Omagh Traveller Health Support Project by dfhrf555fcg

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									Omagh Traveller Health
Support Project
Final Evaluation Report
July 2006

                  McCready Donnelly Lowry
                     27 Auburn Drive
                       Magherafelt
                        BT45 5ED

                      tel. 028 79301042
             email anne.mccready@btconnect.com
Contents

Executive Summary

1.0 Background                                               1

    1.1    Project rationale                                 1
           1.1.1 Traveller health                            1
           1.1.2 Support for the Traveller Community in
                 the Western area                            2
    1.2    Travellers Support Network Project                2
    1.3    Omagh Traveller Health Support Project            4
    1.4    Contribution of Omagh Traveller Health
           Support Project to the aim and objectives of
           the Travellers Support Network Project            5
    1.5    Good practice in Traveller health support
           work                                              6

2.0 Project design                                           8
    2.1    Terms of reference for the Omagh Traveller
           Health Support Project                            8
    2.2    Project area                                      9
    2.3    Roles and responsibilities                        9
           2.3.1 Role of Omagh Traveller Support Group       9
           2.3.2 Operational management                      9
           2.3.3 Traveller Health Support Worker             10
    2.4    Project activities                                10



3.0 Evaluation methodology                                   12

    3.1    Evaluation aims                                   12
    3.2    Evaluation framework                              12
    3.3    Collection of evidence to inform the evaluation   14
           3.3.1 Brief review of the strategic environment
                 relevant to support for Traveller health    14
           3.3.2 Review of Project records                   16
           3.3.3 Consultation with Steering Group members    16
           3.3.4 Consultation with the Traveller Health
                 Support Worker                              16
           3.3.5 Consultation with Travellers                17
           3.3.6 Consultation with other Traveller support
                 organisations                               17
           3.3.7 Consultation with other stakeholders        17
4.0 Project activities – outputs and outcomes                     18
      4.1    Core Project function – outputs and outcomes         18
             4.1.1 Engagement with the Traveller Community        18
             4.1.2 Supporting inclusion                           19
             4.1.3 Partnership working                            21
             4.1.4 Increasing awareness and reducing
                   discrimination                                 23

      4.2    Activities supported – outputs and outcomes          24
             4.2.1 Driving Theory Classes                         24
             4.2.2 Communal Garden                                25
             4.2.3 Computer Class                                 26
             4.2.4 Taster Night                                   27
             4.2.5 Women’s Health Group                           27
             4.2.6 Flower Arranging                               28
             4.2.7 Dance and Physical Activity                    28
             4.2.8 Young Men’s Project                            29
             4.2.9 Summer Scheme                                  29
             4.2.10 Women’s Health Programme                      30
             4.2.11 Activities with Traveller men                 31
             4.2.12 Capacity building programme with
                     Donegal Travellers                           32

5.0    Conclusions                                                34
       5.1   Strategic fit                                        34
       5.2   Response to the original Omagh Traveller
             Health Support Project terms of reference            35
             5.2.1 Identify need                                  35
             5.2.2 Advocate for Traveller families in the area    35
             5.2.3 Act as a link between Travellers and
                   voluntary / community / statutory
                   organisations                                  37
             5.2.4 Develop partnerships                           38
             5.2.5 Facilitate the delivery of a range of health
                   and well-being programmes                      39
             5.2.6 Develop support services for Traveller
                   families in the Omagh area                     40
             5.2.7 Promote a community development,
                   partnership approach                           41
             5.2.8 Build self esteem, personal development
                   and lifeskills throughout the Project          42
             5.2.9 Raise health awareness among Traveller
                   families                                       43
             5.2.10 Reduce discrimination, promote cultural
                    awareness and foster good relations             44
             5.2.11 Share good practice and improve the working
                     practices of those delivering services to
                    Traveller families                              45

      5.3    Contribution to the wider Traveller Support
             Network project aim and objectives                     47
               5.3.1 Increased access to health and social
                     services through partnership working and
                      improved co-ordination                        47
               5.3.2 Establish the most appropriate approach
                     to deliver health and social services to the
                     Traveller Community                            47
               5.3.3 Develop protocols for service delivery
                      to ensure seamless and ‘fast track’ care
                      for Travellers                                47
               5.3.4 Establish a network of service access
                      points for Travellers                         48
               5.3.5 Examine opportunities to provide services
                      on Traveller sites                            48
               5.3.6 Training members of the Traveller
                      Community to develop lay health worker
                      skills                                        49
               5.3.7 Stimulate the development of support
                     services in the Sperrin Lakeland area to
                     complement the development in the Derry
                     area                                           49
               5.3.8 Create links with other Health Boards
                     and Health & Social Services Boards
                     to remove barriers to receiving care           49

      5.4     Project structures and management                     50
               5.4.1 Omagh Traveller Support Group                  50
               5.4.2 Omagh FOCUS as a host organisation             51
               5.4.3 Line management                                52

      5.5     Staffing                                              53
      5.6     Monitoring / evaluation                               55
      5.7     Additionality                                         55
      5.8     Value for money                                       56
      5.9     Summary conclusions                                   57

6.0    Recommendations                                              60
Appendix
Job Description - Traveller Health Support Worker
Executive summary

The Omagh Traveller Health Support Project, represented by the work of the
Omagh Traveller Support Group, is part of a wider range of measures led by
Western Investing for Health and awarded Executive Programme Funding for the
development of support services for the Traveller Community in the Western
Health and Social Services Board area for a two-year period from 2003 to 2006.
The terms of reference for the Project are:

      o   to identify need and share best practice;
      o   to advocate for Traveller families in the area;
      o   to act in the first instance as a link between Travellers and
          voluntary/community/statutory organisations;
      o   to develop partnerships with these organisations;
      o   to facilitate the delivery of a range of health and educational well-being
          programmes;
      o   to develop support services for Traveller families in the Omagh area;
      o   to promote a community development, partnership approach;
      o   to build self esteem, personal development and life skills throughout
          the Project;
      o   to raise health awareness among Traveller families;
      o   to reduce discrimination, promote cultural awareness and foster good
          relations;
      o   to improve the working practices of those delivering services to
          Traveller families.


The work of Omagh Traveller Support Group is targeted towards all Traveller
families in the Omagh area. A Traveller Health Support Worker undertakes a
‘grass-roots’ community development approach to health and well-being with the
Traveller Community. Omagh Traveller Support Group works in partnership on
an interagency basis to support this work and make strategic connections to
relevant organisations to promote accessible and suitable services for Travellers.
Omagh Traveller Support Group has achieved a high level of success in
engaging with the Traveller Community in Omagh. A range of activities has been
initiated and planned in consultation with Travellers which have made a positive
impact on the inclusion of Travellers in the wider community.


The Project has put health and well-being on the Travellers’ agenda and has put
Traveller health and well-being on the agenda of a range of organisations across
all sectors.   It has made substantial progress in relation to each of its own
objectives and has made a significant contribution to most of the objectives of the
Western Travellers Interagency Group and its Executive Programme Funded
Travellers Support Network project.


Key to the success of the Omagh Project has been the community development
approach employed, especially the level and quality of engagement with the
Traveller Community, the advocacy on behalf of individuals and the community
by the Traveller Health Support Worker, and the intersectoral partnership
approach by Omagh Traveller Support Group which has supported this. The
Project management roles of Omagh FOCUS and Western Health Action Zone
have conferred strategic and operational advantages.


The recommendations emerging from the evaluation are as follows:


       the ‘community development in partnership’ approach of Omagh
        Traveller Support Group should continue to be supported for the
        foreseeable future and any potential break in continuity of support
        avoided.    Support must continue until there is clear evidence of
        widespread consideration of Travellers needs in the planning and
        delivery of essential services.
   future work should be defined within the framework of a strategic plan for
    the support of Travellers in the Omagh area which may form part of a
    wider plan for the western area including Omagh and Fermanagh, but
    which should clearly define and respond to the needs in Omagh. The
    most effective approach to this will be within the context of a strategic
    interagency plan for the Western area in its entirety – a responsibility of
    the Western Travellers Interagency Group.


   in the wider context, the Western Travellers Interagency Group, CAWT
    and individual Traveller Support Groups should ensure that particular
    issues for Travellers in the western area are communicated and
    addressed at regional and national levels, including to the All-Ireland
    Traveller Health Study;


   Omagh Traveller Support Group and Traveller Health Support Worker
    should take ‘time-out’ to develop the Omagh strategic plan, which as well
    as guiding work at the strategic level should also provide a framework for
    strengthened operational action planning for the Project and a foundation
    resource for accessing external funding;


   as part of the planning process and beyond, the partnership identity and
    function of Omagh Traveller Support Group should be strengthened,
    including identification of actions by the Group, and by partners, which
    will further advance the aim of mainstreaming consideration of the needs
    of Travellers into service provision;


   Omagh Traveller Support Group should work towards securing Traveller
    representation on the Group, and improve targeting of Travellers in all
    areas in Omagh and, for the future, Fermanagh, including nomadic
    Travellers;
   staffing needs should be reviewed in light of the strategic direction and
    operational needs identified;


   resources should be sought to support future work – given the diversity of
    the activities which underpin the community development approach, the
    work could benefit from a number of funding sources;


   a straightforward, but more robust, action planning, monitoring and
    reporting framework should be designed for Omagh Traveller Support
    Group – care should be taken to ensure that the framework does not lead
    to ‘over-planning’ of activities as the flexible, responsive nature of the
    approach to date needs to be recognised as a significant success factor;


   the profile of Omagh Traveller Support Group should continue to be
    raised including taking further opportunities for positive publicity for the
    Traveller Community;


   there should be an increased focus on the dissemination of learning by
    Omagh Traveller Support Group - to support mainstreaming service
    activity, but also as a model of practice with potential for use in delivering
    support to other minority communities.
                                         Omagh Traveller Health Support Project - Final Evaluation



1.0 Background

1.1       Project rationale

1.1.1 Traveller health

The experience of the Traveller Community of the range of accepted
determinants of health is recognised as contributing to very significant health
inequalities for Travellers. Factors such as social and economic exclusion, direct
and indirect discrimination, racism and hostility, lack of recognition of culture and
ethnic identity and educational status, including poor literacy levels, all contribute
to marginalization, disadvantage and poor health outcomes.


It has been shown 1 that Travellers experience:


          more than double the rate of stillbirths of the settled population;
          infant mortality three times higher than the national rate;
          Traveller men living, on average, ten years less than settled men;
          Traveller women living, on average, twelve years less than settled
           women;
          higher rates of morbidity for all causes of death;
          life expectancy that settled people had already reached by the 1940s.


This presents a challenge to health and social care services if Travellers are to
be effectively supported to achieve an equal health status to the settled
population, requiring achievement of equitable access to, and experience of,
services:




1
  In ‘The Travellers’ Health Status Study – Vital Statistics of the Travelling People’ 1987. (An All
Ireland Traveller Health Study is currently in progress.)


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                                       Omagh Traveller Health Support Project - Final Evaluation




Travellers require special consideration in health care because 2:

      they are a distinct cultural group with different perceptions of health, disease
       and care needs;

      the Health Status Study 1987 has shown that Travellers have different health
       and disease problems to settled people. Infectious disease control, accident
       prevention, ante-natal care, child spacing, genetic counseling, health
       behaviour and health service utilization are all priorities that must be
       addressed.

      these distinct characteristics imply that innovative approaches to service
       organisation, content and delivery are required if health conditions are to
       improve.



1.1.2 Support for the Traveller Community in the western area


Historically, the focus of dedicated support for Travellers and Travellers’ health
within the Western Health & Social Services Board area has been within the
Foyle Health & Social Services Trust area, with little organised support available
in the Sperrin Lakeland Health & Social Services Trust area. The submission of
a project proposal for support via Executive Programme Funds was, for the most
part, a response to this situation.


1.2       Travellers Support Network project


The Omagh Traveller Health Support Project, represented by the work of the
Omagh Traveller Support Group, is part of a wider range of measures awarded
Executive Programme Funding for the development of support services for the
Traveller Community in the Western Health and Social Services Board area.
This wider initiative is known as the ‘Travellers Support Network’ project.


2
    In ‘A Review of Travellers’ Health Using Primary Care as a Model of Good Practice’. Pavee
    Point Primary Health Care for Travellers Project, 2005.




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The Travellers Support Network project received £178,000 for a two-year period
although this was subsequently reprofiled allowing the Omagh Traveller Health
Support Project to continue until December 2006.

The package of Travellers Support Network measures included:

         steps to address the absence of support for the Traveller Community in
          the Sperrin Lakeland Health and Social Services Trust area;
         enhancement of existing development work being undertaken by Derry
          Travellers Support Group, including support for networking in the western
          area and
         initiatives to support nomadic Travellers.


This subsequently translated into three separate proposals as follows:

i.   A Development Worker post for the Omagh area, responsible to a newly
     established local interagency grouping on Travellers – Omagh Traveller
     Support Group - and coordinated through the local community network,
     Omagh FOCUS.


ii. Commissioning of Derry Travellers Support Group to undertake networking
     and support for both Trust areas (Foyle and Sperrin Lakeland).

iii. Development of support structures for nomadic Travellers in the Western
     Health and Social Services Board area.

The aim of the Western Travellers Interagency Group is to increase access to
health and social services amongst the Traveller Community through working in
partnership with Travellers and improving co-ordination among service providers
in the Western Health and Social Services Board area.




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The objectives of the Travellers Support Network project are to:

          establish the most appropriate approach to deliver health and social
           services to the Traveller Community based on available information and
           working with Travellers and their support organisations;
          develop protocols for service delivery across the relevant Health Service
           disciplines and structures to ensure seamless and ‘fast track’ care for
           Travellers;
          establish a network of access points (individuals) for Travellers across
           the relevant disciplines and services;
          examine opportunities to provide services on Traveller sites, both formal
           and informal, and respond as appropriate;
          train and support individuals from the Traveller Community to develop lay
           health worker skills including First Aid, health promotion and social care;
          stimulate the development of support services in the Sperrin Lakeland
           area to complement the development in the Derry area;
          create links with other Health and Social Services Boards and Health
           Boards in the Republic of Ireland to remove barriers to receiving care due
           to high mobility among the Traveller Community.


1.3       Omagh Traveller Health Support Project

The Omagh Traveller Health Support Project is contained in strands (i) and (iii) of
the Travellers Support Network project above, and benefits from some £111,000
of the total funding package. An overview of the Omagh Project funding derived
from the Executive Programme Funds is presented in Table 1.




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Table 1   Breakdown of funding for Omagh Traveller Health Support Project
         from the Executive Programme Funds allocation for the Travellers
         Support Network project in the Western area
Project cost area                         Funding awarded – over a two
                                          year period

Traveller Health Support Worker Salary                            £50,000


Overheads                                                         £18,000


Capital / set-up costs                                            £3,000


Management fee                                                    £10,000


Omagh Pilot Programmes                                            £30,000


Total                                                            £111,000




1.4     Contribution of Omagh Traveller Health Support Project to the aim
        and objectives of the Travellers Support Network project

Omagh Traveller Health Support Project began with the establishment of Omagh
Traveller Support Group in July 2003. The Group aims to improve the health and
well-being of Travellers in the Omagh area, to reduce discrimination among the
public in general towards Traveller families and to make links for Traveller
families with service providers in the Sperrin Lakeland Trust area.


While the Omagh Traveller Health Support Project has its own terms of reference
/ objectives, it is also expected that it will make a contribution to the achievement
of the objectives of the wider package of measures supported by Western
Travellers Interagency Group.



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                                       Omagh Traveller Health Support Project - Final Evaluation




Hence, while this evaluation is primarily concerned with the achievement of the
Omagh Project objectives, account is also taken of the impact of the Project in
relation to the expectations associated with the overall Travellers Support
Network initiative.


1.5        Good practice in Traveller health support work


Good practice in Traveller Health support (including in view of the wider
determinants of health such as housing, living and working environment,
education, safety and security, freedom from harassment and intimidation etc.)
have been identified variously by organisations such as Pavee Point 3 (Ireland)
and the Commission for Racial Equality 4 (England and Wales) as including:


           strong local leadership on the importance of decent accommodation for
            all and understanding of people’s different circumstances;
           maintenance of well resourced and well managed sites and making it
            easier for Travellers to take part in the life of communities;
           active promotion of good race relations and dealing successfully with any
            problems that could lead to tensions between different sections of the
            community;
           organisations with statutory responsibilities making Travellers a routine
            part of their mainstream work at both strategic and operational levels;
           active encouragement for Travellers to get involved in local decision
            making and playing a larger role in the life of the community;
           using community development approaches;
           working in intersectoral partnerships.



3
    In ‘A Review of Travellers’ Health Using Primary Care as a Model of Good Practice’. Pavee
    Point Primary Health Care for Travellers Project, 2005.
4
    See www.cre.gov.uk/downloads/commonground_summary.pdf


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                                  Omagh Traveller Health Support Project - Final Evaluation




This list provides a useful reference point for the evaluation in its consideration of
the quality and relevance of the approach employed by Omagh Traveller
Support Group. Thus the evaluation will take account of these indicators of good
practice in its overall assessment of the Project and its impacts.




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                                   Omagh Traveller Health Support Project - Final Evaluation



2.0 Project design

2.1    Terms of Reference for the Omagh Traveller Health Support Project

The Omagh Traveller Support Group began in July 2003 along with the
appointment of the Traveller Health Support Worker, and aims to improve the
health and well-being of Travellers in the Omagh area, to reduce discrimination
among the public in general towards Traveller families and to make links for
Traveller families with service providers in the Sperrin Lakeland Trust area. The
values of the Project are those of inclusion, support and capacity building.

The terms of reference for the Project are:

       o   to identify need and share best practice;
       o   to advocate for Traveller families in the area;
       o   to act in the first instance as a link between Travellers and
           voluntary/community/statutory organisations;
       o   to develop partnerships with these organisations;
       o   to facilitate the delivery of a range of health and educational well-being
           programmes;
       o   to develop support services for Traveller families in the Omagh area;
       o   to promote a community development, partnership approach;
       o   to build self esteem, personal development and life skills throughout
           the Project;
       o   to raise health awareness among Traveller families;
       o   to reduce discrimination, promote cultural awareness and foster good
           relations;
       o   to improve the working practices of those delivering services to
           Traveller families.


The evaluation has been conducted by treating the terms of reference as
representing the Project objectives. Progress has been assessed in relation to
each area.


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                                     Omagh Traveller Health Support Project - Final Evaluation




2.2       Project area

The work of Omagh Traveller Support Group is targeted towards all Traveller
families in the Omagh area. In Omagh there are two sites of grouped housing,
one at Ballinamullan (6 houses) and one at Tattykeel (8 houses). All the other
Traveller families live in various public housing estates throughout the area.


Consultation by Omagh Traveller Support Group identified that there are
approximately 42 adults and 66 children in the Traveller Community in Omagh.
There are 20 - 25 families in total.


2.3       Roles and responsibilities


2.3.1 Role of Omagh Traveller Support Group


The Omagh Traveller Health Support Project is represented by the work of
Omagh Traveller Support Group which meets on a monthly basis and which
includes representation from the following agencies:


          Western Health Action Zone;
          Omagh FOCUS;
          Sperrin Lakeland Health & Social Services Trust;
          Omagh District Council;
          Western Education & Library Board;
          FOLD Housing;
          Housing Executive.


2.3.2 Operational management


Operational management is undertaken by Omagh FOCUS as the host
organisation for the Project.


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The responsibilities of Omagh FOCUS in this respect include the employment
and practical support of the Traveller Health Support Worker, drawdown of
funding and budget holding.


The Traveller Health Support Worker, in agreement with FOCUS, is supported by
Western Health Action Zone, a key partner in the Project.


2.3.3 Traveller Health Support Worker


The Traveller Health Support Worker undertakes a ‘grass-roots’ community
development approach to health and well-being with Travellers in the Omagh
area and reports on activities and progress to Omagh Traveller Support Group
when they meet at monthly intervals. The Worker is based in Omagh Community
House, a well-recognised resource facility for community / voluntary groups in the
Omagh area. A Job Description for the post is included in the Appendix.


2.4       Project activities


The work of Omagh Traveller Support Group encompasses a wide range of
activities at different levels. These are explored further, later in the report, in
relation to their associated outputs and outcomes but together can be considered
as:


          the experience of Omagh Traveller Support Group and the partnership
           approach represented by the work of the Group;
          the community work undertaken by the Traveller Health Support Worker
           – including effective Traveller Community engagement, work in
           partnership with Travellers, and liaison with a wide range of local
           agencies and community organisations;




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                                  Omagh Traveller Health Support Project - Final Evaluation


       other linkages made by the Omagh Traveller Support Group and by the
        Traveller Health Support Worker beyond the Project area for the benefit
        of the Project.


The full range of Project activities and their impact is considered in depth later in
this report. For the purpose of the assessment of impact, the core community
development approach, including partnership working, is considered, followed by
separate examination of the main Project activities which have been developed
and supported.




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                                    Omagh Traveller Health Support Project - Final Evaluation



3.0 Evaluation methodology

3.1     Evaluation aims

The brief for this evaluation requires that the success of the Project in responding
to its own terms of reference is explored, and to examine the effectiveness of
Project structures, staffing, management, monitoring and evaluation.


The evaluation should culminate in a set of recommendations relating to both the
strategic and operational development of the Project.


An internal interim evaluation has already been undertaken up to October 2005.
Information for the final evaluation was gathered during the period April to June
2006.


3.2     Evaluation framework

The evaluation framework is centred on the stated terms of reference for the
Omagh Project, namely:

        o   to identify need and share best practice;
        o   to advocate for Traveller families in the area;
        o   to act in the first instance as a link between Travellers and
            voluntary/community/statutory organisations;
        o   to develop partnerships with these organisations;
        o   to facilitate the delivery of a range of health and educational well-being
            programmes;
        o   to develop support services for Traveller families in the Omagh area;
        o   to promote a community development, partnership approach;
        o   to build self esteem, personal development and life skills throughout
            the Project;




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                                     Omagh Traveller Health Support Project - Final Evaluation




        o   to raise health awareness among Traveller families;
        o   to reduce discrimination, promote cultural awareness and foster good
            relations;
        o   to improve the working practices of those delivering services to
            Traveller families.

Furthermore, the evaluation takes account as far as possible of the contribution
of the Project to the aim and objectives of the wider Travellers Support Network
project. The impact of the wider project is assessed in relation to the following:

       increased access to health and social services amongst the Traveller
        Community through working in partnership with Travellers and improving
        co-ordination among service providers in the Western Health and Social
        Services Board area by:


            -   establishing the most appropriate approach to deliver health and
                social services to the Traveller Community based on available
                information   and    working with Travellers          and their support
                organisations;


            -   developing protocols for service delivery across the relevant Health
                Service disciplines and structures to ensure seamless and ‘fast
                track’ care for Travellers;


            -   establishing a network of access points (individuals) for Travellers
                across the relevant disciplines and services;


            -   examining opportunities to provide services on Traveller sites, both
                formal and informal, and respond as appropriate;




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                                       Omagh Traveller Health Support Project - Final Evaluation


              -   training and supporting individuals from the Traveller Community to
                  develop lay health worker skills including First Aid, health promotion
                  and skills for social care related activities;


              -   stimulating the development of support services in the Sperrin
                  Lakeland area to complement the development in the Derry area;


              -   creating links with other Health and Social Services Boards and
                  Health Boards in the Republic of Ireland to remove barriers to
                  receiving care due to high mobility among the Traveller Community.


The evaluation framework also includes the assessment of Project structures,
staffing, management, monitoring and evaluation as required in the evaluation
terms of reference.


3.3       Collection of evidence to inform the evaluation


3.3.1 Brief review of the strategic environment relevant to support for Traveller
      health

This evaluation acknowledges that pronounced health inequalities are the subject
of a range of strategic initiatives intended to promote equality of access to good
health and well-being and support structural, community, family and individual
actions for health improvement.


The Investing for Health Strategy5 describes the ‘unacceptable inequalities in
health’ experienced by different ethnic groups and highlights evidence of
deprivation and poor health amongst Travellers. The Strategy includes specific
goals and objectives aimed at tackling health inequalities and describes working
in partnership, including working with communities, as the key vehicle for
achieving progress.

5
    Investing for Health. DHSSPSNI, 2002.


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‘A Healthier Future - a Twenty Year Vision for Health and Well-being in Northern
Ireland6’ confirms the place of Investing for Health ‘at the heart of the
Government’s health and social care agenda’.


The Race Relations (NI) Order 1997 made discrimination against Travellers (and
other racial groups) unlawful. Travellers are formally recognised as an ethnic
group in their own right and, as such, are also legislated for within Section 75 of
the NI Act 1998. This means that public bodies have statutory duties in relation
to equality of opportunity for Travellers.


The Final Report of the Promoting Social Inclusion Working Group on Travellers
was made available in 2001. The package of measures contained in the report
included recommendations in relation to the delivery of health services amongst
others and, overall, was underpinned by five strategic priorities:


           better and more appropriate services for Travellers – effective monitoring
            and evaluation systems, culturally appropriate delivery of services,
            outreach work, measures to raise awareness among services providers
            through the provision of training etc.;


           working in partnership with Travellers;


           accommodating nomadism;


           empowering Travellers – supporting the capacity of the Traveller
            Community for social change;


           promoting good relations between Travellers and the settled community.


6
    A Healthier Future – a Twenty Year Vision for Health and Well-being in Northern Ireland 2005-
    2025. DHSSPSNI 2004.


                                                 15                                      July 2006
                                     Omagh Traveller Health Support Project - Final Evaluation




3.3.2 Review of Project records

The available Project records were reviewed. In the main these consisted of
minutes of Project Steering Group meetings and monthly reports by the Traveller
Support Worker, annual end-of-year financial information for 2003 and 2004, the
Interim Project Evaluation Report, a Review of the wider Travellers Support
Network project activities and some records relating to the Driving Theory Test
classes. An Action Plan was available for the Project for 2005.



3.3.3 Consultation with Steering Group members

Organisations represented on the Project Steering Group were consulted as
follows:

          Western Health Action Zone – Manager and Family Poverty Co-ordinator;

          Omagh FOCUS;

          Omagh District Council;

          Sperrin Lakeland Health & Social Services Trust – Nurse Manager –
           Health Visiting;

          Western Education & Library Board – Travellers’ Support Teacher.

A further Steering Group member who has retired as a Social Worker with
Sperrin Lakeland Health & Social Services Trust was also consulted.



3.3.4 Consultation with the Traveller Health Support Worker

Several meetings were held with the Traveller Health Support Worker as the
evaluation progressed, contributing to the formulation of a rich picture of the day-
to-day experience of the Project and a detailed description of the key activities
undertaken.




                                            16                                      July 2006
                                       Omagh Traveller Health Support Project - Final Evaluation




3.3.5 Consultation with Travellers

Two focus group meetings took place with Travellers, brokered and supported by
the Traveller Health Support Worker. The Worker was not present during the
actual meeting with the Traveller representatives.


The first meeting took place on 21 June 2006 with five Traveller women from
Omagh town present and the second was held on 28 June 2006 with a core
group of four women and two men from Tattykeel.


3.3.6 Consultation with other Traveller Support organisations

Consultations have also taken place with Craigavon Traveller Support Group and
Derry Traveller Support Group.



3.3.7 Consultation with other stakeholders

Other stakeholders in the Project have been consulted as follows:

        Manager - Western Investing for Health;
        St Vincent de Paul in Omagh;
        Health Promotion Co-ordinator – Sperrin Lakeland Health & Social
         Services Trust;
        Play Development Worker – Toybox initiative 7.




7
  Toybox is a partnership project between NIPPA, Save the Children and Traveller support
organisations which promotes child development through play for Traveller children from 0 to 4
years. The Project Workers establish a relationship with each family and visit weekly to provide
toys and materials for play activities.


                                               17                                       July 2006
                                      Omagh Traveller Health Support Project - Final Evaluation



4.0 Project activities – outputs and outcomes

4.1       Core Project function – outputs and outcomes

4.1.1 Engagement with the Traveller Community

After the appointment of the Traveller Health Support Worker in July 2003, the
early work of Omagh Traveller Support Group was heavily focused on building
trust and working relationships between the Traveller Health Support Worker and
the Traveller families in Omagh.


A survey was undertaken to help identify Travellers’ needs from the Project.
Twenty-eight survey questionnaires were completed, largely on the basis of one-
to-one discussion with Travellers across the Omagh area. A further six semi-
structured interviews were held without the use of the questionnaire.


The issues identified included experiences of discrimination and negative
attitudes to Traveller culture from the wider community.                 The treatment of
Travellers attempting to enter retail premises and public houses in Omagh was
highlighted.


Other needs and issues identified included:


          individual and community confidence and self esteem;
          in terms of hobbies or interests that respondents would like to try, the
           highest levels of interest were in relation to beauty therapy, computers,
           electrical work, work with horses, needlework, dancing and vehicle repair;
          poor services for young people and children – rated as ‘terrible’ by the
           majority of respondents;
          greater levels of comfort / confidence consulting a Doctor or Nurse than
           working with Health Visitors, Social Workers, or, at that stage, a
           Community Health Worker;
          a need for a homework club and support with school work;


                                             18                                      July 2006
                                   Omagh Traveller Health Support Project - Final Evaluation




       a preference for classes which targeted Travellers only and which were
        run in the evenings with a weekly mode of attendance.


Every respondent indicated, when asked, that they would be willing to work for
change for the better for their community. As the Project has developed, this has
been followed through and a majority of the Traveller families in Omagh have
engaged in a meaningful way.       About 8 of the total 25 families have yet to get
involved.



4.1.2 Supporting inclusion

By using a community development approach, the work of Omagh Traveller
Support Group was consistently focused on inclusion.              The Traveller Health
Support Worker based all of the Project inputs on the expressed needs of the
Travellers themselves, beginning with the findings from the initial survey and
building on this with ongoing consultations and liaison.


Specific actions included:


       encouragement and support for participation in educational classes,
        including support for progression from one learning experience to
        another;


       encouragement and support for participation in explicitly health-focused
        activities such as the Women’s Health Programme organised from March
        to April 2006;


       agreed signposting to specific services, such as Speech and Language
        Therapy, as a result of participation in Project activities;




                                          19                                      July 2006
                                 Omagh Traveller Health Support Project - Final Evaluation


       support for young men to make use of the Leisure Centre facilities in
        Omagh. Traveller children have also been supported to use the facilities
        via the Summer Scheme organised by the Project each year.


       some educational classes delivered in a local community centre in the
        ‘settled’ community;


       joint work on cultural awareness / anti-discriminatory training which has
        already been delivered to Omagh Traveller Support Group members and
        is planned to be offered to Omagh District Council, other statutory
        organisations and businesses within the area. The latter is especially
        pertinent given the experience of Travellers with public houses and some
        retail outlets.


       taking advantage of opportunities for positive publicity such as the launch
        of the Community Garden at Tattykeel and the participation by Traveller
        children in the Community Football Tournament, reaching the Quarter
        Finals of the Tournament in February 2004.


       the confident use of Omagh Community House by Travellers, initially
        meeting with the Traveller Health Support Worker who is based there but
        subsequently making used of other services in the building such as those
        of Omagh Independent Advice Centre and attendance at other activities.


The success of the Tattykeel Community Garden project in the Omagh
Community Awards in 2004 was a very significant event.                The award was
presented at a Community Awards ceremony where a range of community
groups came together for the event and ten people from the Traveller Community
in Omagh attended.




                                        20                                      July 2006
                                   Omagh Traveller Health Support Project - Final Evaluation


The Travellers themselves report feeling more included and part of the
community.



4.1.3 Partnership working

The Project has demonstrated examples of work in partnership which have
resulted in specific improvements in individual experiences of service delivery
and has created significant potential for longer term improvements in service
delivery on a wider scale.


Strategic level


The most visible area of partnership work is within the operation of Omagh
Traveller Support Group itself, where a number of agencies come together to
oversee and manage the activities supported by the Traveller Health Support
Project.     There is also a Western Travellers Interagency Group which has
evolved from two former interagency groups focusing separately on the Foyle
and Sperrin Lakeland areas. However the Omagh Traveller Support Group is
central to, and has specific responsibility for, the Omagh Project.


The partners represented on Omagh Traveller Support Group report a substantial
amount of learning as a result of participating in the Project and of wor king
through the Traveller Health Support Worker.                 The range of agencies
represented affords the Project links to a number of key organisations relevant to
Traveller health and well-being. At this stage in the Project, partners describe
changes they have made in their approach to work with Travellers and learning
they have been able to take back to their own organisations.                The learning
described includes:


          increased cultural awareness;




                                           21                                     July 2006
                                   Omagh Traveller Health Support Project - Final Evaluation


       increased understanding of the Traveller way-of-life, of the prejudice and
        discrimination faced and of the impact of this;
       awareness of implications for service design and delivery;
       knowledge to support a business case for service re-design or new
        resources for work specifically with Travellers.


Feedback from the Omagh Traveller Support Group members consulted
indicates that this is one aspect of Project activity that will need to be developed
further if the Project is to fully realise its aim of reducing discrimination among the
public in general towards Traveller families and to make links for Traveller
families with service providers in the Sperrin Lakeland Trust area. Progress has
clearly been made, evidenced by the successes of the Project to date, but there
is more work to be done.


A need for re-focusing of partner commitment and efforts has been described,
given the needs that exist, and the continued enormity of the challenge of
mainstreaming responses to the specific needs of Travellers into service
provision.


Operational level


Many of the activities and services initiated in response to needs expressed by
the Traveller Community have been actioned by the Traveller Health Support
Worker and/or Omagh Traveller Support Group working in partnership with other
organisations. Examples of practical partnership working for delivery of specific
actions include:


       work with Omagh FOCUS for the financial management and monitoring
        of the Project;
       work with Sperrin Lakeland Health & Social Services Trust for the
        delivery of a Women’s Health Programme;



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                                 Omagh Traveller Health Support Project - Final Evaluation


       work with Omagh College for the delivery of First Aid training (following
        on from the Traveller Health Support Worker participating in Home Safety
        training provided by RoSPA);
       partnership work with Derry Traveller Support Group for the delivery of a
        Youth Project targeting young Traveller men in Omagh;
       supporting work by Toybox for the promotion of the value of play for
        young children.


Joint work with Craigavon Traveller Support Group has focused on the
development of a pack for use in Cultural Awareness / Anti-racism training.
Sessions have been successfully jointly delivered in the Southern Health & Social
Services Board area as well as to Omagh Traveller Support Group partners.
Further sessions are planned and the training delivery represents an opportunity
for some income generation to contribute to the sustainability of the two Traveller
Support Projects.


A new partnership initiative is underway with the Travellers Primary Health Care
Project in Donegal. Following visits to the Donegal Project, including a visit by
seven Traveller women from Omagh in December 2005, a capacity building
programme has been launched, funded via Western Health Action Zone, which
will be delivered in Omagh by representatives from Donegal.


4.1.4 Increasing awareness and reducing discrimination

The Project has made links with a range of individuals and organisations and
feedback from those consulted for the evaluation indicates an increased
awareness of issues affecting Travellers and of culturally appropriate approaches
to supporting these issues to be addressed.        Omagh Traveller Support Group
partners report significant learning from their involvement with the Project,
including those who had been involved with work with Travellers previously.




                                        23                                      July 2006
                                    Omagh Traveller Health Support Project - Final Evaluation


There is also anecdotal evidence that the Project has had an impact on wider
community awareness and understanding of the Traveller Community and its
culture, although the extent of this is difficult to gauge.


Certainly, opportunities have been taken to use positive publicity in relation to
awards and activities where possible and a number of activities have involved
Travellers participating alongside members of the ‘settled’ community.



4.2    Activities supported – outputs and outcomes

4.2.1 Driving Theory Classes

Classes to provide support with the Driving Theory Test were offered by the
Project from September 2003 in response to an identified need on an individual
and group basis. The Traveller Health Support Worker now provides a good deal
of one-to-one support himself, and participants come to Omagh Community
House for these sessions. Challenges associated with literacy levels have been
supported with specialised software and as time has passed, more people in the
Traveller community have come forward.


Three men joined for the first session and within four weeks the first man passed
the Driving Theory Test. Ten people have gone on to successfully complete the
Test. Three more are currently waiting to take it.


In addition to their value as a support with the Driving Theory Test, the classes
also undoubtedly provide an opportunity for the further building of relationships
and for signposting to other services or activities. An example of this is where
three young women availed of the Driving Theory classes and were motivated by
this to move on to take part in a pilot basic skills programme over a six week
period.




                                           24                                      July 2006
                                 Omagh Traveller Health Support Project - Final Evaluation




Furthermore, Speech Therapy sessions were organised for one young person
when a need was identified and discussed during the one-to-one Driving Theory
support.



Activity output       Thirteen people have undertaken classes and ten have
                      passed the Driving Theory Test to date.

Activity outcomes     Confidence building for individuals as scores increase
                      during practice tests and with the final success of passing
                      the Theory Test.
                      Opportunity for further relationship building between
                      Traveller Health Support Worker and individual Travellers.
                      Increased awareness of the Project in the Traveller
                      Community – a tangible way to promote the Project.
                      Signposting to other activities and services.


4.2.2 Communal Garden

It was an intention as part of the construction of the Group Housing Scheme at
Tattykeel to create a garden at the entrance to the site, although funding was
subsequently unavailable.    Upon consultation with the families on the site,
Omagh Traveller Support Group provided the funds needed to build the garden
with the work being carried out largely by the Travellers themselves, based on
design and technical support from Conservation Volunteers NI.


The garden was launched at a formal ceremony in October 2004.


The garden project took place at an early stage in the wider Project lifetime and
has been described as an ‘icebreaker’ between the Project and the community.
The garden was also the subject of wider positive publicity via its launch and the
achievement of an Omagh FOCUS Community Award in 2005.




                                        25                                      July 2006
                                Omagh Traveller Health Support Project - Final Evaluation




Activity output       Community garden developed.
                      Launch event with community, Parish Priest, local
                      Councillors, and Omagh Traveller Support Group partners.

Activity outcomes     Community participation in a tangible environmental
                      project.
                      Gardening skills developed including growing vegetables
                      and fruit.
                      Garden used by the wider community and providing a
                      welcome alternative venue for community events.
                      Positive publicity in the local media.
                      Garden project awarded ‘Project of the Year’ at the
                      FOCUS Community Awards event in February 2005 –
                      inclusion with other community groups from the Omagh
                      area.


4.2.3 Computer Class

The Driving Theory class offers some understanding of the use of a computer as
it is delivered using specialised software. After their experience of the Driving
Theory Class there was interest from some of the men in undertaking a computer
class.   An introductory computer course was arranged in a local community
centre and was attended by six men.


A deliberate decision was taken for the Traveller Health Support Worker, as
someone the men knew and had worked with previously, to facilitate the class so
that the experience was as unthreatening as possible.



Activity output       Six participants completed an introductory computer class.

Activity outcomes     Skills developed included basic word processing for
                      letters, saving files, printing, creating email accounts /
                      checking email and transferring photos.
                      Further experience of the educational opportunities by the
                      Traveller men resulted in the opportunity for more women
                      to become involved in classes.




                                       26                                      July 2006
                                Omagh Traveller Health Support Project - Final Evaluation




4.2.4 Taster Night

A ‘taster’ night for Traveller women was organised to showcase possible classes
that could be organised in the longer term. Tutors for sewing, beauty therapy,
arts & crafts, flower arranging, essential skills and dance attended and the
women were able to find out more about each topic.



Activity output       A ‘taster’ event to promote possibilities for educational and
                      recreational classes.
                      Twenty-eight women attended.

Activity outcomes     Preferences for future classes identified – flower
                      arranging, beauty therapy and dancing.


4.2.5 Women’s Health Group

Following the taster night, a Women’s Health Group was established and
provided a framework for the organisation and delivery of the class preferences
identified.


The women have taken part together in other activities above and beyond the
classes themselves.   For example, a trip was organised in conjunction with
Craigavon Traveller Support Group to a drama performance in Lisburn which had
been written by and starred a Traveller. Twelve Traveller women attended.


A Beauty programme also ran for three sessions with up to 10 young women
attending. Traveller women also took part in a Keep-Fit Programme.



Activity output       A Traveller Women’s Health Group established – up to 14
                      women attending classes under the umbrella of the group.

Activity outcomes     Sense of togetherness and ownership with the group
                      providing the framework for the delivery of educational
                      opportunities identified at the Taster Night.



                                       27                                      July 2006
                                 Omagh Traveller Health Support Project - Final Evaluation




4.2.6 Flower Arranging

A 10-week Flower Arranging Programme was organised in Autumn 2004 with an
average of 14 women attending each session.



Activity output       10 week recreational class.
                      14 women attending per session – age range from 16 to
                      54 years.

Activity outcomes     Building the cohesiveness of the Women’s Health Group.
                      Further building the relationship with the Traveller Health
                      Support Worker.
                      New learning for the course tutor in terms of work with
                      Travellers – increased awareness.


4.2.7 Dance and Physical Activity

A six-week programme of Dance was organised after the Flower Arranging class
ended. The class led to a group of young women going on to take part in a
Dance Workshop at another community centre, funded by the Health Promotion
Agency’s Physical Activity grants programme.


A further four-session line dancing class was also organised.



Activity output       6 week recreational dance class.
                      4 week line dancing class.
                      Participation by young women in a Dance Workshop.
                      12 women attending the initial programme per session –
                      age range from 16 to 54 years.

Activity outcomes     Progression opportunity from previous class.
                      Promotion of physical activity.
                      Participation in a further Dance Workshop by some of the
                      women – Workshop included participants from the settled
                      community.




                                        28                                      July 2006
                                   Omagh Traveller Health Support Project - Final Evaluation




4.2.8 Young Men’s Project

The Young Men’s Project was delivered in partnership with Derry Traveller
Support Group with the aim of supporting young Traveller men to identify their
social, educational and recreational needs.


An initial focus on fitness was supported by visits to the gym in Omagh Leisure
Centre. This was followed up, based on the outcome of discussions with the
young men participating, by an introduction to welding as a vocational skill area.
As part of the welding course, it was agreed by the young men involved that they
would work on a metal sculpture.


With the support of a sculptor, the figure of a horse was chosen and the
participants worked on designing and building the 10-foot high structure. The
horse sculpture has since been located in the Communal Garden.



Activity output       Three young men participated in a fitness programme
                      followed by a vocational skills training programme.
                      Environmental sculpture produced and displayed in the
                      Communal Garden.

Activity outcomes     Increased levels of physical activity.
                      Development of vocational skills.
                      Team work on a specific project.
                      Visible product of the project and pride in the outcome of
                      the team effort.


4.2.9 Summer Scheme

Summer Schemes were organised for children in 2004 for four weeks and in
2005 for two weeks.     Mothers were involved in both Schemes as there was
reticence around children being away from the family on outings and activities.




                                          29                                      July 2006
                                  Omagh Traveller Health Support Project - Final Evaluation




Trips were organised to Omagh Leisure Centre, the local cinema and further
afield to Bundoran Waterworld, Redcastle Leisure Park and the Dundonald Ice
Bowl. Around 40 children participated in the trips on average.


Due to funding constraints, the volunteer expenses that had been available for
mothers to support their contribution to the supervision of the children in 2004
were not available in 2005. However the mothers in 2005 were undeterred and
took part without receiving any expenses. Feedback during the consultations
indicated the level of pride and enjoyment the mothers attached to their
supervisory role.


The trips also involved Traveller families mixing together from different areas in
Omagh town who normally would not have had the opportunity to do so.



Activity output        30 – 40 children participating in the Summer Scheme
                       activities.
                       Mothers acting in a supervisory role.
                       A programme of activities delivered in 2004 and 2005.

Activity outcomes      Physical and recreational activity for children.
                       Involvement and confidence building for mothers.
                       Contact between Traveller families who would not normally
                       have the opportunity.
                       Use of town facilities.



4.2.10     Women’s Health Programme

A six session Health Programme for Traveller Women was delivered in
conjunction with the Health Promotion Co-ordinator from Sperrin Lakeland Health
& Social Services Trust in March and April 2006. Fifteen women attended on
average.




                                         30                                      July 2006
                                    Omagh Traveller Health Support Project - Final Evaluation




The Programme content included:

        exploration of good health and what it meant to the group;
        blood pressure checks and follow-up;
        smoking and health;
        the value of physical activity;
        health screening including a one-to-one session with each participant;
        healthy eating and the Balance of Good Health – introduction to the
         Cook-It Programme;
        dental awareness.




Activity output         Fifteen women on average taking part (up to 20 in one
                        session) including up to seven teenagers.
                        Introductory health screening – blood pressure, blood
                        sugar, BMI, dental health.

Activity outcomes       Reported increased awareness of health issues by
                        Traveller women taking part.
                        One woman reported reducing her smoking significantly
                        during the lifetime of the programme.
                        One woman reported managing hypertension with lifestyle
                        changes – measured reduction in blood pressure as
                        course progressed.
                        Requests for further activities including the Cook-It
                        Programme.



4.2.11     Activities with Traveller men

Further activities were organised with Traveller men, building on the interest in
the Driving Theory and computer classes. One example is where several men
tried out golf for the first time with the support of the Traveller Health Support
Worker, incorporating physical activity and making use of facilities not visited
previously.




                                           31                                      July 2006
                                      Omagh Traveller Health Support Project - Final Evaluation




Activity output            Seven men participated in the golfing activity.

Activity outcomes          Participation in organised physical activity.




4.2.12      Capacity building programme with Donegal Travellers

Following contact with the Donegal Travellers Primary Health Care Project by the
Traveller Health Support Worker, and a study visit by Traveller women from
Omagh to the Donegal Project, work is underway for the delivery of a capacity
building programme which will be delivered in Omagh in association with people
from the Donegal Project.


The proposed programme includes inputs on:
          Personal development;
          Traveller identity;
          Traveller health;
          Collective action;
          the All Ireland Traveller Health Study;
          work on issues identified by participants.


In addition to this planned programme, the possibility of organising a local
performance of the drama production enjoyed by some of the Omagh women in
Lisburn8 is being explored and it is intended that this will also be attended by the
Traveller representatives from Donegal.



Activity output            Trip by 7 Traveller women from Omagh to the Donegal
                           Project.
                           Programme outline produced for the capacity building
                           initiative – includes refreshing the link to the All Ireland
                           Traveller Health Study.

8
    See page 27


                                             32                                      July 2006
                              Omagh Traveller Health Support Project - Final Evaluation




Activity outcomes   Increased awareness amongst participants of further
                    possibilities based on Donegal Travellers Primary Health
                    Care Project model.
                    Networking.
                    Further planning for collaborative work.




                                     33                                      July 2006
                                     Omagh Traveller Health Support Project - Final Evaluation



5.0 Conclusions

5.1       Strategic fit

The Omagh Traveller Support Group, (in its delivery of this project with its focus
on tackling the determinants of health which contribute to the health inequalities
experienced by the Traveller Community in Omagh, and with its community
development approach to the challenge), fits very well with the current regional
strategic     environment    for   health   improvement,       including    mainstreaming
community development approaches and supporting responses to the priority
areas identified by the Promoting Social Inclusion Working Group on Travellers.


There is more work to be done at the individual organisational level in terms of
influencing service provider strategies for the delivery of services to Travellers.
There is much to learn from the work of the Project to date but a continuing
challenge for the Project lies in how to share this learning such that it impacts as
far as possible on partner organisations and others. The Project has
demonstrated:


           the need for anti-discriminatory awareness-raising and training;
           the need for culturally sensitive service planning and delivery and the
            need for training for managers and staff to support this;
           the need for commitment to the significant relationship and trust building
            work required to engage the Traveller community including the
            importance of timely responsiveness and follow-through on agreed
            plans;
           the value of a co-ordination / liaison mechanism in the form of an
            appropriately skilled and committed individual or individuals supporting a
            grass-roots community development approach and brokering linkages
            with service providers according to identified need;
           the need for effective advocacy so that Travellers are supported to get
            the best from mainstream services.


                                            34                                      July 2006
                                    Omagh Traveller Health Support Project - Final Evaluation




5.2     Response to the original Omagh Traveller Health Support Project
        terms of reference

5.2.1     Identify need

Identification of need has been an ongoing feature of the work of Omagh
Traveller Support Group from its inception and the continuing nature of this task
should be acknowledged.          In addition to the initial survey, with 34 Travellers
participating, the Traveller Health Support Worker consciously explores need in
his day-to-day dealings with the Traveller Community. All work undertaken is
initiated and designed in full consultation with Travellers.


Of note is the way in which participation in one activity, or opportunities to look at
work in other areas, lead to the further identification of useful activities and
interventions as confidence builds and new possibilities are considered.



Outputs               Initial needs assessment completed.
                      Ongoing consultation to identify needs.

Outcomes              Project activities initiated and / or developed in response to
                      feedback from Travellers.

Key learning          Taking opportunities to explore needs further as people
                      become more engaged.

Implications for      Recognition of needs assessment as an ongoing task with
future work           efforts becoming more fruitful and real needs identified
                      more accurately as people become engaged in the
                      development process.


5.2.2     Advocate for Traveller families in the area

As the relationship between the Traveller Health Support Worker and the
Traveller Community in Omagh has developed, the Worker has been called upon
to provide help and support, and act as a mediator, in relation to a wide range of
different issues, for example:



                                           35                                      July 2006
                                  Omagh Traveller Health Support Project - Final Evaluation




       support with completion of forms, from licence applications to registration
        of children for school;
       provision of supporting information in relation to medical and dental
        appointments;
       making representations in relation to service provision, e.g. supporting
        the relationship with Council Technical Services and use of Recreation
        and Leisure Services;
       housing maintenance queries;
       liaison between the Health Visiting team and the Traveller families to
        increase the immunisation rates amongst Traveller children;
       assistance with booking flights;
       making telephone calls to agencies;
       accessing bursary support for a third-level course for one individual;
       liaison with WELB on the provision of buses and pre-school places.

The nature of the advocacy work is to ensure that there is mutual understanding
between the Travellers and the relevant agency. The Traveller Health Support
Worker operates as a key link when required but uses an empowering approach
which leads to learning and the likelihood that people will be better equipped to
deal with the issue themselves in future.



Outputs               Evidence of advocacy by the Traveller Health Support
                      Worker on many occasions.
                      Evidence of advocacy by Omagh Traveller Support Group
                      to secure funding and other support for the Project.
                      Development of materials for anti-discriminatory training.

Outcomes              Travellers’ needs are better met.
                      Improved working relationships between Travellers and
                      service providers.
                      Service providers are better informed and better equipped
                      to offer appropriate services.




                                           36                                    July 2006
                                  Omagh Traveller Health Support Project - Final Evaluation




Key learning          Advocacy is a core aspect of the community development
                      approach and the success of other initiatives is dependent
                      on successful foundation advocacy work.

Implications for      Efforts to ensure that services are more accessible to
future work           Travellers and better targeted to their needs must include a
                      mechanism for effective advocacy based on well-developed
                      working relationships and mutual trust.


5.2.3     Act as a link between Travellers and voluntary / community / statutory
          organisations

The project has made links between Travellers and a wide range of other
individuals and organisations from statutory organisations, (some of whom were
already in contact with the Traveller Community but whose working relationship
has since been further supported) to course tutors, other voluntary organisations
(for example within Omagh Community House), other community centres and
other community groups.


Links have been forged that would have been difficult or impossible without the
help of the Traveller Health Support Worker. These include links with the Toybox
initiative, Omagh College and local schools (who have all been contacted by the
Traveller Health Support Worker to promote the Project) as well as the cross-
border links with the Donegal Travellers Primary Health Care Project and the
links with Craigavon and Derry Traveller Support Groups.


The Project is also linked to the Western Travellers Interagency Group, CAWT
(Co-operation    &   Working   Together),     and    Traveller    Movement       NI    via
representation by the Traveller Health Support Worker and Western Health
Action Zone.



Outputs               Wide variety of linkages at the operational and strategic
                      levels.



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                                   Omagh Traveller Health Support Project - Final Evaluation




Outcomes               Raised awareness of the needs of Travellers.
                       Improved or new mutual engagement between Travellers
                       and a range of support organisations and service providers.

Key learning           Significant effort and groundwork required to support new
                       linkages and to realise the benefits of new and better
                       developed working arrangements.

Implications for       Opportunities to further develop linkages already made and
future work            identify possibilities for further relationship building in
                       response to Traveller needs.


5.2.4     Develop partnerships

In addition to the partnership working evident within Omagh Traveller Support
Group, the Project has developed what are effectively partnerships f or the
delivery of different aspects of the work.               This has led to increased
understanding of Traveller culture and appropriate service responses and has
informed Travellers of the resources that are available that they can benefit from.
Examples include work with Omagh FOCUS on access to wider community
networks, work with the Toybox initiative to introduce and support Toybox with
Traveller families, work with Omagh College for the delivery of training, work with
independent tutors and work with Conservation Volunteers for the design and
delivery of the Communal Garden.            The Project is currently developing a
significant partnership initiative with Donegal Traveller Primary Health Care
Project which has been supported with £3000 via Western Health Action Zone,
has worked with Derry Traveller Support Group on the Young Men’s Project and
works with Craigavon Traveller Support Group on the development and delivery
of anti-discriminatory training.


Outputs                Development of Omagh Traveller Support Group as a
                       working partnership.
                       Partnerships developed for the delivery of specific activities.
                       Contribution to the development of the Western Traveller
                       Inter-agency Group.



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                                   Omagh Traveller Health Support Project - Final Evaluation




Outcomes              Increased profile for Traveller culture and needs.
                      Improvement in the level of inclusion of Travellers.
                      Working relationships developed and sustained.
                      Learning by staff in partner organisations in relation to the
                      needs of Travellers.
                      Learning by Travellers in terms of services on offer and
                      their accessibility.

Key learning          Progress made through partnership work between the
                      Project and other agencies – clear added value of the
                      Project in terms of brokering contacts and providing
                      guidance on appropriate delivery approaches.

Implications for      Recognition of the role of the Project in the success of
future work           working arrangements. Many outputs / outcomes would not
                      have been possible or would have been more difficult to
                      achieve had the Project not been providing grass-roots
                      development work and ongoing support.



5.2.5     Facilitate the delivery of a range of health and well-being programmes

A wide range of programmes has been supported as indicated in Section 4.2
above, based on effective engagement with Travellers and involving significant
numbers in a range of activities impacting directly and indirectly on health and
well-being. There is evidence that the programme has been developmental in its
nature with each activity following on from previous activities and moving towards
addressing issues in relation to health and well-being, therapies and literacy
which are more difficult to tackle at the outset without appropriate lead-in activity.



Outputs               A range of programmes with the potential to impact on
                      health and well-being have been delivered. Further
                      programmes are planned. The programmes have been
                      developed to more and more explicitly address difficult /
                      sensitive issues as people became ready.




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                                  Omagh Traveller Health Support Project - Final Evaluation




Outcomes              Increased sense of belonging and inclusion reported by
                      Travellers.
                      Increased confidence and self esteem.
                      Increased awareness of Traveller rights.
                      Increased use of wider community facilities.
                      Increased interaction with the ‘settled’ community.
                      Increased understanding of health and other services.

Key learning          A community development approach to the planning and
                      delivery of a programme of activities has led to a good level
                      of ownership of the programme and of its future further
                      development.

Implications for      Confirmation of the value of a community development
future work           approach including empowerment of people to make
                      positive choices based on their own needs.


5.2.6     Develop support services for Traveller families in the Omagh area

The Project represents a developing model for support services for Travellers in
Omagh.     The work needs to be sustained until greater mainstreaming impacts
are achieved with local statutory, community and voluntary organisations.

Outputs               A developing model of support services for Travellers.

Outcomes              Improvement in services for Travellers and general
                      heightened awareness of Traveller culture and needs.

Key learning          While there have been improvements in awareness and in
                      service delivery, this continues to be dependent on effective
                      advocacy by the Project. There is a need for the Project
                      work to continue for the foreseeable future.

Implications for      More emphasis needs to be placed on the strategic efforts
future work           of the Project to influence long term planning by service
                      providers as well as attitudes to Travellers in general. The
                      community work with the Traveller community needs to be
                      sustained but the strategic influencing element needs to be
                      further developed. This is ultimately the responsibility of the
                      Omagh Traveller Support Group but will also require more
                      of the Traveller Health Support Worker’s time. This is likely
                      to have implications for staffing requirements.


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                                       Omagh Traveller Health Support Project - Final Evaluation




5.2.7       Promote a community development, partnership approach

The Project is based on a community development, partnership approach as
exhibited by the work of the Traveller Health Support Worker and the
partnerships developed with a range of organisations and individuals. Omagh
Traveller Support Group itself represents partnership working at the management
level.


The rationale behind this approach is well summed up in this quote from Traveller
Movement NI:


‘We believe in the process of community development, as an inclusive way of
working, as being the most appropriate means of working with Travellers. This
means that primary emphasis must be placed on process and a flexible approach
to strategic planning and that we must strive for results which are not necessarily
short term, immediate or visible.’ 9



Outputs                   A community development, partnership approach has been
                          demonstrated.

Outcomes                  Inclusion, engagement of Travellers and of key agencies
                          and organisations.
                          Building of ownership of the initiative, of confidence and self
                          esteem.
                          Building of social capital.
                          Connections made to wider community networks in the
                          Omagh area.

Key learning              Value of the community development approach – further
                          evidence for the potential for the employment of community
                          development approaches by statutory services and others.

Implications for          Continue with the community development approach.
future work               Further strengthen the partnership approach.

9
    From the Value Statement of Traveller Movement NI available at www.tmni.org




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5.2.8    Build self esteem, personal development and lifeskills throughout the
         Project

The development of practical lifeskills via support for the Driving Theory Test and
the computer skills training is evidenced by the success of participants with the
Theory Test itself and the progress with the computer training. One participant
went on to buy a computer for use at home.


The Travellers who took part in the consultation for the evaluation described
feeling more confident generally as a result of the Project.        It was also reported
that the confidence of children had been supported, especially with their
participation in the community football competition, to the extent that school
attendance appeared to have been impacted on positively.


A key factor in the development of their self confidence by the Travellers for
engagement with outside agencies and in different activities has been the role of
the Traveller Health Support Worker.


The Worker has consistently provided support in practical ways from making
introductions, to helping design appropriate activities, guiding tutors and
facilitators, accompanying Travellers to classes and events and ironing out
problems and misunderstandings when they arise.


Comments by the Travellers consulted included:


         ‘…..we would never have tried these things before’


         ‘…..wouldn’t have used the community facility before – didn’t know what
          it was for – thought it wasn’t for ordinary folk’




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          ‘…..best thing ever – wouldn’t know how to have our opinion heard
           before’


          ‘…..before when you went into a shop, you’d be watched – now I feel
           different, I feel the same as everyone else’.



Outputs               Traveller participation in a range of activities and motivated
                      to seek further opportunities to participate.
                      Participation by children in Summer and football activities.

Outcomes              Reported increased confidence and feeling of being more
                      included.
                      Progression to further activities including educational
                      courses.
                      Anecdotal evidence of improved school attendance.
                      Improved relations between the ‘settled’ community and
                      Traveller Community.

Key learning          An approach which is respectful, inclusive and which seeks
                      to involve people in the decisions which affect them will
                      have positive impacts on confidence and self esteem –
                      people will feel empowered as a result.

Implications for      Further confirmation of the value of an approach which is
future work           based on good community development practice.


5.2.9     Raise health awareness among Traveller families

Feedback from people who took part in the Project activities and who were
supported on a one-to-one basis by the Traveller Health Support Worker
indicates a greater level of awareness of health issues. Comments included:

           ‘….makes you realise that health is important’

           ‘…..Conor gives us information so that when we go to the dentist we
            can understand and we know what to ask’

           ‘…..Conor got me leaflets about stroke after my relative had a stroke’



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                                     Omagh Traveller Health Support Project - Final Evaluation




           ‘…..I’d like more women’s health – I think we still don’t know enough
            about it’.



Outputs                  Participation by Travellers in a Women’s Health Programme
                         including health screening, participation in physical activity
                         opportunities by men and women of all ages, healthy eating
                         awareness, increased immunisation uptake, anecdotal
                         evidence of increased attendance at the Child Health Clinic,
                         learning around the value of play, participation in
                         environmental improvements, creative activities etc.

Outcomes                 Reported increased awareness of own health and the
                         factors that influence health. Reduction in discrimination.

Key learning             Work has included impacts on the wider determinants of
                         health as well as education and project work to support
                         healthy lifestyles.

Implications for         Opportunity to build on the raised awareness of, and
future work              interest in, health issues.


5.2.10    Reduce discrimination, promote cultural awareness and foster good
          relations

The Project has worked in a number of ways to promote cultural awareness and
foster good relations.


In addition to the preparation and planned delivery of anti-discrimination training
(having piloted the training with Craigavon & Banbridge Health & Social Services
Trust, the Southern Education and Library Board and Omagh Traveller Support
Group, in partnership with Craigavon Traveller Support Group), conscious efforts
have been made to adopt more inclusive approaches for Travellers and to take
the opportunity for work with or alongside people from the ‘settled’ community
where possible.




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Omagh Traveller Support Group partners also report experiencing learning that
they are in a position to take back into their organisations and there are plans
that local organisations will be targeted for the anti-discriminatory training using
the pack prepared.


The delivery of the training has included input from a Traveller from a Navan
Project, however a Traveller from Omagh has agreed to input to the training
delivery locally and has received training in preparation for this.




Outputs               Development of an anti-discrimination training pack.
                      Delivery of pilot sessions to test the approach – with
                      positive feedback.
                      Local Traveller trained to input to the training delivery.
                      Some wider Project activities not confined to Travellers
                      themselves.

Outcomes              Increased awareness of Traveller culture, circumstances
                      and needs. Reduction in discrimination.

Key learning          An important aspect of Project work is taking opportunities
                      to encourage reflection and promote changed attitudes.

Implications for      Learning and experience of Traveller culture and needs are
future work           fundamental to increased understanding, more appropriate
                      planning and delivery of services and reduced prejudice
                      and discrimination in the wider community.


5.2.11 Share good practice and improve the working practices of those delivering
       services to Traveller families

While there has been learning in relation to good practice in this work, and while
this has been shared to a certain extent, feedback from those consulted indicated
that there is more work to be done in this area. The Project provides tangible
examples of the support, liaison, negotiation and developmental work needed if
services are to truly reflect and respond to Traveller needs.




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                              Omagh Traveller Health Support Project - Final Evaluation




Outputs            Learning from Project approach shared via Omagh
                   Traveller Support Group and via the Western Interagency
                   Traveller Forum.
                   Project interim evaluation published on the Western
                   Investing for Health website.
                   Project consciously encourages reflection by service
                   providers, tutors and others involved in activities on the
                   experience of working with Travellers.
                   Events such as the taster session for women making
                   connections to the Traveller Community for a range of
                   services, service providers and courses.
                   Presentation to a range of Forums and Senior Management
                   Teams.

Outcomes           Learning from involvement in the Project described by
                   partners, tutors and others.
                   Momentum created in relation to sharing learning to support
                   change in practice.

Key learning       Increased awareness of Traveller circumstances and
                   needs.
                   Evidence of new approaches to service delivery – e.g.
                   development of a business case for a dedicated Health
                   Visitor service.

Implications for   Sharing the learning from the Project can happen on an
future work        ongoing basis through existing mechanisms but needs to be
                   approached in a strategic, planned way for further impact
                   and mainstreaming approaches to better meet Traveller
                   needs.




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5.3   Contribution to the wider Travellers Support Network project aim and
      objectives

5.3.1 Increased access to health and social services through partnership
      working and improved co-ordination


Contribution to      The Project has contributed to increased access to health
overall Travellers   and social services by building Traveller and statutory
Support Network      partner confidence, making connections, supporting
aim and              learning by partners and developing support materials to
objectives           facilitate learning.

                     The Traveller Health Support Worker acts as a mechanism
                     to bridge gaps between the needs of Travellers and the
                     current design of services.


5.3.2 Establish the most appropriate approach to deliver health and social
      services to the Traveller Community


Contribution to      The Project demonstrates the effectiveness of a community
overall Travellers   development approach, supported by an interagency
Support Network      partnership approach, to the needs of Travellers in terms of
aim and              accessing health and social services and related services
objectives           which meet their needs.


5.3.3 Develop protocols for service delivery to ensure seamless and ‘fast track’
      care for Travellers


Contribution to      Groundwork has been done which has the potential to
overall Travellers   contribute to the development of protocols if the learning
Support Network      from the Omagh Project can be captured and shared with a
aim and              view to influencing organisational policy and practice more
objectives           widely.




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5.3.4 Establish a network of service access points for Travellers


Contribution to      Key connections have been made or strengthened with the
overall Travellers   Traveller Health Support Worker acting as the first point of
Support Network      contact – e.g. Toybox, Cook It programme, facilitation of the
aim and              work of the Health Visitor, Speech and Language Therapy,
objectives           Sure Start, Council Leisure and Recreation Services,
                     WELB. The community development approach utilized by
                     the Worker has facilitated these connections and the nature
                     and extent of the work involved in this needs to be
                     recognised if a structured network of contacts is to be
                     operationalised effectively. The Project demonstrates that
                     merely designating key contacts and publicising them will
                     be ineffective. The trust and relationship building are vital if
                     Travellers are to be in a position to connect meaningfully to
                     the services they require.


5.3.5 Examine opportunities to provide services on Traveller sites


Contribution to      The location of classes and other activities has consistently
overall Travellers   been negotiated with the Travellers and has led to
Support Network      Travellers using other venues in the wider community
aim and              where facilities on site were not suitable. This has
objectives           demonstrated significant added value in terms of inclusion
                     and building confidence. There are also likely to have been
                     positive impacts on the wider settled community in terms of
                     a more positive perception of Travellers.

                     Learning from the Project has demonstrated that any new
                     initiative needs to be discussed in detail and agreed with
                     the Traveller Community. Some services such as Toybox
                     have been supported to deliver in people’s homes by the
                     Traveller Health Support Worker negotiating for this to
                     happen. The negotiation role of the trusted Worker is a
                     significant success factor in the location of services on site.

                     The type of service which can be delivered on site will also
                     be dependent on the facilities / premises required.




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5.3.6 Training members of the Traveller Community to develop lay health
      worker skills


Contribution to      The Project has demonstrated that where proper support,
overall Travellers   and approaches to learning based on comfortable
Support Network      progression, are on offer, there is great potential for people
aim and              to build their skills according to their interests.
objectives
                     This, coupled with increasing interest in health and well-
                     being issues, demonstrated through participation in health
                     related programmes supported by the Project and by
                     feedback from the Travellers consulted for the evaluation,
                     indicate real potential for interest in lay health worker
                     training in future. Recent training undertaken includes First
                     Aid and Cook It.


5.3.7 Stimulate the development of support services in the Sperrin Lakeland
      area to complement the development in the Derry area


Contribution to      The Omagh Traveller Support Group, with the support of
overall Travellers   the Western Traveller Interagency Group, is developing as
Support Network      a model for an effective support service for the Sperrin
aim and              Lakeland area.
objectives


5.3.8 Create links with other Health Boards and Health & Social Services
      Boards to remove barriers to receiving care


Contribution to      Of relevance to this objective, although not impacting
overall Travellers   directly, the Project has linked with other Traveller Support
Support Network      Projects in Derry, Craigavon, Newry and Donegal with the
aim and              ultimate aim of improving services.
objectives




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5.4 Project structures and management


5.4.1 Omagh Traveller Support Group

The partnership represented by Omagh Traveller Support Group has been
highlighted as a strength of the Omagh Project, bringing together a range of
different service providers. Much of the focus of the early work of the Group has
been to provide appropriate support to the Traveller Health Support Worker in the
establishment of the Project to its current stage. It has been able to do this with
the benefit of the different perspectives and inputs of the partner organisations
represented.    Much emphasis has been around gaining trust and building
relationships and efforts to engage the Traveller community in the work of the
Project have been very successful.


However, while strategic linkages have been made and maintained which have
supported the Project significantly – for example, with Western Investing for
Health with the wider Travellers Support Network concept, and Western Health
Action Zone with a wider view of poverty and health, other linkages have tended
to be more operational in nature, supporting Project actions, or addressing the
needs of individual Travellers.


This has been in keeping with the developmental stage of the Project. However,
it is important that Omagh Traveller Support Group balances its grass-roots
community development approach with the opportunity to make a significant
difference to how services are planned and delivered to take account of the
needs of the Traveller community. Omagh Traveller Support Group provides the
platform with which to achieve this.


The indications are that the Project is already improving the health and well-being
of Travellers in Omagh, certainly raising awareness of health and well-being
issues, that practical steps are being taken to positively influence attitudes



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                                   Omagh Traveller Health Support Project - Final Evaluation


amongst the public in general towards Traveller families and that useful links are
being made between Travellers and service providers.


While provision of support for the Traveller Health Support Worker has led to
more of a focus on operational matters, Omagh Traveller Support Group can now
action plan in consultation with the Western Traveller Interagency Group to
ensure that the Project makes further progress on the strategic aim of the wider
Travellers Support Network project, namely that:


       appropriate approaches are employed for service delivery;
       protocols are developed for service delivery to ensure that Traveller
        needs are met and that
       a network of access points for Travellers is created across all relevant
        disciplines.


Omagh Traveller Support Group has provided significant learning to inform
further development in relation to these considerations.           There is a need to
support this further, particularly by making further attempts to secure meaningful
Traveller participation on the Group itself.

5.4.2 Omagh FOCUS as host organisation

A range of benefits have accrued from Omagh FOCUS acting as the host
organisation for the Project. In addition to budget and monitoring responsibilities,
FOCUS offers day-to-day support for the Traveller Health Support Worker. The
positioning of the Project with Omagh FOCUS has also positively impacted on
the inclusion of Travellers at a number of levels, from the use of Omagh
Community House where FOCUS is located, to the use of other services in the
Community House and linkages made to other community networks in the area.
A good example of the latter is the participation by Traveller representatives in
the FOCUS Community Awards event where the Project of the Year award for
the Communal Garden at Tattykeel was presented.



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There is an understandable desire to have a base more closely located to the
Traveller sites but this should be considered in light of the positive impacts
arising from the current location.

5.4.3 Line management

The Traveller Health Support Worker has been line managed by Western Health
Action Zone, with one member of staff from Western HAZ responsible for this.


The HAZ Co-ordinator meets with the Traveller Health Support Worker between
Omagh Traveller Support Group meetings.                 This has worked well and, in
addition to guiding the work, provides a practical link between the Project,
Western HAZ and the wider Investing for Health structures and activities.


There is a need to communicate the respective roles of Omagh FOCUS and
Western Health Action Zone in relation to the day-to-day management of the
Traveller Health Support Worker as some stakeholders are unclear about where
particular responsibilities lie.     Having reviewed the Project records for the
evaluation, we suggest that it may also be useful to agree a more practical action
planning structure which could further support line management meetings and
the Traveller Health Support Worker’s reporting to the Omagh Traveller Support
Group.


This would also provide a valuable resource for future evaluation exercises.

Key strengths         Good working relationships established.
                      Accessible source of support.
                      Links to wider Western Health Action Zone activities and
                      Western Investing for Health.

Key challenges        Take the opportunity to further develop action planning,
                      recording and reporting mechanisms to satisfy the
                      evaluation and sustainability requirements of the Project.
                      Aim for Traveller representation on Omagh Traveller
                      Support Group.



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5.5    Staffing


There is little doubt that much of the success of the Project has been attributable
to the work and particular approach of the Traveller Health Support Worker. The
post and the postholder are key strengths of the Project.


The community development approach employed needs to continue as a
dominant feature of this Project.


However, while opportunities have been created to build on the work which has
been taken forward so far, there is also a need for work at a strategic level which
makes demands of service providers in terms of articulating a response to
service provision based on increased cultural awareness in respect of Travellers,
full commitment to anti-discriminatory practice and mainstreaming of approaches
designed to be inclusive of the Traveller Community and Traveller needs.


If this Project is ‘benchmarked’ against other Traveller support work, advocacy
and campaigning at organisational and community level (as well as at individual
level) are often a feature elsewhere. The Steering Group will be responsible for
securing strategic impacts but this will require support from staff with increased
attention to the strategic development role.


There are opportunities to focus further on specific areas of work – the needs of
young Traveller women have been highlighted, as has the need for a homework
club, with the attendant need for additional staff resources to facilitate this.


While some additional funding has been sourced, there is also a real opportunity
for the Project to attract further funding for specific pieces of work from external
sources. The potential to lever in further funding has not yet been exploited fully.




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There is a related issue in that the success of this Project is highly dependent on
the relationships that have been built between the Traveller Health Support
Worker and the Traveller Community in Omagh, and on the particular approach
of the individual employed in the post.     In this sense, the continued success of
the Project is potentially fragile and the Project would be vulnerable if the Worker
were to move on.     Building and strengthening the staff team would have an
ameliorating effect on this potential weakness.


All of these issues point to a need to review the staffing requirements of the
Project although this should be carried out against the backdrop of a strategic
plan which reflects Traveller support requirements in the west, including Omagh
and Fermanagh, for the next three to five year period.



Key strengths         The presence and approach of the Traveller Health Support
                      Worker have been key to the success of the Project to date.
                      The individual has skills and attributes which are
                      demonstrated in the effectiveness of building and
                      maintaining working relationships which in turn underpin the
                      effectiveness of the community development approach
                      employed.

Key challenges        As much of the success of the Project depends on the skills
                      of the Traveller Health Support Worker, and while the
                      Worker is effectively supported by Omagh FOCUS at the
                      operational level, this creates a vulnerability in the work
                      where there would be a significant setback if the Worker
                      were to leave this employment or indeed if Omagh Traveller
                      Support Group were not to be supported for the longer
                      term. There are also indications that additional staff
                      resources may be required to enable the Project to achieve
                      a better balance between grass-roots and more strategic
                      work.




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5.6    Monitoring / evaluation


Omagh Traveller Support Group should consider its staffing needs in light of an
agreed strategic plan which recognises the need for an organic approach to the
work and therefore does not state strict targets which do not permit flexibility of
approach, but which defines the direction of the work of the Project in
collaboration with the Traveller Community in Omagh and provides a framework
for action planning over short to medium term periods.


This suggestion is NOT intended to inject a bureaucratic dimension which would
be unhelpful and potentially damaging, however funders and other support
agencies do operate output / outcome based approaches to offering funds and
the Omagh Traveller Support Group needs to respond to this if it is to be
sustainable and sustained.



Key strengths          The organic approach is a strength of this Project – setting
                       out to make progress in relation to a number of identified
                       outcome areas – and care needs to be taken to retain the
                       high level of flexibility of the approach employed to date.

Key challenges         A user-friendly action planning and recording template
                       should be agreed which will facilitate planning, sourcing
                       funding, monitoring and evaluation for the future.



5.7    Additionality


The additionality of a project can be described as the extent to which an activity
takes place at all, on a larger scale, earlier or with a specific designated area or
target group as a result of the intervention. The outputs or outcomes that would
have resulted anyway, without the project are known as ‘deadweight’ and
additionality is represented by that part of the output or outcome over and above
‘deadweight’.



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                                 Omagh Traveller Health Support Project - Final Evaluation




Assessment of        It is clear from the evidence examined for the evaluation,
additionality        including the feedback from key stakeholders, that without
                     the funding for Omagh Traveller Support Group, the vast
                     majority of the impacts of this Project would not have been
                     achieved. In fact it is difficult to identify specific areas
                     where any significant level of progress would have been
                     achieved within a similar period of time or even over the
                     longer term. Certainly there would not have been the
                     targeting of the Traveller Community in Omagh which
                     formed the central focus of the work of the Group. Thus the
                     Project is very significantly additional in economic terms.

5.8   Value for money


It is difficult to benchmark the work of the Omagh Traveller Health Support
Project accurately in terms of value for money.


The Project relies on one member of staff and Omagh Traveller Support Group
while other Traveller Support Projects are longer established and have more
developed infrastructures. However, given that the Project employs one person
full-time with a programme / activity budget of £30,000 over a two year period, it
is safe to conclude that given the progress made in relation to Traveller
engagement and inclusion that value for money is very good, even considering
the time and expertise given by the Steering Group.


As the Project has a strong focus on health improvement and promoting the
relevance and impact of health and social services and other services which
have an influence on health, there are difficult-to-measure impacts which
nevertheless can be acknowledged as relevant to the consideration of value for
money.    Improved health and well-being status and more effective use of
services will both give rise to longer term savings for health and social services
organisations.




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                                   Omagh Traveller Health Support Project - Final Evaluation


The outcomes of the Project represent substantial progress in a much longer
term process. As such, the ‘historical’ value for money of this Project will be
dependent on the continuation of the work. In other words if the work is not
continued, if there is a gap in support, it will only be a short time before there is a
need to start again at the beginning.          Starting again will be a much more
challenging task since a break in continuity is likely to lead to a very substantial
loss of faith in the Project by the Traveller Community and, indeed, by other
partners as well.


5.9      Summary conclusions


The Omagh Traveller Support Group and the Traveller Health Support Project
has achieved a high level of success in engaging with the Traveller Community in
Omagh. A range of activities has been initiated and planned in consultation with
Travellers which has made a positive impact on the inclusion of Travellers in the
wider community.


The Project has put health and well-being on the Travellers agenda and has put
Traveller health and well-being on the agenda of a range of organisations across
all sectors.   It has made substantial progress in relation to each of its own
objectives and has made a significant contribution to most of the objectives of the
wider Western Travellers Interagency Group.


Key to the success of the Omagh Project has been the community development
approach employed, especially the level of advocacy on behalf of individuals and
the community, the intersectoral partnership approach which has supported this
and the support of the Traveller Community for the Project.                  The Project
management roles of Omagh FOCUS and Western Health Action Zone have
conferred strategic and operational advantages.




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                                  Omagh Traveller Health Support Project - Final Evaluation


In comparison to the indicators of good practice in supporting Travellers
highlighted in Section 1.5, Omagh Traveller Support Group has:

       shown leadership on promoting the understanding of people’s different
        circumstances;


       contributed to the maintenance of well resourced and well managed
        sites;


       made progress in making it easier for Travellers to take part in the life of
        the wider community;


       actively promoted good relations and mediated on issues which could
        have led to tensions between Travellers and the wider community and
        vice versa;


       made     progress    in   encouraging       organisations       with    statutory
        responsibilities to make responses to Travellers needs / issues a routine
        part of their mainstream work;


       promoted the inclusion and involvement of Travellers;


       used a successful community development approach;


       developed an intersectoral partnership for project management linked to
        a wider interagency forum which aims to support the needs of Travellers
        in the wider Western area.


Considering the nature of the work and the enormity of the challenge in terms of
designing and delivering services which meet Travellers needs, the Project is still
at a relatively early stage, having been operational for just under three years.




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                                     Omagh Traveller Health Support Project - Final Evaluation


There are a number of areas where further development is now required. These
are:


          strengthening the partnership identity and function of Omagh Traveller
           Support Group including identification of actions by the Group and by
           partners   which   will further      advance the     aim    of   mainstreaming
           consideration of the needs of Travellers into service provision;



          working towards securing Traveller representation on the Group;



          collaborating with the Traveller Community to take a strategic view of the
           future of the Project in Omagh and planning ahead accordingly, including
           identification of the staffing profile required to secure the intended
           impacts;



          seeking resources to support future work;



          defining a straightforward, but more robust, action planning, monitoring
           and reporting framework for the Project;



          communications, namely:



             -   continued work to further raise the profile of the Project;
             -   taking   opportunities   for    positive   publicity for    the Traveller
                 Community;
             -   increased effort in relation to the dissemination of Project learning.




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                                  Omagh Traveller Health Support Project - Final Evaluation



6.0 Recommendations


The recommendations emerging from the evaluation are as follows:


       the ‘community development in partnership’ approach of Omagh
        Traveller Support Group should continue to be supported for the
        foreseeable future and any potential break in continuity of support
        avoided.    Support must continue until there is clear evidence of
        widespread consideration of Travellers needs in the planning and
        delivery of essential services;


       future work should be defined within the framework of a strategic plan for
        the support of Travellers in the Omagh area which may form part of a
        wider plan for the western area including Omagh and Fermanagh, but
        which should clearly define and respond to the needs in Omagh. The
        most effective approach to this will be within the context of a strategic
        interagency plan for the Western area in its entirety – a responsibility of
        the Western Travellers Interagency Group;


       in the wider context, the Western Travellers Interagency Group, CAWT
        and individual Traveller Support Groups should ensure that particular
        issues for Travellers in the western area are communicated and
        addressed at regional and national levels, including to the All-Ireland
        Traveller Health Study;


       Omagh Traveller Support Group and Traveller Health Support Worker
        should take ‘time-out’ to develop the Omagh strategic plan, which as well
        as guiding work at the strategic level should also provide a framework for
        strengthened operational action planning for the Project and a foundation
        resource for accessing external funding;



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                              Omagh Traveller Health Support Project - Final Evaluation


   as part of the planning process and beyond, the partnership identity and
    function of Omagh Traveller Support Group should be strengthened,
    including identification of actions by the Group, and by partners, which
    will further advance the aim of mainstreaming consideration of the needs
    of Travellers into service provision;


   Omagh Traveller Support Group should work towards securing Traveller
    representation and improve targeting of Travellers in all areas in Omagh
    and, for the future, Fermanagh, including nomadic Travellers;


   staffing needs should be reviewed in light of the strategic direction and
    operational needs identified;


   resources should be sought to support future work – given the diversity of
    the activities which underpin the community development approach, the
    work could benefit from a number of funding sources;


   a straightforward, but more robust, action planning, monitoring and
    reporting framework should be designed for Omagh Traveller Support
    Group – care should be taken to ensure that the framework does not lead
    to ‘over-planning’ of activities as the flexible, responsive nature of the
    approach to date needs to be recognised as a significant success factor;


   the profile of Omagh Traveller Support Group should continue to be
    raised including taking further opportunities for positive publicity for the
    Traveller Community;


   there should be an increased focus on the dissemination of learning by
    Omagh Traveller Support Group - to support mainstreaming service
    activity, but also as a model of practice with potential for use in delivering
    support to other minority communities.



                                     61                                      July 2006
Appendix

Job Description - Traveller Health Support Worker
                            Job Description

Job title:          Traveller Health Support Worker

Reports to:         Manager FOCUS

Responsible to:     Omagh Traveller Support Group

Hours:              37.5 per week


Primary function

The post-holder will be responsible for the delivery and co-ordination of a
community development support strategy aimed at improving the health and well-
being of Traveller families within the Sperrin Lakeland Health & Social Services
Trust area.


Key responsibilities

1. Co-ordinate work to identify need among Traveller families living in the target
   area and explore models of best practice in meeting identified need.

2. Facilitate genuine engagement with Traveller families in identifying and
   addressing their own needs in partnership with service providers in the
   statutory, public, voluntary and community sectors.

3. Promote good relations between Travellers and the settled community and
   build on existing links with settled community groups.

4. Advocate for improvements in service provision for Travellers to local
   agencies and organisations.

5. Facilitate the delivery of identified social, health, education and training
   programmes.

6. Encourage empowerment of Traveller families to take ownership of the
   programme in future.

7. Co-ordinate the provision of support services, such as Childcare to encourage
   maximum participation in the programme of activities.
8. Facilitate in the development of culturally appropriate programmes for
   Travellers living in the settled community and those who live on sites,
   incorporating the principles of health, social care and personal development.

9. Work closely with other organisations in order to raise awareness and
   knowledge of Traveller culture among the public in general.

10. Prepare regular progress reports to the Omagh Traveller Support Group and
    to FOCUS Management Committee.

11. Ensure the implementation of appropriate monitoring and evaluation
    procedures.

								
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