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Impact of GHSM Research

Dr Hanna Kienzler's work supports vulnerable families in the West Bank

In regions characterised by social and economic hardship and political upheaval, such as the West Bank, persons with disabilities –and indeed their families–are frequently isolated and stigmatised. Although there are some programmes throughout the region for improving the wellbeing of vulnerable families, they have not typically been accompanied by the type of independent and systematic monitoring and evaluation that is required to provide concrete evidence of efficacy and a framework that allows programme refinement and expansion.

To address this gap, Dr Hanna Kienzler is collaborating with the Institute of Community and Public Health (ICPH) at Birzeit University (occupied Palestinian territories), the Palestinian Community-Based Rehabilitation (CBR) Programme and War Trauma Foundation (Netherlands). Together, they are evaluating a community-based psychosocial intervention, following a Multi-Family Approach (MFA), to help the female carers of people with mental and physical disabilities. The intervention consists of mothers’ support groups, facilitated by trained community-based workers, and is based on evidence that positive and supportive social networks play an important role in effecting behavioural change and fostering well-being.  A number of groups have been established across rural villages in the region; here women and children have a safe space where they can exchange experiences and advice and support each other to alleviate the burden of isolation.

Evaluation of the intervention uses an innovative approach combining ethnographic methods and Outcome Mapping. Ethnography is an approach that is by definition embedded in social and cultural context. Outcome Mapping–a methodology developed by the International Development Research Center and tested in low and middle income countries worldwide–characterizes and assesses the contributions made by development projects, programmes or organizations in terms of changes in behaviours, relationships and/or activities throughout the duration of the project. Specifically, it pays attention to outcomes, rather than outputs and whether or not the ultimate project goal has been fully attained.

Preliminary results from the West Bank indicate improvement in the well-being of mothers as well as in their skills in dealing with the disabilities; in their leadership skills; in their ability to share problems, knowledge and information; and to seek and offer support. And group members have already found strength in lobbying together for the rights of their children to access community schools, receive appropriate education and adequate social and medical care.

Already this project has provided valuable insights into the effectiveness of using MFA in a vulnerable region such as the West Bank. But just as important, the evaluation has enabled the approach to be tailored and refined for the next phase of the project which will see additional support groups established in other villages. Today CBR facilitates 19 women’s support groups in the West Bank using the MFA approach, allowing vulnerable women and their children to come together in a secure environment. The goal is to reach many more vulnerable families and to provide them with a method of support that is both evidence-based and culturally appropriate.

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