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UNICEF undertook an effort to gather reliable information on the access of chil- dren with disabilities to health, education and social protection services. The survey also sought to reveal the levels of participation of children with disabilities in different life activities, such as sport, culture and community events, as well as the attitudes and awareness of their families or caregivers. The analysis of data reveals that children with disabilities in Armenia face strong barriers in access to services, in particular related to school inclusion, rehabilitation and community participation.
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October 16, 2012, Yerevan
Survey Description• Goal: identify the level of access for children with disabilities, to reveal their
participation in different life activities, to identify the barriers to inclusion
• Target: Children with disabilities, aged 0-18
• Primary Source: Pyunik database
• Method: Questionnaire-based face-to-face interviews
• Respondents: Parent (in families), guardian (in orphanages)
• Implementer: Armenian Marketing Association
• Data Collection Period: August- December, 2011
• Analysis: Disaggregated by gender, residence, region and disability
Interview Summary
Interviews by Region
Interviews in the Orphanages
Limitations
• Target group
Primarily children with certified disabilities
• Coverage
• Methodology
Disability classification done based on medical diagnosis in Pyunik database only
GENERAL CHARACTERISTICS OF CHILDREN
Geographical Distribution
145927%
166531%
219841%
Yerevan Regional Urban Rural
Age and Sex Distribution
211(55%)174
(45%)
3633 (68%)
1689 (32%)
Male
Female
Family
Orphanage
20%
20%
16%12%
16%
17%
5%
14%
18%
18%
24%
21%
0-3 y/o
4-6 y/o
7-9 y/o
10-12 y/o
13-15 y/o
16-18 y/o
Orphanage
Family
Type of Disability
Physiological – hematological, cardiovascular, imunological and respiratory functions(b4) , digestive, metabolic and endocrine systems(b5), urino-
genitary, reproductive(b6) and skin and skin-related functions (b8)
32%
2%
32%
4%
4%2%
24% 36%
20%
20%
7%
7%
7%3%
MotorPhysiologicalIntellectual VisualAuditoryEpilepsyCombined
Orphanages
Families
EDUCATION
Kindergarten Attendance
Yerevan Regional Urban Rural Total (Families) Orphanages
50%
43%
23%
36%
9%
44%
37%
23%
33%
14%
48%
41%
23%
35%
12%
Male Female Total
School Attendance
Yerevan Regional Urban Rural Total (Families) Orphanages
13% 18% 23% 18%
72%
12%
13% 10%12%
23%
75%69%
67%70%
5%
General School Special School Does Not Attend
School Attendance
Yerevan
Amavir
Aragatsotn
Ararat
Gegharkunik
KotaykLo
ri
Shirak
Syunik
Vayots Dzo
r
TavushTotal
13%23% 22% 23% 21% 21% 22% 18% 18%
5%
18% 18%
12%
18%
8% 10% 8%14% 10%
13% 14%
7%
2%
12%
75%
59%
70% 68% 70%64% 68% 69% 68%
89%80%
70%
General School Special School Does Not Attend School
School Attendance
Physiological
Motor
Visual
Auditory
Intellectual
Combined
Epilepsy
Total
6%
26%
7%
8%
27%
20%
14%
18%
4%
6%
7%
36%
25%
17%
5%
12%
90%
69%
86%
56%
48%
63%
81%
70%
Does not attend school Special school General school
Out-of-school Children
Yerevan Regional Urban Rural Total (Families) Orphanages
11%
15%
22%
17%
72%
15%
23% 24%21%
72%
13%
18%
23%
18%
72%Male Female
Total
Reasons for Non-attendance
Yerevan Regional Urban Rural Total (Families) Orphanages
36%46%
54%48%
99%38%
39%
29%
34%
19%
18% 19%19%
6%
5%7%
7%9%
7% 4% 6%4%
2% 5% 4%
1%
The child was refused admission to school Distance/transportation
Parents see no need for school The school does not have sufficient conditions
Because of health condition Parents (guardians) think the child cannot study at school
HEALTHCARE
Children NOT under paediatric care
Yerevan Rural Regional Urban Total (Families) Orphanages
11%
23%
18% 18%
3%
13%
28%
20%
21%
1%
12%
25%
19%19%
2%
Male Female Total
Reasons for not being under paediatric care
Yerevan Regional Urban Rural Total (Families)
53% 52%43% 48%
19% 22%30% 26%
4%11%
23%16%
5%
13%
13%
12%
8%
16%
10%
12%
Insufficient Quality
Are not aware of the service
Service is not available in the community
Cannot afford the service
Parents think there is no need
Use of services as per the Individual Rehabilitation Plan
Physiologica
l
Moto
r
Visual
Auditory
Intelle
ctual
Combined
Epile
psy
Total
(Fam
ilies)
Orphan
ages
16%
30%
12%
23% 22%
32%
17%
23%
82%
Frequency of use of paediatric services
Daily Weekly Monthly 3-4 times a year 1-2 times a year Only if necessary
82%
7%4% 5%
2%3%
21% 21% 21%
33%
Families
Orphanages
Provision of Technical Devices
Yerevan Regioanl Urban Rural Total (Families) Orphanages
28%
24% 24%25%
22%
35%
33%
31%
32%34%
30%
27% 26% 27%28%
Male Female Total
Provision of Technical Devices
Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total
8%
43%
33%
75%
9%12%
3%
27%
Reasons for not getting rehabilitation services and technical devices
Other
Cannot afford
Service unavailable in the community
Parents see no need
Are not aware of the service
8%
13%
12%
26%
54%
8%
4%
87%
6%
Technical Device Rehabilitation
SOCIAL PROTECTION AND COMMUNITY-BASED SERVICES
Disability pension Other social protection/support
Medical Services Social Services
Payments
Yerevan Regional Urban Rural Total (Families)
29% 33% 33% 32%
57% 49% 50% 52%
25%16%
24% 22%
23%
29%31% 28%
9%
4%
5% 6%
Equipment Examination Medical Staff Medicine
No Payment
Yerevan Regional Urban Rural Total (Families)
91%82% 86% 86%
4%11% 9% 8%
2% 3% 5% 4%2% 5% 2% 3%
Hard to respond Disab pension provision
MSEC Evaluation No Payment
Daycare centers
Yerevan
Amavir
Aragatsotn
Ararat
Gegharkunik
Kotayk
Lori
Shirak
Syunik
Vayots Dzor
Tavush
Total
10%
9%
2%
3%
9%
0%
3%
8%
10%
1%
17%
7%
Yerevan
Amavir
Aragatsotn
Ararat
Gegharkunik
Kotayk
Lori
Shirak
Syunik
Vayots Dzor
Tavush
Total (Families)
Orphanages
14%
6%
14%
11%
12%
2%
11%
11%
15%
0%
12%
11%
83%
NGOs
Participation
© Armenian Caritas
Leaving home/orphanage premises
Physiologica
l
MotorVisu
al
Auditory
Intellectu
al
Combined
Epilepsy
Total (Familie
s)
Orphanages
1% 4% 1% 3% 4% 2% 2%
13%2%
4%1% 2%
4%6%
3% 3%
10%
5%
11%
5% 6%
11%11%
6% 9%
30%
93%
81%
92% 92%82%
78%
89% 86%
42%
0.05
Periodically, at least a few times a week
A few times a month
A few times a year
Only for visiting a doctor
Never/Rarely
Friends
Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total (Families) Orphanages
6% 12% 5% 4%21% 20%
8% 12% 16%
71% 65% 70% 71%54% 66%
67% 65%
3%
81% 71% 81% 79%55%
52% 78% 71%
6%
6%10%
12%28%
19% 9%
6% 12%
56%
57%45%
58%40%
27% 27%
50% 44%
6%
0.3
Children of the orphanage Non-disabled classmates Classmates/kids with disabilities Neigbour's children Relatives' children Has no friends
Participation in community events
Physiological
Motor
Visual
Auditory
Intellectual
Combined
Epilepsy
Total (Families)
77%
61%
76%
78%
54%
55%
66%
66%
Sports
Yerevan
Regional Urban
Rural
Total (Families)
Orphanages
17%
11%
5%
10%
1%
11%
4%
2%
5%
15%
9%
4%
8%
1%
Male Female Total
Physiological
Motor
Visual
Auditory
Intellectual
Combined
Epilepsy
13%
9%
14%
18%
6%
7%
8%
5%
6%
3%
6%
4%
2%
3%
11%
8%
11%
13%
5%
5%
7%
Art and Culture
Physiological
Motor
Visual
Auditory
Intellectual
Combined
Epilepsy
Total (Families)
Orphanages
13%
9%
16%
16%
6%
8%
10%
10%
9%
Family Awareness
UN Convention On the Rights of the Child
UN Convention for the rights of disabled people
RA Law “On persons in need of special conditions for education”
RA Law “On social protection of disabled people in the RA”
64%
66%
60%
59%
32%
31%
35%
35%
4%
4%
5%
6%
Completely unfamiliar Has Heard of Quite familiar
Priority Services
Yerevan
Regional Urban
Rural
Total (Families)
40%
63%
66%
58%
26%
34%
39%
34%
28%
30%
35%
32%
25%
33%
30%
30%
17%
6%
9%
10%
4%
4%
3%
4%
Specialized medical care Inclusive schools, preschools Special transportation Job Opportunity Leisure, playgrounds
Financial aid
Facts of Concern• 1 out of every 6 children with disabilities surveyed (16%) lives or studies in
seggregated settings (orphanages or special schools).
• Girls with disabilities are relatively more frequently taken to orphanages than boys, and are relatively less frequently visited.
• Only 1 out of every 20 children with disabilities (5%) in the orphanage attends a mainstream school; 23% attend special schools, and 72% do not attend school at all.
• 1 out of every 4 (23%) never leaves the orphanage or leaves the orphanage only for the health services.
• The majority (around 88%) of the children do not have friends without disabilities outside of the orphanage.
Facts of Concern• 1 out of 5 children with disabilities (18%) does not attend school. The
figure is 23% (1 out of 4) in the villages. Children with motor and intellectual issues are more likely to be out of school (26 to 27%).
• 51% of the parents of children not attending school in the regions and 36% in Yerevan believe that their child cannot study in school.
• 12% of the children with disabilities attend special schools, and 70% of them are in boarding settings. The figure is much higher for children with disabilities related to auditory (36%) and intellectual (25%) functions.
• Only 48% and 56% of the children with intellectual and auditory disabilities, respectively, attend mainstream schools.
• 1 out of 5 children with intellectual and combined disabilities (20%) does not have friends, and only half of them have friends among their neighbors (directly in their community).
• 1 out of 3 children with disability (33%) does not participate in community activities. Children with intellectual and combined disabilities are included less (50% of them do not participate in activities).
Facts of Concern
Facts of Concern
• 1 out of 4 children with disabilities (23%) receive services prescribed by the individual rehabilitation plan.
• 4 out of 5 children with disabilities (81%) do not receive services of social protection (support), other than the pension.
• 2/3 of the parents have never heard about the Republic of Armenia laws and international conventions related to disabilities.
Recommendations
• Actively seek out children with disabilities who are not certified and stay invisible to the social protection system
• Revise disability certification and service eligibility criteria based on the ICF principles (biopsychosocial model)
• Ease bureaucratic procedures and involve the multidisciplinary team directly working with the child
Improve identification and assessment procedures
Create a continuum of services for the child throughout the life-cycle
• Ensure cooperation between healthcare, education and social protection services (via the case manager) through mechanisms of referral, exchange of information and coordinated service provision to children.
• Create new community-based prevention and early intervention, as well as health and social rehabilitation and care services.
Enable access to all mainstream preschools and schools.
• Streamline the professional capacity and resources of special school towards inclusive education
• Sensitize and train the teachers and headmasters
• Ensure infrastructure accessibility
• Improve special education needs assessment procedure
Prevent Institutionalization of Children with Disabilities
• Prevent child abandonment through providing early and comprehensive information, services and support to children with disabilities and their families
• Provide alternative care within the wider family or in a foster family
Promote awareness to improve participation
• Organize campaigns
• Ensure active and appropriate media coverage
• Sensitize service providers and parents
personal contact with persons with disabilities
is the most effective way to influence
the way of thinking about disability
Thank you for your attention
IT’S ABOUT INCLUSION!