Inclusive Development

MCNV’s attempts to tackle problems faced by ethnic minority adolescent girls

On June 30th 2017, at Khe Sanh town, Huong Hoa district, Quang Tri province, MCNV collaborated with the Sexual and Reproductive Health (SRH) Centre of Quang Tri province to organise a workshop to consult relevant stakeholders about the situation and solutions to health, education and social inclusion issues related to ethnic minority adolescent girls at Huong Hoa district.

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Learning about the use of Innovative Communication Methods (LICM)

Background

Disadvantaged and discriminated groups of people such as handicapped people, older people, HIV/AIDS infected people or people with a different sexual orientation are often shy, tend to stigmatise themselves, and often struggle with feelings of shame and self-doubt.

MCNV’s response

To assist disadvantaged groups in overcoming their shyness and to encourage them to engage in dialogues with a wider public, MCNV has experimented a lot with the use of Innovative Communication Methods (ICM). MCNV uses the term ‘Innovative Communication Methods’ to denounce creative and entertaining styles of communication such as community-based theatre, shadow drama, narrative story-telling, body mapping, songs, dance and participatory video.

The experience was so successful that MCNV decided to expand the application of the ICM approach to other areas of work including awareness raising on health issues and policy advocacy in areas like garbage collection and Sexual and  Reproductive Health and Rights. The ICMs that MCNV supported to use in Vietnam included theatre based approach, puppet plays, participatory video, dance and folk singing.

 

Achievements

The use of arts (drama and songs) improved the social status of both the Village Health Worker Association (VHWA) and Community Based Organisation (CBO) they cooperated with.  Besides that, the Village Health Worker Association (VHWA) and Community Based Organisation (CBO) members became more confident of themselves through the use of arts and became less afraid of speaking out in public meetings. In 2015, Disabled People Organisations (DPOs) and Old People’s Organisations (OPAs) in ethnic minority areas of Quang Tri province managed to collect Eur 30,000 from their communities through campaigns and public meetings where they performed drama and songs, and they use this money to sustain their community development activities. LICM demonstrated its positive contributions to advocacy as well. For example, in 2014, the Old People’s Organisations (DPO) in Quang Tri successfully lobbied for an increase of the budget of the district allocated to old people’s health by organising lobby events during which they performed drama.

Future plan

Recently, MCNV obtained funding of OXFAM-NOVIB and HIVOS to experiment with the use of ICM in Laos as well. MCNV will assist three vulnerable youth groups i.e. handicapped youth, LGBTQI youth and girls working in garment factories in Laos in using ICM for their own empowerment and for advocacy. The project allows MCNV to enlarge her experience in this field and promote the method further.

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Support women living with and affected by HIV

Background

HIV/AIDS epidemic has become the most emerging public health problems in Vietnam since 1990s. By the end of year 2015 there was a total of 227,000 people living with HIV while more than 75,000 people have died from AIDS. In estimation about 14,000 new cases of HIV are founded every year.

During 12 years working in HIV/AIDS area, MCNV had a considerable contribution to Vietnam HIV/AIDS situation in establishing and providing support to a community – based organization of women who are living with HIV, called Sunflowers, in seven Northern provinces in Vietnam. The program has contributed to improving access to health care for women living with HIV because of the strengthened referral system.

MCNV’s responses and achievements

Beginning in 2004, a group of women living with HIV was established by MCNV’s support. The simple aims were to ensure that, if pregnant, women can access to information and medicine that would help to prevent the transmission of HIV from mother to child. This initial pilot was successful in achieving its goals, and with the generous support of the Royal Netherland Embassy, it was scaled-up to a further three provinces between 2006 – 2009. In its third phase these achievements were consolidated and the model adapted to suit the needs of people living in remote mountainous regions. Then the program covers seven provinces and the Sunflowers group supports over 1,500 women living with or affected by HIV/AIDS and their families.

The Sunflowers groups help to ensure that they can overcome the barriers and obstacles they face to live active and fulfilled lives. This support comes in many forms, it includes: counselling and care at home and in hospitals, support to secure stable livelihoods, assistance with children’s education, and engagement with the community to reduce stigma and discrimination. Over more than 12 years the program has demonstrated that when women living with HIV work together their confidence and self-esteem increases enabling them to become powerful advocates for change and developments.

From 2012, after handing over, the network of Sunflowers had worked more independence with its own steering board of national level, and leaders of each provincial group. The Sunflowers are maintaining supports in improving health care access, income generating, and social by monthly meeting, revolving fund, and many supportive events. From this period, overcoming difficulties, Sunflower maintains its groups and networks with many valuable activities. More than 1,100 women living with HIV frequent attend the monthly meeting. Living with poor health status, many leaders of Sunflowers cannot be able to have a longer contribute to their group. Sunflower have refreshed themselves by changing most of group leaders and Network leaders and its structure.

In addition, MCNV provides health care insurance to Sunflower members, therefore, 100% of women living with HIV are protected by health insurance. The program also organizes vivid trainings to cultivate skills and knowledge to Sunflowers and their family members. Specifically, parenting skills were provided to grandparents who are raising orphan children. The training, such as hepatitis C prevention, ARV therapy, pig raising skills have been delivered to members of the Sunflower groups.

Future plan

Currently and in a couple of year MCNV is providing technical and a little financial supports, which is enabling the Sunflowers to be strengthened, and capable to work more independently as a Community Based Organization of women living with HIV, to bring support to women living with HIV continuously.

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Civil Society Development

Background

Civil Society embraces the general public at large, representing the social domain that is not part of the State or the market. Civil Society is a sphere where people combine their collective interests to engage in activities with public consequence. The increasingly accepted understanding of the term Civil Society Organisations (CSOs) is that of non-state, not for-profit, voluntary organizations formed by people within the social sphere of civil society. These organisations draw from community, neighbourhood, work, social and other connections.

The Disabled People’s Organisation (DPO) encouraged disabled people to share their dreams, to develop personal plans, and to help them to make those dreams and plans come true. As an organisation we grew our capabilities to support the holistic development of individuals, families and groups of people with disabilities (written by a disabled person from a village in Quang Tri Province during a reflection session in 2015).

MCNV’s response

MCNV has increasingly strengthened and cooperated with CSOs over the years. CSOs have become an increasingly common channel through which we assist elderly, women with HIV/AIDS, ethnic minorities, youth and People with a Disability (PWD) to exercise citizenship and contribute to social and economic change. The involvement of Community Based Organisations that are organised by the marginalised people themselves, ensures their full participation in our programs.

Besides working with a myriad of Community Based Organisations in Lao PDR and Vietnam, MCNV also collaborates with civil society organisations at provincial and national level. For example, MCNV has established and cooperates with provincial ‘Village Health Workers Associations’(VWHAs).

In the health system we are so close to villagers that people call us the “long arm” of the health sector. Our Village Health Workers Association was founded in 2006, and now has 1,115 members based in 138 communes in nine districts and towns of the province. On basis of our experiences in Quang Tri, two other Village Health Workers’ Associations have been established in Cao Bang and Phu Yen provinces, in 2010 and 2011. We for example support the Disabled People’s Organisations (DPO) and Old People’s Organisations (OPA) in fundraising activities. We also assist the Community Based Organisations to prepare dramas or to make video clips to lobby and advocate for better health practices and policies (Interview with Board Member of Village health Workers Association, 2015).

Achievements

To date, MCNV has strengthened and collaborated with over a hundred CSOs and CS movements in Lao PDR and Vietnam. In addition to that, MCNV has provided Technical Advice to Civil Society Partners in Sri Lanka, Tajikistan and Georgia, on the strengthening of Civil Society Organisations in their country.

Through CBOs and their clubs, peer-to peer support is channelled and improvements in policy implementation and policy development are lobbied for. For example, Old People’s Organisations in Quang Tri successfully lobbied for an increase of the district budget for health of the elderly.

Due to the flexible characteristics of CSO organisations and due to their profound local knowledge on the culture and values of communities in remote areas of Lao PDR and Vietnam, they are in an excellent position to collaborate with other societal groups in experimenting new approaches in health and sustainable livelihood. For example in Lao PDR, the CBOs at village level named ‘Village Development Committees’ (VDC) have been partners of the district department of agriculture in experimenting new rice varieties, cattle raising and fish ponds.

Trust relationships between villagers and district partners has improved. The VDCs are able to articulate the needs of the ethnic minority groups in the villages and this has led to more communication and achievements of program interventions in the villages. (Interview with consultant evaluating the program in Lao PDR, 2014).

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Support to people with disability

Background

Approximately 7.8% of Vietnamese people are living with a disability (PWD) and about 75% of them are living in rural areas. Vietnam has ratified the UN Convention on the Right of People with Disabilities (CRPD). Accordingly, the Government commits to protect the rights of PWD based on the principles of equal opportunity and inclusive development in a barrier – free society. To realize these rights, the Vietnam National Assembly has approved the Law on Disability. Based on this, the Government has in the last 10 years developed and brought into operation many policies to support the PWD, focusing on health care, education, social security and vocational training.

Problem

However, many PWD are still excluded from different aspects of complete life. About 35 % of disabled children at primary schooling age have never gone to school while this applies to only 3 % among those without disability. Still about 42% of the PWD who can and want to work could not find a job; in comparison to 4% among those without disability. PWD are faced with many challenges in socio-economic development and in their daily life when they could not access transportation vehicles or public buildings; could not participate fully in social activities due to limited access to information and communication; could not benefit from developments as they were not heard and not counted sometime and somewhere. This situation is caused by the limited capacity of public service providers in policy implementation and the weak capacity of PWD in demanding and raising their voices while stigma and discrimination against disability still exists.

MCNV’s response to the problem

MCNV has invested a lot of resources over a long time to implement activities that support the inclusion of PWD in Vietnam. The Disablity program started with Community Based Rehabilitation (CBR) as a part of Community Managed Health Development (CMHD) program in Quang Tri in the 1990s. Then it was expanded to Dak Lak (1998), Cao Bang (2001), Phu Yen (2002), Khanh Hoa (2005), and Dien Bien (2014). Today MCNV’s Disability Program consists of 4 main components:

  • Medical Rehabilitation
  • Inclusive Education
  • Income Generating Activities
  • Empowerment for PWD and Disabled People Organizations

In the implementation of the Disability Program MCNV collaborates with Governmental partners from the national to the commune level based on the existing structure of the public service system. MCNV also always involves the PWD and their families in the process. The program focuses on creating new services that are suitable to the local context of culture and resources to ensure sustainable changes in the quality of life of PWD. Much attention is given to the building of capacity for all stakeholders, including the PWD themselves, from the individual to institutional level. All support for PWD are based on their real needs and distributed with their full participation.

Achievements so far

More than 20,000 adults and children with disabilities and their families have benefited from different types of medical, educational and economical rehabilitation and social support. About 60% of PWD improved their independent functioning in daily life as a result of home based rehabilitation and referral services. 70% of poor PWD have escaped from poverty thanks to MCNV’s financial and technical support to their Income Generating Activities. 88% of CWD at school age now have access to appropriate education in the project areas. In total 47 Disabled People’s Organizations (DPO) were supported to amplify the voices of PWD in communication and dialogue on policies and services in their communities. These DPO play a fundamental role to facilitate the participation of 55% members of DPO in social and sport activities on the local and national level. The CBR model initiated by MCNV was successfully documented and integrated into the rehabilitation policy by the Ministry of Health and replicated in other provinces.

Future plan

MCNV will apply the lessons learned in supporting PWD in new areas including the Northeast and the Mekong Delta. The program will focus on facilitating cooperation among stakeholders to ensure disability issues are integrated in the mainstream of society’s development. Specific projects will be designed for PWD and their organisations to improve their capacity in lobby and advocacy for the rights of PWD. MCNV also will strengthen its cooperation with Ministries and Institutions in development of disability – related human resources as well as in seeking evidence of cost – effectiveness that can be used for policies and decision making.

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Women empowerment

Background

Women empowerment refers to the multi-dimensional development that supports and enable women to take control over their lives and control their future. MCNV focuses on the most disadvantaged groups; the poor rural women under the negative influence of climate change, isolated women in mountainous and remote areas, and women living with disability or HIV/AIDS. Among all projects MCNV supported in Vietnam, women empowerment became a cross-cutting theme to guide our work with particular attention to gender issues and women’s development specifically. In Ben Tre province, MCNV implements a specialized Women Empowerment program which focuses on comprehensive support on women, from economical inclusion through microfinance to improving the political participation by women through elections.

MCNV’s responses

Having a cow is a big asset for poor women. The cow helped her to gain more self-confidence and respect from others

Through microfinance projects, MCNV has made inclusive financial services available and accessible to more than 10 thousands women in Vietnam and contributed to positive changes in their lives. Women who live in rural and remote areas bear a double burden, taking care of their family and children while simultaniously generating an income with normal labor. Household burdens limit women when it comes to finding a wage job, this is due to the job locations being in the city, far from their homes and family duties. So self-employment opportunities created by household micro-entrepreneurs allow poor rural women to earn their own livings and at the same time, being able to complete their housework. The Women Empowerment microfinance project in Ben Tre has provided a wide range of inclusive financial services including credit, saving, health insurance, loans for production groups, loans for building water containers (for drought and salinity preparedness), together with financial literary and training for poor women. These services have helped more than one thousand impoverished women better the quality of their lives and increased their income and social status.

Achivements

Monthly credit group meetings is a good opportunity to learn and share among poor women

Monthly credit group meetings is a good opportunity to learn and share among poor women

Through the microfinance and livelihood development activities, women have more changes and solidarity to perform and contribute better in community work. Regular (monthly) meetings enable them to voice their matters; exchange life experience and production knowledge; and learn from each other. That self-learning process was created and maintained by MCNV projects and has become a sustainable mechanism to empower women. Through the years, many at MCNV have witnessed several examples of life improvements. Poor women became more self-confident and more skillful in production and doing business. The neighborhood and relationships were very much improved which enabled women and also men to care about and help each other.

Ben Tre women who joined MCNV capacity training for People Committee election's candidates

Ben Tre women who joined MCNV capacity training for People Committee election’s candidates

A great step forward for women empowerment is the improvement for their political participation. More female delegations in the local government could ensure the rights and voices of women to be heard and respected. Ben Tre province is the first province in Vietnam to have a project intended to improve the successful rate for women in People Council’s election. Online survey tools were also used to collection ideas and data from the field. The successful rate for women in 2016 election had increased to 28% of total People Council comparing to 22% in the last election in 2011.

Future direction

Enhancing the ongoing women empowerment efforts and sharing our experience widely to other provinces in Vietnam as well as to other countries is the target. We are now cooperating with the Center of Women and Development to start a media development project which could film the best practices and methods in this field and share the experiences widely throughout social network to advocate for women’s development.

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