Include us in Education! Barriers and enablers to education for children with disabilities in Nepal

3rd December

Background• Original analysis of Plan International’s sponsorship dataset across 30 countries (2013)• Children with disabilities were

- on average 10 times less likely to attend school compared to children without a disability - if do attend school, their level of schooling is below that of their peers. - Children with vision and hearing impairments on average more likely to be enrolled than children with

communication or cognitive impairments. - more likely to have reported a serious illness in the last 12 months.

These figures are important

Further qualitative work was needed to understand WHY these inequalities exist.

Methods• In-depth interviews with caregivers and

children and KIs• Participatory tools with children• Sign languageSample:• 259 children with disabilities among Plan ’s

38,450 sponsored children (0.7% of sponsored children (2012)

• Disability was reported by caregivers • Purposeful selection• - 3 districts (hills and plains)• - age, type of impairment, in and out of

school• Thematic analysis

sample

– 21 families- 20 caregivers– 13 child interviews

- Interviews with 19 KIs

CHARACTERISTIC #

GenderBoysGirls

 School status

In schoolOut of school

- Dropped out- Never been

 Impairment type

MultipleIntellectual (only)

Vision (only)Hearing (only)

7

14

12981

9412

Table 1: characteristics of study sample

Some key findings • Children who are not in school

– 8 children dropped out– 1 never attended

• Psycho-social impact of dropping out Boredom, anger, frustration

“I feel like a donkey because I am just staying at home doing nothing all day.”

(17 yr old girls with profound hearing impairment who dropped out of a special school)

• 2 cases of attempted suicide

Case study - AISHA• 12 years old• Physical impairment- deteriorating condition• Attended primary, has not made transition to secondary

“I liked everything about that school,” “I feel sad that I can’t go to school

• In the last couple of weeks Aisha has reportedly tried to commit suicide by drinking pesticides.

• Her mother explains how sad her daughter “she says herself that she can’t go to school and she can’t do any work, so she got frustrated.”

Barriers

Caregiver and teacher attitudes• Particularly for children with an intellectual impairment

“She doesn’t hear anything that’s why…She is dumb, what should I say! I don’t know if she would be able to learn”.

(Case 304: Mother talking about why her daughter, who has a hearing and intellectual impairment, has never been to school.)

Behavioural issues • All children who had intellectual impairments and had behavioural issues had been asked to leave school

She just used to dance in school ………………….. Other children just used to come out of class to watch her… ………………….The teachers said not to send her…………….And I think that she is disturbing others in school.

• Case 303: Father explaining why his daughter, who has an intellectual impairment as well as a minor physical impairment, is not attending school.

Poor health• Half of the caregivers reported that their child was more frequently ill compared to their

siblings. • Described more susceptible to ill health from birth, difficulties with eating, frequent stomach

problems, diarrhoea and fevers. • Time out for ongoing rehab and treatment needs• Hygiene issues - children with intellectual disabilities or mobility limitations. • Caregivers also expressed how difficulties in communication sometimes made it more difficult

for their child to explain their illness.

“He has difficulty with eating. He has a problem with his toilet habits because he doesn’t understand.”

(Mother of child with multiple impairments- explains that they visit doctor more frequently than with siblings- in addition constantly seeking a ‘cure’ for the condition )

Physical accessibility• One third of families cited physical access-

getting to school. Also once in school.

During the rainy days, she can’t walk…she can’t balance herself when the floor is wet. Sometimes she falls even if the floor is dry….she misses around 3 months of school in a year…

Case 313: Aunt explaining why her niece, who has mobility limitations and an intellectual disability, doesn’t attend school during the rainy season.

• Economic factorsMainly opportunity costs caregivers’ time in bringing their children. Also wanting child to work at home or outside of the home, lack of info about cost

Learning challenges

• A third of the children had repeated grades. • More than a third had been upgraded to higher grades without passing:

She repeated three times second or third grade. She can’t really take her exams properly so there isn’t any proper grading. The teachers upgraded her along with her friends…She can’t read and learn.

[At first] the teachers thought it would help her to learn better if she would repeat the same grade, but now she is upgraded to another class [even though she didn’t pass].

– Case 301: Mother discussing grade repetitions of her daughter, who has a mild visual impairment and an intellectual disability

Capacity of teachers, Lack of specialist resources, adapted curriculum and teacher trainingA particular challenge for teachers to manage children with behaviour problems, as well as their understanding and attitude about the child’s impairment, appear to be important reasons for non-attendance and needs to be further explored.

“She goes to a nearby primary school, but she doesn’t understand anything. She sits there all day and returns.” (Father describing the experience of his daughter, who has a hearing and mild visual impairment, at a mainstream school)

Stigma, discrimination, violence and abuse

In schools and the community:

Someone shouts at me and calls me ‘cross-eyed’ (“deri”) and pulls my hair. [How many times has he said this to you?] Many times, 20 times.

Girl with a physical and intellectual impairment talking about bullying

Call the dumb one  (Latu le bulao)   Mother calling her child 

for interview

Other kids used to tease him. This one has no brain, so he would laugh and then they would beat him and he would fight back.

• Three quarters of all families reported bullying abuse and violence in school, on way to school

• Teachers and peers are perpetrators

His teacher used to beat him so he didn’t want to go to the school…[Did he have any friends in school?] No he didn’t have friends. He also didn’t play with other children in the neighbourhood.

Usually her peers tease her for being mad ‘Pagal’, and they get into fights for which teachers would hit Menkhu… Menkhu gets more of the beating compared to other children. That’s why she doesn’t like to go to school…Other kids in Menkhu’s class bully her and get into fight with her, but instead they would complain to the teacher that Menkhu started the fight.

Case 209: Mother talking about her daughter, who has an intellectual impairment

• Those with communication impairments appear to be particularly vulnerable as they may not be in a position to explain what is happening to them, either to teachers, or to their caregivers.

She used to say a female teacher would hit her but a male teacher likes her.  She would say her friends hit me, pulled my hair and threw stone at me.  But I don’t understand her fully.  

•Case 302: Adult brother talking about his sister, who has an intellectual impairment.

Sexual violence

One young person recently raped • 17 year old girl who had a profound hearing impairment

• She had dropped out of her deaf school because she was needed to work at home• Raped by a neighbour whilst at home alone, and has recently tied to commit suicide

- currently going through court case , but without support from the community – from father and teacher– Special school teachers – 4-5 other cases of rape in her school over 5 years, and general violence in relationships

– Children with disabilities, especially children who have hearing or intellectual impairments, appear to be particularly targeted. “These children cannot shout [out] and it’s harder for them to communicate with others .”

• Additional vulnerability of those with disability

Special and integrated schools• 3 of our sample had ever attended• very positive about the experience e.g. Child with profound hearing impairment

Key Reasons for not attending:

• Concerns about safety and appropriate living situation while at school,

• Lack of information

There were only boys in the school, who teased her.

In total there were six students and she was the only girl there…There weren’t any girls so she might have felt alone. [They shared a single room…the caretaker sleeps in one bed and the children in one].

• Limited resources of the schools was a concern • Lack of opportunities for inclusion within the integrated schools- beyond the classroom,

Enablers • Children’s attitudes and resilience

• Bishal – a double amputee who drags himself around the house on his knees. Father left home at his birth. Carried to school by his sister. Had to repeat a year because of missing 3 months of school due to surgery

- wants to go onto university to become a teacher

• Individual teachers and caregiver attitudes towards disability

• Role of some peers • Role of plan and other NGOs

RecommendationsFor Research Ensure all research includes appropriate methods and budgets for involving children

with disabilities Explore further the issue of violence against children with disabilities, including

sexual violence. Explore further the issue of malnutrition, severe health issues and children with

disabilities, Conduct research on the specific needs of children with intellectual impairments Conduct longitudinal research with children with disabilities in order to improve

understanding of the longer term outcomes

Recommendations Recommendations for communities and schools

• Conduct awareness-raising at the family and community level about the rights of children with disabilities

• Promote ‘healthier schools’ which support the participation and inclusion of children with disabilities in all school activities, both in and out of the classroom.

• Advocate for and put measures in place to increase the capacity of all schools to provide inclusive, quality education so that children with disabilities can learn in the communities in which they live and obtain a quality education.

• Combat stigma, abuse and violence perpetrated against children with disabilities. Furthermore develop and test interventions to reduce violence.

• Improve access to health and rehabilitative services. Their health needs must be addressed in order to achieve improved educational outcomes.

Thank you

Limitations• Nature of Plan’s sponsored children – working with poorest of poor• Small no of children with VI – only one child who was VI only. Unclear where other children

blind/VI• Involvement of other family members in the interviews- in some circumstances has to be a

reality for CWds• Some children not able to interview in the limited timeframe