CRS Capacity Overview Disability Inclusion

People with disabilities account for 15 percent of the world’s population — over a billion people. They are a part of every society. Many face social, economic and cultural barriers that limit their access to full and effective participation in society.

Barriers include economic empowerment, education, basic social protections, and employment and health services. These barriers, combined with physical, mental, intellectual or sensory impairments, contribute to poverty and disempowerment. The United Nations Development Program estimates that 80% of all people with disabilities reside in low-income countries. And while people with disabilities represent approximately one in nine people worldwide, they represent one-in-five of the world's poorest people. CRS’ programs for people with disabilities expand access to services such as education, early childhood development, food security, livelihoods, family strengthening, and humanitarian relief services around the globe. 

Using a rights-based approach, activities are adapted to ensure people with disabilities can fully participate in a safe and dignified manner. This requires creating awareness of disability and its implications, addressing barriers to participation (physical, communications, financial, attitudinal, structural), and creating opportunities for people with disabilities to actively participate.

Our projects integrate principles of non-discrimination, full and effective participation, and accessibility across all sectors.

 

Children with intellectual disabilities and those without play together in Nairobi’s Kawangware informal settlement, thanks to Special Olympics, CRS and the Adventist Center for Care and Support (ACCS). The Young Athletes program helped children develop vital motor skills and social interaction.

Photo by Philip Laubner/CRS

 

Tools

Quality Early Childhood Environments for Young Children is CRS’ early childhood development (ECD) curriculum for practitioners and caregivers of children ages 0-5 years. It includes disability-specific information on development and intervention, assessment of young children’s development, quality early childhood environment, and special needs and protection. The curriculum has been used since 2016 in Malawi, Kenya, and Zambia.

In 2017 through its inclusive education programming, CRS Laos developed an interactive training to raise community awareness and understanding about how to support people with disabilities. Jointly facilitated with the Lao Disabled People’s Association, the three-day Community Based Rehabilitation (CBR) training includes village education development committees, health professionals, and schoolteachers.

Participants learn disability prevention and identification, maternal child health promotion and access to health services. They become more aware of challenges faced by persons with disabilities which enables overall community support.

In 2020 under Changing the Way We Care, CRS has developed three tools to support disability inclusion in the context of care reform. These include:

• A disability reflection workshop guide that serves as an entry point for CRS and partner staff to begin addressing disability inclusion in care reform..
• Best practice guidance to reintegrate children with disabilities from residential care to family care settings
• A communications toolkit for supporting community-based messaging in support of family care for children with disabilities.

In  humanitarian relief and development programs, CRS is using the Washington Group Secretariat’s Short Set of Questions (WGSS) and the UNICEF Module on Child Functioning to identify disability in both mainstream and disability-specific projects.

 

Food Security

Food insecurity can lead to disability through poor living conditions, malnutrition and lack of access to health services. Further, disability can lead to food insecurity and poverty through lack of education and employment opportunities, low access to social services and lack of assistive technologies. 

In Ethiopia, CRS leads two USAID Bureau of Humanitarian Assistance-supported projects that improve people with disabilities’ access to food security programming.

In 2019, the projects included a barrier analysis among people with disabilities and their access to food distribution sites and food delivery process. As a result, the project now disaggregates data by disability at registration and during routine monitoring. CRS is committed to understanding the context in which we work and adapting programming accordingly.

In 2020 with Humanity and Inclusion, CRS identified entry points for improved services to people with disabilities, including a review of disability inclusion in the workplace and extensive recommendations to strengthen policies, procedures, and culture for a more inclusive work environment.

In Niger and Madgascar, CRS’ Bureau of Humanitarian Assistance-supported food security projects have forged partnerships with national organizations of persons with disabilities and leading international disability organizations (CBM and Humanity and Inclusion, respectively). These partnerships ensure staff have the skills, knowledge, and attitudes necessary to promote inclusion and full participation of people with disabilities.

 

In Sri Lanka, with 1.75 million people over the age of 5 living with some form of disability, prevention and assistance are national health priorities. Caritas-Valvuthayam runs a center for people with disabilities to aid them with assistive devices, physical therapy and wraparound services.

Photo by Jennifer Hardy/CRS

 

Rehabilitation

Rehabilitation helps people be as independent as possible in their everyday activities, enabling participation in education, work, community and family. It addresses underlying conditions while improving daily functioning to overcome challenges with thinking, seeing, hearing, communicating, eating, and movement.

The global need for rehabilitation is largely unmet, with WHO estimating that in some low and middle income countries, more than 50% of people do not receive the services they require. Where services do exist, the COVID-19 pandemic has largely disrupted them. CRS is expanding access to quality rehabilitation services in partnership with organizations of people with disabilities and government structures.

QADER, a national organization of people with disabilities in Palestine, developed MOVE, a specialized methodology that trains children with severe and complex disabilities to achieve independence, dignity, and holistic lifestyles by improving their motor functioning skills. In partnership with CRS Gaza, QADER trained the Missionaries of Charity to provide high quality physical rehabilitation services to children with disabilities.

In Vietnam, the  USAID-supported Hold My Hand project serves 3,000 people with disabilities with interdisciplinary rehabilitation and community-based depression management. Activities strengthen the rehabilitation system by building capacity of district and provincial hospital staff in interdisciplinary rehabilitation while providing home-based palliative care and referral for people with severe disabilities.  

 

Livelihoods

CRS’ inclusive approaches to livelihoods expand meaningful employment opportunities for people with disabilities. Employment is central to overcoming poverty and maintaining a decent standard of living for people with disabilities and their families. Opportunities to work increase their ability to participate fully in society. Yet, people with disabilities are more likely to be unemployed, face greater economic inactivity, generally earn less than employees without disabilities, and have less access to social protections that help reduce extreme poverty. Unemployment among people with disabilities who are able and willing to work is as high as 80% in some countries.

The Prosperity and Advancement for Palestinian Women and Youth (SALALEM) project in Gaza and the West Bank increases the agency of young women and youth with disabilities. More than 3,000 participants will gain critical life skills and nearly 2,500 will participate in on‑the‑job learning, while building professional networks.

Simultaneously, the project aims to reduce barriers to workforce participation by increasing buy‑in from participant’s families, improving workplace accessibility, and promoting community acceptance. By improving skills and decreasing barriers, young women and youth with disabilities will have improved learning outcomes, better enabling them to enter and remain in the workforce.

Since the start of the COVID-19 pandemic, SALALEM has transitioned to online training platforms to continue delivering vital life skills and job training to participants despite pandemic-related restriction on group gatherings.

 

Jelane Getu, a project participant who has a disability, sits with her husband Getu Erbein front of their temporary shelter that can later be converted into a permanent home in Soddu village, Ethiopia.

Photo by Will Baxter/CRS

 

Emergency Response

People with disabilities are disproportionately affected by conflict and emergencies, yet often fall through the cracks of disaster preparedness and humanitarian responses. They are among the most marginalized people in crisis-affected communities, experiencing a mortality rate that is two to four times higher than that of people without disabilities.

Following the 2019 Anglophone crisis in Cameroon, CRS’ response sought to identify and register  participants with disabilities. During monitoring visits, it was observed that some of the participants with disabilities do not have optimal access to the market and to food once in the vendors' shops. During closeout, the team conducted focus group discussions to better understand the challenges participants with disabilities have faced during the project and adjust for the next phase. This included prioritizing people with disabilities during market transactions through sensitization of vendors and proactive follow-up by the team, adapting communication strategies  for participants with hearing and speaking impairments, and reviewing accountability mechanisms to include protection challenges.

In Uganda, CRS’ Education Cannot Wait project builds and furnishes classrooms in Bidibidi refugee settlements. To accommodate children and teachers with impaired mobility, all CRS-designed school  classrooms, sanitation facilities and administrative blocks include sloping access ramps with a gradient less than 12% and all sanitation facilities include supporting rails and a sizeable cubicle to accommodate a wheelchair. More than 7,000 students use these new facilities. People with disabilities have been active participants in project monitoring.

 

Sok Chen, age 5, cannot speak and requires assistance with mobility, eating and personal care. Through CRS support via private funds, his school made modifications so he could attend each day. The project helped install a ramp at the school, provided a school kit of books and a uniform, and works with teachers, administrators and students to help include children with disabilities into all parts of the school day.

Photo by Jennifer Hardy/CRS

 

Education

Inclusive education is about changing the way education is delivered so it is accessible to students of all abilities and needs. CRS’ inclusive education work recognizes that children may face multiple forms of exclusion and discrimination, and therefore may require additional and more individualized support. Programming in this area includes five main components:

• Advocacy and support to government officials to develop inclusive policies and plans
• Capacity-building of community organizations to raise awareness and make education more inclusive
• Infrastructure improvements, screening services, assistive devices, and linkages with health and social service providers
• Training of teachers, administrators, and parents in inclusive education strategies and tools
• Guidance to students to provide peer support and establish a ‘circle of friends’ for those needing extra help getting to school and participating in the classroom.

As part of its USDA Food for Education project in Laos, CRS developed a community based rehabilitation guide to support inclusion and fight discrimination against children with disabilities in schools and their communities.

In 2019, CRS partnered with the government of Cambodia to produce new technical materials  to help families and educators use local materials to construct toys and games and engage preschool-age children in play at home and at school. The Minister of Education has officially endorsed the Toys and Games Manual and Screening Guidelines and encourages their use by all education actors and stakeholders across Cambodia. Official government support means that nationwide, more than 13,000 preschool teachers and administrators will have new tools at their fingertips to meet the individual needs of their students. Additionally, parents and guardians of every preschooler in Cambodia can access information about numerous low-cost educational games for their children, which they can recreate at home.

In Kenya, CRS partnered with Special Olympics from 2015-2018 to deliver inclusive Early Childhood Development (ECD) services to 365 children with intellectual disabilities and their caregivers in informal settlements of Nairobi. In collaboration with community health volunteers, social workers, physiotherapists and Special Olympics staff, the project improved children’s social, physical and cognitive skills through inclusive therapeutic play activities. The play sessions, based on the Special Olympics’ Young Athletes model, were implemented at weekly sessions at ECD centers. Monthly home visits helped caregivers learn parenting, hygiene and sanitation, and nutrition skills to support their child’s development. Adults with intellectual disabilities provided additional support to children and their families on discipline techniques, toy-making, modeling play relationships between caregiver and child, and social skills. Now two years after implementation, these community-based ECD services are still functioning independent of donor funding.

For more information, please see CRS’ capacity brief on inclusive education, which highlights additional examples of our work.

Family Strengthening

Caregivers of children with disabilities often lack access to specialized community and facility-based resources to promote healthy growth and development of their child, address their own self-care, and provide a nurturing environment for the child. When left unaddressed, these factors limit the child’s overall wellbeing and often result in protection issues as well as child-family separation.

To enhance sustainability and service coverage to underserved marginalized populations, the PEPFAR-supported Pathways project in Zimbabwe is mainstreaming disability inclusion into its social services system strengthening for HIV-affected vulnerable children In 2021. The project aims to screen and assess 780 adolescent girls and young women with disabilities,  then build referral networks for  disability-specialized support including assistive devices and rehabilitation. Pathways will train and mentor  health care professionals, teachers, and reach nearly 900 communities with disability inclusion sensitization campaigns. Pathways will also advocate for disability inclusion into the national HIV strategic plan.

Changing the Way We Care has prioritized efforts to prevent family-child separation and promote family-based care for children with disabilities in Guatemala and Kenya. CRS and partner staff are using a collection of disability inclusion resources to build their capacity to work with these children with disabilities, promote sustainable reintegration models for children with disabilities into family care, and improve community sensitization campaigns around the right of children with disabilities to live with a family.