Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
WHO Library Cataloguing in Publication Data Regional framework for action on community-based rehabilitation : 2010-2020. 1. Rehabilitation. 2. Community health services. ISBN 978 92 9061 482 1 (NLM Classification: WB 320 ) © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). For WHO Western Pacific Regional Publications, request for permission to reproduce should be addressed to the Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, Fax. No. (632) 521-1036, email: publications@wpro.who.int The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
Photo credits: (clockwise from top left) “Wheels of life” by Castillo is an awarded photograph from the WHO photo contest “Images of Health and Disability”. “Competence” by Paler is an awarded photograph from the WHO photo contest “Images of Health and Disability”. “School” by Raghav is an awarded photograph from the WHO photo contest “Images of Health and Disability”. Handicap International - Year
Contents 1. Background 2. Vision and Goal 3. Objectives and Recommended Actions 4. Monitoring and Evaluation Mechanism Annex 1 Annex 2 1 5 7 9 11 13
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
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1. Background Everyone is entitled to all the rights set forth in international declarations and agreements including those of the United Nations. Such human rights and fundamental freedoms need to be upheld and guaranteed particularly for persons with disabilities who continue to face barriers to accessibility and participation in all spheres of life as equal members of society. An estimated 10%-15% of the world’s population, approximately 650 million to 1 billion people of whom 200 million are children, experience some form of disability1. In the Western Pacific Region, the prevalence of moderate and severe disability is reported to be 16%. Persons with disabilities are growing in number as a result of factors such as population growth, ageing, emergence of chronic diseases, and medical advances that preserve and prolong life. The most common causes of impairment and disability include: chronic diseases such as diabetes, cardiovascular disease and cancer; injuries resulting from road traffic crashes, violence, falls and landmine explosions; birth defects; malnutrition; and communicable diseases such as HIV/AIDS and leprosy. These are creating unprecedented demand for health and rehabilitation services, much of which is unmet, particularly among the poor and other disadvantaged groups. Also, the economic and social costs of attending to the needs of persons with disabilities are enormous. Globally, estimates of direct and indirect costs of disability in 2004 ranged from US$ 1.7 to US$2.2 trillion. On the other hand, the economic benefit of supporting persons with disabilities to become productive could be substantial. In the United Kingdom, for example, estimates show that “improving the employment rate of persons with disabilities would boost the economy by US$27 billion, the equivalent of six months’ economic growth”.2 1 Terms that are generally found in literature on disability and CBR and used in this document are to be understood in light of how they are defined in the references cited herein. 2 Disability Rights Commission, “Disability, Skills and Work: Raising our Ambitions”, June 2007 (in Fact Sheet 1), www.un.org/disabilities/default.asp?id=255 (22 June 2009)
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Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Community-based rehabilitation (CBR) has been developed and promoted by WHO as a strategy for rehabilitation, equalization of opportunities and social inclusion of persons with disabilities. CBR upholds and demonstrates practical applications of the general principles and common themes on human rights and works towards a paradigm shift from a charity-oriented to a rights-based approach in disability programmes. Today, CBR is being implemented in more than 90 countries in the world and has evolved into an effective and comprehensive multisectoral strategy in creating access to health care, education and livelihood opportunities, among others. However, access to these opportunities is still limited in many countries. Statistics from relevant UN agencies, among others like ILO, UNESCAP, UNESCO, UNICEF and WHO, provide a picture that leaves much room for improvement in disability programmes. For example, no more than 5% of children and young people with disabilities have access to education. In many developed countries, the unemployment rate among persons with disabilities is at least double the level among non-disabled persons. In low- and middle-income countries, only 5%-15% of people who require assistive devices and technologies have access to them, mainly because of prohibitive costs and lack of trained personnel. Current efforts in promoting CBR are guided by the ILO-UNESCOWHO Joint Position Paper on CBR in 20043 , World Health Assembly Resolution WHA58.234 in 2005 and the WHO Action Plan on Disability and Rehabilitation (2006-2011)5and the United Nations Convention on
3 A Strategy for Rehabilitation, Equalization of Opportunities, Poverty Reduction and Social Inclusion of People with Disabilities ILO-UNESCO-WHO Joint Position Paper on CBR 2004 update of the first joint paper in 1994 http://whqlibdoc.who.int/publications/2004/9241592389_eng.pdf (accessed 22 Jun 09) 4 WHA Resolution 58.23 (2005) – disability prevention, management and rehabilitation www. who.int/gb/ebwha/pdf_files/WHA58/WHA58_24-en.pdf (accessed 22 Jun 09) 5 WHO Action Plan on Disability and Rehabilitation (2006-2011) www.who.int/disabilities/publications/dar_action_plan_2006to2011.pdf (accessed 22 Jun 09)
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the Rights of Persons with Disabilities6 that entered into force on 3 May 2008, as well as its Optional Protocol. In Asia and the Pacific, the Biwako Millennium Framework (BMF) for Action was adopted as a roadmap for the Asian and Pacific Decade of Disabled Persons (2003‑2012)7. Furthermore, the First Asia-Pacific CBR Congress, held in Bangkok, Thailand, from 18 to 20 February 2009, brought key stakeholders together to share information, experiences and practices and to develop an alliance and resource base for taking CBR forward, as clearly enunciated in the Bangkok Commitment to the Promotion of CBR in Asia and the Pacific (Annex 1). The consensus document was adopted by more than 700 representatives of governments, organizations of persons with disabilities and other civil society organizations, regional and international organizations and bilateral and multilateral development agencies. In the Western Pacific Region, at least 25 countries and areas have reported that they are addressing disability through their national policies and programmes. Some countries have well-developed CBR strategies and programmes while others have none or have just initiated one. The Western Pacific Regional Framework for Action on Communitybased Rehabilitation 2010-2020 was formulated during the Regional CBR Workshop held from 24-26 June 2009 in Manila. A multidisciplinary group of participants and representatives from selected Member States, partner organizations and WHO collaborating centres provided invaluable input and practical suggestions from their varied perspectives and experiences. The Framework provides timely and useful guidance in assessing the current situation in the Region and in strengthening CBR policy and 6 UN Convention on the Rights of Persons with Disabilities – supersedes the Standard Rules on the Equalization of Opportunities for Persons with Disabilities www.un.org/disabilities/default. asp?navid=12&pid=150 (accessed 22 Jun 09) 7 Biwako Millenium Framework (BMF) 2003-2012 for the Second Asian and Pacific Decade of Disabled Persons (picking up from the First Asian and Pacific Decade, 1993-2002) www.unescap.org/esid/psis/disability/bmf/bmf.html (accessed 22 Jun 09)
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Regional Framework for Action on Community-based Rehabilitation: 2010-2020
action at the regional and national levels. It extracts key, doable actions from the global and regional policy documents on the rights of persons with disabilities which are mutually reinforcing and would yield optimal results for countries and societies that judiciously implement them. Member States are encouraged to move beyond the recommended actions as they are able to harness more resources to scale up implementation of a comprehensive package of strategies and programmes that covers health, education, employment and other elements of CBR and inclusive development for persons with disabilities as shown in the CBR matrix developed by WHO in consultation with stakeholders.8 CBR plays an important role in reducing the disability burden of countries in enhancing the quality of life of persons with disabilities, and in achieving the millennium development goals in an inclusive and equitable way. CBR Matrix
Health
Education
Livelihood
Social
Empowerment Relationships Marriage and Family Personal Assistance Culture and Arts
Promotion
Early Childhood
Skills Development
Communication
Prevention
Primary Secondary and Higher
SelfEmployment Financial Services
Social Mobilization Political Participation
Medical Care
Rehabilitation
Non-Formal
Wage Employment
Recreation Leisure and Sports Access to Justice
Self-Help Groups Disabled People’s Organizations
Assistive Devices
Life-long Learning
Social Protection
8 www.who.int/disabilities/cbr/CBR%20MATRIX%202008%20update.pdf (22 June 2009)
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2. Vision and goal 2.1 Vision The Framework envisions a region where all persons with disabilities live with dignity, enjoy equal rights and opportunities and are empowered to contribute to and benefit from development in a rights-based, barrier-free and inclusive society.
2.2 Goal The goal of this Framework for Action in the Western Pacific Region is to significantly improve access to health and rehabilitation services, barrierfree environments, information and communication and assistive devices and technologies, for enhanced quality of life for persons with disabilities through: 2.2.1 2.2.2 2.2.3 Mainstreaming disability issues and CBR in development policies and programmes; Strengthening CBR programmes linked to primary health care and integrated in the health system; Promoting the involvement of persons with disabilities in all spheres of life and in all elements of CBR and inclusive development; and Including organizations of persons with disabilities in the development, planning, implementation and monitoring of all the interventions and actions in the Framework.
2.2.4
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Regional Framework for Action on Community-based Rehabilitation: 2010-2020
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3. Objectives and recommended actions The Framework is organized into six (6) main action areas included in and drawn from among the priorities identified during the First Asia-Pacific CBR Congress held in Bangkok on 18-20 February 2009, and elucidated in the Bangkok Commitment. The main action areas are: (1) (2) (3) (4) (5) (6) Policy and programme development and implementation; Capacity building; Partnerships and networking; Awareness raising and advocacy; Creating barrier-free environments and providing assistive devices and technologies; and Research and information management.
The Framework features under each main action area, a set of objectives and corresponding actions by Member States, WHO and partner organizations and collaborating centres (see Annex 2). The three key players would act singly and severally, drawing on their comparative advantages and capabilities and harnessing the power and synergy of coordinated and complementary activities. Close coordination among and between countries, partners and WHO would be essential and WHO would play the important role of facilitating and achieving better alignment and harmonization of efforts. WHO would also advocate at the multisectoral and regional levels to make sure that other sectors are engaged and where there are opportunities, advocacy for visibility of disability issues would be increased. But it is duly recognized and emphasized as well that CBR is an umbrella strategy that encompasses a wide range of components and elements that together would result in a truly inclusive society for persons with
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Regional Framework for Action on Community-based Rehabilitation: 2010-2020
disabilities. A framework for action under the purview of WHO as a technical agency for health should be realistic and focused on what is doable according to its mandate. Other sectors would have their own significant role and contribution in making CBR and inclusive development a reality for persons with disabilities. Thus, the matrix of objectives and actions are neither exhaustive nor comprehensive, but it constitutes a starter set of key actions so that CBR and inclusive development efforts could establish a beachhead in the development landscape and gain momentum in implementing its inclusive development agenda. It is hoped that the Framework would encourage commitment and actions from other sectors and stakeholders, especially at country level, as it is crucial that all sectors and stakeholders, including persons with disabilities and their representative organizations, close ranks and work in complementary and mutually reinforcing ways. Also, to promote inclusive development, the disability and non-disability world need to work together to institutionalize policies and implement and sustain relevant and responsive programmes and interventions. In this regard, a strong, proactive and multisectoral coordinating mechanism at country level would play a pivotal role in leading CBR and inclusive development efforts and consolidating input and resources from all stakeholders, including organizations of persons with disabilities. The purposive and consistent inclusion of persons with disabilities and disabled peoples’ organizations in decision making processes, among others, in policy development, implementation and monitoring and evaluation cannot be overemphasized. In light of persistent discrimination and exclusion in practice of certain groups in the population and among persons with disabilities, e.g., men and women and boys and girls with disabilities, it is emphasized that specific mention of and focus on the needs and priorities of such groups be an integral part of policies and programmes. Inclusion of the prevention aspect is important, with due awareness and consideration of sensitivities in this area. Leprosy and other disease control programmes, e.g., noncommunicable disease control and HIV/AIDS prevention and control,
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among others, could be used as entry points for disability programmes and CBR interventions and building on existing good practices would go a long way in strengthening and sustaining inclusive development efforts for persons with disabilities. The link between the UN Convention on the Rights of Persons with Disabilities and CBR as an overarching strategy to protect and promote the rights of persons with disabilities need to be reflected in disability policy and programme documents. But taking action beyond the ratification of instruments and the development of policies and programmes would be a giant step towards realizing the vision of rights-based, barrier-free and inclusive societies for persons with disabilities.
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4. Monitoring and evaluation mechanism A mechanism for evaluation is an essential component of any framework for action. Country profiles completed in 2009 provide baseline data and two- to three-yearly updates would serve monitoring needs. The process would be supplementary to and supportive of the UNCRPD monitoring approach wherein States Parties are required to report every two years. WHO will lead the periodic review and evaluation of implementation of the Framework at the regional level. It will maintain close communication and feedback with Member States and partner organizations and collaborating centres, and organize teleconferences and follow-up and review meetings as needed. To the extent possible, within the limits of data availability and quality, process and output indicators will be examined to assess the quality, effectiveness and equity of CBR interventions especially at country level.
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Annex 1
Bangkok Commitment to the Promotion of Communitybased Rehabilitation (CBR) in Asia and the Pacific We, representatives of Governments, nongovernmental organizations including organizations of persons with disabilities, regional and international organizations and bi-lateral and multilateral development agencies, met in Bangkok, Thailand, from 18 to 20 February 2009, at the First Asia-Pacific Community-based Rehabilitation Congress, organized by the Ministry of Social Development and Human Security, Government of Thailand, the Foundation of the Asia-Pacific Development Center on Disability (APCD Foundation), the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) and the World Health Organization (WHO), in partnership with 24 supporting organizations adopted the following commitment: Recognizing the importance and complementarities of the global and regional instruments, in particular, the Convention on the Rights of Persons with Disabilities (CPRD), the Millennium Development Goals (MDGs), the Biwako Millennium Framework for Action towards an Inclusive, Barrier-free and Rights-based Society for Persons with Disabilities in Asia and the Pacific (BMF) and the Biwako Plus Five, and the key role of CBR in their implementation; Acknowledging CBR, as defined in the ILO-UNESCO-WHO joint position paper on CBR (2004) and related CBR matrix and guidelines, as an evolving multisectoral strategy (health, education, livelihood, etc.) for rehabilitation, equal opportunities, poverty reduction, social inclusion and empowerment of persons with disabilities; Reaffirming the importance of involving persons with disabilities, irrespective of gender, age, ethnicity, impairment and socio-
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Regional Framework for Action on Community-based Rehabilitation: 2010-2020
economic status, and their representative organizations in all dimensions of CBR and development; Recognizing that planning, implementation and monitoring of CBR should take into account the local, social, economic, cultural, linguistic and religious diversity, as well as the global financial and development concerns; Recommend that: (1) Governments in Asia and the Pacific sign, ratify and implement the CRPD and its Optional Protocol; (2) All stakeholders raise awareness about CBR as a strategy to facilitate access to basic needs and promote the rights of persons with disabilities in development; (3) Support for capacity building be made available to organizations of persons with disabilities and community-based organizations to improve understanding of international and national human rights and development instruments for enhanced decisionmaking in CBR; (4) Partnerships be developed to promote and implement CBR in the region, and ensure that the efforts are coordinated among stakeholders including central and local governments, regional and international organizations, bi-lateral and multilateral development agencies, non government organizations including organizations of persons with disabilities, private sector and the media; (5) The CBR strategy be included and implemented in development policies and programmes at the national and local levels through necessary resource allocations and involvement of persons with disabilities;
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(6) All stakeholders promote the creation of barrier-free environments (transport and physical, information and communication, including ICT) and access to assistive devices and technologies; (7) Research be carried out to generate evidence (related to the efficacy and appropriateness of CBR) and to advocate and improve CBR and development policy and practice; (8) Relevant stakeholders enable persons with disabilities and their organizations to participate in all aspects of CBR policy and programme development, implementation, monitoring and evaluation.
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16 Actions by WHO Actions by partner organizations and collaborating centres Support WHO in advocacy with Member States in their sphere of work and influence Share information and resources with WHO and countries Prepare and disseminate to Member States information on the merits and importance of the Convention on the Rights of Persons with Disabilities and of other instruments on inclusive development and the rights of persons with disabilities, especially as they relate to the achievement of the MDGs Strengthen capacity of WHO country offices on disability and rights issue and CBR as a multisectoral strategy that should be part of every development policy, programme and project Link closely with countries and other organizations and stakeholders in the international community to ensure synergy and non-duplication of efforts
Regional Framework for Action for Community-based Rehabilitation: 2010–2020
Action Area 1: Policy and programme development and implementation
General objective 1:
To promote policy and programme development that is disability and CBR inclusive
Specific objective 1.1. To advocate with Member States for the ratification and monitoring of core international instruments on inclusive development and the rights of persons with disabilities
Actions by countries
Ratify CRPD (for Member States that have not yet ratified the Convention on the Rights of Persons with Disabilities, as well as its Optional Protocol)
Include and give due focus to the needs of women, men, girls, boys and other marginalized and vulnerable persons with disabilities in policy instruments and action plans
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Put monitoring systems in place
Specific objective 1.2: To integrate CBR strategy CBR strategies in development policies, programmes and plans Actions by WHO Review and disseminate tools and guidelines for development and evaluation and implementation and monitoring of inclusive policies, programmes and action plans Provide technical assistance to Member States in policy and programme development and/review, implementation and monitoring Advocate for inclusion or strengthening of CBR strategy in disability programmes Ensure that disability issues are considered in key health programmes and initiatives of WHO in the Region such as mental health, leprosy, child and adolescent health, sexual and reproductive health, chronic diseases, HIV/AIDS, ageing and emergency and humanitarian action Actions by partner organizations and collaborating centres Provide input on evidence-based guidelines and recommendations for strategies and interventions to be considered by Member States Participate proactively in policy and programme development/review processes in countries where they operate Share best practice and resources towards coordinated efforts Support WHO actions
Actions by countries
For countries without existing disabilityspecific policy/programme/plan, develop a disability policy/programme/plan with a strong CBR and development focus
For countries with disability/CBR programmes, provide adequate budgets for disability/CBR programmes/ interventions, especially for countries committed to international and regional instruments and guidelines
Review and strengthen existing policies and programmes in light of current international and regional instruments and guidelines, especially for countries committed to specific international and regional instruments and guidelines
Document and share good experiences and practices, including tools and instruments
Annex 2
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18 Actions by WHO Actions by partner organizations and collaborating centres
Specific objective 1.2: To integrate CBR strategy CBR strategies in development policies, programmes and plans
Actions by countries
For all countries:
Create a multisectoral mechanism
coordination
Advocate for sub national and local policies and programmes to mirror or adapt national policies, particularly for countries with decentralized governance functions
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Ensure that appropriate links with other related areas such as emergency and humanitarian action, including protection against child labour and violence and injury prevention are established and strengthened
Action Area 2: Capacity building
General objective 2: Actions by WHO
To enhance capacity at all levels to strengthen and sustain CBR strategy and programme implementation Actions by partner organizations and collaborating centres Recommend relevant and appropriate content for training and instructional materials on CBR Share good practices in capacity building planning and implementation from CBR project experiences
Specific objective 2.1: To improve personal, technical, management and other relevant skills among CBR stakeholders
Actions by countries
Assess capacity gaps in CBR, especially in priority, high-burden communities Collect and disseminate existing training modules and other instructional materials on CBR Provide technical countries assistance to
Disseminate relevant normative guidelines and assessment tools
Develop or update training modalities and modules, including self-instructional materials and open learning approaches, tailored to different groups of stakeholders, as duty bearers, at community level, e.g., persons with disabilities (by disability type) and their families/care givers, community-based volunteers and health workers
Undertake training and other capacity building activities according to assessed priority needs
Develop and train relevant local government service units, NGOs and self-help organizations such as organizations of persons with disabilities, both specific disability groups and umbrella/multiple disability groups, to provide support during capacity building activities in the communities
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20 Actions by WHO Actions by partner organizations and collaborating centres Actions by WHO Actions by partner organizations and collaborating centres
Specific objective 2.1: To improve personal, technical, management and other relevant skills among CBR stakeholders
Actions by countries
Collaborate with the education sector in curriculum development for a simplified general education subject on human rights, disability and CBR, including disabilitysensitivity training, at elementary level.
Specific objective 2.2: To ensure adequate capacity to deliver medical care and rehabilitation services by integration into PHC and linking with health systems
Actions by countries
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Identify and utilize practical entry points for CBR using primary health care principles, e.g., teacher-child-parent approaches (TCP) and school PTAs, organizing parents of children with disabilities, volunteer health workers and other support groups, towards building up at least a coherent health element of CBR, including home- and school-based care and rehabilitation
Provide technical assistance to member states in initiating and strengthening rehabilitation programmes Collect feedback from and disseminate to Member States good practices for continuous improvement in CBR implementation
Collaborate with and support WHO and countries in identifying effective strategies, approaches and entry points Provide input and/or participate in the process of developing mechanisms and putting them in place
Specific objective 2.2: To ensure adequate capacity to deliver medical care and rehabilitation services by integration into PHC and linking with health systems Actions by WHO Actions by partner organizations and collaborating centres
Actions by countries
Enhance capacity for delivering both general health services needed by persons with disabilities and specific services needed because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, as close as possible to their own communities
Develop or strengthen a referral system, both for health and other elements of CBR, including a list of resource organizations and facilities for rehabilitation and other support services for persons with disabilities
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22 Action Area 3: Partnerships and networking Actions by WHO Actions by partner organizations and collaborating centres Be active members of partnerships and networks to be established in the Region at appropriate levels and in relevant areas of involvement Assist in organizational development and leadership of persons with disabilities and their organizations Strengthen and further develop collaboration and partnership with relevant international, regional and subregional organizations Encourage and support networking and collaboration between and among Member States in developing and implementing joint activities on shared areas of interest, including the development of common understanding and possibly common messages
General objective 3:
To enhance partnerships and networks among CBR stakeholders
Specific objective 3.1: To promote multisectoral and multidisciplinary partnerships and networks in support of CBR at regional, sub regional and national levels
Actions by countries
Establish networks for various disabilityspecific groups and CBR programme elements, e.g., organizations working with the blind or with persons with multiple disabilities, or organizations working in health and its 5 sub-elements in the CBR matrix, ensuring representation of persons with disabilities
Establish an umbrella network of networks to coordinate and consolidate efforts
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Conduct regular feedback and coordination meetings with funding and sectoral partners
Participate in and contribute to the work of higher level networks
Action Area 4: Awareness raising and advocacy
General objective 4:
To raise awareness of and advocate for CBR as a multisectoral strategy to promote equal rights and opportunities and inclusive development for persons with disabilities
Specific objective 4.1: To undertake key advocacy activities (e.g., orientation-seminars, presentations in conferences and to government bodies and other organizations, media campaigns) at various levels throughout society involving different stakeholders in CBR Actions by WHO Actions by partner organizations and collaborating centres at Support advocacy efforts of WHO and Member States by providing input and/or participating in relevant awareness raising and advocacy activities in the Region
Actions by countries
Plan and earmark funds for advocacy activities Provide technical assistance to Member States in developing advocacy plans Develop prototype presentations and other advocacy materials for regional, sub-regional and national forums (e.g., media kit, fact sheets, posters and documentaries) Participate in awareness raising and advocacy activities of Member States Link countries to existing information materials and resources
Undertake advocacy activities on disability and CBR to key stakeholders at national, subnational and local levels, e.g., • organizations of persons with disabilities and of other vulnerable groups • schools and other institutions/settings (prisons, home for older persons, workplaces, etc) • local government units/executives • legislators • media • government agencies • professional organizations/academia • health maintenance organizations (HMOs) • NGOs, civic and volunteer groups
Undertake advocacy activities regional and sub-regional levels
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24 Actions by WHO Actions by partner organizations and collaborating centres Collaborate with WHO in the development of relevant information materials Developa and disseminate similar materials tailored to their specific area(s) of expertise and/or disability groups(s) Share with WHO and Member States testimonials of persons with disabilities and good CBR practices from their own projects and areas of work in the Region and beyond Develop and disseminate prototype practical and stakeholder-tailored information materials on disability and CBR in accessible media (print, Braille, audio-cassette, electronic, etc) Compile and disseminate success stories of persons with disabilities and good CBR practices from other parts of the world, representing various disability types/groups, highlighting common strengths and enabling factors at individual/family/community levels Field test and evaluate materials prior to dissemination.
Specific objective 4.2: To provide key stakeholders and persons with disabilities access to condensed, stakeholder-tailored and user-friendly versions of selected international instruments, guidelines and other information materials on CBR
Actions by countries
Develop, translate and/or adapt information materials according to local context
Reproduce and disseminate information materials consistent with the profile of persons with disabilities in the country
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Compile and disseminate success stories at country level, highlighting struggles as well as capabilities and contributions of persons with disabilities as members of their families, communities and societies.
Action Area 5: Creating barrier-free environments and providing assistive devices and technologies
General objective 5:
To promote the creation of barrier-free environments and the provision of information and communication and assistive devices and technologies
Specific objective 5.1: To enhance the availability, knowledge and use of universally designed environments, information, communication, assistive devices and technologies Actions by WHO Disseminate standards and guidelines on barrier-free, universally designed environments and information/ communications/assistive devices and technologies Collect and disseminate good practices from countries in various aspects of building barrier-free environments Provide technical assistance in monitoring and evaluating progress of implementation Coordinate with academia for strengthening training curricula for relevant health practitioners, including disability-sensitivity Propose the inclusion of sign language as an official UN language Actions by partner organizations and collaborating centres Collaborate with WHO and countries in promoting development of and access to barrier-free environments, information and communication, including the collection and dissemination of good practice Provide input, participate and facilitate in relevant training activities in the Region Demonstrate leadership in practice
Actions by countries
Conduct accessibility audit of major public and private services and transport, using universal design approaches
Develop national accessibility standards and regulatory guidelines covering at least public facilities, infrastructure and transport, communication and other devices and technologies including those in agricultural and rural settings
Develop regulatory and monitoring guidelines for barrier-free environments, information, communication, assistive devices and technologies
Develop incentive mechanisms for institutions, local government units and industry to ensure compliance with accessibility standards, e.g., compliance as criterion for designation as healthy cities/ settings or citations/tax incentives for disability-friendly establishments
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26 Actions by WHO Develop standard guidelines for the production and servicing of assistive devices and technologies Collect and disseminate good practices and financial mechanisms for acquiring assistive devices and technologies Provide technical assistance to countries in the standards, regulation and ethical aspects of the use of assistive devices and technologies Actions by partner organizations and collaborating centres Collaborate with WHO and countries in setting standards and drawing up the content of regulations and ethical aspects of the use of assistive devices and technologies in their respective fields of expertise Make available expertise in other support services including language interpreters and transcribers
Specific objective 5.2: To promote more relevant and effective production and utilization of appropriately designed assistive devices and technologies
Actions by countries
Develop and support local industry to make available assistive devices and technologies specifically tailored to individual needs of persons with disabilities, their environment and daily activities
Ensure accessible information on the utilization of mobility aids, devices and assistive technologies, including new technologies, as well as other forms of assistance, support services and facilities.
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Develop health financing mechanisms, e.g., subsidies, cash transfers, insurance packages, for acquiring assistive devices and technologies
Action Area 6: Research and information management
General objective 6: Actions by WHO Collaborate with relevant agencies and stakeholders to identify a core information set for reporting requirements under pertinent international and regional instruments Provide technical assistance to countries in assessing the adequacy of and in strengthening their current information systems Actions by partner organizations and collaborating centres
To promote evidence-based practice in disability, CBR and inclusive development
Specific objective 6.1:
To strengthen information systems on disability and CBR
Actions by countries
Develop or strengthen information systems on disability and CBR to address information gaps
Adopt definitions on disability based on the UN guidelines and principles for the development of disability statistics
Collaborate with WHO in providing input and support to countries in the process of strengthening and maintaining their information systems Continue sharing in a timely manner pertinent information and evidence collected in the course of their work
Ensure the generation of disabilityspecific health and development data, e.g., gender, age ethnicity, etc, especially those relating to the millennium development goals
Establish a monitoring and evaluation mechanism to inform implementation and continuous improvement of disability programmes and CBR activities Establish a mechanism of disseminating disability programme statistics and information widely, regularly and in appropriate forms to ensure accessibility especially to persons with disabilities
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28 Actions by WHO Provide technical assistance to countries in determining priority research needs and in enhancing research capacity Organize research dissemination and policy forums at regional and subregional levels to ensure evidencebased development of disability policies and programmes Actions by partner organizations and collaborating centres Provide support to WHO and countries in their area of expertise and according to their geographic presence or sphere of work Sharing and supporting research with WHO and countries Collaborate with WHO in facilitating cooperation in research and enhancing access to scientific and technical knowledge Sharing information, resources and tools for monitoring and evaluation Collaborate with Member States and partner organizations in establishing and maintaining a regional observatory and resource centre for disability and CBR Establish, in collaboration with other agencies and partners, an internetbased platform for cooperation in research and continuous and timely access to scientific and technical information exchange Sharing information, resources and tools for monitoring and evaluation
Specific objective 6.2: To promote research and development in priority areas of concern in disability and CBR
Actions by countries
Formulate a priority research agenda for disability and CBR, e.g., identifying gaps in information and developing and updating a comprehensive collection of information on persons with disabilities
Develop capacity to conduct research and translate results towards improved policy and programme development as well as implementation
Undertake priority research activities and analyze and disseminate results to drive CBR strategies and inclusive development policy and practice
Regional Framework for Action on Community-based Rehabilitation: 2010-2020
Encourage and support rehabilitation studies, which include CBR, in training and health care institutions