Advancing Physical Rehabilitation Services and Disability Rights with Senior Leadership Programs

Based on the World Health Organization’s (WHO) estimates, approximately 4.5 million persons with disabilities live in Tanzania. These individuals are among the most historically marginalized populations in the country. They are often under-educated, untrained, unemployed or underemployed, and poor—women, young people, and those living in rural areas are often the most vulnerable. In Tanzania, the disability movement has made important strides to safeguard the rights of Tanzanians with disabilities. Different disabled people’s organizations (DPOs) and their umbrella association, Tanzania Federation of Disabled People’s Organizations (known as SHIVYAWATA), regularly take part in discussions with the government on issues affecting the lives of people with disabilities. Among the outcomes of the DPOs’ movement are the formulation of National Policy on Disability in 2004, the signing and ratification of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), and the Persons with Disability Act of 2010, which together promote inclusion of persons with disabilities in socio-economic affairs and uphold their human rights.

Despite this momentum, there are still challenges. The CRPD obligates the Tanzanian government to fulfill rights that range across sectors and require changes in many already resource-constrained areas, such as education, health, and community life. Commonly, policy makers, human rights advocates, health service managers, and others are overwhelmed by the wide-ranging needs of the community, work in silos, and are often too preoccupied with daily demands to find time to step back and look strategically at how they can ensure greater inclusion for disabled people across sectors.

In August 2013, a diverse group of senior Tanzanian leaders came together with teams of high-level executives from Ethiopia, Sudan and Zambia to participate in LMG’s Senior Leadership Program (SLP), conducted in partnership with the International Committee of the Red Cross (ICRC) and the ICRC Special Fund for the Disabled (ICRC SFD). The Tanzanian team chose to focus on addressing the problem of two national physical rehabilitation service centers that were underutilized, despite significant need in the population. The participants included key representatives from the Ministry of Health, the Disability Unit within the Department of Social Welfare, SHIVYAWATA, a Tanzanian center of excellence for physical rehabilitation services, and ICRC SFD’s Tanzania program.

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The Senior Leadership Program brings together local decision makers to recognize their shared interests, develop and implement an action plan to address pressing challenges, and achieve results. Teams of high-level leaders come together at planned times over nine months and are led through a structured program where they gain skills in problem solving, learn new methods of working with cross-sector teams, and encourage one another as they apply what they learn.

The Tanzanian team focused on improving the quality of life for persons with disabilities in their community, region, and nation through physical rehabilitation services which can restore an individual’s mobility and serves as an entry point for inclusion into society. Through the SLP, the team analyzed the root causes of underutilized services, surveying and directly involving many persons with disabilities in the analysis. They found that lack of awareness of available services and subsidies was the primary contributor to low service uptake. Better understanding the root cause allowed the team to develop a focused strategy to increase service delivery utilization.

To address the problem of low awareness of services and subsidies, the Tanzania team developed and implemented a targeted campaign to increase potential clients’ awareness of the services available and how to access to financial subsidies when needed. This multimedia campaign to be evaluated in May 2015 includes appearances on local TV shows, radio spots, and creation and dissemination of written communication materials throughout DPO networks. They also trained existing clients to serve as ambassadors for physical rehabilitation to promote awareness and access to services in their communities. The team successfully advocated for increased national investment in physical rehabilitation services by leveraging existing resources from within their organizations. These investments improved physical accessibility by directly addressing information accessibility and economic accessibility, two dimensions of accessibility outlined in CRPD.

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Initially, one of the challenges that existed for the team to work together was that many of the individual members were familiar with one another but did not have strong working relationships because there was no existing national coordination structure to bring them together. Through participating in the Senior Leadership Program, these individual leaders realized that despite working in different sectors/departments/clients/agendas, they had shared interests and goals that became easier to achieve when broken down into concrete steps to undertake together. They recognized the value of bringing together their diverse perspectives, skills, resources, relationships and areas of influence. The group continues to meet on a monthly basis, conducting follow-up activities and continuing to advocate for increased investment in physical rehabilitation services.  They have also taken up a new set of challenges to further the implementation of the CRPD.

In this new year, the LMG Project and the ICRC will be conducting two additional Senior Leadership Programs, one in Francophone Africa with Burundi, Chad, DRC, Madagascar, Niger, and Togo; and one in Southeast Asia with Cambodia, Laos PDR, Myanmar, Philippines, and Vietnam. In these programs, the LMG Project will increase the integration of leadership development and human rights programming, support these country teams to achieve results like in the Tanzania experience, and continue to contribute to the evidence base for how development practitioners can support local leaders to build cross-sector coalitions that work on concrete steps toward more inclusive societies.

“As a group we strongly believe the status of rehabilitation services in Tanzania—at the ministry level, with DPOs and among people with disabilities—has been lifted up as a result of our teamwork on promotion of rehabilitation services in Tanzania,” said Vincent Kaduma, ICRC/SFD Tanzania.

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