Global Disability Summit 2018 fostered commitments from 171 governments and organisations on disability-inclusive development. Two years on, we celebrate this anniversary with the latest results from our national ‘iECD’ project in Rwanda. iECD stands for Inclusive Early Child Development, ECD – for the uninitiated – refers to the sensory-motor, social-emotional, and cognitive-language development a child undergoes before they reach school, from birth to 6 years. Research has shown these years are formative for a child’s brain architecture, providing the crucial foundation for all the learning that follows. ECD enrolment in Rwanda stands at around 13% (in the bottom quartile of countries), but among children with disabilities it is much lower (8.8% according to the Rwandan Ministry of Education, 2014).
In our capacity as national inclusion specialists, Chance for Childhood aimed to:
- Increase accessibility of ECD services for children with disabilities
- Train NGOs, sector education officials, teachers, parents and the wider community on how to include children with disabilities
- Enable children with disabilities to enjoy their childhood, playing with their peers without fear of stigma
Here are the headline results:
- Over 4,000 Children with Disabilities identified in 22 of the 30 districts in Rwanda
- 2495 children were enrolled in 54 ECD centres
- By the end of the project, 81% of ECD centres were inclusive
- 110 NGO staff trained
- Over 12,000 community members attended awareness events, 64 inclusive play groups established (including 341 Children with Disabilities), and levels of stigma reduced from 82% to 59%
Chance for Childhood conducted the first mapping of children with disabilities under 3s in Rwanda. We had to first design the survey tools, using international standards of disability statistics and in collaboration with the Government of Rwanda and National ECD Programme. For under 3s it is more appropriate to measure developmental delays than disabilities, and our team of child health and social work experts devised a survey which could be used by community health workers to detect these delays, as well as common risks to a child’s development, such as household living standards and nutrition status.
Community health worker volunteers in 22 out of 30 districts nationally in Rwanda initially collected data for 3,926 children. This dataset gave us a lot of information about the characteristics of children with disabilities for the different age groups, the most common type of disabilities, their household characteristics and for under 3’s the factors that influence developmental delays. For example, children with a developmental delay are twice as likely to have been born with a low birth weight (57% vs 24%), and their parents are half as likely to report that they regularly sing to their child.
Interactive map
The second round of surveys occurred in 3 cells (UK equivalent being parish) and was able to survey every single child in those cells, enabling it to demonstrate critical differences between households of children with and without disabilities. Over 4,000 children were surveyed and 615 children were found to have a developmental delay or a functional disability in any of the domains of the survey (15.3%).
Differences between the three surveys
| Age 0-3 | Age 4-6 | Age 6-8 |
| Measures household characteristics (e.g. mothers school level) | Does not measure household characteristics | Does not measure household characteristics |
| Does not ask about ECD attendance | Asks about ECD attendance | Asks about ECD attendance |
| Community Health Worker asks parent questions about potential risks to the baby’s development in 4 domains (family, birth circumstances, child health and social) | Community Health Worker asks parent questions about the child’s functional capability in 5 domains | Community Health Worker asks parent questions about the child’s functional capability in 5 domains (including module on child’s mental health) |
| Community Health Worker makes an assessment on whether child has a developmental delay | Disability Status is calculated directly from the scores | Disability Status is calculated directly from the scores |
Differences between the two samples:
| 22 Districts | 3 Cells |
| Not a representative sample | A full, representative sample |
| Detailed information on within-group differences (within the population of children with disabilities) | Detailed information on between-group differences (Between children with and without disabilities) |
At baseline, data from the screening showed that when gender, age and village differences are taken into account, children with severe disabilities aged 3-6 are 3 times more likely to not attend any form of education (p=0.001, 95% CI: 1.5-4.7). Only 8.8% of all CwD 3-6 years were attending pre-primary school (MINEDUC, 2014).
In both rounds of surveys, all parents were encouraged to enrol their children in ECD, provided by our network of NGO partners. After a low drop-out rate of 15%, a phenomenal total of 2495 children were enrolled to these ECD centres.
Chance for Childhood were delighted to be invited by UNICEF and the Government of Rwanda to develop the National Standards of Care guidelines to ensure full inclusion of children with disabilities in ECD programmes, in consultation with government education officials, civil society, community-based education providers and international child-focused NGOs.
These consultations highlighted the main barriers to education of children with disabilities in Rwanda as:
- Lack of robust national data on the number of CwDs and gaps in service provision
- Lack of assistive devices for children with disabilities
- Poor accessibility of schools (both the physical environment e.g. rough ground preventing access to classrooms, and the learning environment e.g. no adapted learning resources)
- Teachers lacking access to resources or awareness to make lesson plans inclusive
- Widespread stigma, discrimination, and misconceptions about a child with a disability’s ability to learn
- High rate of poverty among households with children with disabilities means they often cannot afford medical treatment and school materials
Overcoming these barriers motivated the design of our project. We assessed the ECD centres run by our NGO partners for accessibility, at baseline, of the 54 ECD centres assessed only 30% reached the benchmark for a good level of accessibility. By the end of the project this was 65%: 62% of the centres had step-free access (level doorways or shallow-grade ramps), 87% had doorways which are at least 80 cm wide and 59% of the centres had toilets which have adequate turning space for mobility aid users.
Inclusive teaching at Ngugu ECD centre
In terms of play resources, at baseline 23% of the centres mapped had suitable inclusive resources, which increased to 61% by the end of the project.
Inclusive toolkits (translated into Rwanda’s national language of Kinyarwanda) were developed with the intention that the content would be delivered to caregivers and local government education officials, who would then go on to train others. The content included Rwanda-specific minimum standards for inclusive education and relevant referral pathways for identifying and supporting young children at risk of / with developmental delays or disabilities in ECD centres.
Alongside this, we held regular community advocacy events in every part of the country to spread awareness of a child’s right to education and discussed any misgivings parents had about bringing their child to school. In total over 12,000 people attended these events. NGO staff were also trained on how to organise their own advocacy events. We also set up play groups for children with a mix of children with and without disabilities, some of whom had suffered extreme discrimination and had never played with their peers. Additionally, 341 children with disabilities participated in inclusive play groups.
Our inclusion expert Adrian speaking at a community advocacy event
67% of caregivers were regularly using the inclusive teaching practices after the training. Some notable increases in use were: celebrating the achievement of children with disabilities (94%), termly review and update of children’s’ individual support plans (89%) and having children with disabilities attend sessions with age matched peers without disabilities (89%).
Stigma (measured as an index of responses to questions about children with disabilities’ right to education) among members of the community reduced from 82% to 59%, with 94% agreeing that children with disabilities are able to learn and only 4% agreed with the statement that children with disability should be separated from their peers at ECD centres.
We shared the results with other charities and the government to build the evidence base
Through the implementation of this project, we learnt that only a multi-sectoral approach will be enough to ensure children with disabilities enjoy the same right to an education as others. We learn that whilst behaviour changes take time, cascading knowledge through a network of NGOs, local leaders and education professionals is a cost-effective and sustainable method of improving accessibility and moving towards truly inclusive education.
The strength of this project was its focus on capacity building, system-strengthening, and building a consensus on the rights of children with disabilities from the community-level upwards.
Stephen is 7 years old. He lives with his parents and has an intellectual disability which affects his communication. His parents did not understand what was happening to him and so did not take him to the doctor. His life at home used to be miserable as he could not join other children in play, and they called him ‘silly boy’.
When we visited him at home, his mother said: “Stephen cannot run, jump or play on other children’s created swings. He only sits shyly in one place and boomed by fellow children”. Stephen was quietly losing his childhood and the parents were helpless because they could not see a future for him. Stephen’s situation changed for the better when Chance for Childhood in partnership with a local NGO convinced his parents to enrol him at an ECD centre. Stephen, with the help of his parents, started attending every day. He found ECD caregivers who understood his problem and through the encouragement of other children at the Centre, Stephen has made impressive progress!
He really enjoys going to ECD centre, follows instructions, plays with other children, and tries to imitate what others are doing which has greatly improved his learning ability. At the beginning he was shy but now he is so fun-loving! His family is very supportive of Stephen’s determination to attend ECD Centre.
“Since last trimester, we haven’t needed to take him to ECD centre because his centre mates now help every day!” His father said. The family are grateful for support and hope that it will continue to benefit not only their child but many more like him.
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Chris Harris
International Programmes Officer
