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Implementation of Case Plans – a multi-sectoral approach and access to services and information

Implementation of Case Plans - a multi-sectoral approach and access to services and information
Hello, my name is Richard Munyaneza and I work as a Psychologist for Hope and Homes for children in Rwanda. Hello Richard. Thank you so much for joining us. Please can you tell us some of the challenges you’ve been facing in delivering child protection services during the lockdown in Rwanda. Now that the lockdown has been installed in our country we were delivering services to families that have received children from an institution of children with disabilities. The challenging was the fact that it was not easy for us to have access to the family. We were using phone calls to contact the families only.
And all the services in our country were restrained and we had to search in the community people who could reach out to the families directly who could have access to the family so that we can keep on providing other services to the families in need. And please can you tell us how you’ve overcome some of those challenges? Well it was not an easy thing for us to identify the right person who could have access to their families during the lockdown of COVID-19. There was a case of a child who is 6 years old He has been reunited with a mother 6 months ago from an institution of children with disability.
There was a Care Plan already designed for the child for health, for living condition of the family, and the economy of the family so that the mother can look after the child. And it was not an easy thing for us to implement the Care Plan designed for the family and the child as well. To make sure we are at least putting into action some of the, of the details of the Care Plan, we have to identify the right person in the community so that they can support the child and the mother as well.
For example, the child was in need of medication for her mental health so it was not an easy thing for the mother to get the medication for the child. Because the child needs medication from a specialised hospital and the specialist hospital is at 100 kilometers from where the family lives. And to get a medication the mother has to travel like those kilometres to get their medication the child. And to make sure the child has those medications, we have identified in the community a nurse at the Help Centre so that the nurse can help the child to have those, to have those medications.
The nurse has registered the care of the child, has written down all the details of the child and she has transferred the details to the district hospital and this district hospital transferred the details to a referral hospital, a specialised hospital. And the doctor at the hospital has prescribed the medication for the child and within two days the mother has got the medication for the child and she has kept on giving the medication for the child and it was a good thing for the child to keep on having the medication for her mental health. And another thing is was that the child was in need of physiotherapy sessions.
Before the reintegration of the child we have trained the mother for those basic physiotherapy sessions. But we knew she could be benefiting from advises from a physiotherapist. So we have identified and linked a physiotherapist to the family so that the mother can benefiting from, so that the mother can have advice from the physiotherapist to give those detail and basic physiotherapy sessions of strengthening and relaxing the exercises for the child. Another things we knew was that we needed to have access to accurate information about the situation in the families. In the community there is a group of people. A group of people that have been trained by the Minister of Health.
They are community workers at the ground, at the community level. They are trained to deliver those little services, little help services to the community and families in need. And we have, they were mandate just to give information to inform the people about the COVID-19 measures that had been installed by the government. So we have use of them so that we can have accurate information.They were allowed to have access to the family to visit the family. So we have use of to them to have some information about how the family are dealing with the lockdown. And not only those groups of people.
There are also other groups of people at the community level already identified before the lockdown who has been trained, who have been trained by the government as well. And those people are Friends of Families. Friends of Families are social protection group at the community level. They are mandated to look after children and report any abuse case that have, can be, in the community. We have engaged the Friends of Family to support the mother on how she has to look after the child and how to prevent from any kind of abuse during the lockdown.
Not only the Friends of Family groups but also there is another group that has, that we have used during the lockdown and the group of people with disability. There is a committee of People with Disability from the National Council for People with Disability already installed at the community level. They are mandated to follow up people with disability. So we have used them so that they can via phone calls, because they know the family, they have been linked with the family. They live in the same neighborhood so they can have accurate information on how the family is dealing with the lockdown and to provide for us accurate information.
We have kept on also providing counseling session via the phone to families to help them understanding the regulations and recommendations given by the government of Rwanda. And as well providing counseling sessions for them for any issues they are having, anything they are dealing with to help them overcome the challenges. It was a good experience for us to know there’s another kind of way we could support the family even in hard condition as the lockdown, and it was a learning period for us to adapt on how we deliver services to the family, on how we support families. And it was a really interesting experience for us to to identify those services at community level to support the family.
Another thing we have done is we have mapped services that the government is providing to the families, such as providing food for vulnerable families. For any family that was in need of food support we would link the family to the services the government was providing so far. Thank you so much.

Case implementation involves transforming a child’s Case Plans into real actions. As we discussed in the previous course step, within the Case Plan will be details of which services will be provided, taking into consideration any current restrictions. It is important the assigned caseworker remains responsible for overseeing the implementation of the Plan and coordinating the delivery of services and other support.

In this video you will hear from Richard Munyaneza who is a psychologist working for Hope and Homes for Children in Rwanda. Richard explains some of the challenges of implementing child protection case management during lockdown in Rwanda. He tells us about the case of a young child who was reunified with their mother from a residential institution for children with disabilities before the lockdown. Richard speaks about how some of the challenges in implementing the child’s Care Plan have been overcome by working in extended partnerships with local service providers and community groups.

Delivery of services

During the COVID-19 pandemic, working together to achieve the actions and delivery of services identified in a child’s Case Plan will also require ongoing updating of referral pathways to different services, regularly updated directory of services, and ways to refer children – and caregivers when needed – to those services. This might include healthcare, alternative care, cash assistance, water and sanitation, food distribution, legal services and other support services etc. It may also mean a role for members of community-based groups as we discussed in course step 10.

Let us remind ourselves of some of the information this directory should contain:

  • What a services can provide
  • How they can be accessed during the pandemic
  • Named focal points and other contacts – and how to reach them
  • Which teams from which services are still able to safely visit children and caregivers
  • Which facilities such as health centres, police stations etc. are open and safe to visit. When they are open and perhaps maps of where they are.

Implementation of case plans during the COVID-19 pandemic might also mean services and other support is provided to the places a child is living if possible, rather than asking the child to visit another location. If you are visiting a child but you are not a child protection caseworker, please be careful about how you communicate with the child and don’t seek information that does not relate to the service you are offering, or as agreed with the child’s caseworker.

Connecting with children and caregivers

For those of you who are caseworkers connecting with a child and caregivers – or other trusted adults in contact with the child – please also refer to the guidance issued by the Alliance for Child Protection in Humanitarian Action in response to the COVID-19 pandemic. The information below has been adapted from this guidance and includes:

  • Make inquiries about the health of those in the setting the child is residing – before or at the beginning of any interaction – and where necessary, support a referral to a health service provider
  • Reassure the child and relevant caregivers, or other trusted adults, that they will have ongoing contact with a caseworker
  • Inform the child and relevant caregivers, or other trusted adults, about what will happen and how you will communicate with them
  • Make sure the child, relevant caregivers, or other trusted adults, know how to contact the caseworker in the event of an emergency
  • Develop or update safety plans with the child including who and how to contact someone they trust if they are being harmed
  • Document all the interactions with child and relevant caregivers, or other trusted adults
  • Provide key messages and information that focus on stress reduction, parenting, child development, social and emotional learning, safety, how to access services, etc.

It is also important to consider safety considerations for anyone accessing services during the COVID-19 pandemic, as well as those of you who are front-line workers, and how to keep yourselves safe. We will explore this topic in course step 26.

The ‘See Also’ section below has links to other reading material that may be of interest to you.

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COVID-19: Adapting Child Protection Case Management

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