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Report

on

Evaluation of Community Based Rehabilitation Partners Project North West Bangladesh and Dinajpur Sustainable Community Based Rehabilitation Project

Submitted to

Surendra Nath Singh Program Leader Community Program and Rural Health Program, TLMI-B Natkhana, c/o, DBLM, P.O. Box - 3 Nilphamari - 5300, Bangladesh

Submitted by

Sylvester Halder

Subash Theophil Gomes

January 25, 2020


Acknowledgement We would like to express our sincere gratitude to the management of Leprosy Mission International in Bangladesh (TLMI-B) for the opportunity to conduct Evaluation of Community Based Rehabilitation Partners Project North West Bangladesh and Dinajpur Sustainable Community Based Rehabilitation Project. The following persons extended tremendous support for completion of the study such as Surendra Nath Singh, program leader, and respective personnel in the management with major decisions for study design, finalization of data collection tool i.e. guide questions for FGDs, and make necessary arrangement for data collection like ticket, lodging, food and vehicle for the consultants, organize briefing meeting with key project staffs and de-briefing meeting with the staff and selected leaders of upazila and district associations, and support to collect information from the beneficiaries through arrangement of FGDs and discussion with the key informant, and take note of the discussion points by two staffs i.e. Mr. Anwar Hosain, Training Officer and Ms. Kolpona Kispotta, Manager Training Center, and Mr. Delwar Hossain, Project Manager for being with the evaluation team during the field work, provide feedback on the report and others. We earnestly thank relevant personnel in Finance for making necessary arrangements of fund transfer and others during the study period. We would like to acknowledge contribution of the beneficiaries i.e. members of selfhelp groups (SHG) and upazila and district association who were present for focus group discussion and other discussion meetings, and key informants who gave time, shared valuable and relevant information, opinion, experience and understanding. Finally, once again we thank Leprosy Mission International in Bangladesh (TLMI-B) management for the occasion of conducting the study. We are hopeful that findings of the evaluation will provide pertinent information about effectiveness, impact and elements of sustainability of the intervention, and guide respective personnel to prepare next phase of the initiative. The study findings and report are sole responsibility of the consultants and shall not be taken to reflect views of Leprosy Mission International in Bangladesh (TLMI-B).

Sylvester Halder

Subash Theophil Gomes

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Executive summary The Leprosy Mission International in Bangladesh (TLMI-B) is about to complete implementation of two projects named ‘Community Based Rehabilitation Partners Project North West Bangladesh’ and ‘Dinajpur Sustainable Community Based Rehabilitation Project’ that aims to build capacity of upazila/sub-district and district associations, increase their capacity to support members of self-help groups (SHGs) to run and manage their organizations, and advocate with government officials, people’s representatives and other stakeholders for realization of their rights and avail relevant services for leprosy and general disabled persons and other members in the groups at different levels. The organization has conducted an external evaluation to assess progress towards project development goal and objectives as stated in the project proposal and logframe, and document effectiveness, impact, learning and sustainability of the intervention and provide recommendations for future. The evaluation was conducted employing mixed method approach, such as desk review and collection of primary information through fieldwork, such as discussion meeting with key project staffs (before the field work) and joint meeting with project staffs and association leaders (upazila and district) at debriefing session, focus group discussion (FGDs) with the members of SHGs (116), upazila (62) and district (28) association, key informant interview (KII) of government officials (4) and people’s representative (1), in-depth interview of the beneficiaries (3) and observation (present situation of the respondents and results of the initiative). The major findings of evaluation are: The project has facilitated formation of 856 self-help groups with 7,933 leprosy and general disabled and ultra poor people (47.7% female and 52.3% male members); and among them 751 (87.7%) groups are in CBRP working area and 105 (12.3%) groups in DSCBP operation area; and in regards to members, 86.8% are from CBRP and the rest 13.2% are from DSCBP intervention area. The groups that evaluators visited are formed during the period of 2004-2016 with average members 11.16 (male and female in one group). There are instances where several members are from a single family and of different religious beliefs. Age of the SHG members range from 20-70 years, and majority of the group members have either few years of primary schooling or did not have scope for formal education. There are three members management committee in the SHG, i.e. chairperson, secretary and cashier. Since educational attainment of the members is low and there are few persons in the group; therefore, the same person is in the management position for several years. The groups sit once in a month when they discuss issues of their concern, deposit savings, disburse loan, collect loan refund and others. The group records, meeting minutes, financial related khata or documentation are maintained briefly by the respective group members with minimum or no support from the project staff. ii


SHG members deposit different amount of savings that ranges from BDT 50 to BDT 200 in the group following flexible method as per decision of the members. Project record shows that average savings of SHG members is BDT 3,709; BDT 321 for the group members under DSCBP; and BDT 4,233 for the members of CBRP. However, while field work the evaluators noticed that average savings of the members under CBRP is BDT 9,153; while it is BDT 4,083 for the members in DSCBP; furthermore, there are members whose individual savings is BDT 30,000 and/or higher, and there are groups that have BDT 250,000 savings and/or even more than that. Other than savings, SHGs received grant or seed money from the project for investment in different income earning initiatives for enhancing their income. Project records confirmed that the SHGs got average BDT 21,452, participants of DSCBP BDT 21,623, and beneficiaries of CBRP BDT 21,428; however, some of the groups that the consultants visited got BDT 25,000 as donation. The group’s capital is lent either to individual member for different IGAs or group-based initiative to earn higher income for the members as they get equal share of the profit from the investment. Intention of getting higher benefit sometimes lead SHGs to go for risky business that need attention of all the concerned. The project has a target of supporting 70% to 80% SHG members to increase their annual income by 20%; since there was no survey, therefore present study can’t quantify the achievement. But discussion with FGD participants reveal that group members involved with the intervention for longer period, and can move and work, and have taken loan from the group fund and utilize them well, were able to enhance their income. Many of the group members have received training on leadership and group management, and technical training on different trades; which supported them tremendously in managing their groups and IGAs. Some beneficiaries received tri-cycle, artificial legs, crutch, MCR sandals, sewing machines, wheel chair, eye care assistance, treatment from the leprosy hospital and others which help them for healthy living. The group members that have leprosy take care of themselves so that they are out of the danger of ulcer, like taking related treatment and changing shoe or sandal, etc. Majority of the group members have latrines at their house, arranged either by themselves or with support from NGOs or union parishad; other than that they also practice washing hands with soap when their hands are dirty, before and after eating, after defecation, etc; furthermore, most of the respondents reported that they use tube-well water for drinking. Many of the group members’ (older ones) children have completed their education and are in different occupations; and younger members’ children are in school now. This was possible for government policy of inclusive education, supportive attitude and responsible behavior of the school teachers, advocacy initiatives of the upazila associations’ members and others. Some SHG members are included into different committees in the locality like school management, bazaar, mosque, temple, etc. which support them to claim and enjoy their rights, and access to services from different sources. iii


The intervention has facilitated formation of upazila association (UA) and district association with the members of SHGs nominated by the respective group. Many of the UAs (22) got registration from the upazila social welfare department; except district associations that need some more time to obtain the approval. The UAs have been successful in getting various services from different government departments, such as disabled allowance, technical training, loan, seeds and fertilizer for crop production, fish cultivation, and rice from local union parishad (on special occasion) and others. UAs also support low performing SHGs to improve their competency through visit, problem solving, and supply of pass book, khatas and others.

Specific actionable and prioritized recommendations as for future; i)

Continue these two projects as one and keep assisting these organizations function in a well organized manner, with proper accountabilities, documentations, money management and ensure internal equity. ii) Continue Annual Advocacy Meetings with different Government Departments that are in the Upazilla, Locally Elected Upazilla Chairman and Vice-Chairman, Union Council Chairman, with facilitation of Upazilla Nirbahi Officer and Upazilla Social Welfare Officer. District Officers, can be requested as speakers and facilitations. iii) Continue organize similar Awareness and Advocacy Meetings at Union Councils, including Chairman and 12 of his/her Ward Commissioners, Religious Leaders (mosques, temples and churches), High and Primary School and Madrasa Teachers and School and Madrasa Management Committees, Social and Economic Leaders of Influence in the community, who can play a vital and effective role in social acceptance and transformation process. iv) Continue to strengthen people with disabilities (men and women) including leprosy, to have access to their rights and improved socio-economic status, by representing sustainable organizations (Self Help Groups’ Associations) with legal entities, to collectively advocate living with human dignity, rights and social entitlements, ensuring justice and equality as citizens of Bangladesh. v) Promote and enhance social and economic empowerment of these excluded, marginalized and economically poor individuals and their family members were organized, build networks of relationships among families with similar mental, social, economic and spiritual struggles, to pursue their struggle for human existence. vi) Keep focus in mind that people selected and being addressed, are not only vulnerable, but are also excommunicated and will need continued support for their rights and inclusions. Phasing out will reduce momentum these organizations have acquired over last three phases. Conclusion: The intervention aims that targeted people at different levels (SHG, UA, district association and others) are capable of managing their own organizations. These groups are at different stages in the process; therefore, need some more time (at least a three-year phase) to be able to perform well. Considering present situation, the consultants strongly recommend that the donor agency agrees to provide financial support for one more phase of the initiative.

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Table of Contents Page Acknowledgement Executive Summary LIST OF TABLES ACRONYM USED 1. Background 1.1 Bangladesh government’s efforts to heal leprosy infected individuals 1.2 Alternative approach for inclusion of leprosy healed individuals and their families 2. Project overview 3. Objectives of the evaluation 3.1 Focus of the evaluation 4. Study design and sampling 5. Methodology 5.1 Secondary data analysis 5.2 Primary data collection 5.2.1 Focus group discussion (FGD) 5.2.2 Key informant interview (KII) 5.2.3 In-depth interview 6. Data analysis and interpretation 7. Ethical issues of the study 8. Triangulation of information 9. Findings of the study 9.1.1 Self-help groups and their members 9.1.2 Savings and loan 9.1.3 Training and other supports, and WASH 9.1.4 Group members in different committees 9.1.5 Upazila and district association 9.1.6 Benefits of the interventions

i ii-iv vi vii 1 2 2 3 3 3 4 5 5 5 5 6 6 6 6 6 7 7 8 10 11 12 15

10. Conclusion

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11. Recommendations

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Annexure 1: Other Aspects in ToR - Focus of Evaluation Annexure 2: Guide questions for FGD, (SHGs, UAs, DAs, KII, Health Volunteers and Staff Team Members) Annexure 3: Schedule for Field Work Annexure 4: Terms of reference (TOR) Annexure 5: Profiles of Evaluators Annexure 6: Log-frame based performance

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19-22 22-27 28 28-33 33-35 35-38


LIST OF TABLES Table

Page

1

Number of FGDs and number of participants present

6

2

Self-help group and members

7

3 Group savings and seed money

9

4 Upazila and district association

13

vi


ACRONYM USED

BDT

Bangladeshi Taka

CBR

Community Based Rehabilitation

CBRP

Community Based Rehabilitation Partners

DSBRP

Dinajpur Sustainable Community Based Rehabilitation Partners

EB

Executive body

FGD

Focus group discussion

GB

General Body

HSC

Higher secondary school certificate examination

LFA

Log-frame analysis

NGO

Non-government organization

SSC

Secondary school certificate examination

SHG

Self-help group

TLMI-B

Leprosy Mission International in Bangladesh

ToR

Terms of Reference

UP

Union Parishad

UA

Upazila association

UNO

Upazila Nirbahi Officer

WASH

Water, sanitation and hygiene

WHO

World Health Organization

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Report on Evaluation of Community Based Rehabilitation Partners Project North West Bangladesh and Dinajpur Sustainable Community Based Rehabilitation Project 1. Background The Leprosy Mission (TLM) was founded in 1874 in England as an International Christian Service Organization, founded by Wellesley Balley. Over the last 145 years the organization has been serving more than 305 million people infected and affected by Leprosy in 26 countries. The Leprosy Mission consists of 31 member countries that include five supporting and twenty six implementing nations in South East Asia and Africa, with a vision of defeating leprosy and transforming lives and a mission of following Jesus Christ and striving to break the chains of leprosy, empowering people to attain healing, dignity and a life in all its fullness. The organization promotes values of compassion, justice, integrity, inclusion and humility. Leprosy Mission Denmark was formed in 1947 and began working in Bangladesh as Danish Bangladesh Leprosy Mission (DBLM) from 1997 in 24 sub-districts (upazilas) of four North-west districts (Panchagar, Thakurgaon, Rongpur and Nilphamari). DBLM set up a fully fledged Hospital at Nilphamari to provide secondary and tertiary health care services to people infected by leprosy until they are fully cured and can return home with necessary assistive devices. DBLM phased out its operation from Bangladesh 2005, and handed over the entire leprosy control program’s infrastructures and human resources to Leprosy Mission International in Bangladesh (TLMI-B), however they have continued providing financial resources and technical support for its operation up to now. TLMI-B began working in Bangladesh from May 1991, and is implementing 21 projects in 29 districts of 6 Divisions for leprosy control, e.g. treatment, rehabilitation and health education, working through government health care service delivery systems/networks and non-government organizations involved with service delivery to leprosy infected patients and leprosy cured individuals and their families for inclusion, care and belongingness and reducing social stigmas. The agency has five strategic objectives: (i) leprosy affected people have access to quality integrated services; (ii) the socially excluded persons have improved socioeconomic conditions; (iii) strong advocacy and partnership for mainstreaming leprosy healed people, (iv) a learning organization that uses and bears evidence based good practice; (v) an effective and sustainable organization. Global Changes in Leprosy Control and Rehabilitation Programs: With research findings of World Health Organization’s (WHO) global study on leprosy control and rehabilitation program, the number of people infected and cared for is much lesser compared to emerging health issues that were of higher priority and needed greater attention and efforts. Based on WHO’s findings and recommendations that leprosy healed patients should be rehabilitated into their families and communities after are healed. 1


1.1 Bangladesh government’s efforts to heal leprosy infected individuals The Government of Bangladesh has concerns and formed a Directorate under Health Ministry for addressing and providing care of leprosy infected people and has special wards in medical college hospitals, district level sadar hospitals and service centres at the upazila (sub-district) hospitals for providing advice and medications. In most cases these rooms have been allocated to non-government organizations working for eradication and health care services to leprosy infected persons. In addition the Government has taken some safety net programs for disabled, elderly citizens, widows, nutritional intake support for pregnant mothers, housing program (Assrayan), one home one farm (Akti Bari–Akti Kramar). There are different departments that focus on the poor and vulnerable families; however, there are limited resources allocated to these departments compared to the needs. Leprosy infected people require organizations working as advocate or catalyst to access the supports from local government management structures and systems. 1.2 Alternative approach for inclusion of leprosy healed individuals and their families There were deliberate efforts globally so that people infected with leprosy can be integrated into their families and proper medication, when they are no longer a threat of spreading the bacteria to others. TLMI-B and DMLM began community based rehabilitation supports, using group based approach, so that those infected and cured are included in their families and integrated into communities, instead of being put into ‘Leprosy Asylums’ as done historically all across the world including Bangladesh for their whole life being excluded from family as untouchable and highly stigmatized individuals, as for fear of getting infected and considered as curse of God for some evil doing or sins of parents. For integration of leprosy infected and cured individuals into their families and communities, TLMI-B has taken initiatives through two different projects in northern districts, named ‘Community Based Rehabilitation Partners’ (CBRP), and the other one ‘Dinajpur Sustainable Community Based Rehabilitation Partners’ (DSCBRP). The interventions went through several changes from the initial operation, i.e. in 2006 group based Community Based Rehabilitation (CBR) approach was redesigned and from 2008 empowerment and physical disabilities was added with it. Later on, Phase I (2009-2013) focused on forming and developing groups, interactions with other groups and form sub-district associations. In Phase II (20142016) focus was on capacity building of the sub-district associations, increasing their capacity to monitor and support the groups, and advocate with local authorities. In Phase III: (2017-2019) consolidation of sub-district and district associations and achieving financial sustainability. It is expected that by the end of project period the associations will take full responsibility of supporting the groups, formation of new groups, and advocate for their rights. 2


2. Project overview 1.2 Community Based Rehabilitation Partner (CBRP) Project Goal and Objectives: Development goal: People in North West Bangladesh with disabilities (including people with leprosy) have access to their rights and full participation in social and economic life, and are represented by sustainable, independent, functioning organizations. Objective 1: By December 2019, 750 self-help groups for persons affected by leprosy or disability in 4 districts of NW Bangladesh support their members in experiencing full participation in social and economic life, and have the capacity to support the running of 24 sub-district associations. Objective 2: By December 2019, 24 sub-district associations representing and 750 SHGs in 4 districts of NW Bangladesh are able to provide organizational and management support to the groups, and have the capacity to voice the rights of disabled persons regionally and nationally. Objective 3: By December 2019, the mobility, health, and hygiene of 7,500 group members and their households are improved and the results are sustained by the groups and their communities. 1.3 Dinajpur Sustainable Community Based Rehabilitation Project (DSCBRP) Goal and Objectives: Development goal: People with disabilities (including leprosy) have access to their rights and improved socio-economic status by representing sustainable organization. Objective 1: By December 2020 people with disabilities (men & women) mainstreamed in the community by improving socio-economic status and living with rights and entitlement. Objective 2: By December 2020, Upazilla Associations are able to support 105 selfhelp groups and create advocacy at higher level with legal entity. 3. Objectives of the evaluation The objectives of the evaluation of projects (2) are to assess progress towards project development goal and objectives as stated in the project document, and document significant learning and sustainability. 3.1 Focus of the evaluation The evaluation is expected to focus on the followings: • assess effectiveness, impact, and sustainability of CBR projects in terms of achievement according to objectives and LFA; • figure our progress towards group and associations sustainability and participation in the followings: 3


• •

Groups: Development and capacity of groups to be self‐governing and continue without project inputs. ▪ Associations: Assess governance, capacity (including financial capacity) and role of associations; recommend future steps to ensure good governance and their ability to support groups in absence of project staff; summarize and outline recommendations for future and long term sustainability; consider pros and cons of registration with the cooperative department enabling the associations to undertake microfinance versus the implemented registration with social welfare and the entitlements that it gives access to; identify to what extent the project activities impact the acceptance of religious minorities such as Hindus or Christians amongst the population more broadly and give recommendations to what extent it would make sense to prioritize a stronger promotion of freedom of religions and belief;

4. Study design and sampling The assessment was conducted employing qualitative research design as for nature of the study, TOR and availability of time; as such non-probability sampling was employed for the evaluation. In a non-probability sample, units are deliberately selected to reflect particular features of or groups within the sampled population. The sample is not intended to be statistically representative: the chances of selection for each element are unknown but, instead, characteristics of the population are used as the basis of selection (Ritchie and Lewis, 2003:78). Qualitative inquiry typically focuses on relatively small samples. There is no rule for sample size in qualitative inquiry. (Patton 2002:244-245). Lincoln and Guba (1985) recommend sample selection ‘to the point of redundancy. … In purposeful sampling the size is determined by informational consideration. If the purpose is to maximize information, the sampling is determined when no new information is forthcoming from new sampled units, thus redundancy is the primary criterion’ (cited in Patton 2002). WHO (2005) in its Researching Violence against Women1 states that There are no hard and fast rules for sample sizes in qualitative research. As Hudelson (1994) points out, “The sample size will depend on the purpose of the research, the specific research questions to be addressed, what will be useful, what will have credibility, and what can be done with available time and resources.” In qualitative sampling, the selection of respondents usually continues until the point of redundancy (saturation). This means that when new interviews no longer yield new information and all potential sources of variation have been adequately explored, sampling may stop. For most qualitative studies, 10 to 30 interviews and/or 4 to 8 focus groups will suffice (WHO 2005:105-106).

1

https://apps.who.int/iris/bitstream/handle/10665/42966/9241546476_eng.pdf;jsessionid=6060529 F71E3217417942868B4EFBADC?sequence=1

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5. Methodology The evaluation was conducted through mixed method approach, such as secondary data analysis and collection of primary information through fieldwork from project participants e.g. people with leprosy, disability, excluded and discriminated groups or members of self-help group (SHG), members of sub�district (upazila) and district associations, people’s representatives, government officials from social welfare department, personnel of implementing agency, etc. 5.1 Secondary data analysis The secondary data analysis constitute accumulated information related to the intervention such as project proposal and LFA, annual reports, quarterly reports, historical Information of TLMI, DBLM, TLMI-B, data base maintained by the project, annual monitoring report, training records and reports for beneficiaries and leaders, community based vocational training, association reports, group monitoring report, adult literacy program report, group savings, targets and achievements reports, financial summaries, evaluation reports of earlier phases and others. 5.2 Primary data collection Primary data was collected from the field employing qualitative data gathering techniques such as, focus group discussion (FGD), key informant interview (KII), indepth interviews, observations, etc. For conducting FGDs, KIIs and in-depth interview, guidelines with open-ended questions was employed2. A brief description of the methods is given below: 5.2.1 Focus group discussion (FGD)

The consultants conducted 12 focus group discussions (FGDs) with 116 members of self-help group (four from DSCBRP working areas, i.e. three upazilas of Dinajpur district with 39 members; and eight from CBRP e.g. four upazilas from two districts like Rangpur and Nilphmari with 77 participants); six FGDs with members of upazila / sub-district associations where 62 members were present (two from DSCBRP working area with 21 participants and four from CBRP working areas with 41 members), three FGDs with members of district association with 28 members (one from DSCBRP with nine participants and two from CBRP with 19 members) purposefully selected by the project personnel. Table 1: Number of FGDs and number of participants present Sl. No.

Project name

District name Rangpur

1.

CBRP Nilphamari

Upazila name Sadar Badargonj Sadar Saidpur

Total 2.

DSCBP

Dinajpur Total

Sadar Chirirbandar Parbatipur

Self-help group Group Member No. present 2 20 2 20 2 16 2 19 8 77 2 18 1 12 1 9 4 39

Participants categories District association Upazila association Number of Member No. of Member association present association present 1 10 1 9 1 16 1 15 1 10 1 10 4 41 2 19 1 11 1 9 1 10 2 21 1 9

Source: Field work 2

Guidelines contains a list of unstructured questions that were pursued with the FGD participants and key informants.

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The consultants had long discussion meeting with the staffs of implementing agency involved with the intervention (before and after the field work3) to understand their perspective about the initiative, effectiveness, impact and sustainability of self-help groups and associations at different levels, and suggestion for the future, etc. 5.2.2 Key informant interview (KII) The consultant carried out interview with five key informants mainly people’s representatives like UP Chairperson, government officials from district and upazila social welfare office and others to understand their perspective, initiatives, cooperation, recommendations, etc. 5.2.3 In-depth interview The consultants carried out three in-depth interviews of the project beneficiaries to capture their personal experiences who have been benefited from the initiative. Quotation and personal experience of the participants is used in the report and case studies have been prepared accordingly. 6. Data analysis and interpretation The qualitative data collected through focus group discussion and key informant interviews and observation was analyzed based on narratives (what respondents shared about themselves), phenomenology (how individual experiences his/her world), content (what do people talked about most), pattern4 and relationship. 7. Ethical issues in the study Standard ethical issues were taken into consideration during data collection like the team members told the participants about assessment objectives, and information shared by them would be used only for study purpose, and no one would have access to the data. They were free to participate in the research and could withdraw from the discussion at any point if they did not want to continue, and no one including the researcher can link any data to particular respondent. 8. Triangulation of information The consultant employed triangulation in the assessment i.e. collected data from different sources to compare and used different methods to check whether the information is consistent. As such it included multiple data sources, data collection methods, numerous data collectors, and various analytic perspectives (Michael et al. 2007:146-147).

3

In the de-briefing meeting association leaders (upazila and district) with selected project personnel were present; 4 For discovering pattern issues like frequencies, magnitude, structures, process, causes and consequences will be considered.

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9. Findings of the study 9.1.1 Self-help groups and their members The projects (2) have facilitated formation of 856 self-help groups with leprosy disabled, leprosy patient, general disabled, ultra poor people, proxy representatives i.e. other members of the families for severely disabled and old person, etc. during data collection period; and among them 751 (87.7%) groups are from CBRP working area i.e. from 24 upazilas of 4 districts and remaining 105 (12.3%) groups are from DSCBP operation area like four upazilas of Dinajpur district. In regards to members, Table 2 depicts that 86.8% are from CBRP and 13.2% are from DSCBP intervention area, 47.7% are female and 52.3% are male members. In CBRP males and females have equal membership i.e. 50% with average members 9.17; while in DSCBP there are more male members (52.3%) than the females (47.7%) with average membership of 9.95 persons, little higher than the number of members in CBRP. Table 2: Self-help group and members Sl. No. 1. 2.

Project name

No. of self-help group (SGH)

CBRP DSCBP Total

751 105 856

Female members Number % 3,444 50.0 344 33.0 3,788 47.7

Male members Number % 3,444 50.0 701 67.0 4,145 52.3

Total 6,888 1,045 7,933

Source: Project record

The self-help groups that the evaluators visited have 11.16 members in average (this appears to be little higher than the project record, due to the reasons that the evaluators visited good performing groups) that were formed during the period of 2004-2016. There are groups that got new members in the journey; while there are also groups that lost its members due to death or withdrawal of membership. Since many of the members have limited capacity for mobility; therefore, the groups include members who live close to each other; as such in some cases there are several members from one family in the same group. The groups have members from both sexes i.e. male and female, and from different religious beliefs like Hindus, Muslims and others. The age of the members differs to a great extent, i.e. from 20 to 70 years old. Educational attainment levels of the members are generally low like few years of primary education; even there are groups that have more illiterate members than the primary school goers, with few exceptions where there are one or two physically disabled graduates. There are three positions in the group for its management i.e. chairperson, secretary and cashier. The responsible persons can keep records of the group, e.g. the secretary writes meeting minutes, and the cashier keeps passbook and other relevant records in simple way. In most cases the records are maintained by the members in management positions. As education level of SHG members is low and there are few persons in the group; therefore, only few people are selected in the management position for several terms/years. Even there are cases where a single person is to write all the records, as they do not have other alternatives. In such situation, the SHGs can think of involving their children who are in secondary or 7


higher secondary education and are able to write the records or meeting minutes, keep financial records, etc. The groups sit once in a month normally in one of the member’s house where they can make it and discuss issues of their concern, deposit savings, disburse loan to the members, share different information, and decide about group-based income generating activities and other important matters. Generally they gather in the same place for the meeting if they do not face any major difficulty. The secretary of the group keeps records of the discussion points very briefly. On few occasions designated project staffs (as there are few field personnel in the project) make time to visit the group during monthly meeting day. Other than that members of the upazila federation visit the group when there is a specific need or information to share or to see how the group is performing. 9.1.2 Savings and loan The self-help group members deposit savings in the group in monthly meeting. The SHGs are flexible regarding amount of money that a member can deposit in a month that ranges from BDT 50 to BDT 200. As for flexibility there are groups that have BDT 250,000 savings and/or even more and individual savings of BDT 30,000 and/or higher. For savings the groups maintain pass book for individual member and cash book, ledger and others for the group. The SGHs generally put their money in Grameen Bank5, as such they get a pass book from the respective bank. Other than individual member’s saving, the groups received seed money from the project which varies from BDT 25,000 to BDT 28,000 for supporting the group members to take various income generating activities. Table 3: Group savings and seed money Sl. No.

1 2

Project name

CBRP DSCBP Total

Self-help group

Member in SGH

751 105 856

6,888 1,045 7,933

Savings of the group (Tk.)

Average savings (Tk.)

Seed money given (Tk.)

Average seed money (Tk.)

29,089,416 335,345 29,424,761

4,223 321 3,709

16,092,500 2,270,400 18,362,900

21,428 21,623 21,452

Source: Project record

Table 3 reveals that average savings of the group members is BDT or Tk. 3,709; Tk. 321 for the group members under DSCBP; while Tk. 4,233 for the group members for CBRP, which is higher than the former project. One of the reasons could be that the later groups were formed earlier than DSCBP. The average savings of the members under CBRP groups that the researchers visited are Tk. 9,153 which is higher than the average savings of the groups facilitated by the project; while it is Tk. 4,083 for the members in DSCBP. Reasons for the difference in average amount could be that these groups were formed in the initial states of the implementation, members are active, save money regularly and their savings rate is higher than other groups.

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When the researchers asked the members reasons for keeping money with Grameen Bank, and not with other private or public bank, they replied it is easier for them to transact with the bank, like depositing and withdrawing money particularly when they require them during business hour.

8


The Table also confirms that the groups received seed money from the project for investment in different income earning initiatives for enhancing their income; as some members cannot move and work like other physically fit people and have limited asset base. It shows that average money that the groups obtained is Tk. 21,452; i.e. project participants of DSCBP got Tk. 21,623, and beneficiaries of CBRP Tk. 21,428, little less than the former one. The group’s capital (savings and seed money from the project) is lent to individual member for different income generating activities e.g. running grocery shop, agricultural work/crop production, cow fattening, buying and running van and tri-cycle (chargeable), building or repairing of house, and group-based initiative like leasing land from others or giving a member money for crop production for couple of years and get annual return from that investment like Tk. 5,000/10,000 depending on the amount. There are groups where majority of the members took loan from the collective fund particularly those have good amount of savings; on the other hand, there are also groups where few members got loan as for shortage of fund or they do not have scope to invest the money and make profit from it or they have invested the money for group-based initiative like leasing land. There are groups where the members in the management like chairperson, secretary and/or cashier have taken major part of the savings as loan. It is not clear whether they have used their positional power in getting the loan; however, the leaders must ensure so that every member has equal opportunity in getting loan and they should not take opportunities of their authority. There is a tendency among some groups to invest group fund in risky business like giving major part of the fund to a particular person for agriculture work. The group members need to think about the danger with such decision like if the person has an accident and can’t work; how s/he will refund the money. If the refund can’t be made timely, the group will be in big trouble. The members who are in cow fattening business, if there is an accident with the cow, like if it dies how will be the member repay the loan. As such the members need to be careful in assessing risks of the initiative, take preventive measures and then go for investment. The member who takes loan from the group fund refunds the money within a year with 10% interest rate following reducing balance method. The SGHs are flexible in accepting the loan refund, i.e. if a member can’t pay the money in monthly payment; other members are understandable and allow the particular member to repay the installment in the following months. From the group based initiative/s they get an annual interest like Tk. 5,000 or Tk. 10,000 depending on the investment amount. The interests that the groups receive from the loan either individual or group-based initiative, they are divided among the members equally and are added with members’ savings amount in their passbook. The members who take loan and can invest money for different income generating activities and are in their business for some time, and do well in their initiatives, those members were able to increase their income during current project period; but 9


the members who can’t work or have members in the family who can use money for profitable initiatives, it is difficult to comment that their income has increased over the last couple of years, as they have limited opportunity that give them extra income or take loan from the group and invest for IGAs and make profit from them. The CBRP has a target of helping 70% or 4,822 beneficiaries to increase their annual income by 20%; while DSCBR has target of supporting 80% or 836 participants to enhance their income by 20%. The projects do not have any base information about SHG members and data at the end of project period, so it is difficult to remark regarding achievement level of the particular objective, even if the log-frame attainment stated that 94% of the participants have that level of income6. For indicator/s that has percentage, the project needs to conduct systematic survey and keep necessary input in the intervention so that the participants can achieve the objective. Present study could not include survey, as the evaluators did not have any idea about the log-frame and indicators while preparing the research proposal. Therefore, for future research, the project needs to give indication while conducting any study about possible study design depending on project indicators. The members generally do not withdraw money from their savings, even if they have a need, but they can take loan from the group fund. It seems that SHG’s members’ purpose is to have a bigger amount of savings. This is a different approach than other micro-finance program, where the members can take loan; at the same time withdraw money when they need them. The project management, group members and leaders at different levels may think about it and decide that best serve the members’ interest. 9.1.3 Training and other supports, and WASH Participants of FGDs (members of SHGs) acknowledged that they had received training on physiotherapy, leadership, group management, tailoring, leadership development, financial management, self-care, conflict resolution, etc.; and technical training such as welding, beautician, computer operation, tailoring, agriculture, cow fattening, sweater making and others, such as 1,012 beneficiaries got training from CBRP and 168 from DSCBRP. The participants reported that those training support them a lot in performing their activities and managing groups and earn income using technical skills on different trades. Other than that CBRP trained 666 community based disability workers (volunteers), who provide basic physiotherapies to the children and adults and their family members so that they have a better living. There are also beneficiaries who received tri-cycle, artificial legs, crutch, cow, MCR sandals, eye treatment, sewing machines, latrines, tube-wells, wheel chair, artificial limb, eye care assistance and others from the project which help them for their wellbeing and healthy living; other than that there are participants who take health care

6

It is not clear how that conclusion has been made; as such the management needs to careful in drawing such ending.

10


services from the leprosy hospital whenever they get sick, and sandal or shoe for the leprosy patients when the old one can’t be used any more. The leprosy patients/group members take care of themselves or other members of the group remind them so that they are out of the danger of ulcer (disease related to not taking care of leg or hand, when they are injured and are not taken care of properly or regularly due to leprosy), like taking related treatment and changing of the shoe or sandal. In all the groups that the consultants visited, while asked leprosy related disabled members stated that they do not have ulcer any more now or they take proper care of it like using shoe, do regular exercises, etc. Majority of the participants of FGDs mentioned that they have sanitary latrines at their house. They installed those latrines either of their own or with support from the project or other NGOs working in the area or from the union parishad. Those of the members who do not have latrines use other’s one such as relatives and/or neighbors, however those members stated that they have plan to arrange latrine of their own in the future. While asked, most of the respondents reported that they and their family members wash hands, particularly when their hands are dirty, before and after taking meal, after defecation, etc. Furthermore, most of the respondents stated that they use tube-well water for drinking either of their own or neighbors. CBRP has target in different sectors like 95% group members have access to safe water, 90% members use sanitary latrine, 50% members wash hand regularly; even though present study can’t comment on achievement level of those issues particularly percentages (as it is qualitative study, and there is no survey), but from the response of SHG members, the evaluators state that the intervention has accomplished its objectives in those three aspects. Children of many group members (particularly the older one) have completed their education (whatever level was possible for them, some even got tertiary level studies), and are involved with different occupations. Those of the members who have younger children, their children go to school at different levels. As for inclusive education policy of the country, education assistance for the children of the SHG group members and advocacy work of upazila association’s members e.g. meeting with upazila education officer and members of school management committee, children of the disabled members now have easier access to formal education and care from the teachers of respective education institutes contribute in doing well in their studies. 9.1.4 Group members in different committees CBRP log-frame has a plan to include 50 group members and from DSCBR 10 members in different committees such as school management, bazaar, mosque, temple and others. Project records reveals that 274 disabled members from CBRP are selected into local school management, madrasha (Islamic religious institute), mosque, market, burial ground, UP standing committees and others. While talking with SHG members, the evaluators came to know that the beneficiaries are accepted into different committees (as mentioned above, which once were unimaginable for 11


the leprosy disabled persons) and be part of decision making process on different issues in the locality that benefit the disabled people. Membership in different committees provide opportunities for the beneficiaries to speak for the interest of SHG members, claim their rights and get access to different supports from various sources, like one beneficiary who is a member of UP standing committee on agriculture had mentioned about situation of the leprosy and general disabled persons in the committee meeting, and got allocation of seasonal seeds from the agriculture department for the needy group members. Another member in the mosque committee shared that in one occasion after the dead of leprosy disabled person the Imam (Muslim priest) in the mosque was reluctant to lead the prayer and allow to bury diseased person in the local cemetery. He talked to different people like members in the union and upazila parishad and others, and finally was able to convince all the people involved with the structure, and arranged prayer and have the person buried in the graveyard. One member from each SHG is nominated for upazila association. S/he can be either from group management committee like president/secretary/cashier/general member. Each group pay BDT 600 annually to manage expenses of the upazila association arranged from individual member’s saving. The members appear to be acceptable with the idea (as none has complained about it during the discussion) since they get various types of supports from the upazila association and its members on different occasions. 9.1.5 Upazila and district association The intervention has facilitated formation of 28 upazila associations (24 for CBRP and four for DSCBP) and five district associations (four for CBRP and one for DSCBP). In CBRP 22 upazila associations and one district association got registration from upazila social welfare department, 19 upazila associations have managed land for constructing building for their organizations and two upazila associations have built their own offices; while from DSCBP none of the association has got registration yet (as it is in operation for few years only); however, one association was able to manage land for its office (Table 4). The associations (most of them belong to that category) that do not have their own building for doing their official work i.e. meeting and other gatherings; as such they manage them from rented space. While associations that have land leaders of those can continue exploring funding opportunities to construct own office space with support and cooperation from the project management. Table 4: Upazila and district association Sl. No.

1.

2.

Project name

CBRP

DSCBP

Type of association Upazila association District association Upazila association District association

Total Source: Project record

Total no. of association

Registration received

Information need Have own Have own land building

Average balance (BDT, June ’19)

24

22

19

2

23,030

4

1

-

-

2,319

4

-

1

-

51,595

1

-

-

-

8,120

33

22

20

2

12


It appears from the discussion that district association faces difficulty in getting registration from the respective authority as the current law does not permit having recorded of such organization from relevant department in the district; therefore, they may have to find alternatives to obtain the registration. The evaluators also observed that the district association members are seeking possible options to get the permission like from sadar upazila. Project personnel and others involved with planning of the current phase did not think about those limitations, and now even if the district association gets permission from a upazila, the uncertainty remains whether that will allow them to work for members of other upazila associations in the district. The project management will have to think about it and plan accordingly (considering the legal perspective) in the next phase; other than that it will have to support the associations (upazila and district) so that there is uniformity among the bye-laws of those bodies, as it will contribute in reducing differences, conflict, etc. among the organizations and their members, and continue functioning well for improvement of the disabled people. Each of the SHG nominates one member for the upazila association (UA). As such if there are 50 SHGs, there will 50 members in the UA who are considered as general members (GB) in the association. GB is responsible for making policies or major decisions for the association. It elects/selects members for the executive body (EB) for three years as mentioned in the bye-laws. Membership in the EB differs among the associations; like in one association the evaluators visited have 11 members; while in another there are 9 members. Bye-laws of the association differ from one to another. There are also differences regarding positions of the EB in the bye-laws and practice, like in one UA association that the evaluators visited, it has five positions in the bye-laws, but in reality there seven persons in different positions. One of the reasons could be that the association leaders take advantages of the situation or opportunities that appeared to them while registration, and could not make time to look into all the details what is written in the constitution, and take necessary arrangements accordingly within the organization. The UA gets BDT 600 as annual fees from each of the SHG under its jurisdiction; as such if there are around 50 SHGs under that a particular UA, it will get BDT 30,000 per year. Other than fees from the SHGs, UAs get some supports from other projects of the implementing agency. The registered UAs receive an annual grant from the upazila social welfare department, e.g. one UA that the consultants visited got Tk. 28,500 as annual grant7. It is easier for an UA when it is registered and has its own office to receive support from external sources i.e. public and private. The members of UA (GB & EB) sit once in a month to talk about their issues, and the secretary keeps minutes of the discussion points. Members participating in the monthly meeting get conveyance and snacks. As the associations have limited funding support, they can think of having monthly meeting for the members of executive committee and annual meeting for the general body. This will help to 7

UA that gets annual grant from the upazila social welfare deparment need to conduct audit of the fund utilizaltion and submit the report to the respective officials.

13


reduce their expenses related to meetings, increase their surplus and use association fund for other purposes. The UAs play important role in helping the SGHs members to get various supports and services from different sources. During field work, a good number of group members shared with the evaluators that they got disability allowance and other assistances like seed, house, and support for fish cultivation and others with help from the UAs. The consultants came across with some active UAs leaders who are good at relationship building and communication with government officials, people’s representatives and others, and where is any support available for the disabled person (leprosy and general), they take initiative so that the needy SHG members get the assistance from those sources. The project management needs to be vigilant so that leadership positions in UAs are not occupied by few physically disabled members; rather leprosy disabled are also included in different responsibilities and show their leadership and managerial capacities for improving situation of targeted people. During field work, the evaluators talked to one UP Chairperson who is concerned about issues of the project participants. Recently he constructed one room in the union parishad campus, and arranged chairs and table for the disabled people (members of UA) so that they can have meetings and gathering on different occasions in that place. Other than that he had asked the UA leaders to give him a list of 10 needy disabled persons from his union for disabled persons allowance for the latest allocation that he got from the upazila social welfare department. Initially he faced difficulty from his other 12 members, but he told them “EB members of UA know the disabled persons in the area, so they would be able to help us to select the right person for the allowance�. Finally he was successful in convincing others in his team, and the respective UA gave him a list, and after scrutiny he accepted the list and sent it to the upazila social welfare department for approval and the people in the list now get the allowance. That chairperson also supported one needy disabled person to get a house from the respective department of the government. He arranged medicinal trees from the upazila parishad to be planted at the roadside belonging to the union parishad. When they reach maturity SHG members will be able to sell leaves of the plants and get money and share among them. For any benefits allocated for the disabled person, the UP chairperson is always ready to recommend for the disabled people or take measures so that they get the relevant benefits. The UAs were successful in sending participants (SHG group members for different technical trainings), technical and financial support from the department of fishery (upazila) for fish cultivation, seeds and fertilizer from agriculture department, warm clothes during winter, 20 kilograms of rice on different occasions (like Eid) and others. Members of one UA were able to manage 40 golden (subarna) citizen cards for the SHG members under its jurisdiction that will allow them to get relevant benefits from different agencies. The same UA was able to arrange loan from social 14


welfare department for five members of SHGs (each getting Tk. 25,000 with 5% interest) for different IGAs, disabled allowance for 36 SHG members, and sell rice of one member to the UNO at government rate that allowed him to get higher price of the rice than the market. The UAs publish pass books and other registered books (khatas) for the SHGs that allow the groups to have those materials at reasonable price. The leaders of UAs encourage targeted people to form new groups, visit SHGs under its membership to see how they are performing, and take steps to solve problems of the groups and its members on diverse issues. The members of UAs have built relationship with various departments in the upazila, and when there is allocation from government departments they get the information, they take necessary measures so that the members in need get the assistances. 9.1.6 Benefits of the intervention Numerous changes (positive) have taken place in the lives of the targeted people and attitude and behavior of the local people, people’s representatives, government officials and others. The neglected and excluded SHG group members realize that there have been transformations in the way local people behave with them. Now the group members can mix with other people, walk with them on the road (earlier local people did not walk when they were in the street), go to different places together and hotel, drink tea and eat with others, people in the locality talk to them, behave well with the members, do not hate them anymore, invite them in different program, etc. Mizan (20) stated that ‘there is no difference among us i.e. general people and members of SHG, we can go to different places and mix with other people now’. SHG members can gather together in their monthly meeting, tell their stories with other members in the group and deposit savings, get treatment when they are sick (leprosy affected people from the leprosy hospital) and other members receiving treatment of their diseases in the local hospital for common diseases and live healthy life, get loan with easy conditions and low interest rate (like 10% and there is flexibility in refunding the loan money; whereas at outside the interest rate is 20%30% or even more and there is certain time for loan reimbursement), some of the members can move with wheel chair, etc. Few members have bought van, autorickshaws, cows, run grocery shop and have enlarged their business, got leased land and produce crops investing the loan money and increase their income. Hazera (25) told that they can go to Upazila Nirbahi Office (UNO office) easily and share issues of their concern, which they never could think before. Some got agriculture card that allow them to get agriculture input like seeds, fertilizer, etc. Golden citizen card will allow the disabled person to get all the benefits that they are entitled to receive. Mayor of one pourashava allowed that auto-rickshaw driven by the disabled person to run in the area without any further permission; police do not requisite vehicles (battery run auto-rickshaw) driven by the disabled person, even during strike their vehicles are allowed to be on the road. All these and others were possible for collective work of the beneficiaries at different levels. Many of the group members have received allowance for the disabled person with support from the 15


UAs that allow them to maintain some of their expenses. In the group level if there is any problem (generally there is not, but if there is), the members can or do solve it among themselves. Md. Akser Ali finds new hope in life Md. Akser Ali (75) used to pull rickshaw for livelihood. Around 15 years back he noticed a patch on one of his toes of right foot. He consulted a general practitioner, but was not recovered from the disease. His elder brother who is a leprosy patient suggested him to go to Saidpur Leprosy Clinic. After he had gone there, the doctor diagnosed him with leprosy and gave him treatment accordingly. Coming back from the clinic, he had noticed changes among his family members i.e. children and neighbors started avoiding him, even people stopped traveling on his rickshaw; therefore, he had to discontinue pulling rickshaw. Finding no way to arrange food, his wife started working as maidservant at other’s house. After sometime she also became workless due to leprosy of her husband. Finding no other ways he started begging, and due to walking for long distance, he got ulcer at his right foot. For treatment of the disease he went to Saidpur Leprosy Clinic again, but they referred him to DBLM Hospital, Nilphamari. As it was too late, doctors amputated his right leg bellow knee. Finding no way for living he even thought of committing suicide. During that time (in 2008) he came to know about Community Based Rehabilitation Project (CBRP) and SHG in his village, and became member of the group. The group members and CBRP arranged an advocacy meeting in the village where chairperson of respective union parishad and other people attended. The people gathered there came to know about his disability and current situation, and committed to support him. They built a small hut for him at his elder brother’s place. The UP chairperson arranged a disability allowance card for him; and from the project he got an artificial leg for movement. Joining SHG for sometime he took loan of BDT or Tk. 7,000 from the group and bought a cow, and in the following year he sold the cow for Tk. 20,000 and bought 3 decimals of land. Slowly he was elected as chairperson of the SHG and selected member for upazila association (UA) that allowed him to participate in various meetings arranged by the UA and came to know different people at upazila level. When the UNO came to know about the situation of Md. Ali, he gave him a grant of Tk. 100,000 from government allocation with which he built a GI sheet house, installed a latrine and bought an auto-rickshaw. His son drives the auto-rickshaw van and earns Tk. 300-400 daily to manage family expenses. Few years back he bought a cow with loan of Tk. 10,000 from the group. Recently the cow has delivered a calf and gives milk, and Mr. Akser Ali sells part of the milk and consumes the rest in the family. He is now involved with other committees in the locality and has assisted 3 group members to get disability allowances. He says that the project, members of SHG and UA, and others that he has met, helped him to think positively and increased his selfconfidence, and live life with dignity and rights. He is grateful to all the people that supported him to develop new hope and lead meaningful life, even if he had leprosy.

16


10. Conclusion The intervention has created an opportunity for the leprosy and disabled person to form their own small organization named self-help group (SHG), have monthly meeting to discuss their own concern, learn new knowledge and skill, get treatment of their diseases, assistive devices that they require for healthy living, deposit savings, invest money for various income earning activities and increase their income, avail services from different sources particularly from the government departments and others. The group members realize that they are no more excluded members in the society; rather they are one among the equals, as they get treatment like others, people talk to them and behave well with them, eat with them, invite them in different programs. All these have been possible for their coming together and working in self-help group and upazila/district association. The members of SHG got training and formation of managing and leading their small organization. Now many of the SHG’s leaders can conduct meetings, write records like minutes, financial information and others without support of the implementing agency and project staff. Some leaders have got the capacity to help other SHGs to manage their group activities. The intervention has already started giving responsibilities to some of these leaders to support other low performing SHGs or SHGs that do not have capable or expert leaders. Majority of the upazila associations have got registration from the respective social welfare department, district level associations need to work to get approval for their operation. Even if the leaders are facing difficulties in getting registration of district association, as such the people involved with the intervention need to work together in finding ways for having its legal basis. The associations need office space on their own land, increase their income and reduce avoidable expenditures like monthly meeting for all the members of general body. Many of the leaders of these associations have acquired necessary skills and motivation in building relationship with government officials, people’s representatives and other stakeholders and avail services from different sources for disadvantaged members in SHGs. Assistance for another phase will enhance their competency to manage their own organization and support the group members (at different levels) for improving their situation.

11. Recommendations Based on field findings, discussion with different stakeholders, present study recommends the following for sustainability of the initiatives the evaluators recommend that: • Continue these two projects as one and keep assisting these organizations (SHGs’, UAs, DAs) to function in a well organized manner, with proper accountabilities, documentations, money managements and ensure internal equity. • Keep focus in mind that people selected and being addressed, are not only vulnerable but are also excommunicated and will need continued support for their rights and inclusions. Phasing out will reduce momentum these organizations have acquired over last three phases. 17


Continue to strengthen people with disabilities (men and women) including leprosy, to have access to their rights and improved socio-economic status, by representing sustainable organizations (Self Help Groups’ Associations) with legal entities, to collectively advocate living with human dignity, rights and social entitlements, ensuring justice and equality as citizens of Bangladesh.

Promote and enhance social and economic empowerment of these excluded, marginalized and economically poor individuals and their family members, and build networks of relationships among families with similar mental, social, economic and spiritual struggles, to pursue their struggle for human existence.

Supervise SHG’s activities by project staff of next phase or volunteers from capable group leaders, so that the groups continue their regular activities, such as monthly meetings, deposit savings, disburse loans and realize them properly, participate in different meetings and trainings, avail services from various sources for enhancing their well-being. Include children (who have secondary and higher secondary education) of the group members for writing reports/records i.e. meeting minutes, and keeping financial records like pass books, cash books, ledger books, etc. Pay special attention so that major portion of loan is not taken by few group leaders or the groups investing money in too risky businesses or initiatives. Take necessary measures, so that there are uniformities among the ByeLaws or Constitution of Upazila and District Associations (through making amendments in their Annual General Meeting and getting this approved from the respective authority), and continue supporting them (particularly District Association) for getting registration, and this initiative need coordination among members at District Association level and have their office in own land. Continue accessing technical and training support from different Government Departments for SHG members, for income generation activities, e.g. poultry rearing, animal husbandry, fish cultivation, agriculture work (vegetable, other seasonal crop production), and support to increase their income. Support the Associations to explore funding opportunities from public and private sources, to increase their income base, to continue their activities and reduce expenditures that are currently made, through monthly meetings for all members of General Body, rather have meeting of the Executive Body members. Prepare indicators for next phase following SMART, e.g. for present phase there are indicators - 60% of graduated groups experience access to their rights (CRPD & Disability Protection act 2013), and 90% graduated groups experience access to their entitlements. These are difficult to measure; furthermore, there needs to have survey (both at the beginning and at the end of the intervention) to see if the targets have been achieved or not, or the position of the project in the journey.

• •

18


•

Develop Reporting and Monitoring Tools by using the Logical Framework as a management tool, to record progress and take corrective measures, to assess outputs, outcomes and impacts.

19


Annexure-1- Other Aspects given in ToR - Focus of Evaluation The evaluation is expected to focus on the followings: •

Assess effectiveness, impact, and sustainability of CBR projects in terms of achievement according to objectives stated in the project document and LFA;

Both “Community Based Rehabilitation Partnership” (CBRP’s) and “Dinajpur Sustainable Community Based Rehabilitation Project” (DSCBRP’s) has been effective and has made significant impacts on the lives of people and their families included in the Self Help Groups and their Association leaders. Achievements according to the Program and related Activities given the Project Documents were mostly done. Logical Frame Work were reviewed and completed and remarks given in each of the areas. •

Figure our progress towards group and associations sustainability and participation in the followings:

Self Help Groups: Development and capacity of groups to be self‐governing and continue without project inputs.

Comments/ Remarks for consideration: There are some challenging factors that need to be considered for the “Self Help Groups”, to be self governing and continuity without project inputs. These are some unintended limitations, which act as barriers now and in future:– (i) Self Help Groups are too small with 8 to 15 members, this is due locations and disabled people’s limited mobility, for their physical conditions; (ii) Age variations from 70+ years, 60+ years, 50+years, 40+years, 30+years, 20+ years, as a result very limited opportunity to include new members, as the aging members permanently leaves, the Groups will shrink; (iii) Gender variations (female + male) varies from group to group; (iv) Literacy rate is very low, some are literally illiterate and the cyclic changes planned after every two (2) years will not be possible; (v) Departure of literate members will leave the Groups non-functional as there will be no one to keep the financial and other administrative records, as required for ensuring (a) Accountability, (b) Transparency, (c) Good Governance in these organizations’ financial and other human resources (members and others they relate with). (vi) Interactions among the group has some limitations, due to age and gender differences, so most of the monthly meetings are mostly limited to personal savings and revolving loan refunds. Positive Aspects: (i) All members are enthuastic and active in their Groups. If any one does not turn up for any monthly meeting, then some of the members make family visits, to assess the reasons for absence; especially as this involves each member’s savings and loan refunds and to see the health conditions. (ii) Additional time is given in case of any defaults. The small Self Help Groups has helped to set up a platform for interrelationship among the members, as they all have similar type or disabilities and were socially excluded. This has given them a social bondage. 20


Upazila and District Associations: Assess governance, capacity (including financial capacity) and role of associations; recommend future steps to ensure good governance and their ability to support groups in absence of project staff;

Comments/ Remarks: Upazilla Associations are very active and eager, as this has given them an opportunity to be valued as leaders and have access to government and other officials, which they never had before they formed their Upazilla Associations and had these registered with the Social Welfare Department. They were never taken into account and were not courageous to meet them and access any “Government’s Safety Net Programs” benefits for their members in the Self Help Groups. However Upazilla Associations (UAs), who are the spokes persons for the Self help Groups (SHGs), are constantly struggling for financial resources to operate their organizations; because they are dependent on the Self Help Groups’ for monthly membership fees, of taka 50/- per month or taka 600/- per year and an annual grant from the Upazilla Social Welfare Department. This amount varies from taka 12000/- to 18,000/- per year. They know their role and responsibilities as this is well spelled out in their Constitution. Most of the Advocacy Programs at the Upazillas, Union Councils and with Educational and Religious Institutions has been supported through the “Community Based Rehabilitation Partnership” (CBRP) and “Dinajpur Sustainable Community Based Rehabilitation Project” (DSCBRP) project’s funds. This will come to a standstill as they do not have resources to organize such events. District Associations formed has not been registered as there are several requirements that these Associations do not meet. However these are functioning with an allowance of taka 3000/- per every quarter by the CBRP and DSCBRP, for each District Associations, for meeting their meeting and travel costs, as they do not have any source of income. •

Summarize and outline recommendations for the future and long term sustainability: (given in summary)

The 856 Self Help Groups organized TLMI-B initiated with 8,306 members, through two integrated projects namely (i) “Community Based Rehabilitation Partnership” (CBRP) covering 24 sub-districts (Upazillas) in 4 districts (Rangpur, Nilphamari, Thakurgaon and Panchagarh). Through CBRP 751 Self Help Groups were organized with 7,251 members; and another project named (ii) “Dinajpur Sustainable Community Based Rehabilitation Project”, covering 4 sub-districts in Dinajpur district, which organized 105 Self Help Groups with 1,055 members. In addition to organizing the above 856 Self Help Groups, 28 Upazilla Associations to oversee these groups, they also organized 5 District Associations. These organizations have been organized with most vulnerable, poor and socially excluded families in communities, will need much more care, supervision, monitoring, reviewing, training and mentoring, to ensure their organizations’ management and financial governance. TLMI-Bangladesh will have to keep in mind that comments given above on 856 Self Help Groups and their 28 Upazilla and 5 District Associations, has a significant impact on the functionality of these small organizations. With low literacy rate and other compliances that any organization needs, to move on as Sustainable Organizations cannot be met at this stage of the projects life spans.

21


TLMI-Bangladesh through these three project cycles, of these two projects, has began rolling the ball, by focusing to bring these hidden people into limelight and will needs several years to reach the anticipated goal and objectives as envisioned. Leprosy infected and cured people’s inclusion through these two projects is a major achievement and moving them out of the stigma will take many more advocacy and awareness meetings. One or two meetings will not have the anticipated impact on this age old exclusion from social, cultural and religious values, which are fairly ingrained in the minds of communities. However changes are taking place as shared by Self Help Group Members, their Upazilla and District Association Leaders, during out Focus Group Discussions. •

Consider pros and cons of registration with the cooperative department enabling the associations to undertake microfinance versus the implemented registration with social welfare and the entitlements that it gives access to;

Micro Finance Program (MFP) is considered as “Second Generation of Self Help Groups or Cooperatives”. There are several professional requirements and get the “Micro Credit Regularity Act’s Registrations” and will need professional staff members to manage their operations, which Upazilla Associations will not be able to meet. Micro Finance Program (MFP) is an “Informal Banking System”, where staff members visit clients/customers/members, to give loans, collects refund installments and members’ savings. Management cost is met with interests collected from borrowers. The “Self Help Groups” are built on the “Cooperatives Principles”, but on a smaller scale, as “Capital for Loan” is limited and management capacities of members are also limited, with no offices or staff members to keep records and different Committees that Cooperatives Department have as a requirement for “Cooperative Registrations”. TLMI-Bangladesh organized “Self Help Groups” will not meet the criteria required by “Cooperative Department”. However we have advised the Upazilla Associations, to contact other Departments (Cooperative, Agriculture, Fishery, Livestock, Education, Health, Land, Legal etc.) at the Upazilla level. In addition we have met Deputy Director of Social Welfare Department, District and Upazilla Social Welfare Officers, and requested them to advocate for linking TLMI-B organized “Upazilla Associations”, so that they can avail be benefits of other “Safety Net Programs” through their single registration with “Social Welfare Department”, as these are linkages and they operate from the same “Upazilla Complex”. •

Identify to what extent the project activities impact the acceptance of religious minorities such as Hindus or Christians amongst the population more broadly and give recommendations to what extent it would make sense to prioritize a stronger promotion of freedom of religions and belief;

There are mixed groups of Muslims and Hindus as members, in addition we have met a Group that comprised of only Hindus and some only Muslims. We missed group that exclusively consisted of Christians as members. This has been unintentional. However while having Focus Group Discussions (FGDs) with the Project Staff Members, they shared that in early formative stage there were rumors that TLMI-Bangladesh is going to convert people to Christianity and there were oppositions from both Muslim and Hindu communities. However as Leprosy Healed Patients were treated through DBLM Hospital, so there were less resistance from them, but they felt that they would be further marginalized for being involved with TLMI-Bangladesh program. Advocacy Meetings at Union Council Offices with 22


elected leaders, Religious and Educational Institutions’ leaders, Upazillas level Government Officials and Districts level officers minimized this initial tension. For religious integration and building tolerance, TLMI-B should promote the concept that we are (i) All Human Beings created by same God; (ii) We are Bengali by culture and ethnicity; (iii) We are all Bangladeshi nationals; (iv) We follow certain religious’ teachings (Hindus, Buddhists, Christians and Muslims). These four basic values are in reverse order in our country and are major cause of religious tensions, conflicts and community integrations. Changing this mindset among SHG members and community leaders will have a transforming effect and positive impact in the long run. Annexure-2- Guide questions for FGD (SHGs, UAs, DAs, KII, Health Volunteers and Staff Team Members.

i) Guide questions for FGD, General SHG members Consent of the interview The Leprosy Mission International in Bangladesh (TLMIB) has been implementing projects for improving for situation of leprosy affected and physical disabled people through self-help group (SHG) approach, development of group and its members, formation and capacity building of sub-district and district associations, advocate with local authorities for realizing their rights, achieve financial sustainability, etc. For understanding project implementation, achievement, result, outcome, impact and sustainability and others, the organization is conducting an external evaluation of the intervention. As part of the study we would like to discuss with you about your involvement and experience with the program. We thank you for your readiness of being part of the discussion, and we assure you that information of the conversation will be kept secret and used only for the study purpose; and with your consent we want to start the talk. (Would please tell us your name, how are you, age, educational attainment, what do you do (profession) and others Sl. No.

Name of the participant

Age

Sex

Religion

Occupation

Educational attainment

Marital status

Position in the group

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

1. Would you please kindly tell us when and how did you start the group? How many members do you have in the group now – adult and children, male and female, and boys and girls, and other categories; how many were you in the beginning, has any member left the group, what are the reasons for their separation? 23


2. What do you do in the group? If you have meeting in the group, how often can you sit? Where does the meeting take place? Do you keep records of the meeting, who writes them? Do you have the minute register, and who maintains the record books, can you please show us them? 3. Do you have savings activity in the group? How often do you deposit money, do all the members save regularly, do you know individual savings amount? How much is your group savings now? Who collects saving in the group? Where do you keep the savings – with group members, NGO staff, bank or others? What documents or records do you maintain for savings, and who maintains them? 4. Do you give loan to the members from group saving, what is the interest rate, do member pay back the loan? Do you give any benefit to the members who save in the group, if yes how do you do that? Have you received or get any financial support from other sources, if yes, how and what do you with that money? 5. What trainings, capacity building, technical support and others group members have received from the project? Have you received any of the inputs (cash/material/ medicines/tube-wells/ring-slab/latrines/assistive devices), and from where do you get them? As a result of all the supports can you say that your income has increased, how many of you could increase their income and what is the amount? 6. How many from your group are members in the sub-district and district association, how often can you sit for meeting in those associations’ meetings or program, what do you as members of the association? Do members of the group get any support from those associations, what are they and how often do you get them? Do you pay association fees, how much is that, how often do you pay them, how do you arrange them? How many are you members of different committees in the locality like school management committee and others? 7. How many of you get services from government and other sources like disability allowance and others, for how long do you get them, how did you arrange them? 8. How many of you have sanitary latrine at your house and what is its type, how did you arrange it, is it functional, do all the family members use it? When and how often do you wash your hands with soap? Do all primary school going children from your family go to school (DMCDD), if not what are the reasons? 9. Do you face any problem due to leprosy in the society, what are they and how do you deal with them? Do you see any change of people’s attitude and behavior towards people who have leprosy (like more acceptances in the society) due to project intervention and other works over the past couple of years? 10. Do you practice self-care (leprosy disability) regularly? Do you feel that it helps you to prevent leprosy ulcer? 11. For what reasons misunderstandings or conflicts arise among the group members and how do you resolve them? 12. Among all the activities that you do, what helps you most in addressing your needs or improving your situation or gives better results? What positive and negative changes have taken place in your life due to project intervention? To what extent you are satisfied with the supports that you have received from the project? What are the things that you will be able to continue in the long-run? Do you think you will be able to manage your 24


group activities by yourself, what are the things that you can do by yourself, and for what activities you will need external support? 13. Let’s summarize the key points of our discussion. Do you have anything to ask us? Thank you very much for giving time for the discussion. Thank you very much for giving time for the discussion.

ii) Guide questions for FGD, Leaders of Sub-district and District Associations Consent of the interview The Leprosy Mission International in Bangladesh (TLMIB) has been implementing projects for improving for situation of leprosy affected and physical disabled people through self-help group (SHG) approach, development of group and its members, formation and capacity building of sub-district and district associations, advocate with local authorities for realizing their rights, achieves financial sustainability, etc. For understanding project implementation, achievement, result, outcome, impact and sustainability and others, the organization is conducting an external evaluation of the intervention. As part of the study we would like to discuss with you about your involvement and experience with the program. We thank you for your readiness of being part of the discussion, and we assure you that information of the discussion will be kept secret and used only for the study purpose; and with your consent we want to start the conversation. (Would please tell us your name, how are you, age, educational attainment, what do you do (profession) and others Sl. No.

Name of the participant

Age

Sex

Religion

Occupation

Educational attainment

Marital status

Position in the Committee

Type of Disability

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

1. Would you please kindly tell us how many are you in the committee – male and female, for how long are you in the committee, how did you get to the committee? What do you do in the committee/s like responsibilities of individual members, how often do you have meeting of your committee, and do you keep records of the decision that you made in the meeting, and who keeps them, how do you manage expenses of the meeting like travelling and others? Where do you sit for the meeting, do you own the place, if not, do you pay rent for it, how long can you use the facility? 2. Do you have any constitution or bye-law for your association; are you registered with government department, with or under what agency, how did you get the registration, what is the benefit of being registered with that particular agency, do you get any benefit from that agency, if yes, what are they?

25


3. What trainings, capacity building, technical support and others have you received from the project? Have you received any of the inputs (cash/ material/medicines/ tube-wells/ringslab/latrines/assistive devices) from the project and other sources? As a result of all the supports can you say that your personal income has increased, how many of you could increase their income and what is the increased amount? Do all primary school going children from your family go to school (DMCDD), if not what are the reasons? 4. Do you face any problem due to leprosy in the society, what are they and how do you deal with them? Do you see any change of people’s attitude and behavior towards people who have leprosy (like more acceptances in the society) due to project intervention and other works over the past couple of years? 5. Do you practice self-care (leprosy disability) regularly? Do you feel that it helps you to prevent leprosy ulcer? 6. How many of you are members of different committees in the locality like school management committee and others? Do you have linkages with district and upazila level governmental offices and other agencies, what benefits and supports do you get from those offices, are you happy with the services that you get from them? How many of you get services from government and other sources like disability allowance and others, for how long do you get them? 7. What supports do you provide for members of the self-help group, have you contributed in formation of new group, if yes, how many, and according to your opinion how the selfhelp group is doing, do you think that they will be able to manage their groups by themselves, if yes, why do you think so? If not, what are the reasons? 8. What is your association annual income, how do earn the income or what are the sources of your income, do you get any funding from external sources? How much is your annual expenditure, what is the surplus now, who maintains the records, can you do them by yourself, do you think you will be able to manage your expenses with the money that you can earn? Do you have any audit of your records, who does it for you, can you do it by yourself in the future? 9. Among all the activities that you do, what helps you most in addressing your needs or improving your situation or gives better results, or managing your association? What positive and negative changes have taken place due to project intervention? Do you feel any change is needed in the way you do things or work that you do, and in which area? 10. What are the things that you will be able to continue in the long-run? Do you think you will be able to manage your association activities by yourself, what are the things that you can do by yourself, and for what activities you will need external support, for how long you may need that assistance? What is your future plan, and what do you want to do in coming days? 11. Have you done any advocacy work in your association locally, in the region and nationally for the benefits of association members and what are their results? 12. Let’s summarize the key points of our discussion. Do you have anything to ask us? Thank you very much for giving time for the discussion. Thank you very much for giving time for the discussion

iii) Guided Questions for Key Informant Interviews 26


1. How much do you know about TLMB and their program with those who were healed from Leprosy and other disabilities in your area of responsibilities? 2. Did the Self Help Groups and their Associations approach you and other leaders of influence, for any help and assistance? Can you give us few examples? 3. What else can you do to support these small community organizations and influence others who can or could help them, to live a life with dignity and social acceptance? 4. What else these SHG and their Associations do, for more effectiveness and sustaining their efforts for health care services, capital generation, income generation, social inclusion and seek social justice and equality as citizens of this country? 5. What are consequences for these organizations, if TLMB phases out of this area and how you can help to link them with other Government Ministries, Departments and NGOs, so that they can sustain and continue to provide services to these SHGs and their Associations? Thank you very much for your time, sharing your ideas and assisting Upazila Associations and TLMI-B staff team members.

iv) Guided Questions for Community Health Volunteers 1. As a Volunteer what are the type of help do you provide in the community? 2. How long was the Training? 3. While working as a Volunteer what are the Challenges and Painful experienced or are experiencing? 4. What are your Expectations from TLMI- Bangladesh? Thank you very much for your time, open sharing and suggestions.

v) Guided Questions for Staff Team Members 1. What are the Impacts you do you expect among the Self Help Group Members? What impacts do you expect the Associations will have on the Self Help Groups? 2. What are the Outcomes you expect that the project’s Outputs have on members of the Self Help Groups? What are the Outcomes you expect the project’s Outputs have on members of the Associations of the Self Help Groups?

3. What are the project’s Activities, Inputs and Process followed by the Project Team Members? What are the Leadership, Management and Administrative support given by the organization for achieving goal and objectives? 4. How do you perceive the Self Help Groups and their Associations Leaders feel about their inclusion and participation in these organizations and your efforts to build their capacities to operate their organizations?

27


5. What are the programs you feel has been done well and other areas that could have been done better? What are future opportunities of these Self Help Groups and their Associations? What are the challenges you faced while implementing this project’s activities and what will you do differently if you had another opportunity to implement the project once again? 6. Sustainability of all the efforts you have given for the Self Help Groups and their Associations – (i) Program Sustainability (Health Care Services, Income Generations, Social Inclusions, Advocacy for Rights, Justice and Entitlements)? (ii) Leadership and Management Sustainability (Good Governance, Accountability, Transparency, Record and Document keeping and Participatory Monitoring and Evaluation)? (iii) Technical Sustainability of programs being implemented (Health Care Support, Volunteer Selections, Capacity Building, Income Generation Activities, Loan disbursements and collections, Financial and other essential Record Keeping)? (iv) Financial Sustainability of SHG and Associations, so they can generate adequate income to operate their organizations? (v) Social Sustainability – acceptance, integration and mainstreaming with wider communities? Which are the areas you feel the SHG and their Associations needs further support or else all your efforts will disintegrate in the long run? 7. Can non leprosy or other non-disabled poor and vulnerable persons/ families be included into SHG and their Associations, for increasing number of Group Members and in the process increase social acceptance and inter-mixing others non-excluded families, for increasing inclusion and generating more capital of other poor members in the communities, where the SHG are organized? 8. What monitoring and annual assessment /evaluation process can be applied, for participatory engagements of the SHG and Association leaders after the project has phased out or additional resources cannot be generated to operate this project? 9. How these SHGs and Associations can be assessed and contacts maintained from TLMB Dinajpur Office (Hospital) Project, to ensure that efforts given over last three phases, does not disintegrate without needed support? 10. Which are the non-government organizations or Ministries and Departments for addressing the Sustainability factors of SHGs and Associations? Thank you very much for sharing your opinions and open discussions.

Annexure –3- Field work schedule Upazila Nilphamari sadar Saidpur

FGD with SelfHelp Group

FGD with UZ Association

FGD with DT association

16/10/19 (T1)

19/10/19 (T1)

16/10/19 (T1)

16/10/19 (T1) 17/10/19 (T1)

17/10/19 (T1)

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FGD with GOB official 16/10/19 SSO (T1) UP Chairman

CDW FGD & debriefing


(T1)

Badarganj Dinajpur sadar Rangpur sadar Parbotipur

Nilphamari Office

17/10/19 (T1) 16/10/19 (T2) 16/10/19 (T2) 17/10/19 (T2) 17/10/19 (T2) 18/10/19 (T1) 18/10/19 (T1) 18/10/19 (T2) 18/10/19 (T2) 19/10/19 (T2) Document Review Document Review Document Review

16/10/19 (T2)

SSO (T2)

17/10/19 (T2)

SSO (T2)

18/10/19 (T1)

18/10/19 (T1)

18/10/19 (T2)

18/10/19 (T2)

FGD-CDW

FGW-PST

SSO (T1)

Debriefing 20/10/19 21/10/19 22/10/19

Team 1: Subash Gomes and Kalpona Kispotta Team 2: Sylvester Halder, Anwar Hossain and Delwar Hossain Annexure- 4 - Terms of Reference for Projects’ Evaluation 1. Introduction The Leprosy Mission International in Bangladesh (TLMIB) has been working in North West Bangladesh since the early 1990’s. At that time, the majority of the work was in field leprosy control and leprosy complication management through a hospital. In the late 1990’s there was increasing attention placed on rehabilitation and TLMIB began working with Community Based Rehabilitation using group-based approaches. The Community Based Rehabilitation Partners Project (CBRP) implemented under the Community Program of TLMIB Dinajpur Sustainable Community Based Rehabilitation Project (DSCBRP) also falls under Community Program. There are total 782 groups and 7,251 members in CBRP, 105 groups with 1,055 members in DSCBRP. In 2006, the group based Community Based Rehabilitation (CBR) approach was redesigned with newly trained staff, a clear methodology and a clear direction towards empowerment of the target group. Since 2008, the project has built on previous relationships with past patients who are disabled because of leprosy. (At least 10% of new leprosy patients are disabled at the time of diagnosis). The new approach is using an empowering methodology and including other people in the community with physical disabilities, or who are otherwise marginalized from society. The Leprosy Mission in Denmark, DMCDD and the Community Program (CP) of TLMIB has worked together on the planning of all phases. The project received significant input from the beneficiaries, who are full partners in the project. Phase 1 (2009-2013) focused on forming and developing groups. Groups were encouraged to develop interactions with other groups and to develop sub-district associations. In Phase 2 (2014-2016) focus was on capacity building of the sub-district associations, increasing their capacity to monitor and support the groups, and to advocate in relation to local authorities. In Phase 3: (2017-2019) sub-district and district associations will be consolidated and will reach financial sustainability. By project end the associations will take full responsibility for 29


supporting the groups, encouraging the start-up of new groups, and advocating for the rights of their members. Dianjpur Sustainable CBR Project (DSCBRP) started in November of 2010 and final phase (2018-2020) will be completed in December 2020. It covers four sub-districts out of 13 subdistricts in Dinajpur. It is a sister project of CBRP and methodology is similar. The external evaluation is being planned in cooperation between the Danish Mission Council Development Department (DMCDD), who is administering the grant from CISU, TLM Denmark and TLMI/TLMIB. It will be a joint evaluation for both CBR projects in the north. The evaluation is needed to assess the progress towards the project development goal and objectives as stated in the project document, to document significant learning and sustainability. 2. Project overview

i) Community Based Rehabilitation Partner (CBRP) Project Goal and Objectives: Development goal: People in North West Bangladesh with disabilities (including people with leprosy) have access to their rights and full participation in social and economic life, and are represented by sustainable, independent, functioning organizations. Objective 1: By December 2019, 750 self-help groups for persons affected by leprosy or disability in 4 districts of NW Bangladesh support their members in experiencing full participation in social and economic life, and have the capacity to support the running of 24 sub-district associations. Objective 2: By December 2019, 24 sub-district associations representing and 750 SHGs in 4 districts of NW Bangladesh are able to provide organizational and management support to the groups, and have the capacity to voice the rights of disabled persons regionally and nationally.

Objective 3: By December 2019, the mobility, health, and hygiene of 7500 group members and their households is improved and the results will be sustained by the groups and their communities

ii) Dinajpur Sustainable Community Based Rehabilitation Project (DSCBRP) Goal and Objectives: Development goal: People with disabilities (including leprosy) have access their rights and improved socio-economic status by representing sustainable organization. Objective 1: By December 2020 people with disabilities (men & women) mainstreamed in the community by improving socio-economic status and living with rights and entitlement. Objective 2: By December 2020, Upazila associations are able to support 105 self-help groups and create advocacy at higher level with legal entity. 30


Based on lessons learnt in last phases and future sustainability in mind, in final phase we keep focus on strengthening associations role in representing and supporting the groups. Project long-term vision for this phase that the sub‐district and district associations are that they be able to sustain the project results in the future. Associations will form new groups and advocating for the rights of their members.

3. Project Area The CBRP project operates in Rangpur, Nilphamari, Thakurgaon and Panchagarh districts and DSCBRP operates in Dinajpur district (Sador, Fulbari, Parbattipur, Chirirbandor).

4. Focus of the Evaluation The TLMI guidelines outline the 10 aspects of evaluation, which should be covered in the evaluation. In particular, this evaluation should focus on: a) Assess the effectiveness, impact, and sustainability of CBR projects in terms of achievement according to the objectives stated in the project document and LFA. b) Assess the progress towards group and association’s sustainability and participation in the following contexts: • Groups: The development and capacity of the groups to be self‐governing and to continue without project inputs. • Associations: To assess the demonstrated governance, capacity (including financial capacity) and role of the associations. To give recommendations on future steps to ensure the good governance of the associations and their ability to support the groups in absence of project staff. c) summarize and outline recommendations for the future if anything is really important for long-term sustainability; d) consider pros and cons of registration with the cooperative department enabling the associations to undertake microfinance versus the implemented registration with social welfare and the entitlements that it gives access to; e) consider to what extent the project activities impact the acceptance of religious minorities such as Hindus or Christians amongst the population more broadly and give recommendations to what extent it would make sense to prioritize a stronger promotion of freedom of religions and belief;

5. Evaluation Methodology We expect that participatory and consultative methods will be followed at every step of the evaluation process, i.e. ensuring participation of relevant stakeholders in the process. As part of the methodology the following can be considered along with other methods: - Desk review e.g. project proposal and LFA, annual reports, quarterly reports, annual, participatory monitoring reports, project financial reports, annual review reports etc.; - Field visits and interview/group discussion with relevant stakeholders e.g. staffs, people with leprosy and disability, partners, GoB line authority, other NGOs working in the same field, etc.; - Evaluator will propose detailed methodology in the proposal;

Key Stakeholders include: 31


• • • • •

A sample of Project Participants (Target groups (around 7000 persons total) – people with leprosy, disability, excluded and discriminated groups), family members and communities; Self-help groups, sub‐district/district associations; Staff TB and Leprosy Coordination Committee (TLCC) members (if appropriate); GoB line authority, e.g. NELP, CDC, Civil Surgeon, UHFPO, PO, TLCA, Social welfare, union health centers etc.; Partners;

6. Key Documents for review The following documents will be provided to the evaluator: • TLMI End‐of‐Project Evaluation Guidelines • Project Proposal and LFA • Annual reports of present phase • Quarter reports • Annual Participatory Monitoring reports • Annual Review reports etc.

7. Qualifications of Evaluator/Evaluation Team We expect the evaluation team to consist of two members, preferably with two different areas of expertise (such as program, disability, people’s organization, VSLA etc.) The main evaluator should have 3‐5 years’ experience in village savings and loans associations (VSLA) programs. It would be a significant advantage if the evaluator is fluent in Bengali and English. The evaluators should submit 1 sample of a previous evaluation report with that project contact person address/number.

Application Guidelines TLMI Bangladesh invites proposal from renowned consulting agency/ individual consultants. Interested institutions/agency/individuals should clearly indicate their background experience and knowledge of subject area, demonstrate how they meet the required skills and experience, a statement of their availability. In addition, we ask consultants to send: - Short Technical proposal proposed including task, scope, methodology, plan of action etc. - Details Financial Proposal including person days, cost for each members, VAT and tax issues - CV of consultants - Organizational profile (in case of firm)

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TLMIB will not fund the preparation, submission or presentation of proposals in response to this TOR. The selection of the Consultancy firm/ individuals will be competitive based on the quality of the proposal, the profile of the proposed team, and cost. TLMB does not bind itself to accept the lowest bid submitted in response to this TOR. The deadline to submit proposal by close of business on 20th of July 2019. All submissions should be sent to the following address: surenS@tlmbangladesh.org and Kristine Kaaber Pors kkp@dmr.org by 20th July 2019.

8. Timeframe The evaluation will be undertaken and completed by August 2019. The evaluation will involve tentatively 12 working days for the evaluator, calculated as follows but: a) 1 day for preparation and review of documentations; b) 1 day for inception report c) 6 days for field implementation d) 2 days for data analysis, draft report writing and discussion e) 2 days for finalizing evaluation report Working day calculation is idea but evaluator can propose differently. Before going ahead, the evaluator must submit a timeline to TLMIB and DMCDD, allowing for at least 2 days for TLMIB and DMCDD to comment on inception report, and 3 days to comment on draft report, before the report is finalized.

9. Reporting The evaluator should provide a final evaluation report in English, 20‐25 pages long excluding annexes. The report should that consists of the following items: 1. Executive summary 2. Introduction and background to the evaluation 3. Methodology used 4. Context analysis that include findings, conclusions and assessment; 5. Lessons Learned. The evaluator is expected to consider on how good practice has been incorporated in the project. The evaluator is also encouraged to draw attention to examples of ‘better practice’ demonstrated by the project. 6. Specific Actionable and Prioritized recommendations as for future;

7. Annexes: • • • • • •

Terms of reference for the Evaluations Profile of the Evaluation Team Evaluation Schedule Documents consulted during the evaluation Persons participating in the evaluation Field data used during the evaluation, including baselines and focus group stories and data;

The draft report should be prepared within two weeks of evaluation completion, discussed and presented to DMCDD and TLMI Bangladesh for comments. The final draft will be ready within one week after the remarks and comments are received. Within 5 days after the 33


comments are made the final report will be received by the Country Director, Program Leader and Program Support Coordinator TLMIB.

10. Human Resources The evaluation team will consist of 2 evaluators. The evaluation team will report to the Community Program leader.

Annexure-5- Profiles of Evaluators Mr. Sylvester Halder (A). Education background: (i) Masters in Business Administration for Executives (EMBA); majoring in four different areas Human Resource Management; Marketing Management, Financial Management and Operation Management. In addition completed (ii) Masters in Education (M Ed) and obtained a (iii) Post Graduate Diploma in Business Administration (PGDBA). (B) Professional background: (01) Presently working as Organization Development and Management Consultant after departing from CCDB in 2019 and have worked for (i) Bangladesh Social Services, for developing Project Proposal for KNH- Germany; (ii) Baptist Aid- BCFB, for updating 3 existing Policies (Gender Development Policy, Child Protection Policy and Vulnerable Adult Protection Policy); (iii) Bangladesh Youth First Concern, for developing (a) New Organization Structure, (b) Developing Job Descriptions for senior and mid level staff members, (c) Roles and Responsibilities of different Program, Finance, Procurement and Administrative Management Teams, (d) Revising Human Resource Management Policy and (e) Administrative Management Policy; (iv) Bangladesh Association for Sustainable Development, for developing project proposal on Climate Change Resilience Building, Environment and Socio-Economic Development (CAFOD); (v) Lutheran Health Care- Bangladesh, facilitating Project Proposal Development for Lutheran Health Care USA and Evangelical Lutheran Church of USA-Global Ministries. (02) Worked in Christian Commission for Development in Bangladesh (CCDB) in three different senior leadership and management positions for 10+ years. (i) Head of Special Bilateral Projects, Human Resource Management and Development; (ii) Head of Programs (both multilateral and bilateral projects); (iii) Head of Human Resource Management and Development and Administration. Except Administration, the nature of work was similar to World Vision-Bangladesh and HEED Bangladesh. (03) Worked in HEED Bangladesh (Health, Education and Economic Development) as Associate Executive Director, responsible for Operations Department, for 4 years. (i) Providing leadership, management, administrative support to 9 Area Managers; (ii) Providing Leadership and Management support to Special Bi-Lateral Projects’ Directors, Program Managers, Project Managers; (iii) Management of Technical Staff Members (Doctors, Agriculturists, and Civil Engineers); (iv) Emergency Humanitarian Responses and Rehabilitations Program; (v) Preparing New Concepts and Project Proposals, to generate resources and negotiating resources and partnerships; (vi) Selecting New Staff Team Members, Developing Job Descriptions, Setting up Performance Evaluations Measurement Standards; (vii) Organizing Capacity Building Training-Workshops. (04) Worked as Organization Development and Management Consultant for two years. (i) Engender Health, earlier known as AVSC International; (ii) National Council of Churches in Bangladesh (NCCB)-Organization and Strategy Development ; (iii) Dhaka YMCA – Organization Strategy Development; (iv) Nazarene Mission– Training-Workshop on Organization Development through Staff Performance Management; (v) Lutheran Health Care–Bangladesh- Training-Workshop on Organization Development through Staff Performance Management. .

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(05) Worked as Associate Director, responsible for Operations in World Vision Bangladesh for 20 years. (i) Providing leadership, management, administrative support to 11 Area Managers; (ii)Leadership and Management support to Special Bi-Lateral Projects’ Directors, Program Managers, Project Managers; (iii) Management of Technical Staff Members (Doctors, Agriculturists, Fishery and Livestock Officers and Civil Engineers); (iv) Emergency Humanitarian Responses and Rehabilitations Program; (v) Preparing New Concepts and Project Proposals, to generate resources, negotiating resources and partnerships; (vi) Selecting New Staff Team Members, Developing Job Descriptions, Setting up Performance Evaluations Measurement Standards; (vii) Organizing Capacity Building Training-Workshops. (05) Worked as Program Secretary in Dhaka YMCA for 4 years, for local fund raising, supervising social service programs and organizing programs for YMCA members. (C)Professional Trainings: Attended several In-Country and External Training sessions, some are listed here: (i) Grassroots Level Development, (COADY International, St. Francis Xavier University, Canada), (ii) Grassroots Level Leadership Development (COADY International, St. Francis Xavier University, Canada); (iii) Management- Planning, Organizing, Leading, Controlling (Louis Allen Management Training Institute, Philippines), (iv) Four Fold Rural Development Management (International Institute for Rural Reconstruction, Philippines); (v) Disaster Management (Asian Institute of Technology, Thailand); (vi) Stress Management (Community and Family Life International-USA), (vi) Small Entrepreneurship Development (Asian Institute of Technology, Thailand); (vii) Principle Centered Leadership (World Vision International); (vii) Training of Trainers (World Vision International); (viii) Food Aid Management (World Vision International); (ix) Disaster Risk Reduction (Tear Fund- UK); (x) Development Communication (Asian Institute of Christian Communication, Thailand); (xi) Transformational Leadership (World Vision International); (xii) Total Quality Management (McGill University, Canada); (xiii) Contingency Planning (Tear Fund- UK and Transform Aid-Australia) From early stage of my professional career, while working in Dhaka YMCA, began working with “Self Help Groups”. This was introduced in World Vision Bangladesh and still continues as Community Based Organizations. In HEED Bangladesh and in Christian Commission for Development in Bangladesh (CCDB), this concept already was in operation, for empowering the poor, especially women. For present Evaluation- In HEED Bangladesh, was responsible for providing leadership, management and administrative support to Leprosy and Tuberculosis Control Program in Sylhet division (4 districts covering 36 Upazillas). Self Help Group was also organized with individuals’ healed, being treated and those identified to be infected by Leprosy, for socio-economic development and integration into their families and communities (a test case at Komolganj, Moulavibazar).

Subash Theophil Gomes, MDM (Masters in Development Management), MSSD (Masters of Science in Social Development) is in social development profession for around 28 years, and has worked extensively in the field of strategic & project management, design M&E system, manage financial and human resources, arrange training for diverse participants, conduct systematic study like baseline, mid-term, end project evaluation, impact assessment and others. Academic formation (two master degree studies from the Philippines with thesis) helped to have strong theoretical orientation and knowledge on development, management (strategic, project, operation, marketing, finance, human resources), organization development and psychology, gender and development, micro-finance, right-based approach to development, research and statistics, evaluation, impact assessment and experience of conducting different types of studies systematically employing qualitative and quantitative methods. 35


Mr. Gomes has experience of implementing projects that include micro-finance, formation of self-help groups, and formation and management of people’s organization; furthermore, he has conducted several studies on the issue/s related to present study including an assessment for an agency that work for the people with disabilities. For the last seven years, Mr. Gomes is in consultancy work (full-time), such as write research proposal, collect information, analyze data and write report, etc.; and within this time, he has conducted more than 23 studies independently like baseline, mid-term review, end project evaluation, i.e. study design, collect information, data analysis and report writing for various donor agencies like (i) Irish AID, (ii) Plan International Bangladesh, (iii) Concern Worldwide Bangladesh, (iv) Stromme Foundation, (v) Oxfam Novib, (vi) HASAB and BRAC, (vii) Save the Children Bangladesh, (viii) European Union, (ix) WaterAid Bangladesh, (x) HEKS/EPER Switzerland, (xi) BPKS, Bread for the World, Germany, (xii) International Organization for Migration, (xiii) Caritas Bangladesh, (xiv) NETZ Bangladesh as team leader, consultant and consultancy manager. For present evaluation: Mr. Gomes will be responsible for study design, secondary data analysis, prepare guide questions, carry out FGDs, KIIs, in-depth interview, observation, etc., contribute in writing the report, and finalize report after feedback is received from Leprosy Mission International in Bangladesh (TLMIB). As independent consultant, Mr. Gomes will be full time available for the study.

Annexure- 6- Log-frame Based Performance (CBRP) Log-frame: Community Based Rehabilitation Partners (CBRP), modified for Evaluation Purpose without any Changes in Contents for Comments/ Remarks/ Explanations Please Note: This document was filled while working with the Project Management Team Members, reviewing documents maintained, to assess how the logical frame work has been used for implementing, supervising, monitoring and evaluating the Phase-3. Yes indicates 100% achievement, some-what indicated less than the target set in the measurement parameters and comments has been added by the evaluators.

Objectives

Indicators

Verification

36

Yes

Some what

Remarks


Objectives Development objective: People in NW Bangladesh with disabilities (including people with leprosy) have access to their rights and full participation in social and economic life, and are represented by1. sustainable, independent, functioning organizations

Indicators

Verification

- Members of 750 Self-Help Groups are represented by functioning, independent organisations which continue to offer assistance with disability management and equal opportunities for group members.

Group Register & records, central Database, annual participatory monitoring

24 sub-district Associations are supporting 750 SelfHelp Groups and advocating regionally and nationally for the rights of people affected by disability.

Yes

Some what

751 Self Help Groups are functioning as independent organizations for social inclusions, entitlements, and income generations through their savings and seed money given for increasing capital and serving more members.

Yes

record of Project Manager, Record at Association office

Assumptions - We assume that in the future the government of Bangladesh will continue to welcome NGO’s.

24 Upazilla Associations have been organized for advocating the needs of 751 Self Help Groups at Upazilla level. 22 of these are registered and 2 Associations are in the process. Expected to be completed by this year.

Yes

- We assume that Bangladesh will remain a secular state. Objective 1: By December 2019, 750 self-help groups for persons affected by leprosy or disability in 4 districts of NW Bangladesh support their members in experiencing full participation in social and economic life, and have the capacity to support the running of 24 sub-

- 750 groups have graduated and are functioning without any assistance from project staff. - 60% of graduated groups experience access to their rights (CRPD & Disability Protection act 2013) - 90% graduated groups experience access to their entitlements. - 50 disabled persons

Record & report of Association office Record of Project Manager

Yes

Yes

Group record Database

Assumptions - We assume that no legislation will be introduced that would

37

Yes

Yes

Yes

Remarks

- 751 Self Help Groups are operating independently, however staff support, supervision, attending meetings, concerns and encouragements are an essential part to keep these groups functional. - Groups feel that they are a part of TLMI-B and Project staffs’ members’ relentless efforts. - 93% Groups knows about their rights


Objectives district associations.

Indicators are elected/selected to local committees (such as e.g. school committees) - 70 % group members express that their income has increased by 20 % - 90 % of groups pay their yearly fee to the associations

Verification

Yes

interrupt the projects use of seed capital;

Some what

Yes

- We assume the government will continue to provide disability ID cards and benefits to people with disabilities

Remarks - 95% groups had access to their entitlements from Upazillas, but not all members. - 274 disabled members selected/elected to local school, madrasha, mosque, market and burial ground committees. - 94% expressed increase in income. - 80% are able to pay membership fees to Upazilla Associations

Objective 2 By December 2019, 24 subdistrict associations representing and 750 SHGs in 4 districts of NW Bangladesh are able to provide organizational and management support to the groups, and have the capacity to voice the rights of disabled persons regionally and nationally.

- 24 sub-district associations have facilitated the formation of 100 new groups without any assistance from the project. - 80% sub-district associations have sufficient funds to support groups (at least BDT 15,000 a year)

Assumptions

- We assume that government registration of the Association will be allowed. - We assume that all staff will continue as planned through the final phase up to December 2019

- 90% sub-district associations have performed at least 70 % of their groups’ financial audit and profit distribution.

Yes

Yes

Yes

- 24 Upazilla (subdistrict) Associations have organized 105 Self Help Groups through their own initiatives. - Upazilla Associations generates income from SHGs’ Membership. This varies with number of SHG under each association. - 100% of the Upazilla Associations have reviewed - 75% groups financial reviews and profit distribution - District level Network with the list of high level government officials, as they were unable to get themselves registered for several requirements needed by District Social Welfare Departments.

- 90% District associations have successfully networked with Deputy Commissioner, Deputy Director

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Objectives

Indicators

Verification

Yes

Social Service and Civil Surgeon to achieved 5 benefits per year for the target group.

Yes

5. District associations have successfully advocated to National Leprosy Elimination Program (NLEP) and WHO chief for budget allocation for leprosy services and rehabilitation of people affected by Leprosy. - 50% of registered association have accessed funds from other sources

Objective 3: By December 2019, the mobility, health, and hygiene of 7500 group members and their households is improved and the results will be sustained by the groups and their communities

- 150 volunteer community disability workers (CDW) are supporting physical rehabilitation services in the communities without any project input. - 85% of group members with plantar anaesthesia (a leprosy related condition which can lead to ulcer) are free from ulcer.

Some what

Yes

Yes

Record & report of Association Yes Data base Record of project manager

Remarks - District Associations were unable to conduct advocacy with National Leprosy Elimination Program and WHO Chief for Budget allocation for Leprosy Care and rehabilitation programs.

- 100% of registered associations accessed funds from other sources.

- 261 volunteers were trained as “Community Disability Workers� to provide physiotherapy services to those needing such support

Assumptions We assume that all staff will continue as planned through the final phase up to December 2019

Yes

- 50% (baseline 15%) group member practice hand washing routinely.

Yes

- 95% group members have access to clean water (Baseline 93%) and 90% group member use sanitary latrine. (Baseline latrine 82%)

Yes

- 90% of Group Members with plantar anaesthesia are free from ulcer.

- 72 % of Group Members practice hand washing routinely.

- 99% members have access to clean water and use sanitary (ringslab) latrines.

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Report on Evaluation of CBRPP in NW Bangladesh and Dinajpur SCBRP  

Report on Evaluation of Community Based Rehabilitation Partners Project North West Bangladesh and Dinajpur Sustainable Community Based Rehab...

Report on Evaluation of CBRPP in NW Bangladesh and Dinajpur SCBRP  

Report on Evaluation of Community Based Rehabilitation Partners Project North West Bangladesh and Dinajpur Sustainable Community Based Rehab...

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