MACOHA’s CBR Programmes in Malawi - fast networxbezev.fastnetworx.de/fileadmin/Neuer_Ordner/Tagung_CBR/Praesentationen/... · MACOHA, Gov. of Malawi and CBR (1.) MACOHA responsible

Community Based Rehabilitation – a Strategy for Achieving Inclusive Development

MACOHA’s CBR Programmes in Malawi

A paper presented in Bonn, Germany (3-4th May 2012)by

Alick Chavuta, Executive Director MACOHA

Email: [email protected]. +265 888 781 680

Malawi Council for the Handicapped

in partnership with

Presentation OverviewPresentation Overview

1. Introduction to Malawi and MACOHA

2.Outline of MACOHAs CBR Programs

3.CBR structure and coverage in Malawi

4.Challenges of Malawi CBR

5.Priority areas that need external support

6.Way forward


Mandate of MACOHA (1.)Mandate of MACOHA (1.)

� Advise government on matters relating to care and welfare of persons with disabilities

� Design and implement rehabilitation programmes and services

� Run vocational training centres for persons with disabilities

� Regulate the work of service providers whose key mandate is to support the disability cause


MACOHA, Gov. of Malawi and CBR MACOHA, Gov. of Malawi and CBR

(1.)(1.)

� MACOHA responsible for all matters concerning rehabilitation of people with disabilities in Malawi

� Government adopted the CBR approach in its development plan of 1987-1996

� MACOHA adopted CBR as strategy for disability program planning

� CBR utilises the existing structures and resources ( no need to create parallel structures)


2. Outline of Malawi CBR Programmes2. Outline of Malawi CBR Programmes

Provides rehabilitation through facilitation (referral) of following interventions:

i. Corrective surgery and access to drugs for mental health disorders

ii. Rehabilitation training

iii. Provision of assistive devices

iv. Education sponsorship

v. Inclusive education

vi. Physio- and occupational therapy

vii.Guidance and Counselling

viii.Job placement

ix.HIV and AIDS related servicesMalawi Council for the Handicapped

Outline of MalawiOutline of Malawi’’s CBR Programs s CBR Programs

(2.)(2.)

Overall Aim

To promote access to education, health, livelihoods, social inclusion and empowerment of persons with disabilities for them to play their rightful roles in the community


STRATEGIC OBJECTIVES (STRATEGIC OBJECTIVES (2.)2.)

� Facilitate access to quality, equitable and relevant education to persons with disabilities

� Improve livelihood for persons with disabilities

� Ensure that health needs are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices

� Promote participation of persons with disabilities in the social life of their families and communities through empowerment

� Increase capacity of CBR cadres at all levels


Education Component Education Component


A Learner with visual impairment using a computer with Dolphin Pen (Talking Software) - Blantyre Secondary School

2011 MoE Statistics on Learners with 2011 MoE Statistics on Learners with

disabilities in Malawidisabilities in Malawi

Special Learning Need

Primary School Learners

Secondary School Learners

Boys Girls Boys Girls

Blind 188 151 58 51

Deaf 1414 1173 88 25

Hard of Hearing 10281 9889 126 112

Learning Difficulties

20265 18,653 252 107

Low Vision 9352 8767 210 225

Physical Impairments

4730 3664 207 199

Total 46,230 42,297 941 719


� Identification of learners with disabilities

� Provision of bursaries to needy students with disabilities in secondary schools

� Provision / facilitation of assistive devices to learners with disabilities

� Advocate for the adaptation of school structures, water & sanitation facilities for accessibility to all

� Building capacity of teachers and administrators in special needs and inclusive education

� Lobby for the construction of junior schools to reduce distance for learners with disabilities

Activities in CBR Component Education Activities in CBR Component Education

Parents providing support in a resource room for Special Needs Education


Parent of Children

with intellectual disabilities

in a resource

room supporting the class teacher


1. Introduction to 1. Introduction to

MalawiMalawi Population: 13.2 Million (NSO 2008)

� 85% live in rural areas

� National literacy levels: 69% for males and 59% for females

� The economy is agro-based

� Has 28 district councils

Disability & Community based rehabilitation

� Malawi has as no reliable disability statistics

� 4.2% of the population are people with disabilities (NSO, 2008)

� 13% disability prevalence among working-age individuals in Malawi (World Bank, 2011)

� MACOHA is mandated by government to provide rehabilitation programmes through Handicapped Persons Act 1971

� CBR programmes in 14 districts (50% coverage)

Livelihood componentLivelihood component


Pass-on project (Balaka)

� Awareness campaign on vocational skills training

� Identification of youths with disabilities eligible for vocational skills training

� Train youths and adults with disabilities in various vocational skills e.g. tailoring, carpentry, farming,

� Provision of start-up kits, e.g. carpentry

� Lobby money lending institutions to include people with disabilities

CBR Activities under Livelihood cont.CBR Activities under Livelihood cont.

CBR activities under Livelihood component CBR activities under Livelihood component

contcont..

� Awareness Campaigns targeting prospective employers to employ people with disabilities

� Lobby local leaders and district councils to include people with disabilities in social programmes such as public works programmes, subsidized farm inputs

� Lobby existing technical colleges to adapt the existing structures for access to people with disabilities



Livelihood component cont.

Community based vocational training (Dowa)

2011 MoE Statistics on livelihood of 2011 MoE Statistics on livelihood of

Persons with Disabilities in MalawiPersons with Disabilities in Malawi

Students enrolled at Soche Technical College 133

Local Artisans oriented to train people with disabilities 192

People with disabilities self employed 239

People with disabilities employed by Public and Private sectors 419

People with disabilities given loans 409


Compare: � Total pop. > 13 Mio.;� 13% disability prevalence among working-age individuals;

Health ComponentHealth Component


Ear Screening Training in Walking Using Parallel Bars

1. Promotion-health talks, community sensitisation and mobilisation

2. Prevention-community screening and assessments, early intervention

3. Medical care- eyes, ears, epilepsy, clubfoot, orthopaedics, etc

4. Rehabilitation-developmental stimulation

5. Assitive devices-wheel chairs, prosthesis, tricycles, and others

Activities in CBR Component HealthActivities in CBR Component Health

Example: Example: Results from health component in one of the CBM Results from health component in one of the CBM

supported MACOHA CBR Programmes in 2011supported MACOHA CBR Programmes in 2011

M F

Orthopedic surgeries facilitated 391 253

Access to assistive devices provided 106 108

Eye operations facilitated 217 245

Provision of Epilepsy treatment 247 216

Access to physio /occupational therapy provided 261 240


Empowerment componentEmpowerment component


Self Help Groups:- Peanut Butter Making-Blantyre CBR/Poultry Keeping-Balaka CBR

� Facilitate formation/strengthening of disability support groups and disability peoples organisation (DPOs)

� Promote Self representation of people with disabilities in local government structures at District-, Area-, and Community level

� Capacity development for self help groups and DPOs

� Lobby chiefs and civic leaders to include people with disabilities in political and leadership positions

CBR Activities under Empowerment CBR Activities under Empowerment

componentcomponent

Empowerment component cont.Empowerment component cont.

People with disabilities trained in human rights 1882

People with disabilities aspiring for political positions 29

People with disabilities in leadership positions 1126


� Relationships, marriage and family -Counselling of individuals and families

� Personal Assistance- To facilitate education and/or participation in family and community activities

Social componentSocial component

2011 Statistics under social component2011 Statistics under social component

People with disabilities seen participating in cultural and artactivities

5,708

People with disabilities able to get personal assistance 384

People with disabilities participating in sports 86


Ministry MGCCD NACCODI – Nat. Coord. Committee

NAT. CBR STEERING COMMITTEE

MACOHA HEAD OFFICE

DISTRICT EXECUTIVE COMMITTEE

LOCAL COUNCILS

MACOHA District Projects / Officer

DISTRICT CBR COORDINATING COMMITTEE

AREA DEVELOPMENT COMMITTEE

MACOHA Community worker CRWs

TRADITIONALAUTHORITY

AREA REHABILITATION COMMITTEEE

VILLAGE DEVELOPMENTCOMMITTEE

VILLAGE HEADMEN AND LEADERS

MACOHA CBR Volunteers

3. MALAWI CBR STRUCTURENational

level

District level

Area level

Comm. level

Objectives of the CBR Structure (3.)Objectives of the CBR Structure (3.)

• To mainstream disability in sectoral plans, programmes and services at all Government levels

• To ensure that District Executive Committees feel responsible for development, implementation and review of CBR plans and budgets at district level

• To ensure joint planning and monitoring

• To ensure that CBR programmes live beyond the project life (sustainability), the structure aims at programmes being owned by respective District Councils of the Government


Objectives of the CBR Structure Objectives of the CBR Structure cont.cont.

� To enhance coordination of CBR through District Coordinating Committees

� To promote active participation and involvement of people with disabilities, their families, communities, organisations and govt. ministries in the implementation of CBR “Nothing about US without US”

� District Coordinating Committee ensures that disability issues are built into District Development Plans


National CBR Steering CommitteeNational CBR Steering Committee

(NCST(NCST) ) ) ) ) ) ) )

� Initiate discussions with development partners towards harmonisation of the CBR programmes

� Mobilisation of human and financial resources at national level

� Development of national CBR plans

� Undertaken mid year reviews and reports

� Strengthen the CBR referral system

� Oversee implementation, monitoring and evaluation of CBR


CBR Trainers Team (NCTT)CBR Trainers Team (NCTT)

� A multidisciplinary team of trainers from health, education, disability people organisations (DPOs) and other sectors

� Transfer of knowledge and skills largely to field level cadres on specific intervention within the community set up targeting Community Rehabilitation Workers (CRWs) at Area level, and Community Rehabilitation Volunteers (CRVs) and Community level, etc.

� Transfer of knowledge to district government and mainstream development organizations;


CBR COVERAGECBR COVERAGE

MACOHA-NAD MACOHA-CBM MACOHA-GOVT

Balaka Lilongwe Karonga

Machinga Dowa Nsanje

Mzimba Nkhotakota Chikhwawa

Blantyre Nkhata Bay Neno

Salima

Ntchisi

Dedza

Ntcheu


50% of Malawi remains

uncovered

4. Challenges of National CBR4. Challenges of National CBR

� Unable to extend CBR programme to the remaining 12 districts for true nat. coverage

� Vocational Rehabilitation and training centres have reduced intake, staff staying without any activity, lack of training resources and resettlement packages

� Government ministries still unable to mainstream disability in their policies and programmes due lack of additional knowledge and skills on disability.


5. Priorities in Malawi CBR 5. Priorities in Malawi CBR

Programmes that need assistance and Programmes that need assistance and

supportsupport� Increased efforts to mainstreaming,

provision of TA to sector ministries, and creation of awareness

� Adaptation of public infrastructure

� Passing of disability law to enforce UNCRPWD

� Provision of assistive devices & access to employment and vocational skills training

� Capacity building of DPOs, CBR personnel

� Extension of CBR to the remaining districtsMalawi Council for the Handicapped

6. Way forward6. Way forward

� MACOHA, CBM and NAD work together with Government on disability mainstreaming

� MACOHA sees the coordination and harmonization of approaches between CBM and NAD in CBR work as exemplary, and an opportunity to:

1. Further extension of CBR coverage with support from CBM, NAD and other partners

2. Build capacity of the newly appointed Disability Desk Officers in each government ministries to mainstream disability issues


Thank you for your attention !

End of PresentationEnd of Presentation

Documents

MACOHA’s CBR Programmes in Malawi - fast networxbezev.fastnetworx.de/fileadmin/Neuer_Ordner/Tagung_CBR/Praesentationen/... · MACOHA, Gov. of Malawi and CBR (1.) MACOHA responsible