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Imbere Heza- (Bright Futures) for adolescents and young people with disabilities in Rwanda

An innovation project to address SRH and livelihoods challenges for young people with disabilities in drought affected areas of Rwanda

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What specific problem(s) are you trying to address?

We seek to work with adolescents and young people with disabilities (particularly those with hearing impairment), between the ages of 15 and 19 in drought hit areas of Nyagatare District of Rwanda to access comprehensive SHR services. This group encounter multiple barriers and social exclusion on access to information on SRH packages and services. Communication barriers are of particular concern when they seek SRH health services in the absence of sign language interpreters. This coupled with livelihoods challenges means youth with hearing impairment, not only lack access to health sensitization issues within their own community, but that they miss out on appropriate learning and livelihoods opportunities to achieve their full potential.

What are some of your unanswered questions about the problem(s) you are working to address?

What are the attitudes of parents and guardians of adolescents and young people with disabilities with regards to sensitive SRH issues? From our own experience, families with children with disabilities face stigma at community level and are in many instances unwilling to let their children participate in actions that expose them, this might be even harder for SRH interventions. We will aim to constantly innovate to ensure that we have sustainable gains within a conservative society

Explain Your Idea

We believe that adolescents and young people with hearing impairment in drought crisis affected areas will lead healthier, happier and more productive lives if the burden of poor SRH is reduced. To achieve this we will address socio-economic barriers (as a result of drought crisis) that result in poor health seeking behaviours, we will ensure a supportive environment where young people with hearing impairment are empowered to take control of the sexual and reproductive lives. Our theory of change envisions vulnerable adolescents and youth with hearing impairment empowered to realise their SRH rights through improved access to SRH information and gain skills to seek alternative livelihoods in drought crisis affected areas. Central to the change is the inclusion and capacity building of young people with hearing impairment as knowledge brokers and advocates, whose voices will lead to better targeted and more appropriate SHR responses in crisis affected areas. Our approach proposes to create community based centers to act as spaces for engagement with young people with hearing impairment within the community. Within these centers, we will work with various providers to create a ‘one stop shop’ for SHR services and information and skills development for life and work. We will work primarily with young people with hearing impairment who, besides intellectual impairment, are traditionally most disadvantaged in terms of access to SHR services, information and livelihoods options.

Name the three most important ways that your idea will address your identified problem(s).

1. Enhance access to quality SRH information and services for youth with hearing impairment by working with them and service providers to develop SHR information and packages that are friendly to them (e.g. improving sign language skills of community health workers) 2. Support youth with hearing impairment to gain access to decent livelihood options through skills and enterprise development which will provide them a decent income allowing them to exercise greater control in access to SRH services and products. 3. Enhance family and community information, understanding and support for youth with hearing impairment. This also allows them to avoid risky behaviours when livelihoods shocks hit due to recurrent drought crises.

How is your idea unique?

Our idea is unique because it seeks to address interrelated issues which have not been previously addressed together. Our proposed approach seeks to provide an integrated and holistic package of care and support to youth with hearing impairment to enable them to gain as much control of their sexual and reproductive lives as possible in challenging socio-economic environments. In our experience, there are few to none initiatives that support adolescents and youth with disabilities with comprehensive SHR services and information as well as livelihoods interventions in our targeted areas. We believe our idea is unique as it is challenging.

What are some outstanding concerns or questions that you have regarding your idea?

Access to quality data and information on the prevalence of hearing impairment amongst youth in Nyagatare District remains a challenge. Additionally, while we know from our own assessment that there are significant number of young people between the ages of 15 and 19 with hearing impairment, their location remains a challenge due to data challenges. This is particularly important for out of school youth who will be harder to trace. We propose to use special schools as our entry points.

Who are your end users?

Our proposed project will work with 300 young people with hearing impairment between the ages of 15 and 19 who are out of school in targeted areas of Nyagatare District, Rwanda, which are perennially affected by severe drought. Our targeted group will benefit from access to comprehensive SHR services (provided by government providers) and information through our community based centres, additionally, to ensure that the gains made are not rolled back due to economic pressures which force young people to make risky decisions regarding their SRH lives, we will ensure that we provide them with skill for life and work and support them to initiate micro-enterprises to create alternative livelihoods streams and lessen the economic.

Where will your idea be implemented?

  • Rwanda

What is the primary type of emergency setting where your innovation would operate?

  • Extreme drought

Tell us more about the emergency setting that you intend to implement in

Nyagatare District, Rwanda is highly susceptible to drought shocks. The District Development Plan outlines the challenges of very low annual precipitation that are both very weak (827 mm/an) and very unpredictable to satisfy the needs in agriculture and livestock with challenges of youth participation in economic activities being highlighted as a major challenge. As such, Nyagatare District has amongst the highest poverty incidence in the country which disproportionately affects young people.

What is your organization's name?

Voluntary Service Overseas (VSO)- Rwanda

Tell us more about you.

VSO is the world’s leading independent, international development organization that works through volunteers to fight poverty in 36 fragile and less developed countries in the world. VSO is at the forefront of thinking and practice on the application of volunteering to development. VSO works in Africa, Asia and the Pacific. We have been operating in Rwanda since 1998, across all districts in the country focusing on strengthening government and community structures to increase access of young people to quality inclusive education, economic empowerment and entrepreneurial skills, health and other social services.VSO supports all young people to meaningfully engage in development regardless of their ethnicity, disability and economic status

Organizational Characteristics

  • International/global organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

VSO Rwanda is a branch of VSO International registered in England and Wales. VSO Rwanda address: KG Street, House N. 12, Kimihurura Sector, Gasabo District, Kigali, Rwanda.

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Roll-out/Ready to Scale: Completed a pilot and am ready / in process of expanding.

Website

https://www.vsointernational.org/

How has your idea changed based on feedback?

In refining our idea, we propose to incorporate a peer approach model. Peer educators will be both deaf young people and non-deaf from a wide range of healthcare providers and frontline healthcare workers. The deaf peer educators will link SRH services to deaf youth. We shall use this opportunity to train healthcare providers and frontline healthcare workers in sign language to cascade and sustain the model at public health service facilities. We also adjusted the idea to add in a behavior change activities targeting parents, local leaders and other service providers. This will create awareness and challenge negative briefs and attitudes that hinder young deaf people in accessing comprehensive sexual reproductive health services. The community based centers will act as a model centres where service providers, parents are facilitated to learn, adopt and transfer skills, knowledge of how best to include deaf youth in SRH provision and SRH risk reduction interventions.

Who will implement this idea?

VSO aims to implement this idea in collaboration with key sector players. We propose to work mainly with the Umutara School for the deaf and the Ministry of Health in Rwanda. VSO Rwanda to provide over all leadership, coordination and providing technical guidance for idea implementation’s has a sub office in Nyagatare district,1 health project manager,2 national volunteers and 1 international volunteer to fully support the project. Umutara School for the Deaf to provide sign language training and livelihood skills. The school is located in Nyagatare district, 2 staff committed to the project. Ministry of health to offer comprehensive SRH services. There is a district health team in Nyagatare district. We shall work with the team to avail health workers to provide SRH services to the center

Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?

VSO is a people centered organization. We work with people in their communities to identify key challenges affecting their own development, we work with them to create potential ideas and solutions, we test the ideas, learn, adopt and build into our programmes. The cycle continues till we have identified a workable solutions to pertaining issues affecting local, national and global citizens.VSO is a dynamic organization, we highly value partnerships in addressing real world challenges, we learn from people we serve, development actors, donors etc. We share our learnings that are beneficial to others. We embrace change very quickly. In VSO every voice counts.

What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?

At Individual level; Communication is biggest challenge young people with hearing impairment face. Sign language is the only means possible for them to communicate, In absence of this, deaf youth miss basic human rights including education and health. Critical services such as SRH services remain unavailable to them and the risk of abuse is increased where young people are living with disabilities. With many young deaf people living in poverty, control over their lives is challenged as they cannot exercise freedom of choice. At system level; Services are not inclusive. This means deaf youth will miss on preventative and curative health care services. In absence of sign language, awareness on disability client oriented services countries will hardly be achieved.

Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?

IMPACT: By 2020, we aim to reach over 15,000 disadvantaged young people including 4,500 deaf youth with comprehensive and quality SHR services incentivised by skills development for life and work. QUESTION: How do we remain innovative in our approach to improve access to information, delivery, accessibility and quality of AYSRH services for the most disadvantaged youth in Rwanda?How do we measurably impact over 15,000 youth in and out of school,of different ages,in challenging environments?

What is it that most attracted you to Amplify instead of a more traditional funding model?

VSO is excited to work with Amplify as opposed to traditional funding modalities due to the fact that Amplify is a collaborative process that allows for critical peer review that helps in refining ideas further. We appreciate the honest feedback and critical questions raised by the panel of experts that allows us to design interventions that are well thought. When successful, we anticipate that the technical support provided will be invaluable in helping deliver a holistic intervention.

Do you intend to implement your Amplify idea in refugee camps / temporary settlements?

  • We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.

How long have you and your colleagues been working on this idea together?

  • Between 6 months and 1 year

How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?

  • Under 5 paid, full-time staff

Is your organization registered in the country you intend to implement your idea in?

  • We are registered in all countries where we plan to implement.

My organization's operational budget for 2016 was:

  • Above $1,000,000 USD

What do you need the most support with for your innovation?

  • Other Technical Expertise

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Team

1. What would teens seek out of the help centers?
The proposed community youth centers are not help centers per say but rather a model one stop center aimed at providing youth with hearing impairments access to helpful SHR information and services (where possible) by interfacing with service providers as well as skills for life and work as an incentive for participation and a way to ensure that the young people are able to gain a decent livelihood which in turn affects their SHR lives. Research shows that when people have access to a decent income, they are better able to take charge of their SRH lives by having options to critical services and avoiding risky behaviors that may put them at risk. From these centers, the targeted youth will gain access to age appropriate SRH information, products and services coupled with skills development for life and work. Where possible, the centers will create interlinkages with service providers to provide information, counselling and some family planning products dispensed at community level including pills and short term injectables.
2. Why would parents let them come? It would be great to learn more about the behavior change that would require teens to come to these classes: what is the incentive to come?
From our experience and additional research, we have determined that integration of services is the best approach to ensure sustainable solutions to youth SRH services. In resource constrained environments, where economic pressures take priority, standalone SRH initiatives are unlikely to be successful. We believe that in areas such as Nyagatare District where livelihood pressures are high, creating an avenue for young people to gain skills for life and work alongside SRH services and information will be a great incentive to parents to allow them to participate. By creating opportunities to gain critical skills, we will be supporting the young people to diversify their livelihoods options which remains a strong incentive for the youth in the region. For young people with disabilities in rural Rwanda, stigma remains high and there are few opportunities and initiatives targeted towards them. Most of them remain at home with their families feeling that they are unable to succeed in anything. Such an initiative, targeted specifically to youth with hearing impairment, we believe will provide a much needed avenue for parents to meaningfully engage their children. Research shows that potential synergies between youth, enterprise, livelihoods and reproductive health are immense and that integrated services provides the most feasible approach to successful initiatives by providing critical information and knowledge as well as incentives for youth to ensure meaningful participation.
Finally, in rural Rwanda, reproductive health discussions are shunned. Parents find it hard to discuss such issues with their children. While parents understand the importance of this discussion, cultural barriers prevent them for doing so. We believe, by providing a platform for young people with disabilities to access SRH information and knowledge, we will have removed a significant barrier for the parents in discussing such issues with their children. Our aim is not to replace the critical conversations that should be happening between children and parents, but to create a bridge and safe space to for these discussions to happen. To ensure this, we will ensure that we work towards behavior change both at community level (working with parents and service providers) and the youth themselves through the centers to open up spaces and demystify sexual and reproductive health issues. [ additional comments to expert feedback attached as PDF]

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