thurs. 5 december 2013 impact assessment seminar – phnom penh local assessment of the situation...
TRANSCRIPT
Thurs. 5 December 2013
Impact Assessment Seminar – Phnom Penh
Local assessment of the situation and access to services in Gabès and Douz-Kebili
• Population: 10.8 million (2012 source: Tunisian INS) • Per capita GDP: €7,300 (2012)• Territory divided into 24 administrative regions
Regions where the assessment was implemented
Focus on Tunisia
PRESENTATION OUTLINE
►PART 1: The VAPS assessment
►PART 2: Results analysis
►PART 3: Recommendations
PART 1 – The VAPS assessment
► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates
► b. Goals of the assessment
► c. Methodology
► d. Survey and sample zone
PART 1 – The VAPS assessment
► a. The VAPS project in the Gabès and Kebili governorates
► b. Goals of the assessment
► c. Methodology
► d. Survey and sample zone
► Purpose of the project
► Expected results in the two governorates:
► a. The VAPS project
Improve the quality of life, self-reliance and social participation of people with disabilities
R1: Increased participation of emerging self-advocacy movements of PWD and their families in local development processes
R2: Improved quality of services via concerted initiatives involving public structures, associations and self-advocacy movements
R3: Enhanced quality of services for PWD via the implementation of PSS (personalised social support) principles and tools
3 years (2012-2015)
► Budget€525,000 (75% European Union + 25% HI)
► Duration
► Beneficiaries
► Primary activities
► a. The VAPS project in the Gabès and Kebili governorates
► a. The VAPS project
- People with disabilities
- Local associations of people with disabilities
- Service professionals, local administrators of decentralised national services and local officials
- Participatory assessment of the situation of PWD, current status of the identified structures
- Support and capacity-building for self-advocacy groups in the two governorates
- Development of a space for member collaboration and training
- Training of professionals in personalised social support (PSS) for PWD and introduction of PSS in the two governorates
- Support for implementation of local initiatives
- Leverage of activities and sharing of best practices
PART 1 – The VAPS assessment
► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates
► b. Goals of the assessment
► c. Methodology
► d. Survey and sample zone
Know the social and economic characteristics of people with disabilities in the two governorates;
Compare the use and needs for various services of people with disabilities with the general population;
Determine the level of accessibility to services and identify existing barriers;
Analyse the system of actors and know the professionals’ practices;
Formulate a series of recommendations for local agents in the assessed territory by domain and sector of intervention.
► projet Vie Au
► b. Goals of the assessment
PART 1 – The VAPS assessment
► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates.
► b. Goals of the assessment
► c. Methodology
► d. Survey and sample zone
1
The method is global
2
The method is operational
3
The method is participatory
4
The method is dynamic
The assessment involves, informs and mobilises local agents in identifying, comparing and reporting data.
• Consultative approach• Enables joint reflection on:o Practiceso Needs of people with disabilitieso Attitudes of actorso Solutions to the problems
• Approach by: service sectors / professional profiles.
• An accessible, succinct and operational discussion document.
• Quantitative and qualitative elements for a global intervention strategy.
• Full status report on the situation and access to services.
► c. Methodology
IMPLEMENTATION OF 4 KEY PRINCIPLES
► c. Methodology
FIVE IMPLEMENTATION PHASES
•Design of methodology framework•Exploratory research
Phase 1: Preparation of the assessment
•Designation and training of survey administrators and tandems•Presentation of the assessment process to field agents
Phase 2: Launch of the assessment
•Quantitative study of the situation and access to services of people with disabilities•Service accessibility audit (audit checklist)•Examination of the needs analysis and needs solutions (focus groups)•Interviews with the region’s dedicated associations and stakeholders (in-depth interviews)
Phase 3: Field surveys
•Statistical analysis of the data collected (EPSOS, SPSS, Excel)•Critical review and discussion groups
Phase 4: Data analysis
- Publication of a report and summary document- Seminar to present results and recommendations
Phase 5: Data feedback
► c. Methodology: participatory process
VAPS project
PARTNERSHIP
UTAIM Gabès, AGIM Douz and Handicap International
Steering committee + project team
External consultant + polling agency
Participatory approachCreate a dialogue framework and
organise a field teamUnderstand the local contextCapacity-building for actors
Gabès2 UTAIM coordinatorsSelf-representative group (5 interviewer pairs)Project actors and stakeholders
Douz2 AGIM coordinatorsAutonomous representative group (5 surveyor pairs)Project actors and stakeholders
PART 1 – The VAPS assessment
► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates.
► b. Goals of the assessment
► c. Methodology
► d. Survey and sample zone
► d. Survey and sample zone
Quantitative survey:
Individuals surveyed1000
People with disabilities497
213 284
Control subjects503
190 313
People who responded to the surveyPWD sample
Number of individuals surveyedWho responded
Respondents with disabilities
► d. Survey and sample zone
140 structures audited
61
24
1
Gabès
31
Kébili
3
Douz
centre sportif
écoles primaires
école spécialisée
URR
associations
21 interviews with dedicated associations
6 focus groups with professionals
PART 2 – Results analysis
► a. Quantitative approach: social perception and socio-economic situation of PWD
► b. Accessibility of services by activity sector
► c. Qualitative approach: professionals’ practices
PART 2 – Results analysis
► a. Quantitative approach: social perception and socio-economic situation of PWD
► b. Accessibility of services by activity sector
► c. Qualitative approach: professionals’ practices
► a. Quantitative approach
► Method 1,000 individuals surveyed
► Outputs Quantitative data on the profiles of people with disabilities: age,
gender, family situation, education level, employment, disabilities Comparative data on social participation
➔ Identification of collective perceptions of Disability (beliefs, attitudes)
Relevance of the approach Limits to the approach
- Almost no existing data on the situation of PWD
- Initial situation indicators- Specific knowledge of the
region
- Leverage of results- Declarative- Filtering and eligibility of PWD via
Washington Group questionnaire- External professional survey
administrators
► a. Quantitative approach
► Results Perception of disability and social participation
Participation sociale et citoyenne PSH Non PSHAssister à un événement familial 66% 91%Visiter la famille en Tunisie 17% 32%Voyager à l'étranger 2% 6%Participer à un événement culturel 6% 12%Participer à une manifestation politique et syndical 4% 15%Membre d'un parti politique 2% 7%Membre d'un syndicat 4% 6%Membre d'une association de personnes handicapées 10% 5%
Social and civic participation*Take part in a family event
Visit family in Tunisia
Travel abroad
Take part in a cultural event
Take part in a political or labour demonstration
Member of a political party
Member of a union
Member of an association of people with disabilities
*: over the past 12 months
► a. Quantitative approach
► Results Perception of disability and social participation
43.4% of PWD voted in the last
electionscompared with
76.7%
Ability to carry out activities of daily life (go to the pharmacy, bank, hairdresser, market, grocer, Hammam, Hammas, restaurant, etc.)
Social and civic participation(participate in family, cultural, political, labour union, etc., event)
Difficulty with personal and family responsibilities (able to make decisions for oneself, for family, and benefit from family support in daily life)
PSH non-PSH40,80% 63,50%
PSH non-PSH13,90% 21,70%
PSH Non-PSH43,40% 31,10%
327
PSH
547
Non PSH
► a. Quantitative approach
► Results Socio-economic situation of PWD
Relative income (TND)
327
547
Education level reached PWD Non-PWDUniversity 6% 16.1%Secondary 30% 51.5%Primary 43.1% 29.2%No formal education 19.7% 2.4%Other 1.2% 0.8%Total 100% 100%
PART 2 – Results analysis
► a. Quantitative approach: social perception and socio-economic situation of PWD
► b. Accessibility of services by activity sector
► c. Qualitative approach: professionals’ practices
► b. Accessibility
► Method - 140 structures audited following mobility chain principle:Reach, Enter, Circulate, Use (RECU) + quantitative survey
► Outputs➔Accessibility measure using concrete indicators Quantitative data on the level of knowledge, need and utilisation
of the different services Identification and categorisation of barriers to access to these
servicesRelevance of the approach Limits to the approach
- Real movement towards mobilisation of PWD
- Indicators of initial accessibility situation
- Rates of attendance and utilisation- Figures to support advocacy- Specific knowledge of barriers
- Leverage of results - Mobilising and involving local
architects and decision-makers in collecting data would be useful
► b. Accessibility
Results Health services:
1) Level of accessibility / RECU standards
ReachAccessible exterior
EnterEnter the buildings
CirculateCirculate indoors without obstacles
UseAccessible toiletsAccessible informationReception of PWD
76% 58% 71% 55%
Scale Accessibility complies with regulations Rate between 70-100%Partially accessible Rate between 50-70%Non accessible Rate between 0-50%
► b. Accessibility
2) Level of knowledge, need, utilisation expressed in number of individuals
Knowledge Need UtilisationServices PWD Non-PWD PWD Non-PWD PWD Non-PWD
Basic healthcare unit 438 494 409 417 399 395
Physical rehabilitation service 183 205 128 51 78 19
Service providing technical assistance 119 153 71 20 35 5
Private physician’s office 272 386 170 200 105 144
Regional rehabilitation unit 94 128 53 12 26 5
Private clinic 224 331 133 144 28 56Psychological and psychiatric service 58 120 22 5 9 0
► b. Accessibility
3) Difficulty accessing services
4) Comparable satisfaction rate
Taux de satisfaction comparé des services de santé
Figure 1, source BJKA, Taux de satisfaction comparé des services de santé.
Oui Non
56,2% 43,8%PSH
60,4% 39,6%Non PSH
Difficulty in: PWD Non-PWD
Receiving care from a service 53.7% 7.5%
Paying medical costs 69% 13.5%
Entering and circulating in the services 56% 6.6%
Receiving information 53% 9%
Getting a proper reception 46.9% 10.1%
PART 2 – Results analysis
► a. Quantitative approach: social perception and socio-economic situation of PWD
► b. Accessibility of services by activity sector
► c. Qualitative approach: professionals’ practices
► c. Qualitative approach
► Method - 6 focus groups, 52 individuals representing: dedicated associations, local administrative officials, the various healthcare, education, vocational training, employment, recreation
professions.
► Outputs Identification of professionals’ perceptions of the needs of PWD Problem tree chart: Identify needs and barriers by sector Information about professionals’ practices
Relevance of the approach Limits to the approach
- Structure and organise the network of professionals
- Inexpensive and motivating tools- Launch a process of change for
practices
-Summary and qualitative analysis are challenging- No quantitative data to measure the
barriers named- Need to also involve the families in
reflection
► c. Qualitative approach
Needs related to vocational
training and employment
Guidance and information on
existing vocational and academic courses
Recognition and legal status for diplomas
from specialised institutions
Strategic repositioning of professional workshops and
production centre
Personalised professional and social support:
managing money, finding work
Micro-project financing
Advocacy for the right to work with local
companies
FG Results, vocational training and employment
► c. Qualitative approach
Needs of the dedicated associations:
Human resources
Operational effectiveness for better support of
PWD (PSS)
Financial resources
• Staff training• Recruiting of care staff• Involvement of families, network, etc.
• Financial resources targeting different governance: rules for good governance, professional practices
• More comprehensive case management• Person-centred support (decision-making
and involvement)
• Knowledge of funding bodies, drafting of grant requests
• Budget preparation and monitoring• Logistics support and assistance via
network development, etc.
PART 3 – RECOMMENDATIONS
► Recommendations by domain of intervention
► Recommendations by sector of intervention
► Towards the implementation of change indicators and monitoring tools
III – RECOMMENDATIONS
By sector of intervention:
Healthcare
Social services and programmes
Education
Employment and vocational training
Recreation
► projet Vie Au
III – RECOMMENDATIONS
► Recommendations by domain of intervention
Towards the implementation of change indicators and monitoring tools
Current status: Description of local target population / Initial situation indicatorsIdentification and analysis of system of actors
Assessment
Recommendations
ImplementationInformation
Evaluation
READJUSTMENT
Workshop
O
In
dica
tors
Method / Tools
Goal /
Purpose
Standards
Par
ticip
ator
y
appr
oach
Resources committed
Actors
invo
lved
Resistances
What we want to find
Obstacle
s/ What w
e want
to avoid
What we want to
involve?
How?