October 16, 2012, Yerevan
Survey Description• Goal: identify the level of access for children with disabilities, to reveal  their participation in d...
Interview Summary
Interviews by Region
Interviews in the Orphanages
Limitations• Target groupPrimarily children with certified disabilities• Coverage• MethodologyDisability classification do...
GENERAL CHARACTERISTICS OF         CHILDREN
Geographical Distribution                   Yerevan   Regional Urban      Rural                                           ...
Age and Sex DistributionMale                                 Family         1689Female   (32%)          174               ...
Type of Disability                              3%                      7%                         Families          7%   ...
EDUCATION
Kindergarten Attendance50%            48%                                      Male              Female        Total      ...
School Attendance          General School          Special School                      Does Not Attend                    ...
School Attendance            General School         Special School          Does Not Attend School      59%               ...
School Attendance                Does not attend school                     Special school                            Gene...
Out-of-school Children Male Female                                                                    72% 72% 72% Total   ...
Reasons for Non-attendanceThe child was refused admission to school               Distance/transportationParents see no ne...
HEALTHCARE
Children NOT under paediatric care                                             Male            Female               Total ...
Reasons for not being under paediatric                 care                               10%                             ...
Use of services as per the Individual            Rehabilitation Plan                                                      ...
Frequency of use of paediatric services      82%                      Families                      Orphanages            ...
Provision of Technical Devices      35%                      Male                  Female                        Total    ...
Provision of Technical Devices                                   75%                43%                        33%        ...
Reasons for not getting rehabilitation services            and technical devices                                  6%  Are ...
SOCIAL PROTECTIONAND COMMUNITY-BASED SERVICES
Other socialDisability pension                     protection/support
Payments            Medical Services                                                Social ServicesEquipment              ...
Daycare centers                                               NGOs                                           Orphanages   ...
Participation© Armenian Caritas
Leaving home/orphanage premises                                                           Periodically, at least a few tim...
FriendsChildren of the orphanage   Non-disabled classmates   Classmates/kids with disabilities   Neigbours children      R...
Participation in community events  Total (Families)                 66%         Epilepsy                  66%       Combin...
Sports                                    Male          Female         Total                                              ...
Art and CultureOrphanages                9%     Total                           10%   (Families)    Epilepsy              ...
Family Awareness                    Completely unfamiliar                    Has Heard of          Quite familiar         ...
Priority Services     Specialized medical care               Inclusive schools, preschools            Special transportati...
Facts of Concern• 1 out of every 6 children with disabilities surveyed (16%) lives or studies in  seggregated settings (or...
Facts of Concern• 1 out of 5 children with disabilities (18%) does not attend school.  The figure is 23% (1 out of 4) in t...
Facts of Concern• 1 out of 5 children with intellectual and combined  disabilities (20%) does not have friends, and only h...
Facts of Concern• 1 out of 4 children with disabilities (23%) receive  services prescribed by the individual  rehabilitati...
Recommendations
Improve identification and assessment procedures    • Actively seek out children with disabilities who are      not certif...
Create a continuum of services for the child throughoutthe life-cycle • Ensure cooperation between healthcare, education a...
Enable access to all mainstream preschools andschools. • Streamline the professional capacity and   resources of special s...
Prevent Institutionalization of Children with Disabilities• Prevent child abandonment through  providing early and compreh...
Promote awareness to improve participation• Organize campaigns• Ensure active and appropriate media coverage• Sensitize se...
IT’S ABOUT INCLUSION!Thank you for your attention
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Access of Children with Disabilities to Education, Health and Social Protection Services in Armenia

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UNICEF undertook an effort to gather reliable information on the access of chil- dren with disabilities to health, education and social protection services. The survey also sought to reveal the levels of participation of children with disabilities in different life activities, such as sport, culture and community events, as well as the attitudes and awareness of their families or caregivers. The analysis of data reveals that children with disabilities in Armenia face strong barriers in access to services, in particular related to school inclusion, rehabilitation and community participation.

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Access of Children with Disabilities to Education, Health and Social Protection Services in Armenia

  1. 1. October 16, 2012, Yerevan
  2. 2. Survey Description• Goal: identify the level of access for children with disabilities, to reveal their participation in different life activities, to identify the barriers to inclusion• Target: Children with disabilities, aged 0-18• Primary Source: Pyunik database• Method: Questionnaire-based face-to-face interviews• Respondents: Parent (in families), guardian (in orphanages)• Implementer: Armenian Marketing Association• Data Collection Period: August- December, 2011• Analysis: Disaggregated by gender, residence, region and disability
  3. 3. Interview Summary
  4. 4. Interviews by Region
  5. 5. Interviews in the Orphanages
  6. 6. Limitations• Target groupPrimarily children with certified disabilities• Coverage• MethodologyDisability classification done based on medicaldiagnosis in Pyunik database only
  7. 7. GENERAL CHARACTERISTICS OF CHILDREN
  8. 8. Geographical Distribution Yerevan Regional Urban Rural 1459 28% 2198 41% 1665 31%
  9. 9. Age and Sex DistributionMale Family 1689Female (32%) 174 211 (45%) Orphanage (55%) 3633 5% Family (68%) 21% 14% 17% 20% 0-3 y/o 4-6 y/o 7-9 y/o 16% Orphanage 10-12 y/o 20% 18% 13-15 y/o 24% 16-18 y/o 12% 16% 18%
  10. 10. Type of Disability 3% 7% Families 7% 24% Motor 32% 36% Physiological 7% Intellectual Visual 2% Orphanages 4% Auditory Epilepsy 4% 2% Combined 20% 32% 20%Physiological – hematological, cardiovascular, imunological and respiratory functions(b4) , digestive, metabolic and endocrine systems(b5), urino- genitary, reproductive(b6) and skin and skin-related functions (b8)
  11. 11. EDUCATION
  12. 12. Kindergarten Attendance50% 48% Male Female Total 44% 43% 41% 37% 36% 35% 33% 23% 23% 23% 14% 12% 9% Yerevan Regional Urban Rural Total (Families) Orphanages
  13. 13. School Attendance General School Special School Does Not Attend 5% 23% 67% 69% 70% 75% 72% 13% 10% 12% 12% 18% 23% 18% 13%Yerevan Regional Urban Rural Total (Families) Orphanages
  14. 14. School Attendance General School Special School Does Not Attend School 59% 68% 64% 70% 70% 68% 69% 68% 70%75% 80% 89% 18% 10% 15% 10% 8% 8% 13% 15% 12%12% 2% 23% 22% 23% 21% 21% 22% 18% 18% 7% 18% 18%13% 5%
  15. 15. School Attendance Does not attend school Special school General school Total 18% 12% 70% Epilepsy 14% 5% 81% Combined 20% 17% 63% Intellectual 27% 25% 48% Auditory 8% 36% 56% Visual 7% 7% 86% Motor 26% 6% 69%Physiological 6% 4% 90%
  16. 16. Out-of-school Children Male Female 72% 72% 72% Total 23% 24% 22% 23% 21% 18% 17% 18% 15% 15% 13%11% Yerevan Regional Urban Rural Total (Families) Orphanages
  17. 17. Reasons for Non-attendanceThe child was refused admission to school Distance/transportationParents see no need for school The school does not have sufficient conditionsBecause of health condition Parents (guardians) think the child cannot study at school 2% 5% 4% 7% 4% 6% 4% 7% 9% 5% 7% 1% 6% 19% 18% 19% 19% 29% 39% 34% 38% 99% 54% 46% 48% 36% Yerevan Regional Urban Rural Total (Families) Orphanages
  18. 18. HEALTHCARE
  19. 19. Children NOT under paediatric care Male Female Total 28% 25% 23% 21% 19% 20% 19% 18% 18% 13% 12% 11% 3% 2% 1% Yerevan Rural Regional Urban Total (Families) Orphanages
  20. 20. Reasons for not being under paediatric care 10% Insufficient Quality 16% 12% 13% 12% 13% Are not aware of the service 8% 23% 16% 5% 11% 4% Service is not available in the 19% 22% 26% community 30% Cannot afford the service 53% 52% Parents think there is no need 48% 43% Yerevan Regional Urban Rural Total (Families)
  21. 21. Use of services as per the Individual Rehabilitation Plan 82% 32% 30% 23% 22% 23% 16% 17% 12%Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total Orphanages (Families)
  22. 22. Frequency of use of paediatric services 82% Families Orphanages 33% 21% 21% 21% 7% 4% 5% 3% 2% Daily Weekly Monthly 3-4 times a year 1-2 times a year Only if necessary
  23. 23. Provision of Technical Devices 35% Male Female Total 34% 33% 32% 30% 31% 28%28% 26% 27% 27% 25% 24% 24% 22% Yerevan Regioanl Urban Rural Total (Families) Orphanages
  24. 24. Provision of Technical Devices 75% 43% 33% 27% 12% 9% 8% 3%Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total
  25. 25. Reasons for not getting rehabilitation services and technical devices 6% Are not aware of the service 54% 87% Parents see no need 26% Service unavailable in the community 12% Technical Device Rehabilitation 4% Cannot afford 13% 8% Other 8%
  26. 26. SOCIAL PROTECTIONAND COMMUNITY-BASED SERVICES
  27. 27. Other socialDisability pension protection/support
  28. 28. Payments Medical Services Social ServicesEquipment Examination Medical Staff Hard to respond Disab pension provisionMedicine No Payment MSEC Evaluation No Payment 2% 3% 2% 5% 5% 9% 5% 2% 3% 4% 6% 4% 9% 8% 4% 11% 23% 31% 28% 29% 25% 24% 22% 16% 91% 82% 86% 86% 57% 49% 50% 52% 29% 33% 33% 32%Yerevan Regional Urban Rural Total (Families) Yerevan Regional Urban Rural Total (Families)
  29. 29. Daycare centers NGOs Orphanages 83% Total 7% Total (Families) 11% Tavush 17% Tavush 12%Vayots Dzor 1% Vayots Dzor 0% Syunik 10% Syunik 15% Shirak 8% Shirak 11% Lori 3% Lori 11% Kotayk 0% Kotayk 2%Gegharkunik 9% Gegharkunik 12% Ararat 3% Ararat 11% Aragatsotn 2% Aragatsotn 14% Amavir 9% Amavir 6% Yerevan 10% Yerevan 14%
  30. 30. Participation© Armenian Caritas
  31. 31. Leaving home/orphanage premises Periodically, at least a few times a week 42% A few times a month 81% 78% 82% 86% 92% 89% 93% 92% A few times a year 30% Only for visiting a doctor 5% 10% 11% 11% 11% 9% 6% 6% 13% Never/Rarely 5% 4% 5% 6% 4% 3% 3%1% 2% 4% 1% 1% 2% 3% 4% 2% 2%
  32. 32. FriendsChildren of the orphanage Non-disabled classmates Classmates/kids with disabilities Neigbours children Relatives children Has no friends 40% 57% 58% 45% 50% 44% 29% 6% 12% 27% 27% 10% 6% 12% 19% 9% 81% 81% 79% 78% 71% 52% 71% 55% 30% 6% 66% 56% 65% 54% 71% 70% 67% 65% 71% 6% 3% 21% 20% 16% 6% 12% 5% 4% 8% 12% Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total Orphanages (Families)
  33. 33. Participation in community events Total (Families) 66% Epilepsy 66% Combined 55% Intellectual 54% Auditory 78% Visual 76% Motor 61% Physiological 77%
  34. 34. Sports Male Female Total Epilepsy 8% 3% 7% 1% 0.6%Orphanages Combined 7% 2% 5% Total 10% 5% 8% (Families) 6% 4% 5% Intellectual 5% 2% 4% Auditory 18% 6% 13% Rural Visual 14% 3% 11% Regional 11% 4% 9% Urban Motor 9% 6% 8% 17% 11% 15% Yerevan 13% 5% 11% Physiological
  35. 35. Art and CultureOrphanages 9% Total 10% (Families) Epilepsy 10% Combined 8% Intellectual 6% Auditory 16% Visual 16% Motor 9%Physiological 13%
  36. 36. Family Awareness Completely unfamiliar Has Heard of Quite familiar 59% 35% 6%RA Law “On social protection of disabled people in the RA” RA Law “On persons in need of special conditions for 60% 35% 5% education” 66% 31% 4% UN Convention for the rights of disabled people 64% 32% 4% UN Convention On the Rights of the Child
  37. 37. Priority Services Specialized medical care Inclusive schools, preschools Special transportation Job Opportunity Leisure, playgrounds Financial aid 4% 58% 34% 32% 30% 10%Total (Families) 3% 66% 39% 35% 30% 9% Rural 4% 63% 34% 30% 33% 6%Regional Urban 40% 26% 28% 25% 17% 4% Yerevan
  38. 38. Facts of Concern• 1 out of every 6 children with disabilities surveyed (16%) lives or studies in seggregated settings (orphanages or special schools).• Girls with disabilities are relatively more frequently taken to orphanages than boys, and are relatively less frequently visited.• Only 1 out of every 20 children with disabilities (5%) in the orphanage attends a mainstream school; 23% attend special schools, and 72% do not attend school at all.• 1 out of every 4 (23%) never leaves the orphanage or leaves the orphanage only for the health services.• The majority (around 88%) of the children do not have friends without disabilities outside of the orphanage.
  39. 39. Facts of Concern• 1 out of 5 children with disabilities (18%) does not attend school. The figure is 23% (1 out of 4) in the villages. Children with motor and intellectual issues are more likely to be out of school (26 to 27%).• 51% of the parents of children not attending school in the regions and 36% in Yerevan believe that their child cannot study in school.• 12% of the children with disabilities attend special schools, and 70% of them are in boarding settings. The figure is much higher for children with disabilities related to auditory (36%) and intellectual (25%) functions.• Only 48% and 56% of the children with intellectual and auditory disabilities, respectively, attend mainstream schools.
  40. 40. Facts of Concern• 1 out of 5 children with intellectual and combined disabilities (20%) does not have friends, and only half of them have friends among their neighbors (directly in their community).• 1 out of 3 children with disability (33%) does not participate in community activities. Children with intellectual and combined disabilities are included less (50% of them do not participate in activities).
  41. 41. Facts of Concern• 1 out of 4 children with disabilities (23%) receive services prescribed by the individual rehabilitation plan.• 4 out of 5 children with disabilities (81%) do not receive services of social protection (support), other than the pension.• 2/3 of the parents have never heard about the Republic of Armenia laws and international conventions related to disabilities.
  42. 42. Recommendations
  43. 43. Improve identification and assessment procedures • Actively seek out children with disabilities who are not certified and stay invisible to the social protection system • Revise disability certification and service eligibility criteria based on the ICF principles (biopsychosocial model) • Ease bureaucratic procedures and involve the multidisciplinary team directly working with the child
  44. 44. Create a continuum of services for the child throughoutthe life-cycle • Ensure cooperation between healthcare, education and social protection services (via the case manager) through mechanisms of referral, exchange of information and coordinated service provision to children. • Create new community-based prevention and early intervention, as well as health and social rehabilitation and care services.
  45. 45. Enable access to all mainstream preschools andschools. • Streamline the professional capacity and resources of special school towards inclusive education • Sensitize and train the teachers and headmasters • Ensure infrastructure accessibility • Improve special education needs assessment procedure
  46. 46. Prevent Institutionalization of Children with Disabilities• Prevent child abandonment through providing early and comprehensive information, services and support to children with disabilities and their families• Provide alternative care within the wider family or in a foster family
  47. 47. Promote awareness to improve participation• Organize campaigns• Ensure active and appropriate media coverage• Sensitize service providers and parents personal contact with persons with disabilities is the most effective way to influence the way of thinking about disability
  48. 48. IT’S ABOUT INCLUSION!Thank you for your attention
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