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利用监测、评估和学习来扩大印度和全球残疾儿童赋权包容项目的规模。

Leveraging monitoring, evaluation, and learning to scale the Enabling Inclusion program for children with disabilities in India and globally.

机构信息

Enabling Inclusion Program, Amar Seva Sangam, Tenkasi, Tamil Nadu, India.

Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.

出版信息

Front Public Health. 2023 Dec 12;11:1165034. doi: 10.3389/fpubh.2023.1165034. eCollection 2023.


DOI:10.3389/fpubh.2023.1165034
PMID:38162603
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10757565/
Abstract

INTRODUCTION: Children with disabilities in low- and middle-income countries face many challenges and lack adequate services, including access to rehabilitation professionals. To address this lack of access, Amar Seva Sangam Ayikudy (ASSA), a non-governmental organization (NGO) in India, designed a technology-leveraged rehabilitation program called Enabling Inclusion (EI), and implemented it in one state (Tamil Nadu, India) before scaling it. The model is supported by the EI app, which enables organizations to screen, assess and monitor progress of children with disabilities via rehabilitation specialists and community rehabilitation workers, and to provide family-centered, goal-based interventions. An extensive monitoring, evaluation, and learning (MEL) framework is embedded into the program. This paper explores how this MEL system supported the scaling of the EI model, reaching additional beneficiaries nationally and globally. METHODS: This paper describes ASSA's MEL framework and demonstrates its use for decision-making in the process of scaling. It also explores how collaborations with various government departments, NGOs, and private partners contributed to the scaling of the EI model and technology. RESULTS: Scaling of the EI program was achieved by (1) expansion of the program in rural Tamil Nadu (vertical scale-up) in partnership with the Tamil Nadu government and private partners, and (2) by licensing the EI app and model to other NGOs in various states in India and globally (horizontal scale-up). Systematic examination of key program and performance indicators, as well as stakeholder feedback, informed decisions to modify the EI app over time. This included further customizing to the needs of children and service providers, covering a greater range of age groups and contexts, and modifying service delivery models. Child functional independence, participation, and inclusion was further strengthened by mobilizing parent empowerment groups, community awareness programs, school advocacy, and entitlements from the government. Flexibility in the implementation model of the EI app allowed for adaptation to local contexts and organizations, and facilitated its scale-up. CONCLUSION: A dynamic, inclusive, and locally grounded MEL system, a flexible and collaborative approach, and an adaptive implementation model increased the accessibility of an early intervention and childhood rehabilitation program for children with disabilities and their families throughout the state of Tamil Nadu, across India, and internationally.

摘要

简介:在中低收入国家,残疾儿童面临许多挑战,并且缺乏足够的服务,包括获得康复专业人员的服务。为了解决这种服务不足的问题,印度的非政府组织 Amar Seva Sangam Ayikudy (ASSA) 设计了一种名为“使包容成为可能”(EI)的技术型康复项目,并在一个邦(印度泰米尔纳德邦)实施该项目,然后将其推广。该模式得到了 EI 应用程序的支持,该应用程序使组织能够通过康复专家和社区康复工作者对残疾儿童进行筛选、评估和监测进展情况,并提供以家庭为中心、以目标为基础的干预措施。该项目中嵌入了一个广泛的监测、评估和学习(MEL)框架。本文探讨了该 MEL 系统如何支持 EI 模型的推广,使其在全国乃至全球范围内惠及更多受益人群。

方法:本文介绍了 ASSA 的 MEL 框架,并展示了其在推广过程中用于决策的方法。还探讨了与各政府部门、非政府组织和私人合作伙伴的合作如何促进 EI 模型和技术的推广。

结果:EI 项目的推广是通过以下方式实现的:(1)与泰米尔纳德邦政府和私人合作伙伴合作,在泰米尔纳德邦农村地区扩大项目规模(纵向扩展);(2)向印度各邦和全球的其他非政府组织授权 EI 应用程序和模型(横向扩展)。对关键项目和绩效指标的系统检查以及利益相关者的反馈意见,为修改 EI 应用程序提供了决策依据。这包括根据儿童和服务提供者的需求进一步定制,涵盖更广泛的年龄组和背景,并修改服务提供模式。通过动员家长赋权团体、社区宣传计划、学校宣传和政府赋予的权利,进一步加强了儿童的功能独立性、参与度和包容性。EI 应用程序实施模式的灵活性允许适应当地情况和组织,并促进了其推广。

结论:一个动态的、包容的、立足本地的 MEL 系统、灵活的合作方法和适应性实施模式,增加了残疾儿童及其家庭获得早期干预和儿童康复服务的机会,使该项目在整个泰米尔纳德邦、印度和国际范围内得到普及。

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引用本文的文献

[1]
Process Evaluations for the Scale-Up of Complex Interventions - a Scoping Review.

Int J Integr Care. 2024-11-8

本文引用的文献

[1]
Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019-21).

Front Public Health. 2023

[2]
Accelerating progress on early childhood development for children under 5 years with disabilities by 2030.

Lancet Glob Health. 2022-3

[3]
Measurement for Change: From Idea to Approach.

Front Public Health. 2020-11-26

[4]
The Aspirations of Measurement for Change.

Front Public Health. 2020-11-26

[5]
Rapid-Cycle Evaluation in an Early Intervention Program for Children With Developmental Disabilities in South India: Optimizing Service Providers' Quality of Work-Life, Family Program Engagement, and School Enrollment.

Front Public Health. 2020-11-30

[6]
Impact of a family-centred early intervention programme in South India on caregivers of children with developmental delays.

Disabil Rehabil. 2022-6

[7]
The Use of Implementation Science Tools to Design, Implement, and Monitor a Community-Based mHealth Intervention for Child Health in the Amazon.

Front Public Health. 2020-8-19

[8]
Early intervention for children with developmental disabilities in low and middle-income countries - the case for action.

Int Health. 2021-4-27

[9]
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BMJ Open. 2019-8-15

[10]
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BMC Health Serv Res. 2019-3-25

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