Presentation is loading. Please wait.

Presentation is loading. Please wait.

Comparative study of HI programmes in Albania, Kosovo and Mozambique 2012 Khatmandu, 28 January 2013.

Similar presentations


Presentation on theme: "Comparative study of HI programmes in Albania, Kosovo and Mozambique 2012 Khatmandu, 28 January 2013."— Presentation transcript:

1 Comparative study of HI programmes in Albania, Kosovo and Mozambique 2012 Khatmandu, 28 January 2013

2 MOZAMBIQUE 24 M HDI: 184 KOSOVO 1,7 m HDI N/A ALBANIA 3,2 m HDI: 70 Structured health system Lack of policies for rehabilitation No specialized trained staff Mine Victim Assistance Present during the civil war + in the long- term reconstruction ; emergency and reconstruction

3 1. TO WHAT EXTENT HAVE THE PROGRAMME INTEGRATED A SYSTEMIC APPROACH? 2. WHICH PARTNERSHIP MODALITIES? 3. WHICH IMPACTS ON CRITICAL DIMENSIONS, INCLUDING SUSTAINABILITY ?

4

5 LEVELS OF INTERVENTION: DONORS iNGOS

6 All the interventions of HI prioritised: The promotion of national policies in PMR The training of professionals The development or the strengthening of services, including in the community (except Albania) The capacity building and support to the disability movement was implemented differently in the three countries and in parallel to the PMR strategy

7 THE CASE OF KOSOVO Interventions were comprehensive, though uncoordinated; interactions between actors remained poor. Regulatory mechanisms such as territorial need assessment, gate keeping procedures, quality standards, referral system are still missing

8 RESSOURCE ALLOCATION: -In Mozambique and Kosovo: high number of expatriate and local staff (from emergency) -In Albania:few expatriate staff; short external technical experts,including regional resources PROJECT DESIGN Project designs were all based on needs assessments, more systematic and comprehensive in Albania, including participation of DPOs; Their participation continued, to a much lesser extent, during the implementation phase

9 Who’s the ownership How decisions are made Role of each stakeholder in planning, implementation, monitoring

10  The demand for the development of rehabilitation services came officially from DPOs  A project steering commitee and a Physical Medicine and Rehabilitation working group were set up  Written agreements for almost all actions  Strong influence of local stakeholders in decision making  Full ownership of Albanian actors since the design phase  Technical support was assured by external experts, including from the region.  Weak participation of local stakeholders in monitoring

11  Lesson learned: securing the commitment of the public support to develop PMR services and policies was essential to at least consider universal access, geographical coverage and affordability to PwDs (equity)  Challenges: -poor exit strategy, poor consultation with stakeholders (funding constraints) - missing strategies to maintain quality of services

12 MOZAMBIQUEKOSOVOALBANIA DIRECT SERVICE PROVISION CAPACITY BUILDING SUPPORT TO POLICY MAKING OVERALL COORDINATION

13

14  Lack of data in the three countries to allow comparison and measure of impact and availability of services (either baseline or final data )  In Mozambique, services were multiplied and exist with a good geographical cover, but needs of rural areas are not addressed and the quality has deteriorated  In Albania and Kosovo so far few new centres were opened by national authorities, the rest is with the private sector

15 The case of Mozambique  Development of a national policy; rehabilitation centres are included at secondary and tertiary level  Services are managed by the governement and are free of charge for PwDs  Basic data collection procedures in place in the centers

16 ASSETS  → National policies were developed in the three countries -national action plans  → rehab services are included at secondary/tertiary level and free of charge in Moz and Kosovo  Capacity building on management in Moz. CHALLENGES  Poor policy implementation: lack of financing, managerial and monitoring capacities  Poor links between communities and centers, rural areas are undersearved  Absence of regulatory mechanisms

17 ASSETS  Innovative training in Albania for P&O  PT programme directly set up with the local training institute  In Kosovo and Moz., trainings were institutionalized following the crisis CHALLENGES  Long-term quality of training and practice  Recognition of community level profiles  Retention and planning

18 ASSETS  All P&O workshops set up by HI are run by the government today  Number of PT clinics increased in urban areas –with a good coverage in Mozambique - including private clinics in Albania and Kosovo  CHALLENGES  Costs of materials for P&O workshops  Gaps in rural areas  Lack of central regulatory interventions  RH

19  Consultation/participation to policy making is very little  Advocacy and lobby: effective networking but only at local level in Kosovo and Albania  Participation in functioning and evaluation of services: poor, and very limited access to actual services

20 DESIGN Participatory design and agreement on roles and timeframe identification of roles and responsibilities of partners, both institutional and CSO; knowing the barriers to access to services in the local context Provide a cost analysis IMPLEMENTATIONPHASING OUT

21 DESIGNIMPLEMENTATION Promote participation of PwDs in management; directly support the strenghtening of regulatory mechanisms; strenghten links with community actors; HR: promote competences and recognitions for non professionals and professionals PHASING OUT

22 DESIGNPHASING OUTIMPLEMENTATION special attention to monitoring mechanisms define long term partnerships for technical support in order to continue beyond the project anticipate to the implementation phase the transfer of knowledge

23  Relevance of knowing the barriers to access services  Relevance the deep understanding of role and interactions of stakeholders, including PwDs  participatory definition of objectives, responsibilities, timeframe is effective for actual engagement in the long term  a cost analysis of services, including set up and maintenance, should be based on local capacities and resources to be feasible  - Identification of risk factors and definition of monitoring tools since the beginning  Relevance of knowing the barriers to access services  Relevance the deep understanding of role and interactions of stakeholders, including PwDs  participatory definition of objectives, responsibilities, timeframe is effective for actual engagement in the long term  a cost analysis of services, including set up and maintenance, should be based on local capacities and resources to be feasible  - Identification of risk factors and definition of monitoring tools since the beginning

24  For an equitable and sustainable access to REHABILITATION SERVICES for PWDs, who should contribute, and how, to: 1. The improvement of the quality of services ? 2. The development of regulatory mechanisms? 3. The design and monitoring of rehabilitation policies?

25  Promote the participation of PwDs in management of services  Contribute actively in the setting up of regulatory mechanisms : need assessment, gate keeping procedures, quality criteria, monitoring mechanisms  Encourage services to develop closer relationships with community actors :  Promote both the competences of local actors for recognition in the community and professionals at the central level for regulation of performances and quality control  Promote the participation of PwDs in management of services  Contribute actively in the setting up of regulatory mechanisms : need assessment, gate keeping procedures, quality criteria, monitoring mechanisms  Encourage services to develop closer relationships with community actors :  Promote both the competences of local actors for recognition in the community and professionals at the central level for regulation of performances and quality control

26 Define with partners longer term strategies to: 1. -strengthen monitoring mechanisms for actual implementation of policies 2. -develop long term partnerships with external technical resources for training (when necessary) 3. -transfer of knowledge requires to anticipate a lot Define with partners longer term strategies to: 1. -strengthen monitoring mechanisms for actual implementation of policies 2. -develop long term partnerships with external technical resources for training (when necessary) 3. -transfer of knowledge requires to anticipate a lot


Download ppt "Comparative study of HI programmes in Albania, Kosovo and Mozambique 2012 Khatmandu, 28 January 2013."

Similar presentations


Ads by Google