LMG Project's Work with Vulnerable Populations

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See this short presentation on LMG's work with vulnerable populations to understand why this work with outstanding global leaders with disabilities and those who work with other vulnerable populations …

See this short presentation on LMG's work with vulnerable populations to understand why this work with outstanding global leaders with disabilities and those who work with other vulnerable populations is so important.

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  • Across the world, people with physical disabilities have poorer health, lower education achievements, fewer economic opportunities, and higher rates of poverty than people without disabilities. The World Report on Disability (World Health Organization, 2011) estimated that 30 million of these individuals in Africa, Asia, and Latin America need prostheses or orthotics and related services, and many live in countries whose health and social systems lack the capacity to meet their rehabilitation needs.  For over 30 years, the International Committee of the Red Cross (ICRC) has been a global leader in providing physical rehabilitation services to vulnerable groups, particularly those affected by conflict. Through the Physical Rehabilitation Programme (PRP) and the Special Fund for the Disabled (SFD), ICRC has helped hundreds of thousands of people regain their mobility. Restoring mobility through the provision prostheses, orthotics, walking aids, and wheelchairs is a critical first step toward improving the quality of life for people with physical disabilities to participate fully in society. Supported by USAID’s Special Programs to Address the Needs of Survivors (SPANS), the Leadership, Management, and Governance Project (LMG) is working with the ICRC’s PRP and SFD to promote the long- term viability of local physical rehabilitation centers. ICRC has been working with these physical rehabilitation centers to improve the quality of services by providing materials to customize mobility devices for individual users, training prosthetic and orthotic professionals and other providers, and supporting additional capacity-building activities. LMG aims to complement ICRC’s good work and technical expertise through strengthening the centers’ leadership and management capacity.  LMG at the Bahir Dar Physical Rehabilitation Center, Ethiopia In July, LMG staff traveled to Ethiopia to see ICRC’s activities on the ground, and to develop a strategy for our collaboration. We visited the Bahir Dar Physical Rehabilitation Center (BDPRC), one of two government physical rehabilitation centers in the Amhara region. Bahir Dar is a lakeside town in northwestern Ethiopia, and one of the fastest growing urban centers in the country. According to the Amhara National Regional State Bureau of Labor and Social Affairs (2011), there are approximately 33,000 persons with physical disabilities in BDPRC’s service area.  On the outside, the physical rehabilitation center looked like an average public building, fairly non-descript, with plain concrete walls in a small compound off a gravel road. Inside the building we found an extremely welcoming and committed small staff who were busy modeling prostheses, treating a young girl with clubfoot, and fitting a wheelchair to an older man. We met with BDPRC’s manager, EndalkachewGetachew, who himself is physically disabled—though we never would have known if he had not shown us his prosthetic leg beneath his pants.  Mr. Getachew boasted about his staff’s passion for their clients and expressed gratitude for the support the clinical staff received from ICRC PRP experts. He also told us about his challenges, and his desire for greater knowledge and skills. Though he has a business degree, he has never had formal health leadership and management training and relied on searching the internet for professional development. He and the rest of the leadership team were further challenged by the lack of standard procedures and protocols to guide management actions such as supervision, planning, and human resources management. Mr. Getachew gave us a tour of the clinical areas and the workshop where mobility devices are made. We were impressed by the number of job aids and other protocols displayed throughout these spaces—many provided by ICRC—that served as helpful reminders and guidelines for quality care. Everything was clearly ordered and organized. For example, in the workshop, each tool had a storage space on the wall and the outline of each tool was drawn in the exact place where that tool should be hung, so that each tool would fit in its specific spot and anyone who walked in would know exactly what was missing.   Caption: Organization system for workshop tools at BDPRC in Bahir Dar, Ethiopia. LMG Collaboration with ICRC This ordered and organized picture is a good representation of how the LMG project will collaborate with ICRC to strengthen the leadership and management of BDPRC and other similar centers over the next few years. We will work with ICRC and local managers to develop standardized management systems to order and organize operations and administration. Along with clearly defined and established operational procedures, LMG will work to ensure that each center’s staff have the skills and competencies to run the systems through providing centers with a package of user-friendly Leadership Development Modules that can be self-directed by the local leadership teams. This standardized package will equip centers to strengthen their team dynamics, identify gaps in organizational capacity, develop a systematic way to ensure continuous improvement, and establish a pathway to sustainability in the future.   
  • Displaced Children and Orphans Fund (DCOF) programs provide care, support, and protection for children at risk, including orphans, unaccompanied minors, children affected by armed conflict, and children with disabilities. Programs strengthen the capacity of families and communities to address the physical, social, educational, economic, and emotional needs of children in crisis. Leahy War Victims Fund (LWVF) programs address the needs of civilian victims of conflict by expanding access to affordable and appropriate prosthetic/orthotic services. Programs provide not only essential orthopedic services and related medical, surgical, and rehabilitation assistance, but also work to enable amputees and other people with disabilities to regain accessibility to mainstream educational, recreational, and economic opportunities. Victims of Torture Program (VOT)programs enable people and communities affected by torture to resume their roles within family and community and work to protect individuals against future incidents of torture. The fund provides four major categories of service—treatment, rehabilitation, training, and research— and works to provide direct medical, psychological, and social services to torture survivors and their families.Wheelchair Program programs support the production, provision, and distribution of wheelchairs. The fund strives to improve the quality of life of the wheelchair user by providing appropriate wheelchairs, training, and services to wheelchair users.Disability Mandatecalls for the inclusion of people with disabilities and those working on their behalf in activities that extend from the design and implementation of USAID programming to advocacy for and outreach to people with disabilities. USAID's strives to engage host-country counterparts, governments, implementing organizations, and other donors in promoting a climate of equal opportunity.
  • LMG’s work with Programs for Vulnerable Populations spans across 20 countries
  • LMG’s work is done in collaboration with existing USAID partners. Generally, these partners have existing projects with USAID and we are applying LMG is working with partner organizations (including International Committee for the Red Cross, Centers for Victims of Torture, Ponseti International Association, and Mobility International USA) LMG primarily focuses on strengthening the leadership capacity, strategic planning, management systems, governing boards, and organizational sustainability of partner organizations that provide services and protection for vulnerable groups. Additionally, LMG is working with partners to identify, test, and document the essential elements needed to successfully introduce, scale up, sustain, and ensure the quality of evidence-based intervention packages at the country-level.  Throughout these activities, LMG is applying its gender approach to support the full and equal participation and inclusion of women and vulnerable persons in decision making, and opening the doors for these groups to take on and thrive in leadership positions at all levels.  
  • Across the world, people with physical disabilities have poorer health, lower education achievements, fewer economic opportunities, and higher rates of poverty than people without disabilities. The World Report on Disability (World Health Organization, 2011) estimated that 30 million of these individuals in Africa, Asia, and Latin America need prostheses or orthotics and related services, and many live in countries whose health and social systems lack the capacity to meet their rehabilitation needs.  For over 30 years, the International Committee of the Red Cross (ICRC) has been a global leader in providing physical rehabilitation services to vulnerable groups, particularly those affected by conflict. Through the Physical Rehabilitation Programme (PRP) and the Special Fund for the Disabled (SFD), ICRC has helped hundreds of thousands of people regain their mobility. Restoring mobility through the provision prostheses, orthotics, walking aids, and wheelchairs is a critical first step toward improving the quality of life for people with physical disabilities to participate fully in society. Supported by USAID’s Special Programs to Address the Needs of Survivors (SPANS), the Leadership, Management, and Governance Project (LMG) is working with the ICRC’s PRP and SFD to promote the long- term viability of local physical rehabilitation centers. ICRC has been working with these physical rehabilitation centers to improve the quality of services by providing materials to customize mobility devices for individual users, training prosthetic and orthotic professionals and other providers, and supporting additional capacity-building activities. LMG aims to complement ICRC’s good work and technical expertise through strengthening the centers’ leadership and management capacity.  LMG at the Bahir Dar Physical Rehabilitation Center, Ethiopia In July, LMG staff traveled to Ethiopia to see ICRC’s activities on the ground, and to develop a strategy for our collaboration. We visited the Bahir Dar Physical Rehabilitation Center (BDPRC), one of two government physical rehabilitation centers in the Amhara region. Bahir Dar is a lakeside town in northwestern Ethiopia, and one of the fastest growing urban centers in the country. According to the Amhara National Regional State Bureau of Labor and Social Affairs (2011), there are approximately 33,000 persons with physical disabilities in BDPRC’s service area.  On the outside, the physical rehabilitation center looked like an average public building, fairly non-descript, with plain concrete walls in a small compound off a gravel road. Inside the building we found an extremely welcoming and committed small staff who were busy modeling prostheses, treating a young girl with clubfoot, and fitting a wheelchair to an older man. We met with BDPRC’s manager, EndalkachewGetachew, who himself is physically disabled—though we never would have known if he had not shown us his prosthetic leg beneath his pants.  Mr. Getachew boasted about his staff’s passion for their clients and expressed gratitude for the support the clinical staff received from ICRC PRP experts. He also told us about his challenges, and his desire for greater knowledge and skills. Though he has a business degree, he has never had formal health leadership and management training and relied on searching the internet for professional development. He and the rest of the leadership team were further challenged by the lack of standard procedures and protocols to guide management actions such as supervision, planning, and human resources management. Mr. Getachew gave us a tour of the clinical areas and the workshop where mobility devices are made. We were impressed by the number of job aids and other protocols displayed throughout these spaces—many provided by ICRC—that served as helpful reminders and guidelines for quality care. Everything was clearly ordered and organized. For example, in the workshop, each tool had a storage space on the wall and the outline of each tool was drawn in the exact place where that tool should be hung, so that each tool would fit in its specific spot and anyone who walked in would know exactly what was missing.   Caption: Organization system for workshop tools at BDPRC in Bahir Dar, Ethiopia. LMG Collaboration with ICRC This ordered and organized picture is a good representation of how the LMG project will collaborate with ICRC to strengthen the leadership and management of BDPRC and other similar centers over the next few years. We will work with ICRC and local managers to develop standardized management systems to order and organize operations and administration. Along with clearly defined and established operational procedures, LMG will work to ensure that each center’s staff have the skills and competencies to run the systems through providing centers with a package of user-friendly Leadership Development Modules that can be self-directed by the local leadership teams. This standardized package will equip centers to strengthen their team dynamics, identify gaps in organizational capacity, develop a systematic way to ensure continuous improvement, and establish a pathway to sustainability in the future.   
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  • All the above are important for women with disabilitiesEmployment: significantly less women are employed than males Only 1% of the world disabled women are literate and access to education severly limitedPolicy and legislation to support the rights of the disabled an important objectives. While some of the countries have ratified the Convention on People with Disabilities others have not. Even those who have ratified the convention have not been able to make it operational since it requires resources as well as stigma and discrimination against the disabled is prevalent.One of the most discussed topic was access to health care either through mobility issues or lack of translation for sign languages or provider bias against those who are disabled. This gets particularly pronounced when they are pregnant or delivering where providers do not believe that women witihdisabiilities should have healthy sexual lives.There needs to be a lot of advocacy for the rights of the disabled. Listerning to the history of disability rights movement was very helpful to the participatnsMany DPO’s do not have the capacity to engage in all the activities that are being impelemented because they lack capacity. Violence seems to be a big problem for women who are disabled who cannot fend for themselves. In places where there is conflict it is even worse because they cannot escape due to their disabilities.A lot of time was spent on Sexual and reproductive health. The Hesperian Guide for the Health of Disabled women (they are the publishers of the book where there is no doctor) was distributed to the participants

Transcript

  • 1. Improving Services for Vulnerable Populations through Better Leadership, Management, and Governance November 2012 Leadership, Management, Governance Project (LMG) Management Sciences for Health
  • 2. Agenda Overview of LMG and USAID’s Programs for Vulnerable Populations Snapshots: 5 LMG Programs with Vulnerable Populations Closer Look: Women with Disabilities Guest Speaker: Kristi Rendahl from CVT
  • 3. LMG Overview The LMG Project improves leadership, management, and governance practices to strengthen health systems andMission: improve health for all, including vulnerable populations worldwide. Key Result Area 1: Key Result Area 2: Key Result Area 3:Global Support & Advance & Implement & Utilization Validate Scale-upStrengthen global Advance and validate Implement and scale upsupport, commitment, and the knowledge and innovative, effective, anuse of state of the art understanding of d sustainableleadership, management sustainable leadership, managementand governance leadership, management , and governancetools, models, and and governance programsapproaches for priority tools, models, andhealth programs. approaches
  • 4. USAID/DCHA/DRG andUSAID Programs for Vulnerable Populations DCHA Bureau Center of Excellence on Democracy, Human Rights, And Governance Human Rights Team Programs for Vulnerable Populations
  • 5. LMG’s work with Programs for Vulnerable Populations Over 20 countries: Vulnerable populations: • Latin America • Victims of torture and • Africa trauma • South and Southeast Asia • Civilian victims of conflict • Middle East • Children at risk • Eastern Europe • People with disabilities
  • 6. Working in Partnership
  • 7. SNAPSHOT: International Committee of the Red CrossSpecial Fund for the Disabled and Physical Rehabilitation Program• What: – Standard operational package for center-level – Senior Leadership Program for policy-level• Where: 23+ local rehab centers in Africa Why:• KRA: Implement and Scale Up Improve physical rehabilitation services to help• Brownbag: October 10 people walk and work again
  • 8. SNAPSHOT: Ponseti International Association• What: Identify intervention package to establish, institutionalize, and sustain clubfoot screening and treatment• Where: Nigeria, Pakistan, Peru Why:• KRA: Advance and Scale up use of proven Validate, Implement and Scale practice to eliminate Up neglected clubfoot
  • 9. Professionalizing Wheelchair SNAPSHOT: Service Provision• What: – Global sector coordination – Strategic rollout and institutionalization of WHO training package – Professional recognition of trained providers• Where: LMICs globally Why:• KRA: Global Support and Move from wheelchair distribution to Utilization, Implement and appropriate, high- Scale Up quality, wheelchair service
  • 10. SNAPSHOT: Mobility International USA (MIUSA) Women’s Institute on Leadership Development (WILD)• What: – Document and make the case for the value of WILD – Make recommendations for strengthening WILD• Where: Eugene OR with women from 27 countries Why:• KRA: Advance and Strengthen leadership skills and build international networks of Validate, Implement and women with disabilities and Scale Up increase support for inclusive development programming• Brownbag: November
  • 11. Women and Disability
  • 12. Disability is ahuman rights issue & adevelopment issue
  • 13. Women and Girls with Disabilities: “The Double Whammy”• Two-fold discrimination: as women and as persons with disabilities• Vulnerable and marginalized• Often invisible
  • 14. Women with Disabilities: The Facts• 75% of disabled people in low- and middle-income countries are women (World Bank)• 1% of disabled women in the global south are literate (UNDP)• Men with disabilities are almost twice as likely to have jobs than women with disabilities (ILO)
  • 15. Challenges for Women with Disabilities• Inadequate policies• Stigma & discrimination• Lack of access to services, employment• Inadequate funding for programs• Lack of participation
  • 16. Sexual and Reproductive Health Issues for Women with Disabilities• At higher risk of exposure to HIV & unplanned pregnancy• Especially vulnerable to sexual assault or abuse• RH providers often lack knowledge about disability issues• Lack of access due to stigma that women with disabilities are not sexually active• Existing programs generally fail to meet specific needs
  • 17. • Poor health outcomes How are the • Lower educationallives of women achievement living with • Less economically active disabilities • Higher rates of poverty • Many cannot live affected? independently & participate fully in the community
  • 18. What can women leaders living with disabilities do toface the challenges?
  • 19. Advocate for access tomainstreamprograms & services
  • 20. Advocate forspecific programs and services forpeople living with disabilities
  • 21. Advocate for implementationof the UNCRPD, &national disability strategies and plans of action
  • 22. Involve peoplewith disabilitiesin development programs
  • 23. Increase access to employment andmeans for earning a livelihood
  • 24. Inform women living withdisabilities about their rights
  • 25. Assure thatwomen and girlswith disabilities receive SRHinformation and services
  • 26. Improvecapacity of service providers
  • 27. Increase public awareness andunderstanding of disability
  • 28. Conclusion Women leaders withdisabilities have a strong role to play in strengthening thecapacity of organizations to advocate for and deliver services for women and girls withand without disabilities.
  • 29. SNAPSHOT: Centers for Victims of Torture (CVT) Partners in Trauma Healing Project (PATH)• What: – Provide targeted TA to individual centers – OD/M&E workshop• Where: 10 local centers in 10 countries Why: Promote long-term• KRA: Advance and organizational viability so Validate, Implement PATH partners can strengthen and sustain their missions
  • 30. Thank you!