Keeping the promise: Mainstreaming Disability in the Millennium Development Goals towards 2015 and beyond in Pakistan.

Keeping the promise: Mainstreaming Disability in the Millennium Development Goals towards 2015 and beyond in Pakistan.

ACHIEVING THE MILLENNIUM DEVELOPMENT GOALS FOR PERSONS WITH DISABILITIES THROUGH COMMUNITY BASED REHABILITATION (CBR) IN PAKISTAN.

The Millennium Development Goals (MDGs) are 8 development objectives set by the UN and membership organizations for the global community. The Goals consist of 21 quantifiable targets and are measured by 60 indicators. They address the needs of the world’s poorest citizens and the world’s most marginalized populations by fostering collaborative action in key areas - poverty, education, health and the environment.

While the MDGs do not specifically mention disability, it is increasingly being recognized that the MDGs will be impossible to achieve without inclusion of people with disabilities. In September 2010, the General Assembly adopted the resolution, "Keeping the promise: united to achieve the Millennium Development Goals" (A/RES/64/299), recognizing that policies and actions must also focus on persons with disabilities so that they benefit from progress towards achieving the Millennium Development Goals. Disability-inclusive MDGs would also support the implementation of the Convention on the Rights of Persons with Disabilities (CRPD).

Given the challenges that Persons with Disabilities face, it is vital that the global community works to mainstream Disability across all development sectors. Thus supporting implementation of the CRPD and achievement of the MDGs.

WHAT IS COMMUNITY BASED REHABILITATION (CBR)?

Community-Based Rehabilitation is a development strategy that is currently implemented in over 90 countries throughout the world to address the needs of people with disabilities and their family members. CBR aims to provide rehabilitation, reduce poverty, equalize opportunities and promote the inclusion of persons with disabilities in their communities.

The new WHO/UNESCO/ILO/IDDC CBR Guidelines were launched on 27 October 2010 in Abuja, Nigeria. These guidelines focus on four key development areas – health, education, livelihood and social – and promote mainstreaming and empowerment of Persons with Disabilities and their family members. CBR has become a flexible and dynamic strategy which can be adapted to suit different contexts, and where properly funded and supported, can make a contribution towards the implementation of the CRPD and achievement of the MDGs.

WHAT ROLE CAN COMMUNITY BASED REHABILITATION (CBR) PLAY IN PAKISTAN

 Goal 1: By Supporting in Eradicating Extreme Poverty and Hunger.

Poverty is both a cause and consequence of Disability. Persons with Disabilities face stigma and discrimination in their communities and are frequently denied their basic rights such as food, education, employment and access to health services. Persons with Disabilities may incur extra costs, such as those related to healthcare, and they are less likely to work. CBR promotes livelihoods and employment by:

Identifying and overcoming barriers that prevent participation.

Exploring potential employment opportunities for Persons with Disabilities in their communities.

Providing or ensuring access to skills training for income-generating activities and employment.

Goal 2: By Supporting in Achieving Universal Primary Education.

Estimates of the percentage of children with disabilities not attending school is extremely variable, however, in general, Children with Disabilities are less likely to start school and have lower rates of staying and being promoted in school than their peers without Disabilities. The correlation between low educational outcomes and having a Disability is often stronger than the correlations between low education outcome and other characteristics such as gender, rural residence or poverty.

By informing families of children with Disabilities that they have a right to access educational opportunities.

Providing recommendations and practical assistance to make school environments physically accessible and teaching flexible and child centered.

Referral of children to specialized services to enable their inclusion in primary education, for example, referral for assistive devices.

Goal 3: By Promoting Gender Equality and Empowering Women with Disabilities.

Many Women with Disabilities face discrimination based on both their gender and Disability. Women with Disabilities are likely to be denied access to education and employment opportunities and are at increased risk of violence and abuse. For those women who care for family members with Disabilities, they may face significant hardships particularly where there are limited support services.

Promoting equal access and participation for Women with Disabilities in all community development initiatives.

Centre for Disability in Development Supporting Women with Disabilities to access educational opportunities.

Supporting the development of self-help groups for Women with Children with Disabilities.

Goal 4: By Supporting in Reducing Child Mortality.

Mortality rates for children with Disabilities are difficult to estimate, however, it has been suggested that they may be as high as 80% in countries where under-five mortality as a whole has decreased to below 20% (2). Children with disabilities are more at risk of dying, not only because of life threatening medical conditions or lack of access to health services, but also because in many cultures they are neglected or left to die.

Ensuring early identification of children with impairments and referral of children to specialized medical and rehabilitation services where required.

Providing Disability awareness training to primary health care staff to ensure Children with Disabilities are able to access general health care.

Providing basic home-based therapy interventions to promote child development.

Goal 5: By Supporting in Improving Maternal Health.

Millions of women experience Morbidity and Disability as a result of pregnancy and childbirth complications. At the same time, women with Disabilities can also become mothers themselves, and sometimes need particular consideration during pregnancy or when bringing up children.

Raising awareness within communities that people with disabilities have sexual and reproductive health needs.

Supporting women with disabilities to access Maternal Health Services in their communities.

Ensuring traditional birth attendant training programs have a focus on Disability.

Centre for Disability in Development, Bangladesh /

Goal 6: By Supporting to Combat HIV/AIDS, Malaria, and other diseases like Infectious diseases which are disabling; for example, HIV can cause blindness, neuropathy and dementia.

At the same time Persons with Disabilities also have as high or higher risk of contracting HIV. Research conducted in Mozambique on disability and HIV found that one reason Persons with Disabilities are routinely excluded from HIV and AIDS policies and programs is a sign of refusal or reluctance to acknowledge their sexuality.

Reducing the stigma surrounding sexuality and Persons with Disability.

Promoting the provision of health information to be available in accessible formats.

Developing tailored prevention programs for Persons with Disabilities where mainstream programs are inappropriate and ineffective.

CBR programs can work with Disabled People’s Organizations (DPOs) to develop appropriate education methods to inform Persons with Disabilities.

Goal 7: By Supporting to Ensure Environmental Sustainability.

Environmental risks, such as poor sanitation and water quality, and natural disasters can cause ill health and Disability. Many Persons with Disabilities and elderly people, particularly in the rural areas of developing countries, face barriers to move around their homes and communities due to inaccessible buildings or in accessing community facilities such as wells and latrines and they are often excluded from disaster management activities.

Ensuring communities involve Persons with Disabilities when designing safe water and sanitation facilities   along with ramped access, grab rails and accessible toilets. .

Making recommendations and modifications to ensure access to existing facilities. Ensuring disaster response training within communities considers the needs of Persons with Disabilities and appropriate strategies are in place.

Goal 8: By Supporting to Develop a Global Partnership for Development.

CBR is a partnership approach, and works with all development sectors to achieve positive outcomes for Persons with Disabilities. The International Disability and Development Consortium (IDDC) and 3 CBR global alliances – CBR Asia-Pacific Network, CBR Africa Network, and the CBR American and Caribbean Network - work to promote CBR and inclusive development. Networking with government sectors, DPO’s, NGOs (local, national and international) and communities.Promoting CBR as a strategy for Mainstreaming Disability across all development sectors.

  

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