A teenage boy with Down syndrome sitting in a school classroom. He is wearing a baseball hat and glasses and leaning on one hand.
Anibal Alejandro (14) attending a mainstream school in Guatemala

Community-based inclusive development

Throughout this week, we’ve considered the broader needs of children with developmental disabilities and their families, but how can we bring about change in our communities to achieve disability inclusion and address these broad needs?

In this step, we will provide an overview of Community Based Inclusive Development (CBID), a person-centred, collaborative approach to achieving disability inclusion.

What is CBID?

CBID addresses the challenges to equitable and inclusive communities faced by persons with disabilities and their families. CBID is a person-centred approach where community members and community-based organisations take collective action to bring about sustainable change. Self-empowerment and participation of children and adults with disabilities is central to the approach.

Who is implementing CBID?

CBID is implemented by women, men, girls and boys with different types of disabilities, their families, communities and relevant health, education, transport, livelihood and social services. CBID is often facilitated and initiated by a group from outside of the community, such as Disabled People’s Organisations (DPOs), Non-Governmental Organisations (NGOs), faith based organisations, local or national governments and other community based organisations.

A boy with a hearing impairment is pointing at a book with images in. He is being supported by a woman. They are in a bedroom Leandro (8) attending speech therapy in Bolivia. © CBM/Foto Backofen Mhm

Key outcomes

CBID uses bottom-up, participatory approaches to help children and adults with disabilities realise their rights. Programmes can help ensure that services (including healthcare) are accessible, affordable, acceptable and of high quality. CBID programmes will include health, education, livelihood, social and empowerment activities.

In addition, CBID tries to make sure that children and adults with disabilities are adequately and appropriately supported to participate in family and community life. This includes strengthening peer support functions, local self-help groups and DPOs, as well as access to specific support, such as assistive technology.

Importantly, CBID promotes the voice and autonomy of children and adults with disabilities, and programmes work to reduce discrimination and prejudice.

Activity areas

CBID is founded on community mobilisation, in which action is stimulated by the community itself (with the help of facilitators). Programmes should be planned, implemented and evaluated by community individuals and groups.

To ensure community mobilisation, CBID activities will include:

  • Participatory mapping: to understand local stakeholders, resources, services, infrastructure and barriers to inclusion within a community.
  • Capacity building: to develop the community’s knowledge, change attitudes and improve ability, so action can be taken to improve accessibility of services and help children and adults fulfil their rights. Capacity building activities may include group discussions or training courses.
  • Awareness raising: to help reduce discrimination and change attitudes. Advocacy and awareness raising could include community gatherings, individual discussion or media campaigns.
  • Networking: between actors across different services and sectors, so they can complement each other’s approaches and processes.
  • Sharing, learning and accountability: continuous learning is vital if activities and actions can be changed and adapted to constantly changing context. Community members should have ownership and accountability for CBID. This will include community-led evaluation and research.

DPOs are integral to each of these activities and across CBID.

A teenage boy with cerebral palsy sitting at his desk in school Alexis (16) attending a mainstream school in Gahini, Rwanda. © CBM/Hayduk

Role of the healthcare professional

Children with developmental disabilities who are able to fulfil their right to community participation, education and social protection, will have better long-term health outcomes and an improved quality of life.

Healthcare professionals will not necessarily be a facilitator of CBID programmes, but they still hold a vital role in this framework. CBID for children with developmental disabilities and their families cannot be achieved unless professionals and organisations within key sectors work together with community members to improve inclusive care.

Healthcare professionals can work with children, parents, DPOs and stakeholders across other sectors (including other healthcare services, schools, local authorities, social care services, criminal justice) to improve the overall care for children with developmental disabilities. This will involve improving the accessibility to healthcare services, and healthcare professionals may also be engaged to help across other CBID activities, such as awareness raising and capacity building.

Healthcare professionals should keep themselves up to date on existing programmes and ask themselves how they can get involved and improve a child’s community and quality of life. A good way to do this is to engage with DPOs. DPOs can help review healthcare workplace policies and ensure they are inclusive of children with developmental disabilities. DPOs can also help ensure any health promotion activities engage with the targeted service users and can help reduce barriers to access. DPOs can also help healthcare professionals work with other sectors to address identified gaps and challenges to a good quality of life for children with developmental disabilities.

Discussion

  • How do you think healthcare professionals can contribute to CBID programmes?
  • How can a healthcare professional engage with DPOs to make sure healthcare is an important aspect of CBID?

In the next step, we will consider example of a collaborative programme in Pakistan, from DeafKidz International, which addresses a broad range of needs, including health, discrimination and inclusion, and access to education.

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This article is from the free online course:

Integrated Healthcare for Children with Developmental Disabilities

London School of Hygiene & Tropical Medicine