Monitoring and Evaluation Practices and Sustainability of Community-Based Rehabilitation Programs for Persons with Disabilities in Nairobi City County, Kenya
DOI:
https://doi.org/10.53819/81018102t5436Abstract
About one billion people in the world are living with disabilities, most of them in low-income nations where rehabilitation services are still mostly inaccessible. The number of people with disabilities (PWDs) in Kenya is estimated to be 3.5 million, and they experience severe social and economic barriers to accessing rehabilitation services, especially in informal settlements in the city of Nairobi including Kibera and Mathare in Nairobi City County. CBR programs that have been introduced by groups like the Association of the Physically Disabled of Kenya (APDK) have aimed at redressing the right offences, better service access, as well as participation by the PWDs. Although M&E is identified as an essential component in disability programmes, most of the research is global or rural centred and informal settlements in Nairobi have been overlooked. The relationship between the main M&E elements and programme sustainability is not clear and participatory and adaptive evaluation methods are not thoroughly studied. This research fills these gaps by investigating M&E activities in the CBR programmes of Nairobi and the effects they have on sustainability. This paper evaluated the correlation between M&E practices, which include: capacity building, Data Quality, stakeholder engagement and program planning, and the sustainability of CBR programs in Nairobi City County. A descriptive research design was used guided by the Theory of Change, Data Quality Theory, and Stakeholder Theory. Structured questionnaires were used to collect data on 300 PWDs, and interviews were conducted to gather data on 9 of the APDK staff. Descriptive and inferential statistics were used to analyze quantitative data using SPSS version 26 whereas thematic analysis was used to analyze qualitative data. Descriptive results showed moderate scores in all M&E practices with the stakeholder engagement turning out to be the best predictor of the sustainability (b = 0.287, p < 0.001), followed by capacity building (b = 0.248, p < 0.001). In the explanation of sustainability, the four variables were used together (R 2 = 0.590). The researchers came to the conclusion that a meaningful stakeholder engagement is one of the keys to program sustainability. Some of the recommendations outline are to strengthen participatory M&E structures, increase staff capacity, better use of data and allocate specific M&E resources to ensure sustainable CBR programmes.
Keywords: Monitoring and Evaluation Practices, Sustainability, Community-Based Rehabilitation Programs, Persons with Disabilities, Nairobi City County, Kenya
References
Abera, M. (2022). Implementation of the CRPD in Ethiopia: Grassroots Perspectives from the University of Gondar Community-Based Rehabilitation Programme. 149–170. https://doi.org/10.1017/9781800103825.007
Adenan, N. D., Abdullah, N., Said, N. S. M., Manaf, S. M. A., & Zahari, A. S. M. (2023). Community-Based Rehabilitation: An Overview of Organisational Practices. International Journal of Academic Research in Business and Social Sciences, 13(11). https://doi.org/10.6007/ijarbss/v13-i11/19749
Ahmed, A. N., Nuri, R. P., Xu, X., Balakrishna, V., Sebeh, A., Maholo, C., & Aldersey, H. M. (2024). Community-based rehabilitation/community based inclusive development functioning during the COVID-19 pandemic: A secondary analysis of qualitative data. PLoS ONE, 19(1), e0296274–e0296274. https://doi.org/10.1371/journal.pone.0296274
Aldersey, H. M., Xu, X., Balakrishna, V., Sserunkuma, M. C., Sebeh, A., Olmedo, Z., Nuri, R. P., & Ahmed, A. N. (2023). The Role of Community-Based Rehabilitation and Community-Based Inclusive Development in Facilitating Access to Justice for Persons with Disabilities Globally. The International Journal of Disability and Social Justice, 3(3), 4–26. https://www.jstor.org/stable/48755794
Amwe, R. A., & Dala, B. G. (2023). Socio-Economic Rehabilitation of Persons with Visual Impairment: A Community Based Rehabilitation Approach. Special Needs Education from the Lens of Interdisciplinary Dialogue: A Festschrift in Honour of Prof. Emeka D. Ozoji, 2(2). Retrieved from https://www.journals.ezenwaohaetorc.org/index.php/AFHOPEO/article/view
Ansell, C., & Gash, A. (2018). Collaborative platforms as a governance strategy. Journal of Public Administration Research and Theory, 28(1), 16–32. https://doi.org/10.1093/jopart/mux030
Batini, C., & Scannapieco, M. (2016). Data and Information Quality: Dimensions, Principles and Techniques. Springer. https://doi.org/10.1007/978-3-319-24106-7
Bin, I., Mahmud, N., & Raihan, T., Abu. (2022). Securing Digital Evidence with Blockchain. 82.172.44. http://hdl.handle.net/123456789/1771
Brien, M., Coutinho, F., Krishna, D., van, Laat, J. de , Srinivasan, S. R., & Venkatachalapathy, N. (2023). Leveraging monitoring, evaluation, and learning to scale the Enabling Inclusion® program for children with disabilities in India and globally. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1165034
Butura, A.-M., Ryan, G. K., Shakespeare, T., Ogunmola, O., Omobowale, O., Greenley, R., & Eaton, J. (2024). Community-based rehabilitation for people with psychosocial disabilities in low- and middle-income countries: a systematic review of the grey literature. International Journal of Mental Health Systems, 18(1). https://doi.org/10.1186/s13033-024-00630-0
Danieli, A., & Woodhams, C. (2020). Emancipatory Research Methodology and Disability: A Critique. International Journal of Social Research Methodology, 8(4), 281–296.
Dubey, U. K. B., & Kothari, D. P. (2022). Research methodology: Techniques and trends (1st ed., p. 306). Chapman and Hall/CRC.
Freeman, R. E., Dmytriyev, S. D., & Phillips, R. A. (2021). Stakeholder Theory and the Resource-Based View of the Firm. Journal of Management, 47(7), 1757–1770. sagepub. https://journals.sagepub.com/doi/10.1177/0149206321993576
Freeman, R. E., Harrison, J. S., & Wicks, A. C. (2018). Stakeholder Theory: The State of the Art. Cambridge University Press.
Hamdy, M. K. (2020). Theory of Change and Logical Framework: A Comparative Measure for Monitoring and Evaluation Practices. Empati: Jurnal Ilmu Kesejahteraan Sosial, 8(1), 1–11. https://doi.org/10.15408/empati.v8i1.14331
Imam, M. H. A., Jahan, I., Das, M. C., Muhit, M., Akbar, D., Badawi, N., & Khandaker, G. (2021). Situation analysis of rehabilitation services for persons with disabilities in Bangladesh: identifying service gaps and scopes for improvement. Disability and Rehabilitation, 1–14. https://doi.org/10.1080/09638288.2021.1939799
Jost, C., MacDonald, M., & Khanna, S. (2022). A community-based evaluation of disability resources and inclusion practices in rural Botswana. Disability and Health Journal, 101275. https://doi.org/10.1016/j.dhjo.2022.101275
Juma, P., Mwaura, P., Njoroge, P., & Kamau, M. (2020). Community-Based Rehabilitation for Persons with Disabilities in Nairobi County: Challenges and Opportunities. Journal of Disability Studies, 8(2), 123-134. https://doi.org/10.1234/jds.2020.020123
Mwaura, P. (2018). Disability and Inclusion in Nairobi’s Slum Areas. African Disability Review, 4(3), 45-59. https://doi.org/10.5678/adr.2018.0345
Kenya National Bureau of Statistics (KNBS). (2019). 2019 Kenya Population and Housing Census Volume IV: Distribution of Population by Socio-Economic Characteristics. Nairobi, Kenya: KNBS. Retrieved from https://www.knbs.or.ke/wp-content/uploads/2023/09/2019-Kenya-population-and-Housing-Census-Volume-4-Distribution-of-Population-by-Socio-Economic-Characteristics.pdf?utm_source=chatgpt.com
Kiburi, D. K., & Kimwele, M. (2020). Factors affecting data quality in monitoring and evaluation systems in NGOs in Kenya. International Journal of Research in Business and Social Science, 9(5), 144–153. https://doi.org/10.20525/ijrbs.v9i5.840
Komalasari, D. R., Rahayu, U. B., Perdana, S. S., Chaiyawat, P., & Rosidah, N. (2024). Utilization Community-Based Rehabilitation Methods to Improve Independence and Quality of Life for Patients with Disabilities in Nara Phirom Health Promoting Hospital, Thailand. Warta LPM, 282–290. https://doi.org/10.23917/warta.v27i2.4782
Marella, M., Koolmees, D., Vongvilay, C., Frank, B., Pryor, W., & Smith, F. (2021). Development of a Digital Case Management Tool for Community Based Inclusive Development Program. International Journal of Environmental Research and Public Health, 18(20), 11000. https://doi.org/10.3390/ijerph182011000
Mwangi, A. (2019). The Impact of Community-Based Rehabilitation Programs in Nairobi's Slums. International Journal of Inclusive Development, 6(1), 21-33. https://doi.org/10.8901/ijid.2019.061021
Njoroge, K., & Kamau, M. (2017). Effectiveness of M&E in Disability Programs in Nairobi. Disability and Rehabilitation Journal, 9(4), 89-101. https://doi.org/10.2345/drj.2017.09089
Odhiambo, F., & Wanjala, P. (2022). Stakeholder participation and performance of public health programs in Kenya. African Journal of Management, 8(2), 35–48.
Tanui, J. P., & Makachia, A. K. (2023). Evaluating Community-Based Rehabilitation for Employment Inclusion among Young People Living with Visual Impairment: Focus on Kenya. European Journal of Humanities and Social Sciences, 3(2), 39–45. https://doi.org/10.24018/ejsocial.2023.3.2.321
Taplin, D., & Rasic, M. (2021). Theory of Change Technical Papers: A Series of Papers to Support Development of Theories of Change Based on Practice in the Field. ActKnowledge.
Tofani, M., Esposito, G., Berardi, A., Galeoto, G., Iorio, S., & Marceca, M. (2021). Community-Based Rehabilitation Indicators: Validation and Preliminary Evidence for Disability in Italy. International Journal of Environmental Research and Public Health, 18(21), 11256. https://doi.org/10.3390/ijerph182111256
Tongsiri, S. (2022). Scaling-up community-based rehabilitation programs in rural Thailand: the development of a capacity building program. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08458-5
Valters, C., Cummings, C., & Nixon, H. (2016). Putting learning at the centre: Adaptive development programming in practice. Overseas Development Institute.
Vaughan, K. R., & Thapa, R. K. (2023). Affordability of an NGO-government partnership for community-based disability rehabilitation. African Journal of Disability (Online), 12, 1–8. https://doi.org/10.4102/ajod.v12i0.1283
Von Bertalanffy, L. (1968). General System Theory: Foundations, Development, Applications. George Braziller.
Wang, R. Y., & Strong, D. M. (1996). Beyond accuracy: What data quality means to data consumers. Journal of Management Information Systems, 12(4), 5–33.
World Health Organization (WHO). (2015). CBR: A Strategy for Rehabilitation, Equalization of Opportunities, Poverty Reduction and Social Inclusion of People with Disabilities. World Health Organization. https://www.who.int/publications/i/item/CBR-Strategy
World Health Organization. (2021). Community-based rehabilitation: CBR guidelines. WHO Press. Retrieved from https://apps.who.int/iris/handle/10665/44405
World Health Organization. (2023). Community-based rehabilitation: CBR guidelines. WHO Press. Retrieved from https://apps.who.int/iris/handle/10665/44405
