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The 3rd Asia-Pacific CBR Congress

ABSTRACT FORM

Information about Presenter Name, Designation, Organization 1. Mr. Kholov Abduljhakim, Director, State Agency on Social Protection, Ministry of Health and Social Protection, Republic of Tajikistan
2. Ms. Sharipova Mahfuza, Director, PO “Manbai Mehr” / Ms. Inoyatova Saida, Director, Disabled Women’s League, “Ishtirok”
Country Represented Tajikistan Nationality Tajik
Email Address nilu-shohaidarov@mail.ru
manbaimehr@gmail.com / dilsuz@yahoo.com
Website http://www.health.tj/
Concurrent Session Number and Title Concurrent Session 4-3: Public and Private partnership
Title of Presentation Community Based Rehabilitation in Tajikistan: Reaching the unreached
ABSTRACT PROPER
Introduction In 2010, Tajikistan had the largest polio outbreak in the world since 2005. Many people with polio have developed impairments over the last 4 years and need long term rehabilitation care. Also, there are a significant number of children with multiple impairments, people with noncommunicable diseases especially stroke and diabetes, landmine victims and older people with reduced functioning or mobility who are in need of rehabilitation services. Disability rehabilitation services were not very well-known until the polio outbreak in 2010. The World Health Organization (WHO) generally recognizes that 15% of the population have a disability (2011). With a current population of about 7.8 million inhabitants, Tajikistan can be expected to be home to about 1.17 million persons with disabilities (PWD), while the official figure for registered PWD is only 175,447. Persons with disabilities face widespread barriers in accessing services such as those for health care, rehabilitation, education, employment, social services including housing and transport. To uplift the lives of persons with disabilities it has become a necessity to establish strong Community Based Rehabilitation (CBR) programmes which focuses on health, education, livelihood, social mobilization, empowerment of PWDs through inclusive community development with participation of both public and private sector.
Methods/ Approaches/ Strategies Used/ How Did You Do It? CBR was officially introduced in Tajikistan with active support of international agencies and organizations. In December 2014, the Ministry of Health and Social Protection, Republic of Tajikistan and the WHO organized the first national conference on CBR entitled "Reaching the unreached" in Tajikistan. The conference was organized with the active support and participation of other relevant ministries, civil society organizations, international agencies and organizations of people with disabilities. With 400 participants, the conference was one of the largest events on disability issues in Tajikistan. The conference reinforced the message that through the combined efforts of PWDs, their families and communities, and relevant government and nongovernment health, education, labour, social and other services, an equitable environment can be generated. Policy-makers and other stakeholders in the fields of health, social protection, education, labour, finance, justice, transport and infrastructure seized this opportunity to - highlight advances in CBR practices; launch CBR guidelines in the Tajik language; identify potentially suitable CBR models for Tajikistan; foster collaboration and knowledge exchange across sectors; and, generate potential solutions for disability issues in Tajikistan. The conference provided guiding principles to implement CBR programmes and laid foundations for initiation of Government-managed CBR programmes in Tajikistan.
The availability of disability rehabilitation services for PWD in Tajikistan has increased in recent years. Many of the current pilot rehabilitation programmes show great promise, despite the harsh geography of the country and the difficulty of extending services to everyone who needs them. CBR and the joint collaboration of public and private sector have given a new hope to Tajikistan.
Results The consolidation of disability issues in 2014 under the new Ministry of Health and Social Protection is a potential asset for Tajikistan. The Ministry is leading the process for a coordinated multisectoral and multidisciplinary response through development of an appropriate disability strategy and legislation and their enforcement; human resource development in line with international standards; identification and consensus on an appropriate service delivery model focusing on the decentralization of rehabilitation services; support for the development of a barrier-free, accessible and non-discriminatory environment; and, participation by persons with disabilities in decisions that directly affect their lives.
In 2015, national CBR strategy was finalized with an aim to internalize CBR in Government policy framework and services. Following this, the Ministry of Health and Social Protection adopted its current service delivery mechanism and initiated CBR programmes in 10 districts of Tajikistan. CBR programmes are implemented in collaboration with local nongovernmental organizations. This is followed by intensive capacity development initiatives on CBR and development of appropriate planning, monitoring and evaluation tools for implementation of Govt. managed CBR programs in coordination with local NGOs. This is followed by strengthening of Tajikistan CBR network and the plan is to expand to 20 districts through the public-private partnership model. A new National state program on Health, rehabilitation and social protection of person with disabilities in Tajikistan is currently been drafted which will have a strong component on CBR.
Conclusion and Recommendation Accession by Tajikistan to the Convention on the Rights of Persons with Disabilities would provide an overall framework for and create synergies in the disability and rehabilitation response. Tajikistan is currently moving from “side-stream” disability services to “mainstream” services. There is a growing awareness of the need for and benefits of CBR and their contribution to the empowerment of people with disabilities. Efforts to improve the accountability, responsiveness and transparency of public and private partnership must continue as this will contribute in development of an inclusive, rights-based society with equal opportunities for all.

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