Global Partnership for Education and Children with Disabilities

May 7 11, 2012 Washington, D.C.

Natasha Graham Senior Education Specialist Global Partnership for Education Secretariat

Out of School Children: the Global Challenge

100 million

67 million

56 million

2000

2009

2015

What is needed?
Partnerships Out of School + Disability data to set goals and to monitor progress Targeted funding

Reaching the Unreached Program for Identification of Out of School Children including Disability Screening

Cambodia : 1st model GPE country Data collection linked with service planning and provision Data used for planning costing and including children with disabilities and other special educational needs in education

WHO is out?

Never been to school

Dropped out

In school, but at risk for dropping out

WHY are they out?

No school

Members of linguistic/ethnic minorities

School too far

Orphans

Disabled

30 25 20 15 10 5

Out-of-school rate for children of primary school age (%)

Mauritius Uzbekistan Belarus Ukraine Moldova Cambodia

0 1998 2000 2002 2004 2006 2008 2010

Many countries=Similar Problems No data=No Policy (or badpolicy)

-Lack of data for Policy and Program planning
Kenya: lack of clear guidelines on the implementation of an all inclusive education policy, lack of reliable data on children with special needs, inadequate tools and skills in identification and assessment, and curriculum that is not tailored to learners with special needs

Priorities with respect to disability in GPE countries

Most of the 46 countries receiving support through the GPE partnership mention children with disabilities in their education sector plans

Creation of databases on children with disabilities and special needs through surveys and screening

Countries express the need to develop screening methodologies

Education Sector Plans and Children with Disabilities

Establishment of SNE unit within MOE; Strategy and/or implementation plan; Center within school; Teacher training; Learning materials/equipment/curriculum; Access to school buildings/classrooms; Situation analysis; Disability data; Capacity building; Parents/community education, involvement and awareness.

Method for Identification and Disability Screening Linked with Service Provision
Two phase method for gathering data on out of school children and those with disabilities Validated and tested in Jamaica, Pakistan, Bangladesh and Ethiopia Adapted, simplified and linked with service provision for children with disabilities in Cambodia .

Cambodia: Quality Education for ALL children

Cambodian Education System Today

Primary: 6-11 (Grades 1-6) Lower Secondary: 12-14 (Grades 7-9) Upper Secondary: 15-17 (Grades 10-12) Higher Education: 34 public+54 private

Todays scenario:

Grade 1

100

10 years

Grade 7

50
20

Grade 12 University

Achievements since 2005

Construction of more than 500 Lower Secondary and 300 Primary Schools New basic teacher qualification approved (06) New curriculum developed and currently being put in place Learning standards for students at grades 3,6 and 9 are being finalized National program to improve the teaching of Early Grade Reading established (10) CFS policy adopted (07) Gender Mainstreaming Strategic Plan developed and implemented (06-10) National study to identify prevalence rates of OOSC including disability screening (the results to be used to create targeted interventions to increase enrollment and reduce/prevent drop out) Annual Operating plans, Code of Conduct for Teachers, School grants offered to 650 primary schools, Teacher Prof. Standard Adopted, School director training begun in 05, Re-org of MOEYS departments, ECD policy adopted in 10, 6000 in service teachers trained to become Basic Ed. Teachers (2010), Core breakthrough Indicators established (2010)

Method
Study gathers data on out of school children aged 2-17 and those with disabilities aged 2-9 Data collected in 12 provinces for out of school children and 7 of these 12 provinces on those with disabilities Identified children linked with service providers Sample sizes:
35,000 for out of school study 20,000 for disability prevalence study

School Mapping Infrastructure

School Mapping: 1 commune HH w. OOSC are marked

Identification of Out of School Children including children with disabilities using School Mapping infrastructure
Identification of out of school children (w. reason why children are not in school) Professional screening of children with disabilities (both in/out of school) Provision of support services/referrals to identified children Data management: school leveldistrict level- MOE Use of data for planning

NEW Objectives of School Mapping Who are the kids out of school? Who is at risk for dropping out? Why are they out of school? What can be done to bring them to school? How much will it cost?

Two-phase method for Disability Prevalence Calculation

Phase one: Household information+ School participation+ Disability Screening form (TQSI-Ten Question Screening Instrument)

Phase two: Professional assessment by health professionals of those children who answered Yes to at least one question in Disability Screening form in phase 1

What is TQSI?
Ten Question Screening Instrument is a set of 10 simple questions about a childs hearing, vision, speech, cognition, motor, epilepsy and language Its been used as a single phase approach, or as the first phase of a two-phase approach, which aims to identify the prevalence of disability (MICS) Two-Phase TQSI has been tested in epidemiological surveys involving screening and clinical assessments of more than 22,000 children, aged 2-9, in Bangladesh, Jamaica and Pakistan

The Ten Questions Screening Instrument (TQSI)

Basic info and Pros
10 Simple questions in a Yes/No format Cross culturally appropriate (universal abilities) Relies on parental ratings (conducted in an interview format) at the HH level Low cost and rapid Non-gender biased Increases efficiency of professionals Estimates prevalence Service planning and implementation, investigation of risk factors and prevention

Cons and Limitations Although reliable, feasible, and valid across cultures for detecting serious cognitive, motor and seizure disabilities in 2-9 year-old children in low resource settings, the screen has low sensitivity for previously undetected vision and hearing disabilities. Not diagnostic (phase 2 is needed)

Module 1: Workshop to design questionnaire

Out of school (never in school) Out of school (dropped out) In-school (at risk for dropping out

Too young Disabled/ill No school /too far Can not afford schooling Not interested in school School is not safe To learn a skill/trade To work (paid/unpaid/at home/outside of home Harvest season Teacher Absenteeism

Reasons why children are not in school

Descriptive Data
Note more disabilities shown here than total children w/disabilities, as many children had multiple disabilities

A lot of children had completely blocking ear wax(impairment) but no disability(once removed) Category Gross Motor Fine Motor Seizures Vision Hearing Behavior Cognition Speech(Motor) Speech (Language) Other: # of Impairments 20 19 56 27 61 13 82 53 36 39 # of Disabilities 19 17 12 24 23 12 81 51 36 16

Pre-test: December 2010

Training of data collectors for the national scale up: Dec 2011

Phase 1 data collection

Re-fresher training

Phase 2: Medical screening (Dec 2011)

Vision screening

 Hearing test

Fairly simple, but invasive procedure.

Criteria

Cognitive assessment: some children have cognitive disabilities because of developmental delays, and have been referred to CBR/developmental therapy

Some Data
Number of households visited = 16,859 Number of children aged 2-9 = 14,034 Number of children aged 2-17 = 32,752 Number of appointments for phase 2 =2,725

Descriptive Data
-Out of 692 screened children 145 were identified with one or more disabilities
-61 children with hearing impairments ->after receiving treatment only 23 had hearing disabilities

-421 (out of 692) received medication for untreated infections

-For some children untreated infections turned into impairments and/or disabilities (i.e. ear infections)

-65 (out of 692) had been referred for additional services -Nutrition breakdown: -262 (38%) out of 692 were identified as malnourished with 138 (20%) out of 692 being severely malnourished
-Many malnourished children had mild cognitive disabilities and/or untreated infections

Cost Analysis
All children identified with some type of a disability or an impairment received treatment or referral to a provider Infections: cost of antibiotic treatment is 50 cents Vision: cost of a pair of glasses $3$4 Total cost of providing services for all identified and screened children: $150,000 (from the sample size)

Costing
-of out of school+disability data collection: $500,000/country Adding service provision for identified children $150,000 Next steps: Developing a national referral system as part of the Education Sector Plan Working and linking with MOH for health interventions

Lack of a pair of eye glasses could prevent a child from going to school

65% hearing loss due to untreated ear infection->30-35% re-gained on the spot, and the remaining 30% with antibiotics.

Cambodia: Next steps?

Getting ALL children in school and learning. 1. NGO mapping workshop (what services are available? Where? Are they scalable? What are the needs? Finish the data collection Briefing outlining priority areas to include children with disabilities Planning and costing to be included in the next ESP linking with MOH New ESP: Education for All Cambodian children

2. 3. 4.

5.