Sichuan Community Based Rehabilitation Project for Children with Cerebral Palsy: Mid-Term Evaluation

Background:
The Sichuan Community Based Rehabilitation Project for Children with Cerebral Palsy is a five-year joint project with NMA and the DPF of Sichuan, China. Following a preliminary inquiry in spring 2003, it was decided that NMA and China DPF would jointly apply for support to an urban rehabilitation project in Sichuan Province. Xincon AS. of Kunming, Yunnan China, manages the project since NMA does not have a representative office in China. This project is designed to improve the access of children with Cerebral Palsy to rehabilitation and education using a community rehabilitation/education format. The project selected two locations in Sichuan – Chengdu and Panzhihua. The PDF in these two cities have former experience with rehabilitation of children with CP and had done throughout preparatory work that showed that there is a great need for a program that can address the needs of these children and their parents.

The project is focusing on:
- Meeting a service need for children with physical and mental disabilities.
- Supporting and focusing on the equal rights of all people by focusing on the rights of children with disabilities. That they are member of society, they also have a right to get an education and they should not be discriminated against.
- Providing more timely and comprehensive information regarding the condition of CP to the parents and families of children with CP.
- Providing opportunities for parents to network together to allow them to support each other.
- Developing improved competence in rehabilitation personnel to address the needs of these children with CP.

Purpose/objective:
Along with the mid-term evaluation for the spring 2006, a broader project evaluation was desired by the local and Norwegian counterparts. The purpose for the evaluation was to gather information on the status of the project, information that could be used to adjust the project so that both short term and long term objectives would be achieved. The goal was therefore to identify the strengths and weaknesses of the project, and to give clear recommendations for improvements of the projects plans related to implementation, organization and structure. More specific objectives were articulated, relating to areas of: relevance, project design, process and management, accomplishments, efficiency and sustainability.

Methodology:
The evaluation was carried out through; discussion and presentations by DPF at all levels; visits to the rehabilitation centres and stations; interviews with family members and rehabilitation staff; observation, questions and answer interaction with the rehabilitation staff as they worked with children with CP; visits to the resource partner sites; and random chart reviews and paper work evaluations.

Key findings:
- The project is a good start at meeting the needs of children with cerebral palsy (CP) in Sichuan.
- The project has started the training of the rehabilitation personnel, but has lacked a clear structure and plan for the rehabilitation training that has resulted in needs for more specific training in a variety of rehabilitation skills.
- There is a lack of rehabilitation evaluations by the rehabilitation staff. The evaluations are done in hospitals and done from a medical model point of view as compared to a community rehabilitation point of view.
- There has been the development of some liaisons between the DPF and local schools such that approximately 35 children are receiving some education.
- The ability of the rehabilitation personnel to address the educational needs of the children with CP needs further development.
- The development of cognitive training is stronger in Chengdu, possible due to a stronger information connection with the Holy Love School located in Chengdu.
- Some of the staff are affiliated with the community health centres and have divided loyalties between the project and the Health Department that hired them.
- Nearly all of the personnel in Panzhihua were part-time employees with the project and part-time with the Health Department. This did not allow them to focus on the development of the rehabilitation skills needed to guide the children and parents in community rehabilitation.
- Awareness of CP media campaigns have been used and have impacted on the awareness of the local community citizens.
- The parent handbooks look relatively detailed, but may be too complex for most parents to fully be comfortable with. Therefore, many parents have not really utilized the parent handbook well.

Recommendations:
- Increase expert support for rehabilitation.
- Continue to develop a systematic training approach that will strengthen the rehabilitation personnel’s skills in fundamental and key areas.
- Develop and train in the use of a community based rehabilitation evaluation process.
- Target key personnel for further training to allow them to become stronger in the rehabilitation skills necessary. Allow these personnel to be more involved in supporting the other rehabilitation personnel.
- Encourage some personnel to become specialized in physical therapy/occupational therapy, speech therapy, or special education.
- Continue to develop the relationship between Holy Love and the project.
- With Holy Love, develop a training plan for the development of educational specialists over the next 2.5 years.

Comments from the organisation, if any: