The role of extension workers in CBR in Malawi by Peter Ngomwa

Executive Summary
Provision of rehabilitation services to Persons with Disabilities (PWDs) need to be increased and improved. This will help them to become self-reliant and integrated in their communities. Extension Workers need to identify PWDs who need services and make assessments and plans for rehabilitation. This is a role they must take since budgets that are approved by Parliament are for all.

It is important to tackle this issue because Extension Workers have been sidelining PWDs. As a result, this has forced government to create parallel structures in order to support them. However, with the current economic situations, government has not been able to finance these structures adequately. Neither can these structures have all the necessary services required by PWDs.
Therefore, there is great need to sensitise Extension Workers on mainstreaming disability issues in their service delivery mechanisms. The draft National Policy on Equalization of Opportunities for PWDs provides guidelines to this.

Extension Workers require sensitisation in this area because they are not aware of the problems, needs and services that PWDs require. It is a right for PWDs to receive all services that are provided by government, since they are part of the population.

We need to carry out advocacy for PWDs to various service providers. This will ensure that they are given constant pressure, and consequently realising the problem. This will change their mindset for the better and will be the first step towards equalization of opportunities for PWDs. Extension Workers have direct initial contact with community members, and line ministries or organizations. Therefore, they need to make deliberate efforts to include PWDs in their daily work. They can do this by following the 13 key Policy Priority areas.

Introduction
The Government of Malawi is providing various services to the populace. However, there is very little social benefit as regards to PWDs. Extension Workers do sideline them because they think disability is a charitable issue and is not in their interest and mandate. Extension Workers are required to mainstream disability issues in their daily work plans. This is so because services that are required by PWDs should be part of the general government’s service delivery mechanism.

Increasing and Improving Service Provision for Persons with Disabilities
Provision of rehabilitation services to PWDs require to be Increased and improved. This will make them become self-reliant and achieve social integration in their communities, thereby contributing to the socio-economic development of the country.

However, for this to be achieved, there is need for the Extension Workers to know the following important aspects:

Disability Friendly Policies:
All government ministries, departments and state bodies have a responsibility to ensure that PWDs have equal access, rights and responsibilities, as any other Malawian. Extension Officers from the multi-sectors must therefore look at the key policy priority areas that concern them and include them in their plans. (Ref: National Policy on Equalization of Opportunities for Persons with Disabilities- July 2005).


THE ROLE OF EXTENSION WORKERS IN CBR IN MALAWI

The Ministry for Social Development and Persons with Disabilities, as an arm of Government, has spearheaded the National Policy on Equalization of Opportunities for Persons with Disabilities. This is aimed at giving guidelines to the multi-sectors on the following 13 Priority Policy Areas that require mainstreaming:

Prevention, Early Identification and Intervention
This will ensure that systems are put in place for prevention, early detection and intervention of disabilities to prevent secondary disabilities.

Rehabilitation
To ensure that necessary equipment, skills and services are available to all PWDs. This will enable them achieve and maintain their optimum physical, sensory, intellectual and social function level.

Accessibility
This aims at ensuring easy access to the physical environment.

Transport
Develop an accessible, appropriate and affordable transport system for PWDs.

Information and Communication
Promote disability awareness in society and ensure that PWDs have full access to public information and communication.

Education and Training
To ensure equal access and inclusion of PWDs in education and training programmes.

Employment
To ensure that PWDs have equal access to employment opportunities.

Social Welfare and Social Protection
This will ensure that welfare systems are in place to enable PWDs live self sufficient, independent and inclusive lives.

Self-representation and Participation
This will ensure that PWDs are represented, included and participate at all levels in decision-making, planning and development activities.

Sports, Recreation and Entertainment
To ensure the participation and inclusion of PWDs in sports, leisure, entertainment and crafts.

Housing
To ensure that PWDs have access to adequate housing.

Research and Appropriate Technology
Promote and support disability research and the developments and application of appropriate technologies for disability programmes.

HIV/AIDS
To ensure prevention and impact mitigation of HIV/AIDS in relation to PWDs.
Each sector has a role to play as evidenced from the key Policy priority areas. PWDs, like any other person, have diverse and unlimited needs that require addressing, hence the need for mainstreaming.

Sensitising Persons with Disabilities to their Rights
PWDs have been “down trodden” because of the numerous negative attitudes that prevail in the communities.

This has made them marginalized even to the point of accepting the situations they find themselves in. For example, most PWDs have never been to school. This creates a vicious cycle, as they have low literacy levels, culminating into low employability. As a result, there is lack of livelihood hence makes them resort to begging in the streets. This is a risk factor for further disabilities, diseases like HIV/AIDS and increased lack of education.

Therefore, PWDs, like service providers, need to be sensitised about their rights. This will help them be able to stand up and fight for what they are entitled to.
Sensitising Service Providers
Service providers need to be sensitised on mainstreaming disability issues in their service delivery mechanisms. It is so because they may not know problems, needs and rights of PWDs. For them to be able to mainstream disability issues in their work, they need to know the steps that are involved in the rehabilitation process.

The Rehabilitation Process
Service providers need to know about aspects of rehabilitation. It is said that
“Rehabilitation is not my job, his job, her job but all of us together!”
The process of rehabilitation is as follows: -

Identification/Fact Finding
This involves getting the particulars of an individual and the problem.

Assessment
This involves finding out the real need pertaining to aspects of rehabilitation, notably:
Medical
Psychological
Educational
Vocational skills training
Economic Empowerment
Social adjustment

Rehabilitation Plan
Following the needs that have been found in the assessment, a rehabilitation plan needs to be drawn. This is a plan on how best the individual is going to be rehabilitated.

Mobilization of Resources
At this point, resources have to be identified in order to effect the rehabilitation plan. A good plan may be made but if it is not implemented, there in no work done.

Implementation
When all resources are mobilized, the plan is implemented together with the individual with the disability. There is need for supervision and monitoring to make sure the plan is on course and that the set objectives are met.

Follow-up/Closure
Follow-up is necessary for success of the plan. When all the objectives are met, the case may be closed.

Advocating for Persons with Disabilities to Service Providers
Some service providers turn to be sceptical about abilities of PWDs. Those that have been successful in their endeavours should be used as role models. This will help those in doubt to believe that PWDs, given a chance, can perform like any other.

Conclusion
If all extension workers can do what has been stipulated in this paper, services to PWDs could be part of the general service delivery mechanism to the general populace. This would be effective since no parallel structures would be required. For example, ramps are expensive to construct as remedial measure. However, they are not so expensive if they are included in the initial building plan. Moreover, where these have been constructed, every individual prefers using them than the flight of stairs.

In order to achieve the above, mainstreaming should be the order of the day. Extension workers should follow the Key Priority Policy Areas in the National Policy on Equalization of Opportunities for PWDs. This will also guide organizations in reviewing policies that will result into comprehensive provision of services to all citizens of the country for the betterment of the socio-economic status of the nation.