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Services // Early Intervention & Community Based Development

Early Intervention & Community Based Development
CSF "Shishu Shorgo" (Children's Heaven) Early Intervention and Rehabilitation Centre

 

A number of therapy centres are operated in rural communities of Bangladesh by CSF Global. Currently four (04) Shishu Shorgo (Children’s Heaven) Early Intervention and Rehabilitation Centres are operational at Khanzandear, Jamirta and Sreefoltola, in Shahjadpur, Sirajganj, Bangladesh. These rehabilitation centres are staffed by personnel trained in therapy and rehabilitation of children with disabilities. The facility staff includes physiotherapists and community therapists who have received specialized training in disability programs and services and have also been oriented towards providing research support as required. The disability centres named “Shishu Shorgo” (a Bengali name that translates to Children’s Heaven in English) Early Intervention and Rehabilitation Centres are central in the BCPR (Bangladesh Cerebral Palsy Register) research. A motivated and trained Field Project Coordinator is responsible for coordinating between the various fixed field sites in an area as well as providing coordination during medical camps, research surveys, etc. through mobilization of resources and activation of linkages. Field project coordinators are also trained to carry out interviews.

 

Children with disabilities following identification by Key Informants (KIs) through use of the novel approach of Key Informant Methodology (KIM) are diagnosed by medical experts and referred accordingly for treatment and/or rehabilitation. Those in need of rehabilitation and therapy are recommended to enroll into Shishu Shorgo or other such similar service providing centres.  Children with disabilities along with their caregivers (parents, grandparents, or other relations) can enroll for rehabilitation care and therapy services at Shishu Shorgo centres. Each Shishu Shorgo centre serves a number of nearby unions (administrative unit comprised of several villages and the surrounding areas). The main program offered at the centres is a Transition Program, alongside offered are Saturday Clinic services.  

 

In the Transition Program, daily activities involving the children with CP (cerebral palsy) and their caregivers take place 5 days a week, in two shifts, morning and afternoon. The entire program lasts 6 months, after which is a 1 month follow-up period. Per year there are two intakes or batches, each consisting of around 20 children. The major program components are group therapy, individual physiotherapy, and parent support and education program. The goal of the Transition Program is to increase the child’s participation in their family, school and community.  Group therapy is an intensive component of the program that focuses on assisting the child for building the skills associated with activities of daily life (toilet training, dressing, eating), functional mobility, play, communication, school-readiness, and productivity. The child attends the session with at least one primary caregiver, allowing both of them to develop skills. Individual physiotherapy is given to the children with CP who have special needs. The service includes balancing, stretching, transitional movement, gross motor functional training, fine motor training, and gait training. This therapy program helps the children to improve their body movement.

 

Meanwhile the Saturday Clinic is intended for individual assessment and therapy services for children with CP. Saturday Clinic services are provided every Saturday primarily for children who are not admitted to the Transition Program. It also includes registration of new children with CP, referral services, health education and activities of daily living (ADL) training to both children with CP and their caregivers, and follow-up.

 

Complete with modern amenities and utility services (dedicated electricity, water and gas supply), trained full-time staff, and with an existing base of beneficiaries, the Shishu Shorgo centres are an ideal location for prospective disability research and programs. The children already have their records included into the BCPR and the parents are oriented towards cooperation and participation in research and follow-up activities. These centres can serve as the backbone for research on many aspects of CP and broaden the scope of researchers. The Shishu Shorgo centres have been upgraded with computers along with scanners and printers. A wide collection of therapeutic equipment such as walkers, pediatric standing frames, gym/physio ball, capsule ball, wooden stairs, parallel bars, wedge boards, arm and leg gaiters, tilting boards and balance boards, squatting boxes, dumbbells and sand bags, corner chairs, trampolines, hydrotherapy pools, etc. are used in therapy services. Opportunities are available for experts and organizations interested in design and development of assistive devices and technologies. AIDD offers the support of personnel trained in handling assistive devices, access to various health facilities in different parts of Bangladesh for field trial of these devices. By building on existing experience and capacities, an evaluation mechanism is also in place for providing feedback assessments in order to determine the efficacy and efficiency of innovative technologies.

 

In order to facilitate convenient and low-cost transport of the children with CP and their primary caregivers, each centre has a dedicated auto-van. The vehicle is a locally manufactured three-wheeler vehicle having the capacity to carry 10-12 passengers and is equipped with an electric motor and a rechargeable battery. The auto-van is ubiquitous is a clean or ‘green’ form of transport and requires limited operational costs.

 

Presently arrangements are underway to not only expand the number of centres, but also to expand the range and quality of therapy services being provided by means of improved and modernized training programs, incorporation of learnings from experiences, and addition of more therapeutic equipment such as specialized stationary cycles and treadmills for children, and audiovisual systems for audiovisual group study and stimulation. With regard to increasing the number of such centres, collaborative partners are being sought for establishment of additional ‘Shishu Shorgo” centres in other areas to expand the reach of services and create a network for richer disability research opportunities. AIDD and CSF Global are committed towards extending cooperation for establishment of new facilities as well as improving the existing ones by working with other organizations in the respective areas of operation.

 

Current research at the Shishu Shorgo centres:

 
 
Parent Self-Help Groups

As part of community-based rehabilitation services, formation of support groups is facilitated with the members of the family/household of children with disabilities. Parent support and education is provided through involving the child’s caregivers in all elements of the transition program at the Shishu Shorgo (Children’s Heaven) Early Intervention and Rehabilitation Centre. The trainers/centre staff and fieldworkers involve the parent in the group therapy and community follow-up by providing family-centred care, keeping the caregiver informed about the child’s progress, and providing recommendations and empowering caregivers to advocate for and facilitate their child’s participation in their home, community, school and vocation. Through this program, caregivers form support networks with other caregivers of children with disabilities. To find out more about these groups please visit our page on self-help groups.

 
Inclusive Education

With the goal of creating inclusive-education in the community, as part of the follow-up phase of community-based rehabilitation activities, support is provided to the child’s local school to enable their admission to school and participation in school activities. Teachers, school administration and other staff are sensitized towards the needs of children with disabilities in order to ensure inclusive education. Wheelchair accessibility is ensured through construction of wheelchair ramps at local schools. To find out more please visit our page on education research 

 
 
Advocacy and Awareness Raising
 

Apart from a network of over 25,000 trained Key Informants (KI), trained personnel such as community mobilizers and field project coordinators are present to raise awareness at the communities regarding disability-inclusive development as well other issues relevant to public health, aid in mobilization of community resources, and initiating advocacy from the local levels of power structure. Increasing awareness about disability and the child’s abilities and rights is necessary to facilitate the child’s family and community to develop support networks, and thus increase opportunities for the child to participate in the community. In order to effectively address the strategic needs of children with disabilities, these activities are vital to ensure sustainable outcomes. To find out more please visit our pages on community mobilization  and advocacy and awareness raising.