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Community based inclusive development

Joerg Weber provides overview of community based inclusive development and Maria Zuurmond gives an example from a parent training programme in Ghana.
JOERG WEBER: In this step, we will introduce community based inclusive development, or CBID, and present a related case study. CBID is a person-centered approach where community members and community-based organisations take collective action for achieving disability-inclusive development within their communities. CBID addresses challenges for people with disabilities, their families, and their organisations, especially working in situations of poverty. CBID particularly promotes the participation and voice of people with disabilities in decision-making processes at the local level, and it aims to ensure services, such as health, education, livelihood, and social, are accessible to all people with disabilities, whether women, men, boys, or girls.
CBID programmes include health, education, livelihood, social, and empowerment activities, working closely with local partners, local governments, and representative groups of people with disabilities to bring about change. CBID actively seeks to ensure the full participation of people with disabilities as empowered self advocates in all development processes and works to address the barriers which hinder access to mainstream services and participation in diverse community activities, as well as access to impairment-related services. CBID programmes and initiatives may be the only possibility for improved quality of life for people with disabilities living in the poorest communities, where limited local infrastructure is in place. For example, in many communities, children with disabilities don’t attend school.
Working with local education bodies, parents of children with disabilities, and disabled people’s organisations, DPOs, have successfully convinced parents to send their children to school, motivated local schools to enrol children with disabilities, and worked with school authorities to make school buildings more accessible and education provision inclusive. CBID initiatives aim at working across disability. They include women and girls, infants, and young children, people with complex disabilities, people who are deaf, deaf-blind, and people with intellectual and psychosocial disabilities, and older people with cognitive impairments, like dementia. CBID aims to identify and build on good practices, support innovation, and ensure particularly marginalised people engage in planning, implementing, and evaluation processes.
Improved development outcomes are the results of the quality of work of multiple actors and the effectiveness of their interactions. Sustaining development outcomes depends on the sustainability of the local system– specifically, durability and adaptability that allow actors and their relationships to accommodate shocks and respond to changing circumstances. CBID initiatives, therefore, target and strengthen inclusive and effective local systems in health, education, livelihood, and social security, working with local governments as well as local functions of national systems by contributing to strengthening these systems and supporting the participation of people with disabilities to claim their rights. CBID works with existing community programmes and the initiatives are community-owned and directed. It is important to notice, however, that in many places, local systems are weak.
Our aim here is to ensure people with disabilities have increased access to services and opportunities as close to home as possible, or to link them with services not available at the community level through established referral systems. The overall aim is to ensure these services are linked to the appropriate government system service provider to the greatest extent possible, so they work better together and are more effective and inclusive. CBID builds on the resources available in the community, including material resources and human resources. Additionally, CBID particularly promotes the participation and voice of people with disabilities in decision-making processes at the local level. People with disabilities are encouraged to take on leadership roles in planning, implementing, monitoring, and evaluation processes.
Twin-track means that CBID idea ensures that services in a community, both mainstream and disability-specific, are accessible for people with disabilities. Barriers to participation are being removed, and the change is reflected in inclusive programmes that result in equal participation in cultural, religious, political, and social events, including accessible features such as universal designs, communication features, accessible media, and technology. This can be achieved by expanding existing services to include people with disabilities by using existing structures, such as school, local hospital and health centres, faith-based premises, and government institutions.
MARIA ZUURMOND: An example of community-based inclusive development is a training programme with parents of children with disabilities, developed for working in low and middle-income countries. The focus of the training is with children with cerebral palsy. This is the most common reason for childhood disability globally. The training is called Getting to Know Cerebral Palsy and works by establishing local community support groups at community level with parents and caregivers. It’s a participatory training programme which aims to empower caregivers. The training is modular and follows some basic aspects of caregiving and talks about disability rights and disability in your community. The focus is on adult education, taking a problem-solving approach and being participatory.
It’s about building the capacity of caregivers, facilitating peer support, and strengthening support networks for the longer term.
Here is an example of how caregivers can learn simple techniques around positioning. If you look at the pictures, how is the child before and then after the training?
This slide shows a support group in the Upper East region of Ghana. A group meeting of caregivers and their children are discussing the daily challenges and coping strategies.
Community engagement is key to change. For example, many caregivers may experience stigma and discrimination from community members, and so any programme needs to engage with community members. This can take many formats, depending on the country and the context. In this slide, there’s a community meeting called a ‘Durbar’ to discuss the training programme with other community members. At the end of the training, many of the mothers also talked on the local community radio about their experience in the training, and this resulted in a wider discussion about the lives of children with cerebral palsy and their parents.
A key focus of the training is around empowerment, which is also a core component of community based inclusive development. This is a picture of one of our grandmothers, who describes the value of collective sharing of problems and finding solutions.
All of the materials that we have shown are free to download on our website and in the links below, so do take a look.

In this Step, Dr. Joerg Weber from LSHTM and CBM provides an overview of community based inclusive development. Maria Zuurmond (LSHTM) then provides an example of a CBID programme from her research in Ghana.

Community based inclusive development (CBID) is a person centred approach where community members and community based organisations take collective action for achieving disability inclusive development within their communities.

Dr. Weber details some of the following key principles of CBID: ensuring the full participation and empowerment of people with disabilities; working cross disability and cross sectoral (health, education, livelihood and social security etc.) with multiple actors; and working within existing community programmes building on the resources available. He emphasises the importance of twin track so CBID ensures that services in the community (both mainstream and disability specific) are accessible for people with disabilities.

Maria then provides an CBID example of a training programme with parents of children with disabilities from her research in Ghana, Getting to know Cerebral Palsy. She highlights that community engagement is key to change and a key focus of the training is around empowerment.

What are your experiences with community based inclusive development? Please share in the comment area below.

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Global Health and Disability

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