Evaluation of Support to CBR Programme in Lesotho

Background:
Since 2003 the Government of Lesotho and the Norwegian Association of the Disabled (NAD), have in partnership, been developing a CBR programme. The Ministry of Health and Social Welfare (MOHSW) through its Rehabilitation Unit has been the main implementing agency. Financial and Technical support has been provided by NAD to the MOHSW to strengthen and mainstream multisectoral services to accommodate the needs of disabled people.

Purpose/objective:
The main purpose of the evaluation was to provide guidance for strengthening the programme’s response to the needs of disabled people in the next long-term period 2010 – 2014. So as to focus on approaches that will lead to an enhancement of programme outcomes and quality, the evaluation looked particularly at relevance, efficiency and coherence rather than at impact.

Methodology:
The evaluation was carried out firstly through a study and review of the extensive documentation available. Secondly the evaluation was carried out through a series of intensive interviews and meetings with key stakeholders at all levels of the CBR system.

Key findings and Recommendations:

1) At the grass-roots, implementation by village volunteers (LSs) has brought results for many disabled people.  Considering the very poor economic environment and the inaccessible terrain in which they work, their work could be described as being impressive. However they work alone. There is no responsibility taken by local councils and no community participation. The next phase requires training of both DCBROs and LSs in social mobilization methods so they could harness community responsibility through the decentralized local government structures, and community participation. Both these will add considerably to programme relevance, coherence and sustainability bringing enhanced outcomes for disabled people in terms of their rights.
2) The transfer of funds from the centre to the district has caused significant delays in implementation. In many instances planned activities could not be carried out. The evaluation recommends reduced procedures to ensure that donor funds for CBR will be used more efficiently.
3) Absence of clear allocation of responsibilities and tasks to officers of the MOHSW both within the Rehabilitation Unit and in the district has impeded smooth implementation. The evaluation has recommended that the post of SRO currently vacant in the Rehabilitation Unit be converted to that of SCBRO as a matter of some urgency. And at the district level that there be two distinct cadres working for and with disabled people – a DCBRO who will carry out solely CBR tasks, and a DRO who will do generic rehabilitation work which is also the responsibility of the Rehabilitation Unit. The responsibilities and tasks of all officers working in CBR as members of the DRT and NRT need to be documented. This together with documented inclusion of CBR in their sectoral policies, plans, actions and budgets will not only institutionalize mainstreaming, but will also contribute to sustainability.
4) LNFOD as the umbrella organization of DPOs and their four affiliates together with their branches will be required to take a greater role in CBR development in the next phase in two main areas.
5) Achievements made in special education by MOET are impressive and provide wide scope for support. Chief among them are strategies to strengthen inclusive ECCD centres; institutionalize inclusive teacher training for ECCD as well as for primary and secondary school teachers in both the LCE and NUL; assist IT teachers and schools inspectors to more efficiently carry out their responsibilities; and improve facilities in schools including teaching/learning materials, accessibility and libraries, so that all children will benefit.
6) An area that requires the consideration of NAD for support in the next phase is livelihoods. The depth of poverty that is prevalent in the periphery is a very severe obstacle to the fulfillment of expected CBR outcomes. It impedes the development and progress of disabled individuals, especially children.

The Evaluation team is confident that with the implementation of these recommendations in the next phase of programme support, the successful evolvement of a rights-based, multisectoral development framework for sustainable CBR could be well on the way in Lesotho.

Comments from the organisation, if any: