Disability Inclusive Eye Health Services Practice Guidelines editors cbm viet Nam

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Disability Inclusive Eye Health Services
Practice GuideLINES

CBM Viet Nam

Nathalie Maggay, Nguyen Ngoc Anh, Nguyen Thi Hong Nga, Pat Sawyer

Hanoi Association of People with Disabilities

Duong Thi Van, Hoang Cam Linh, Phan Thi Bich Diep, Nguyen Trung


Vu Thi Binh Minh

Hanoi Association of People with Disabilities

Tran Quoc Nam

CBM National Office in Vietnam

3rd fl., 30 Mai Hac De St, Hai Ba Trung, Hanoi

Tel: +84 (4) 6278 0073 * Fax: +84 (4) 6278 0074 * Email: info@cbm.org.vn

Table of Content

Introduction 5

Part 1 – Basic Concepts 6

About people living with disabilities 6

So What is Disability? 6

What is Disability Inclusion? 7

Part 2: Disability Inclusiveness in Eye Health Services 10

Barriers and Solutions for Accessible Health Services 10

2- Where can Change be Implemented? 12

3- How can Eye Health Services be made more Disability Inclusive? 15

Step One: Screening and Initial Identification Processes 16

Step 2: Patient Transport and Transfer Processes 17

Step 3: Clinical Diagnosis of Low Vision and Blindness and Appropriate Counselling Process 18

Step 4: Effective Referral to Disability Service Organisations such as The Blind Association, DPO, Rehabilitation Centers and Special Units (if they exist). 19

Step 5: Reliable Follow-up Process 19

Step 6: Eye Health Promotion Activities 20

Step 7: Health Information System 20

Step 8: Accessible Building Upgrade 20

Xã Quang Hợp, Huyện Quảng Xương, Thanh Hóa 30

18 Phan Đình Phùng, TP Thanh Hóa 30

Người liên lạc chính: Nguyễn Thị Phượng, 30

CLB NKT Hương Dừa, Thanh Hóa 30

Người liên hệ: Bà Lê Thị Tuyết, chủ nhiệm 30

Phú Tiên, Hoằng Quí, Hoằng Hóa tình Thanh Hóa 30

0376626515 30

Email: tuyet102@yahoo.com.vn 30

CLB NKT Vì màu xanh Tương lai, Thanh Hóa 30

Liên hệ: Ngô Văn Biểu, chủ nhiệm 30

Đội 1, xã Quang Lộc, huyện Hậu Lộc, Thanh Hóa 30

0376276917, 30

Di động: 0973286406 30

NghỆ An 30

Khối 10 Lê Lợi, 41 Nguyễn Thái Học, Tp Vinh 30

038 3842712 30

64 Bình Minh, Thị xã Cửa Lò, Nghệ An 30

038 3824585 30

88 Bình Minh, Thị xã Cửa Lò, Nghệ An 30

038 3824154 30

Xã Nghi Phú, TP Vinh, Nghệ An 30

038 3851588 30

Phong Đình Cảng, Nghệ An 30

038 3848036 30

150 Đinh Công Tráng, tp Vinh 30

038 3848907 30

38 Đường Đinh Bạt Tụy, TP Vinh 30

038 3844773 30

Trung tâm Nghị lực sống, Nghệ An. 30

Liên hệ: Nguyễn Công Hùng - Giám đốc 30

Cơ sở 1: phòng 812, lô 9A, bán đảo Linh Đàm, Hà Nội 30

Cơ sở 2: Nghệ An 30

Website: www.nghilucsong.net 30

04 36419700, 30

Di động: 0989550678 30

Email: admin@conghung.com 30

Sơn La 30

Tiểu khu 1, Thị trấn Yên Châu. 30

0946510455, 30

0223852486 31

51 Tô Hiệu, TX Sơn La 31

0223 854954 31

tổ 5 Phường Quyết Thắng, TX Sơn La 31

0223852487 31

343 Đường Lò Văn Gia TX Sơn La 31

022 3852313 31

Xã Chiềng Cơi, TX Sơn La 31

022 3853427 31

Part 3: Annex………………………………………………………………………21
Pictures of suggested adaptations…………………………………………………………….

Brief Summary of the Law on Disability…………………………………................22

DPO Contacts in Viet Nam……….…………………………………………………………………25


These Guidelines are an adaptation from a document “Disability Inclusive Practices in Eye Health: A Practice Guide” that was produced through a co-operation between CBM and The NOSSAL Institute for Global Health in Australia.
The original document was designed as a general guide for eye care organizations and aimed to increase the understanding of disability and the implications for developing inclusive practices in eye health care. The aim was that each organization would then tailor the recommendations to their own program setting.
Viet Nam

CBM Viet Nam used the original document as a base and designed this country specific Guideline for developing disability inclusive practices in their avoidable blindness initiatives in three provinces. In 2010, a set of workshops were established in Nghe An to pre test the first draft document. As a result of the pre test, amendments were made. The second draft was produced and a workshop designed using the information in the Guidelines as a basis for the content.

In 2011, there have been successful workshops completed in three provinces, Nghe An, Son La and Thanh Hoa. Further amendments have been made to the Guidelines in response to lessons learned during the workshops and through a collaboration between CBM and DP Hanoi.
Purpose of this Practice Guideline:

To support the development of disability inclusion in eye health services to improve general practice and to meet the needs of people with low vision/ blindness who also have other disabilities.

Who should use this material?

Staff and health workers in eye health services, persons with disabilities, their families relevant government agencies and mass organizations.

How to use this material most effectively

  1. As a written support for participants who have already attended a workshop that was designed around the content of the Guidelines.

  2. As a tool to design and implement a workshop for eye health care workers.

Part 1 – Basic Concepts
About people living with disabilities

About 15% of the world's population lives with some form of disability, of whom 2-4% experience significant difficulties in functioning. The global disability prevalence is 10% higher than previous WHO (World Health Organisation) estimates. The increase is due to population ageing and the rapid spread of chronic diseases, as well as improvements in the methods used to measure disability.

In Vietnam, the figure is about 15.3, according to General Statistics Organization (http://nccd.molisa.gov.vn).
People living with disabilities encounter many barriers including discrimination and exclusion by society. Exclusion can happen for many reasons including inaccessibility, lack of communication, limited funds, lack of education and attitudes. These barriers frequently prevent people who live with disabilities from accessing health services, education, vocational training, recruitment and employment. This can, and does, contribute to increased challenges in life and limited integration into society as a whole.
Disability as Defined in the Law on Disability, Viet Nam 2010

Persons with disabilities by definition of Vietnam Law on disability are those who have impairment of one or more part of their body, or functional impairment which are shown in different forms of disability, and may cause difficulties in work, daily life and learning.

So What is Disability?

To begin to understand disability is it is useful to understand the difference between ‘impairment’ and ‘disability’.

Impairment is defined as:

A physical, intellectual, mental or sensory characteristic or condition, which places limitations on an individual’s personal or social functioning in comparison with someone who does not have that characteristic or condition.”

Disability is defined as:

The disadvantage and exclusion which arise as an outcome of the interactions between people who have impairments and the social and environmental barriers they face due to the failure of society to take account of their rights and needs.”

This is a useful formula for understanding the differences in a practical sense.

An example to support the formula is of a young lady who lives in Ha Noi. Ha has no sight at all. In order to participate in a developmental program, she went to live in Japan for one year. While in Japan, she was able to live independently, having her own apartment and travelling on her own to and from the university.

While in Japan, she considered herself to have an impairment. On her return to Ha Noi, she met many barriers including the traffic, the lack of clear walkways on the pavements, unsympathetic public transport and few assistive devices for the home. In Ha Noi she felt that her Impairment and the Barriers meant that she experienced a Disability.

What is Disability Inclusion?

Disability Inclusion is an approach for actively ensuring that people with disabilities benefit from services to the same degree as nondisabled people. This is in accordance with the United Nations Directive on Human Rights.

Disability Inclusion applies to all health, education, employment and infrastructure programs. Within this document, we are focusing on the provision of eye health care services.

How do we move from a Position of Exclusion to Inclusion?
The Twin Track approach offers a frame for the development of concepts and practice that supports inclusion. The tracks were originally designed for general development of inclusive practices. In this Guideline, we have kept the same principles but the original wording has been adapted to reflect the needs of developing inclusion within eye care services.
When both tracks are kept in focus and developed, we have a PROCESS of sustainable change with an ultimate GOAL of equal rights for all people living with disabilities.

The aim is to focus on specific projects & initiatives to increase empowerment & participation of people with disabilities.

 actively involve DPO’s in planning, implementing, reviewing all relevant policies and training


 information is made accessible for those who cannot hear or read, live in remote areas and/or lack confidence


 solutions to barriers are identified and addressed ie lack of transport and finances


 referrals are made to DPO’s, rehabilitation services, CBR, assistive devices

 PWD are empowered by responding with empathy NOT sympathy (avoid Charity Model)



The aim is to create a disability inclusive projects & initiatives to ensure accessible services for everyone.


 building services on the basis of legislation & rights ie Disability Law & UN Convention


 accessibility of buildings, facilities and services for everyone on an equal basis


 on going information, awareness and skills training is provided for all staff


 positive attitudes are encouraged and supported


 the development of a needs led service that acknowledges that some people need more support

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