country report on intellectual disability bangladesh1 country report on intellectual disability...
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1
Country Report
on
Intellectual Disability
Bangladesh
19th Asian Federation on Intellectual Disabilities Conference,
Singapore, 2009
Presented by
Dr. Shamim Ferdous
Executive DirectorBangladesh Protibondhi Foundation
2
Population : 150 million
Average population : 980
people/sq. km.
Facts of Bangladesh
Any Disability : 15 million
Intellectual Disability : 4.6 million
(WHO)
3
Background
Until 1977 people of Bangladesh were unaware of
intellectual disability.
In the same year Society for the Welfare of the
Intellectually Disabled, Bangladesh (SWID,
Bangladesh) was established by parents and
Professor Sultana S. Zaman renounced psychologist
and disability expert started programmes for children
with intellectual disability.
It is the milestone in the history of services for the
Person with Intellectual Disability.
4
Prevalence of Disability in Bangladesh
National Forum of Organization Working
with Disabled & Handicap International in
collaboration of DFID in 2005
5.6 %
Govt. of Bangladesh Survey : 1982
1986
1995
(Bangladesh Bureau of Statistics-1996)
0.64
0.52
1.06
According to the National Census 2001
(full report still not published)
< 1%
not accepted
by the Govt.
Action Aid in 1996 14 %
Bangladesh Protibondhi Foundation 1987 &
2001
6.8% (1987)
& 11.7 %
(2001)
5
Scale of the problems in Bangladesh
Prevalence of childhood disabilities in population-based
surveys in 1988 and 2001
69
118
29
66
20
36
16
32
69
59
0
20
40
60
80
100
120
per 1000
children
Any
Hea
ring
Cogniti
on
Visio
n
Moto
r
Seizu
re
Disability
1988
2001
Infant mortality: 65/1000 (2004)
MGD 4: 31/1000(2015)
Mortality under 5yrs: 24/1000 (2004)
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Risk Factors of Childhood
Disability
Poverty
Malnutrition
Maternal illiteracy
Maternal history of
pregnancy loss
Maternal depression
Small for gestational age
Consanguinity
Iodine deficiency
Exposure to environmental toxin
Pre and postnatal brain infection
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Govt. Policy and Legislation for People with
Disabilities
National Policy on Disability 1995
(Govt. adopted)
The Disability Welfare Act – 2001 Enacted by the
National Parliament to
provide a legal
framework.
The National Plan of Action II September 2006,
approved by the National
Coordination
Committee constituted
under the Disability
welfare Act 2001.
8
* Currently the Disability Welfare Act 2001 is being
reviewed for amendment to make it complaint with the UN
Convention on the Rights of Persons with Disabilities
(UNCRPD)
Bangladesh is one of the member, committee on Rights of
Persons with Disabilities, UN
A Disability Rights Watch Group and National Forum of
Law and Legislation committee is formed in Februrary16,
2009
9
The United Nations Convention May 9, 2007
on the Rights of Person with
Disabilities (CRPD)
signed and
Ratified November 30, 2007
by Govt.
United Nations Convention on The Rights of
Persons with Disabilities (UNCRPD)
10
Govt. and NGOs working in the field of Disabilities
NGOs are working 55,000 (approx)
Claiming to work 400 NGOs
for people with disabilities
Human resources development 275 NGOs
(cater rehabilitation)
Service Providers 95% services by NGO,
5% by the Govt.
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Prominent Service providers in the field
of ID
• National Center for Special Education (NCSE) Govt. and
other Govt integrated Schools - 13
• Self Contained School for the Intellectually Disabled –
2 Branches
• Society for the Welfare of the Intellectually Disabled
(SWID) - 46 Branches
• Bangladesh Protibondhi Foundation (BPF) - 7 Branches
• Rehabilitation Institute and Hospital for the Disabled
(RIHD)
• Centre for the Rehabilitation of the Paralyzed (CRP)
• Tori Foundation (Gifted Children’s School) – 2 Branches
• GBSS (Gram Bikash Shohaok Sangstha)
12
The National Forum of Organizations Working with
the Disabled (NFOWD) Est. 1991, Rgd. (Ministry of Social Welfare and NGO Affairs Bureau)
Executive Member The Boards of the National Social
Welfare Council
Member The National Coordination
Committee and the National
Executive Committee on Disability
(constituted under the Disability
Welfare Act 2001)
International Member The South Asian Network on
Community Based Rehabilitation
Currently NFOWD consists of 318 members from 59 districts out of 64
districts.
13
Local Other NGOs
Disabled People’s organization (DPOs)
Civil Society Organizations (CSOs)
14
INGOs, Finance Institutions and Donors
Action Aid Bangladesh
Handicap International
Sight Savers International
Save the Children
The Polli Karma Shohayak Foundation
The Corporate Sector and many more
15
International Commitments on Education of
Children with Disabilities
• Education For All (EFA) : Jomtien (1990) declarations
• Salamanca Declaration (1994) World Conference on
Special Needs Education
• Dakar Framework for Action (2000)
• E-9 Declaration (2000)
• UN Standard Rules on the Equalization of Opportunities
for Persons with Disabilities (1993)
• Biwako Millennium Framework for Action (Asia-Pacific
Decade of Disabled Persons (2003-2012)
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National Commitments and Programmes
• National Policy on Disability-1995
• National Disability Welfare Act-2001. Currently the law is
being reviewed for amendment to make it complain with
the UN Convention on the rights of persons with disability
• National Action Plan on Disability-2006
• Institutional Programmes by Department of Social
Services for Persons with Disabilities relating 2000
• Primary Education Development Programme (PEDP)-II
• Teaching Quality Improvement in Secondary Education
Project-under Department of Secondary and Higher
Education- Ministry of Education
• National Plan of Action (NPA-II) for children (2004-2009)
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The goals are:
1. Increase primary school access, participation and
completion in accordance with government's EFA
(Education for All) and other policy commitments;
2. Improve the quality of student learning and
performance outcomes; and
3. Build and facilitate a positive relationship between the
Government of Bangladesh, donors and consultants.
PEDP II aims to provide quality primary
education to all eligible children in Bangladesh
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System of Formal Education
(Mainstream Ed.)
Primary
Duration: 5 Years
Class: 1 to 5
Age group : 6 to 10
Secondary
Duration: 5 years
Age group: 11 to 15 years
Lower Secondary
Duration: 3 years
Class: 6 – 8, Age: 11 & 13
Secondary
Duration: 2 years
Class: 9 & 10, Age: 14 & 15
Higher Secondary
Duration: 2 years
Class: 11 & 12 Age: 16 & 17
Education For ID
Special
School
Integrated
School
Inclusive
Primary School
• Home Based Education
• Early Intervention
• Pre School Prog.
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Access to Education of ID Children
Any disability of school going age : 6-10 yrs 44%
16-18 yrs 15%(Source: ESTEEM, 2002)
Access to Education of school going age 11%
(Boys:Girls=56:4)
Enrolled 8% in Various Educational Set up
Primary Education 68%
Pre Primary Ed. 15%
Among 8% children enrolled in educational set up :
Physical disability 55%
Visually Impaired 13%
Hearing Impaired 12%
Intellectual Disabilities 10%Source: Educational Status of PWID in Bangladesh, Dr. Shirin Z. Munir, 5th International SIVUS Conference
on M.R.,2009
20
Target
At least 75% of children & youth with
disabilities of school going age will able to
complete primary education by 2015 .
Source: Mid-point review of the Asian and Pacific Decade of Disabled Person 2003-2012
21
140
150
90
75
37
95
0-less 1 yr.
Above 1-2 yrs
Above 2-3 yrs.
Above 3-4 yrs.
Above 4-5 yrs.
Above 5 yrs.
Number of children
Research on Early Detection
Source : Child Development Centre, Shishu Bikash Network
22
Pre-School Education
Virtually there are no services for the pre-school age
children with disabilities. Only few programmes
designed & implemented through NGOs for example :
Save the children - SUCCED project, BRAC, Plan
Bangladesh, Bangladesh Protibondhi Foundation and
CSID.Source: Paul Ackerman, Mary S. Thormann, Sharmin Huq, 2005
In July 2009 Govt. has made a Working Draft and a
Policy Framework on Compressive Early Childhood
Care and Development (ECCD).
Source: Ministry of Primary and Mass Education, Bangladesh
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Government of Bangladesh has allocated Budgets as
stipend for students with disabilities.
Ministry of Social Welfare is responsible for selection and
distribution of stipend monthly in following rates :
Primary level Tk. 300
Secondary level Tk. 450
Higher secondary Tk. 600
Tertiary & above Tk. 1000
Govt. Facilities for the students with disabilities
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Govt. Vocational Training Centres (5) :
• Industry for Production of Plastic Goods
• Mineral Water (Maitry Shilpo)
NGOs Vocational Training Centres :
• Trust for the Welfare of Intellectually Disabled (TWID) run by SWID
• Bangladesh Protibondhi Foundation (BPF)
• UCEP, CSID
• Centre for the Rehabilitation of the Paralyzed (CRP) and
• other NGOs, Private Sectors.
Vocational Training Centers, Sheltered Workshop &
Job Placement for PWD
In July 2007, M/O Youth and Sports, Industries have taken
steps to reserve seats for persons with disabilities in their
vocational training institutes.Source: Mid-point review of the Asian and Pacific Decade of Disabled Person 2003-2012
25
Employment Sectors
Government
5%
Non-
Government
17%
Others
12%
Self-
employment
66%
(8% intellectually disabled)
Source: Center for Services and Information on Disability 2002
26
Special Olympic
Children with ID participate in different events of
Special Olympics in 2007 and own
Gold 37
Silver 22
Bronze 19
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Community based Rehabilitation (CBR)
CBR cervices are very effective in Bangladesh run by
the NGOs.
Community Based Rehabilitation Programme (CBR)
is a specific strategies for implementing rehabilitation
activities for the person with disability in the
Community.
CBR approach has been increasingly accepted and
medical, education, and occupational rehabilitation
services have been included in CBR.
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• To experiment and gain practical experience on
CBR.
• To collect and disseminate information among the
number organization.
• Assisting member organization to conduct survey,
research on CBR.
• Helping in evaluating the impact and achievement
of CBR and
• Organizing meeting, seminars, workshops,
conference etc. To aware and motivate the people.
A National CBR network was formed in
Bangladesh(1990) with the following
objectives.
29
23.4426.03
49.18
23.14
30.2132.77
10.83
31.4
4.078.55
0
10
20
30
40
50
60
Dhamrai Savar Kishoregonj Norshindi Faridpur
Disability Impairment
Impact of CBR Services
(Population based surveys in 5 CBR areas in 2001, BPF)
30
Health
Bangladesh Govt. has incorporated appropriate
provisions for prevention of avoidable disablement
in the National Health Policy.
Though 30 % disabled people never met
doctors/specialist for disability treatment.
31
Malnutrition high risk for Cognitive DisabilityNutritional survey of 2-9 year old children in Kishoreganj, BPF and
Columbia University, 2001-2002 (Number of children=944)
Chi-square df P value
Stunting
(ht/age)
11.380 1 .000
Underweight
(wt/age)
5.649 1 .010
Wasting
(wt/ht)
.436 1 .288
Bangladesh Govt. has declared to provide one hot meal as
School Lunch which is also provided by many NGOs earlier.
32
Activities undertaken at different levels for
improving the Health situation of the children
with disabilities in Bangladesh
1.The Extended Programme of Immunization (EPI) of
Bangladesh Govt. has helped to
Decrease the infant mortality rate (IMR)
Dropped under five mortality rate (U5MR)
2. Countrywide Mass Awareness Programme to
prevent disability/ Increasing in community
participation
3. Care of pregnant mother through traditional birth
attendants.
33
4. Bangladesh Integrated Nutrition Project (BINP) made
impact to reduce malnutrition among children and
women.
5. Increasing awareness about nutrition breast feeding,
food habit, home gardening, use of iodized salt.
6. Declining malnutrition and low birth weight and adaptation
of family planning practices among eligible couple.
7. Early Detection and intervention by pediatrician,
psychologists and therapists of different Child
Development Centres at district hospitals in 14 medical
colleges. At present Child Development Centre is
running five Medical College Hospital in Bangladesh.
8. Initiating programmes for the primary and secondary
prevention on the occurrence of the causes of disability.
34
Human Resource Development by Govt. and NGOs
• Post Graduate Bachelors and Masters
Degree in Special Education in the
area of Intellectual Disability, Hearing
and Visual Impairment.
• Certificate Course in Physiotherapy
Occupational Therapy, Rehabilitation
Nursing and Certificate course in
Special Need.
• Several other short and long courses
for different level of people in the
prevention, identification, management
treatment, rehabilitation and counseling
of the children with disabilities.
National Centre for Special
Education (Govt.)
Bangladesh Protibondhi
Foundation, SWID
Bangladesh and Institute
of Education and Research
(IER), Dhaka University.
CRP, Orthopedic Hospital
CDD, ADD, Child
Development Centre
(Dhaka Children's Hospital)
and different NGO’s
35
• Group formation
• Mobilization of Savings
• Training in awareness development
• Skill development
• Micro-credit
• Health, Sanitation and Nutrition
The Govt. poverty alleviation programme for improving of
PWDs overall socioeconomic condition by
36
Disability and Resource Allocation
Disability has been included in PRSP-II but not
adequately and the issues of Children and
Women with Disabilities are missing in PRSP-II.
Government of Bangladesh is now implementing MDG
but since disability issues are excluded from MDG, the
Government is reluctant to allocate budget on disability
development issues.
In August 2007, Ministry of Social Welfare has started a
pilot project with USA based company to develop a
digital data based of person with disability in 6 selected
districts for insurance of ID cardSource: Country Report of Bangladesh on mid-term review of the Asian and Pacific Decade of
Disabled Person 2003-2012, 19-21 September 2007.
37
Rules of Business
According to the Rules of Business, the Ministry of Social
Welfare, since its inception in the early 1960s, has been
the lead ministry catering for all issues of people with
disabilities in Bangladesh, including the areas of
education, employment, and rehabilitation. Since
disability is considered a cross-cutting issue, it demands
an active involvement of other ministries and
departments. Due to said Rules of Business, the role and
participation of other ministries and departments seems
to be limited.
In 2007 steps have been taken to revise the current Rules
of Business of the Government and it is expected that all
leading nation building departments, divisions and
ministries will be taking up responsibilities to serve the
persons with disability in their respective work areas.
38
Recommendation
• A database can be established & update regularly to
identify disabled people.
• Without the presence of appropriate data, developing
and implementing comprehensive legislation is
difficult.
• Plus it makes it extremely difficult to access whether
actions and programmes are relevant and has had an
impact on equity to services.
• Allocation of necessary fund in the national budget.
• Uniform Curriculum of special education.
• Promote inclusive education of children excluded
from the mainstreaming education.
• Adequate number of special education institutes
39
• Adequate number of special education institutes
special Education Services need to be provided
through the regular educational institutions, like
Primary schools, High schools and other educational
institutions.
• Teachers of the general educational institutions need
to be trained through the special education teachers
training institutes. Teachers training programmes
could incorporate special education subjects related
to the disability in their existing courses.
• More Medical Persons could be trained on disability
issues and posted regional hospitals.
40
• Necessity for relevant support system such as
therapeutically and assistive technology.
• A National Policy should be formulated to promote
the achievement of this targets (such as
mandatory reserve quota, employer incentives,
awareness-raising, campaigns, debriefing
employers & employees and extending technical
support to the employers).
• Strengthening sensitization at all levels though
organizing national and local level dialogues
workshop and seminars and advocacy to
concerned agencies for job placement etc.
41
Conclusion
People with disabilities and their organizations working
in this field should address, work collectively to
implement existing policies and overcome the gaps.
They would now act on this platform to increase mass
awareness campaigns for reducing violation of Child
Rights .