1

Country Report

on

Intellectual Disability

Bangladesh

19th Asian Federation on Intellectual Disabilities Conference,

Singapore, 2009

Presented by

Dr. Shamim Ferdous

Executive DirectorBangladesh Protibondhi Foundation

2

Population : 150 million

Average population : 980

people/sq. km.

Facts of Bangladesh

Any Disability : 15 million

Intellectual Disability : 4.6 million

(WHO)

3

Background

Until 1977 people of Bangladesh were unaware of

intellectual disability.

In the same year Society for the Welfare of the

Intellectually Disabled, Bangladesh (SWID,

Bangladesh) was established by parents and

Professor Sultana S. Zaman renounced psychologist

and disability expert started programmes for children

with intellectual disability.

It is the milestone in the history of services for the

Person with Intellectual Disability.

4

Prevalence of Disability in Bangladesh

National Forum of Organization Working

with Disabled & Handicap International in

collaboration of DFID in 2005

5.6 %

Govt. of Bangladesh Survey : 1982

1986

1995

(Bangladesh Bureau of Statistics-1996)

0.64

0.52

1.06

According to the National Census 2001

(full report still not published)

< 1%

not accepted

by the Govt.

Action Aid in 1996 14 %

Bangladesh Protibondhi Foundation 1987 &

2001

6.8% (1987)

& 11.7 %

(2001)

5

Scale of the problems in Bangladesh

Prevalence of childhood disabilities in population-based

surveys in 1988 and 2001

69

118

29

66

20

36

16

32

69

59

0

20

40

60

80

100

120

per 1000

children

Any

Hea

ring

Cogniti

on

Visio

n

Moto

r

Seizu

re

Disability

1988

2001

Infant mortality: 65/1000 (2004)

MGD 4: 31/1000(2015)

Mortality under 5yrs: 24/1000 (2004)

6

Risk Factors of Childhood

Disability

Poverty

Malnutrition

Maternal illiteracy

Maternal history of

pregnancy loss

Maternal depression

Small for gestational age

Consanguinity

Iodine deficiency

Exposure to environmental toxin

Pre and postnatal brain infection

7

Govt. Policy and Legislation for People with

Disabilities

National Policy on Disability 1995

(Govt. adopted)

The Disability Welfare Act – 2001 Enacted by the

National Parliament to

provide a legal

framework.

The National Plan of Action II September 2006,

approved by the National

Coordination

Committee constituted

under the Disability

welfare Act 2001.

8

* Currently the Disability Welfare Act 2001 is being

reviewed for amendment to make it complaint with the UN

Convention on the Rights of Persons with Disabilities

(UNCRPD)

Bangladesh is one of the member, committee on Rights of

Persons with Disabilities, UN

A Disability Rights Watch Group and National Forum of

Law and Legislation committee is formed in Februrary16,

2009

9

The United Nations Convention May 9, 2007

on the Rights of Person with

Disabilities (CRPD)

signed and

Ratified November 30, 2007

by Govt.

United Nations Convention on The Rights of

Persons with Disabilities (UNCRPD)

10

Govt. and NGOs working in the field of Disabilities

NGOs are working 55,000 (approx)

Claiming to work 400 NGOs

for people with disabilities

Human resources development 275 NGOs

(cater rehabilitation)

Service Providers 95% services by NGO,

5% by the Govt.

11

Prominent Service providers in the field

of ID

• National Center for Special Education (NCSE) Govt. and

other Govt integrated Schools - 13

• Self Contained School for the Intellectually Disabled –

2 Branches

• Society for the Welfare of the Intellectually Disabled

(SWID) - 46 Branches

• Bangladesh Protibondhi Foundation (BPF) - 7 Branches

• Rehabilitation Institute and Hospital for the Disabled

(RIHD)

• Centre for the Rehabilitation of the Paralyzed (CRP)

• Tori Foundation (Gifted Children’s School) – 2 Branches

• GBSS (Gram Bikash Shohaok Sangstha)

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The National Forum of Organizations Working with

the Disabled (NFOWD) Est. 1991, Rgd. (Ministry of Social Welfare and NGO Affairs Bureau)

Executive Member The Boards of the National Social

Welfare Council

Member The National Coordination

Committee and the National

Executive Committee on Disability

(constituted under the Disability

Welfare Act 2001)

International Member The South Asian Network on

Community Based Rehabilitation

Currently NFOWD consists of 318 members from 59 districts out of 64

districts.

13

Local Other NGOs

Disabled People’s organization (DPOs)

Civil Society Organizations (CSOs)

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INGOs, Finance Institutions and Donors

Action Aid Bangladesh

Handicap International

Sight Savers International

Save the Children

The Polli Karma Shohayak Foundation

The Corporate Sector and many more

15

International Commitments on Education of

Children with Disabilities

• Education For All (EFA) : Jomtien (1990) declarations

• Salamanca Declaration (1994) World Conference on

Special Needs Education

• Dakar Framework for Action (2000)

• E-9 Declaration (2000)

• UN Standard Rules on the Equalization of Opportunities

for Persons with Disabilities (1993)

• Biwako Millennium Framework for Action (Asia-Pacific

Decade of Disabled Persons (2003-2012)

16

National Commitments and Programmes

• National Policy on Disability-1995

• National Disability Welfare Act-2001. Currently the law is

being reviewed for amendment to make it complain with

the UN Convention on the rights of persons with disability

• National Action Plan on Disability-2006

• Institutional Programmes by Department of Social

Services for Persons with Disabilities relating 2000

• Primary Education Development Programme (PEDP)-II

• Teaching Quality Improvement in Secondary Education

Project-under Department of Secondary and Higher

Education- Ministry of Education

• National Plan of Action (NPA-II) for children (2004-2009)

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The goals are:

1. Increase primary school access, participation and

completion in accordance with government's EFA

(Education for All) and other policy commitments;

2. Improve the quality of student learning and

performance outcomes; and

3. Build and facilitate a positive relationship between the

Government of Bangladesh, donors and consultants.

PEDP II aims to provide quality primary

education to all eligible children in Bangladesh

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System of Formal Education

(Mainstream Ed.)

Primary

Duration: 5 Years

Class: 1 to 5

Age group : 6 to 10

Secondary

Duration: 5 years

Age group: 11 to 15 years

Lower Secondary

Duration: 3 years

Class: 6 – 8, Age: 11 & 13

Secondary

Duration: 2 years

Class: 9 & 10, Age: 14 & 15

Higher Secondary

Duration: 2 years

Class: 11 & 12 Age: 16 & 17

Education For ID

Special

School

Integrated

School

Inclusive

Primary School

• Home Based Education

• Early Intervention

• Pre School Prog.

19

Access to Education of ID Children

Any disability of school going age : 6-10 yrs 44%

16-18 yrs 15%(Source: ESTEEM, 2002)

Access to Education of school going age 11%

(Boys:Girls=56:4)

Enrolled 8% in Various Educational Set up

Primary Education 68%

Pre Primary Ed. 15%

Among 8% children enrolled in educational set up :

Physical disability 55%

Visually Impaired 13%

Hearing Impaired 12%

Intellectual Disabilities 10%Source: Educational Status of PWID in Bangladesh, Dr. Shirin Z. Munir, 5th International SIVUS Conference

on M.R.,2009

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Target

At least 75% of children & youth with

disabilities of school going age will able to

complete primary education by 2015 .

Source: Mid-point review of the Asian and Pacific Decade of Disabled Person 2003-2012

21

140

150

90

75

37

95

0-less 1 yr.

Above 1-2 yrs

Above 2-3 yrs.

Above 3-4 yrs.

Above 4-5 yrs.

Above 5 yrs.

Number of children

Research on Early Detection

Source : Child Development Centre, Shishu Bikash Network

22

Pre-School Education

Virtually there are no services for the pre-school age

children with disabilities. Only few programmes

designed & implemented through NGOs for example :

Save the children - SUCCED project, BRAC, Plan

Bangladesh, Bangladesh Protibondhi Foundation and

CSID.Source: Paul Ackerman, Mary S. Thormann, Sharmin Huq, 2005

In July 2009 Govt. has made a Working Draft and a

Policy Framework on Compressive Early Childhood

Care and Development (ECCD).

Source: Ministry of Primary and Mass Education, Bangladesh

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Government of Bangladesh has allocated Budgets as

stipend for students with disabilities.

Ministry of Social Welfare is responsible for selection and

distribution of stipend monthly in following rates :

Primary level Tk. 300

Secondary level Tk. 450

Higher secondary Tk. 600

Tertiary & above Tk. 1000

Govt. Facilities for the students with disabilities

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Govt. Vocational Training Centres (5) :

• Industry for Production of Plastic Goods

• Mineral Water (Maitry Shilpo)

NGOs Vocational Training Centres :

• Trust for the Welfare of Intellectually Disabled (TWID) run by SWID

• Bangladesh Protibondhi Foundation (BPF)

• UCEP, CSID

• Centre for the Rehabilitation of the Paralyzed (CRP) and

• other NGOs, Private Sectors.

Vocational Training Centers, Sheltered Workshop &

Job Placement for PWD

In July 2007, M/O Youth and Sports, Industries have taken

steps to reserve seats for persons with disabilities in their

vocational training institutes.Source: Mid-point review of the Asian and Pacific Decade of Disabled Person 2003-2012

25

Employment Sectors

Government

5%

Non-

Government

17%

Others

12%

Self-

employment

66%

(8% intellectually disabled)

Source: Center for Services and Information on Disability 2002

26

Special Olympic

Children with ID participate in different events of

Special Olympics in 2007 and own

Gold 37

Silver 22

Bronze 19

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Community based Rehabilitation (CBR)

CBR cervices are very effective in Bangladesh run by

the NGOs.

Community Based Rehabilitation Programme (CBR)

is a specific strategies for implementing rehabilitation

activities for the person with disability in the

Community.

CBR approach has been increasingly accepted and

medical, education, and occupational rehabilitation

services have been included in CBR.

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• To experiment and gain practical experience on

CBR.

• To collect and disseminate information among the

number organization.

• Assisting member organization to conduct survey,

research on CBR.

• Helping in evaluating the impact and achievement

of CBR and

• Organizing meeting, seminars, workshops,

conference etc. To aware and motivate the people.

A National CBR network was formed in

Bangladesh(1990) with the following

objectives.

29

23.4426.03

49.18

23.14

30.2132.77

10.83

31.4

4.078.55

0

10

20

30

40

50

60

Dhamrai Savar Kishoregonj Norshindi Faridpur

Disability Impairment

Impact of CBR Services

(Population based surveys in 5 CBR areas in 2001, BPF)

30

Health

Bangladesh Govt. has incorporated appropriate

provisions for prevention of avoidable disablement

in the National Health Policy.

Though 30 % disabled people never met

doctors/specialist for disability treatment.

31

Malnutrition high risk for Cognitive DisabilityNutritional survey of 2-9 year old children in Kishoreganj, BPF and

Columbia University, 2001-2002 (Number of children=944)

Chi-square df P value

Stunting

(ht/age)

11.380 1 .000

Underweight

(wt/age)

5.649 1 .010

Wasting

(wt/ht)

.436 1 .288

Bangladesh Govt. has declared to provide one hot meal as

School Lunch which is also provided by many NGOs earlier.

32

Activities undertaken at different levels for

improving the Health situation of the children

with disabilities in Bangladesh

1.The Extended Programme of Immunization (EPI) of

Bangladesh Govt. has helped to

Decrease the infant mortality rate (IMR)

Dropped under five mortality rate (U5MR)

2. Countrywide Mass Awareness Programme to

prevent disability/ Increasing in community

participation

3. Care of pregnant mother through traditional birth

attendants.

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4. Bangladesh Integrated Nutrition Project (BINP) made

impact to reduce malnutrition among children and

women.

5. Increasing awareness about nutrition breast feeding,

food habit, home gardening, use of iodized salt.

6. Declining malnutrition and low birth weight and adaptation

of family planning practices among eligible couple.

7. Early Detection and intervention by pediatrician,

psychologists and therapists of different Child

Development Centres at district hospitals in 14 medical

colleges. At present Child Development Centre is

running five Medical College Hospital in Bangladesh.

8. Initiating programmes for the primary and secondary

prevention on the occurrence of the causes of disability.

34

Human Resource Development by Govt. and NGOs

• Post Graduate Bachelors and Masters

Degree in Special Education in the

area of Intellectual Disability, Hearing

and Visual Impairment.

• Certificate Course in Physiotherapy

Occupational Therapy, Rehabilitation

Nursing and Certificate course in

Special Need.

• Several other short and long courses

for different level of people in the

prevention, identification, management

treatment, rehabilitation and counseling

of the children with disabilities.

National Centre for Special

Education (Govt.)

Bangladesh Protibondhi

Foundation, SWID

Bangladesh and Institute

of Education and Research

(IER), Dhaka University.

CRP, Orthopedic Hospital

CDD, ADD, Child

Development Centre

(Dhaka Children's Hospital)

and different NGO’s

35

• Group formation

• Mobilization of Savings

• Training in awareness development

• Skill development

• Micro-credit

• Health, Sanitation and Nutrition

The Govt. poverty alleviation programme for improving of

PWDs overall socioeconomic condition by

36

Disability and Resource Allocation

Disability has been included in PRSP-II but not

adequately and the issues of Children and

Women with Disabilities are missing in PRSP-II.

Government of Bangladesh is now implementing MDG

but since disability issues are excluded from MDG, the

Government is reluctant to allocate budget on disability

development issues.

In August 2007, Ministry of Social Welfare has started a

pilot project with USA based company to develop a

digital data based of person with disability in 6 selected

districts for insurance of ID cardSource: Country Report of Bangladesh on mid-term review of the Asian and Pacific Decade of

Disabled Person 2003-2012, 19-21 September 2007.

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Rules of Business

According to the Rules of Business, the Ministry of Social

Welfare, since its inception in the early 1960s, has been

the lead ministry catering for all issues of people with

disabilities in Bangladesh, including the areas of

education, employment, and rehabilitation. Since

disability is considered a cross-cutting issue, it demands

an active involvement of other ministries and

departments. Due to said Rules of Business, the role and

participation of other ministries and departments seems

to be limited.

In 2007 steps have been taken to revise the current Rules

of Business of the Government and it is expected that all

leading nation building departments, divisions and

ministries will be taking up responsibilities to serve the

persons with disability in their respective work areas.

38

Recommendation

• A database can be established & update regularly to

identify disabled people.

• Without the presence of appropriate data, developing

and implementing comprehensive legislation is

difficult.

• Plus it makes it extremely difficult to access whether

actions and programmes are relevant and has had an

impact on equity to services.

• Allocation of necessary fund in the national budget.

• Uniform Curriculum of special education.

• Promote inclusive education of children excluded

from the mainstreaming education.

• Adequate number of special education institutes

39

• Adequate number of special education institutes

special Education Services need to be provided

through the regular educational institutions, like

Primary schools, High schools and other educational

institutions.

• Teachers of the general educational institutions need

to be trained through the special education teachers

training institutes. Teachers training programmes

could incorporate special education subjects related

to the disability in their existing courses.

• More Medical Persons could be trained on disability

issues and posted regional hospitals.

40

• Necessity for relevant support system such as

therapeutically and assistive technology.

• A National Policy should be formulated to promote

the achievement of this targets (such as

mandatory reserve quota, employer incentives,

awareness-raising, campaigns, debriefing

employers & employees and extending technical

support to the employers).

• Strengthening sensitization at all levels though

organizing national and local level dialogues

workshop and seminars and advocacy to

concerned agencies for job placement etc.

41

Conclusion

People with disabilities and their organizations working

in this field should address, work collectively to

implement existing policies and overcome the gaps.

They would now act on this platform to increase mass

awareness campaigns for reducing violation of Child

Rights .