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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 THE INCLUSION OF DISABILITY IN NORWEGIAN DEVELOPMENT CO-OPERATION – January 2002 8 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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