Early childhood development strategy for the world's children with disabilities.

Early childhood is foundational for optimal and inclusive lifelong learning, health and well-being. Young children with disabilities face substantial risks of sub-optimal early childhood development (ECD), requiring targeted support to ensure equitable access to lifelong learning opportunities, especially in low- and middle-income countries. Although the Sustainable Development Goals, 2015-2030 (SDGs) emphasise inclusive education for children under 5 years with disabilities, there is no global strategy for achieving this goal since the launch of the SDGs. This paper explores a global ECD framework for children with disabilities based on a review of national ECD programmes from different world regions and relevant global ECD reports published since 2015. Available evidence suggests that any ECD strategy for young children with disabilities should consists of a twin-track approach, strong legislative support, guidelines for early intervention, family involvement, designated coordinating agencies, performance indicators, workforce recruitment and training, as well as explicit funding mechanisms and monitoring systems. This approach reinforces parental rights and liberty to choose appropriate support pathway for their children. We conclude that without a global disability-focussed ECD strategy that incorporates these key features under a dedicated global leadership, the SDGs vision and commitment for the world's children with disabilities are unlikely to be realised.

Assessing the Impact of the Twin Track Socio-Economic Intervention on Reducing Leprosy-Related Stigma in Cirebon District, Indonesia.

The consequences of leprosy go beyond the physical, social and psychological, as leprosy can drive persons affected and their families into poverty, stigmatization and disability. This paper describes the impact of a socio-economic development (SED) intervention that uses a twin-track approach (two micro-credit models) to reduce leprosy-related stigma in Cirebon District, Indonesia. A randomized-controlled mixed-methods study design was used to test the effectiveness of the SED intervention. Three scales were used to measure stigma and participation restrictions among 30 SED clients and 57 controls, 20 in-depth interviews with SED clients and seven Focus Group Discussions (FGDs) with key persons were held and 65 profiles of the clients were written up and analysed. The qualitative data shows the socio-economic status of 44 out of 65 SED clients (67%) improved. The median family income increased by 25%, more clients reported higher self-esteem, better interaction with neighbours and less stigma than before, although disclosure concerns remained an issue. The scales indicate a positive effect of the intervention on reducing stigma (e.g., Stigma Assessment and Reduction of Impact (SARI) stigma scale mean difference total score of pre and post assessment for SED clients versus the control group was 8.5 versus 5.6). A twin track socio-economic intervention, if embedded and integrated, can increase participation, and be constructive in reducing leprosy-related stigma.

The Concept of Community-based Inclusive Development (CBID) and its Application for Human Resource Development of Inclusive Society and Education of SDH / 医学教育

The multicultural coexistence with increasing number of foreigners has been promoted in Japan. In this paper, the authors introduce the concept of community-based inclusive development (CBID) and CBR Matrix as an useful tool to understand not only the situation of foreigners but low income families and social withdrawals, to visualize community resources, and to learn Social Determination of Health (SDH) which is one of the curriculum of medical education. The paper contains explanation of SDH which is included in the core model curriculum of medical education, historical background of CBID and CBR Matrix. It also includes practices in the community and educational practicum at the medical school which both are engaged by authors respectively.

Role of the Overseas Social Worker in Community-Based Rehabilitation in Sri Lanka —JICA Volunteers’ Practice in a Rural Area— / 国際保健医療

  This case study examines the role of the overseas social worker in the National Programme on Community Based Rehabilitation for Persons with Disabilities in Sri Lanka.<BR>  We used document data from the official reports written by overseas social workers (n=3), and complementary data from the author’s field notes and previous research, whilst collecting official documents related to the CBR core group officers, amongst others. Data were chronologically and descriptively summarised in line with the role of the overseas social worker as well as CBR core group officers. The roles of the overseas social workers were classified into four categories as follows: (1) to assess and evaluate in the community; (2) to introduce new practice and promote model practice; (3) to enhance existing local resources; and (4) to coordinate multi-professionals. <BR>  Finally, we discuss implications of these findings from the viewpoint of community-based inclusive development, twin-track approach, social model and human rights model, which show a basic framework of their role at the grass-roots level. The results also indicate the importance of a perspective of community’s ownership and professional’s indirect support.