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.
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 and
Mission:
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-up
Strengthen global Advance and validate Implement and scale up
support, commitment, and the knowledge and innovative, effective, an
use of state of the art understanding of d sustainable
leadership, management sustainable leadership, management
and governance leadership, management , and governance
tools, models, and and governance programs
approaches for priority tools, models, and
health programs. approaches
4. USAID/DCHA/DRG and
USAID 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
7. SNAPSHOT: International Committee of the Red Cross
Special 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
12. Disability
is a
human rights
issue & a
development
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 educational
lives 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 to
face the challenges?
28. Conclusion
Women leaders with
disabilities have a strong
role to play in
strengthening the
capacity of organizations
to advocate for and
deliver services for
women and girls with
and 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
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.
INSERT VIDEO?
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