1
Promoting a long-term funcitioning of
services
– 1 - Introduction
– 2 - Objectives of the ICRC Assistance in the
area of Physical Rehabilitation
– 3 - ICRC Approach
– 4 - Autonomy
– 5 - Conclusion
– 6- Two Questions
The International Committee of the Red Cross
(ICRC)
• The International Committee of
the Red Cross (ICRC) is an
impartial, neutral and
independent organization
whose exclusively
humanitarian mission is to
protect the lives and dignity of
victims of war and internal
violence and to provide them
with assistance.
• As part of its mandate, the
ICRC provides physical
rehabilitation assistance
through its physical
rehabilitation programmes
(PRP) and through the Special
Fund for the Disabled (SFD).
3
Objectives of the ICRC physical
rehabilitation assistance
• The main aims of ICRC
support for physical
rehabilitation activities are
to increase accessibility
to services, improve the
quality of these services
and ensure their longterm functioning
4
ICRC Approach
• ICRC physical rehabilitation projects are
planned and implemented in such a way
as to strengthen the physical rehabilitation
services offered in the country concerned,
the primary aims being to improve access
to services for people with disabilities, to
upgrade the quality of those services and
to ensure their long-term availability
5
Promoting long-term functioning
of services
– Ensure to implement projects with national
partners
– Ensure services are imbedded into a national
health/social care system
– Provide support to ensure services are
financially, technically and managerially
sustainable
6
National partners in 2013
7
Sustainability
Sustainability is the ability of programmes to continue
over time to meet the demands of users, providing
appropriate technology, of acceptable quality, at
affordable cost, in an accessible manner, enabling
PWD to assert their rights, while contributing to the
strength of the local health/social system, with
minimal external input
8
ICRC Approach
• 2 main axes:
– 1. ICRC Support at service providers level
– 2. ICRC Support at National level
Autonomy of services
• Seeks Autonomy in 3 specific areas:
– Technical,
– Management and administration
– Financial
Technical Autonomy
Technical autonomy means that national
partners have the capacities to provide
appropriate services autonomously
• ICRC Approach:
– Training of professionals
– Support and mentoring by expatriate expertise
– Development of service provision guidelines and
protocols
– Availability of appropriate technology
11
Managerial Autonomy
• Managerial autonomy means that national
partners have the capacities to manage
appropriately the services and the sector
• Managerial autonomy have to be
addressed differently at centre level and at
national level
12
Managerial Autonomy
At centre level
The directorate must be able to manage
appropriately all operations including: service
users, service provision, stock management,
human resources, financial, etc. and are able to
monitor the implementation of all operations
• ICRC Approach:
–
–
–
–
–
Training for managers
Support and mentoring by external expertise
Development of "Standards Working Procedures"
Development of monitoring mechanisms
Development and implementation of management tools
13
Managerial Autonomy
At national level
At national level, the authorities must be able to
manage, monitor and regulate the sector.
• ICRC Approach:
– Development of national strategies/policies and plan
of action
– Training for managers
– Support and mentoring by external expertise
– Development of national standards
– Development of monitoring mechanisms
– Development and implementation of management
tools
14
Financial Autonomy
Financial autonomy means that funding
mechanisms are in place to finance and
sustain the sector
• ICRC Approach:
– Developing and implementing a service cost
calculation system
– Analyze all possible sources of funding
– Advocacy
15
Challenges
• Economic situation: in low-income setting,
achieving progress is complicated by the
broader set of complex challenges that
most developing countries face
• Lack of national strategies / policies and
plan of action
• Lack of qualified human resources at
management level
16
Conclusion
• Sustainability should not be seen only
from the financial point of view, but must
encompassed all aspects related to:
– The provision of services,
– The management of services provision and
the sector and
– The monitoring of the activities
17
Conclusion
• To become long-term sustainable,
rehabilitation services must not work in
isolation from the national sector but must
be an integrated part of this, with links to
other stakeholders and referral services,
and adhering to national regulations and
strategies.
18
Open Questions
• As availability of trained personnel
(professionals and managers) is a key issue in
regard of sustainability, how to retain these
personnel?
• How to increase the funding available for the
sector?
– without negatively affecting access to services for the
users
19