1 DISABILITY MAINSTREAMING ACTIVITY PLAN REVISED VERSION
2 Content 1. Introduction 3 2. The Challenge 3 3. Objectives of the Mainstreaming Activity Plan 4 4. Scope of Johanniter s Work in the Field of 5 5. Inclusion as part of Johanniter s Strategy 5 6. Guiding Principles 5 7. Field of Actions 7 Field of Action 1: Inclusion of People with Disabilities at Organizational Level 7 Field of Action 2: Accountability for Inclusion 10 Field of Action 3: Specific Projects Monitoring of the Implementation of the Activity Plan Main Reference Documents 14 Abbreviations: Desk 1.01: International Disaster Response & Security Desk Desk 1.02: Africa Desk Desk 1.03: Southeast Asia/East, South America, Caribbean Desk Desk 1.04: South/Central Asia, Middle East and Europe Desk Desk 2.02: Logistics Desk CBR: Community Based Rehabilitation CRPD: Convention on the Rights of Persons with Disabilities P&O: Prosthetics and Orthotics P&O : Prosthetics and Orthotics
3 1. Introduction In the last 20 years, Johanniter International Assistance has implemented more than 40 physical rehabilitation projects in around 25 countries. Accordingly, Johanniter has proven a high level of competence in physical rehabilitation for persons with disabilities. As a consequence, Johanniter has defined rehabilitation of persons with disabilities in its five-year strategic concept ( ) as one of three key areas within Johanniter s core competency health. In the beginning of 2011, Johanniter has created the positions of the Prosthetics & Orthotics and the in order to extend Johanniter activities in the field of rehabilitation and to mainstream disability in health, disaster preparedness and response. The Mainstreaming Activity Plan defines Johanniter s conceptual framework and precise objectives in the field of disability mainstreaming for the years The Activity Plan has been developed by the and the Prosthetics & Orthotics with participation of Johanniter headquarters and country offices as well as partner organizations. It reflects Johanniter s previous and present discussions and should give direction for the future. The implementation of the plan is closely monitored. A first interim report about the status of implementation of the activity plan was presented in May On the basis of the report, a revised plan was adopted in June A second interim report will be published in May 2015 and the final report on the implementation of the Mainstreaming Activity Plan is due in May The final report will include lessons learned as well as recommendations for the future The Challenge 1 prevalence is growing According to the World Report 2011, over a billion people, about 15% of the world s population, live with some form of disability. Around 80 % of the persons with disabilities live in Developing Countries. It is estimated that between 3 and 4 % of the world s population have a severe disability and is in need of rehabilitation. Women, elderly people and poor families are disproportionally affected by disability. In part due to population ageing and increases in chronic health conditions the rates of disability are increasing. Lack of data on disability The lack of comparable and reliable data and statistics on disability is a major obstacle in inclusion of disability in mainstream activities. Existing data statistics are of varying nature and quality and are based on a wide variance of definitions and methodologies to identify disability. 1 Main Source: World Health Organziation (2011). World Report. Geneva.
4 Poverty and disability People with disabilities are among the poorest and vulnerable in developing countries. and poverty are directly linked: Poverty increases the risk factors which lead to disability, and persons with disabilities are more likely to be poor because they lack access to health, education, political and socio-economic opportunities. 50% of impairments leading to disabilities are preventable and directly related to poverty. Unmet health care needs 2 Persons with disabilities have high unmet needs for primary health care as well as secondary or tertiary health care. People with disabilities are often excluded from health promotion and prevention activities. High costs, limited availability of services, physical barriers and inadequate skills and knowledge of health workers are the main barriers that people with disability encounter when they attempt to access health care. Unmet physical rehabilitation needs 3 It is estimated that 0.5 % of the population in developing countries needs prostheses and or orthotics. The Number of persons with disabilities in developing countries who require a wheelchair is 1 % of the population. Studies on living conditions of people with disabilities in African countries found that only % of people received the assistive devices they needed. Main barriers to access physical rehabilitation are the limited financial resources, inadequate service delivery, lack of rehabilitation professionals, lack of access to adequate material and equipment, physical barriers as well as limited awareness, cultural and social barriers. Exclusion from disaster preparedness and response In disaster situations, persons with disability have the same basic needs as everyone else in the community. In addition, some may also have specific needs. Due to physical, institutional and attitudinal barriers, persons with disabilities face disproportionate risks in disaster situations and are often excluded from relief and rehabilitation processes. Both mainstreamed and specific activities are required Objectives of the Mainstreaming Activity Plan The overall objective of Johanniter s work in the field of disability is to improve the quality of persons with disabilities lives and to promote their equal participation. We focus on realizing their right to appropriate health care and rehabilitation and equal access to disaster preparedness and response. The Objective of the present Mainstreaming Activity Plan is to define the conceptual framework and precise objectives for our activities in the field of disability for the time period All activities are linked with clear responsibilities, time periods and output indicators to ensure close monitoring of the Activity Plan. 2 World Health Organization (2014). WHO global disability action plan : Better health for all people with disability. Geneva. 3 World Health Organization (2011). Joint position paper on the provision of mobility devices in less-resource settings. Geneva.
5 4. Scope of Johanniter s Activities in the Field of Johanniter strives for the implementation of a Twin Track-Approach. The approach combines disability inclusion with projects or components which target people with disabilities specifically. Johanniter s Twin Track-Approach mainstreaming at organizational level and into primary health care, disaster risk reduction and disaster response Specific disability projects in the field of rehabilitation: prosthetics and orthotics services, wheelchair services, Community Based Rehabilitation (CBR) (Fields of Action 1 and 2) (Field of Action 3) Objective: To improve the quality of persons with disabilities lives and to promote their equal participation inclusion and specific activities interlink and should ideally be combined. Awareness raising of the rights of persons with disabilities should complement inclusive and specific activities. 5. Mainstreaming as part of Johanniter s Strategy Johanniter has defined rehabilitation of persons with disabilities in its five-year strategic concept ( ) as one of three key areas within Johanniter s core competency health. 5 Furthermore, the strategic concept shows Johanniter s commitment to continuously improve the quality of its work at home and abroad. The Mainstreaming Activity Plan contributes to the adherence of international guidelines and policy documents in the field of disability (see reference documents, page 14). 6. Guiding Principles Definitions According to the Convention on the Rights of Persons with Disabilities (CRPD) disability is an evolving concept and results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others (Social Model). Persons with disabilities include those who have longterm physical, mental, intellectual or sensory impairments. Mainstreaming Mainstreaming disabilities is the process to ensure that persons with disabilities can fully participate and are supported to do so within any type of structure and services intended for the general public. The concept implies to include persons with disabilities in the design, implementation,
6 monitoring and evaluation of projects and programs. Mainstreaming needs to be accompanied by specific measures to ensure equality of opportunity, so that persons with disabilities can enjoy their rights. Rehabilitation Rehabilitation is the process of removing or reducing as far as possible the factors that limit the activity and participation of a person with a disability, in order that he/she can attain and maintain the highest possible level of independence and quality of life; physically, mentally, socially and vocationally. The ultimate aim of rehabilitation is to provide the individual with the best possible opportunity for full and effective participation and inclusion in society, with possibilities to study, work, access services, etc. that are equal to those of the other citizens. Inclusion of persons with disability in disaster response and international cooperation The CRPD recognizes the importance of inclusive disaster response and international cooperation for improving the living conditions of persons with disabilities. Article 11 makes specific reference to the safety and protection of persons with disabilities in conflict and emergency situations. Article 32 stipulates that international cooperation, including international development programmes, is inclusive of and accessible to persons with disabilities. Rights based approach In compliance with the CRPD, Johanniter sees persons with disabilities as having the same rights as others who are capable of claiming those rights and making decisions for their lives based on their free and informed consent as well as being active members of society. Johanniter values existing and potential contributions made by persons with disabilities to the overall well-being and diversity of their communities. 6 Diversity The lived experience and perspectives of men, women, children and elderly with disabilities are diverse. Their needs cannot be addressed in a one size fits all approach. Johanniter s projects, therefore, must take into consideration the particular needs, interests, abilities and resources of individuals with different types and degrees of impairments living in a variety of different contexts. Quality Johanniter strives for appropriate quality of services, facilities and products. Quality can be measured through technical standards or guidelines and in terms of outcomes, user satisfaction and quality of life. Resource constraints should not compromise the principle of quality. Partnership Johanniter actively promotes partnership with other organizations in order to combine efforts of different actors. In the field of disability, main partners are national and international NGOs, service providers, training institutions, disabled people s organizations, civil society organizations, and government bodies.
7 7. Field of Actions Johanniter s Mainstreaming Activity Plan includes three fields of actions. Each activity is linked with clear responsibilities, time periods and output indicators. Field of Action 1: Inclusion of Persons with Disabilities at Organizational Level Objective Johanniter International Assistance takes a lead with regard to disability inclusion by example. Rationale inclusion starts within the organization. In order to reinforce credibility towards beneficiaries, staff, donors and partners, Johanniter strives for an accessible physical working environment, accessible information and an inclusive human resource management at HQ and country office level. Capacity building and knowledge management should ensure that our staff is skilled and confident with regard to disability mainstreaming. Activity Responsibility Period Output Indicator 1.1 mainstreaming will be taken into account during Johanniter s organizational development process (beginning May 2013). Strategy & Quality, 2014/2015 The organizational development process has strengthened disability mainstreaming at organizational level A working group disability mainstreaming will be established and will meet when required in order to support the implementation and monitoring of the action plan. ToRs for the working group (including participants, mandate and objectives) will be drafted., P&O Ongoing Clear ToRs for the disability working group are developed. Objectives of ToRs are realized. Inclusive human resource management 1.3 Johanniter will start a discussion about opportunities and obstacles with regard to an inclusive personnel policy at HQ and country office level. Personnel Dept., 2014/15 Recommendations are available. Accessibility 1.4 The new Johanniter International Assistance website will be designed accessible for persons with sensory impairments. Marketing, Fundraising 2014/2015 The website is accessible for persons with sensory impairments.
8 1.5 Accessibility of field offices will be improved on the basis of Johanniter s accessibility guidelines for field offices., Desk Basic accessibility guidelines for Johanniter s field offices are produced and distributed. The field offices have implemented basic measures to improve accessibility. 1.6 Accessibility guidelines for the built environment will be introduced to HQ and field office staff and will be implemented in Johanniter s projects., P&O, Desk /15 Accessibility of the physical environment is implemented in all Johanniter projects. 1.7 Accessibility of public events and meetings at HQ and country level will be improved Accessibility guidelines for public events are produced and distributed. 1.8 Accessibility of awareness-raising and training material at country level will be improved by providing accessibility guidelines for publications (posters, banners, leaflets etc.). Capacity building 2013 Accessibility guidelines for awareness-raising and training material are produced and distributed New BAH employees and expatriates are briefed on disability mainstreaming, specific disability activities and have knowledge about the topic., P&O Ongoing All employees receive a briefing on disability mainstreaming and specific disability activities Relevant desk officers of the marketing and fundraising departments will be sensitized with regard to disability mainstreaming., Marketing, Fundraising 2013 A joint workshop is conducted and recommendations on disability mainstreaming in PR and fundraising activities are developed and implemented.
9 1.11 Trainings in the field of disability mainstreaming are organized for HQ and country office staff (conducted by the or qualified external trainers) Johanniter s expatriate and national staff working in specific rehabilitation projects receives specific technical training Johanniter s volunteer disaster response workers will be sensitized for disability issues. 1.13a A Sharepoint Website will be developed and regularly updated. Lobbying and networking at national and international level 1.14 Johanniter is represented in the Venro working group and Development Membership in international networks/associations is intended (e.g. International Society for Prosthetics and Orthotics ISPO; Global Partnership on and Development GDPP; International and Development Consortium IDDC; Inclusive DRR Network) Formal and informal cooperation with NGOs, networks, companies and training institutions in the field of disability will be extended., P&O Desk 1.04 Desk 1.01,, P&O Ongoing Ongoing A disability awareness training manual for Johanniter employees and partner organizations is developed. At HQ level, at least one training course per year is organized. At least one training course per year is organized in one of Johanniter s country offices. Urgent technical training needs are adequately addressed. 2014/15 issues are included in the training curricula Information about disability inclusion is easily accessible. Johanniter staff widely accesses the Sharepoint website. Ongoing attends the working group meetings and reports back to HQ. 2013/2014 Johanniter has become a member in selected international networks/associations. P&O Ongoing Cooperation with important stakeholders in the field of disability is extended. 9
10 Field of Action 2: Accountability for Inclusion Objective mainstreaming is embedded in Johanniter s processes and procedures. Rationale To ensure that disability mainstreaming efforts are sustained, management support and organizational commitment are essential. Integration of disability in policies and processes should also assure the quality of our work. Activity Responsibility Period Output Indicator 2.1 The and P&O advise the desks 1.02, 1.03 and 1.04 on disability inclusive country strategies including both mainstreamed and specific activities. Desk 1.04,, P&O Ongoing In 2014, and P&O have commented on all country strategies. inclusion is incorporated in all country strategies The handbook is available and wellknown among staffmembers. 2.1a A handbook Mainstreaming in Practice will be produced and widely distributed As a member of the Sphere Working Group, the develops a guidance note on Inclusion of crosscutting themes in Johanniter s projects., Sphere Working Group 2013 The guidance note is developed and included in Johanniter s general Sphere guidance. 2.3 inclusion will be incorporated in proposal writing and reporting processes. Johanniter s project application, logframe, budget and reporting templates will be adjusted accordingly. Strategy & Quality, 2013/2014 inclusion is incorporated in Johanniter s proposal writing and reporting processes. The will provide information about disability policies of Johanniter s main donor organizations.
11 2.4 is generally consulted with regard to inclusion of persons with disabilities in all stages of a project during - project planning and/or - proposal writing. Consultation should be provided in a timely manner. Timeframe and scope of the advisor s support is agreed between the desks and the advisor., Desk 1.04 Ongoing In 2015, consults on at least 50% of the projects. Project objectives, activities and indicators increasingly reflect the disability inclusive approach. 2.4a Up to 6 focus countries will be identified in order to develop a sound disability mainstreaming strategy., Desk /2015 Up to 6 focus countries are identified and have developed sound disability mainstreaming strategies. 2.5 will increasingly be included in data collection (e.g. needs assessments, baseline surveys) in order to provide relevant data for planning, implementation and monitoring of disability inclusive activities., Primary Health Care, Desk ongoing Necessary data for planning and monitoring of disability inclusive activities are available a Criteria and indicators for disability inclusive projects will be developed. 2014/2015 Criteria and indicators for disability inclusive projects are available and well-known among all staff members. 2.5b On the basis of criteria for disability inclusive projects, tools to monitor disability inclusion will be developed and implemented. 2014/2015 Tools to monitor disability inclusion are developed and implemented.
12 Field of Action 3: Specific Projects Objective Johanniter strives to improve the access of children, women and men with disabilities to adequate rehabilitation services. Rationale To realize their rights, persons with disabilities also need specific support. Due to Johanniter s strong expertise in physical rehabilitation, specific projects mainly focus on the provision of assistive devices such as prostheses, orthotics, walking aids and wheelchairs along with appropriate therapy allowing an optimal use of the device. Physical rehabilitation services are usually combined with outreach/follow up services and Community Based Rehabilitation (CBR) activities. To offer comprehensive physical rehabilitation services, Johanniter strive for the implementation of P&O services, wheelchair services, therapy and CBR. As a strategy, Johanniter considers CBR as a link between mainstreaming activities and specific projects in the field of rehabilitation. Johanniter s activities in the field of physical rehabilitation include: - Renovation/modernization or construction of rehabilitation centers (including P&O workshop, wheelchair services, therapy) - Provision of machinery and equipment - Training of rehabilitation professionals - Provision of rehabilitation services (P&O, wheelchair and therapy services) - Establishment and support of mobile and outreach services 12 In the field of CBR, Johanniter mainly focuses on the following components: Health: - Health promotion: e.g. disability inclusive health promotion campaigns; disability related health promotion - Prevention: e.g. avoidance of diseases, disorder, injuries (primary prevention); early detection and early treatment (secondary prevention); rehabilitation (tertiary prevention) - Medical care: access of persons with disabilities to all levels of health care - Physical rehabilitation: all measures which enables persons with disabilities to achieve and maintain optimal functioning in their environments - Provision of assistive devices: mobility devices, visual devices, hearing devices Empowerment: - Raising the awareness of individuals, families and communities about disability issues - Information of individuals, families and communities about the rights of persons with disabilities - Capacity building of persons with disabilities - Support peer groups, self-help groups and disabled people s organizations (DPOs)
13 CBR projects must have a broad network of collaborative partners in the fields of health, education, livelihood, social services and empowerment. Main stakeholders are persons with disabilities and their families, DPOs, NGOs and community based organizations and authorities. Specific disability projects are always mid- or long-term development projects and should be planned accordingly. Activity Responsibility Period Output Indicator 3.1 Technical guidance notes for HQ, project staff and partner organizations will be developed in order to support the sound implementation of physical rehabilitation and CBR projects in compliance with international guidelines (see main reference documents, page 14). P&O, 2014/2015 Technical guidance notes are available and introduced. The notes are continuously updated. 3.2 Assessment guidelines for physical rehabilitation and CBR projects will be developed. P&O, 2013/2014 Assessment guidelines are developed and introduced Monitoring guidelines for physical rehabilitation and CBR projects are included in Johanniter s M&E guidelines. 3.3 Monitoring guidelines for physical rehabilitation and CBR projects will be developed. P&O, Johanniter continues its activities in the field of physical rehabilitation and CBR and strives to further improve the quality of the activities (according to the technical guidance notes). P&O, Desk 1.04 Ongoing Number of beneficiaries, user satisfaction. All physical rehabilitation and CBR activities are developed and implemented in cooperation with the P&O and s. 3.5 Johanniter partners with Motivation and Handicap International for the DFID Innovation Fund project The rapid provision of appropriate wheelchairs in emergency situations in order to explore opportunities to include wheelchair provision in Johanniter s emergency response., P&O, Desk 1.01, Desk 2.02 Aug 2012 March 2014 A project report including recommendations regarding the inclusion of wheelchair provision in Johanniter s emergency response is available.
14 3.6 Until the end of 2015, at least one specific project will be evaluated (midterm or final evaluation) and recommendations for future projects are developed. Program Desks,, P&O 2014/15 At the end of 2015, an evaluation report and recommendations are available. 8. Monitoring of the Implementation of the Activity Plan Following activities are planned to closely monitor the implementation of Johanniter s Mainstreaming Activity Plan: If required: meetings of the working group Mainstreaming May 2014: First interim report on the implementation of the Acitivity Plan prepared by the and P&O advisor 2 nd quarter 2014: Workshop at HQ-level to review the plan - prepared by the and P&O 2014: Consultations with Johanniter staff at country level and beneficiaries May 2015: Interim report on implementation of the Activity Plan prepared by and P&O 2015: Consultations with Johanniter staff at country level and beneficiaries May 2016: Final report on the implementation of the Activity Plan 9. Main Reference Documents 14 UN (2006).Convention on the Rights of Persons with Disabilities (CRPD). Geneva. World Health Organization (2014): WHO global disability action plan : Better health for all people with disabilities. Geneva. World Health Organization (2011). World Report. Geneva. World Health Organization (2010): CBR Guidelines. Geneva. World Health Organization (2011). Joint Position Paper on the Provision of Mobility Devices in Less-Resourced Settings. A step towards the implementation of the Convention on the Rights of Persons with Disabilities (CRPD) related to personal mobility. Geneva. World Health Organization (2008). Guidelines on the provision of Manual Wheelchairs in less resourced settings. Geneva. The Swiss Agency for Development & Cooperation and Landmine Survivors Network (2006): Prosthetics and Orthotics Project Guide. Supporting P&O in low-income settings. A common approach for organizations implementing aid projects.
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