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					   THE INCLUSION OF DISABILITY IN NORWEGIAN
          DEVELOPMENT CO-OPERATION


Planning and monitoring for the inclusion of disability issues in
             mainstream development activities




                       NORAD January 2002
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002              2


Contents

Introduction                                                                             3

Summary and guidance to the reader                                                       4


PART I: BASIC DISABILITY AND DEVELOPMENT ISSUES                                          5

1. Disability and the Objectives of Norwegian Development Co-operation                   5

2. Global Conventions and Regulations Concerning Disability                              7
   2.1 Fundamental concepts in disability policies                                       7
   2.2 Human rights conventions                                                          8
   2.3 International frameworks and declarations                                         9

3. Disability and the Challenges for Development                                         10
   3.1 Disability and poverty                                                            10
   3.2 Disability and human rights                                                       11
   3.3 Disability and accessibility                                                      11
   3.4 Disability as a challenge for the family and household                            12

4. Strategies for the Inclusion of Disability Issues in Programme Development            12
   4.1 General principles of inclusion                                                   12
   4.2 Complementary strategies for the inclusion of disability issues                   13


PART 2:        SOME PRACTICAL GUIDELINES                                                 16

5. The Operationalization and Use of Mechanisms for the Inclusion of Disability Issues   16
   5.1 Goal, principles and main priority areas                                          16
   5.2 Mechanisms                                                                        17

6. Checklist for the Inclusion of Disability Issues in Programme Cycle Management        19
   6.1 Guidelines related to programme / project cycle management                        19
   6.2 Checklist for country negotiations/dialogue with partners                         20
   6.3 Checklist for programme planning (from identification and justification to
      programme document)                                                                21
   6.4 Checklist on implementation and monitoring                                        21

7. Indicators for the Inclusion of Disability Issues                                     22
   7.1 A framework for defining indicators for the inclusion of disability issues        22
   7.2 Examples of defining indicators related to NORAD strategy                         23
   7.3 Example of indicators within a programme approach                                 24

References                                                                               25
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                 3


Introduction

The intention

This document is a response to NORADs obligation to include people with disabilities, and their
specific needs in all aspects of development co-operation. The framework for this obligation is
provided by decisions made in the Norwegian Parliament and subsequently articulated in
parliamentary propositions, and in an action plan adopted by the Norwegian Ministry for Foreign
Affairs.

The goal is to follow up these policy obligations by providing basic information, including some
references on selected disability issues, and guidelines on planning for and monitoring the inclusion of
disability issues in future development work. The intention is not to produce yet another handbook,
but to supplement existing materials by highlighting key issues, and illustrating how these can be
managed within mainstream programme development. Accordingly, the content of the document
covers the following areas:
      Objectives of Norwegian development co-operation, and their relationship to disability issues
      Global instruments on disability
      Basic disability - development issues
      Strategies for making persons with disabilities visible in development co-operation
      Checklist and indicators for the inclusion of disability issues in mainstream development
          programmes

The target group

The document has been prepared primarily for NORAD staff, as guidelines for their co-operation with
partners abroad, as well as for Norwegian NGOs supported by NORAD. It is also intended as
information for partners in co-operating countries.

The working group

A working group, commissioned by NORAD under the Social Sector Initiative1 produced the
document, The group included representatives of Disabled People’s Organisations, the Norwegian
State Council on Disability, as well as NORAD and the Norwegian Ministry of Foreign Affairs.

The document is written in two parts, a format that reflects the manner in which it was developed. Part
I - chapters 1-4 - focuses on objectives, global instruments, and basic disability and development
issues. This part was adopted by the NORAD Direction in October 2000, and distributed to the
development agencies of the Nordic governments, as well as to the organisations for persons with
disabilities, as information to the Nordic Ministers' Conference on Disability and Development Co-
operation held in November 2000.

The working group prepared Part II - chapters 5-7. This segment deals with the practicalities of
including the disability dimension in programme and project cycle management. To facilitate
utilisation of Parts I and II as self-contained entities, some of the more general points made in Part 1
are also repeated in Part II.




1
    The Director General of NORAD endorsed the Terms of Reference for the working group on 19. September 1999.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                          4


Summary and guidance to the reader

PART 1: BASIC DISABILITY AND DEVELOPMENT ISSUES

Chapter 1 provides an overview of the State policy obligations for Norwegian development co-
operation, on the inclusion of disability issues. These obligations are spelt out in the Norwegian
Ministry of Foreign Affairs’ “Plan for the Inclusion of Persons with Disabilities in Development Co-
operation”, of 10. November 1999.

Chapter 2 deals with the basic concepts in disability, and describes the most important global
regulations and conventions concerning disability. This global framework, within which the “UN
Standard Rules on the Equalisation of Opportunities for Persons with Disabilities” is central,
establishes crucial obligations, and important reference points for the development of an inclusive
disability policy in Norwegian development co-operation.

Chapter 3 looks at the challenges that disability issues raise for development. Human Rights
principles give important directions for change. Poverty can be seen as both a cause and a consequence
of disability. Accessibility to all aspects of society is another challenge, and is critical for creating
equal opportunities for people with disabilities.

Chapter 4 outlines four complementary strategies that are relevant for the inclusion of disability
issues, ranging from disability-specific projects to the inclusion of disability concerns in all aspects of
mainstream planning. Examples from specific programmes are included.

PART 2: SOME PRACTICAL GUIDELINES

Chapter 5 focuses on the operationalisation of the inclusion of disability issues. The point is made
that this process shall take place according to the universal principles of Human Rights, and also
according to principles of development co-operation approved by NORAD. A participatory approach
to planning and implementation is important. In this perspective, people with disabilities are perceived
as the primary stakeholders.

Chapter 6 is closely connected to chapter 5, and presents a checklist for ensuring/monitoring the
inclusion of disability issues in Programme Cycle Management.

Chapter 7 provides examples of indicators for the inclusion of disability issues in the planning and
monitoring phases of programme development.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                          5


PART 1:            BASIC DISABILITY AND DEVELOPMENT ISSUES

1.   Disability and the Objectives of Norwegian Development Co-operation
The Norwegian commitment to the inclusion of persons with disabilities in development co-operation
- is articulated in parliamentary propositions and white papers2. The UN Standard Rules on the
Equalisation of Opportunities for Persons with Disabilities shall form the basis for work with persons
with disabilities in Norwegian development co-operation.

A basic problem
- a person who is categorised as disabled by her/his society is frequently attributed lower status and
value than so-called non-disabled persons3. Disability is not understood as normal, consequently, and
to an extent not commensurate with the physical and/or other constraints that might be inherent in the
disability itself, persons with disabilities are often excluded from many of the processes, and benefits
of human development. This de facto exclusion occurs, even if there is no formal policy legitimising
such action.

People with disabilities as a group
- disabled persons are estimated to comprise one of every six of the poor in developing countries4.
Even in their own communities, those who are poor and disabled tend to be regarded as the most
disadvantaged. Women with disabilities are often in an even worse situation, as they find themselves
doubly discriminated against; as females and as disabled.

Poverty alleviation in all areas or sectors5
- is the key principle of Norwegian development co-operation. Disabled persons therefore, who are
often over-represented amongst the poor, constitute an important target group for development
assistance. Global estimates of disability indicate that – as a consequence of disease, trauma,
malnutrition, genetic causes etc. - about 10 % of a given population can be defined as disabled. In all
countries the rates vary according to age, ranging from 1,3 % in age group 0 – 4 to 56,0 % in age
group 80 +6. At the same time however, disabled people often make up to one of every six of the poor
of developing countries, with women with disabilities being even more exposed to poverty7.

Inclusion of disability issues in mainstream development actions
- inclusion is the main strategy in Norwegian development co-operation on disability (Norwegian
Ministry of Foreign Affairs 10.11.1999, “Plan for the Inclusion of Persons with Disabilities in
Development Co-operation” - see Box 1). An inclusive strategy focuses on the society, local
community and interpersonal relations in which the persons with disabilities are, or have the right to
become, members and participants. Accordingly, an inclusive strategy aims at promoting access to the
community and to an active and responsible social life for all its members. If groups are excluded,
focus will be on mechanisms for exclusion, and the barriers to access.




2
  Proposition No. 1 to the Storting (the Norwegian Parliament), 1998-99
Focus on Human Dignity, Norwegian Plan of Action for Human Rights, White Paper No. 21 (1999-2000)
The plan of action for the disabled 1998-2001, White Paper No. 8 (1998-99)
3
  Even though there are good examples of the opposite. Gender, family, age, education, cultural beliefs etc influence the
status of a person with disability.
4
  Indicated in “Poverty and disability – a survey of the literature”, World Bank December 1999.
5
  Emphasised in: “NORAD invests in the future - NORAD’s strategy for 2000 – 2005”
6
  “Prejudice and Dignity – an Introduction to Community Based Rehabilitation”, 2 nd ed. UNDP 1999.
7
  It should however be emphasised that the above estimates are based on incomplete data. There is therefore, an urgent need
for better documentation and statistical data on disability.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                        6


  Box 1.
  The Plan for the Inclusion of Persons with Disabilities in Development Co-operation (1999)

  Priority Areas mentioned in the plan are:
            To improve the situation of persons with disabilities and to ensure that their rights are safeguarded in
             areas such as public services, accessibility, health, education, employment, organisation, culture,
             democratisation and co-determination
            Development assistance must be directed towards the poorest, and focus on developing and using
             methods that involve them in the efforts to improve their situation. Since persons with disabilities are
             often among the poorest of the population, efforts to improve their situation should therefore be
             specifically highlighted in the poverty alleviation efforts of development assistance.
            Since the main goal is inclusion in society, Norwegian development co-operation emphasizes measures,
             which will ensure that existing services provided for the local community are also available for persons
             with disabilities.
            The right to life and to medical care is an important part of the UN Standard Rules. Preventive measures
             in primary health care are essential, as well as access to health services in general.

  For NORAD, the Plan of Inclusion outlines some follow-up guidelines among which are:
         The rights of persons with disabilities must be an integral part of the dialogue with the authorities in
          partner countries.
         NORAD will draw up a plan for the operationalisation and use of measures in the efforts to provide
          bilateral aid to persons with disabilities.
         NORADs co-operation with the organisations of people with disabilities will be further developed, like
          their umbrella organisation the Atlas Alliance, as well as with other NGOs that provide support to
          persons with disabilities in accordance with the present Plan.
         NORAD will ensure that assistance to persons with disabilities is clearly indicated in management and
          reporting systems.


The NORAD Strategy for poverty alleviation focuses
- on six areas for development co-operation. People with disabilities must be included in all six areas
in order to reach this objective, both in the administration of long-term government-to-government co-
operation, and in co-ordinating co-operation with civil society and other partners. These strategic areas
are outlined here, with some indications as to how people with disabilities can be included:

         1. Social development
            To include people with disabilities in the development of mainstream services in all
            sectors: Health, education, water and sanitation, transport, etc
         2. Economic development
            Inclusion of disabled in employment policy, business, all aspects of income generating
            opportunities, and appropriate vocational training.

         3. Peace, democracy and human rights
            Participation in a human rights approach to community development, in the development
            of democratic decision processes, and in reconciliation efforts in post-war societies.
         4. Environment and natural resource management
            Prevention of pollution and the provision of safe work places in order to prevent
            disabilities; give people with disabilities equal share of access to, and management of
            natural resources
         5. Humanitarian assistance in the event of conflicts and natural disasters
            People with disabilities as a group are frequently not included in emergency humanitarian
            assistance Give access to and include people with disabilities into the assistance, aim at
            their participation in the planning process; focus on preventive measures in the assistance.
         6. Women and gender equality
            Make sure that women and children with disabilities are included in all aspects of
            programmes and projects
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                         7


2.     Global Conventions and Regulations Concerning Disability
This chapter presents definitions of basic concepts in disability policies, followed by an overview of
the most important global regulations concerning the inclusion of disability issues.

2.1        Fundamental concepts in disability policies

The UN Standard Rules on the Equalisation of Opportunities for Persons with Disabilities were
developed on the basis of experiences gained during the UN Decade of disabled persons 1983–1992,
and approved by the UN General Assembly in 1993. The international conventions on Human Rights
and related issues constitute the moral and political foundation for the Rules. Although they are not
international laws, the UN Standard Rules can become international customary rules when they are
applied by a large number of states with the intention of respecting the rules of international laws.

The purpose of the UN Standard Rules is to ensure that children, women and men with disabilities, as
members of their societies, are able to exercise the same rights and obligations as others8. There are 22
Rules covering the following 4 areas:
(a) Preconditions for equal participation: Awareness raising, medical care, rehabilitation and support
    services
(b) Target areas for equal participation: Accessibility, education, employment, income maintenance
    and social security, family life and personal integrity, culture, recreation and sports, and religion
(c) Implementation measures: Information and research, policy making and planning, legislation,
    economic policies, coordination of work, organisations of persons with disabilities, personnel
    training, national monitoring and evaluation of programmes in the implementation of the rules,
    technical and economic co-operation, international co-operation
(d) Monitoring mechanisms: A Special Rapporteur is appointed by the UN to monitor the
    implementation of the rules in the individual states. International organisations of persons with
    disabilities have consultative status, and shall also support the formation of national organisations
    of disabled.

Standard Rule No. 21, on Technical and economic co-operation should be emphasised:
       “States, both industrialised and developing, have the responsibility to cooperate in and take
       measures for the improvement of the living conditions of persons with disabilities in
       developing countries.”

The Standard Rules define fundamental concepts in disability as follows - these definitions are also
taken as points of departure in the official Norwegian documents (see however, Box 2).

Disability summarises a great number of different functional limitations occurring in any population in
any country of the world. People may be disabled by physical, intellectual or sensory impairment,
medical conditions or mental illness. Such impairments, conditions or illnesses may be permanent or
transitory in nature.

Handicap means the loss or limitation of opportunities to take part in the life of the community on an
equal level with others. It describes the encounter between the person with a disability and the
environment. The purpose of this term is to focus on the shortcomings in the environment, and in
many organised activities in the society, for example, information, communication and education,
which prevent persons with disabilities from participating on equal terms.




8
    From the introduction to the UN Standard Rules
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Prevention means action aimed at preventing the occurrence of physical, intellectual, psychiatric or
sensory impairments (primary prevention) or at preventing impairments from causing a permanent
functional limitation or disability (secondary prevention). Prevention may include different types of
action, such as primary health care, prenatal and postnatal care, education in nutrition, immunization
campaigns against communicable diseases, measures to control endemic diseases, safety regulations,
programmes for the prevention of accidents in different environments, including adaptation of
workplaces to prevent occupational disabilities and diseases, and prevention of disability resulting
from pollution of the environment or armed conflict.

The term rehabilitation refers to a process aimed at enabling persons with disabilities to reach and
maintain their optimal physical, sensory, intellectual, psychiatric and/or social functional levels, thus
providing them with the tools to change their lives towards a higher level of independence.
Rehabilitation may include measures to provide and/or restore functions, or compensate for the loss or
absence of a function or for a functional limitation. The rehabilitation process does not involve initial
medical care9. It includes a wide range of measures and activities from more basic and general
rehabilitation to goal-oriented activities, for instance vocational rehabilitation.


    Box 2
    A note on concepts

    Disability concepts have been disputed by organizations of persons with disabilities:
      Impairment refers to the physical or mental injury that may have chronic consequences for a
      person's daily functioning. Disability on the other hand, refers to the mechanisms within
      society that disable the person from access to participation on equal terms with other
      citizens.
    The main concern for organizations of persons with disabilities is that the concepts become discriminating labels. People
    become defined by their physical impairment, which somehow becomes the basic trait of their personality - for example,
    "the blind", "the crippled", "the handicapped". It is the society therefore, which excludes and disables the people, and the
    responsibility to organize measures for inclusion remains with the society, and not with the individual who is socially
    disabled, or his/her family.




The UN standard Rules defines two key policy principles:

Equalization of opportunities means that the process through which the various systems of society and
the environment, such as services, activities, information and documentation, are made available to all,
particularly to persons with disabilities.

Equal rights implies that the needs of each and every individual are of equal importance, that those
needs must be made the basis for the planning of societies and that all resources must be employed in
such a way as to ensure that every individual has equal opportunity for participation.

2.2        Human rights conventions

A number of international legal instruments have been ratified by Norwegian Governments and will
thus serve as guidelines for international co-operation. Some of the most relevant for co-operation on
disability issues are the Universal Declaration of Human Rights of 1948, the Convention of the Rights
of the Child of 1989 – CRC (see Box 3), the Convention on Elimination of Discrimination Against all
Women 1979 – CEDAW (see Box 4), and the Mine Ban Convention of 1997 (see Box 5). The UN
Standard Rules are closely connected to these conventions.



9
  This definition covers people with permanent impairments. People with illnesses that can be cured are not included, for
example people with tuberculosis – TB, even though their condition often is disabling. The incidence and prevalence of TB
in combination with aids increases vastly, in these cases TB is disabling when the access to TB treatment is difficult.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                           9


  Box 3
  Convention of the Rights of the Child – CRC

  The CRC, in article 23, emphasises the needs of children with disabilities, and that they have the right to:
      -   protection and preparation for life skills and development
      -   access to education, health services and adequate nutrition
      -   access to sports and recreation
      -   safe and supportive environment free from exploitation and abuse.

  Besides, the following general principles are equally valid for children with disabilities as for all other children:
      -     States shall ensure that each child enjoys full rights without discrimination or distinctions of any kind
            (Article 2)
      -     The child’s best interests shall be a primary consideration in all actions concerning children, whether
            undertaken by public or private social institutions, courts, administrative authorities, or legislative
            bodies (Article 3)
      -     Every child has an inherent right to life and States shall ensure, to the maximum extent possible, child
            survival and development.
      -     Children have the right to be heard (Article 12)

  Box 4
  Convention on Elimination of Discrimination Against all Women - CEDAW

  The CEDAW relates to discrimination in all areas, which in general are of importance for women with
  disabilities, here are some statements that illustrate the importance:
       -     Discrimination against women violates the principles of equality of rights and human dignity, it is an
             obstacle to the participation of women on equal terms with men in all areas of life in their countries;
             which hampers general growth, and the full development of women’s potentialities
       -     In situations of poverty women have the least access to food, health, education, training and
             opportunities for employment



  Box 5
  The Mine Ban Convention

  Commits the Norwegian government to develop policy guidelines in support of mine action ranging from
  preventive measures and the universalisation of the Convention; mine-awareness and risk-reducing measures;
  mine clearance; victims assistance including care, physical and psychosocial rehabilitation; as well as economic
  and social integration of victims in the society. It is stressed that all persons with disabilities should be included
  in the development co-operation in the framework of this Convention, not only people injured by landmines.



2.3      International frameworks and declarations

Regulations for the education of children with disabilities (see Box 6) emphasise the principle of
inclusive education in mainstream schools:

  Box 6.
  The Salamanca Statement and Framework of Action on Special Needs Education ( 1994) - The
  guiding principle of the Framework is that:
           “Schools should accommodate all children regardless of their physical, intellectual, social, emotional,
           linguistic or other conditions. This should include disabled and gifted children, street and working
           children, children from remote or nomadic populations, children from linguistic, ethnic or cultural
           minorities and children from other disadvantaged or marginalized areas or groups.”

  The Salamanca Declaration introduces the term “children with special education needs” which include all
  children and youth with needs arising from disabilities or learning difficulties. The declaration removes
  emphasis from the individual child as “owner” of learning problems in favour of the responsibility of schools
  to successfully educate all children, including those who are seriously disadvantaged and disabled.
  The Norwegian Plan for the Inclusion of Persons with Disabilities explicitly mentions that this Declaration “ -
  should serve as the basis for assistance in the education sector”.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                       10

The UN Social Summit (see Box 7) emphasise the rights to access to all areas of society:

Box 7.
The Copenhagen Declaration and Programme of Action

Emphasises the commitments of UN member states to social development in all areas, and mentions the
promotion of equal access to education and health services for people with disabilities, as well as to
rehabilitation and other independent living services and assistive technology to enable them to maximise their
well-being, independence and full participation in society.




3.    Disability and the Challenges for Development
Although disability issues have a powerful human rights dimension, they are frequently associated
with social exclusion and exposure to poverty. The consequent concern with disability issues has
followed various international development trends or phases, from the period of charity by religious
and humanitarian organisations to the stage where people with disabilities themselves initiated their
struggle for human rights and equal opportunities.

3.1      Disability and poverty

Poverty can be seen as both a cause and a consequence of disability, reinforcing each other, and
contributing to increased vulnerability and exclusion10. In general disabled people have lower
education and income levels than the rest of the population. They are more likely to have incomes
below poverty level, and less likely to have savings and other assets than the non-disabled population;
this holds for both developing and developed countries. Case studies in developing countries show that
higher disability rates are associated with higher rates of illiteracy, poor nutritional status, lower
immunisation coverage, lower birth weight, higher unemployment and underemployment rates, and
lower occupational mobility11. Early marriages, when girls in their early teens become mothers before
they are physically mature, may be another cause for disability.

Poor households do not have adequate food, basic sanitation, and access to preventive health care.
They live in lower quality housing and work in more dangerous occupations. Malnutrition may often
cause disability, as well as increase susceptibility to other disabling diseases. Malnourished mothers
frequently have low birth-weight babies who are more at risk of debilitating diseases than healthy
babies. Lack of adequate and timely health care can exacerbate disease outcomes; in this situation an
impairment that usually can be treated may become a permanent disability12.

Certain groups among people with disabilities are more vulnerable to the risk of poverty, including the
elderly, those with mental disabilities, and women. In some communities disabled girls receive less
care and food, have less access to health care and rehabilitation services and fewer education and
employment opportunities. They also tend to have lower marriage prospects than disabled men, and to
be at a higher risk of physical, sexual and mental abuse13.




10
   From the summary of “Poverty and disability – a survey of the literature”, Ann Elwan, World Bank 1999.Ibid, under the
heading “Poverty as cause and consequence”.
11
   Ibid.
12
   Ibid.
13
   Ibid.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                           11

3.2          Disability and human rights

     Box 8
     How to make Human Rights operational in a disability perspective

     A rights-based approach in the fight against poverty will affect the work with disability. Poverty is in itself a
     violation of human rights in terms of lack of choices and possibilities. Additionally the inequality common for
     disabled people frequently leads to further restrictions in rights achievement in terms of non-access to productive
     activity and political participation. This, again, strengthens the poverty aspect even further. A rights-based
     approach will, in short, break this circle by ensuring rights achievements for people living in poverty and social
     isolation.


 “Disability is a Human Rights issue. As long as people with disabilities are denied the opportunity to
participate fully in society, no one can claim that the objectives of the Universal Declaration of
Human Rights have been achieved”14.

There is an important and fundamental difference between disability and other forms of disadvantage.
People with disabilities can only organise themselves to claim their rights when their additional
practical needs, for example for mobility aids, have been met. In order to fight for the right to
inclusion, people with disabilities need to live in an environment in which they are empowered.

People with disabilities face specific barriers to their efforts at realising equal opportunities:
    Environmental and access barriers,
    Legal and institutional barriers,
    Attitudinal barriers, which cause social exclusion.
   
The latter are frequently the most difficult to overcome, and are usually associated with feelings of
shame, fear and rejection. Negative stereotypes and attitudes are commonly attached to disability.
People with disabilities are often assigned a low social status and in some cases considered
worthless15.

3.3         Disability and accessibility

 “States should recognise the overall importance of accessibility in the process of equalisation of
opportunities in all spheres of society. For persons with disabilities of any kind, States should a)
introduce programmes of action to make the physical environment accessible; and b) undertake
measures to provide access to information and communication16”

Accessibility is crucial in order to create equal opportunities for people with disabilities. Society itself
is not accessible, as a consequence it creates barriers for equal opportunities, here are some examples:
     Lack of adequate information adapted for people with seeing or hearing problems
     Lack of transport adapted for people with seeing or movement problems
     Lack of access to buildings and public places
     Legislation that discriminates people with disabilities or do not mention this group explicitly
     Attitudinal barriers and stereotypes concerning the abilities and roles of people with
         disabilities, which cause seclusion.




14
   From “World disability report”, 1999, by UN Special Rapporteur, Bengt Lindqvist.
15
   From “Disability, poverty and development”, DFID 2000.
16
   From UN Standard Rule No. 5, concerning accessibility, under “Target areas for participation”.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                         12

3.4       Disability as a challenge for the family and household.

Even though it is important to focus on the rights and the general situation of the individual with
disabilities, in many developing countries it might be even more important to focus on the family, the
care unit or the household in which the individual is a member or participant. Too narrow a focus on
the individual disability might lead to less preferable solutions. In most situations it is a qualitatively
better rehabilitation process to strengthen the family’s ability to give care and support. One example
is to promote better physical access for a child with movement disabilities at home and in the local
school instead of sending him/her to a special school far away from home.

4.    Strategies for the Inclusion of Disability Issues in Programme
      Development
There are a number of general principles that provide the parameters for all inclusion strategies. On the
basis of these, a range of complementary strategies may be conceptualised for programme
development.

4.1       General principles of inclusion

4.1.1 .“A society which is good for disabled people is a good society for all” 17.

Planning for access, participation and inclusion of people with disabilities most frequently means
planning for better quality for other groups as well. - for example for families with small children or
the elderly.

Box 9
Relevant sectors for planning from a disability perspective = most sectors!

      -   Design and construction of public buildings, facilities, housing.
      -   Development of infrastructure, including transport systems, telecommunications, water supply and sanitation
          amenities
      -   Development of small-scale industries and enterprises
      -   Urban/rural community development
      -   Development of health care and social service systems facilities, including family care
      -   Human resource development, including
               o Preschool, primary and secondary education
               o Higher education
               o Adult education
               o Vocational training
               o Awareness raising campaigns
      -   Income generation, with special emphasis on improving the situation of the poorest in the society
      -   Training of development policy, programme and project personnel



4.1.2 “Nothing about us without us”18

There is a growing consensus that people with disabilities themselves should participate actively in all
stages of the co-operation process. Disabled persons and/or their representative organisations must
contribute with their own experiences in the planning of various actions, so that development becomes
a process of persons with disabilities, and not something carried out by bureaucrats and “good-
wishers” alone as a process for disabled people.



17
   From the chapter ”Introduction to current concepts and issues. – Planning for all“, in “The disability dimension in
development action – manual in inclusive planning”. UN / STAKES 1997.
18
   This is the title of the most recent book by David Werner, 1998, on participatory planning in the disability field.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                           13
Box 10
Participation by disabled people’s organisations in programme development, examples from Ghana:
National level
- An inter-ministerial advisory committee has been established to involve ministries at the political level and facilitate
coordination and decision-making for the national Community Based Rehabilitation Programme. Ghana's umbrella
organisation of disabled persons organisations (Federation of Disabled Peoples Organisations – FODA) is represented in
the committee
- A group of programme managers at administrative level of all participating ministries has been established to secure
coordinated planning and to monitor implementation of the programme - The Core Team. FODA is represented in this
group.
- The three national organisations for the disabled – Ghana Association of the Blind, Ghana National Association of the
Deaf and Ghana Society of the Physically Disabled (all members of FODA) participate in evaluations and monitoring of
the programme
- Representatives of the three organisations of disabled are invited as lecturers in training and education of government
staff, for example in health sciences and teachers training colleges
- The three organisations are represented in the annual meetings with donors.
District level
- District planning: Local branches of the three organisations are represented , where they exist, in coordinating committees
and in planning and monitoring activities for the programme at regional and district levels
- Representatives from local branches are invited as resource persons and participants in workshops and training.

4.2      Complementary strategies for the inclusion of disability issues

The general tendency is to move away from a focus on separate projects towards:
 larger programmes aiming at coordination and inclusion of the main efforts in an entire sector19,
   the Sector Wide Approaches (SWAP) for mainstream development. The intention is that the needs
   of people with disabilities shall be integrated into the mainstream services
 In addition, specific components may also be included into mainstream programmes, set up in
   order to secure the inclusion of people with disabilities in development
 Separate programmes or projects may still be implemented for groups of disabled people with
   specific needs, preferably coordinated with mainstream approaches
 Another strategy aims at coordinating efforts across sectors, towards a general community
   development where several vulnerable groups can profit from the actions, including people with
   disabilities.

The inclusion of disability issues in programme development can be made visible within these four
complementary strategies. In bilateral cooperation, the inclusion of disability issues in mainstream
planning should be the main focus. Disability specific projects and community based rehabilitation
programmes remain the main strategies in the co-operation between NGO/DPO partners. At the same
time, there is a need for better co-ordination between NGO/DPO projects and bilateral programmes.

4.2.1 Inclusion of disability concerns in all aspects of mainstream planning, including
      sector wide approaches

An inclusive approach implies that the disability dimension is included in all aspects and stages of
mainstream planning and implementation in a qualitatively different way. The programming process
should lead to appropriate adaptation of mainstream facilities and services so that they can adequately
serve both persons with disabilities and non-disabled people. This approach also implies full and
effective involvement of persons with disabilities as equal partners in the planning and running of a
development activity. Specific components of support services may be needed to assure inclusion; for
example, if a deaf student shall follow lessons in mainstream schools, sign language interpreters
and/or technical aids are required20.



19
   Confer the reports “Programtilnærming i norsk bistand” (The programme approach in Norwegian development co-
operation) NORAD / Centre for Health and Social Development 2000. “Veiledning I NORADs arbeid med
programtilnærming” (Guidelines for NORAD’s programme approach). NORAD 2000.
20
   The inclusive approach is discussed in a similar way in “The disability dimension in development action – manual in
inclusive planning”, United Nations / STAKES 1996
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                              14

Mainstream development planning and implementation refers to programmes for ordinary services or
activities in the society, aimed at the population at large. These may relate to general social
development – of institutions in the society for the promotion of good governance, equity, trust and
social responsibility. They may also relate to ordinary services – health, education, housing etc.

When people with disabilities are integrated into an existing system that is not open for change in
accordance with their specific needs or situation, mainstreaming may not always imply good quality
services or social development for these groups. However, access to existing systems within
education, employment and health services will benefit most disabled, as well as the non-disabled. A
minority will have special needs, which will challenge the existing system. But access remains the
starting point, in order to cater for the majority and to initiate needed changes for the minority.

4.2.2 Disability-specific components in mainstream programmes

Specific programme components can be developed in order to support full inclusion of people with
disabilities into larger bilateral sector programmes, for example in preventive or primary health care
programmes or in education. When planning is worked out in a holistic and inclusive manner, with the
aim of including persons with disabilities (and other marginalized groups), these specific components
will become important prerequisites for the inclusion of people with specific needs. In a long-term
perspective, these components should be fully included in the mainstream activities, see the following
box:

  Box 11
  The Disability and Rehabilitation Section, Ministry of Health, Uganda. – An example of specific
  components in a sector programme:

  The strategic approach for the project is mainstreaming or integration of services for persons with disabilities into the
  general work of the health sector.

  Technical and financial resources from the Norwegian Association of the Disabled – NAD, with NORAD support
  has assisted the Ministry of Health in establishing this Section, and in developing standards, guidelines and a District
  Rehabilitation Package, to be implemented according to a 5 year plan. The plan addresses how rehabilitation and
  medical treatment can be extended to persons with different types of disability. The major objectives are:
       1. To improve the skills of health workers in rehabilitation and prevention of disabilities.
       2.   To strengthen rehabilitation services in 15 districts
       3.   To establish systems of provision of assistive devices, rehabilitative drugs etc. in 15 districts
       4.   To sensitise political and administrative leaders
       5.   To prevent disability arising from non communicable diseases, injury and eye and ear diseases


4.2.3 Disability - specific projects – links to mainstream development

Projects targeted specifically to persons with disabilities are most frequently found within the health
and education sectors, as well as in vocational training and income generating activities. Smaller and
larger projects or programmes may aim at the development of specific services, but also at awareness
raising, sports etc. Such projects may have a potential for innovation, both related to content and to
organisation. The challenge for such projects is to coordinate the different activities with other efforts
and plans for the same target group so that they do not remain isolated episodes or good happenings,
only to create false expectations among the target group. They must be incorporated into local
structures and into government responsibility to have prospects for sustainable development.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                              15

Box 12
Example of a specialised system, which became part of the referral health system and support to
community based care / rehabilitation:

A small orthopaedic workshop was established in a provincial town in Eritrea, not far from the district hospital. When
mine injured or polio affected children had received the appropriate medical treatment and surgery, the hospital started to
refer them to the workshop with their family to get prostheses or callipers and training, which the family could follow up
at home. Local rehabilitation workers were also welcomed to learn how to support the training in the family at home.
Orthopaedic technicians and rehabilitation assistants went to local meetings with rehabilitation workers to teach them
how to make appropriate appliances from local material, and basic training techniques.




Box 13
Example of a specialised system, which did not become part of mainstream development.

NFU, the Norwegian Association for Persons with Developmental Disabilities supported a project on special needs
education training for teachers in Bangladesh. At the same time NORAD supported general teacher training. The two
projects were not coordinated.



With reference to the definition of handicap, the main actions of a rehabilitation process can be
directed towards the community and not towards the disabled individual – for example to remove
physical and attitudinal barriers in the environment.

4.2.4     Inter-sectoral programmes that aim at mainstreaming people with disabilities

 When programmes aim at local development, they may start with a focus on persons with disabilities,
but will ideally mobilise community resources and develop into more general community
development, relating to different types of identified needs in the local community, across sectors.
Examples of such programmes are Community Based Rehabilitation - CBR, even if it originated as the
recommended concept from WHO for governments’ policy on rehabilitation. Some projects called
CBR are still small isolated efforts, there are however some programmes that aim at mainstreaming on
a larger scale.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                             16


PART 2:          SOME PRACTICAL GUIDELINES
Any given society consists of a heterogeneous mass of people. In order to reach marginalised groups,
among them people with disabilities, special tools and mechanisms must be utilised. These guidelines
represent a first attempt to secure an inclusive approach within Norwegian development co-operation.
They can also be used as guiding principles for targeting other marginalised groups within a larger
context, such as ethnic minorities, slum populations, children, women etc.

5.   The Operationalization and Use of Mechanisms for the Inclusion of
     Disability Issues
This chapter indicates how NORAD staff can promote the inclusion of disability issues in programme
development in accordance with the approved main priority areas of Norwegian development co-
operation: Poverty alleviation, human rights, the fight against HIV/aids and priority for children.

5.1 Goal, principles and main priority areas

5.1.1 Goals

The main goal for this part of the document on the inclusion of disability issues is to ensure that
NORAD staff at home and abroad, Norwegian NGOs and other relevant Norwegian networks will
avoid excluding people with disabilities from programmes and projects receiving Norwegian support.
The aim should be to make sure that programmes and projects supported by NORAD should be
adjusted and made accessible for people with disabilities.

In many cases this can be done in relatively simple ways, without the need of any special technical
knowledge.

5.1.2 Principles and main priority areas

Making people with disabilities visible, i.e. emphasising the needs and rights of people with
disabilities in policies, plans, monitoring tools, evaluations etc., is vital to attain the most important
priority areas of Norwegian development co-operation:

The fight against poverty: People with disabilities constitute a large group of the poorest; more than
one of six in the least developed countries. The risk of becoming disabled is greater when you are
poor, and poverty often leads to disability. People with disabilities are frequently excluded from
education, and their chances in the labour market are small. Thus they often become a burden for their
family and community, rather than the resource they could have been.
 The human capital dimension of people with disabilities is key words in this context.

Human rights: People with disabilities are very often discriminated against. They are excluded from
vital social, economic and political arenas and institutions, and are only to a small degree allowed to
make choices and decisions with regards to their own life.
 Participation and co-determination are key words in this context.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                              17

The fight against HIV/AIDS: There is a great risk that people with disabilities will be infected by
HIV/AIDS, which is to a large extent a poverty disease. Relevant information reaches people with
disabilities to an even less degree than what is normally the case for poor people in general. Many
women with disabilities are more in danger of being sexually assaulted than other women – and in
some places damaging myths are linked to e.g. women with developmental disabilities21. Many
children become orphans as a consequence of HIV/AIDS. The traditional solution to this problem has
been that the extended family has taken care of these children. Children with disabilities are, however,
often looked upon as burdens, and with the constraints that are now commonly felt by families and
communities in many countries, it may be very difficult to find someone to care for children with
disabilities. Often they end up as street children.
 Access to information and health care – and developing alternative care systems are key words in
    this context.

Giving priority to children: According to the Minister for Development Co-operation, children’s
situation and children’s rights stand first among the prioritised areas of Norwegian development co-
operation. Children with disabilities are among those who will be shown special attention. Children
with disabilities living in poor countries are especially vulnerable. They attend school less often than
other children; many figures indicate that approximately 50% of the 120 million children who do not
go to school, have a disability. The majority of these are girls. Due to lack of health care, illnesses and
injuries often lead to lasting disabilities. For the same reason existing disabilities easily deteriorate, or
new disabilities are added. It is also a sad fact that children with disabilities are overrepresented among
children exposed to violence and sexual abuse.
Fundamental aims in Norwegian development co-operation regarding children’s rights, education for
all and eradication of poverty will be impossible to reach if children with disabilities are excluded
from community activities and institutions.
 Inclusion and the right to care and fundamental services are key words in this context.

5.2 Mechanisms

All over the world people with disabilities are made invisible; they are forgotten and overlooked in
most contexts. Making people with disabilities visible, making them a clearly expressed part of any
target group, will in many contexts be the most important mechanism to start a process that will
change this situation.

5.2.1 Main mechanisms for inclusion

 Increased accessibility – in a broad sense. Accessibility should be both physical; i.e. accessibility
  to buildings, transport etc., but also accessibility to information, knowledge and communication.
 Increased stakeholders’ influence. People with disabilities should have equal rights to influence
  issues relating to their own lives. In many cases and on different levels, the organisations of
  people with disabilities (DPOs) should be given the responsibility to participate and influence on
  behalf of the individuals.
 Increased awareness and knowledge. This goes for all parties involved; from NORAD staff at
  home to partners on different levels and within different sectors. Disability issues should be
  included in the training of Ministry for Foreign Affairs/NORAD employees and the training of
  other key persons. It should also be included in relevant higher education (teachers’ training,
  education within the health and social sectors etc.) in partner countries.
  When needed, external competence should be obtained.




21
  Some people believe that sexual intercourse with these women will cure you of the virus. It is more usual
however, to look upon women with disabilities as “safe”, meaning that they are less likely to be infected because
they are unlikely to have had sex before.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                   18

5.2.2   Mechanisms linked to priority areas.

Human rights
 To request legislation, a national policy and follow up of UN Standard Rules in relevant settings
   like country negotiations, programme negotiations etc. (See NORAD’s Handbook in Human
   Rights Assessment – HRA – state obligations, awareness and empowerment)
 To support the development of legislation which secures the rights of people with disabilities and
   prohibits discrimination.
 To support the establishment of a National Council on Disability
 To request and demand the participation of Disabled People’s Organisations in relevant forum.
 To make sure that stakeholders are given advisory roles in the development of relevant
   programmes and projects.
 To support the development of appropriate guidelines and technical manuals aiming at making
   infrastructure and information accessible for different groups of people with disabilities, and to
   make sure that buildings and transport systems supported by Norwegian development funds are
   made accessible

The fight against poverty
 To support the participation of Disabled People’s Organisations in the work to reduce poverty (NB
   Participation Action Plan/(Interim)Poverty Reduction Strategy Papers)
 To make sure that the disability dimension is included in strategies and plans directed towards the
   eradication of poverty.
 To make sure that people with disabilities are included in relevant data collection.
 To support DPOs in capacity building, for them to participate fully in relevant stakeholders’ fora.
 To work to include a component directed towards people with disabilities in income generating
   activities and adult/vocational training programmes.
 To support activities aiming to promote a positive attitude towards people with disabilities in
   working/economic life.
 To discuss possible affirmative action with relevant partners.

The fight against HIV/AIDS:
 To make sure that information about the virus is made accessible for people with disabilities.
   Existing information should be mapped.
 To utilise DPOs for disseminating information about HIV/AIDS to people with disabilities. The
   training required should be given.
 To support relevant projects and programmes which include orphans with disabilities – and which
   work to develop alternative care structures for orphans belonging to marginalised groups.

Giving priority to children
 To make sure that children with disabilities are mentioned as a specific target group in any
    programme aimed at children
 To recognise and raise awareness about the fact that children with disabilities constitute a large
    percentage of those children who drop out or are excluded from community activities and services
    – and to initiate relevant actions to rectify this
 To support inclusive health and education systems and institutions to secure the fundamental
    rights of children with disabilities and other marginalised children
 To make sure that programmes aiming at children exposed to violence and/or sexual abuse must
    include elements to make sure children with disabilities will be reached
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                               19

5.2.3. Mechanisms linked to programmes and sectors

The promotion of health care systems
 To support the development of a public, decentralised and nationwide primary health care system
   that is accessible to people with disabilities
 To demand that essential drugs are to be found at every health facility
 To make sure that health personnel are trained in early diagnosis and preventive treatment of
   impairments – and to support training in these fields if necessary.

The promotion of an inclusive education sector
 To promote the principle of Inclusive Education as a means to reach the goal of education for all.
   (ref. Salamanca declaration)
 To make accessibility for children with mobility impairment and impairment linked to orientation
   a condition for supporting the building/renovation of schools – and to make sure that this principle
   is included in NORAD’s plans and guidelines for investment support.
 To make sure that the requirements of children with special needs are taken into consideration
   within the education sector – and to support the development of teaching material for children
   with e.g. visual and hearing impairments..
 To support specific programme components or projects aiming at reaching children who do not go
   to school.

6.    Checklist for the Inclusion of Disability Issues in Programme Cycle
      Management
The point of departure is to define checklists for the participation of people with disabilities at all
stages in planning, implementation and monitoring in development co-operation. The objective for the
inclusion of disability issues is to make them visible and action oriented, at all stages, throughout the
programme cycle. The first step in making disability issues visible, is to include them explicitly at all
stages described in the current manuals and other tools for programme and project cycle
management22. This has been done with other cross cutting issues in Norwegian development co-
operation, as with gender issues23 In the follow up and completion phases it should be assessed
whether the implementation of the programme activities have in fact included people with disabilities,
and obtained the planned impact on their situation.

Paragraph 6.1 gives a list of some key considerations that are relevant at each stage of the Programme
(project) cycle; 6.2 and 6.3 give more detailed checklists concerning dialogue with partners and
programme development, 6.4 gives a checklist for the monitoring phase.

6.1     Guidelines related to programme / project cycle management

1. Strategic dialogue with partners to identifying main objectives and approaches
In the social sector (and others), based on human rights perspectives and poverty alleviation;
networking with various stakeholders as part of preparations to identify objectives and approaches.
 Check point: Are representatives of the disabled included among the partners / stakeholders?

2. Programme planning
Once main objectives and approach are decided, the process of securing a good ownership is
important. Ideally different stakeholders, among them representatives of the disabled, should be
included in needs assessment, data collection and analysis. (Cf. the Ghana example).


22
   For example in NORADs “Programme and Project Cycle Management – Manual for Government – to Government Co-
operation”, 1998.
23
   Confer NORADs manual “Handbook in Gender and Empowerment Assessment”, 2000.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                          20

 Check point: Relevant aspect of the situation of people with disabilities analysed as part of
  planning

3. Agreement with partners
 Planning of programmes and projects within the framework of agreement, including the definition of
target groups / beneficiaries of the programme, identification of activities etc. Stakeholders included in
the planning. Decide on criteria for good performance and results.
 Check points: Representatives of disabled people included in planning. Targets of goal attainment
    related to disability are defined

4. Implementation, follow up
Management and programme development according to the defined targets. Check whether the
indicators of progress are relevant.
 Check points: Process indicators related to the progress of defined target group / targets

5. Monitoring and evaluation
Collect information and reports on progress according to the defined criteria.
 Check points: Progress in accordance with criteria for good performance / results

6.2          Checklist for country negotiations/dialogue with partners

Have the concerns of people with disabilities been raised through:
 Requesting information about national policies, legislation, follow up of UN Standard Rules etc?
 Initiating a “Strategic Dialogue” from a Human Rights perspective – on how people with
   disabilities should be included in programmes and activities?
 Deciding to make people with disabilities a visible part of any target group within relevant sectors,
   programmes and activities? 24 Confer Ch. 4.1)
 Discussing the issue of accessibility (buildings, transport, information)?
 Making decisions with regards to the issue of accessibility?
 Discussing the principle of stakeholders’ participation input and advises?
 Making decisions with regards to stakeholders’ participation?
 Deciding on concrete actions with regards to improving the rights and living conditions for people
   with disabilities?

     Box 14
     Contributions to the development of national policies on disability – Norwegian skills resources

     Member organisations of the Atlas Alliance have been partners or facilitators for the development of National
     Policies on Disability in Uganda, Namibia, Eritrea and Palestine.
     The Norwegian State Council on Disability participates in the development of a State Council in Uganda, where
     the aim is to monitor and follow up the implementation of the policy on disability, legislation on disability, and
     make sure that the UN Standard Rules are considered in the development.




24
   Design and construction of the built environment, particularly public buildings, facilities and housing;
Development of infrastructure, including transport systems, telecommunications, water supply and sanitation amenities;
Development of small-scale industries and enterprises; Urban/rural community development; Development of health care and
social services systems facilities; Human resources development; Income generation, with special emphasis on improving the
situation of the poorest segments of society; Training of development policy, programme and project personnel. If the
development activity includes one or more of the above elements, then the activity is relevant from the perspective of people
with disabilities. (See Ch 4.1)
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                                 21

6.3      Checklist for programme planning (from identification and justification to
         programme document)

The checkpoints below could also be used when assessing project application from Norwegian NGOs:
 Disability relevance – has this been studied, and have appropriate conclusions been made?
 Target groups – has it been noted that there may be people with disabilities within all target
   groups? Are conclusions reflected?
 Stakeholders – Have all the important groups been involved?
 International commitments and instruments in the social and economic sector – Are these
   reflected in the development objectives?
 Accessibility – are the programme components, activities and expected results accessible to people
   with functional limitations?
 Vulnerability – Has the vulnerability of people with disabilities and the disability dimension been
   taken into account? Have any balancing measures been included?
 Resources of people with disabilities and their organisations – has this been noted, and will
   people with disabilities be effectively involved in components concerning them?
 Sustainability – will the sustainability of results for people with disabilities be ensured through
   systematic and continuos policy-backing, involvement of people with disabilities and a sustainable
   resource flow?
 Non-discrimination – is the programme non-discriminating and does it support the objective
   “development for all”?
 Follow-up measures – will these be sensitive to disability issues and involve people with
   disabilities to an appropriate degree?

6.4       Checklist on implementation and monitoring

When assessing whether the disability dimension has actually been included and led to changes for
this target group, one can make use of many of the questions asked under chapter 6.2. Below you will
find some added considerations that are disability sensitive and will be useful during the
implementation and monitoring phases:
 Accessibility – are the services developed through the programme accessible to people with
     disabilities, for example access to schools and health facilities; or access to information.
 Reachability –do the services reach the groups for whom they were intended?
 Usability - do the services correspond to expressed needs? Do people with disabilities regard them
     as useful?
 Orientation – are people with visual impairments able to orient themselves, e.g. in the new
  health facility, other public building?
 Safety - are safety measures included in skills training and income generating activities?
 Equity – do the programme give equal opportunities for people with disabilities as well as for
  other beneficiaries?
 Affordability – are the services affordable for people with disabilities, confer school fees, user fees
  for health services

  Box 15
  Assessing needs and resources in the disability field - examples from a survey of a district in Ghana

  The first part of the survey collected information on the average rate (prevalence) and types of disability in the
  district population.
  The second part collected information about the existing resources in health services and education in this district, as
  well as on existing DPOs and NGOs.
  The results could give reliable answers to pertinent questions for the planning and coordination of inclusive services
  for the persons with disability in this district, some of the questions were:
  For health personnel: What are their level of experience in diagnosing, treating and classifying 7 major types of
  disabilities? – Is the public health system able to identify disabilities and intervene at an early stage in a child’s life?
  For education personnel: How many children are already enrolled in mainstream schools?
  How many teachers in primary schools have experience in teaching disabled children? – Which skills are most
  needed in their inclusive education?
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                        22

       Box 16
       Stakeholders in a participatory process

       Different partners will have different, sometimes opposed, interests in the planning and implementation of
       development programmes. In order to secure a real ownership and responsibility for the planning and
       implementation process, active participation of all groups of stakeholders is important, for example:
                       a. The disabled people
                       b. The funding agency
                       c. The implementing agency
                       d. The responsible government agencies
                       e. The NGOs responsible for service delivery
       Stakeholders in a participatory process have inherent inequalities, which affect their ability to participate
       effectively in decision-making. In a World Bank project the poor and marginalized groups and their
       organisations, on which the project focused, were defined as primary stakeholders. Those who are not
       themselves marginalized, comprising NGOs, government agencies, sectoral experts etc. were defined as
       secondary stakeholders.
       This lead to the following definition of participation: “-- a process through which primary stakeholders
       influence and share control over their own their own development initiatives, decisions and resources
       which affect them”.
       In order to work for participative planning of inclusive projects by persons with disabilities themselves, its
       important to empower this group, because they frequently will have the status as “primary stakeholders”
       according to the definition above.


7.    Indicators for the Inclusion of Disability Issues
In the development of sector wide programmes and other mainstream services, it is particularly
important to make disability issues visible. Specific data on the situation of disabled must be collected,
specific indicators for the progress, and results of the programmes defined.

7.1        A framework for defining indicators for the inclusion of disability issues

The indicators should:
 be defined within the strategic framework of NORAD
 as nearly related to the ordinary programme development cycle as possible
 limited in number
 defined according to the set objectives for development co-operation in the individual cooperating
   country
     at national and district levels and below
     in relation to sector programmes, specific components in such programmes, and to
      specific projects aimed at disabled

Those responsible for programme development and implementation must make sure that someone
follows up these indicators with specific responsibility, if not they will be omitted. Proxy indicators
may be utilised if direct measures cannot be taken.

NB! Indicators are also dependent on definitions of disability, as different from illness.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                 23

7.2     Examples of defining indicators related to NORAD strategy

Strategic area           Objective                   Strategies, shown in            Suggested indicators
                                                     programmes
SOCIAL DEVELOPMENT       Promote higher quality of   SWAP (national level):    Number/proportion disabled of total
                         social services             Develop quality standards population within catchment area of
                         Improve access to                                     health station.
                                                     of facilities and training of
                         services for poor and       PHC personnel. Include    Access to particular facility - and
                         marginalized groups         disability issues.        Proportion of facilities accessible
                                                     Local level: Construct,   Proportion of skilled personnel per
                                                     manage accessible health  facility
                                                     facility                  Proportion of facilities with at least
                                                                               1 skilled person
                                                                               Proportion/number of disabled
                                                                               received PHC
                                                                               Proportion/number of disabled
                                                                               referred to special
                                                                               assessment/treatment
                                                                               Proportion/number of disabled
                                                                               children enrolled in school
ECONOMIC                 Develop employment         Support to income          Number/proportion disabled of total
DEVELOPMENT              policy which include       generation projects        included in project.
                         disabled                   Support to quota           Average income of disabled in
                                                    programme for the          project compared to average income
                                                    inclusion of disabled in   of others in project
                                                    civil service              Number/proportion of disabled total
                                                                               in public service employment
PEACE, DEMOCRACY         Include vulnerable groups Support to the development Number/proportion of disabled in
AND HUMAN RIGHTS         in democratic community of local government where community health committees.
                         development                disabled are represented   Number/proportion of disabled in
                                                                               decision making village committees
ENVIRONMENT AND          Promotion of safe and      Support to the development Existence of work safety and
NATURAL RESOURCE         pollution free             and monitoring of work     environmental protection laws and
MANAGEMENT               environment                safety and environmental   regulations
                                                    protection laws and        Existence and/effectiveness of
                                                    regulations                agencies to monitor work safety and
                                                    Support to clean water     environmental protection laws and
                                                    supply and sanitation      regulations
                                                    initiatives                Number/proportion of disabilities by
                                                    Support to improved        cause (work-related, communicable
                                                    physical accessibility to  diseases, environmental pollution)
                                                    infrastructure by disabled Number/proportion of public
                                                    persons                    buildings (e.g. schools, health
                                                                               centers, banks…) and water and
                                                                               sanitation facilities with provision
                                                                               for physical access by disabled
                                                                               persons
HUMANITARIAN             Promote humanitarian       Support to health and      Number/proportion of disabled in
ASSISTANCE IN THE        assistance on the basis of education in IDP camps,    camp
EVENT OF CONFLICTS       human rights               with focus on access and   Number/proportion of disabled
AND NATURAL                                         the needs of disabled      enrolled in education.
DISASTERS                                                                      Number/proportion of disabled
                                                                               served by health facilities
WOMEN AND GENDER         Promote development        Skills training for women  Number(proportion of women with
EQUALITY                 projects that strengthen   Revolving funds for        disabilities involved in the project
                         the position of women in income generation
                         society                    Support of community
                                                    development that includes
                                                    women

Within these strategic areas, indicators must be related to objectives and strategies in concrete
programmes / projects within the bi- or multilateral agreements; and linked to different phases of
programme development.
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                                  24

7.3     Example of indicators within a programme approach

  To build a mainstream primary school and plan physical access and inclusive teaching methods. . Indicators in
  different phases.
  Survey of catchment area                - Number/Percentage disabled children in area by sex, and
                                          disability
                                               -     Description of needs for specific support in education
                                               -      Mapping those children who never attend and those who
                                                     drop out of school.
  Community/PTA involvement in            - Participation of DPOs / parents of disabled
  planning
  Physical planning and construction      - Physical access for movement disabled
                                               -     Optimal conditions for hard of hearing / partially sighted
                                               -
  Planning and organising teaching        - Number / percentage of disabled students enrolled
                                          - Number of teachers trained in special needs education / sign
                                          language
                                          - Available support material for teaching, e.g. books in Braille
                                          - Types and amount of time for special support for disabled
                                          students
  Schooling activities                    - Number/proportion of movement disabled included in sports
                                          activities
                                          - Number/proportion of sensory disabled included in ordinary
                                          lessons
                                          - Types of support for disabled students included in mainstream
                                          schooling activities
  Other social activities                 - Number/proportion of disabled enrolled in music, song, other
                                          groups
THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002                       25


                                            References

Assessing Needs and Resources. Ghana CBR programme, 1999

Disability in Nordic development co-operation. Synthesis report prepared for the Nordic Conference.
NORAD, June 2000

Disability, poverty and development, DFID, February 2000

Guidelines for SIDAs Support in the Disability Area. Swedish International Development Authority,
1992

Including the perspective of people with disabilities in Nordic development support of education.
Danida / DSI February 2000

It’s a matter of attitudes – mainstreaming disability issues in the Nordic development co-operation.
Gender and children perspectives. SHIA, March 2000.

Norsk bistand rettet mot bedring av funksjonshemmedes kår i 1985 – 1995 – erfaringsoppsummering
med forslag om videre arbeid. DIS, FBS, NORAD June 1997

Poverty and Disability – a survey of the literature. Ann Elwan, World Bank, December 1999

Persons with disability in development co-operation – a focus on health support by the Nordic
countries. NORAD, January 2000

Prejudice and Dignity: An Introduction to Community Based Rehabilitation,
Helander, UNDP, 2nd edition 1999 (on internet )

The Disability Dimension in Development Action. Manual on Inclusive Planning, Wiman, UN
document prepared by STAKES, 1996

The standard Rules on the Equalisation of Opportunities for Persons with Disabilities
Adopted at the 48th regular session by the United Nations General Assembly on 20. December 1993,
by its resolution 48/96.

				
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