NIDS Development Services

NIDS Development Services Mapping of the Norwegian support to promote the rights of persons with disabilities follow up 2013 Report 2014-02-20 Annika Nilsson Zozan Kaya Mari Mogen 1

Table of Contents Executive summary... 3 1. Background... 5 2. Method... 5 3. Findings... 6 3.1 Statistics 2010-2012 targeted initiatives... 6 3.2 Statistics 2010-2012 mainstreamed initiatives... 11 4. General developments since 2011... 13 5. Summary of interview responses... 14 6. Recommendations... 15 Annex 1 Mental Health projects... 17 Annex 2 Interview summary... 19 Annex 3 Mainstreamed and partly mainstreamed projects... 24 2

Executive summary This is a mapping of Norwegian support to development aid projects that target or include persons with disabilities. It describes the changes since 2011, when an extensive evaluation was carried out by Norad, and analyses long term trends. The mapping is based on information from the Norad database, which covers statistics up to 2012. Questions have also been posed to Ministry of Foreign Affairs (MFA), Norad and selected NGOs to capture developments not yet visible in the statistics. The mapping shows that there have been no significant changes in the number of projects or amounts spent on targeted disability projects during the past 12 years. Since year 2000, the number of such projects has been around 100 each year. In 2012 there were 106 targeted projects. The total expenditures for these targeted projects have remained the same, around 130 million NOK per year. In 2012, the expenditure was 133 million NOK. Atlas Alliance and its members 1 spent almost half of that amount. The Red Cross was the second largest contributor. Compared to the total aid budget, the share given to targeted disability initiatives has been reduced from 1 % to 0.5 % between 2000 and 2012. Direct service provision, especially medical rehabilitation for persons injured in conflicts or disasters still takes almost half of the funding for targeted projects. A quarter of the funding goes to capacity development of disabled peoples organisations. The remaining funds are used for individual empowerment of persons with disabilities and for influencing governments to improve their policies and practices. Most targeted projects are funded via Norad. No major changes are noted for the period 2010-2012 in terms of type or focus of the projects. The mapping shows that the number of projects that are including disability as a component (mainstreamed and partly mainstreamed) have also remained at a constant level of around 50 projects per year. These are often education, health or other public sector programmes. 70% of these projects focus on service provision or capacity building of governments. In the past three years, the most notable change is that UNICEF has started to include children with disabilities in their overall strategy and in education and child protection programmes. Other big programmes that include children with disabilities are national education programmes in Palestine, Nepal and Burundi. In the past two years, Norwegian NGOs have increasingly started to include persons with disabilities in their policies and projects. In the evaluation 2011, Plan Norway was highlighted as the outstanding example. In 2012-2013, also Save the Children and FOKUS have adopted new inclusive policies and started to implement them. Digni, Adina and Fredskorpset also report that the focus on persons with disabilities has increased in the past three years. These shifts are not yet visible in the statistics, except for the huge UNICEF funding which is now coded as inclusive/mainstreamed. During 2013, Ministry of Foreign Affairs developed a policy document, Norway s international efforts to promote the rights of persons with disabilities. However, the status of this document is not yet confirmed. MFA has also entered into a strategic partnership with Atlas Alliance and promised to pay for its support in promoting inclusion of disability in Norwegian aid. MFA has also provided financial support to the UNCRPD 2 secretariat and included disability in its framework agreement with WHO, with a focus on disability statistics. The statistical project is implemented by Statistics Norway. Norad has introduced a question on disability in its general funding application format, requiring applicants to describe how they will include disability. 1 Excluding LHL, as LHL projects do not target persons with disabilities 2 UN Convention on the Rights of Persons with Disabilities 3

Norad has also commissioned research on best practices in the area of rehabilitation of children with disabilities in Africa. These emerging efforts by MFA and Norad are positive signs, but there is not yet a strategic approach or coordinated action plan. Based on the findings in this mapping we recommend the following: - MFA should develop the policy document from 2013 into an action plan that can guide all Norwegian development actors. MFA should also consider appointing a Disability ambassador to be the focal point for the disability work (recommendation from previous evaluation) who could work more proactively as a full time supporter of the present focal points at MFA and Norad. - MFA should develop terms of reference and formally contract and fund Atlas Alliance to take on the assignment to support MFA in implementation of the action plan. This would enable Atlas Alliance to take a more proactive role in establishing cooperation with international agencies, Norwegian organisations and embassies (all working with Norwegian funding) and inspire/coach them on how to practically include persons with disabilities in their programmes. This could be an expansion of the present partnership. - Atlas Alliance should approach Norad to request a disability marker in the Norad statistics (as a Norwegian adaptation) and lobby through its European networks to influence the common DAC statistical system to do the same. Having a marker that tells if disability is the main focus or is partly a focus would be sufficient. This will substantially facilitate future mappings and monitoring. - Atlas Alliance should monitor the disability inclusive initiatives supported by Norway to ensure that implementing agencies have capacity to practice what they set out to do in terms of inclusion/mainstreaming and that monitoring indicators are in place. If not, to offer advice on capacity development measures. - Atlas Alliance should monitor disability initiatives implemented by other Norwegian agencies to create synergies, especially to identify and engage with strategically important projects such as a) the disability statistics projects WHO/Statistics Norway and b) the research on best practices in the area of rehabilitation undertaken by Høgskolen i Bergen 3. 3 The role of local and international NGO s in pursuing best rehabilitation practices. The aim of the study is to explore factors influencing the provision of adequate rehabilitation services for children living in Africa low-income countries and to understand the role of local and international civil society. Children with disabilities are extremely marginalized and studying what interventions are working well and the role of CSOs is relevant and important. 4

1. Background In 2011, Norad commissioned an evaluation of the Norwegian support to promote the rights of persons with disabilities. As part of the evaluation a statistical mapping of the support was made to determine the quantity and type of programmes supported between 2000 and 2010. The mapping covered initiatives having disability as a main objective and those that had included disability components in programs with a broader objective. The mapping was published as Annex 1 of the evaluation. Atlas Alliance now wants to follow up the mapping from 2011, to see if there are any changes in quantities or types of support to disability rights. 2. Method A word search was made of the Norad data base to identify projects in the period 2010-2012 that targeted or included persons with disabilities. We asked for all Atlas Alliance projects and in addition we used the following search words: - rehabilitation - disab - habilitation - funksjons - inclusive education - blind - special education - deaf - special needs - døv - differently abled - utviklingshem - universal design - mental health - impair - handikap - handicap - CBR - DPO - autism - cerebral The search word «rehabilitation» provided many projects related to rehabilitation of roads and buildings and these had to be deleted. The search of mental health gave a number of projects, but they were removed from the analysis for comparative reasons, as they were not included in the 2011 evaluation statistics 4. From the Atlas Alliance list all TB related projects which focussed on health and health systems were deleted. The remaining projects were sent to the agreement partners for verification and questions were also asked about possible missing projects. A word search does not capture projects were disability is included, but not mentioned in the title or description text. In this way we managed to find some additional projects. We then used the old, coded Excel list from the evaluation in 2011 as a basis and compare it with the new list. In addition to contacting agreement partners for updating the lists/coding projects, more indepth, qualitative information was collected through telephone interviews. A short interview guide was developed, consisting of ten questions 5. Staff in some of the most relevant organizations and embassies was asked to participate (those who were seen to have many or new disability initiatives). The response rate was relatively good among the 25 organizations and 11 6 embassies contacted. In total 7 embassies and 14 organisations replied. While most of the participants were positive towards contributing, both with verifying lists and answering further questions, there were a few who did not respond to our request. The reasons for this may be a lack of time, due to holidays coinciding with the timing of the study, or incorrect email addresses. 10 people were invited to an additional telephone interview and 5 of these were interviewed 7. In addition, one organization and two embassies answered interview questions via 4 An analysis of the identified mental health projects is found in annex 1 5 A summary of all replies are found in annex 2 6 Malawi, Ukraine, Kazakstan, Zimbabwe, Sri Lanka, Tajikistan, China, Nepal, Serbia, Kosovo and Palestine 7 Adina, Red Cross, NPA, Digni, FK 5

e-mail 8 and two were interviewed in person (Atlas Alliance and Save the Children). Interviews were also held with Norad staff and questions e-mailed too MFA to ask about developments in the past three years 9. It was not possible to schedule a meeting with MFA, and some of our questions to them remain unanswered. Our combined quantitative and qualitative methods have proved us with a good overview of the portfolio 2010-2013. We are sure that we have captured almost all projects that target persons with disabilities. We have probably not managed to find all that are mainstreaming disability. This will not be possible until a disability marker is introduced. 3. Findings 3.1 Statistics 2010-2012 targeted initiatives Since 2010, the number of targeted projects has increased by 10 (from 96 to 106), but the annual disbursements have been reduced by around 11 million NOK (from 144 MNOK to 133 MNOK). The new projects are typically small initiatives such as leadership seminars (Atlas Alliance) and small grants (embassies in Serbia and Kosovo). If taking a longer view, the disability specific projects have remained at a rather constant level since year 2000, with around 100 projects and disbursements of 130 MNOK annually. 120 110 100 90 80 70 60 50 Number of projects, targeting disability 101 108 101 101 103 106 96 97 96 91 97 90 86 2 000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 8 Fokus and the embassies in Serbia and Kosovo 9 People met or contacted at Norad and MFA: Lena Plau, Ida-Eline Engh, Grant Dansie, Halvor Erisen, Gunvor Skancke (Norad), Ismail Noor Abdi (Norad statistics), Elin Eikeland, Cathrine Halsaa (MFA), Vibekke Nielsen (SSB) 6

170 000 Total disbursements, targeting disability, 1000' NOK 150 000 148 887 130 000 110 000 90 000 94 929 70 000 50 000 During the same period, there has been an expansion of the total aid budget, meaning that the disability share has been reduced from 1,03 % to 0,48 % over time. Of this small share, half of the funding has gone to provision of health services for persons with disabilities (see more below). 1,50% 1,00% 0,50% 0,00% 2 000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Share of targeted disability projects of total Norwegian aid 2000-12 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 We find that it is still the same organisations that provide support to targeted projects. Atlas Alliance and Norwegian Red Cross are still the biggest. Atlas Alliance has increased its share of the disbursements slightly since 2010 (from 43% to 46 %). Organisation Disbursed to targeted disability projects (1000 NOK) 2010-2012 % Atlas Alliance 185 159 44 % Norwegian Red Cross 139 913 33 % Tromsoe Mine Victim Resource Center 21 241 5 % Digni 8 644 2 % Mission East 8 060 2 % Handicap International 7 450 2 % Kunnskapsdepartementet 7 114 2 % Save the Children Norway 5 108 1 % Adina Stiftelsen 4 698 1 % Det Norske Misjonsselskap 3 964 1 % Total for ten largest 391 351 92 % Others 32 783 8 % Total disbursed all agreement partners 424 134 7

70% Atlas Alliance share of total amount disbursed 2010-12 60% 50% 40% 30% 20% 57% 59% 43% 41% 54% 46% Atlas Alliance Other agreement partner 10% 0% 2010 2011 2012 The focus of the targeted support is almost the same as for the period 2000-2010. Most of the funding is going towards medical and social rehabilitation services for persons with disabilities. However, the service provision share of the total disbursements has been reduced from 54% to 48% since 2010. As much as 41 % of the total funding is going specifically to persons affected by conflict or natural disasters, e.g. mine victims. This refers to treatment, rehabilitation and to support to mine victim s organisations. Main focus 2010-12, "Targeted" projects Dutybearers/gov. 6 % Individual level empowerment 18 % Research 3% Other 1 % Service-provision 48 % DPOs 24 % 8

Cause of disability, "Targeted"projects 2010-12 Both 24 % Other causes of disability 35% Persons affected by conflict, natural disaster or small arms 41% 9

Also the types of disabilites in focus are still the same, with a heavy focus on all types, mobility and and visual impairements. We know from experience that when all types are in focus, the distribution within that segment will not be reflecting prevelance, but have an overrepresentation of physical/mobility disability, a fair representation of visual disability and underrepresentation of other disability groups. 10 This probably has to do with the limited knowledge of how to adress obstacles that go beyond physical adaptations and provisions of assitive devices. It should be noted that mental health projects have not been included in the analysis. Type of disabiliy, "Targeted"projects 2010-12 Cognitive/ Intellectual Visual 5 % 12 % Hearing 3 % Other 1 % Mobility 27 % All types 52 % The sectors targeted were also very much the same as in the previous mapping study. Sum of 2010-12 Disbursed (1000 Main DAC sector 2010-12 NOK) Conflict prevention and resolution, peace and security 140 144 Health 73 778 Government and civil society 71 397 Other social infrastructure and services 62 048 Unallocated/unspecified 26 782 Education 25 759 Banking and financial services 11 335 Population policies/programmes and reproductive health 5 929 Child Protection 5 108 Blank 2 653 Other multi-sector 700 Total 425 633 10 The prevalence of various disabilities in a population varies according to context and there are no global figures, e.g. visual impairments are common in areas with poor sanitation and river blindness, intellectual disabilities are common in areas with intermarriages. Problems with sight and hearing are more common among older people and not so common in children etc. The South African census from 2007 gives the following; Sight 32,1%, hearing 20,1%,Communication 6,5,% Physical 29,6%, Intellectual 12,4% Emotional 15,7%. 10

3.2 Statistics 2010-2012 mainstreamed initiatives When analysing all initiatives that have included disability in a deliberate and comprehensive manner (mainstreamed) or have small components targeting disability (partly mainstreamed), we found that the numbers have decreased slightly during the past three years. The reason for the higher numbers in 2005-2008, was a health programme in Malawi with many disability components. At the same time, it should be stated that interviews reveal that substantial changes took place in 2013. These new initiatives have not yet been captured in the statistics. Number of projects, mainstreamed and partly mainstreamed 60 50 40 30 20 10 20 18 30 27 34 54 57 55 45 36 51 49 47 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 The top 15 partners in terms of budget size of mainstreamed and partly mainstreamed programmes 2010-2013 are displayed in the list below 11. Compared to the previous analysis, UNICEF and Save the Children have entered the scene with very big programmes that are now including children with disabilities. In terms of number of projects Save the Children, Plan Norway, Digni and Atlas Alliance are the biggest, but not in budget. The biggest in budget is UNICEF, where the core funding, the education programme and the child protection programme now include children with disabilities specifically (all three supported heavily by Norway) 12. Second biggest in size is the national education programme in Nepal (also supported by UNICEF and Save the Children). Education programmes in Palestine and in Palestinian UNRWA camps are also reported to be inclusive 13. Save the Children Norway is supporting inclusion of children with disabilities in education programmes in Albania, Nepal, Cambodia, Laos, Palestine, Nicaragua, Ethiopia and Uganda. In Ethiopia there is also an inclusive child protection programme. 11 Total 2010-12 Disbursed (1000 NOK) Number of initatives 2010-12 Agreement partner UNICEF 2071000 3 Nepal Ministry of Finance 157132 1 Save the Children Norway 138253 9 Malawi Ministry of Agriculture and Food Security 102000 1 MEHE (Ministry of Education, Palestine) 70000 2 Norsk Folkehjelp 44944 2 11 A complete list of all mainstreamed and partly mainstreamed projects is shown in annex 3. 12 http://www.unicef.org/disabilities/index_65841.html 13 Burundi education programme was also mentioned but did not appear in our statistics. We could not find the agreement number and title.

Norwegian Refugee Council 40000 5 Plan Norway 36287 1 UNRWA - UN Relief and Works Agency 21000 1 SNV - Netherlands Development Organisation 17678 1 ILO - International Labour Organisation 16200 5 Atlas Alliance 14 13959 2 UNDP - UN Development Programme 12000 1 Norwac - Norwegian Aid Committee 10753 1 UNESCO - UN Educational, Scientific and Cultural Organisation 8250 3 The main focus of the mainstreamed and partly mainstreamed projects has been to build capacity of governments and provide services in the health and education sectors. DPOs are hardly ever part of general civil society programmes (1%). Main Focus M&P, Total number of projects 2010-12 3 % 1 % 18 % 9 % 31 % 38 % Duty-bearers Service provision Individual empowement Reserach Other DPOs Very few of the mainstreamed and partly mainstreamed projects focus on conflict/disasterinduced disabilities (only 7%). Most of the initiatives support service provision or developmental programmes in governments. Almost all of the projects are said to be inclusive of all types of disabilities (96%), at least in theory. As expected, the three most common sectors for the mainstreamed and partly mainstreamed projects are Education (31%), Government and civil society general (25%) and Health (13%). Since 2010 there is more focus on education and on duty bearers capacity development (as a result of the UNICEF developments). 14 These include LHL TB programmes that include persons with disabilities and global mainstreaming seminars. 12

4. General developments since 2011 The most spectacular changes taking place since 2011 is the change of policy and practice in UNICEF 15 (a big recipient of Norwegian support) and Save the Children Norway 16. Both these organisations have adopted disability inclusive policies and developed programmes that include children with disabilities in the areas of education, protection and governance. On the Christmas Card 2013, Save the Children Norway had a photo from an inclusive education classroom to illustrate the policy shift. Plan Norway has continued to work inclusive and be a model. Also, the umbrella organization FOKUS (women s organization) adopted a policy on inclusion of women with disability in 2012. During 2013, FOKUS started to train partners in how to be inclusive of women with disabilities. Partners in Tanzania have been trained by disability activists identified by the Atlas-alliance and trainings in South Africa are underway through collaboration with DPOs supported by the Atlas Alliance. The training will move on to other countries in the portfolio in the years to come. FOKUS applied for an increase in their annual framework agreement with NORAD to implement the policy, which was granted. NOK 369 653 was used on disability training in the South in 2013, and NOK 300 000 are committed to the same purpose in 2014. Furthermore, MFA has developed a policy document describing the Norwegian efforts to promote the rights of persons with disabilities, Norway s international efforts to promote the rights of persons with disabilities. This is a document which could potentially provide direction and practical guidance, if formally adopted and developed into an action plan. However, the status of the document is not yet confirmed and so far it is not well known by embassies and NGOs. MFA has also entered into a strategic partnership with Atlas Alliance to develop training for MFA and Norad employees, and for civil society, on how to better include the rights of the persons with disabilities in development assistance. Financial support has been promised to Atlas Alliance to develop this project, which also includes support to MFAs own training center on how to include modules on this in regular training on development and HR issues. This work is in progress and a designated staff member has been appointed by Atlas Alliance. However, negotiations on the budget are still to be finalised. MFA has also provided substantial financial support to the UNCRPD secretariat. This funding has not been possible to capture in the mapping as we were unable to get the information on the agreement number and title. As from 2013, the Norwegian Central Statistical Bureau has been supported by the MFA/Norad to work with WHO on a project Statistics Norway s assistance to WHOs Model Disability Survey. 2.6 MNOK was disbursed to this initiative in 2013. Norad has also introduced a question on disability inclusion in the general funding application format. Applicants are requested to explain how they plan to include persons with disabilities, in addition to questions on gender and environment. Digni, Adina and Fredkorpset also report that the focus on persons with disabilities has increased in the past three years. Fredskorpset has a new partner that wants to focus on 15 http://www.unicef.org/disabilities/index_65841.html 16 Redd Barna Strategy 2014-2017, English version, Redd Barnas landsmøte vedtok, 15 September 2013 ny strategi for perioden 2014-2017. 13

hearing impaired/deaf persons in Malawi, Digni has been influenced by the new MFA policy document and Adina refers to their own increased awareness and the dialogue with Plan Norway in Uganda. 5. Summary of interview responses When asked of their knowledge of the MFA policy document, Norway s international efforts to promote the rights of persons with disabilities, half of the interviewees were aware of these, while the other half had no knowledge of the document. None of the embassies had heard of them. The existence of the policy document has seemingly not influenced the work directly. Only one respondent noted that, due to the policy document, disability issues have become more integrated and reported on in all projects (Digni). Only two respondents (Norwegian Peoples Aid and FOKUS) replied that they had received support specifically to capacity building on inclusion of persons with disabilities. FOKUS have been supported by Atlas Alliance and NPA has received such support from Swedish Sida for the programme in Rwanda. From previous interviews we also know that Plan Norway is cooperating with Atlas Alliance. However, a majority of the organizations/embassies interviewed have not yet had any contact or collaboration with the Atlas Alliance. Nevertheless, as one respondent says; we are aware of what they do and their work is crucial when it comes to raising awareness on these issues in the development working world. Attitudes towards potential collaboration with Atlas Alliance were generally positive. The organizations were further asked to rate the importance of including women, men, girls and boys with disabilities in general programmes, the majority state that it is important. For the organization Adina, this is the core of what they do. For others, such as Red Cross, it is somewhat important. It is rare to speak about disability inclusion as one of the core activities of Red Cross. Here, the focus is more on direct assistance to victims of conflict and disasters, rather than disability inclusion in general programmes. Digni on the other hand, rates disability inclusion as highly important, while the Embassies replied somewhat important and not important to the same question (The Embassy of Serbia and Kosovo respectively). The embassy in Kosovo also stated that their support was provided despite disability not being a priority (taking more of a charity approach). As regards FK, one of their main principles is non-discrimination. There is no specific focus on disabled people as such, however, health is a focus area, and they view disability inclusion as part of this area. When asked to note the main reasons for including disability in their projects, the organizations answered that disabled people are a marginalized and thus vulnerable group. Others pointed to the fact that societies cannot afford to exclude this group they deserve the same rights as others. If given the opportunity and support, persons with disabilities will be important contributors in their respective societies. Lastly, the interviewees were asked what they perceive as main challenges, if any, in their disability related work. Here, answers were mixed. One challenge was said to be that local organizations were not heard, this was the case with promoting rights for disabled Palestinian refugees in Lebanon, for instance 17. A general obstacle is the lack of political will (and 17 Obviously this organisation was not aware of ongoing support from NAD (in cooperation with Swedish Diakonia and UNRWA) to the these camps in Lebanon 14

competence) to actually address the issues at hand. Charity is still a dominating approach. In some programmes corruption is impeding to development on a policy level. According to Red Cross, a challenge is not necessary a lack of funding, but rather lack of technical expertise in programme countries. Fredskorpset (FK) on the other hand, mentions the lack of applications as an obstacle. According to FK the number of applicants who work in the disability field has been low, leading FK to question whether their scheme is not known among the potential applicants. FK would welcome more applications in this area, as it fits well with their non-discrimination focus. In conclusion, the majority of NGOs are very positive towards including disability issues/persons with disability in their programmes, seeing this as an important issue for them. There is potential for Atlas Alliance to help them move to concrete action, as is done in the cooperation with FOKUS. Although the embassies in Nepal, Malawi and Palestine have indeed taken an interest in disability issues, only the Nepal education programme seem to have taken a more deliberate and strategic approach. In general, embassies do not yet see disability as a priority area in poverty reduction and human rights focussed work. In order for Atlas Alliance to engage constructively with embassies regarding these obstacles, there is a need for formal direction from MFA (e.g. policy and action plan). 6. Recommendations Based on the findings in this report we recommend that - MFA should develop the policy document from 2013 into an action plan that can guide all Norwegian development actors, and make it known among the various actors (embassies, departments, UN agencies and NGOs working with Norwegian funding). MFA should also consider appointing a Disability ambassador to be the focal point for the disability work (recommendation from previous evaluation) who could work more proactively as a full time supporter of the present focal points at MFA and Norad. - MFA should develop terms of reference and formally contract and fund Atlas Alliance to take on the assignment to support MFA in implementation of the action plan. This would enable Atlas Alliance to take a more proactive role in establishing cooperation with international agencies, Norwegian organisations and embassies (all working with Norwegian funding) and inspire/coach them on how to practically include persons with disabilities in their programmes. This could be a broadening and a continuation of the partnership presently being negotiated between MFA and Atlas Alliance. - Atlas Alliance should approach Norad to request a disability marker in the statistics (as a Norwegian adaptation) and lobby through its European networks to influence the common DAC statistical system to do the same. Having a marker that tells if disability is the main focus or is partly a focus would be sufficient. This will substantially facilitate future mappings and monitoring. - Atlas Alliance should monitor the disability inclusive initiatives supported by Norway (projects appearing in the mappings) to ensure that implementing agencies have capacity 15

to practice what they set out to do in terms of inclusion and that monitoring indicators are in place. If not, to offer advice on capacity development measures. - Atlas Alliance should monitor disability initiatives implemented by other Norwegian agencies to create synergies, especially to identify and engage with strategically important projects such as a) the disability statistics projects WHO/Statistics Norway and b) the research on best practices in the area of rehabilitation of children with disabilities in Africa, undertaken by Høgskolen i Bergen 18. - Atlas Alliance could also consider monitoring disability initiatives implemented by other Norwegian NGOs to create synergies. Project descriptions could be shared with Atlas Alliance members working in the same country in order for them to make contact. This mapping found the following projects where such synergies could be achieved; Adina in Uganda, Deaf Aid (education in Tanzania and Kenya), NCA in Zambia, NIF - Norges Idrettsforbund og Olympiske Komité in Zambia, NPA in Lebanon (Palestinian refugee camps), SIU - Senter for internasjonalisering av høyere utdanning (teacher training in Uganda). We also found that Norwac has been funded by MFA to build/renovate institutions for persons with mental health/intellectual disabilities in Eastern Europe, which could be in contradiction to Norwegian policy? 18 The role of local and international NGO s in pursuing best rehabilitation practices. The aim of the study is to explore factors influencing the provision of adequate rehabilitation services for children living in Africa low-income countries and to understand the role of local and international civil society. Children with disabilities are extremely marginalized and studying what interventions are working well and the role of CSOs is relevant and important. 16

Annex 1 Mental Health projects Mental health projects have grown in number since 2010, the most important agreement partners being Ministry of Health in Vietnam and Norwac, Norwegian Aid Committee http://www.norwac.no/. Mental health, number of projects 2010-12 20 10 7 10 20 0 2010 2011 2012 Agreement partner Total number of projects 2010-2012 Vietnam Ministry of Health 9 Norwac - Norwegian Aid Committee 4 Friends Of The Mind - Norway 3 Gaza Community Mental Health Program 3 FTK - Foundation Together Kosova 2 Oslo Univserity hospital HF 2 UNHCR - UN Office of the UN High Commissioner for Refugees 1 WHO - World Health Organization 1 Digni 1 RPH (Council for mental health) 1 The Norwegian Medical association 1 SIU (Center for internationalisation of higher education) 1 Grand Total 29 17

In terms of funding, mental health projects have increased slightly since 2010, from 11 million NOK to 11.9 million NOK in 2012. Norwac is by far the biggest in terms of funding http://www.norwac.no/ Mental health, total disbursements 2010-12, 1000 NOK 12 000 11 500 11 000 11 084 11 515 11 877 10 500 2010 2011 2012 Mental health: Top 10 agreement partners 2010-12 Total Disbursed (1000 NOK) Norwac - Norwegian Aid Committee 18 834 Digni 3 970 RPH (Council for mental health) 3 200 SIU (Center for internationalisation of higher education) 3 183 Gaza Community Mental Health Program 2 000 Vietnam Ministry of Health 1 216 Friends Of The Mind - Norway 747 UNHCR - UN Office of the UN High Commissioner for Refugees 500 The Norwegian Medical association 398 FTK - Foundation Together Kosova 186 Grand Total 34 234 18

Annex 2 Interview summary Spørsmål: Svar: Har din organisasjon økt støtten til initiativ/tema relatert til funksjonshemming eller personer med funksjonshemming de siste tre årene? Hvorfor har det skjedd/hvorfor ikke? Norsk Folkehjelp: Ja, i den forstand at Rwanda er et nytt prosjekt. Når det gjelder Libanon så er det på samme nivå som før. Libanon-prosjektet er ikke Norad støttet, men får støtte fra Dfid og SIDA. I dette prosjektet er funksjonshemmede en av gruppene Adina: Ja, vi øker for hvert år-startet prosjektet i Uganda i 2010 med målsetningen om å nå ut til barn med funksjonshemming og deres familier som målgruppe. Dette har vokst, og vi ser at det fungerer. Røde Kors: Nei, det er ikke økt støtte, men på samme nivå. RK driver ikke med disability som hovedsatsning. Digni: Ja. Hvorfor? Grunnet et samspill av mange ting, men det har blitt økt fokus på denne gruppen de siste tre årene. FK: Ja, det tror jeg at jeg kan si. Hvorfor? Vi har fått et nytt partnerskap (det er åpent å søke for alle) som retter seg mot hørselshemmende i Malawi. Den Norske Ambassade i Serbia: Our support increased. Vulnerable groups are a clear target and we are receiving more well- prepared applications form this sector. Den Norske Ambassade i Kosovo: No. Based on the Grant Letter provided by WB, support to persons with disabilities is not one of the priorities. Er du informert/kjenner du til UD s guidelines som kom i 2013? Hvis ja, har disse påvirket deres arbeid? Norsk Folkehjelp: Nei. Adina: Ja. Ser ut til at Norge ønsker større satsning på funksjonshemmede. Tidligere hadde vi ingen støtte. Men guidelines har ikke påvirket direkte, vi valgte vår policy før dette, men synes likevel det er flott at de satser på dette området. Vi er så vidt vi vet de eneste som jobber i Nord-Uganda med barnesoldater og funksjonshemmede og her er lite blitt gjort pga av krig. Fattigdomsbekjempelse er selvfølgelig viktig men funksjonshemmede er enda mer sårbare, utsatt for misbruk etc., og vi synes det er en svært viktig målgruppe. Røde Kors: Ja, jeg kjenner til UD s retningslinjer, men ikke i detalj. Arbeidet vårt er ikke påvirket av dette. Digni: Ja. UD s guidelines har påvirket vårt arbeid, vi er en paraplyorganisasjon slik som Atlas, og vi har hatt økt trykk på underorganisasjonene våre, - informert disse om forpliktelser de har til å ivareta disability relaterte tema. Funksjonshemming var ikke fraværende tema før, men det har blitt mer integrert hos alle, vi har innbakt det i våre rapporteringsskjema i alle prosjekter. FK: Nei, jeg kjenner ikke til guidelines. Den norske ambassade i Serbia: No. Den norske ambassade i Kosovo: No. Har dere mottatt støtte til kapasitetsbygging når det gjelder temaet Norsk Folkehjelp: Ja, fra Dfid og SIDA- en av partnerne i Rwanda har fått kapasitetsbygging via en samleorganisasjon for funksjonshemmede (ca 450 000kr). I Libanon er det støtte (av potten til UD) til et rehabilitets- senter i Beirut hvor kapasitetsbygging er en del av 19

funksjonshemming? prosjektet via partneren i Libanon. Adina: Nei, ikke spesifikt, men vi har en dialog med Plan i Norge om å samarbeide i Nord- Uganda, få bistand til kapasitetsbygging. Røde Kors: Vi har ikke mottatt spesifikk støtte til kapasitetsbygging, og har ingen egne prosjekt på kapasitetsbygging. Men i de prosjektene vi har er dette innbakt med UD og Norad funding. Digni: Nei. Ikke i det hele tatt. Ingenting er øremerket kapasitetsbygging. FK: Fredskorpset driver med kapasitetsbygging, det er kjernen i alle prosjekter. Den norske ambassade i Serbia: No. Den norske ambassade i Kosovo: No. Hvor viktig er det for din organisasjon å støtte tiltak som fremmer funksjonshemmedes rettigheter? Norsk Folkehjelp: Kan ikke si noe om NPA overordnet, men det støttes ofte prosjekter e.g mineryddingsprosjekter, hvor funksjonshemmede drar nytte av f.eks proteseverksted, uten at det nødvendigvis fremgår som disability markert i en prosjektbeskrivelse. I Libanonprogrammet er det veldig viktig; hovedmålgruppen er palestinske flyktninger og de har en organisasjon som samarbeider med en libanesisk organisasjon for å fremme funksjonshemmedes rettigheter. Hva er de viktigste grunnene for å inkludere funksjonshemmede i din organisasjon sine prosjekter? Adina: Nesten det viktigste vi gjør. Men det er vanskelig å gradere, vi jobber jo helhetlig med rettigheter, informasjonsarbeid, gir kunnskap og teknisk bistand. Vår kjernevirksomhet er rehabilitering. Vi bistår altså med rullestoler, krykker etc., samtidig som vi fokuserer på det sosiale og jobber med barns foreldre i grupper, med lokalsamfunnet. Røde Kors: Noe viktig, men ikke veldig viktig sammenlignet de andre områdene vi jobber med. I land som f.eks Somalia og Gaza er det viktigere men det er sjelden vi snakker om disability inclusion som et av kjerneområdene til RK. Digni: Veldig viktig, så viktig som det kan bli. FK: Vi har det som et gjennomgående prinsnipp at det ikke skal være noe diskriminering ift. grupper eller deltagere, men har ikke spesiell satsning på funksjonshemmede som sådan. Derimot har vi helse som en hovedsatsning, og det er innenfor helse/rettigheter at funksjonshemmede kommer inn. Den norske ambassade i Serbia: Somewhat important. Den norske ambassade i Kosovo: Not important. Norsk Folkehjelp: For Libanons del er det viktig å inkludere denne gruppen da støtten går til et rehabiliteringssenter for krigsskadede, og dette har utviklet seg til å inkludere funksjonshemmede også, og til helseopplæring i Shatila. Der UNRWA ikke har fylt behovet, har NPA gått inn og prosjektet vil fortsette så lenge vi har støtte fra UD. Adina: Fordi de som gruppe får minst. De får ikke sine rettigheter oppfylt. En funksjonshemmet har mye å gi og det å avskrive en hel del av befolkningen som unyttige; denne holdningen må endres.vi kommuniserer med politikere og forklarer at de ikke har råd som stat å utelukke disse ressursene i samfunnet. 20

Røde Kors: Fordi de er en sårbar gruppe, og vi skal jobbe for de mest sårbare. Sammenlignet med andre organisasjoner har vi kanskje mer midler - men ift. den totale porteføljen utgjør disability en liten del. Digni: En viktig grunn ut ifra menneskerettighetsprinsipper, å forhindre at denne gruppen blir ekskludert fra samfunnet. At de blir gitt like muligheter. Det er en svært sårbar gruppe, som behov for ekstra tilrettelegging. FK: Noe viktig. Men som sagt er det ikke spesielt fokus på denne målgruppen. Den norske ambassade i Serbia: They are a marginalized/vulnerable group. Den norske ambassade i Kosovo: Even though the direct support fir persons with disabilities was not a priority of our grant scheme, our embassy supported several projects targeting this specific group of people aiming social support for marginalized groups (list of projects is already on your disposal). Hvor viktig er støtte fra Norad (eller andre donorer) med tanke på implementering av initiativ rette mot funksjonshemmede? Norsk Folkehjelp: UD s støtte er helt nødvendig for å kunne fortsette arbeidet. Veldig få donorer som støtter slikt arbeid nå. Tvilsomt om UD hadde støttet flere slike prosjekt i dagda helse, disability og drift av slike senter ikke er prioritert. Adina: Ekstremt viktig, helt essensielt. Vi er glade for å få støtte fra Norad også i år, og har fått en treårig avtale (øremerket Uganda) som gir forutsigbarhet til vårt helsesenter i Uganda. Pengene er viktig for å planlegge dette langsiktig. Røde Kors: Veldig viktig. Vi er en organisasjon som har mye statlig støtte fra Norad og UD. Digni: Vi har kun støtte fra Norad (til Digni sekretariat), og det er derfor meget viktig med støtte fra Norad. Vi jobber samtidig med norske organisasjoner som har finansiell støtte fra ulike hold (19 medlemsorganisasjoner i Norge- misjonsorganisasjoner som har Norad støtte til deler av sin organisasjon). FK: I det store og hele, helt avhengig av offentlig støtte (all vår støtte kommer fra UD). Vi får årlige bevilgninger som vedtas i statsbudsjett. Ville dere fortsatt med disse prosjektene UTEN støtte fra Norad eller andre donorer? Norsk Folkehjelp: Nei, hadde vært umulig for NPA å samle inn penger på egenhånd. Adina: Vanskelig. Norad dekker 50% av budsjettet vårt. Resterende får vi fra gaver, innsamling, fadderordning, bedrifter, det private. Budsjettet vårt er på om lag 1 ½ million NOK i året. Røde Kors: Vanskelig å svare på om vi kunne fortsette uten støtte. Å drive kun med egne midler ville vært vanskelig, da måtte vi nok ha trappet ned. Kunne ikke jobbet med en så stor portefølje. F.eks når det gjelder minearbeid (som er disability relatert) har vi 3 års avtaler med UD, og med Norad 4 år- dette er et langsiktig samarbeid, som gir en forutsigbar økonomi og situasjon. 21

Digni: Ikke Digni som sekretariat- vi kunne ikke fortsatt uten Norad støtte, da vår jobb er å forvalte Norad penger. Men underorganisasjonene, ja, - de får inn penger på andre måter. FK: FK fullfinansiert av Utenriksdepartementet, så vi er helt avhengige av denne bevilgningen. Hvor viktig er bistand fra Atlas alliansen når det gjelder bevisstgjøring omkring temaet funksjonshemming og arbeid med dette? Norsk Folkehjelp: Jeg har personlig ikke selv hatt mye kontakt med Atlas Alliansen, men jeg mener at bevisstgjøringen omkring temaet og arbeidet de utfører er viktig. Adina: Vi har ikke hatt noe med Atlasalliansen å gjøre. Vi har kontaktet dem og Handicapforbundet for å advare dem om en uprofesjonell, korrupt organisasjon som vi samarbeidet med i Uganda. Men vi lurer på om vi kvalifiserer til å delta i Atlasalliansen. Røde Kors: Veldig lite kontakt med Atlas. Vi er en stor bevegelse, RK komiteen har rehabilitering som spesialfelt, men vi har hatt liten støtte, faglig kompetanse fra Atlas. Vi møter de på kurs av og til, men ikke konkrete samarbeid på prosjekt. Digni: Formelt sett har vi ikke hatt mye støtte, men uformelt hatt hjelp, støtte, besøk fra Atlas for å tenke rundt temaet funksjonshemming. Atlas er viktig for å synliggjøre temaet i norske bistandsverden. Men det er mest som har tatt kontakten med Atlas, ikke omvendt. FK: Vi har ingen avtaler med Atlas som sådan, Atlas ikke mottaker av våre midler, men det er mulig at noen av våre partnere har samarbeidet med Atlas. Den Norske Ambassade i Kosovo: We have no contact with Atlas Alliance or any other actors related to disability. Noen positive/negative erfaringer ift. disse prosjektene hittil? Norsk Folkehjelp: Ingen negative erfaringer så langt. Adina: Negativ erfaring i starten- vi startet med et annet prosjekt først hvor Adina var copartner, men oppdaget at de underslo penger. Vi avsluttet dermed samarbeidet. Men vi så behovet for denne type assistanse i Uganda, og startet derfor Adina Uganda. Røde Kors: Ikke spesielt, vi anser prosjektene å ha positiv impact, har ingen negative erfaringer så langt. Digni: Vi har 130-40 prosjekter totalt, vanskelig å svare om disse er mer negative eller /positive. FK: Jeg kan gi deg en liten oppdatering av de prosjektene jeg er kjent med: I Zambia startet det i 2006 et service/helsetjeneste prosjekt, hvor ergoterapeuter/fysioterapeuter ble utvekslet fra Norge (disse yrkesgruppene fantes ikke i Zambia tidligere) etter hvert har det blitt fokus på community based rehabilitation og etter hvert også på rettigheter. Så en ting er ferdigheter på personell, men nå krever også pasientene sine rettigheter- dette er en bra utvikling. Prosjektet er godt forankret i lokale helsemyndigheter, det er god bærekraft i prosjektet, og det har fått mye oppmerksomhet. Voksne og barn får tilrettelagt sin tilværelse. Ellers så har vi hørselshemmede prosjekt, men det er nystartet og det er ikke jeg som jobber med dette, så kjenner ikke detaljene. Et annet som vi støtter som kan være relevant er støtte av fysioterapeuter sin utdanning i Sudan, som startet i 2008. Slik får vi inn community based rehabilitation på pensum. En annen satsing, startet i 2009 via Sofies 22

Minde ortopedi AS (sykehus i Oslo) er samarbeid med skoler i Kambodsja, Malawi, Tanzania; utveksling av personell til skole og klinikk = styrker lærekraft / tjenestetilbud (også ift proteser). Hva er de største utfordringene med å jobbe med denne tematikken? Norsk Folkehjelp: I Libanon er det en utfordring at nivået bør opprettholdes, og da er vi helt avhengige av støtte fra UD. En annen utfordring er at palestinske organisasjoner skal få gjennomslagskraft for funksjonshemmedes rettigheter i Libanon (palestinske flyktninger har ingen rettigheter til arbeid, utdanning osv i Libanon- her er kanskje funksjonshemmedes rettigheter enda mer sårbare ). Derfor er det et viktig arbeid. Adina: Ikke store utfordringer, heller stor glede og takknemlighet fra funksjonshemmede /barn/lokalsamfunn/foreldre. Vi inkluderer foreldre og driver kunnskapsformidling innen andre områder som økonomi, lesing, skriving, alt som gjør at de kan ta ansvar selv. Vi får mye lokal støtte for at vi gjør noe med denne gruppen som tidligere har blitt stigmatisert. Også mye goodwill fra sponsorer her hjemme når de hører våre historier. Kravet kommer fra grasrota og vi jobber med enkeltindivider, ikke på policynivå. Politikere gjør lite og det er mye korrupsjon. Røde Kors: Ift. de kontekstene vi har er det ikke nødvendigvis lite midler, men lite ekspertise i felt, vi jobber med lokale organisasjoner og de er avhengige av teknisk ekspertise, men det er vanskelig å finne i noen av disse landene. Derfor har vi støttet opplæring av tekniske folk- men dette tar ofte opp til 5 år- og det er stor risiko for at de siden raskt forsvinner etter endt opplæring- braindrain =kvalitet på proteser, oppfølging og funksjonshjemmedes rettigheter blir ikke riktig fulgt opp. RK jobber uansett mest med mineoffer som tematikk ikke disability inclusion spesifikt. Men prøver å jobbe med mainstreaming av disability i andre operasjonelle prosjekt. Det skjer nok ting/positiv utvikling ift. inkludering av funksjonshjemmede i Norge (mainstreaming kommmer sterkere nå) men vår portefølje er mer operasjonell, ikke så mye inclusion. Vi er likevel på god vei- det blir gjort advocacy work i grasrotorganisasjoner og vi prøver å rette mer arbeid mot inclusion. Digni: Å få gjennomslag på grasrotnivå som en selvfølgelig del av tankegangen det er lett på papir og planer men utfordringen ligger i å skape endringsholdning, at folk deltar på lik linje i samfunnet. Her i Norge blir man påminnet om sine rettigheter, så det er det enklere. Man lykkes hvis det blir et omtalt tema blant folk da kan det skape endringsholdninger. Viktig med et arbeid mer rettet mot rettigheter/påvirking, kontra å fokusere kun på symptomene for enkeltpersoner. FK: Helt konkret for vår del, kunne vi ønsket oss flere søknader- vi har ikke avslått noen som har ønske å jobbe med denne tematikken. Vi kunne vært bedre kjent blant organisasjoner, for vi gir muligheten til å utveksle. Ellers har vi ikke spesielle utfordringer med denne tematikken ift andre prosjekter. Å jobbe med denne tematikken betyr å jobbe med grupper som er neglisjert i mange land, og det tar tid med aksept, men vi bygger på arbeid som allerede er i gang hos lokale partnere. 23

Annex 3 Mainstreamed and partly mainstreamed projects Total 2010-12 Disbursed (1000 NOK) Number of initatives 2010-12 Agreement partner mainstreamed and partly nainstreamed UNICEF 2071000 3 Nepal Ministry of Finance 157132 1 Save the Children Norway 138253 9 Malawi Ministry of Agriculture and Food Security 102000 1 MEHE (Ministry of Education, Palestine) 70000 2 Norsk Folkehjelp (NPA) 44944 2 Norwegian Refugee Council 40000 5 Plan Norway 36287 1 UNRWA - UN Relief and Works Agency 21000 1 SNV - Netherlands Development Organisation 17678 1 ILO - International Labour Organisation 16200 5 Atlas Alliance 13959 2 UNDP - UN Development Programme 12000 1 Norwac - Norwegian Aid Committee 10753 1 UNESCO - UN Educational, Scientific and Cultural Organisation 8250 3 Kirkens Nødhjelp 8113 2 SIU - Senter for internasjonalisering av høyere utdanning 7282 1 Women Centre for Legal Aid and Councelling 7200 7 Digni - Bistandsnemnda 6188 1 Norwegian Red Cross 5720 1 FAO - Food and Agricultural Organization of the United Nations 5710 1 Lions Clubs International 5292 1 FORUT - Solidaritetsaksjon for utvikling 5100 1 AIHRC- Afghanistan Independent Human Rights Commission 5000 1 FEDO/Sankalpa - Feminist Dalit Organisation (Nepal) 4743 1 TAMER- Tamer Institute for Community Education 4304 1 Gaza Community Mental Health Program 2000 1 IANSA - International Action Network on Small Arms 1950 1 Right to Play 1500 1 SOS Children's Villages 1037 3 QKSTQE (Kosovo) 181 1 Høgskolen i Oslo og Akershus 150 1 Social organization Sayor 100 1 FVS Streetball Kosova 60 1 Blind Women s Committee of Kosovo 38 1 KAPAK - Advokacy Club for Persons with Disability in Kosovo 30 1 Lef Nosi 25 1 Visoki Decani Monastery (Kosovo) 25 1 Invalidi Rada 8 1 Total 2831211 71 24