This is an Evaluation Report of Uganda Deaf Awareness and Communication (U-DAC) project that was implemented in the Greater Masaka districts of Kalungu, Masaka, Lwengo, Rakai and Bukomansimbi between April 2013 and February 2016. The project was funded by Comic Relief and implemented by Signhealth Uganda (SU) in partnership with Signal, UK. The main aim of the project was to increase access to education, improve retention and academic achievement for deaf and hearing impaired children (HIC) and challenge negative cultural stereotypes regarding deafness in Masaka districts.
The purpose of the evaluation was to undertake an independent and impartial review of Signal’s U-DAC project, and the extent to which it delivered its intended outcomes to the target beneficiaries. The evaluation explored the lessons learned from this project; how this learning can be used and shared; the relevance and appropriate targeting of project activities; the extent to which attitudinal change has been affected; and the long-term sustainability of project activities.
Overview of the Evaluation Methodology
The evaluation was performance based evaluation and used mixed-methods approach, utilizing primarily mostly qualitative data collection and evaluation methods. The evaluation involved extensive desk review and analysis of existing quantitative project data and documentation, and primary collection and analysis of qualitative data. Data collection consisted of a survey questionnaire among a random sample of 70 hearing impaired children (HIC); Key Informant Interviews (KIIs) with 8 caregivers, 13 teachers, 8 local government representatives, 2 project staff and 5 community leaders (exposed to U-DAC project); Focus Group Discussions (FGDs) among 8 groups of caregivers and community members; In-depth Interviews (IDIs) with 8 HIC; and Observation of 6 HIC in the school playground.
The U-DAC project began in 2013 and directly reached 1,015 (592 girls; 423 boys) HIC in 20 primary schools and the surrounding communities across the 5 districts of Masaka region. The project reached the caregivers or parents of the HIC, 124 primary school teachers, school management committees and the community leaders including Village health team members and religious leaders. Project team worked closely with the district authorities in selection of target communities. These were all relevant target groups that enabled the project to achieve its outcomes.
The project activities were mainly pilot in nature, but effectively and efficiently achieved the desired outcomes. To a large extent the project was successful in increasing awareness about hearing impairment, and changing the attitudes of the caregivers, community leaders and teachers about educational achievements of the HIC in the mainstream schools. There are strong improvements in the HIC enrolment in mainstream schools, in their academic performance and in their school learning environment. Although, the project objectives and activities were pre-determined, many stakeholders considered them very relevant to the context and plight of the HIC. The project has led to the district education and community development authorities to start developing district level strategic plans to support the identification of HIC and to streamline their support in the mainstream schools.
The project demonstrated that the prevalence of HIC in mainstream schools is as high as 4% and the ear problems of most HIC are temporary and can be unblocked by health-workers with use of correct and fairly inexpensive treatment. It also showed that with positive attitudes and appropriate support from the teachers and caregivers, these children can progress normally through the mainstream schooling system.
Lessons learnt about the project implementation process
The summary of some of the lessons learned in the process of implementing the UDAC project are as follows:
- There is a high prevalence of HIC in the mainstream schools struggling with poor academic performance and unconducive learning environment. Both the provision of Hearing assessment and treatment services and processes that lead to a positive school learning environment are necessary for the HIC to function well in the mainstream schools. Thus, both the health service delivery and education service delivery authorities and community leaders will have to work jointly. District and community level meetings involving health-workers, teachers and community leaders are necessary. It is also necessary to work in partnership with other organizations supporting the disabled and education outcomes.
- The project used an effective model that combined the child’s right to education with community and school mobilization to rally the community and teachers for action and engagement in support for the HIC. Teachers and community members actively participated in the identification of the HIC and referred them for treatment. The parents and teachers became agents for change at community level, with individual parents becoming influential reference points for community mobilization by other groups and local leaders.
- It is noted that the treatment of the HIC and their recovery does not automatically lead to positive results in mainstream schools; few treated HIC still faced some challenges. This was common especially within the first six months of recovery. Some schools became innovative and made some of the HIC school prefects and class monitors. This hastened the integration. Involvement in the games and sports was also done in some schools. Thus, in a short run, to ensure active integration and positive results of learning in mainstream schools, teachers will have to be equipped to offer counselling and guidance after the HIC have been medically treated.
- Enrolment, retention and academic performance of the HIC will remain challenged due to poverty. The project, however, demonstrated that sensitizing caregivers and helping them to form groups to run IGAs is easy and can transform socio-economic status of their households.
- An establishment of multi-stakeholder advisory groups at district level and community level comprising of local education authorities, teachers’ union representatives, district level education coalition members, and community leaders, health-workers, and children representatives can provide necessary guidance and expertise during a project implementation period similar to UDAC.
- Dealing with long standing cultural/traditional issues, such use of herbs to treat ear infections and value of education for the HIC, demand the active engagement of local agents such as the village health teams, community leaders and cultural leaders. The project demonstrated that it is easy to get the traditional herbalists to buy-in to correct treatment of ear infections.
- Teachers are capable of reaching to the communities – many of them have a passion to help the children beyond academics alone – little facilitation can help them achieve more.
- Availability of the Hearing assessment and treatment in nearby health facilities is important in support of HIC education in the mainstream schools and the sustainability of the outcomes. Currently, Hearing assessment and treatment services are offered in hospitals but these are too far for caregivers to travel to.
- The HIC can be become direct agents of change and create awareness within their communities. Communities now routinely invite some of the beneficiary children to talk about challenges faced by HIC in community and schools meetings. Formation of child clubs e.g. child protection clubs can make the role of the HIC in the community visible and transform community attitudes.
There is a high prevalence of 4% of HIC in the mainstream schools who are also struggling with poor academic performance and unconducive learning environment. Little is known about the causes of their plight. The UDAC project has demonstrated that without provision of Hearing assessment and treatment services and sensitization of the teachers and the other school children a positive school learning environment for the HIC is not possible. However, medical treatment need to be accompanied by a positive school learning environment and positive attitudes of caregivers and teachers to enable the HIC progress normally through the mainstream schooling system.
The project used an effective model that combined the child’s right to education with community and school mobilization to rally the community and teachers for action and engagement in support for the HIC. The parents and teachers became agents for change at community level, with individual parents becoming influential reference points for community mobilization by other groups and local leaders. Further, teachers are capable of reaching out to the communities – many of them have a passion to help the children beyond academics alone – little facilitation can help them achieve more.
To download the full report please clink the link: UDAC Evaluation -GR002-07320-XSTA