ICEVI, Country Representative, Nepal 3 Es / Preschool to Children with Visual Impairment (CVI), an Attempt in Nepal 22 August, 2016 Madhav Prasad Aryal ICEVI, Country Representative, Nepal

Introduction 3Es : Inter related for development of children. Enrolment campaign plays a significant role in enrolling 4-5 years of age children >98% enrolment at primary schools in 2013 (WB) is directly related to ECDCs / Pre primaries run by N/GOs in Nepal.

Introduction cont… Achievement is dependent on the ECDCs enrolment campaign started in 2005 Education of CVI was introduced in 1964 NDBA working for all types of disabilities was established in 1969 A Special School was established in 1977

Introduction cont… In 1982 – enrolment was 84 CVI. NAWB/SEC, supported 12 Integrated Schools in Nepal from1986 to1990 DoE started Resource Class in Schools from 1990/091 and reached to 81 , where 9, 425 children were enroled till 2014 .

Problem statement Found no practice of 3 Es /Preschool for CVI and CwDs. 3 Es was endorsed in line with the Dakar Framework of Action for EFA (2001-2015). No enrolment system for CVI /CwDs at more than 34, 000 ECDCs/Pre primaries.

EFA VI Campaign the Ice Breaker 3 years ago BPEF started pre-ECDC Emphasis of ICEVI/EFA VI Campaign 2006 on 3 Es can be taken as Ice Breaker. EFA VI Campaign 2009-2011 in Nepal supported by GTF and follow up from 2012 onward has initiated 3 Es.

3 Es Model and BPEF initiative ICEVI, works with Eye Hlth Org., SHOs and MoE/DoE BPEF, a member of NTF started 3 Es model class at CHEERS since 2013 CHEERS involves eye, Physio Units and trainers to impart practical life skills and Braille literacy including Parents training

3 Es Model and BPEF initiative ICEVI Nepal and RTs supervise training. Performance evaluation is done at three to six months of training and graduates are sent to ECDCs/ Pre-Primary classes. CHEERS steering committee (DOE, LDO, RPs and ICEVI Nepal) meets four monthly to guide Pre ECDC.

3 Es Model and BPEF initiative BPEF model is inclusive and right based as CVI are enrolled in government schools It is sustainable with practical approach for L&DCs

3 Es Model and BPEF initiative Nepal needs support in developing such training centres for a few years more This model is in line with meeting a theme of EFA VI children beyond 2015: Inclusion with Sustainability.

Working procedure 1. Identify children for early intervention: Different approaches are taken to identify CVI aged 3-8 years. Networking is done with concerned stake holders (eye health service providers, District level government offices, CBR workers and parents.)

Working procedure contd… Local Medias are mobilized to raise awareness among parents to bring CVI. CHEERS organizes health Camps to Screen the children.

Working procedure contd… 2. Arrival of children Identified CVI from different regions of Nepal arrive at CHEERS with their parents/guardians and RTs.

Working procedure contd… 3. Comprehensive health examination CHEERS does health examination of children and those not improving through treatment are referred to pre ECDC services. Trained staffs assess the eligibility of children in the presence of parents.

Working procedure contd… 4. Training of CVI at enabling centre: IP is made in consultation with experts and parents. Children are trained in life skills, socio cultural activities, O&M, and Braille literacy.

Working procedure contd… 4. Training contd… Training period ranges from 3 to 6 months as per individual capacities. Services are preferably provided on day care basis and dormitory for remote districts.

Working procedure contd… 5. Refer to ECDC/ Resource Class: Graduates are referred to ECDCs/Pre-Primaries run by government. BPEF provides initial logistic support to children.

Working procedure contd… 5. Refer contd… Government provides scholarship to complete school education. CHEERS have received 62 CVI of which 39 of them graduated and enrolled at ECDCs/pre-primary schools in 14 districts.

Recommendation Eye hospital can be utilized for clinical assessment where MoH / MoE can come together to finalize the reference model. RTs/Facilitators can be sent for short training on vision screening and childhood blindness; and CHEERS can provide training on rehabilitation.

Recommendation contd… The working model of BPEF/CHEERS coordinated by EFA VI campaign/NTF can be replicated in other eye hospitals

Suggestions To accomplish BPEF model, ICEVI, WBU authorities, and concern partners should consider: Organizations and educational institutions come forward for opening the door at ECDCs/ pre primary schools.

Suggestions cont……. Role of paediatricians, eye health staff, physiotherapists, special educators and stake holders are important for providing training to facilitators. Ccoordination committee within concerned ministries at central, district and VDC level should be formed to facilitate ECDCs .

Suggestions cont……. UN agencies, I/NGOs should encourage MoE to enrol the CVI and other CwDs in ECDCs with barrier free environment.

Conclusion ECDC model of BPEF can be an example of inclusion and sustainable in nature . CVI in Nepal are accepted by government schools if facilities are provided. School aged CVI as estimated by MoHP, GoN in 2011 is 30,240 and the enrolled CVI in all schools was 9,425 in 2013.

Conclusion cont….. ICEVI, WBU and other I/NGO's should take it as a challenge and work coordinately with BPEF to open the door to all ECDCs/ pre primary schools Like-minded organizations and professionals should work together to bridge gap

Conclusion cont….. The BPEF model can be replicated in other L&DCs to meet the objective of inclusion and sustainability beyond 2015

Thank you for your attention