Thurs. 5 December 2013 Impact Assessment Seminar – Phnom Penh Local assessment of the situation...

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


► a. The VAPS project in the Gabès and Kebili governorates


► c. Methodology


► 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


► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates


► c. Methodology


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



► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates.


► c. Methodology


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

SAMSUNG

AccessibilitéDifférents types de handicapASPBesoins spécifiques des PSH


► a. The Vie Autonome et Participation Social (VAPS, self-reliance and social participation) project in the Gabès and Kebili governorates.


► c. Methodology



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


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

► 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


► 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


► 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


► 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%

► 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


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%


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


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%

► 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


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


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


For 9 intervention domains:


By sector of intervention:

Healthcare

Social services and programmes

Education

Employment and vocational training

Recreation

► projet Vie Au



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

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?

Workshop

In order to increase our capacities to monitor and measure our indicators of the changes we want to achieve, when we develop baselines:

1. What we must stop; 2. What we already do but we need to improve; 3. What we don’t do but we should start to do;

3 to 4 people per group

Thurs. 5 December 2013 Impact Assessment Seminar – Phnom Penh Local assessment of the situation...

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