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Health and disability rights: building coalitions

Posted on 04/08/2020
By Commonwealth Foundation

The Foundation recently convened learning exchanges with civil society leaders working on health and disability rights—particularly the rights of vulnerable populations who have been ‘left behind’. The participants, who hailed from 11 Commonwealth countries and had each received support from our grants programme, shared strategies and approaches to realise these rights by making governments more accountable; this is the second in a series of blogs profiling the case studies our partners shared.

The evidence is unambiguous: vulnerable and marginalised groups—including women and girls, the poor, and persons with disabilities (PwDs)—are very far from achieving the promise of universal health coverage or the Sustainable Development Goal of ensuring healthy lives and wellbeing for all. Further, the estimated one billion PwDs in the world are denied equitable participation in society due to prevailing material and attitudinal barriers. They face higher rates of multidimensional poverty, lower educational attainment and rates of employment, and poorer health outcomes. The COVID-19 pandemic has made these inequalities starker.

Coalition building can be a powerful force for change, not least because coalitions of like-minded organisations working towards a common purpose provide greater visibility for a cause by engaging groups across society. As the following case studies demonstrate, those within a coalition also share information and pool their skills, vastly increasing their potential to create and sustain change.

Two case studies from Kenya

Action Network for the Disabled (ANDY) is a Disabled Persons Organisation (DPO) in Kenya. They are working in partnership with Able Child Africa to realise the rights of children and young people with disabilities.

ANDY builds coalitions at both the national and community levels in Kenya.

The National Disability Coalition brings together disability rights activists with other civil society groups working on related issues such as education, health, and employment. The coalition builds relationships with decision-makers. It also establishes nationwide policy priorities, key messages, and raises awareness of disability rights issues.

At the community level, ANDY identifies informal groups that are organising around an issue. For instance, the Sagana Disabled Self-Help Group in Kirinyaga county is an informal collection of businesspeople with disabilities who are looking for ways to make the business environment more disability-friendly, including through seeking exemptions from business fees. Such groups, which ANDY calls disabled people’s groups, have a detailed understanding of the local needs of people with disabilities but often lack the capacity to engage government on matters of policy. ANDY and other civil society organisations in the network build their partners’ skills in advocacy, fundraising, and collecting evidence. They then connect the disabled people’s groups with the relevant decision-makers in the network.

This strategy has proven effective. For example, a disabled people’s group in Machakos county worked with a number of formal organisations in the network to improve the accessibility of local buildings and, together, they managed to successfully lobby the county government to pass the necessary legislation. In another example, in Kirinyaga county, ANDY connected a disabled persons group working to protect children with disabilities from abuse to the government’s local children’s officer. They now work regularly together to resolve cases.

Using Community Champions

KELIN’s mission is to improve the quality of life for people living with HIV by making sure the government meets its commitment to protect their health and wellbeing. A fundamental part of their strategy is to build the capacity of people living with HIV to collaborate.

KELIN use a two-step process. First, they identify all relevant non-government stakeholders in an area—this includes people living with HIV, communities affected by HIV, health providers, civil society organisations, community-based organisations, and media with an interest in health issues. They then bring the groups together for a two-day training and networking session. Those involved are provided with information on the rights of people living with HIV and how decisions are made by government. They then develop work plans based on the priorities they agree on, as well as the most appropriate methods for engaging relevant decision-makers.

At the end of the event, the group selects a sub-group of Community Champions who meet on a quarterly basis. Community Champions continue to identify and prioritise the most important issues throughout the year to ensure the coalitions’ advocacy strategy is responsive to evolving needs. For example, Community Champions in Mombasa noticed that women with HIV or TB were being detained in a health facility after giving birth, due to non-payment of hospital charges. The coalition met formally with officials at the facility to point out that the practice of detainment was not in line with the government’s stated commitment to free maternal services. This led to the head of the health facility working with their team to eliminate the practice.

KELIN has found that building coalitions in this way leads to sustainable change. For example, involving journalists in the coalition results in coverage and raised public awareness. Community Champions gradually develop the confidence and know-how for independent advocacy. And the government also begins to see the value in regular community feedback. This is well illustrated in Mombasa, where local officials now invite Community Champions to join regular working groups so they can provide input on policy and practice. 

Dr Shobha Das is a former Director of Programmes at Minority Rights Group International and Gillian Cooper is the Programme Manager of Knowledge, Learning, and Communications at the Commonwealth Foundation. 


Ensuring the right to health for vulnerable people

Accessing health services for the most vulnerable in Kenya is a struggle. Although all people in Kenya have the right to health, resources allocated for health services are not decided in an accountable and transparent manner.