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Sightsavers’ approach to
Inclusive Eye Health
April 2016
© Sightsavers
Rationale
1. THE GLOBAL CONTEXT
What are the most relevant international frameworks and policies related
to Inclusive Eye Health?
2. SIGHTSAVERS’ SOCIAL INCLUSION
STRATEGIC FRAMEWORK
How does Inclusive Eye Health fit in the context of Sightsavers’ social
inclusion strategy?
3. INCLUSIVE EYE HEALTH
What is Sightavers’ approach to Inclusive Eye Health?
© Sightsavers
1. THE GLOBAL CONTEXT
© Sightsavers
Why Inclusive Eye Health?
Every human being is entitled to the fundamental, inalienable right to health,
without distinction of sex, ethnicity, disability, language, religion, political or other
opinion, national or social origin, property, birth or other status.
•Universal Declaration of Human Rights (UDHR), Art 25: “Everyone has the right to
a standard of living adequate for the health and well-being of himself and of his
family”
•International Covenant on Economic, Social and Cultural Rights (ICESCR), Art.
12: “The States Parties to the present Covenant recognize the right of everyone to
the enjoyment of the highest attainable standard of physical and mental health
•Convention on the Rights of the Child (CRC), Art. 24: “States Parties recognize
the right of the child to the enjoyment of the highest attainable standard of health and
to facilities for the treatment of illness and rehabilitation of health”
© Sightsavers
Convention on the Elimination of All
Forms of Discrimination against
Women (CEDAW)
• Adoption: 18 December 1979
• Entry into force: 3 September 1981
By accepting the Convention, States commit themselves to undertake a series of
measures to end discrimination against women in all forms, including:
• to incorporate the principle of equality of men and women in their legal system,
abolish all discriminatory laws and adopt appropriate ones prohibiting
discrimination against women;
• to establish tribunals and other public institutions to ensure the effective
protection of women against discrimination;
• to ensure elimination of all acts of discrimination against women by persons,
organizations or enterprises.
© Sightsavers
CEDAW Article 12.1 – Health
“States Parties shall take all appropriate measures to
eliminate discrimination against women in the field of
health care in order to ensure, on a basis of equality of men
and women, access to health care services, including
those related to family planning.”
© Sightsavers
Inclusive Eye Health (IEH) & CEDAW
•Article 1 – Discrimination
•Article 2 – Policy Measures
•Article 3 – Guarantee of Basic Human Rights and
Fundamental Freedoms
•Article 4 – Special Measures
•Article 5 – Sex Role Stereotyping and Prejudice
•Article 8 – Representation
•Article 11 – Employment
•Article 13 – Economic and Social Benefits
•Article 14 – Rural Women
© Sightsavers
United Nations’ Convention on the
Rights of Persons with Disabilities
(UN CRPD)
• Adoption: 13 December 2006
• Entry into force: 3 May 2008
• First comprehensive human rights treaty of the third millennium
• The fastest negotiated human rights treaty in history
Paradigm shift: Persons with disabilities are not viewed as "objects" of
charity, medical treatment and social protection; rather as "subjects" with
rights, 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.
© Sightsavers
UN CRPD
Definition of disability in the Preamble:
“Disability is an evolving concept that results from the
interaction between persons with impairments and attitudinal
and environmental barriers that hinders full and effective
participation in society on an equal basis with others.”
© Sightsavers
UN CRPD Article 25 – Health
“States Parties recognize that persons with
disabilities have the right to the
enjoyment of the highest attainable
standard of health without
discrimination on the basis of
disability.”
“States Parties shall take all appropriate measures to
ensure access for persons with disabilities to health
services that are gender-sensitive, including health-
related rehabilitation.”
© Sightsavers
Inclusive Eye Health (IEH) and the
UN CRPD
•Article 6 - Women with disabilities
•Article 7 - Children with disabilities
•Article 8 - Awareness-raising
•Article 9 - Accessibility
•Article 16 - Freedom from exploitation, violence and abuse
•Article 19 - Living independently and being included in the
community
•Article 20 - Personal mobility
•Article 21 - Freedom of expression and opinion, and access to
information
•Article 22 - Respect for privacy
•Article 26 - Habilitation and rehabilitation
•Article 27 - Work and employment
•Article 31 - Statistics and data collection
© Sightsavers
The 2030 Agenda
•Transforming our world: the 2030 Agenda for Sustainable
Development
– Political commitment of the governments of all 193 Member States of the
United Nations (UN).
•Resolution adopted by the UN General Assembly on 25 September 2015
•17 Sustainable Development Goals (SDGs) with 169 associated targets
•Based on human rights approach:
– “[…] respect, protect and promote human rights and fundamental freedoms for
all, without distinction of any kind as to race, colour, sex, language, religion,
political or other opinion, national or social origin, property, birth, disability or
other status”
© Sightsavers
The 2030 Agenda
•Commitment to “Leave no one behind”
– “we pledge that no one will be left behind. Recognizing that the
dignity of the human person is fundamental, we wish to see the
Goals and targets met for all nations and peoples and for all
segments of society.”
– “People who are vulnerable must be empowered. […] all children,
youth, persons with disabilities (of whom more than 80 per cent
live in poverty), people living with HIV/AIDS, older persons,
indigenous peoples, refugees and internally displaced persons and
migrants.”
•For the goals to be reached, everyone needs to do their part:
governments, the private sector, civil society
© Sightsavers
The SDGs
© Sightsavers
SDGs – GOAL 3
Good health and well-being
Ensure healthy lives and promote well-being for all at all ages
3.8 – Achieve universal health coverage, including financial risk protection,
access to quality essential health-care services and access to safe,
effective, quality and affordable essential medicines and vaccines for all
© Sightsavers
SDGs – GOAL 5
Gender equality
Achieve gender equality and empower all women and girls
5.1 End all forms of discrimination against all women and girls everywhere
5.5 Ensure women’s full and effective participation and equal opportunities
for leadership at all levels of decision-making in political, economic and
public life
5.c Adopt and strengthen sound policies and enforceable legislation for the
promotion of gender equality and the empowerment of all women and girls
at all levels
© Sightsavers
SDGs – GOAL 17
Partnership for the goals
Strengthen the means of implementation and revitalize
the Global Partnership for Sustainable Development
Data, monitoring and accountability
17.18 By 2020, enhance capacity-building support to developing countries,
including for least developed countries and small island developing States,
to increase significantly the availability of high-quality, timely and reliable
data disaggregated by income, gender, age, race, ethnicity, migratory
status, disability, geographic location and other characteristics relevant in
national contexts
© Sightsavers
Disability in the SDGs
Source: IDDC & IDA, The 2030 Agenda – The inclusion of persons with disabilities
© Sightsavers
UN CRPD and SDGs
The UN CRPD serves as a guiding framework for
implementing the SDGs
© Sightsavers
2. SIGHTSAVERS’ SOCIAL INCLUSION
STRATEGIC FRAMEWORK
© Sightsavers
Sightsavers and disability
1950: Sir John Wilson founds the British Empire Society
for the Blind (today’s Sightsavers)
Initial focus:
•Education
•Rehabilitation
•Welfare
© Sightsavers
Our Theory of Change
© Sightsavers
SI strategy – Mainstreaming
© Sightsavers
SI strategy – Empowerment
© Sightsavers
SI strategy – Cross-cutting
© Sightsavers
3. INCLUSIVE EYE HEALTH
© Sightsavers
Inclusive Eye Health (IEH)
Definition
“Eye health services that are provided
within a barrier free environment, which
are inclusive by design and are
sustainable”
Sightsavers’ priority focus is to address the
barriers experienced by people with
disabilities and women and girls.
© Sightsavers
Goal and objectives
Goal
Improved eye health for urban poor with focus on people with disability
and women in barrier free inclusive and sustainable health services
Objectives
•To facilitate uptake of eye health services by improving health seeking
behavior amongst the urban poor, especially people with disability and
women
•To ensure provision of barrier free quality, affordable and convenient eye
health services by strengthening the urban public health system
•To facilitate improved community and policy environment for inclusive eye
health through building capacities of urban local bodies
© Sightsavers
A systemic approach to IEH
Source: “Advancing Equity and Inclusion – A Guide for Municipalities”
© City for All Women Initiative (CAWI), Ottawa
© Sightsavers
IEH Theory of Change
1. Leadership and governance
2. Sustainability
3. Infrastructures
4. Human resources
5. HMIS
6. Service delivery
1. Legislative framework
2. Policy implementation
1. Networking
2. Awareness raising activities
3. Barrier analysis and mitigation
Sustainable and
inclusive eye
health services are
accessed by all,
including people
with disabilities
and women
© Sightsavers
Decision making and sustainability
•Participatory approach
•Sensitisation of decision makers
•Development of internal policies within health facilities
•Long term sustainability plan
•Inclusive clinical and non-clinical protocols
© Sightsavers
Disability and Gender Data
Disaggregation
•Understand access / lack of access and service
provision
•Inform inclusion strategy, monitoring and
decision making
•eHMIS
© Sightsavers
Accessibility and capacity building
• Accessibility audits
• Accessibility interventions
• Capacity building of eye health staff
© Sightsavers
Networking and referrals
•Establishment of network with DPOs, WROs, CBOs, CBR
programmes, self-help groups, health services, local and international
development agencies, financial institutions, religious institution and other
relevant stakeholders
•Referral checklist, referral protocol, team briefing
© Sightsavers
Gender and disability barrier
analysis and mitigation
•Attitudinal barriers
•Financial barriers
•Mobility
© Sightsavers
Advocacy
Targeted interventions
•Community
•Institutions
Twin-track approach
•Inclusive eye health awareness raising activities
•Awareness raising on gender and disability inclusion
© Sightsavers
Thank you

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Sightsavers' approach to inclusive eye health

  • 1. Sightsavers’ approach to Inclusive Eye Health April 2016
  • 2. © Sightsavers Rationale 1. THE GLOBAL CONTEXT What are the most relevant international frameworks and policies related to Inclusive Eye Health? 2. SIGHTSAVERS’ SOCIAL INCLUSION STRATEGIC FRAMEWORK How does Inclusive Eye Health fit in the context of Sightsavers’ social inclusion strategy? 3. INCLUSIVE EYE HEALTH What is Sightavers’ approach to Inclusive Eye Health?
  • 3. © Sightsavers 1. THE GLOBAL CONTEXT
  • 4. © Sightsavers Why Inclusive Eye Health? Every human being is entitled to the fundamental, inalienable right to health, without distinction of sex, ethnicity, disability, language, religion, political or other opinion, national or social origin, property, birth or other status. •Universal Declaration of Human Rights (UDHR), Art 25: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family” •International Covenant on Economic, Social and Cultural Rights (ICESCR), Art. 12: “The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health •Convention on the Rights of the Child (CRC), Art. 24: “States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health”
  • 5. © Sightsavers Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) • Adoption: 18 December 1979 • Entry into force: 3 September 1981 By accepting the Convention, States commit themselves to undertake a series of measures to end discrimination against women in all forms, including: • to incorporate the principle of equality of men and women in their legal system, abolish all discriminatory laws and adopt appropriate ones prohibiting discrimination against women; • to establish tribunals and other public institutions to ensure the effective protection of women against discrimination; • to ensure elimination of all acts of discrimination against women by persons, organizations or enterprises.
  • 6. © Sightsavers CEDAW Article 12.1 – Health “States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning.”
  • 7. © Sightsavers Inclusive Eye Health (IEH) & CEDAW •Article 1 – Discrimination •Article 2 – Policy Measures •Article 3 – Guarantee of Basic Human Rights and Fundamental Freedoms •Article 4 – Special Measures •Article 5 – Sex Role Stereotyping and Prejudice •Article 8 – Representation •Article 11 – Employment •Article 13 – Economic and Social Benefits •Article 14 – Rural Women
  • 8. © Sightsavers United Nations’ Convention on the Rights of Persons with Disabilities (UN CRPD) • Adoption: 13 December 2006 • Entry into force: 3 May 2008 • First comprehensive human rights treaty of the third millennium • The fastest negotiated human rights treaty in history Paradigm shift: Persons with disabilities are not viewed as "objects" of charity, medical treatment and social protection; rather as "subjects" with rights, 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.
  • 9. © Sightsavers UN CRPD Definition of disability in the Preamble: “Disability is an evolving concept that results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders full and effective participation in society on an equal basis with others.”
  • 10. © Sightsavers UN CRPD Article 25 – Health “States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability.” “States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health- related rehabilitation.”
  • 11. © Sightsavers Inclusive Eye Health (IEH) and the UN CRPD •Article 6 - Women with disabilities •Article 7 - Children with disabilities •Article 8 - Awareness-raising •Article 9 - Accessibility •Article 16 - Freedom from exploitation, violence and abuse •Article 19 - Living independently and being included in the community •Article 20 - Personal mobility •Article 21 - Freedom of expression and opinion, and access to information •Article 22 - Respect for privacy •Article 26 - Habilitation and rehabilitation •Article 27 - Work and employment •Article 31 - Statistics and data collection
  • 12. © Sightsavers The 2030 Agenda •Transforming our world: the 2030 Agenda for Sustainable Development – Political commitment of the governments of all 193 Member States of the United Nations (UN). •Resolution adopted by the UN General Assembly on 25 September 2015 •17 Sustainable Development Goals (SDGs) with 169 associated targets •Based on human rights approach: – “[…] respect, protect and promote human rights and fundamental freedoms for all, without distinction of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, disability or other status”
  • 13. © Sightsavers The 2030 Agenda •Commitment to “Leave no one behind” – “we pledge that no one will be left behind. Recognizing that the dignity of the human person is fundamental, we wish to see the Goals and targets met for all nations and peoples and for all segments of society.” – “People who are vulnerable must be empowered. […] all children, youth, persons with disabilities (of whom more than 80 per cent live in poverty), people living with HIV/AIDS, older persons, indigenous peoples, refugees and internally displaced persons and migrants.” •For the goals to be reached, everyone needs to do their part: governments, the private sector, civil society
  • 15. © Sightsavers SDGs – GOAL 3 Good health and well-being Ensure healthy lives and promote well-being for all at all ages 3.8 – Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
  • 16. © Sightsavers SDGs – GOAL 5 Gender equality Achieve gender equality and empower all women and girls 5.1 End all forms of discrimination against all women and girls everywhere 5.5 Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life 5.c Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels
  • 17. © Sightsavers SDGs – GOAL 17 Partnership for the goals Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development Data, monitoring and accountability 17.18 By 2020, enhance capacity-building support to developing countries, including for least developed countries and small island developing States, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts
  • 18. © Sightsavers Disability in the SDGs Source: IDDC & IDA, The 2030 Agenda – The inclusion of persons with disabilities
  • 19. © Sightsavers UN CRPD and SDGs The UN CRPD serves as a guiding framework for implementing the SDGs
  • 20. © Sightsavers 2. SIGHTSAVERS’ SOCIAL INCLUSION STRATEGIC FRAMEWORK
  • 21. © Sightsavers Sightsavers and disability 1950: Sir John Wilson founds the British Empire Society for the Blind (today’s Sightsavers) Initial focus: •Education •Rehabilitation •Welfare
  • 23. © Sightsavers SI strategy – Mainstreaming
  • 24. © Sightsavers SI strategy – Empowerment
  • 25. © Sightsavers SI strategy – Cross-cutting
  • 27. © Sightsavers Inclusive Eye Health (IEH) Definition “Eye health services that are provided within a barrier free environment, which are inclusive by design and are sustainable” Sightsavers’ priority focus is to address the barriers experienced by people with disabilities and women and girls.
  • 28. © Sightsavers Goal and objectives Goal Improved eye health for urban poor with focus on people with disability and women in barrier free inclusive and sustainable health services Objectives •To facilitate uptake of eye health services by improving health seeking behavior amongst the urban poor, especially people with disability and women •To ensure provision of barrier free quality, affordable and convenient eye health services by strengthening the urban public health system •To facilitate improved community and policy environment for inclusive eye health through building capacities of urban local bodies
  • 29. © Sightsavers A systemic approach to IEH Source: “Advancing Equity and Inclusion – A Guide for Municipalities” © City for All Women Initiative (CAWI), Ottawa
  • 30. © Sightsavers IEH Theory of Change 1. Leadership and governance 2. Sustainability 3. Infrastructures 4. Human resources 5. HMIS 6. Service delivery 1. Legislative framework 2. Policy implementation 1. Networking 2. Awareness raising activities 3. Barrier analysis and mitigation Sustainable and inclusive eye health services are accessed by all, including people with disabilities and women
  • 31. © Sightsavers Decision making and sustainability •Participatory approach •Sensitisation of decision makers •Development of internal policies within health facilities •Long term sustainability plan •Inclusive clinical and non-clinical protocols
  • 32. © Sightsavers Disability and Gender Data Disaggregation •Understand access / lack of access and service provision •Inform inclusion strategy, monitoring and decision making •eHMIS
  • 33. © Sightsavers Accessibility and capacity building • Accessibility audits • Accessibility interventions • Capacity building of eye health staff
  • 34. © Sightsavers Networking and referrals •Establishment of network with DPOs, WROs, CBOs, CBR programmes, self-help groups, health services, local and international development agencies, financial institutions, religious institution and other relevant stakeholders •Referral checklist, referral protocol, team briefing
  • 35. © Sightsavers Gender and disability barrier analysis and mitigation •Attitudinal barriers •Financial barriers •Mobility
  • 36. © Sightsavers Advocacy Targeted interventions •Community •Institutions Twin-track approach •Inclusive eye health awareness raising activities •Awareness raising on gender and disability inclusion

Editor's Notes

  1. Facilitator highlights that social inclusion is part of our history, as Sightsavers’ initial focus was on the inclusion of blind people. The first eye health programmes were developed only in the 1960s.
  2. Facilitator explains that: the SI strategy is based on a Theory of Change that aims to fulfil the human rights established in the UN CRPD the TOC identifies three interrelated pathways that will inform our programmes: Human rights policies and laws are in place and implemented People with disabilities have equality of opportunity Stigma and discrimination are addressed
  3. Facilitator explains that the SI strategy has seven strategic objectives, and the first three focus on mainstreaming inclusion in what we do. (For detailed explanation consult SI strategy)
  4. Facilitator explains that two objectives focus on the empowerment of women and men with disabilities. (For detailed explanation consult SI strategy)
  5. Facilitator explains that the final two objectives are cross-cutting. The first one specifically focuses on gender inequalities and the rights of girls and women with disabilities. The second one aims at strengthening advocacy on disability rights as an integral aspect of programme planning. (For detailed explanation consult SI strategy)