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Inclusive development strategies

FOCUS: inclusive strategies in the sectors of HIV/AIDs and inclusive employment

Inclusive strategies in the area of HIV/AIDS
Inclusive strategies in the sector of inclusive employment

Inclusive strategies in the area of HIV/AIDS

Introduction

This section proposes to focus on a ‘sectoral’ strategy of disability-inclusive development applied to the area of ​​HIV/AIDS. It uses the contents of the document "From Africa to Southeast Asia: Handicap International's work on HIV/AIDS."

It contains key ingredients discussed in previous sections of this chapter, including:

This approach is illustrated by a video that shows the experience of HIV/AIDS and disability in Cambodia.

HIV and disability inclusion

As a key development issue, Handicap International has been involved in the global response to HIV and AIDS since 1994. The primary rationale for Handicap International’s operational strategy on HIV and AIDS concerns the marked vulnerability to HIV/AIDS of people with disabilities, who constitute approximately 15.6% (11.8–18.0%) of the world’s population. People with disabilities have an equal or heightened risk of HIV infection1  compared to people without disabilites.

To date, HIV and AIDS remains one of the most widespread disabling epidemics worldwide. The disease leads to impairments, activity limitations and reduced social participation. This has a severe impact on quality of life, both for people infected with HIV and AIDS and their affected families and communities2.

Indeed, any person living with HIV/AIDS is likely to experience episodic and/or chronic impairments at different phases of the illness due to acquired infections and/or side effects from taking antiretroviral drugs.

People with disabilities who become HIV-positive might also undergo similar activity limitations, in addition to initial impairments. Furthermore, in light of the UN Convention on the Rights of Persons with Disabilities (2007), asymptomatic people living with HIV can also be considered disabled due to exclusion from social participation as a result of stigma and attitudinal and environmental barriers related to their health status.

To this effect, the UNAIDS Disability and HIV Policy Brief (2009)3 recognizes the relationship between HIV/AIDS and disability and stresses the importance of addressing both areas in an integrated fashion.

Salient highlights of the Policy Brief focus on:  

Current interventions

Capacity building

One of the main strategies adopted by Handicap International has been the building of the capacity of health facilities and project personnel to provide inclusive information and services. Training on disability and inclusion is a key means to embracing different views and positive behaviour changes, and imparting new knowledge and skills among health professionals and authorities.

Awareness-raising

Coupled with capacity building and training of health services providers, raising awareness of the intersection of HIV/AIDS and disability among target groups and populations, as well as their family members and community peers, has been pivotal in the implementation of all HIV-related projects. Awareness-raising is usually undertaken in people’s communities, through various methodologies such as education and communication and information (IEC) material, behaviour change and communication (BCC) strategies, peer education, mass sensitization, and the utilization of radio and television programmes, magnet theatres and group discussions alike.

Removing barriers and increasing accessibility

In line  with the social model on disability promoted by the UN Convention on the Rights of Persons with Disabilities, the guiding principles of Handicap International’s action have focused on removing the communication, physical and environmental barriers impeding or limiting participation and access of persons with disabilities to basic services. Specifically, efforts and tailored strategies have been put in place so that: there is representation of people with disabilities and other vulnerable groups in prevention and information messages; IEC materials are properly adapted to include sign language, Braille or large print; infrastructure and equipment are adapted to allow accessibility for all; and the location of buildings or meeting points are considered for accessibility of persons with impairments, young and older people, and sick people, as well as others due to distance, cost, or lack of assistive devices.

Policy change

By the same token, Handicap International is also working at the national level and with National AIDS Authorities, in order to lobby for the inclusion of disability in National AIDS Strategic Plans, to not only increase accessibility for all, but also to ensure persons with disabilities receive adequate and appropriate services in HIV prevention, treatment, care and support. Parallel efforts have been deployed to promote the inclusion of persons with disabilities in HIV planning not only at the regional and international levels, but among Development Partners and their funding mechanisms as well.  Furthermore, the promotion of national and international policies enabling the inclusion of disability throughout projects has been a driving factor towards the scaling up of services at Handicap International.

Significant participation of persons with disabilities

The inclusion of disability issues in the continuum of HIV services cannot be carried out without the participation, involvement and commitment of women and men with disabilities and DPOs. Their participation and input are crucial at all stages, from project design through implementation, to the monitoring and evaluation phases. Furthermore, their views of how best to design and implement HIV/AIDS services catering to their different needs have been integrated in order to keep the promise of universal access and reassert their ownership of the inclusion process.

Monitoring indicators and evaluation

Monitoring and evaluation indicators have been elaborated to track the number and sex of beneficiaries with disabilities, as well as other vulnerable groups. Furthermore, indicators of change (at beneficiary/community, service and policy levels) have been incorporated to enable the projects to better respond to their needs and determine whether project activities have been successful in reaching them according to set targets. Though specific strategies have been undertaken to improve project monitoring and evaluation systems, more effort is needed to fine tune the way a project addresses the HIV-related needs of beneficiaries.

Research and studies

To date, overall, there is still a paucity of research data and reports on disability inclusion at beneficiary, service and policy levels in HIV and AIDS programming. To address this issue, many of Handicap International’s current projects have conducted baselines, Knowledge, Attitudes and Practices assessments, studies and evaluations to increase the knowledge base and skills related to inclusion of disability and other vulnerable groups in HIV and AIDS programming.

In-house evidence has shown that while capacity building and awareness-raising are key, working on the policy front in tandem with national stakeholders and DPOs is necessary to promote and include disability more effectively and efficiently in HIV-related projects.

A video illustration: the HIV and Disability project in Cambodia

The HIV and Disability Project started in 2008 in 13 districts of Battambang and Kampong Cham. Its goal was to give access to information about medical, psychosocial and justice services to 520 Cambodians with disabilities, and to deaf women in particular.

The video presents the different steps of the project :

1) Building relationships in order to detect deaf women, integrate them in the project and communicate with the family to explain the project and reassure them,
2) Communication in sign language for reproductive health, sexual violence, HIV and AIDS,
3) DDP (Deaf Development Program) staff teaching HI project team Cambodian sign language,
4) Information, education and communication to resolve problems of communication with women who were not yet used to sign language and to study,
5) Training delivery with demonstrations containing pictures and explanations,
6) Linking learning to life situations,
7) Lessons learnt and recommendations (cooperating with parents and family, continuing sign language training).

Access the video (20 min):

Inclusive strategies in the sector of inclusive employment

Introduction

This part of the section focuses on possible strategies in the field of inclusive employment, reiterating important concepts and illustrating them on video through an innovative experience on the island of Reunion.

Inclusive employment of people with disabilities

Inclusive employment covers activities encouraging access to remunerative and decent employment. It concerns people with disabilities, whose job opportunities are significantly reduced.

The objective is to promote decent employment that generates incomes according to modalities focusing on development and poverty reduction under conditions respectful of freedom, equity, security and dignity.

To facilitate access to decent employment that generates an income, several actions are possible, according to specific needs and contexts: the main categories are vocational training, self-employment or employed work.

Vocational training:

This type of training is made up of learning techniques and ‘know-how’, and improving skills to prepare for a job. These steps are necessary for an individual’s vocational inclusive process. For people with disabilities, access to technical and vocational training and apprenticeship are essential. Preparing candidates for training, reinforcing initial skills before starting vocational training, ensuring that training processes are inclusive, following students and trainees, and adapting workstations, if necessary, are all crucial activities to improve access to salaried employment or self-employment opportunities.

Self-employment:

Self-employment means the creation of one’s own employment with the establishment of a micro-enterprise or the development of a revenue-generating activity. Self-employment accounts for 80% of employed people with disabilities in developing countries.
To support entrepreneurship, it is important to intervene on the qualifications, capacities, skills and knowledge of projects holders—mainly through monitoring and training services. It is also crucial to ensure access to capital through subsidies, contributions in kind or credits.
Microfinance provides poor people with the opportunity to access financial services such as credits or savings. People with disabilities have restricted access to microfinance, mainly because of discrimination and self-exclusion. It is important that institutions of microfinance learn to consider the specifics needs of people with disabilities. To this end, the training of staff can be conducted, along with the creation of partnerships with rehabilitation structures (to analyse the cost of adapting workstations and compensating for impairments) and social services.

Salaried employment: 

This covers permanent employment contracted by another person, company or organization. Encouraging access to wage employment for people with disabilities requires interventions involving several actors:

Access to waged employment for people with disabilities: an innovative project on Reunion Island

This video presents a project followed on Reunion Island from 2008 to 2010, which aimed to facilitate the employment of people with disabilities in the retail sector.

The project targets three clearly defined objectives:

1. Strengthen enterprise initiatives to recruit people with disabilities and include them in mainstream employment;
2. Ensure these people’s ongoing employment within the large-scale distribution sector;
3. Develop an internal culture of employment and inclusion and raise the awareness of all staff.

A number of arrangements necessary to carry out this type of project have been identified: mobilize and establish solid links between all socio-economic stakeholders, who have been clearly identified in advance; support each person with a disability in the company, case by case; rely on trained and mobilized people within the company to serve as a “driving force”; eliminate prejudice from the workplace; adapt the company to diversity; and develop an internal policy. Beyond providing methods and tools for employment and inclusion of people with disabilities, this project also reaffirms the key role of the employer and the company in the battle against workplace discrimination and the promotion of diversity in employment.

Access the video

 

 

Theme Name of the tool Type Author Language Description
AREA OF HIV/AIDS

Relation between HIV/AIDS and disability

Disability and HIV policy brief

Policy brief

WHO
UNAIDS

in English

Description of
actions
needed to increase the participation
of persons with disabilities in the HIV/AIDS
response

Implementation of National Strategic Plans inclusive of people with disabilities

Framework for the Inclusion of Disability in the National Strategic Plans on HIV and AIDS

Policy brief

UNAIDS
Handicap International

in English

Framework for the development and the revision of national strategic plans to include people with disabilities

HIV-related Policy and National
Progamming: How to Include the
World’s Largest Minority?

Manual

UNAIDS, Handicap International

in English

Skills Building Workshop Manual for
Participants at the XIX International AIDS Conference

The President‘s Emergency Plan for AIDS Relief: Technical Considerations

Guide

PEPFAR

in English

Tool for planning the inclusion of disability in HIV/AIDS programs

Examples  of the inclusion of disability in HIV/AIDS programs

From Africa to South East Asia:
Handicap International’s work on HIV and AIDS

Summary report

Handicap International

en Français in English

Overview of HIV/AIDS projects by Handicap International

Inclusion of persons with disabilities in HIV and SGBV programming in Cambodia

Information note

Handicap International

in English

Summary of the project in Cambodia on the inclusion of people with disabilities in the National Strategic Plan for HIV/AIDS

AREA OF INCLUSIVE EMPLOYMENT

Implementation of projects for the inclusive employment of people with disabilities

Inclusive employment:
How to develop projects which promote the employment of people with disabilities and
other vulnerable populations

Policy brief

Handicap International

en Français in English

This policy document discusses the organization’s mandate and values with regard to the field of inclusive employment. It is intended as a guide to the different approaches and reference tools used by Handicap International.

Achieving Equal Employment Opportunities for Persons with Disabilities through legislation

Guide

ILO

in English

This Education and Training Guide has been designed to
support improved capacity of governments in collaboration
with social partners and civil society agencies to design,
implement and evaluate legislation that effectively supports
equal employment opportunities for people with disabilities.

Examples of projects in inclusive employment

Microfinance for people with disabilities : an example of a project in Central African Republic

Feedback

Handicap International

en Français

The document relies on expertise developed on the socio-economic inclusion of people with disabilities and presents a feedback from a project in Central African Republic

Inclusive employment of people with disabilities, Bamako, Mali

Poster

Handicap International

en Français

Presentation of the PIPROH project to offer people with disabilities a facilitated access to vocational training and employment by integrating them in national action plans.

Improving access to livelihood opportunities for persons with disabilities in the post-tsunami context of Aceh Province, Indonesia

Capitalization document

Handicap International

in English

This document presents the project, the influence of the context, methodology and tools used, outcomes and perspectives

 

1. Groce, N. (2004). HIV/AIDS and disability: Capturing hidden voices. World Bank/Yale University.

2. Hanass-Hancock, J. & Nixon, S. (2010). HIV, disability and rehabilitation. Consideration for policy and practice. HEARD and University of Toronto.

3. UNAIDS/WHO/OHCHR (2009). Disability and HIV policy brief.