Mid-term Evaluation
DFID Global Poverty Action Fund Programme:
Expanding Services for Deafblind People in India 2012-2015
(DFID contract reference: GPAF-IMP-009)
June 2014
Sneha Joseph---Kottayam Social Service Center
1
Contents
Acronyms and abbreviations ........................................................................................................................ 4
Basic information .......................................................................................................................................... 7
Executive Summary....................................................................................................................................... 8
1)
Report Findings Impact and Overall Results ....................................................................................... 12
2)
Key Evaluation Criteria and Value for money (VfM) ........................................................................... 15
Relevance ................................................................................................................................................ 15
Effectiveness ........................................................................................................................................... 17
Efficiency ................................................................................................................................................. 19
Sustainability ........................................................................................................................................... 20
Impacts.................................................................................................................................................... 21
3)
Risk Management & Mitigation .......................................................................................................... 25
4)
Project Accountability to Stakeholders............................................................................................... 26
5)
Lessons ................................................................................................................................................ 27
Innovation: .............................................................................................................................................. 27
Equity and Gender .................................................................................................................................. 27
Capacity building ..................................................................................................................................... 28
Monitoring & Evaluation......................................................................................................................... 28
Approaches to Empowerment and Advocacy: ....................................................................................... 28
Others lessons learned ........................................................................................................................... 29
Applied learning ...................................................................................................................................... 29
6)
Conclusions ......................................................................................................................................... 31
Summary of achievements against evaluation criteria........................................................................... 31
Supporting statistics................................................................................................................................ 33
Summary of problems and issues encountered. .................................................................................... 35
2
Overall impact and value for money of GPAF funded activities. ............................................................ 36
7)
Recommendations for the future ....................................................................................................... 37
Annexes ....................................................................................................................................................... 42
SWOT Analysis in assessing the project to date ..................................................................................... 42
Strengths ................................................................................................................................................. 42
Weaknesses ............................................................................................................................................ 42
Opportunities .......................................................................................................................................... 43
Threats .................................................................................................................................................... 43
Case Study
Shiva-Caritas Kottayam ..................................................................................................... 46
Case Study – Sneha Joseph ..................................................................................................................... 49
Case Study - Caritas Goa ......................................................................................................................... 51
Case Study – Bhupendra Deshpande ...................................................................................................... 56
Sample Innovations................................................................................................................................. 58
Doctors/Hospitals: .................................................................................................................................. 62
Organizations visited by Goa staff as part of awareness and assessments ............................................ 63
Schools/Colleges visited by Goa staff as part of the awareness programs :- ......................................... 64
Some Samples of material published as part of this project .................................................................. 66
Compilation of responses from partners to key evaluation questions (compiled by Uttam Kumar)..... 67
3
Acronyms and abbreviations
A&A
Aids and Appliances for persons with disabilities
ADHD
Attention Deficit Hyperactive Disorder - a type of disorder, not
recognized by law, in India
APT
Appropriate Paper Technology, a low-tech paper-based technology ,
developed in Zimbabwe, for developing assistive devices and modified
furniture for persons with disabilities
B Ed.
Bachelor of Education
BPA
Blind People’s Association, a leading NGO in Gujarat
CBM
Chistoffel Blinden Mission ( a reputed international voluntary
organization )
CD
Compact Disc
CP
Cerebral Palsy ( a type of disability, mandated by Indian law)
CSR
Corporate Social Responsibility, now mandated in the Companies Act
2013
CWSN
Children with Special Needs, terminology used in SSA-MHRD
DB
Deafblind
Dip Sp.Ed.
Diploma in Special Education
DONER
Department of North East ( A Ministry in the Government of India, for
the specific welfare of 8 States in the North Eastern part of India)
EFA
Education for All
EI
Early Intervention
ENT
Ear Nose Throat
GOI
Government of India
HBE
Home-based education
HI
Hearing Impaired
HIES
Household Income and Expenditure Survey
4
ICDS
Integrated Child Development Scheme ( the largest child welfare
program in the world )
ICMR
Indian Council for Medical Research
ID
Intellectual Disability
IE
Inclusive Education ( referred to as Mental Retardation in Indian law)
IEP
Individual Education Plan ( sometimes called Individual Program PlanIPP )
IGNOU
Indira Gandhi National Open University ( the largest open university in
the world)
IMFAR
An independent body for conducting medical research in India ( they
have taken over 9 years to develop/field test an overarching and
indigenous tool for identification of childhood disabilities )
JS
Joint Secretary
KSID
Kerala State Initiative on Disability
MD
Multiple Disability
MDGs
Millennium Development Goals
MHRD
Ministry of Human Resource Development
MOHFW
Ministry Of Health and Family Welfare
MP
Madhya Pradesh, a State in central India
MR
Mental Retardation ( same as ID)
MSJE
Ministry of Social Justice and Empowerment/GOI (nodal Ministry for
disability)
MT
Master Trainers
NAB
National Association of the Blind, a leading NGO, with chapters in
many States of India
NGO
Non-Governmental Organization
NHFDC
National Handicapped Finance and Development Corporation ( a
public sector initiative under MSJE for providing easy loans to
persons with disabilities)
5
NICU
Neonatal Intensive Care Unit
NIEPMD
National Institute for the Empowerment of Persons with Multiple
Disabilities, one of 7 national Institutes in India (Under MSJE)
AYJNIHH
Ali Yavar Jung National Institute for the Hearing Impaired
NIVH
National Institute for the Visually Impaired
NSDA
National Skill Development Authority, GOI
NTA/NT Act
National Trust Act
OT
Occupational Therapist
PT
Physiotherapist
PWD
Persons with disabilities
RBSA
Rashtriya Bal Swasthya Abhiyaan (National Child Health Program
Ministry of Health/GOI)
RMSA
Rashtriya Madhyamik Shiksha Abhiyaan (National Secondary
Education Program— Ministry of Human Resource Development)
RTE
Right To Education Act 2009, Amended in 2012
SQ
Social Quotient
SI(I)
Sense International (India)
SSA
Sarva Shiksha Abhiyaan (Education for ALL Program at primary Level
Ministry of Human Resource Development)
TLM
Teaching Learning Material
UNCRPD
United Nations Convention on the Rights of Persons with Disabilities
UP
Uttar Pradesh (the largest State in India)
VFM
Value for Money
VI
Visual Impairment
VT
Vocational Training
VTC
Vocational Training Center
WB
West Bengal, a State in eastern India
6
Basic information
Project title
Expanding services for Deafblind people in India
GPAF number
GPAF-IMP-009
Country
India
Name of local partner(s)
Sense International (India) – others listed below
Total project budget (1 figure)
GBP 684,191
Total DFID budget (1 figure)
GBP 478,934
Report author
Aloka Guha
Supporting team
Uttam Kumar (SII team)
Brahada Shankar (SII team)
All Project Coordinators of SLCs and the teams
RLC team, plus Dr. Bhushan Punani
Evaluation date
2nd – 22nd February 2014
Name of local partner(s):
1. Sense International (India), Gujarat (national coverage)
2. Blind People’s Association, Gujarat (RLC West region)
3. Digdarshika Institute of Rehabilitation & Research, Bhopal (SLC- Madhya Pradesh)
4. Caritas-Goa (SLC-Goa)
5. National Association for the Blind, Nasik (SLC- Maharashtra)
6. Holy Cross Service Society, Tamil Nadu (RLC South region)
7. Kottayam Social Service Society, Kottayam (SLC-Kerala)
8. Uma Manovikas Kendram, Kakinada (SLC- Andhra Pradesh)
9. National Association for the Blind, Bangalore (SLC- Karnataka)
7
Executive Summary
Introduction
This mid-term evaluation relates to the project entitled “Expanding Services for
Deafblind People in India”, funded by Department for International Development (DFID)
Global Poverty Action Fund (GPAF) Impact Fund.The GPAF is a demand-led fund
supporting projects focused on poverty reduction and pursuit of the Millennium
Development Goals (MDGs) through tangible changes to poor people’s lives including
through, service delivery, empowerment and accountability, work on conflict, security
and justice.
The project is managed by Sense International (SI)1 with Sense International (India)
(SII)2 and 8 other local partners in India.3 SI is an international non-governmental
organization working in partnership with local organisations for deaf blind people and
their families.
Deafblindness is a combination of vision and hearing impairments. It is also described
as multi-sensory impairment (MSI). Some people are completely deaf and blind, but
many have a little sight and / or hearing they can use. Some may have other physical
and learning disabilities to cope with.
Purpose
The purpose of the mid-term evaluation, as per the Terms of Reference, was to:



1
Identify the impact of the project at the mid-term and make recommendations for the
second half of the project.
Account to local stakeholders and funders for the project’s achievements/results
against the stated purpose and outputs.
Record and share lessons that will assist in improving UK support to civil society.
Assess whether the project is representing value for money in its efforts to deliver
results.
Sense International http://www.senseinternational.org.uk/
Sense International (India) http://www.senseintindia.org/
3
Blind People's Association, Gujarat (RLC West); Digdarshika Institute of Rehabilitation & Research,
Bhopal (SLC Madhya Pradesh); Caritas, Goa (SLC Goa); National Association for the Blind, Nasik (SLC
Maharashtra); Holy Cross Service Society, Tamil Nadu (RLC South); Kottayam Social Service Society,
Kottayam (SLC Kerala); Uma Manovikas Kendram, Kakinada (SLC Andhra Pradesh); National
Association for the Blind, Bangalore (SLC Karnataka).
2
8
Methodology
Five out of eight project sites were visited (four State Learning Centres in Karnataka,
Kerala, Goa and Maharashtra and one Regional Learning Centre in Ahmedabad,
between 2nd February and 22nd February 2014. At the end, one whole day was spent
with the entire Sense International (India) team, at their office.
In addition, the Evaluator attended the 3-day National Conference of Sense
International (India) from 15th-17th January 2014, in New Delhi, where large numbers of
Project partners, adult deafblind persons and their families, participated very actively.
Many of them presented papers on their innovative strategies and practices. This
Conference provided ample opportunity for the Consultant to familiarize herself with
each partners’ work, and hold discussions with them.
Findings
Under Impact and Overall results (section 1), it was observed that everywhere, the
parents/stakeholders felt overwhelmingly grateful for the opportunity to see their
children transformed from low-functioning individuals to functioning individuals capable
of communication as well as contribution. In year two, all six SLCs were supported by
RLCs through visits and exposure visits. Capacities of two RLCs were strengthened and
six SLCs were established to deliver early intervention, education and vocational
training services for deafblind people.
State level networks of deafblind people, their families & teachers were very
successfully established, representing the estimated 484,000 deafblind people in India
in advocacy & policy influence. In each of the first two years 2 regional, 1 national and 8
local meetings were held.
The biggest gains have been in the area of inclusion in government schools. Each year
8 state SSA missions (10 officials/ 30 teachers per SSA) were trained by project staff.
Deafblind children (age 6-14) have received quality education through this project. By
the end of March 2014 (end of Year 2), in education under the 6-14 years age group
318 deafblind boys and girls (196 male, 122 female) had been reached directly by all 8
project partners. The indirect reach via the Education for All (SSA) schools is expected
to be 6,263 (3,717 male, 2,546 female). This shows that the project team’s training of
SSA staff has paid rich dividends. (16 on-site training by SII staff; 12 mentoring visits
and 12 visits to SLCs by RLC staff, in each of the first two years.
Programs in Early intervention (EI) have been established to screen newborns and
infants in 8 hospitals and have provided services for 166 deafblind children (0-6 yrs) by
end of March 2014. Newborn screening was initiated in EI in hospitals in Gujarat, Tamil
nadu, Maharashtra and Kerala (4 in year 1) and 2 in year 2 as in Madhya Pradesh and
9
Andhra Pradesh, with a total of 2,536 babies screened. 122 deafblind young adults (14+
yrs), 30 males and 5 females, have received vocational training, with 40 generating
income of their own. This is no mean achievement in India, where even the mildly
disabled persons find themselves unemployed, and the overall picture of unemployment
is a serious concern.
Conclusion
In conclusion, it may be said that this is an innovative and exciting project reaching out
to a hitherto-unreached group, which, by definition, is an activity worth undertaking, for
the simple but sufficient reason that people who were earlier left out, are now being
brought into the mainstream disability grid.
It is also appreciated that this project has a comprehensive approach to the issue, which
is a horizontal one rather than a vertical one. At each step of the project there is an
attempt to dovetail into the existing Government services, rather than to set up a
standalone (vertical) project which is not only unsustainable but also very expensive to
replicate elsewhere, especially for low-resourced settings like India. As it stands, the
project is both replicable and scalable.
The word comprehensive is used here to refer to a continuum of efforts, starting with
awareness and advocacy, followed by early identification and intervention, school and
vocational education, leading to economic empowerment. A tactical strategy of
empowering parents has paid rich dividends in that they have become a reliable source
of multi-layered support.
The numbers reached and served, are documented in sync with the targets set (and
efficiently monitored), but the important issues are not the numbers, but the approaches
and strategies used to roll-out this project on expansion of services for a hitherto littleknown group. This includes:
i.
the selection of credible partners with local influence
ii.
piggy-backing on their experience/goodwill/expertise
iii.
building of strong networks within each of the States through partners
iv.
transitioning seamlessly from Regional Centers to State Centers
v.
capacity-building on felt and perceived needs, directly from SI India experts
vi.
dovetailing with established Government services, wherever feasible
vii.
empowering parents
viii.
developing role models of DB adults and showcasing them effectively
ix.
simultaneously, pressurizing the GOI to include DB in policies, laws, programs
and in data-collection
10
x.
Developing and helping to run professional training courses on DB, in order to
ensure regular availability of trained professionals from across the country.
These 10 strategies are the main gains of this project. They are both replicable and
scalable.
A seamless transition from region-specific interventions to a state-specific one has
meant that more direct services are reaching out to the target groups and that
stakeholders are giving direct feedback at local levels which helps to inform and guide
the next level of interventions. This is affirmative action which is global in approach but
local in application.
This project is running efficiently, effectively, is extremely relevant, very strictly
monitored and is 98% sustainable. The 2% in question relates to the NAB Karnataka’s
interest and ability to sustain services. As far as value for money is concerned, the
strategies outlined above, are proving to be both cost-effective and reach-effective.
There is no evidence of any wastage/expensive usage of project funds. This was
checked frequently and found to be true of project staff as well as of SI(I) team.
Having said all of that, it must also be mentioned that there are a few areas, minor
areas admittedly, that are discussed under the section on recommendations. These
include the need to focus on 1) capacity-building on associated disorders like cerebral
palsy, autism and hyperactive disorders.2) While Si –I has excellent networking skills,
the partners need some more reaching out to government sectors of health and
education at the local level.3) Considering the pioneering nature, the scale and high
quality of services, it may be turned into a Research paper.4) At the local level, more
media engagement would be useful .5) The networks provide a good opportunity for
more rights-based empowerment.6)Vocational training ,as a valuable and needs-based
component of the Project, has shown good results, may need to be strengthened now
that there is more understanding of abilities as they relate to occupations. Finally, it
would be very worthwhile to see if this same project can be replicated in Eastern and
North Eastern India.
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1) Report Findings Impact and Overall Results
What is the project’s overall impact in relation to its outcome and how does this
compare with what was expected?

The impact is favorably comparable with the expected outcomes. Everywhere, the
parents/stakeholders felt overwhelmingly grateful for the opportunity to see their
children transformed from low-functioning individuals to functioning individuals
capable of communication as well as contribution.
What are the key results against the outputs and how did this compare with the targets
set in the original logical framework?
OUTPUT 1
ACTIVITY 1.1
Year 1
Year 2
Capacity of two RLCs
strengthened and six
SLCs established to
deliver early intervention,
education and vocational
training services for
deafblind people.
Awareness visits and training for partners
(Awareness visits for all SLCs every year to
RLCs or to the organisation from where their
mentors comes)
All 6 SLCs were
supported by
RLCs through
visits and
exposure visits
Year 1
All 6 SLCs were
supported by
RLCs through
visits and
exposure visits
Year 2
Regional & national deafblindness (DB) &
project management (PMT) trainings.
(8 Regional training by RLCs (4 each),
Deafblindness:
Regional – 4
National – 3
Capacity Building
Regional – 2
National – 1
Deafblindness:
Regional – 4
National – 3
Capacity Building
Regional – 2
National – 1
OUTPUT 2
ACTIVITY 2.1
Year 1
Year 2
Early intervention (EI)
established to screen
newborns and infants in 8
hospitals and provide
services for 250 deafblind
children (0-6 yrs)
Initiate EI in hospitals.
2 in year 2
(Madhya
Pradesh and
Andhra Pradesh)
ACTIVITY 2.2
4 in year 1
(Gujarat, Tamil
nadu,
Maharashtra and
Kerala
Year 1
Train medical/para-medical (M/PM) staff.
6 trainings
6 trainings
OUTPUT 3
ACTIVITY 3.1
Year 1
Year 2
Deafblind children (age 614) receive quality
education.
(625 directly and 9,000 via
SSA)
Train partner staff to provide education
16 on-site training
by SII staff; 12
mentoring visits
and 12 visits to
SLCs by RLC
staff.
ACTIVITY 3.2
Year 1
16 on-site
training by SII
staff; 12
mentoring visits
and 12 visits to
SLCs by RLC
staff.
Year 2
12
ACTIVITY 1.2
Year 2
Provide deafblind children education services
directly.
8 partners
working
8 partners
working
ACTIVITY 3.3
Year 1
Year 2
Train 8 state SSA missions (10 officials/ 30
teachers per SSA).
3 state SSA
sensitised
2 state SSA
sensitised
ACTIVITY 3.4
Year 1
Year 2
Partner with state SSA missions to provide
deafblind children with education.
No partnership,
but meetings held
no partnership,
but meetings
held
OUTPUT 4
ACTIVITY 4.1
Year 1
Year 2
125 deafblind young
adults (14+ yrs.) receive
vocational training, with
40 generating income.
Needs based vocational training for income
generating activities (IGA).
4 organisations
(Gujarat,
Maharashtra,
Tamil nadu and
Andhra Pradesh)
4 organisations
(Gujarat,
Maharashtra,
Tamil nadu and
Andhra Pradesh)
OUTPUT 5
ACTIVITY 5.1
Year 1
Year 2
State level networks of
deafblind people, their
families & teachers
established, representing
484,000 deafblind people
in India in advocacy &
policy influence.
Promote networks to advocate for the rights of
deafblind people.
2 Regional, 1
national and 8
local meetings
held
Year 1
2 Regional, 1
national and 8
local meetings
held
Year 2
Meetings with
MHRD, MSJE
including RCI and
NT, state level
meetings
Meetings with
MHRD, MSJE
including RCI
and NT, state
level meetings
ACTIVITY 5.2
Advocacy planning and information
dissemination.
How effective is the project’s overall strategy?




13
Very effective in terms of reach, the transitioned from Regional Level Centers
(serving 5-6 neighboring States surrounding their own headquarters),directly to State
Level Centers, has cut down on travelling for parents and provides greater access
for stakeholders in each of the State-level centers
Effective also in terms of quality, because many deafblind persons are getting direct
services now, reaching out to the whole State directly, with qualified professionals.
Also evidenced, is the excitement of addressing a ‘new’ disability, as seen in Goa
Caritas. (They already serve many other disabilities, have a regular and special
school of their own, plus residential facilities)
In Kottayam Social Service Center (which is owned by Caritas) and NAB Karnataka
(where many management concerns exist), the joy of being able to help all those
persons who have been rejected by other institutions (who cater only for the hearing
impaired or for visually impaired), is unbounded



Almost all partners have incorporated persons with Deafblindness into the entire
spectrum of their existing social-cultural programs
In KSSC-Kottayam, an elderly person with Deafblindness was asked to participate in
their annual fish-curry making contest. He won the first prize this year.
All the SLCs are getting their capacities built/strengthened directly by SI(I) experts
If relevant, in what ways does the project: i) improve global/regional/national/local
policy; ii) and/or strengthen legislation and enforcement mechanisms to protect and
empower disadvantaged target groups; iii) and/or raise awareness amongst civil society
and service deliverers about rights. Provide examples


Inclusion of deafblindness as a discrete disability, in the New Bill on Disability, is
entirely due to the very active participation of Akhil Paul, Director Sense International
(India), over a period of 2 years-- creating awareness throughout India on the rights
of persons with deafblindness. It’s been a huge effort.
Several national and regional consultations and 3 National Conferences, have
instilled confidence, commitment and renewed energy to walk further on this journey
of deafblindness in India, among persons with deafblindness, their parents and
professionals
If relevant, in what ways does the project improve practice by providing greater access
to quality services for disadvantaged groups? Provide examples.





14
When CBM/UN collected data this year on disability, SI(I) ensured the inclusion of
persons with deafblindness, as a separate category
The new Kerala State Initiative on Disability (KSID), was influenced by this Project to
include DB as a separate disability with its own very unique needs and challenges;
KSID plans for the establishment of district-wise early intervention centers, and
Rubella Immunization for the entire state.
There will be many other positive unintended consequences from this.
In both Goa and in Kottayam, there are orphanages where project staff visit
regularly, provide direct services, and also train the nuns who run the orphanages on
activities of daily living, communication skills and so on. This has greatly improved
practice by providing greater access to direct quality services from qualified
professionals. Sneha, on the cover page, is from the orphanage in Kottayam, and
her improvement curve, within a short space of time, is amazingly good.
The 3 policies introduced during this project for staff awareness and compliance are:
the Child and Vulnerable Adult Policy, The Anti-bribery Policy and the
Whistleblowers Protection Policy. These are all excellent safeguarding policies for
stakeholders/beneficiaries.
2) Key Evaluation Criteria and Value for money (VfM)
Relevance
To what extent is the project supporting achievements towards the MDGs, specifically
off-track MDGs?


The off-track MDGs 1, 2 and 4, (regarding poverty, child mortality and health, and
education) are being addressed, though not uniformly. Poverty and education
appear to be doing better. The child mortality and health issue needs greater
attention, and is included within recommendations.
I might add that India (public and private sectors) is not overly involved in the
implementation of the MDGs, in general.
To what extent is the project targeting, reaching and benefiting the poor and
marginalized?



This project’s target group is almost entirely the poor and the marginalized since
persons with disabilities are over-represented in the poverty group, especially in low
and middle income countries (LMIC) like India. This was evidenced through
checking of the beneficiaries’ BPL (below poverty line) cards, issued by the
government during the evaluation. The majority of the beneficiaries had them.
As seen in all projects, large proportions of the target group had Cerebral Palsy CP
and Intellectual Disabilities ID as additional disabilities, most evident in babies
delivered at home, among very poor and very illiterate families from non-urban
areas.
Every child, whose file was available, was checked and found to have shown
improvement, in the domain of social skills, if nothing else. This has been verified
after scrutinizing the Individual Education Plans, IEPs as well as from interviews with
individual parents. Behavioral changes have helped parents in home management
and in reducing some of the isolation that they have been facing. In Indian societies,
these are major gains.
To what extent is the project mainstreaming gender equality and equity (men, women,
girls and boys) in the design and delivery of activities (and/or other relevant excluded
groups)?

15
There does not appear to be any discrimination between genders, in any of the
projects. The database shows that more girls than boys are receiving services. Over
the years, especially as an outcome of earlier projects by SI(I), the creation of
awareness regarding disability and gender equity has been very penetrative, even in
rural areas.


In the 3rd National Conference, the presence of fathers was noticed; on enquiry, it
was understood that presentations from fathers were encouraged and accepted
without scrutiny or denial.
In a parents’ meeting in NAB-Nasik (as part of the mid-term evaluation), during office
hours on a weekday, there were 38 parents present and fathers outnumbered
mothers. This is pretty unusual in India, where looking after children is very much a
mother’s accepted duty /role, especially for disabled children.
How is the project ensuring activities respond to the needs of target beneficiaries?





When it was found that NAB-K needed more attention in management matters as
well as in technical ones, this was provided.
When it was found that partners’ understanding of the seriousness of fundraising
was below expectations, this too was provided. (Goa)
When the staff found that parents did not understand the complexity of DB, they
spent many hours training parents, and getting adult DB persons to talk to them.
(Caritas -Kerala). This was very effective
When SLCs in Goa and Kerala, found 2 DB children in orphanages, they also
trained the Sisters there who help the children in ADL activities.
Several children with serious health issues were helped by Project staff to apply for
a national level health insurance scheme (Niramaya of NT) and parents are now
getting regular reimbursements for doctors’ fees, medicines etc. This has helped to
create stronger bonds/faith between parents and project staff.
To what extent and how is the project affecting people in ways that were not originally
intended?
The unintended consequences and benefits are many, some of which are listed below: The Government of India’s flagship program to realize Education for All, SSA, now
recognizes DB as a separate category, nationally and in all the States, they made
the data available to SI(I).
 Fr. Michael of SLC-Kerala happens to be the President of the NGO group in the
district and he is creating many worthwhile linkages on behalf of DB, mobilizing
church-going youths to provide voluntary services to persons with DB.
 The KSID includes DB now, with its unique needs; this will have many spin-offs of its
own, in terms of inclusion into health, education and rehabilitation programs.
 The entire Diocese in Goa and in Kerala is spreading the word about DB because
the Archbishop is the Chairman of the Board of Caritas, in each of these
organizations (both Caritas).
 In the general B.Ed course in Maharashtra, DB is now included because of this
project in Nasik; this is a very positive unintended consequence. (Many, many
projects have tried this in the past, but failed.),This effort to modify basic teacher
16



training programs goes back at least 25 years, I can personally endorse that,
because I have tried to do this in Chennai, Delhi and in Mumbai, through NGOs and
through related Government agencies. (A similar effort is the one to change the
basic MBBS course to add disability in it, unsuccessfully, I might add). As mentioned
earlier, there is a wave of reforms in public thinking now, where concrete efforts to
INCLUDE the excluded, is met with gradually increasing success from the
government side.
There will be many more regular teachers now trained in DB, at the pre-service
stage, who will not look at Inclusive Education as an addition to their role but as part
of their regular duties.
Many of the parents were guided by project staff to apply for and receive Legal
Guardianships from the National Trust, as were 4 orphans.
In all the projects visited, Aids and Appliances are being sought free of cost, through
convergence with SSA.
RLC Ahmedabad has arranged for free Kits (containing teaching learning materials,
toys and games) for each DB child, from the National Institute for the Empowerment
of persons with Multiple Disabilities, NIEPMD. Now, the other centers are should get
the same, for each of their children.
Effectiveness
To what extent is the project delivering activities that are value for money with regards
to their economy and efficiency?




17
To a great extent, because each partner is contributing land/building, existing
infrastructure/related
expertise/credibility/
goodwill/network/leverages
with
governments and many other benefits
With the exception of SLC-Karnataka, all the partners were found to be very
efficiently saving money by using what they already have, perhaps in a modified
format. Some of the materials (including formats) developed as an outcome of
earlier projects, have been very effectively translated into local languages. Many of
the existing activities of partners, such as sport, cultural activities, teaching learning
materials, vocational activities like paper plate making ,career–building (like the
Masseur Training course in BPA), were originally intended for those with other
disabilities but have been appropriately modified/adapted to facilitate inclusion of
persons who are deafblind.
The salaries are not high, everyone is using public transport (in Goa, there is only a
private bus services, which is very erratic and infrequent causing time wastage)
Several partners have provided transport for picking up and dropping the children to
their homes, because transport is a major issue when you have to carry a teenage
child with multiple disabilities.
To what extent is the project using evidence to improve programming?




The first evidence of improvement in the child is what motivates parents to continue
with services. Staff are using this insight to showcase others’ achievements, so that
parents from economically-challenged backgrounds can be motivated to leave their
chores/work and carry their DB child to a center several times a week.
Evidence from some partners is also inspiring others to improve programming.
The 3rd National Conference provided enormous opportunities for evidence-based
learning to take place, for staff, parents and the beneficiaries themselves. Now,
everyone sees Zameer as a role model (Zameer is a deaf blind adult, a father of a 3
year old girl, who is employed by SI India as an Advocacy Officer. Zameer’s
communication skills, his grasp of subjects and his confidence, surprise and impress
everyone who comes in contact with him).
Many parents were found to be beating their children, this was stopped only when
the children were responding to the interventions and displayed clear signs of
improvement
What are the key drivers and barriers affecting delivery of results for the project?
Barriers
DISABILITY WISE PROPORTION –
CENSUS 2011
25
20
15
10
5
0
Persons
In Seeing
In Hearing
In Speech
18.8
18.9
7.5
In
Mental
Movement Retardation
20.3
5.6
Mental
Illness
2.7
Multiple
Disability
7.9
Any Other
18.4
Disabled persons constitute 2.21% - 2.68 crores
Source: Census 2011
3
The major barrier for any disability work in India is the lack of reliable data. As you can
see from the figure above based on 2011 Census data, India is showing a prevalence of
only 2.21 % whereas Australia shows 20%, the World Report on Disability 2011 (WHO
18
and World Bank) talks of 15% and neighboring Bangladesh reports 9.07 % in a HIE
Survey 2010.
Other barriers are:



Huge turn-over of staff is a challenge to continuity.
Lack of highly qualified therapists (Speech, PT, OT), at affordable prices.
Drop-outs, because of death, migration or parents’ transfers, are barriers.
In NAB-Karnataka, there seems to be a disconnect between the management and
team, as well as within the senior management.
Drivers:



SI(I) team
Parents expectations
Growing Stakeholder aspirations
Project staff
To what extent do the activities, services and results being delivered by the project align
with the intended objectives of GPAF?
Completely in alignment with the intended objectives and actually gone beyond them.
Efficiency
To what extent is the grantee delivering activities on time and on budget against agreed
plans?



To a very large extent. There is some under-spending on assessments in Goa,
which is being addressed. Some variations are there because cost of living differs
between states.
The SI(I)team is very consistent and dedicated in their follow-up and monitoring
The project is very efficiently run; I say that with confidence based on my own huge
experience in running NGO projects in India. I have personally checked files,
registers, reports and email chains.
To what extent and in what ways is the project achieving good value for money?


19
The project is achieving very good value for money, because partners are accessing
government sources for additional benefits (SSA and National Trust etc.), wherever
and whenever feasible.
All partners are using their existing infrastructure to facilitate service delivery of this
project, over and beyond the funds made available as seen in Nasik and Kottayam
where transport is provided free of cost to facilitate continuity in interventions.

In Gujarat, for the very first time in India, the ICDS Director (Integrated child
development scheme) was persuaded by the BPA team to utilize from its own funds,
and amount of Rs. 2000 per child with disability per year. The Director was
sensitized appropriately, and he agreed. The result was that he organized training
for identification and simple intervention. The workers were then able to identify
children, help them to get disability certificates and other entitlements. The Director
ensured the payment for “Niramaya” health insurance policy for all children
identified. All children also received NIEPMD, TLM Kit an excellent kit given free of
charge from the government.
Are resources being used efficiently to optimize the results achieved compared to the
required level of inputs?
Sustainability
To what extent is the project leveraging additional resources (financial and in-kind) from
other sources?





Parents in Nasik are helping to raise funds.
Staff in Goa are using innovative methods for raising funds (football game).
Caritas-Kottayam, BPA-Ahmedabad and NAB-Nasik are large and financially sound
organizations, leveraging a lot of internal resources from other projects.
Ministries of Education and Social Welfare are helping in a myriad ways in all the
SLCs and the one RLC visited.
Many doctors and psychologists are donating their time for free checkups/assessments.
To what extent is the project engaging with others to ensure their interventions
complement existing activities or leading to replication of approaches elsewhere?



The 3 Networks are also leveraging their collective clout to lobby with governments,
local, State and national
Each SLC partner and the RLC, have their own linkages with different departments,
where trainee-teachers and therapists are interning with them to provide extra
support and spread the word
An exemplar is included from Goa Caritas which lists their experts and partners.
To what extent are the benefits being realized by civil society groups supported by the
project sustainable?

20
With the exception of NAB-K, all the projects will be sustained, perhaps not in its
present intense form, but BPA, Kottayam, Goa, and Nasik have track records of
continuity of services even after withdrawal of funds.

Fr. Michael of Kottayam said to me, very clearly, “We look at every Project with a
Program approach”. I am convinced that he was referring to sustainability.
What is or can be done to ensure the sustainability of the project results? This includes
the sustainability of poverty reduction outcomes and, where appropriate, the
continuation of services developed during the project period.






Please see the recommendations section for additional information
All partners have unconditional praise for the SI(I) team
Fr. Maverick in Goa said specifically that “Sense is the best partner that
we have ever had. They are like family to us. We can call them on a 24x7 basis, and
they are always very supportive”.
With that background, I feel that the SLCs (other than NAB-Karnataka) need another
2 years before they can be weaned off, and after that, minimal handholding will
ensure sustainability of all SLCs except perhaps Karnataka.
RLC in Ahmedabad (BPA), is on a higher, different plane altogether. They are
recognized as the largest NGO in Asia, and they are capable of sustaining at the
present level, and beyond. Most of the comments made earlier, regarding projects,
do not apply to them. I am scanning the cover pages of some of their publications
which demonstrate their level of competencies and understanding of important
issues. It is only when you have mastered your subject thoroughly, that you can then
simplify and present it to others. Their EI as well as their VT work is more advanced
and effective than that of the SLCs. Their hospital-based work is very good and
capable of moving into 2nd generation early intervention activities. The goodwill they
enjoy in the large multi-specialty Government Hospital visited during this evaluation
is evidence of the dedication that they bring to their work. The Coordinator Vimal
Thawani and her full team are to be specially appreciated.
For that matter, all the others also deserve loud cheers for the commitment, hard
work and tremendous devotion they have to the children they work with. Working
with children who are not only severely disabled, but also have very complicated
systems of communication, is very difficult work, and cannot be done without The
project teams and Coordinators in Kerala, Goa, and Nasik deserve a lot of praise,
and even the Bangalore team is very good, except for the lack of leadership and
direction from a good Coordinator.
Impacts
To what extent has the project put in place M&E systems that are fit for purpose and are
being used to support the delivery of activities?

21
The existing M&E system of Mentoring, Reporting, Meetings etc is doing well



SLCs in Goa, Nasik and Kerala will benefit from more mentoring (for speech, PT/OT)
and Karnataka needs additional support.
Quarterly reports, planned on-site visits by both technical as well as finance persons
from Sense, on every alternate month, on-site visits
Some visits and meetings are need-based, as expressed by partners
To what extent has the project built the capacity of civil society?


Every partner has been reaching out to civil society within their districts and their
States. A sample from Goa is included later; lack of space prevents me from
including lists from others.
Media coverage for this DB project is uniformly excellent.
S.N
Date of
Training
Theme of Training
Nature of
Participants
Total
numbe
r of
partici
pants
Trainers
1
10th –14th
December,
2012
Training on
deafblindness
Special
Educators of
State Learning
Centres
11
Technical
Team of Sense
International
(India)
2
8th–10th
January, 2013
Training on
Communication
assessment of
deafblind people
Special
educators of
partner
programmes
of Sense
International
(India)
28
Ms. Sampada
Shevde,
Director
Perkins Voice
and Vision,
India
3
26-27th
February 2013
Training on
Legislation and
guidance, Service
and rights
Senior
Practioners,
Mentors and
Sense India
team
38
Dr. Bhushan
Punani,
Executive
Director, Blind
People’s
Association
and Mr. Akhil
Paul, Director
Sense
International (
22
India)
4
21-23rd June,
2013
Training on
‘Approaches to
assessing the
functional vision
and hearing of
young children with
deafblindness
Special
Educators of
SLCs and
RLC South
16
Ms. Deiva
Jayaram,
Vision
Consultant,
Frontline
Hospital,
Chennai
Faculties of
National
Institute for
Speech and
Hearing
Impaired,
Trivandrum,
Kerala
4
1st – 3rd
August 2013
National Training
on Communication
Assessment for
deafblind people
Senior
Professional,
Mentors,
Sense India
team
38
International
Faculties - Dr.
Paul Hart,
Sense Scotland
and Ms. Liz
Duncan, Sense
UK
How many people are receiving support from the project that otherwise would not have
received support? How many of these people are unintended beneficiaries?


23
Overall, through its advocacy work the project can potentially benefit the
approximate 500,000 estimated deafblind people in India. In terms of beneficiaries
receiving support in this project, at the end of Year 2, 1,321 deafblind people are
receiving services directly (387 adult males 18+ and 616 adult females 18 years +,
196 child males under 18 years and 133 child females under 18 years). In addition,
over 6,000 deafblind people are benefiting from education in the Government
Education for All SSA schools (latest figures to be confirmed in June/July 2014
Government data).
None of the beneficiaries would have received services otherwise.


24
The unintended beneficiaries parents, and word of mouth is a powerful weapon as
word spreads quickly within small communities.
The unintended beneficiaries under this project are persons with other disabilities,
who are not deafblind. These persons are mainly with Cerebral Palsy, multiple
disabilities with communication limitations. These children are not direct
beneficiaries, but had to be included in services, as there are no other options for
those children. The project staff also referred some children to other organisations,
where ever alternate options were available.
3) Risk Management & Mitigation
Did the risks identified in the original proposal and annual reports materialize?
Risk identification in the original project was based on past experience earned by Sense
International (India). There was not much risks faced by project. At the partner level
also, not much risk was faced. However, in advocacy related work, our anticipation of
inclusion of deafblindness in central disability act could not succeed, due entirely to the
upcoming general elections. The rapid change in the political situation disappointed not
only deafblind persons and their families, but the whole disability sector. Sense
International (India) will continue to take up the issue with governments and civil
societies to ensure that deafblind persons are not deprived of all their human rights and
fundamental freedoms.
If so, how did the project deal with risk to minimalize negative impact on project results?
Though, one is not in position to do anything other than to wait for new government
formation, Sense International (India) has adopted the strategy to work with Department
of Disability Affairs under Ministry of Social Justice and Empowerment, to make sure
that deafblindness is included in all the government’s policies and schemes on disability
issues.
This evaluator is privy to the fact that the present set of bureaucrats (Secretary, JS)
think very highly of the SI(I) Director and his team, and consult with them on many
issues over and above DB.
25
4) Project Accountability to Stakeholders
How has the project collected feedback from beneficiaries and how has this been used
to influence project decisions on implementation?


26
Feedback is routinely taken from parents, project partners, teachers/therapists and
used to influence implementation. For example:
o The IEP is filled up with parents jointly.
o Teachers take inputs on home management from parents
o Staff meet parents groups regularly
o Decisions on visit-dates, frequency of visits, social and cultural events,
doctors-visits, visits for SQ tests are all influenced by parents feedback about
their availability
o Several mothers are expecting another baby—staff are seen to then increase
the number of home-visits , so that pregnant women do not have to carry their
disabled child to the therapy center
o In Kerala, large numbers of children from Muslim families were seen at the
centers. Staff are seen to make special provisions for prayer times, home
visits by female staff for girl children, and so on.
A great deal of flexibility was evidenced, which is necessary for a multicultural,
economically-multilayered society like India.
5) Lessons
Innovation:
Describe any project innovations which have the potential for scaling-up or replication
by Sense International or other organisations.








DB had a separate stall in a National Level Exhibition on disability in Delhi.
The Aids & Appliances scheme of GOI now has Packmate on its list, influenced by
SI(I). For many years now, the Ministry of Social Justice and Empowerment, has had
a scheme for distribution of appropriate appliances for persons with visual
impairment (white cane), hearing aids for those who have hearing impairments,
crutches/calipers and other orthotics for those who are mobility-impaired, etc.
Because of this project, the SI(I) team has persuaded the government to now,
include assistive devices for those with DB, like Packmates, which help them to
communicate better with others.
The National Institute of Persons with Multiple Disability (NIEPMD) now has started
DB services.
NIEPMD has Akhil Paul, Director SI(I) on many of its Committees and in the
Interview Panel for new staff.
NIEPMD also has started distributing boxes with material for DB specifically, again,
influenced by SI(I). This is being distributed free of cost.
A 2-day module on DB has been included in the SSA Teachers Training program,
for general school teachers as well as for Resource Teachers.
The INDIRA GANDHI National Open University has a module now on DB as part of
its distance learning course for teachers.
The regular B.Ed course in Maharashtra will now have a component on DB plus
other disabilities) because of the relentless efforts on Advocacy from SI(I) team and
SLC teams in Nasik.
Equity and Gender
What are the key lessons learned from the project’s approach to reducing inequalities
between men, women, girls and boys or other relevant aspects of diversity?

27
No lessons needed to be learnt as there was no discrimination. This is the result of
tremendous efforts by the teams to drive in the concept of gender equity, from day 1,
in all of their awareness and advocacy programs. The Networks also spread this
message and empowered adult deafblind girls, seen and heard at the Network
meetings, and at the National Conference, further enhances the impact. Word of
mouth among the mothers groups has also helped.

As mentioned earlier, there were more girls than boys on the beneficiary list
Capacity building
Describe key lessons learned in relation to capacity-building of partners, community
groups etc.



There were obviously inter-project variations in capacity-building needs of partners,
even between the SLCs, depending on their history of disability work in general and
their DB work in particular.
A major lesson is the need to expand the base of Mentors, covering
o A Region-wide roster of experts.
o Non-DB experts who can address CP, MR, Speech-related disorders.
Greater role-clarity between RLCs and SLCs vis a vis capacity-building.
Monitoring & Evaluation
What tools and methods have been most useful and practical in measuring and
demonstrating evidence of project achievements?




Site visits.
Quarterly Reports.
Continuous and comprehensive communication by email, telephone, skype calls and
meetings.
Strong bonds created between SI(I) and the partners have created an atmosphere
where honesty forms the basis of all exchanges.
Approaches to Empowerment and Advocacy:
What lessons have you identified in relation to factors that enhance approaches to
empowerment or advocacy processes?





Stakeholders’ collective voices are by far the most powerful change- maker.
Parents’ pressure comes second.
Regular, frequent media coverage, especially on events showcasing abilities.
Success stories, especially if the journey has been hard and long.
Use of social media and networking.
What lessons have you identified in addressing resistance against the empowerment of
marginalized groups?
28





The current wave of reforms (in public and private sectors), especially in a general
election year, include pro-poor approaches favorable for persons with disability who
are doubly disadvantaged because of their disability and because of poverty.
The upcoming general elections are a good time for those in power to be seen to be
inclusive of the marginalized.
The Right to Education 2009 and the Amendments to the same 2012 (which
included children with multiple disabilities) has been a harbinger of real change for
this group.
Currently, the resistance to empowerment of excluded groups is much less than
what it was even 5 years ago.
The revised Companies Act 2013 has made CSR mandatory, providing an
opportunity for greater linkages with NGOs.
Others lessons learned
Please describe any other lessons learned from the implementation of this project that
you think may be useful for other partners, grant holders or DFID (e.g. policy level,
sector level, GPAF fund level, organization level – management, design and
implementation)?




Role clarity between RLCs and SLCs may need to be revisited, with well-defined
responsibilities of RLCs towards SLCs.
This will ensure less time spent on “developing” new strategies (more time on
learning from others), and more ownership from RLCs.
Year 3 could be a good time for another round of discussions on:o What constitutes second generation early interventions, possible catchment
areas, training in non-medical newborn screening in the Hospital premises
before mother is released after delivery and follow-up visits.
o What constitutes vocational training, kinds of trades DB persons can do.
Now that partners have become more competent in handling DB work, another
mapping exercise could possibly be undertaken at this point to reassess the viability
of moving to government hospitals, more SSA schools, local trades, local job
opportunities /expertise available and so on, on the lines of a participatory appraisal.
Applied learning
How has the project used learning so far to improve delivery?

29
Feedback is routinely taken from parents, project partners, teachers/therapists and
used to influence implementation. For example:
o The IEP is completed jointly with parents.
o Teachers take inputs from parents on home management

30
o Staff meet parent’s groups regularly
o Decisions on visit-dates, frequency of visits, social and cultural events,
doctors-visits, SQ test visits are all influenced by parents feedback about their
availability and willingness
A great deal of flexibility was evidenced.
6) Conclusions
Summary of achievements against evaluation criteria



Inclusion of DB as a separate disability in laws, policies, local programs which has
long-term benefits/impact.
The 3rd National Conference in January 2014 with huge participation from
stakeholders was so impressive that the JS (Disability Division) Mr. Awasthi, actually
sat through the Valedictory session, which included a presentation on
recommendations by the audience, and made on-the–spot promises to provide most
of the facilities asked for by DB persons themselves. In 44 years of my work with the
Indian Government, I have never seen that happen.
The massive numbers included through the Education for All effort4:o 41,744 identified children with db
o 38,248 enrolled,
o 1,365 in school readiness program and
o 1,566 in home-based program
The realization among civil society, even among Doctors, that this is a group which
can LEARN, and DEVELOP unique competencies, is a huge achievement .This
means that other children with DB who will inevitably visit them in the future, will not
leave them with despair and negative prognosis.
Summary of achievements against rationale for GPAF funding
Education related
In the opinion of this evaluator, the education related gains have been the biggest, most
sustainable and the most path-breaking gains. That students with DB are being
identified, enrolled and retained in the government education system, that DB-specific
data is collected, and SI(I) included in the whole cycle of EFA (Education for All) is a
huge recognition and an even bigger achievement.
4
rd
These numbers were presented by SSA in the 3 National Conference on Deafblindness in
Delhi but have not been verified.
31
SUPPORT FOR CWMD/ DB
Physical
Access
• Assessment of CWMD
for mapping of needs
• Educational
Placement
• Aids and appliances
• Removal of
architectural barriers
Quality of
Access
• Support services
(including therapy)
• Teacher training
• Resource support
• Curricular access
• Individualised
Educational Plan (IEP)
Social
Access
• Parental
training and
community
mobilization
• Peer
sensitization
14
32
Supporting statistics











33
Children with Special Needs identified: (under SSA) is 27.79 lakh (1.19%)
Enrolment is 23.64 lakh (85.08%)
Coverage of CWSN is 94.64%
Resource Teachers appointed: 16863
Home Based Education coverage: 1.93 lakh
No. of HBE Volunteers: 11856
Resource support:
o Surgical support provided: 55099 CWSN
o 2.97 lakh CWSN given therapeutic support,
o 1.26 lakh given transport support and
o 2.18 lakh CWSN given escorts
Teacher Training
o In-service orientation: 69.20% teachers oriented
o Special 3-day IE module: 52.74% teachers given a specific 3-day training on
IE.
o 90-day course: 3.63% teachers trained
IEP: 33.73%
Infrastructure:
o Ramps & handrails: 79.78% (11.42 lakh schools out of a total of 1431702
schools have been provided with Ramps & handrails)
o Friendly toilets: 14.82% (2.12 lakh schools)
Partnership with NGOs: 812
o Partnership with MHRD. SI(I) is part of the national expert group on IE/
CWSN constituted by MHRD
o Partner of SSA for Master Trainer’s training conducted in 2011 at the national
level. 292 MTs trained across all States. Out of 18 days,4 days were devoted
to DB & MD
o SI also member of State Resource Group in Andhra Pradesh, Chandigarh,
Chhattisgarh, Delhi, MP, Rajasthan, Jharkhand,
o SI partnership with SSA in 17 states for training of general teachers
o Sensitisation programme for SSA staff in WB, Rajasthan, Kerala, Haryana,
Gujarat
o Bachpan Centres in UP included deafblindness in their service provision
CATEGORY- WISE---SSA
700000
600000
600000
500000
500000
400000
400000
300000
300000
200000
200000
100000
100000
0
Au
tis
m
Identified
6E+06E+05E+06E+01E+02E+02E+02741
42
VI
•
HH
OI
M
R
CP
M
D
LD
0
Au
tis
m
Enrolled 5E+ 5E+ 5E+ 5E+ 7532 1E+ 2E+ 1838
VI
H
H
OI
M
R
CP
M
D
LD
•
The above table shows identification on the left side, and actual enrollment on
the right side.
•
The above table clearly shows that those students with disabilities in government
schools who are being retained are the ones with visual (VI), hearing (HH),
orthopedic (OI) and intellectual disabilities (MR).Children with CP, (or cerebral
palsy), MD (multiple disabilities) and LD (learning disabilities) are not being
retained in the system because of the complexity of their problems; DB will come
under MD.
STATUS OF DEAFBLIND CHILDREN IN SSA
State
A & N Islands
A.P.
Ar. Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
D & N Haveli
Daman & Diu
Delhi
Goa
Gujarat
Haryana
HP
J&K
Jharkhand
Karnataka
DB CWSN
identified
0
178
16
45
52
0
179
1
0
0
16
1152
7
0
0
2276
3306
DB
CWSN
Enrolled
in
Schools
0
48
0
20
0
0
114
0
0
0
2
584
0
0
0
947
3306
DB CWSN
DB CWSN
Enrolled in
provided
School
Home
Readiness
Based
Programmes Edu. (HBE)
(SRP)
0
0
0
41
0
16
0
21
0
40
0
0
17
48
0
1
0
0
0
0
0
9
52
74
0
7
0
0
0
0
856
473
0
0
State
Kerala
Lakshadweep
MP
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
TN
Tripura
Uttrakhand
UP
West Bengal
Total
DB CWSN
DB
DB
DB
identified Enrolled CWSN
CWSN
in
Enrolled provid
Schools
SRP
ed HBE
191
156
15
20
0
0
0
0
32981
32335
0
646
13
13
0
0
47
0
0
47
3
0
0
3
0
0
0
0
2
0
0
2
25
23
0
2
32
30
0
2
222
140
35
32
26
17
0
9
0
0
0
0
31
12
3
16
0
0
0
0
2
0
1
1
0
0
0
0
941
499
386
56
41744
38246
1365
1566
20
•
The above table is a list of children with db, specifically, and not just Multiple
Disabilities, who have been identified in the SSA program. Some of them, are in
34
schools, some in Resource Rooms and the rest are receiving services through
home-based education. This is Sense I’s biggest achievement through this
project. It is no mean achievement.
STEPS TO BE TAKEN FOR INCLUSION OF CWMD/ DB
•
•
•
•
•
•
•
•
•
•
School strengthening
Provide resource materials, information, equipment, counseling,
etc.
Sensitize peers, teaching and non teaching staff towards MD &
deafblindness
Strengthen teacher training on teaching of CWMD and DB
Provide support services to deafblind students for academic as
well as co-curricular areas
Collaboration with NGO’s / special schools
Braille and large print books and learning materials
Provide all types of access, equal opportunities, encourage
participation of deafblind students in academic and non
academic areas.
Provide interpreters cum guide to deafblind students and
financial assistance to hire such services.
Mass awareness on a large scale.
32
INCLUSION OF YOGESHSWARI JAMBLE
In the context of CWSN we hear and say many times “see their
abilities not their disabilities”. This thought comes true when we
meet Yogeshwari a 10 year girl with deaf blindness. Studying in class
IVth of Zilla Parishad, Girls Primary School, Bardapur, Taluka
Ambajogai in district Beed. In the year of 2011 during the summer
vacation household survey for the purpose of identification of CWSN,
Yogeshwari was identified. Then with the help of special educator
Yogeshwari was assessed. After the assessment individualized
educational plan developed for Yogeshwari as per her need and
current level. The special educator began by giving home based
education to the Yogeshwari. Here yogeshwari was preparing for pre
inclusive skills, orientation and mobility skills, ADL, etc. After 8
months of home based education now Yogeshwari was ready to keep
her feet and face the society. At the place of Taluka Patoda under the
Inclusive Education programme, 3 month school readiness
programme was given to Yogeshwari. Here Yogeshwari learnt skills
that are needed in the regular classroom and school. As Yogeshwari
achieved independence in her day to day life, her supports gradually
decreased. Now Yogeshwari goes to the regular school and sits there
2 to 3 hours daily.
The successful inclusion of Yogeshwari has increased acceptance level
SMC & community members. Teachers have started to believe that
every special child can be mainstreamed and all children have a right
to enjoy and learn. Parents feel highly encouraged and motivated.
34
This case study has helped to break the attitudinal barriers.
Summary of problems and issues encountered.

35
All the difficulties that are normally associated with the introduction of a new subject,



Lack of awareness, even among doctors, thereby wasting many precious primary
/critical years
—Management issues within partners: NAB-Karnataka is a case in point where the
management appear to be at loggerheads with each other
Difficult to terminate funding, even when based on mismanagement, as seen in
NAB-Karnataka, because ultimately everyone has to be on board, perhaps a clause
can be built into the next project on mid-term closure based on management
difficulties.
Overall impact and value for money of GPAF funded
activities.









36
Pioneering work in introducing a ‘NEW’ disability.
Brought hope to many who were neglected, even by their own families at home.
Parents’ strengths/support is visible.
Media, civil society support is visible too.
SI (I) has earned enormous goodwill.
Earlier projects carry-over benefits are being utilized.
Choice of strategy (piggy-backing) is good value for money.
Combined goodwill of two organizations— Local partner and National (as in Sense
International India) --is multidimensional in impact, in terms of reach,
policies/schemes, and technical expertise/ skills.
The young and energetic team is very hard-working.
7) Recommendations for the future
Please specify at least 5 key recommendations, including recommendations for the
short-term (i.e. before the end of the project), medium-term (i.e. for a next phase
project) and long-term (i.e. longer-term strategy).
A point needs to be made before I begin the section on recommendations. The fact is
that there is a lot of high quality work already going on in the RLCs and also the SLCs.
They have defined and refined services to deafblind children beyond and above the
expectations of all of the parents.
Each SLC partner has its own unique strengths, locally and organizationally
contextualised adaptations, derived from experience as well as from the goodwill
earned over the years, and the inherent benefits of networking.
The SI(I) team needs to be congratulated for the strategies adopted, of collaborating
with local NGOs with excellent track records, and getting the best value for every pound
spent on this project. The land/building comes free, the goodwill comes free, the
networks and the publicity come free, as does the credentials. In almost all of the SLCs,
the sustainably has been guaranteed, by the simple strategy chosen by them, i.e.to
build existing capacities horizontally rather than start from scratch a vertical expensive
program of their own which cannot be sustained.
This evaluator pays tribute to the painstaking work of all partners, the SI(I) team and the
parents who have contributed immensely by their belief, their faith and their energy.
37
Justification
Short-term recommendations
Mid-term recommendations
1. Training

Of specific concern is
positioning, seating, gaittraining, feeding, posture,
Low-cost A&A, from mud,
used cardboard etc. can be
developed by the staff, using
APT and similar readily
available material
Request SPASTN for training
on the above-mentioned
subjects, (including APT).
All SLCs can benefit from
upgrading of non-db skills.

SI(I) training team may
need to expand in order to
include some more
therapists.
Request for senior
physiotherapist with specific
training in developmental
therapy, to be included in the
team as a Mentor.
Those with I yr training in DB
may need Bridge Course,
(now it is a 2yr course).

More focused capacity –
building needed on these
areas.

Start Training courses in
Goa, Kerala, on Diploma in
Deafblindness because
larger numbers of children
will then have access to
quality services from fully
qualified professionals
a. Multiple nature of the
disability, need to address
other disabilities.
In addition to deafblindness,
most of the children in the SLC
programs have CP, MR, ADHD
or Autism –like traits.
Staff need to be better
equipped to address these
issues appropriately.



b. Music therapy, Hydrotherapy
and more advanced Sensory
Integration, needs
strengthening in most of the
centers, except RLC west.
c. Professional development of
staff needs to be upgraded
both in EI and VT

d. There is a continuous need
for professionals especially in
Goa, Kerala and even in Nasik



The Project has provided
equipment
for new-born
38

Expertise in Goa and in
Kerala is available, and
names have been suggested
to SI(I).
For Nasik, the AYJNIHH and
ADAPT should engage with
hospitals, especially NICUs
in Govt. Hospitals.
May consider getting training

May wish to think of 2nd
generation EI, if possible
Long-term
recommendations
 SI(I) may wish to lobby
with RCI to modify its
training in Dip in Spl.Ed.
(DB), so as to include
more content, theory and
practicals on CP, MR,
Autism and ADHD and
other associated
disabilities.
 Request reputable
institutions to
mentor/advise, on an
ongoing basis, those
aspects that are
ASSOCIATED with
severe DB.
 Diploma to include more
content on these aspects.
 Request RCI for Bridge
course
 Request funding support
from NT as was done for
first 3 years in Autism
training(2003-4-5)

Include this in diploma
course, offered by the
Helen Keller institute
screening for hearing
impairment.
It is important therefore to
provide for new-born
intervention as well.
Early intervention is meant to
be from 0-6; however, none of
the centers had children below
2.5yrs (other than a few in
BPA).
Very early intervention needs
to be initiated, now if possible.
2. Stronger Linkages with
appropriate authorities.
(SI(I) team is very good in
networking, building linkages
and bridges)
Access to SSA schools need
strengthening in Goa,
Kottayam, Bangalore and
Nasik.
b. No linkages yet with
Rashtriya Bal Swasthya
Abhiyaan (RBSA) even with
the RLC.
(National Child Health Program
of Ministry of Health GOI)
c. Link with ICDS is good, but
the next step from EI is
placement IN the ICDS
programs, at least for a few to
start with. Not easy, but efforts
may be considered.
3.Engage more with media,
like Goa
39





in physical newborn
screening/intervention (other
than the machines given in
the hospitals).
May wish to use Nancy
Bayley and similar tests.
Each SLC to start a dialogue
with the State SSA-IE and
RBSA programs, for the
express purpose of getting
involved with it, and availing
benefits thereof.
RBSA targets disability as
one of its major focus areas.
ICDS—access to these
centers could benefit from

Invite groups of journalists
from the print and electronic
media for an interaction with


At the national level,
SI(I)may wish to directly
dialogue with the MOHGOI, to ensure that DB is
included as one of the
recognized disabilities in
their national and state
programs
SI(I) has a lot of ready IEC
material that RBSA will be
grateful for.
Prepare and disseminate
case studies in regional
languages about Daya and
4.Research not seen, despite
pioneering work being done,
both in IBR and CBR

the children and their
families, on regular basis and
not just for events.
Survey by AWWs, after

training could be conducted


others like her.
NIEPMED and NIVH/NIHH
to be explored for possible
research tie-ups.
PREM division/MSJE also.
ICMR to be contacted also


5.Rights-based approach
missing


6.Hydrotherapy-swimming
pools needed because most of
the children are older, and will
benefit from the buoyancy and
sensory benefits of water

7. Parents want life-long
residential care, since a
majority of the clients are in the
severe category, and their
parents are growing old.

Train teams in RTE, PWD,
UNCRPD, NTA
Train parents in fighting for
SSA admissions, and act as
pressure groups
NAB-Nasik, and CaritasKottayam can start first as
construction work is going on
in these centers
Management is very
supportive as well as
resourceful
Again, NAB-Nasik, CaritasKottayam can start first as
construction work is going n
these centers

Prepare local language
materials

Include these (or, more of
it ) in the training courses

SI(I) may wish to target
transfer –of- skills in these
areas

To include in the training
course

Parents’ networks should
also work towards this.
Simultaneously network
with Parents Groups of
other disabilities
Good example of Parents
group in Kerala, where
about 30 parents bought
adjoining land and formed
a large residential center as
well as farmland

GOI’s support was
promised by the
JS/MSJE, at the 3rd
National Conference in
Delhi in Jan2014, and this
may be seen as a priority
for SI(I).


NT provides for this kind of
support, under its Gharonda
Scheme. This could be
sourced.
40
Time to develop
indigenous tool on DB in
India. Request NT to take
this up with MOHFW as
was done for Autism in
2004-5
Alternatively, check if the
new IMFAR tool is
inclusive of DB.
8. Doctors giving wrong advice
to parents, wasting critical
years of maximum learning in
the early childhood years.

9. Vocational training is still
rudimentary in most projects,
with the exception of RLC
west.

10. This project is actually very
good.
Replicate in Eastern and
Northeastern States of India
where poverty levels are even
lower, more unmet needs, but
plan for at least 5 years
because 3 is too short for a
new disability in a new
organization.
41

Projects to hold awareness
/sensitization of THOSE
specific doctors who are
advising
“ nothing can be done, leave
them alone”
NAB-N to visit ADAPT’s Job
Development Center in
Mumbai.
All partners may wish to visit
Ramanna Maharshi
residential agro-animal
husbandry training center for
disabled adults, outside
Bangalore

Larger groups of
Pediatricians, Neurologists
ENT and Eye specialists

Write articles/ notes for
medical journals with
case-studies

NHFDC, NT ARUNIM,
Labour Ministry VTCs—to
be explored for possible
linkages

SI(I) may wish to lobby
with National Skills
Development Authority
(NSDA)


Engage with donor, GOI
Explore NGOs in MD, VI,
and HI.
Explore opportunities with
NE HU
Also with IGNOU Training
Centers


Annexes
SWOT Analysis in assessing the project to date
Strengths









Pioneering work in introducing a new disability
Brought hope to many who were neglected, even at home
Parents’ strengths/support is visible
Media, civil society support is visible too
Sense has earned enormous goodwill
Earlier projects carry-over benefits are utilized
Choice of strategy(piggy-backing) is good value for money
Combined goodwill of two organizations— Local and national --is multidimensional in terms of reach,
policies/schemes, and technical expertise/ skills
Young and energetic teams
Weaknesses




42
All the difficulties associated with a new subject
Lack of awareness, even among doctors, thereby wasting many precious primary /critical years
Inter as well as Intra-NGO egos cause fragmentation within the disability sector
NAB-K is a case in point where the management appear to be at loggerheads with each other
Opportunities






There are enormous opportunities for working together, GO and NGO, but a history of mistrust overshadows the
disability sector in general.
Need aggressive marketing of Organization’s abilities, and benefits thereof.
Sense team led by Akhil Paul is extremely well respected, and included now in every sphere.
Networking with SSA, RBSA, NIs, NT (Niramaya, Arunim, Gharonda, Respite Care, and other schemes ), are there,
but not all partners are making the effort to explore and/or follow-up( Nasik is and so is BPA)
All the NGOs-projects have some goodwill with civil society as well as with the Health (Govt. and private), and
Employers, but NAB-Karnataka is not utilizing those contacts either for early intervention or for employment-related
training.
NHFDC has not been explored for IGA by most partners, except by RLC west
Threats


43
Of non-sustainability, especially with NAB-K
Of non-professionals taking over, after funding stops, thereby triggering a downslide in quality
April 2013
Hansa’ s story
Hansa was born into a family of poor, rural wage
labourers in the remote village of Dhanki, Gujarat.
Profoundly deaf with low vision and learning difficulties,
Hansa’s life was a lonely struggle. Her disabilities were
not understood by local villagers and she was branded
as the lord’s curse. The family was shunned. Their
presence in the fields or in local homes was seen as bad
luck. The family’s livelihood depended on the work they
could get in the fields and this stigma was a heavy
burden to bear for Hansa and her family.
Fortunately, things took a turn for the better with the
arrival of Deepak Bhai, the educator from Ashirwad
Viklang Trust trained by Sense International (India). He
helped Hansa to understand her environment and soon
Hansa began responding, displaying remarkable progress. She learnt to count with
beads, do simple arithmetic and took over the household chores, becoming an asset to
her mother. She began communicating with sign language and a new medium of
conversation and expression opened up. Deepak convinced the local school to admit
Hansa and in a short while Hansa was spelling her name in English among other things.
The reclusive Hansa transformed in to a confident young girl who could wield a cricket
bat with flair!
It took a while for these changes
to be recognised by local villagers
but slowly the community began
to accept Hansa and her family
again. Farmers employed
Hansa’s parents in the fields and
Hansa herself is now a farm
hand. The family is invited to
social and community functions
and Hansa has found her own
group of friends.
44
1
Today, Hansa and her family are more positive about their future. Hansa is registered under the Government of India’s Mahatma Gandhi National
Rural Employment Guarantee Act (NREGA). The Act enhances the livelihood security of people living in rural areas by guaranteeing a hundred
days of wage-employment in a financial year to a rural household. Recently, Hansa’s family also built their own home under the Government of
India’s social welfare programme ‘Indira Awaas Yojana’.
With the right support isolation has become a thing of the past for Hansa and her family and with the help of SI(I) she is now able to live a full and
active life with as much independence as possible.
45
Case Study
Shiva-Caritas Kottayam
Moving towards Independence...
Introduction
Shivalakshmi is a 4 year old child and the second child in the family. She hails from Pathuva village in Kottayam, Kerala
State and her family comprises grandmother, parents and two siblings. Her father works as a wood cutter and mother is a
house wife.
46
Shivalakshmi was born in 2009. She is the pet for her family members and neighbors and with love they call her ‘Shiva’.
Shiva is very sweet and loving. She loves to play with other children and happy when cuddled.
KSSS Intervention
When the Deafblind programme field worker of KSSS located the child, the child had delayed development milestones
with no head coordination, poor motor coordination, poor eye movements and no hearing. As the family was economically
weak they were unable to take regular treatment for epilepsy and she suffered from frequent episodes. It was clear from
the medical certificate that Shivalakshmi suffered from Down’s syndrome with Cerebral Palsy and epilepsy.
Thereafter the KSSS team visited the child. Shiva’s mother Mrs. Usha narrated the sad story of her ignorance that
caused the problem. She was very depressed when we met her and was overwhelmed with guilt when she was narrating
this story. Mrs Usha said that before setting out a pilgrimage, she took tablets to prevent menstrual cycle unknowingly that
she has already conceived. Soon after delivery though the doctor had informed them about the disability of the child still
they had no much information about it but when the developmental milestones delayed they consulted the Pediatrician
and understood the problem. But due to the poor financial condition they were unable to continue the treatment.
The child was assessed by the KSSS team and found problems with functional vision and hearing. The family members
were oriented about the child’s needs and the interventions required for the development of the child. The family was
given awareness about the deafblind programme and the need to render specialized training. Several counseling
sessions were conducted for the family members and especially for the mother who believed strongly that her ignorance
had caused the disability. Hence our initial efforts were to strengthen Shiva’s mother. The regular counselling sessions
helped to uplift mother’s mental state from her depressive ideations and to extend a ray of hope. She also joined the CBR
SHG and is a member of the Family Networks. She is empowered now and actively takes part in all the programmes of
deafblind project. She is also a good trainer and takes up the training of Shiva at home efficiently.
The KSSS team along with the parents prepared the Individualized Education Plan and training was planned in the areas
of Communication, ADL, Motor Skills and Sensory. The staff initially rendered home based training and thereafter she
started attending the Samaritan Resource Centre. Initially the family was not much interested to come to the resource
centre because of the inconveniences in the family but the positive changes in Shiva through Resource Centre trainings
47
impressed them especially the sensory trainings which was very new to them boasted their confidence about Shiva and
they found the Resource Room very useful.
Through the Family Networks under the advocacy initiation of KSSS, Shiva’s mother is getting benefit of Rs 525/ monthly
under the Aashwas Kiran Scheme. Applications have been forwarded for Pension and Scholarship benefits. Shiva has
also attended Medical Camp organized by the Block Resource Centre under Sarva Shiksha Abhiyan for assistive
equipments.
For her social development she is taken to the CBR group meetings and she participated in the Tableau presented by
deafblind children during the Golden Jubilee Annual Agricultural Fest of KSSS. She acted out Saint Alphonsa and she
really looked so pretty and blessed and her role added to her happiness.
Results
A year of regular interventions and trainings has resulted in tremendous changes in Shivalakshmi. Currently Shiva can sit
independently and has improved her hand coordination. She can hold biscuits for a few seconds. She has improved her
expressive communication the sensory training for vision has enabled her for tracking and focusing at objects. Shiva is
very fond of luminous toys in the sensory room and tries to hold them. Moreover she has also improved her hearing skills.
Through the regular medical and nutritional support given to the family by KSSS with the support of Sense International
India, her health has improved and the occurrences of episodes of epilepsy have reduced.
KSSS team along with Shiva’s family now dreams of leading her to independence with the generous support of Sense
International India.
48
Case Study – Sneha Joseph
‘When one door of happiness closes, another door of happiness opens’
-Helen Keller
Sneha Joseph resides in an Orphanage named Providence Home at Arpookara village in Kottayam. She is a 4 year old
child and being the youngest among the inmates of the home she is very\dear to them. She belongs to a family residing
at Tamil Nadu and has three siblings. Her mother found difficult to manage the family as Mr. Joseph was an alcoholic and
assaultive so she brought Sneha to the Providence Home and rarely visits the child. The sisters of Providence Home were
confused about her further rehabilitation because she has no vision and also suffers from hearing impairment but she was
an intelligent girl. In this situation they consulted a doctor who is also their Board member and this particular doctor had
attended the sensitisation programme conducted by KSSS hence he referred this child to our deafblind programme thus
the Sisters of the Home approached the Project Coordinator. The project staff team of Deafblind Rehabilitation
Programme visited the child at Providence Home and gradually a good rapport was established with the sisters.
Sneha was born in 2009. She belongs to a broken family and her mother had undergone severe stress during her
pregnancy. Sneha is a deafblind child. The Sisters of the home were unaware about a disability named ‘deafblindness’.
49
Hence the team explained them about the child’s disability and convinced them about the unique nature of the disability
They realised that deafblind persons required a specialised trainings and this would only help to cater the needs of Sneha.
Sneha had lot of behaviour problems. She was dependent daily activities, could not communicate and has no orientation
of place and no mobility (Could not move even inside the home and was carried by the Sisters and inmates).
KSSS Intervention through Deafblind Rehabilitation
When the Deafblind programme, special educator first visited Sneha she was very upset because the child had severe
behaviour problems and it was difficult to handle her. However Sneha’s assessments were completed by the team and
Individualised Educational Plan was formulated. The Special Educator gradually trained the child to identify the teacher
through her smell and by symbol and very soon Sneha became very close to her. Now Sneha attends the services
rendered through Samaritan Resource Centre.
Tactile sign language mode of training is used to teach Sneha. Her IEP includes Activities of daily living, Communication,
Orientation & Mobility training and Sensory trainings.
Results
After a year’s regular training we are proud that Sneha has developed a lot and is moving towards independence. Her
behavioural problems have reduced through various activities. Currently she can indicate sign & communicate her need
for toilet. The orientation and mobility training helped her to gain awareness about her environment and at present she
can walk with the support of ramp to her room as well as independently walk to her training room which is outside the
main building.
Sneha participated in a Tableau presented by the deafblind children during the Golden Jubilee Agriculture Fest and she
took the role of an ‘angel’. In the costumes of an Angel she looked very gracious and her participation made her happy.
The KSSS team and the Sisters of Providence Home are confident that the intense trainings will help Sneha to win over
her disability and live independently. And we are happy to acknowledge that this has been possible only because of the
generous support and pioneering efforts of Sense International India.
50
Case Study - Caritas Goa
Name- Mohamad Gaus Mulla. (Ayaan)
D/O/B- 15/05/2006, Age- 8 year’s, Sex- Male
Hearing- He can hear. (ENT Evaluation BERA Profound hearing loss)
Vision- Low Vision.
Special Educator - Sabyasachi Deb (Trained from Hellen Keller Institute in the Diploma course)
Communication- Expressive- Speech, (water, T.V, (Chota Bhim) mamma, Aulla, glass, A to Z) Body Language, Basic sign
language, (water, toilet, fish, apple, finish, ball, Fan, cat, A to Z) Vocalization, Facial Expression, pointing,
51
Receptive- Speech, Sign Language, Facial Expression, Picture, Objective Symbols, body language, pointing, Total
Communication.
Family History








Father Name- Mr. Karim Mulla.
Education- B.A
Occupation- Govt. job.
Mother Name- Nasimabanu Mulla.
Education- M. Com.
Occupation- Private Job.
Present Address- Mapusa Goa.
Phone No-
Medical Information






Development Milestones
Head holding- at 2 years
Rolling Over- 1 year
Sitting- 2 year
Standing/ Walking- 3 years
Speech/ Babbling- 6 month.
1st word- Allah.
Age of identification


Hearing- 5 month
Vision- 5 month
Age intervention
52


VisionHearing- 2year.
Service providers- P.T, O.T, Special Educator
Achievements:-
Language and Communication:ACTIVITIES OF DAILY LIVING
Sitting
53
Drinking
ACADEMIC
Reading & Writing
Concept - About Rain.
54
MOTOR SKILL:
CARITAS GOA (networking)
55
Case Study – Bhupendra Deshpande
56
The 6 pictures above, of Bhupendra Deshpande from NAB Nasik, clearly show that words are not surroundings. He is
seen above with the NAB Nasik Project Coordinator Jyoti, confident and necessary to tell the story of his journey, as the
child gets more and more involved with his trusting.
57
Sample Innovations
5 a side Football Tournament Organized by
Caritas-Goa
A 5 aside Futsal tournament was organized as a fund raiser for the DEAFBLIND children & young adults in Goa, on the
21st& 22nd of September 2013 at the Don Bosco Oratory, Panjim.
58
We had 38 teams that registered for the event. The entry fee for each team was 500/- The matches took place over 2
days from 3pm to 12.30am.
We started the evening by introducing deafblindness and by telling them what Caritas & Sense were doing! We ended by
showing our video…
Screening of the video
On day 1 the knock out matches took place and the teams were categorized into batches and pairs to play one another.
On day 2 the quarter finals, semi finals and finals took place.
The prizes that were been given were:




1st prize: Rs 6000/- , trophy, certificates
2nd prize: Rs 4000/- , trophy, certificates
Best Player
Best Goalkeeper
The whole show was managed and organized by the Caritas team and by volunteers, who came and helped make this a
big success.
At the end the certificates and trophies were presented to the winners and runner ups.
59
We managed to sensitize a large group of people and youth from the sports sector, who were very interested and reached
out to a lot of interiors of Goa. 3 of the winners spontaneously even gave back their award money, as a donation to the
deafblind project
Player in Action!
Donating their cash prize to DB project
60
Raj, BPA Ahmedabad, is now a trained masseur with a certficate from their recognized course. He has passed his 12th
standard examinations and is now economically independent.
61
Sample list of persons that the Goa project staff get help from:-
Doctors/Hospitals:
Sr. No
1.
2.
Name
Dr. Edelweise De Sa
Hospital
Private
Practitioner
Dr. Roque Rebeiro
JMJ Hospital
3.
Dr. Megha
4.
Dr. V. N. Jindal
5.
Dr. Basil Yuri Cotta
6.
Dr. Ramnath Naik
Novi Survat
Goa Medical
College
Private
Practitioner
Private
Practitioner
7.
8.
9.
Dr. Ravindra
Panandikar
Dr. P. D. Nachinolkar
Dr. Ira Almeida
Private
Practitioner
Hospicio
Hospicio
10.
Dr. Kulkarni
11.
Dr. Nelly De Sa
12.
Dr. Chandrakant
Gaonkar
Private
Practitioner
Private
Practitioner
My Eye
Hospital
Pediatric Ward
13.
62
Position
Physician
Address
Panjim, Goa
Obstetrician &
Gynecologist
Alto, Porvorim,
Goa
Physiotherapist
Porvorim, Goa
Dean
Bambolim, Goa
Ophthalmic
Surgeon
Pediatrician
Margao, Goa
Paediatric
Ophthalmologist &
Squint Specialist
Medical Suptd
Seniro
Pediatrician
Eye Clinic
Pediatrician
Margao, Goa
Margao, Goa
Margao, Goa
Margao, Goa
Margao, Goa
St. Cruz, Goa
Nuvem, Goa
The consultants
GMC
Bambolim
14.
Dr. Siddarth Darji
15.
Dr. Kartihaivalem
16.
Dr. C. P Das
17.
Dr. Pinky Palienkar
18.
Dr. Ramaswamy
19.
20.
Dr. Rajeev Kamat
Dr. Virendra Gaunkar
21.
Dr. Ameet Kaisare
22.
Dr. Shyam Telwankar
23.
Dr. Ulhas Kaaisare
24.
25.
Dr. Victor Fernandes
The director
Manipal,
Hospital
Manipal
Hospital
GMC
Sr, Executive
(Operations)
Private
Practitioner
Polyclinic
Hospital
Asilo Hospital
Citicare
Children’s
Hospital
Private
Practitioner
Asilo Hospital
Child Specialist
Private
Practitioner
Eye Clinic
Neuro Rehab
Centre
CEO
HOD – ENT
The administrator
HOD – ENT
Goa.
Bambolim,
Goa.
Caranzalem
Altinho, Panjim.
Goa
Mapusa, Goa
Campal. Panaji
Panaji, Goa
Medical
Superintendent/Dy
Director
Ophthalmic
Surgeon
Eye Surgeon
Mapusa, Goa
Panaji, Goa
Porvorim, Goa
Bambolim Goa
26.
Organizations visited by Goa staff as part of awareness and assessments
Sr. No
1
63
Name
Mr. Zeferino D’souza
Position
Secretary
Organisation
Diocesan
Society Of
Education
Address
Panjim, Goa
2.
Mr. Naresh Babu
3.
4.
Fr. Valmiki Gonsalves
5.
Dr Nandita
Director
Sister Superior
The Director
The Director
INSYNC – kidz
Rehab Centre
Daddy’s Home
Peace Heaven
Home & school
for mentally
challenged
children
SETHU
Disha
Charitable
Trust
Sancoale, Goa
Gogol, Goa
Caranzalem
Panjim, Goa
Panjim, Goa
Schools/Colleges visited by Goa staff as part of the awareness programs:Sr.
No
1.
2.
3.
4.
5.
6.
7.
8.
64
Name
Position/Name
Fairyland School
New Dawn Ashadeep
Special School
St. Vincent De Paul
Special School
Naval K G
The Headmistress
The Chairman
Ms. Elsa
Polytechnic College
People’s School for
appropriate learning
Lok Vishwas
Pratishtan
Anand Niketan
Address
Goa, Velha
Sada Vasco
The Headmistress
Curtorim, Goa
The Headmistress
Ss Vasco,
Mormugao
Altinho, Panjim
Ms. Thakur
Panjim, Goa
The Principal
Ponda, Goa
Ms. Veinola Mohe
Mapusa, Goa
9.
10.
11.
12.
13.
14.
65
Gujrati Samaj
Educational Trust
Our lady of Lourdes
High School
Hamara project
Sanjay School
The Chairman
Aquem, Margao
The principal
Utorda, Goa
The Principal
The Director
Taleigao, Market
Porvorim, Goa
National Association
for Blind
The director
St. Cruz
Some Samples of material published as part of this project
This project has contributed extensively to material development on important matters relating to persons with
deafblindness. There are many, many more than the ones seen in the pictures above and below.
The Goa team has done a very good video; just adding the titles of sponsors is to be done. It will help the other partners
too.
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67
Compilation of responses from partners to key evaluation questions (compiled by Uttam Kumar)
Impact and Overall Results so far:
What is the project’s overall impact in relation to its outcome and how does this compare with what was expected?
 The overall impact in relation to its outcome : Empowerment of Deafblind persons.
 Streamlining into society
 Right to Education, Health, Social Security & Economic Independence.
 Empowerment of Parents
 Public awareness could be created about deafblindness
 Improvement in the living conditions of the Deafblind Persons.
What are the key results against the outputs and how did this compare with the targets set in the original logical
framework?
 Assessments have benefited for early diagnosis and early intervention will ultimately reduce the intensity of the
disability.
 Regular Medical Services and control over epilepsy.
 Cataract, Ptosis and Orthopaedic Surgery was conducted for 6 deafblind children.
 Assistive devices provided and regular therapeutic interventions have reduced the disability.
 Through Exposure visits the children got a good exposure and happiness and ‘We-feeling’ among members
 Advocacy and lobbying resulted to stand for the rights of deafblind persons to education, health, social security and
economic independence.
 Socio-Cultural development of children through participation of deafblind in extra curriculum activities has brought
happiness to them and their parents and boasted a well feeling in children as well as in parents.
 Setting of Resource Room and trainings in Sensory Room have enhanced the quality of training and cater the needs of
the unique nature of the disability and better developments in children.
 Inclusion of adult deafblind in IGP and livelihood has their reduced poverty and increased their self esteem.
How effective is the project’s overall strategy?
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The project’s overall strategy is very beneficial for the empowerment of the deafblind persons and caters the needs of all
age groups.
Assessment and Medical assistance
 Regular Medication and Improved Quality of Training given by the Special Educators
 Improvement in the living conditions of the Deafblind Persons.
 Regular therapeutic services will reduce the disability.
Cataract, Ptosis and Orthopaedic Surgery was conducted for 6 deafblind children.
Trainings and Resource Room
 Home based and Centre based trainings have benefited 28 children. Setting of Resource Room and trainings in
Sensory Room have enhanced the quality of training and cater the needs of the unique nature of the disability and
better developments in children.
 Home based Vocational trainings for adult deafblind has also beneficial to attain self reliance.
Assistive Devices
 Assistive devices provided and regular therapeutic interventions have reduced the disability.
 Through Exposure visits the children got a good exposure and happiness and ‘We-feeling’ among members
EI Screening Machine:
 New Cases were identified, Policy Formulation: Hospital made it a Policy for Compulsory Vision & Hearing Screening of
each new born baby
State level Training on deafblindness:
 More organizations started working for deafblind persons.
 New cases identified after Training
 Early identification and early intervention will reduce the intensity of the disability
 Awareness about deafblindness in the public
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State level Advocacy and Networks Meet
 Advocacy and lobbying resulted to stand for the rights of deafblind persons to education, health, social security and
economic independence
 Strong and Vibrant Family Network.
 Empowerment of Parents and adult deafblind.
 Family Network Meeting in every Three months
Exposure visits for children
 Through Exposure visits the children got a good exposure and happiness and ‘We-feeling’ among members
Other Activities
 Inclusion of adult deafblind in IGP and livelihood has their reduced poverty and
increased their self esteem.
 Participation in various cultural programmes developed the innate talents of the children.
 Staff capacitating trainings have equipped staff to render enhanced professional services.
If relevant, in what ways does the project: i) improve global/regional/national/local policy; ii) and/or strengthen
legislation and enforcement mechanisms to protect and empower disadvantaged target groups; iii) and/or raise
awareness amongst civil society and service deliverers about rights. Provide examples.
If relevant, in what ways does the project improve practice by providing greater access to quality services for
disadvantaged groups? Provide examples.
Key Evaluation Criteria 5and Value for money (VfM)6 questions:
Relevance
To what extent is the project supporting achievements towards the MDGs, specifically off-track MDGs?
The project is supporting various programmes to achieve towards the MDGs:-
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Promote gender equity and empower women:
 KSSS believes in empowerment of women. Gender inequity is one of the major problems in our villages but we focus
on empowering our mothers. Mothers’ day, Women’s day, such occasions are celebrated.
 We maintain gender equity and promote equal ratio of Male and Female. In our PTA meetings participation of both
parents is compulsory.
Improve Maternal Health
 To improve maternal health, health awareness programmes are conducted for the mothers.
Ensure environmental sustainability
 For environmental sustainability we promote kitchen gardens. The seedlings of different vegetables are provided to
them from KSSS and we have launched a programme for the deafblind persons to make a kitchen garden in their
homes and the deafblind person having the best vegetable garden will be given prize.
 The children of the Samaritan Resource Centre have also made a vegetable garden in the centre.
To what extent is the project targeting, reaching and benefiting the poor and marginalized?
 Through this project we are able to provide services to the 54 deafblind persons. Most of them belong to BPL
category. We also have few deafblind persons belong to the schedule caste.
To what extent is the project mainstreaming gender equality and equity (men, women, girls and boys) in the
design and delivery of activities (and/or other relevant excluded groups)?
 KSSS always focus gender equity. Gender inequity is one of the major problems in our villages but we focus on
empowering our mothers. Mother’s day and Women’s day are celebrated.
 We maintain gender equity and promote equal ratio of Male and Female. In our PTA meetings participation of both
parents is compulsory.
In all our programmes we ensure gender equity.
How is the project ensuring activities respond to the needs of target beneficiaries?
 The Individual Educational Plans are prepared with the support of parents and the needs of the children are taken
into consideration. The family-teachers –adult deafblind networks and the PTA meetings help us to understand the
needs of the target beneficiaries and cater their needs. The weekly Staff review meetings and monthly Staff case
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review meetings the condition of each deafblind person is taken and discussed and the needs of beneficiaries is
taken into consideration.
To what extent and how is the project affecting people in ways that were not originally intended?
In Kerala the people were not aware about the concept of deafblindness, The NGO’s and Special Schools were rendering
trainings to the deafblind persons similar to the multi-disabled children but after KSSS started functioning as the State
Learning Centre on deafblindness, the public got aware about the disability ‘deafblindness’ and the need to give special
training to cater their needs. The Resource Room which we started especially visual stimulation and auditory training given in
the dark room is a very new concept. The sensory room trainings and sensory garden and positive changes in the children has
good impact on the public and created awareness that the trainings given to deafblind children differ from other disabilities.
Effectiveness
To what extent is the project delivering activities that are value for money with regards to their economy and
efficiency?
The project provides trainings, screening and assessment facilities, therapeutic services and assistive devices, medical and
nutritional support, vocational trainings, and IGP support for the adult deafblind persons.
To what extent is the project using evidence to improve programming?
 The weekly Office level Staff Meetings and the monthly Staff Case Review meetings takes each component of the
project is discussed and evaluated.
 The Family networks, adult deafblind and Parents meetings helps us to evaluate our work and to improve
 The valuable suggestions for improvements are taken into consideration.
What are the key drivers and barriers affecting delivery of results for the project?
As deafblindness is a new concept some government departments are not willing to accept this concept or their ignorance
have caused delay in services, the deafblind persons of our project are scattered in different and distant villages so all the
children they are unable to get the benefits of resource centre. Lack of Funds is also another barrier.
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To what extent do the activities, services and results being delivered by the project align with the intended objectives
of GPAF?
The activities and services are delivered to reduce poverty, attain self-reliance and improve the livelihood conditions of the
deafblind persons.
To what extent is the grantee delivering activities on time and on budget against agreed plans?
Other than the planned activities we also raise Local Resources. Eye and Orthopaedic surgeries were conducted for six
deafblind persons. Also assistive devices are provided to the beneficiaries through the support of various agencies.
To what extent and in what ways is the project achieving good value for money?
KSSS encourages promotion of Kitchen gardens and this is of good value in terms they will get vegetables from their house,
moreover the yields are free of pesticides.
Are resources being used efficiently to optimize the results achieved compared to the required level of inputs?
 All the facilities and benefits of KSSS are rendered to the deafblind persons.
 The home based and centre based trainings have brought good changes in the children. The assistive devices and
therapeutic services have been beneficial to reduce the capacity.
 The medical camps has the improved the health of the people.
 Through the Panchayats the children get pension and scholarships.
 The OAE equipment launched at Caritas Hospital have compulsory screening of new born babies.
Sustainability
To what extent is the project leveraging additional resources (financial and in-kind) from other sources?
 The project to leveraging additional amounts from other sources. We are getting assistive devices for children from the
Block Resource Centre of the SSA as well supported by the Little Flower Hospital, Angamali.
To what extent is the project engaging with others to ensure their interventions complement existing activities or
leading to replication of approaches elsewhere?
 The Olessa Blind School, Jyothigamaya, Villooni School for deaf are also working for deafblindness.
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To what extent are the benefits being realized by civil society groups supported by the project sustainable?
 KSSS has civil society groups. In every village there is a Village Development Committee which is the apex body. In the
meetings of the Village Development Committee the functioning of the village level the functioning of the deafblind
programme is also discussed and evaluated.
 What is or can be done to ensure the sustainability of the project results? This includes the sustainability of poverty
reduction outcomes and, where appropriate, the continuation of services developed during the project period.
 The deafblind persons can be included in NREGA scheme of the Panchayat.
 Promotion of Income Generation Programmed for the deafblind persons with support of the Panchayats or Government
Building capacities of adults with MD and Db to lead inclusive life
 Vocational training
 Income generation
 Family and social life
Impact
 To what extent has the project put in place M&E systems that are fit for purpose and are being used to support the
delivery of activities?
To what extent has the project built the capacity of civil society?
 The deafblind persons are included in all the programmers of KSSS.
 Inclusion in the SHG of Persons with disability.
 Inclusion of deafblind persons in public functions and events.
How many people are receiving support from the project that otherwise would not have received support? How many
of these people are unintended beneficiaries?
 Forty five of the beneficiaries are receiving support from the project.
Risk Management & Mitigation
Did the risks identified in the original proposal and annual reports materialise?
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

During the initial period of the project there were difficulties. Though the staff had experience in disability but as the
concept of deafblindness was new they were not much confident and we had the risk about output of trainings for
communication and regarding improvements through training.
Initially it was also difficult to convince the parents about the unique nature of the disability and the specialized
trainings.
If so, how did the project deal with risk to minimalize negative impact on project results?
 To deal with the risk to minimalize negative impact on project results the following steps were taken:
 Staff capacitating trainings were conducted
 Parents also attended training programmers and were sensitized about the concept of deafblindness.
 Parents also come with the children in the resource centre and were trained in different areas like communication,
visual training, auditory trainings etc.
 Mentor’s visits and Onsite visits also helped and uplifted the confidence of the team.
Project Accountability to Stakeholders
How has the project collected feedback from beneficiaries and how has this been used to influence project decisions
on implementation?
 After every programme we conduct evaluation and the suggestions of improvement are implemented.
 Regular house visits are conducted in the beneficiaries’ houses and their feedbacks are taken.
 In the case review committee each and every feedback given by the beneficiaries are discussed.
 In the Networks meet and in Parents teachers meeting their suggestions (positive & negative) are taken for each and
every activity and we ensure that the negatives are not repeated.
Lessons
Innovation: Describe any project innovations which have the potential for scaling-up or replication by Sense
International or other organisations.
UN has declared this year as the Family Farming Year and to support the MDGs environmental sustainability we have launched
a programme, ‘My food at my home only’. The beneficiaries are provided seedlings from KSSS, and will plant various types of
vegetables and make a vegetable garden in the courtyard or at the roof of the house.
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Equity and Gender: What are the key lessons learned from the project’s approach to reducing inequalities between men,
women, girls and boys or other relevant aspects of diversity?
We have learned that already there is gender inequity in our villages so we should ensure the participation of equal ratio of
males and females in all our programmes.
Capacity-building: Describe key lessons learned in relation to capacity-building of partners, community groups etc.
 The capacity building of partners, community groups have motivated them to work for the deafblind persons.
 Few people have shown interest to do volunteer services.
 More references from other NGO’s and services could reach to more deafblind people.
 The screening of new born babies because of the OAE machine had helped to identify risk babies and early
interventions will be beneficial.
Monitoring & Evaluation: What tools and methods have been most useful and practical in measuring and
demonstrating evidence of project achievements?





The most useful and practical tools and methods in measuring and demonstrating evidence of project achievements
are:The positive changes in children through training
The changes in the attitude of parents and their confidence level has raised
We are getting more support and cooperation from the Panchayats.
A vast change in the attitude of the society towards the deafblind persons.
Evaluation
Approaches to Empowerment and Advocacy: a) what lessons have you identified in relation to factors that enhance
approaches to empowerment or advocacy processes?
Through a collective group rights and benefits of the deafblind persons can be attained and the Policy makers can be
influenced.
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B) What lessons have you identified in addressing resistance against the empowerment of marginalized groups?





The identified resistances against the empowerment of marginalized groups are:Difficulty in accepting of concept deafblindness by the government authorities.
Lack of family support and over protection of parents towards the deafblind persons.
Lack of proper legislation and policies.
Deafblindness is not considered as a special category.
Others lessons learned: Please describe any other lessons learned from the implementation of this project that you think
may be useful for other partners, grant holders or DFID (e.g. policy level, sector level, GPAF fund level, organisation level –
management, design and implementation)?
Capacity building and vocational training classes to be introduced for adult deafblind.
Applied learning: How has the project used learning so far to improve delivery?
Conclusions
 Summary of achievements against evaluation criteria.
 Summary of achievements against rationale for GPAF funding.
 Summary of problems and issues encountered.
 Overall impact and value for money of GPAF funded activities.
Recommendations for the future
 Formation of Vibrant State Level Federations of deafblind persons will be beneficial.
 The deafblind persons can be included in NREGA scheme of the Panchayat.
 Promotion of Income Generation Programmes for the deafblind persons with support of the Panchayats or Government
 Encouragement of deafblind persons in policy making structures of Panchayat three tier system.
77