due to malnutrition.  
Prevalence of Disability in Selected Countries


                 Percent of Disabled Population
Bangladesh                   0.8
Niger                        1.3
Egypt                        4.4
Italy                        5.0
Germany                      8.4
United States                15.0
Australia                    18.0
       Disability, Employment and Social Protection
About 80-90% of persons with disabilities are unemployed
or outside the work force. Most of those who have jobs receive 
little or no monetary remuneration. 


                                                 In Ecuador, 
                                                 84% of 
                                                 persons with 
                                                 disabilities 
                                                 have no
                                                 insurance
                                                 benefits.
                     Disability and Conflict


                                                      High prevalence of
                                                      disability amongst
                                                      conflict-affected
                                                      populations: ex-
                                                      combatants,
                                                      civilian and
                                                      refugees.




Refugees with disabilities face double vulnerability of being a refugee
and having a disability.
               Disability in Emergency Situations
Emergencies - conflict or natural disaster:
In the short-term:                                          Haiti, 2010
- injury and malnutrition,
leading to disability.

In the longer term:
- destruction of health and
education services
- higher rates of disease
- all resulting in disability.


   - PwD must be included in the planning of humanitarian responses
     (providing shelter, sanitation, health-care, food and education).
Poverty & Disability

       UK:
       Poverty rate:
       PwD = 23.1%
       Non-disabled people = 17.9%

      If extra expenses associated with
      being disabled added,
      Poverty rate disabled people =
      47.4%
      (Amartya Sen)

           
                   Disability and Education
Estimated 40 million of 115
million out-of-school children have 
disabilities. 

UNESCO: 90%  of  children  with 
disabilities  in  developing  countries 
do  not  attend  school; therefore 
absent  in  school  data  sets,  and 
invisible on national policy agenda.


Estimated 30%  of world’s children  who  live  on  the  street  are 
children with disabilities.
    Disability, Child Mortality and Child Protection

                                               In Kazakhstan, 80% of
                                               fathers  are  reported  to 
                                               abandon  their  wife  and 
                                               family upon the birth of a 
                                               child  with  a  disability 
                                               (ADB).  The situation  is 
                                               similar elsewhere.  


Mortality for children with disabilities may be as high as 80% in
countries where under-five mortality, as a whole, has fallen to below
20%.
In some cases, it seems as if disabled children are being “weeded
out.” (DfID, UK)
Disability Data in Mozambique
         PWDs Living Conditions Study in MOZ
• Education: A higher proportion than normal of PWD who have never 
  attended school; or have a low frequency; or high dropout rate. Men with 
  disabilities have a higher proportion of school dropout than women (65%).
• A higher proportion of women with disabilities have never attended school 
  (53%) - twice than of women without disabilities, as well as men with and 
  without disabilities.
• The proportion of PCD who can write was higher than the general population 
  (24% versus 15%). Almost a quarter of PCD cannot write while in the general 
  population the proportion is less than 1/6. The number of women/men with 
  disabilities who cannot write was higher than that of the general population.
• Communication and information: availability and accessibility to telephone, 
  radio, television, internet, banking facilities, newspapers, post office and 
  library. PWDs have significantly limited access to different forms of 
  communication and information compared to the general population.
                          Access to Services

                        Incidence of low and moderate
                        disabilities is higher than severe
                        disabilities.  
                        Most cases can be attended at the 
                        community level, with simple,                  
                        cost-effective interventions.
                          

    Without necessary attention, low functional limitation,
    can become severe disability, generating high risk of 
    social and economic exclusion. 
      Inclusive and Sustainable Public Policies

Cost of special services to address the specific needs of each
group in society is much higher and less cost effective than of
those of public policies and programs designed and implemented
for all. 
               Inclusive Development
Based on Human Rights and Equity Approaches:

Recognizes DIVERSITY as fundamental aspect in process of 
socioeconomic and human development.

Recognizes the contribution that each human being can make 
to development process.

Promotes an integrated strategy benefiting society as a whole,
rather than implementing isolated policies and actions. 

Is an effective approach for overcoming social exclusion, 
combating poverty and ensuring social and economic sustainability.

Sustainable Development means Inclusive Development!!!
    Strategies for Promoting Inclusive Development
                 Across all MTSP FAs:
• Build on existing opportunities;  propose inclusive strategies
in initiatives already being implemented;
• Develop capacities among different actors to advocate and
negotiate for inclusive policies, programs, humanitarian actions;
• Establish mechanisms for participation and collaboration of
PwD,CwD & families in design, implementation,  M&E of policies, 
programs and humanitarian actions. 
• Invest in public discourse & communication to change
attitudes towards people with disabilities. 
Selected Examples
        for
MTSP Focus Areas
    MTSP 1: Young Child Survival and Development

•   all projects, including ECD, health promotion, social protection: 
consider CwD & families among their clients 

•  all projects related to health, nutrition, WASH, prevention, etc.: 
adopt outreach efforts towards CwD and their families; ensure 
access to information, communication & social services
(including transportation & access to surrounding areas)

•  all YCSD initiatives: address attitudes of service providers & 
community; incorporate inclusive components e.g. appropriate 
services & approaches for parents and CwD, accessibility, and staff
training on CBR.
   MTSP 2: Basic Education and Gender Equality

- all teacher training : inclusive education perspective; 
  address attitudes towards CwD
- CFS & quality education initiatives: promote inclusive
  education
- life skills & sexual/reproductive health initiatives: equal
  access to children and young PwD
- policy advocacy:  mainstreaming of CwD in formal & non
  -formal education
- all gender mainstreaming efforts should include girls and
  boys with disabilities
                    MTSP 3: HIV-Aids & Children
- all sexual & reproductive health initiatives, including prevention & provision 
  of services: specifically include girls, women, boys and men with
  disabilities as direct clients & as service providers

- all public education materials & initiatives:  accessible to & inclusive of 
  children & adults with wide range of disabilities
PREVENTION: ALL OF US HAVE A ROLE TO PLAY
                    MTSP 4: Child Protection

• all family services (e.g. child care, parenting education): include
  families of CwD; address attitudes towards PwD
• training of service providers, alternative care/foster care  
  providers: include building understanding of CwD & how to care for 
  them
• capacity building to prevent, detect & manage 
  abuse/exploitation: include building understanding & skills to
  cope with different types of disability
• engagement with community & faith based organizations:
  address stigma & discrimination
MTSP 5: Policy Advocacy & Partnerships for Children’s Rights

• Advocate for & facilitate dialogue on rights-based approach to
  CwD; promote ratification, implementation & monitoring of CRPD
• Strengthen DPO capacity to effectively advocate for ratification of 
  CRPD & monitor its implementation: focus on rights of CwD
• Support national statistical offices/government agencies to include 
  disability in census & household surveys, and disaggregate
  data to include CwD
 


• Support participation of CwD & their families in design/revision & 
  monitoring of policies & legislation, & development of inclusive 
  strategies for systems strengthening

           NOTHING ABOUT US WITHOUT US!
             THANK YOU!
                                    Rosangela Berman Bieler
                                        Chief,  Disability Unit
                Gender, Rights and Civic Engagement Section
                                            Program Division
                                                       UNICEF
  Three United Nations Plaza, Room 452, New York, NY 10017
                      Tel: 212-824-6067 - Fax: 212-735-4420
e-mail: rbermanbieler@unicef.org – web site: www.unicef.org

				
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