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ANNUAL REPORT

Beyond De-institutionalization The Unsteady Transition towards an Enabling System in South East Europe

	This report is based on Handicap International’s 12 years of experience in South East Europe supporting people with disabilities and their representative organisations, service providers, policy-makers and local stakeholders in their effort to improve the situation of people with disabilities. It describes the innovative initiatives being undertaken on the grass-roots level to make positive changes in the lives of people with disabilities. The report mainly documents initiatives for services and reform measures that are needed to ensure equal opportunities and the full participation of people with disabilities.

Table of contents FOREWORD Acronyms and Abbreviations INTRODUCTION AND OVERVIEW GLOSSARY PART I - SHIFTING THE DISABILITY PARADIGM TOWARDS FULL PARTICIPATION 1. Evolution of approaches to disability towards rights and participation 1.1 Towards a holistic approach to disability 1.2 International legal instruments 2. Beyond de-institutionalisation, the necessary development of an enabling system 2.1 Institutionalisation of disability: a medical-based and overprotective care system leading to social exclusion 2.2 De-institutionalisation: the necessary development of community-based services 2.3 Shifting the disability paradigm in order to move towards an enabling society PART II - THE UNSTEADY DEVELOPMENT OF COMMUNITY-BASED SERVICES IN SOUTH EAST EUROPE 1. De-institutionalisation in South East Europe 1.1 Assessment of community-based services in South East Europe 1.2 International standards and recommendations as references for analysis 2. Medical care: the need to ensure an equal access to Primary Health Care 3. (Re)habilitation: from specialised hospital care to comprehensive community-based services 4. Support services: towards increased level of independence for people with disabilities by providing better access 5. Education: from segregation to inclusion 6. Vocational guidance and employment: from sheltered workshops to mainstream employment 7. Moving away from residential institutions: development of Community Residential Care and alternative housing PART III - ACHIEVING THE CHANGE: KEY STEPS AND SHARED RESPONSIBILITIES 1. The various stakeholders in the transition 1.1 The state 1.2 Local civil society 1.3 The international community 2. Changing perceptions of disability 2.1 Raising awareness on disability 2.2 Information and research on disability issues 2.3 Training of professionals working in services that concern persons with disabilities 3. Comprehensive and anti-discrimination legislation 3.1 Initiatives for change 3.2 Looking ahead 4. Redirecting resources 4.1 Gate-keeping 4.2 The need for quality standards, licensing and accreditation 4.3 The need for disability pension reform 5. Moving forward: the need for a National Disability Strategy and National Council on Disability 5.1 Key step: developing and implementing a National Disability Strategy and establishing a National Council on Disability 5.2 Initiatives for change 5.3 Looking ahead CONCLUSION LEGISLATIVE OVERVIEW DIRECTORY of good practices presented in the report BIBLIOGRAPHY LEGISLATION INTERNATIONAL INSTRUMENTS ANNEX 1 - UN Standard Rules for the Equalization of Opportunities for People with Disabilities ANNEX 2 - Agenda 22 download the report in English .pdf (2MB)