The role of the welfare and protection sectors to ensure realization of the rights
of children with disability
4th Central Asian Republics Child Protection Forum
Dushanbe, Tajikistan, 1-3 August 2013
Irina Malanciuc, Country Director for Lumos Moldova
Introduction
• Art. 23 Children with disabilities The right of the disabled child to special care, education and training designed to help him or her achieve greatest possible self-reliance and to lead a full and active life in society
Convention on the Rights of the Child
Education/training Health care services Rehabilitation services Preparation for employment Recreation opportunities Social security, including social insurance Expression of opinion and participation in decision making
Concepts
DisabilityNegative aspects of the interaction between individuals with a health condition and personal and environmental factors
Social protectionSet of public measures that a society provides for its members to protect them against economic and social distress, the provision of services and care, the provision of benefits for families with children
WelfareServices and institutions concerned with the physical, social, and psychological well-being of children, particularly children suffering from the effects of poverty or lacking normal parental care and supervision
Current situation
Between 500 and 650 million people live with a significant disability;
Out of these, around 10 percent are children and youth with different levels of sensory, physical and intellectual impairments;
Persons with disabilities account for up to one in five of the world’s poorest people;
Poverty, inadequate medical care and unsafe environments contribute to the incidence and impact of disability, and complicate efforts for prevention and response;
In many countries, by law, children are covered under different types of social assistance benefits; yet, difficulties exist in accessing benefits, doubled by their low financial value.
Challenges
Insufficiently accessible and flexible universal services;
Lack of family- and community-based alternative to institutionalization
services;
Lack of specialized services that could meet the needs of children and
young people with disabilities at all ages;
Segregated education system;
Lack of an integrated system of services;
Lack of professionals with specialized skills to address the needs of children
with disabilities;
Insufficient interagency working in relation to children and families;
Discriminatory practices and attitudes;
Lack of protective legislative measures in the domain of
education, employment and housing of young people with disabilities.
As consequences
1) Families taking care of children with disabilities don’t have
access to services, benefit of limited support, and in most
cases live in extreme poverty.
2) The countries of Central and Eastern Europe (CEE) including
Commonwealth of Independent States continue to rely on
the placement of children with disabilities in large residential
institutions.
Institutionalized children with disabilities
Are isolated from the community, having little opportunity for inclusion in normal everyday life and experiences;
Live in large groups of non-family members who are compelled to live together;
Experience prolonged separation from their families, friends and communities;
Are organized according to a restricted routine that cannot respond to the individual needs and wishes of the children;
Are segregated based on diagnosis of disability faraway from their communities of origin.
Views on vulnerability
vulnerability
exposure of individuals
and households
to risk
limited capacity to
respond and cope
Vulnerabilities are shaped by underlying structural social, political and economic factors. Economic and social problems increase subsequently the family poverty.
Social protection must work on both reducing exposure to risks and strengthening individuals’ and households’ capacities to deal with these difficulties.
Social protection components
Key
components
Social transfers
Programmes to ensure access to
services
Social support and
care services
Legislation and policy
development
Social transfers
Cash transfers: pensions, child benefits (social allowances), targeted social assistance, special social benefits and benefits for children with disabilities, seasonal support;
In-kind transfers, i.e. school feeding programmes, schoolbooks, clothing, food transfers, nutritional supplementation;
Public works, i.e. special type of transfer (usually cash or food) that is given on completion of a work requirement generally to increase workers’ income.
Programmes to ensure access to services
Birth registration;
User fee abolition;
Health insurance;
Exemptions, vouchers, subsidies;
Specialized services to ensure equitable access for all.
Social support and care services
• Early intervention, juridical, psychological, educational support to the child and his/her family
• Day care centre for children
• Respite services – foster or residential type of service
• Personal assistant
Family support services
• Ergo-therapy, physiotherapy/kineto-therapy, speech therapy, psychological assistance, etc. – provided within specialized facilities, but also as outreach services
Rehabilitation services for children
with disabilities
• Emergency services
• Foster care and small group homes for children separated from their families
• small group homes, protected houses, social apartments for young people leaving care
Family substitute services
Legislation and policy reform
Minimum and equal pay legislation;
Employment guarantee schemes;
Maternity and paternity leave;
Removal of discriminatory legislation or policies affecting service provision/access or employment.
Integrated social protection systems
Address both social and economic vulnerabilities;
Provide a comprehensive set of interventions based on assessed needs and context;
Go beyond risk management interventions and safety nets to integrate responses to structural as well as shock-related vulnerabilities;
Facilitate multisectoral coordination;
Coordinate with appropriate supply-side investments to enhance availability and quality of services;
Frame social protection strategies within a broader set of social and economic policies.
Development of social protection system
Central level – design of system
Local level – planning and implementing
Individual level – case management
Inter-sectoral coordination needed at each level
The design of social protection systems and services
Vulnerability and child poverty assessments – better understanding of risks faced by children with disabilities – better decisions upon interventions
Institutional frameworks and mechanisms existing in the state –comprehensive strategy/policy establishing the country’s approach to social protection – provide strategic guidance and oversee implementation
Monitoring and evaluation plan – effective policy tools in social protection sector – provide evidence to strengthen support for particular interventions regarding children with disabilities
Participation – key stakeholders, civil society, citizens (beneficiaries and non-beneficiaries, including children with disabilities)
Social planning
Government agencies engage in large-scale
development, research, and planning to address
social problems
Non-profit agencies, local planning
councils, and community groups plan services and programs to address community
needs
Social planning at local level
1. Social protection financing:
re-allocating current public expenditures is the most orthodox option, which includes assessing ongoing budget allocations through public expenditure reviews and thematic budgets, replacing high-cost, low-impact investments with those with larger socio-economic impacts, eliminating spending inefficiencies and/or tackling corruption;
2. Transparent governance structures:
local public authorities should focus on justifying the expectations of the citizens regarding quality life improvement and on offering solutions to problems;
Social planning at local level
3. Sequencing and prioritization:
by keeping the logical sequence of activities related to social planning and by putting the real priorities first, local public authorities can achieve better results with impact on the lives of children with disabilities and their families;
4. Institutional capacity:
the continuous training of personnel from social services shall be included in the general social planning process at local level in order to ensure that they know and use the most recent techniques and tools in working with the children with disabilities and their families.
Case management
Case Management is a method of providing services
collaboratively by assessing the needs and
arranging, coordinating, monitoring, evaluating, and advocating
for a package of multiple services to meet the specific complex
needs;
Case Management addresses both the individual child’s
biopsychosocial status as well as the state of the social
system, the intervention occurs at both the child, his family and
system levels;
Case Management includes linking the clients with systems, that
will provide them with needed services, resources, and
opportunities.
Case management process
Identification Evaluation Planning
ReferralMonitoringClosure of
case
The case manager coordinates the whole process, acting as key point for the beneficiaries.
The children with disabilities and their families are part of this process.
Different professionals are involved based on the needs of the child and his/her family.
General recommendations regarding welfare and social protection sectors
Maximise impacts by integrating social protection efforts;
Maximise impacts by developing guidance on how to implement and enforce existing legislation;
Extend reach of social assistance schemes by reviewing eligibility criteria and application processes for means-tested social assistance;
Extend reach of social protection through awareness-raising and pro-active search and support to vulnerable families;
Strengthen equity in provision of social protection;
Continue drive for non-institutional care solutions;
Ensure evidence-based policymaking by developing effective monitoring and evaluation systems.