The World Bank Qualitative Survey on Disability and Living Standards in Georgia Report 2007 The World Bank Qualitative Survey on Disability and Living Standards in Georgia Report 2007 © PA Knowledge Limited 2006 PA Consulting Group 4601 N. Fairfax Drive Prepared by: PA Consulting Suite 600 Arlington, VA 22203 Tel: +1-571-227-9000 Prepared for: Fax: +1-571-227-9001 www.paconsulting.com Final Draft Analysis Report 4/26/07 Institute for Policy Studies (IPS) Institute for Policy Studies 10, Chavchavadze av. VI ent. Tbilisi, Georgia World Bank Tel/Fax:899532-220060 Disability and www.ips.ge Development Team Final Draft Analysis Report 4/26/07 Disclaimer This paper has not undergone the review accorded to official World Bank publications. The findings, interpretations, and conclusions expressed herein are those of the author(s) and do not necessarily reflect the views of the International Bank for Reconstruction and Development / The World Bank and its affiliated organizations, or those of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. i Final Draft Analysis Report 4/26/07 … Foreward Report has been prepared by PA_Consulting and The Institute for Policy Studies (IPS). The analysis was done by Tatyana Yamova and Nana Sumbadze, field work was carried out by Nana Sumbadze, Giorgi Cheishvili, Tamar Makharadze, Ekaterine Pirtskalava and Tiko Nozadze. The meetings were organized and working group was consulted by Manon Khachidze. Report reflects the situation with disability in Georgia as for September, 2006. Since then a number of important changes has occurred, The procedure of acquiring disability status has been changed-According to the order 63/n (27.02.2007) of ministry of Labor, Health and Social Protection instead of abolished medico-social bureaus status is granted by medical facility of general or specialized character, the list of nozologies entitled for getting inability status has been shortened; According to the Government Resolution of January, 4 2007 subsidizes to persons, and among them also to those with disabilities, who had benefits on communal payments increased; According to Georgian Law on Social Assistance (4289-RS, 29.12.2006) reintegration subsidies are provided to those biological families, who decide to take back the disabled child from specialized institution. According to the same law the care is compensated to the families who take back an adult disabled person; Disabled person can be provided by in-kind subsidy; The order of the Minister of Labor, Health and Social Protection has been prepared on forming at the Ministry of Coordination Committee on Disability Issues. 10 representatives of NGOs will sit in the committee. Working group would like to express its deep gratitude to all the participants of the study for sincerity and cooperation. Participation in discussion required serious effort for many. The names of all the respondents and focus group participants except representatives of official structures and experts are changed. Report reflects the attitudes, perceptions, thoughts and hopes of persons with disability, their caregivers and other key stakeholders. We hope that it will have an impact on the formulation of disability policy and will contribute to the integration of disabled and improvement of the quality of their lives. ii Final Draft Analysis Report 4/26/07 List of Abbreviations… List of Abbreviations GEL Georgian Lari ICF International Classification of Functioning, Disability and Health NGO Non-Government Organization MoES Ministry of Education and Science MoHLSP Ministry of Health, Labor and Social Protection SU Soviet Union SUSIFIG State United Social Insurance Fund of Georgia US United States of America USAID United States Agency for International Development WHO World Health Organization iii Final Draft Analysis Report 4/26/07 TABLE OF CONTENTS… TABLE OF CONTENTS 1. INTRODUCTION ..........................................................................................................1-1 1.1 Brief Overview of Disability Statistics in Georgia.................................................1-1 1.2 Research Methodology...........................................................................................1-3 2. RESEARCH FINDINGS................................................................................................2-1 2.1 Key stakeholders ....................................................................................................2-1 2.1.1 Disabled Persons...............................................................................................2-1 2.1.2 Caretakers .........................................................................................................2-1 2.1.3 Organizations of Disabled People and Care Providers.......................................2-2 2.1.4 Government Entities...........................................................................................2-4 2.1.5 Educational and Health Care Facilities...............................................................2-5 2.1.6 Service Providers...............................................................................................2-5 2.1.7 Donors ...............................................................................................................2-6 2.1.8 Church ...............................................................................................................2-7 2.2 State Policy and Social Assistance .......................................................................2-7 2.2.1 Overview of the Georgian Legislation on Disability.............................................2-7 2.2.2 Social Assistance.............................................................................................2-10 2.3 Health care.............................................................................................................2-11 2.3.1 State Healthcare Coverage ..............................................................................2-11 2.3.2 Institutions and Services for Disabled People...................................................2-11 2.4 Education...............................................................................................................2-13 2.4.1 Primary Education............................................................................................2-13 a. Regular Schools ..................................................................................................2-14 b. Home schooling...................................................................................................2-14 c. schools with inclusive education component........................................................2-14 d. Boarding Schools.................................................................................................2-15 e. Day Centers.........................................................................................................2-15 2.4.2 Vocational and High Education ........................................................................2-16 2.4.3 Main Barriers to Attending Educational Facilities..............................................2-16 2.5 Employment...........................................................................................................2-17 2.5.1 Employment Opportunities ...............................................................................2-17 2.5.2 Importance of Employment for Disabled Persons.............................................2-17 2.5.3 Georgian NGOs Providing Employment Opportunities .....................................2-19 2.6 Recreation and Leisure.........................................................................................2-19 2.7 Integration Factors................................................................................................2-20 2.7.1 Severity, Type and Onset of Disability..............................................................2-20 2.7.2 Attitude of Society ............................................................................................2-20 2.7.3 Attitude of Parents/Caretakers .........................................................................2-21 2.7.4 Mobility and Architectural Barriers....................................................................2-21 iv Final Draft Analysis Report 4/26/07 TABLE OF CONTENTS… 2.7.5 Access to Information, Communication and Social Network.............................2-21 2.7.6 Economic Condition of the Household and Place of Residence .......................2-22 2.7.7 Personality of Disabled People and Skills for Independent Living.....................2-22 2.7.8 Religious Faith .................................................................................................2-23 3. CONCLUSIONS ...........................................................................................................3-1 3.1 Main Barriers Faced by Disabled People in Georgia ............................................3-1 3.1.1 Unclear and Inconsistent State Policy towards Disability....................................3-1 3.1.2 Isolation, Lack of Representation and Participation in Country’s life...................3-1 3.1.3 Society’s Attitude