organizational development and restructuring for the yemen

CONSULTANCY TO SUPPORT ORGANISATIONAL DEVELOPMENT OF THE CARE AND REHABILITATION FUND OF THE DISABLED, AND THE NATIONAL UNION OF DISABLED ASSOCIATIONS (SOCIAL FUND FOR DEVELOPMENT)

Final Report

Authors: Marian Guest Ashley Schofield May 2011

Consultancy to Support Organisational Development of the Care and Rehabilitation Fund of the Disabled, and the National Union of Disabled Associations

© Oxford Policy Management, May 2011 i

Preface/Acknowledgements

This study was prepared by Marian Guest and Ashley Schofield, with the assistance of Tareq Saeed Al-Malhhaji and Ali Al-Qubati. The analysis and conclusions proposed are those of the consultants and should not be attributed to the Social Fund for Development or any other agency

The consultants would like to express their sincere gratitude to Mrs Jalila Shujaadeen, and the SFD team who supported this project: Kawkab Al Hibshi, Samar Morad, Mona Al-ghbari), and the interpreter Mr Abdulwadood Annuzaili. We also wish to express our appreciation to the many stakeholders who made their time available to provide information for the study, in particular Dr Al Hamadani (DF) and Mr Ottman (Union), and to take part in process workshops.

Contact Details:

For further details please contact:

[email protected] or [email protected]

mailto:[email protected]

mailto:[email protected]


© Oxford Policy Management, February 2011 ii

Executive summary

Oxford Policy Management (OPM) was contracted by the Social Development Fund Yemen, to carry out an organisational capacity assessment of the two major stakeholders in the area of disability safety nets: the Care and Rehabilitation Fund of the Disabled, and the National Union of Associations for the Disabled. The objective of this short assignment was to rapidly carry out a capability assessment and develop a targeted set of performance improvement recommendations for the funding of service delivery for Persons with Disabilities (PWDs) and Disabled Persons Organisations (DPOs). The assignment reviewed both the Fund and Union but the main focus of attention was on the Fund as the organisation with the greatest potential impact. A particular aspect of the assignment was the focus on achieving improved outcomes for people with disabilities in Yemen, rather than limiting thinking to institutional changes.

Yemen, in common with the global trend, has adopted a rights-based, social model of disability and has recently carried out a lengthy consultative exercise to agree on a National Disability Strategy. This study of the Fund and Union has much to do with re-appraising whether the two organisations are capable of implementing this Strategy This assignment has taken evidence of current activity as the strongest indicator for assessing change required to meet the new strategic objectives

The study used data from analysing earlier reports, activity and results oriented reports, wherever possible, together with key stakeholder interviews.

The Fund carries out essential functions and delivers services on behalf of the disabled and this activity is a major advance on services available to the disabled before the Fund came into existence. By most of the normal organisational effectiveness criteria, however, it is failing to demonstrate that it is functioning effectively and efficiently, and it appears to lack the sustainability and institutional strength to adapt and grow into the new role as defined by the National Disability Strategy.

The Union is the apex organisation for associations of the disabled and is viewed as an essential component in providing a powerful “voice” for the disabled in national fora and on decision-making bodies. As with the Disability Fund, this advocacy and policy role, while seen as important, attracted less attention than the core implementation functions of the Union, routine fire-fighting and support for individual members encountering problems. While these activities are clearly valuable, the advocacy/policy space is weakened by the limited role of the Union in this area.

Despite the various capability issues that exist, it must always be borne in mind that the existence of the Fund (since 2002) has been a major force for good and its work has been a transforming and positive factor in the lives of many people with disabilities. It is also recognised that the Fund and the Union will both have a significant role to play in improving the future provision of services for the disabled. The findings therefore must be seen as addressing the question of whether and how the capacity of the Fund and the Union can be strengthened in order to meet current and future challenges and, in particular, how these organisations can play their part in implementing the National Disability Strategy over the medium term.

Two general observations can be drawn from our analysis: Firstly, there is a striking contrast between the culture underlying the current operations of the Fund (and to a lesser extent the Union) and the strong adherence to a rights-based approach contained in the National Strategy. Whatever other reforms take place, the Fund will need a substantial cultural change to reflect this rights-based approach. Secondly, there was little clarity in either the Fund or the Union as to how they should be delivering their mandate, or indeed a clear understanding of their mandates and a clear delineation of their


© Oxford Policy Management, May 2011 iii

respective boundaries. This lack of focus on their mandated role has had major effects – in both cases there has been a drift into the areas of service delivery, meeting immediate needs, a desire to please and placate individuals and interest groups in the short-term, with little strategic attention to mainstreaming the interests of PWD.

The lack of a clear mandate for each organisation has affected the nature of the relationship between the two organisations and precipitated deviations in the activities of one as a result of a set of behaviours of the other. In other words, if the Fund acts in a certain way, the Union will adapt its behaviour to maximise opportunities on behalf of its members. Overall, there is a loss of focus on the mandates of both institutions in their activities as both organisations tend to focus on pursuing their own organisational needs rather than the needs of PWDs. In the case of the Fund, this loss of focus has led to an extraordinarily broad range of implementation and service activities, which it does not currently have the capacity or the capability to effectively manage. The current role of the Board in relation to the executive management of the organisation poses critical governance issues, including poor accountability, independence and decision making inertia. In summary, the study found evidence of:

A fluid structure where functions appeared to move between Departments and new Departments were established without addressing the dependent changes that would be needed in related Departments. This lack of a coherent and robust structure impacts not only the efficiency and effectiveness, but also the governance of the organisation.

The Management Team (i.e. Departmental Directors) had very little delegated authority and input into strategic decisions; no regular Management Team meetings take place, either as a peer group or under the leadership of the Executive Director; and this contributes to a lack of ownership for the development of their teams.

Centralised information and decision-making processes place an insupportable burden on the role of the Executive Director. Such processes inevitably carries with it excessive pressure on the Executive Director, and work against the “rights-based” approach to disability provision that is contained in national policy statements.

With no effective delegation, routine activities practically precludes the Executive Director from having the time and perspective to address the more strategic issues of the Fund‟s role in creatively finding solutions to meeting the needs of the disabled in Yemen.

There was little evidence of a people management strategy or processes. Appointments were made through the Ministry of Civil Service and Insurance and, frequently, the appointment criteria supplied by the Fund were ignored and wholly unqualified people were appointed. No training and development of Fund staff was reported by any respondent

A small number of Branches have been established as part of a decentralisation strategy but their role and functions were very underdeveloped, and there is no planning evident on how this could cost-effectively managed and financed. This is a major strategic decision that will require extensive funding, and a shift in the nature and management of the Fund‟s operations. We were concerned that no formal feasibility or planning process for this shift had been documented for scrutiny by the Board and shared with other stakeholders1.

The financial management of the Fund is poor with an over-reliance on cash transactions, lack of follow-up to debtors and creditors, inadequate internal controls, ineffective auditing

1 Subsequent to the data gathering for this Report, the Fund Management has confirmed that there is now a

plan of action to develop a Branch structure. This action plan has not been sighted by the consultants.


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framework, incomplete and untimely financial reporting, insufficient cash management and limited budgeting capacity. The budget was presented two months into the financial year for 2010 and identified relevant and planned expenditure but did not match this with identified revenue streams

In the case of the Union, it is a functioning voluntary agency with governance and processes in place to carry out core tasks and represent its member organisations. However, concerns surfaced over

Whether the systems and practices at the Union are aligned with the significant responsibilities allocated to it, e.g. in implementing the public sector employment quota., We see a mismatch between an entirely voluntary agency that is required to carry out professional, and specialist tasks. The Union has powers to change lives through its decisions. So, the employment committee will effectively determine who will be employed by the Government and who will not. Two issues arise from this mismatch; firstly although criteria and processes are used by the Committee, there are clearly risks of pressure and influence being brought to bear; secondly, the Union cannot be expected to operate professional Human Resources Management standards of selection and placement - demonstrate fairness, transparency – that would protect decision-makers from such personal pressure.

Fairness and transparency among the members who were given the most active support. Associations reported that their treatment by the Fund was often dependent on some sort of intermediation by the Union. Whether this is in fact the case, the perception is strong, and with no formal system of ensuring an even-handed approach for all members and limited resources, charges of unfairness will remain. The Union has come to represent a sort of “gatekeeper” to Fund resources, and in this way it may have created an additional barrier rather than increased access for DPOs.

This type of informal intermediation in support of member associations or individuals is rooted in the discretionary nature of ultimate decision-making in the Fund, described above. If the Fund had consistent, robust and fair processes in place that were well-communicated to the Union, its member DPOs and other stakeholders, intermediation would only be needed and useful when there were cases of clear deviation or non-compliance with operating procedures. For this reason, we believe that the role and activities of the Union have been somewhat distorted by the weak and inconsistent institutional processes within the Fund

This intermediation role in relation to the Fund also has the unfortunate effect of compromising the Union‟s position as a wholly independent voice advocating for the rights of those with disabilities and providing valuable inputs to policy-makers.

We also found the financial management reporting of the Union to be poor.

Recommended actions to address these issues go beyond a standard institutional capability review and explore options that take account of the wider context of services for the disabled in Yemen. We believe that further thought should be given to investigating a different approach to funding services for the disabled such as using the developed skills and efficiencies of private sector insurance agencies to handle the eligibility/ approval/payment process2. In the shorter-term we propose a small number of interventions that we believe will each address a number of performance issues and generate the leverage for sustainable change.

2 This is a highly specialised area and will require input from a subject matter expert


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In summary, the immediate recommendations will seek to: re-define the scope of the Fund’s activities within the National Disability Strategy and change critical factors to build its capability to carry out those activities. These action points will involve:

Mandate changes to impose a more rational and bounded role for the Fund together with clear definitions of eligibility and criteria for resource provision

Changes to the current role and practices of the Board to improve governance and reporting

The development of organisational strategies for both the Fund and Union to clarify focus and operational plans

Structural changes will certainly be needed at the Fund to create a genuine management framework and to implement a new strategic plan that incorporates the objective of decentralisation to create greater access for the disabled in all regions.

A focused capacity building programme targeting skill gaps and attitudes towards the disabled in the Fund and the Union

This is by no means an easy option and will require political will, commitment of resources by stakeholders and some external support. It should be noted that with limited management resources, there is no central mechanism for identifying, planning and implementing the organisational change interventions that are necessary


© Oxford Policy Management, May 2011 vii

Table of contents

Preface/Acknowledgements i

Executive summary ii

Table of contents vii

Abbreviations x

1 Introduction 1

1.1 Background 1

1.2 Objective 1

1.3 Methodology 2

Fig 1 Capability Framework 2

Fig. 2 Capability Review Team Members 3

1.4 Layout of the Report 3

2 Disability Services in Yemen 4

2.1 The Prevalence of Disability 4

2.2 Defining Disability 4

Fig 3: The ICF Model 5

2.3 Legislative Framework 6

Fig 4: Laws and Resolutions relating to Disability 6

2.4 Disability Services Delivery Model 7

3 Care and Rehabilitation Fund for the Disabled 10

3.1 Overview 10

3.2 DF Mandate 11

3.3 Governance 12

3.4 Strategy 13

3.5 Management Structure 13

3.5.1 Current Structure 13

3.5.2 Management Capability 14

Fig 5: Disability Fund: Head Office Organogram 15

Fig 6: Disability Fund – An Organisational Process View 16

3.5.3 Public Services Department 17

3.5.4 Social Welfare Department (SWD) 18

Fig 7: Fund Service Quality: Hearing Aids for the Deaf 19

3.5.5 Rehabilitation and Training (RTD) 20

Fig. 8: Fund Consultation with Associations 21

3.5.6 Public Relations and Publications 22

3.5.7 Inspection and Control 22

3.5.8 Strategic Financial Management 23


© Oxford Policy Management, February 2011 viii

Fig. 9: Breakdown of DF External Funding (2009) 25

3.5.9 Branches Department 26

3.5.10 Administration (HRM) 26

3.5.11 Planning 27

3.5.12 Processes and Accountability 27

3.6 Human Resource Capability 28

3.7 Networking and Advocacy 31

3.8 Summary of Organisational Findings 32

4 National Union of Disabled Associations 33

4.1 Overview 33

4.2 Mandate 33

4.3 Strategy 33

4.4 Management and Governance Structure 34

4.5 Processes 36

4.6 Resources and Capability 36

4.7 Summary of Organisational Findings 37

5 Analysis 38

6 Recommendations 42

6.1 Action Points 42

6.2 Mandate change 43

6.3 Corporate governance: the role of the Board 43

6.4 Eligibility Criteria and Fund Services 45

6.5 Management Framework and HR Capability 47

Fig 14: Disability Fund (Proposed) Structure 49

6.6 Strategy and Decentralisation 50

6.7 The Union 51

6.8 Alternative Disability Funding Models 51

7 Conclusion 53

Annex A Terms of reference 55

Annex B Process Mapping Workshops Outputs 67

Annex C Example Definition of Disability 76

Annex D References/Bibliography 78

Annex E List of Consultations and Organisations Visited 79

Annex F Disability Fund Values Orientation 81

Annex G Example Code of Ethics 82

Annex H Draft Terms of reference for a Financial Audit of the Fund 83


© Oxford Policy Management, February 2011 x

Abbreviations

CBO Community-based Organization CBR Community-based Rehabilitation DF Care and Rehabilitation Fund of the Disabled DPO Disabled Persons‟ Organization HRM Human Resources Management MDAs Ministries, Departments and Agencies MoSAL Ministry of Social Affairs and Labour NGO Non-governmental Organisation NUAD National Union of Associations for the Disabled OPM Oxford Policy Management

PWD People with Disability

PSD Public Service Department

RTD Rehabilitation and Training Department

SFD Social Fund for Development SWD Social Welfare Department SWF Social Welfare Fund WB World Bank


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1 Introduction

1.1 Background

This report summarises the results of the main activities conducted during the consultants‟ visits to Sana‟a during July and August 2010 for data gathering missions under the SFD project to carry out institutional reviews of the Disability Fund (DF) and the National Union of Disabled Associations (Union) in Yemen.

It is fair to say that with a recently published National Disability Strategy and proposed national elections due in 2011, this project takes place against a backdrop of an evolving landscape of social welfare reform and an acceptance that if the rights of the disabled in Yemen are to be genuinely met, a root and branch review of the architecture of service provision will be required. Such a review is beyond the scope of this organisational development consultancy however, this Report will provide essential information for such a policy-based review. This Report has incorporated this wider perspective of a changing policy scenario into a detailed institutional review of capability, and recommendations of the capacity development activity that will be required to meet current and likely projected needs.

Although a number of earlier studies have included the Fund and the Union within their scope, there has been no focused examination of institutional capability. This is the diagnostic gap the current study is intended to fill. In consultation with the client at the Inception stage, the consultants were given the flexibility to develop new lines of enquiry and research where this was suggested by the data gathering process. The result is therefore slightly modified from that defined in the original Terms of Reference.

1.2 Objective

In the context of this ongoing reform agenda, the objective of this project is to advise and assist the Ministry of Social Affairs and Labour (MoSAL) and the Government of Yemen with data on organisational capabilities and a set of concrete reform proposals for the Fund and Union.

The terms of reference for this first phase of the project were in broad terms:

To carry out a document/literature review in order to gain a clear view of the Yemeni Social Welfare context, other models of disability safety nets, and to be informed of the findings of previous research on the target organisations.

The final definition of a clear methodology and framework for research. This framework was based on the contextual chart shown below in Fig. 1.

To conduct various data gathering exercises in order to fully inform the assessment of current organisation capability, together with evidence for key recommendations and action items

The consultants were clear in their instructions that the desired outcome of this activity is not only a comprehensive Report – necessary as that is – but implementable reform proposals relevant to Yemen‟s disability service agenda. This requirement has substantially focused the research agenda of this project and the analysis carried out. In other words, the project continually questioned not simply whether the Fund and the Union are able to meet their existing mandate, but also whether they are able they meet the requirements of the National Strategy


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1.3 Methodology

The assignment benefitted from a review of earlier studies of disability services and disability in Yemen, and special attention should be drawn to the work of Tines, Metts, Mont, Turmusani, among others. A full listing of references is included in Annex C. The Yemen-based missions were focused on working closely with SFD staff and their research team to carry out various data-gathering activities over the course of two missions in July and August 2010.. The activities undertaken were:

Key informant interviews with the Executive Director of the Disability Fund, the Chairman of the Union, Directors and other responsible management of the institutions using a semi-structured format (qualitative)

Key informant interviews with partners and stakeholders of the two target institutions, including the Honourable Minister of Social Affairs and Labour, the Deputy Minister MoSAL, and beneficiary associations and service suppliers. These were conducted by telephone where necessary to reach regionally-based centres.

Meetings with service suppliers and other agencies active in the field of social welfare and safety net provision, e.g. State hospitals, Social Welfare Fund, physiotherapy centre, etc

Collection and analysis of documents, reports and data representing bundles of evidence of key activities of the two organisations

Process mapping workshops to gain an in-depth view of core processes at the Fund and the Union.

Fig 1 Capability Framework

This data-gathering activity was defined by the need to answer the key questions that figure in the Capability Framework, not just in terms of the organisations themselves, but also the wider context that create the parameters for their work, question such as:

What is the mandate of the organisation – what is it accountable for?

What does the total disability supply map look like?

How does this total supply match up with demand?


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What resources are available for the organisation?

What can the organisation do now – what gaps exist?

What will it need to do in the future – what gaps will exist?

What steps must be taken to fill gaps?

The Report, as far as possible, will follow the standard institutional format of reviewing: mandate, governance, strategy, structure, management, processes, and human resource capability

Fig. 2 Capability Review Team Members

Name Affiliation Role

Marian Guest OPM: Senior Consultant, Public Management and Accountability

Inputs on institutional capacity assessment, reform and capacity strengthening

Ashley Schofield OPM: Senior Consultant Public Sector Financial Management

Inputs on financial management, governance and capacity strengthening

Tareq Saeed Al-Malhhaji Interaction for Development Statistician / Researcher

Ali Al-Qubati Central Statistics Office Statistician / Researcher

1.4 Layout of the Report

This Report contains five components:

1. A brief summary of the scope of disability needs in Yemen, derived from various recent studies, in order to provide an order of magnitude for the work carried out by the Fund and the Union

2. A description of the capability of the Disability Fund. This description follows conventional assessment categories and criteria in the various service delivery areas, defined by the existing legal mandate of the Fund, and a projected future mandate that may be required to implement the National Strategy

3. A description of the capability of the National Union. This description will contain many of the same areas of research but as an apex organisation of NGOs, the Union‟s role differs radically from the DF and a review will again be based on its mandate and how this has been implemented.

4. Analyses and conclusions on whether and how this two-organisation model, in its current form, is capable of delivering the bold ambitions of the National.

5. Finally, a set of proposals in the form of action plans that can be implemented rapidly to achieve the necessary organisational reforms.



2 Disability Services in Yemen

2.1 The Prevalence of Disability

The scope and scale of need for services for the disabled in Yemen has yet to be satisfactorily assessed. Recent studies give widely different estimates of the numbers of people with disabilities (PWD). More revealing, in many cases the same data is recycled with the same caveats concerning accuracy and reliability.

The consensus appears to be that:

While Metts estimates a figure of 776.197 PWD (2005), other studies quote totals in the region of 1.2 million PWD. Such a wide spread indicates very little apart from a serious paucity in reliable data.

Mobility impairments are the most common form of disability (42.1% of total), followed by visual impairment (18.4%), hearing impairment (14%), mental disorders (8.1%), non-specific (6.8%), multiple disabilities (6.7%) and speech impairment (3.9%) (Metts)

While it has often been assumed that the majority of PWD will live in rural areas (75% of the total population), a trend exaggerated by links between disability and poverty and lack of awareness of preventative measures, studies appear to bear this out with an estimated 3.3 times as many PWD living in rural areas (Suraimi 2009)

Despite the recent efforts to give more priority to mainstreaming disability to create greater equality of opportunity, the reality is that disabled people are still ignored, marginalized, and under-valued by all societies

3

There are many causes of disability however “a large proportion of impairments in Yemen are…preventable”, ranging from accidents, conflict casualties, low immunisation rates, to consanguineous marriages and poor maternal care

In Yemen, the link with poverty is clear - disability is twice as high in the lowest income deciles as it is in the highest income deciles (NHS 2005) This is in line with international studies such as Yeo and Moore (2005) where country case studies tended to confirm that on the one hand disability was a cause of poverty and, on the other, that poverty is a cause of disability. The most widely quoted statistic is that about 10% of the world‟s population live with a disability, but that 20% of the world‟s poorest people are disabled.

2.2 Defining Disability

Determining the scope of the disability need in Yemen brings us squarely up against the issue of defining “disability”– a far from simple matter “not least because disabled people comprise a heterogeneous group of people with a range of impairments and functional capabilities” (Riddell 2009). And a shift from a “medical” to a “social” definition of disability complicates things further.

In the past, the medical model focused on the physical or mental state of individuals and characterised them by impairments that were relatively easy to identify and categorise. This

3 Looking the Other Way. Disability in Yemen.


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model had the advantage of making it comparatively easy to recognise and “count” those with disabling conditions. Interventions usually included medical rehabilitation and the provision of social assistance.

This medical model has recently been replaced in Yemen, along with most other countries, by the social model of disability, which views disability as” arising from the interaction of a person‟s functional status with the physical, cultural, and policy environments.”4 This is well represented by Fig 3 below showing the WHO International Classification of Functioning, Disability and Health Model (ICF). Quite simply, disability is not an absolute state but an outcome of how an individual can function within their environment. The more supportive the environment can be made to be the less disability will be experienced. In this case, interventions are not only at the individual level (e.g., medical treatment, rehabilitation, education, etc.) but also at a much wider policy, built environment and social level. This approach formed the basis for the United Nations Convention on the Rights of Persons with Disabilities, which came into force in May 2008 and has been ratified by Yemen.

In Yemen, the 2006 Resolution states that anyone will be classified as disabled if “evidenced to be completely or partly disabled through a medical diagnosis; and this disability prevents him/her from learning or doing any business works partly or completely”. However, it is notable that a clear definition of disability was not included in the National Disability Strategy.

Source: WHO, International Classification of Functioning, Disability and Health

4 See, for example, Shakespeare, T. and N. Watson, “Defending the Social Model,” Disability and Society, 12(2):293-300, April (1997) and Hughes, B. and K. Paterson, “The Social Model of Disability and the Disappearing Body: towards a sociology of impairment,” Disability and Society 12(3):325-340, June (1997)

Health Condition (disorder/disease)

Environmental Factors

Personal Factors

Body Function & Structure (Impairment)

Activities (Limitation)

Participation (Restriction)

Fig 3: The ICF Model



The question of models and definitions of disability is not academic but central to the difficulties in accurately assessing the size and scope of services required from the Fund and the Union. It has also added significance in Yemen, where the accreditation as “disabled” by the Fund confers a categorisation of entitlement to benefits at no or reduced charge that others not defined as disabled will be either unable to access or only at possibly prohibitive cost. This accreditation has the characteristics of a “precipice” factor – if you are one side of the line you will benefit, if you are on the other you will receive nothing. Definition is therefore extremely important, it must be clear, the derived criteria sound and accepted, and possible to be applied consistently by many practitioners who would generally come to the same decisions.

2.3 Legislative Framework

The Yemeni constitution establishes the rights of the disabled to medical treatment and rehabilitation, education, training and social integration so that, as far as possible, they have equality of opportunities with able-bodied citizens.5

A large number of laws translate the broad constitutional entitlement into government policies – policies that are in the process of being harmonised with international standards.. Table 1 below sets out some of the main pieces of legislation providing the mandate and framework for entitlements for the disabled. The list summarises legislation and regulations approved by parliament or government decision. Numerous other secondary regulations, not shown, have been approved by decision of the relevant Ministries. With so many different pieces of legislation dealing with disability it can be difficult to ensure the overall coherence of the system; however, the complex legislative framework is symptomatic of the very wide range of benefits that should exist

Fig 4: Laws and Resolutions relating to Disability

Legislation Fund / Union relevance

Public Health Law No. 4 (2009). Min of Health and Pop refers to special segments of the population that have special needs

Both

Republic Decree No 5 (1991) established the Supreme National Committee, refers to developing disability prevention programmes

Both

Disability Welfare and Rehabilitation Law No. 61 (1999) entitles PWD to receive free medical care and health security.

Cross-sectional

Plus access to the built environment and public transport

By-law No. 284 (2002) reaffirmed employment quotas

Does not address communication, media and IT rights for PWD (need to amend). The Fund and Union lack adequate professional skills for policy and advocacy PR and Information programmes

Disability, Welfare and Rehabilitation Fund created by Law No. 2 2002 – Fund responsible for provision of health care to PWD, incl health awareness, establishment of prosthetic

Fund

5 Direct quotations from legislation have been avoided unless clear and unequivocal translations are

available.


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centres and provision of other health services No cross-sectoral mandate

Civil Service Law No. 19 (1991) – quota employment scheme in public sector

Union

Labour Law No 5 (1995) quota system for private sector Union

Rehabilitation and Welfare of Disabled Persons Law No. 61 Both

General Law on Education No. 45 (1992) – PWD right to basic education

Both

Law No. 23 Technical Education and Vocational Training (2006) – stipulates education for PWDs

Resolution 299 (2009) supports access to education and training for PWD

Both

Building Code No. 19 (2002)

Modified in 2008 with By-law No. 35 – facilitated access of PWD to public and private buildings

Union

Needs amendment in light of National Strategy

Fund and Union are not active in supporting new built environment legislation

Land Transport Law No. 33 (2003)

UN Convention on the Rights of Persons with Disabilities (2006)

Union

Following this body of legislation, there is now a major new policy initiative in form of the National Strategy on Disability, which is likely to require new legislation. It is worth noting that the National Strategy took the view that the existing legal framework lacked an overall coherence across all concerned Ministries, Departments and Agencies (MDAs), and also noted that laws were not always observed and enforced, nor were they supported by a delivery architecture that was robust and appropriate to implement such legislation successfully. In other words, it would be a mistake to assume that policy rhetoric and legislation is fully reflected in action.

2.4 Disability Services Delivery Model

The matrix of service providers for the needs of the disabled will include

The Ministry of Health

Ministry of Education

Ministry of Technical Education & Vocational Training

Ministry of Social Affairs & Labour

Ministry of Planning & International Cooperation

Ministry of Public Work & Roads



Ministry of Public Transportation

National Association of Disability Organizations (Union)

Numerous non-state providers

NGOs and DPOs

Fund for the Welfare and Rehabilitation of Disabled People (Disability Fund)

The principal distinguishing characteristic of the Fund is that it exists to ensure that the needs of the disabled are met with and by all other agencies. Despite the various capability issues that we will describe, it must always be borne in mind that the existence of the DF (since 2002) has been a major force for good and its work has been a transforming and positive factor in the lives of many people with disabilities. It is also recognised that the Fund and the Union will both have a significant role to play in improving the future provision of services for the disabled. The findings of this study therefore must be seen as addressing the question of how the capacity of the DF and the Union can be strengthened in order to meet current and future challenges. In particular, how these organisations can play their part in implementing the National Disability Strategy over the next 5 years.

Reviewing the overall service delivery situation, a number of general observations apply:

1. There is a striking contrast between the “philosophy” or culture underlying the current operations of the Fund (and to a lesser extent the Union) and the strong adherence to a rights-based approach to disability contained in the National Strategy. Whatever other reforms take place, the Fund will need a substantial cultural change to reflect this right-based approach

2. A number of recent studies6 have analysed the capabilities of the Fund, either as the primary focus or as one agency in wider reviews, and made cogent and practical recommendations. It appears that some “cherry-picking” has taken place and the Fund has implemented some recommendations that are most easily adopted. There will always be excuses to delay – the imminent legislative reform being one example – but there is a need for action now... We would argue that change is a permanent feature of public administration and this study will work from the assumption that institutional reform in the Fund is urgently needed and the adverse effects of continuing to delay change are considerable. Recommended actions will be defined for rapid implementation.

3. The culmination of work on the National Strategy creates the opportunity for a re-think

on how disability services are financed and delivered, which might entail a radical departure from the reform of existing institutions that is largely the topic of this study. The alternative models that have been raised are:

A decentralisation of the Fund‟s disability services

A version of outsourcing the management of disability service funding involving the private health insurance sector.

Both of these options will be reviewed in section 6

4. There was a general lack of clarity in either the DF or the Union in how they should be delivering their mandate, or indeed a clear understanding of their mandates and a

6 National Disability Strategy, ESCWA ,Looking the Other Way: Disability in Yemen, Turmusani, Majid

Yemen: Disability Profile (www.disabilityworld.org); Centre for Quality and Business Excellence Report on Organisational Self-Assessment of the Disability Fund 2009; Tines, Jeffrey Report on the Consultation Workshop for the Rehabilitation Fund and Care of Handicapped Persons in Yemen August 2008

http://www.disabilityworld.org/


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definition of their boundaries and focus. This lack of focus on mandated roles has had major effects – in both cases there has been a drift into the areas of service vacuum, immediate need gratification, an understandable desire to please and placate individuals and interest groups in the short-term, and little strategic use of resources for medium and long-term benefit for PWD.



3 Care and Rehabilitation Fund for the Disabled

3.1 Overview

The Care and Rehabilitation Fund for the Disabled (otherwise known as the Fund) was established by Public Law No. 2 of 2002, following on from major legislation (Public Law No. 61/1999), which “defined persons with disabilities and entitled them to rights of education, employment, health and rehabilitation services”. This initiative was at least partially as a result of pressure from DPOs, whose members were most affected by a lack of financial support.

This entitlement lacked any means of fulfilment until the Fund was created to provide finance to government programs that targeted persons with disabilities (PWD). The Fund was structured to provide direct support to PWD covering equipment and prosthetic devices, education, health services and some recreational and cultural activities. The Fund also provides indirect support through funding disability organisations. In order to carry out these roles the Fund has six core processes7:

To act as a registration centre for individuals to establish an identity as a PWD within the legal sense of the term in Yemen, and for groups, as associations providing services for the disabled

The assessment of need for individuals and institutions

The identification of solutions and fulfilment activities

Contracting and procurement of services for the disabled

Management of income and disbursement of funds

Building the capacities of institutions supporting the disabled

The Fund has an annual income from duties raised on cigarette, cinema and airline seat sales, and investment revenue of YER 2.7 billion8 (US$11.3 million9) in 2008, with about YER 2.4 billion being provided to beneficiaries including associations and NGOs. Tines10 has deduced that 39% of the Fund‟s total budget is spent on wages, salaries, rewards and incentives to staff who provide services; transportation and debt repayment. (2006) (it should be noted that Tines was unable to calculate the actual running costs of the Fund.

Tines is one among a number of respected sources who acknowledge the achievements of the Fund but are consistent in the view that it is inefficient, performing poorly and lacking the capability to greatly improve its performance to meet the requirements of the National Strategy. Indeed, the National Strategy11 was exceptionally blunt in its view that the Fund repeatedly failed to implement what it planned, that it still “lacks a systematic and updated database on disability in Yemen”; and that it does it have “the capacity to adequately monitor and evaluate the services” supported by the Fund. It also stated that there was “clear neglect for the capacity building programmes”.

7 Verified by members of the Fund Management Team at a workshop in August 2010

8 YER Yemen Rials

9 Based on an FX rate of 240YER to 1USD as at 1 September 2010.

10 Tines, J. Report on the Consultation Workshop for the Rehabilitation Fund and Care of Handicapped Persons in Yemen. Aug 2008 11

National Disability Strategy MoSAL, Yemen June 2010


12/05/201115:03:48 11

In summary these recent studies contain a number of common analytical threads:

The mandate of the Fund lacks clarity and contains a number of omissions and ambiguities

Its institutional management capacity is weak resulting in poor planning, implementation and capacity building

No clear targeting or selection criteria exist so decisions were ad hoc and discretionary

There was poor geographical distribution of benefits, and between rural and urban areas e.g. Sana‟a receives a completely disproportionate 48.3% (Tines)

There is a centralised management and decision-making structure that encourages this concentration of attention in the major urban centres, and marginalizes the rural areas where there is a high degree of unmet need.

Bottlenecks and delays are common in carrying out processes

There is undue pressure on decision-makers

There is a serious lack of technical skills and disability awareness among staff

The fact that the evidence of ineffectiveness and inefficiencies have been brought to the attention of the board and management team with little result leads to the more significant questioning of the capability of the current management to address these issues. The consultants were made aware of many plans and intentions, but there was little to no evidence of concrete action. The most obvious hypothesis is that, in the Fund, the very factors that constrain an organisation are also those that mean it is unable to identify and implement necessary changes.

3.2 DF Mandate

The Fund operates under the law (61/1999) „Concerning the care and rehabilitation of disabled persons‟ through which disabled people are accorded all the rights due to them under the constitution. The law allocates responsibility for this sector to the Ministry of Social Affairs and Labour (MoSAL) and to the Disability Fund (DF). MoSAL is specifically given the responsibility of coordinating services for the disabled, and working closely with all other agencies active in this sector. The law entitles PWD to receive support in the areas of health, education, employment, sports and leisure; and encourages all efforts to integrate PWD into mainstream economic and social activities. In some cases, this integration stops at the level of exhortation, e.g. in the area of education, while in the area of employment both public and private sectors are required to employ at least five per cent of suitably qualified PWD (enforcement may or may not take place). The mandate of the Fund was further defined by a special Law No. 2 of 2002 and is extraordinarily broad and is in no way related to the source of income vested in it. Its income cannot be changed to reflect a rise or fall in demand. With fixed incomes, the Fund cannot be expected to directly deliver all the services and funding that may be required by PWD and DPOs but no direction is provided in the legislation on how the Fund may work with Ministries responsible for core services, who perceive the Fund to be well-resourced. There is also no direction on how funding is allocated among services and users, so the Fund is legally entitled to allocate one-third of its expenditure to drugs, if it so chooses. It must also be noted that the current mandate of the Fund does not have a clear definition of disability, which is essential for eligibility criteria to be truly effective.



3.3 Governance

The purpose of any Board is to provide strategic direction and accountability of the organisation to its stakeholders, whether they are shareholders, government or beneficiaries. The governance framework is there to encourage the efficient use of resources and equally to require accountability for the stewardship of these resources. The key to such sound corporate governance – understood as the means through which and manner in which control is exercised over the entity – lies in the way in which the role and responsibilities of the Board are defined, and in the arrangements for the appointment and if necessary removal of Board members. In the case of the Fund, the composition and means of appointment of the Board are also of central significance in articulating the Fund‟s relationship with MDAs and DPOs. So, when we consider the capacity of the Board to meet its objectives, we ask a number of key questions:

Is the Board focusing on the organisation‟s purpose and on outcomes for citizens and service users?

Is the Board performing effectively in clearly defined functions and roles?

Is the Board promoting values for the whole organisation and demonstrating the values of good governance through behaviour?

Is the Board taking informed, transparent decisions and managing risk?

Is the Board developing the capacity and capability of its members to be effective?

Is the Board engaging stakeholders and making accountability real?

In accordance with the provisions of Article (16) of the Law, the Board of Directors of the Disability Fund consists of the following members:

Minister of Social Affairs and Labour - Chairman

Deputy Minister of Social Affairs and Labour- Deputy Chairman

Deputy Minister of Finance

Deputy Minister of Planning and Development

Three businessmen

Three members from the leadership of the National Union of Yemen Handicapped Associations

Executive Director of the Fund

In the interviews with members of the Board, we noted a number of concerns that may need to be considered by the Chairman in order to improve the governance and accountability framework of the Board.

The Executive Director is a voting member of the Board. The Executive Director is also the secretary to the Board and is responsible for the completion of the Board minutes.

The Board meetings are supposed to be monthly however, since mid-2008, the Board has only met five times12 due to a range of reasons. The Chair, as Minister of Social Affairs and Labour, is often not available to lead the Board due to other important ministerial engagements. Other members cannot keep shifting appointments as the Board meeting time changes many times before actually meeting. Hence, Board meetings are not held as

12

According to the Union, they were aware of only two meetings during the period.


12/05/201115:03:48 13

regularly as they should be in order to provide the strategic decision making body for the Fund.

In the context of governance it is also critical that all members of the Medical Committee, by which beneficiaries access services through the Fund, are not compromised by directly or indirectly benefitting from the decision to approve medical services to an applicant. Furthermore, the members must be able to demonstrate the appearance of being independent and having no pecuniary interest in the decision making process. This independence was not evident, while clear conflicts of interests were13.

3.4 Strategy

The Resolution 200614, spelt out the following high level objectives of the Fund

Contributing to awareness of disability prevention

Integrating PWD into society, and extending their social, cultural and sporting activities

Contributing to poverty reduction among PWD

Expanding employment opportunities for PWD.

But the Fund has no articulated organisational strategy for achieving these objectives. The reasoning put forward for this was that such matters were “on hold” awaiting the finalisation of the National Strategy. But no organisation can function effectively without an organisational strategy even in the interim (very simply, “what are we going to do and how are we going to do it?”). This has had direct implications in terms of the Fund‟s tendency to try to be all things related to disability, regardless of its capability, or the opportunity cost of doing so. An organisational strategy is also essential to support the financing model of a fund-disbursing organisation, such as the DF, in that the objectives of the Fund must be aligned with its resources and its strategic allocation and management of funds to meet those objectives. There is also a sentiment that the Fund‟s role should be limited to providing finance, and not service delivery.

3.5 Management Structure

3.5.1 Current Structure

The lack of strategy is a weak foundation for a weak and vague structure within the DF. In fact, the term “structure” implies a form and solidity that, arguably, does not exist. Organograms did not exist, even for the institution as a whole, and were drafted only at the request of this study. Even so, these versions contained inconsistencies and included roles that did not and never had existed in reality. A version has been reproduced as Fig 5.below; together with a process based view of how the organisation actually works (Fig. 6) but this study is still not confident that it has complete and accurate information on the current structure of the Fund.

13

The Fund Management wishes it to be noted that changes in this area have been made subsequent to the data gathering for this Report. If available these changes will be included in Annex H

14 The Resolution No ( ) 2006 of the Chairman of the Board of Directors regarding the issuance of the

Organizational Bylaw and the Administrative Structure of the Rehabilitation Fund and Care of Handicapped Persons



Functions appeared to move between Departments, and new Departments were established without addressing the dependent changes that would be needed in related Departments. There seemed, for example, little logic in the fact that operations of the Medical Committee, which we would expect to see within Public Service Department (PSD) or the Social Welfare Department (SWD), were in fact under the Public Relations Director; the Inspection and Control Department failed to manage quality, and the Branches Department had no knowledge of what actually happened in Branches and in no way “managed” these operations. This lack of a coherent and robust structure impacts not only the efficiency and effectiveness, but also the governance of the organisation15.

We would expect to have seen a robust management framework that facilitates the delegation of responsibility to managers and more junior staff. Instead there is a high level of micro-management, which practically precludes the Executive Director from having the time and perspective to address the more strategic issues of the Fund‟s role in creatively finding solutions to meeting the needs of the disabled in Yemen.

3.5.2 Management Capability

The Management Team (i.e. Departmental Directors) did not operate as such. Without clear job descriptions and decision-making authority aligned with their roles, the Directors are operating as little more than team managers. No regular Management Team meetings take place, either as a peer group or under the leadership of the Executive Director. The result is that each has limited knowledge of other‟s activities and they are unable to identify or address performance issues that invariably cross functional boundaries. This is a classic case of functional silos that fail to focus on service delivery to the end-user, unless transcended by informal personal working relationships between department heads.

All indicators suggested centralised information and decision-making processes that placed an unacceptable burden on the role of the Executive Director. Under the current operating model, even the most trivial request must be authorised by the Executive Director and in many cases, the process takes documentation to the Executive Director‟s desk several times. Moreover, the Executive Director is seen as the sole arbiter and decision-maker by organisations and individual beneficiaries and so attracts what are in effect “petitioners” or supplicants requesting a favourable decision. This generates “shadow” processes that circumvent and undermine the standard operating procedures. Such a situation inevitably carries with it excessive pressure on the Executive Director, and a total reversal of the “rights-based” approach to disability provision that is contained in national policy statements.

15

The Fund Management wishes it to be noted that changes in this area have been made subsequent to the data gathering for this Report, and a current organogram will be included as an Annex if submitted.


_________________________________________________________________________________________________© Oxford Policy Management, February 2011 15

Fig 5: Disability Fund: Head Office Organogram

Board of Directors

Inspection and Control

Rehabilitation and Training

Public Relations

Finance

Executive Director

Administrators (tbc)

Social Welfare Public Services

Dept

Administration (HRM)

Planning

Branches



Secretariat office of the Exec. Director (IT)

Accounting Procurement Maintenance



Pla

nn

ing

Ins

pec

tion

an

d C

on

trol

Pu

blic

Se

rvic

es

Dep

artm

en

t

Bra

nch

es

Invisibly supporting the program- focused core functions

Disability-focused functions (Client relationship, assessing, advising, funding, monitoring, developing)

Fin

an

ce

Ad

min

istra

tion

(HR

)

Social Welfare Department

Rehabilitation and Training Department

Executive Director’s Unit Stakeholder management Authorisation and approvals Team leadership Financial leadership IT

Processing of payments Information gathering Compile financial reports Procurement. Ensure legal and auditing compliance

Reception facility, registration of PWD, eligibility checking,

end-to-end processing of applications

Processing applications from PWDs, supplier management, verification of health and education providers.

Design Communication and Information materials, website and promotion of Fund

Processing applications from PDOs, NGOs and related orgs. Information gathering, capability development; programme support – planning, budgeting, M&E

Fig 6: Disability Fund – An Organisational Process View

PR and communications


_________________________________________________________________________________________________© Oxford Policy Management, February 2011

17

This centralisation of decision-making may have been adequate or even necessary when the Fund was in its infancy, but with its current and emerging larger role it is causing bottlenecks, pressure points, instances of undue influence, lack of transparency, and represents a major risk management problem (e.g. in the event of illness or exit by the Executive Director). For all practical purposes, the current management capability of the Fund is defined by and limited to the profile of the Executive Director and no succession plans were in place even as a contingency. Rather than possessing any institutional robustness, the Fund is in a highly fragile situation that needs to be addressed as a matter of importance and urgency. The current functions of the Fund are described in the following section, by Department.

3.5.3 Public Services Department

The PSD is one of the most recent institutional developments at the Fund. It was established in 2008 in response to widespread concerns over the reception facility available to clients. The Department is housed in a poorly-insulated, temporary building16 within the Fund compound but separate from the main building and carries out the functions of reception and registry for all applicants, reviewing applications for basic eligibility, status, disability and degree of urgency before forwarding on to SWD, the Rehabilitation and Training Department (RTD), the Medical Committee or directly to hospitals in urgent cases.

The Department‟s workload is organised along the lines indicated in the organogram above and in the core process maps for the Fund, included in Annex B

In terms of organisational effectiveness the PSD is exceptional in some ways in that it appears to have:

1. Defined roles, responsibilities and workflows that were strongly geared to a rights-based view of client needs rather than internal procedures

2. Some guidelines and standard procedures that appear to be understood and implemented by all staff. Activity reports were used to forecast workload and manage throughput

3. Staff had been recruited by the usual Ministry of Civil Service channels so many lacked specialist knowledge and skills appropriate for the roles. A variety of academic backgrounds were reported e.g. sociology, psychiatry, accounting, and management. While technical knowledge was certainly desirable, investigative skills, the ability to

16

The conditions may be “average” for Sana‟a

Public Services Department

Archiving and ID Issueance

Officers x 3

Follow-up and

Coordination Officers

x 6

Investigation and

Recording Officers

x 3

Reception Officers

x 5

Zaid Salman

Head of Deprtment



view problems analytically, and communication were also significant competence needs

4. A degree of self-motivation among staff that made possible less of a command and control environment and more one of empowering experienced staff to “own” tasks, allied with “values” that were disability-oriented and rights-based

5. Access to better IT and communications resources. This is far from satisfactory for a unit fulfilling such a role, but it is substantially better than many other core departments of the Fund and probably has benefited from its recent establishment.

Problems remain however, firstly in that no training has been provided other than basic on-the-job demonstrations from other staff members. In particular, no training had been provided in how to communicate with and assist PWD, leading to frustration and wasted time for applicants and staff. This was a strong area of dissatisfaction among clients such as the deaf who commented on the fact that there was no capacity for sign language at the Fund. For deaf societies, this necessitated taking their own translator to meetings, which was possible, but created enormous difficulties for individual deaf people, making communication impossible. The same disabled group reported that even if there is a translator, to progress any issue required the presence of an Association Chairman or the Head of the Union to “add weight” or to escalate.

As the first point of contact between the Fund and PWD, the Head of the PSD was very focused on “service” to clients but staff were conscious of their own knowledge gaps, such as sign language, that reduced the service level that they were able to offer. The aim of creating a “One-stop window” for users has not wholly been achieved. A task rarely takes place entirely within PSD so cross-departmental processes require clear and robust linkages to ensure a minimum of delay and errors. Given that the location of the PSD is in a separate building and that core activities such as producing ID cards are situated in the main Head Office building, problems were inevitable.

It was also apparent from process work that while standard processes and procedures were in place to ensure fair access and services related to need, applications were received directly by the Executive Director‟s office, and the other service Directors, so parallel processes were likely to take place unconnected with PSD. This not only undermines the efforts of PSD to establish a consistent and equitable service level for all, it reduces the accuracy of the recording and reporting of applications that takes place in PSD

3.5.4 Social Welfare Department (SWD)

SWD carries out the formal registration of individual PWD to enable them to benefit from the entitlements granted to them by law, and facilitates various health and educational procedures. A team of 29 Administrators is responsible for vetting and authorisation processes, organised along the following functional lines:

Coordination and Follow-up

Technical assessment

Reception and search

Education

Orthotics

Health services



19

The Department suffers from the same lack of specialist skills as other parts of the Fund. Key competencies were identified as strong clerical skills, such as adherence to processes and rules, as well as commitment and ethical values, but there appeared to be little encouragement to staff to generate ideas for continuous improvement in performance.

The team clearly works closely with PSD, the Branches and service providers such as hospitals. The department worked with seven computers, but with no external phone link, so there was a sense of isolation and frustration in communicating with clients and service providers. Respondents in the department believed that SWD worked satisfactorily and that service levels were “acceptable”, but serious constraints exist:

1. As the unit responsible for direct services for PWD, it was surprising that there was no reported requirement for, or pressure being exerted for, a National Disability Register, either to be compiled by SWD or another agency. Such a computerised Register is a pre-requisite for effective case handling. It is understood that the Fund lacks a mandate to develop such a Register but it would be the major user of such a Register.

2. If quality of staff performance is based on a “strong adherence to processes and criteria” to deliver a transparent and fair service to all, eligibility criteria must be entirely clear. These criteria did not exist. It is understood that definitions of eligibility have been the subject of recent action by the Board, but this had yet to filter down into criteria for staff in SWD.

3. Cases were reported where individual members of staff were able to sign-off on requests and were indulging in rent-seeking activities in order to progress requests. Similarly, staff could be subject to strong pressure by the Union to approve requests that might be border-line. This is an inevitable consequence of unclear or discretionary criteria for decisions

4. Because Branches in the Governates were not “activated” there was the appearance of a reduction in workload that was not the case.

5. The Medical Committee deliberations were a source of delays as all referrals cannot be reviewed in the time allocated – the Committee were reported to be once a week for four hours.

6. Substantial re-work and double or even triple handling of cases was a regular occurrence.

7. As with PSD, the role of the Executive Director was central in the approvals process, and in making discretionary decisions where direct applications were made.

8. Total service quality was lacking and there appeared to be little appetite for seeking user feedback and incorporating information into improving services (see Fig. 7 below)

Fig 7: Fund Service Quality: Hearing Aids for the Deaf

Among the detailed specifications in the Resolution of 2006, Regulation Nine states that (1) “the hearing aid shall be effective and clearly helpful” User dissatisfaction about the supply of hearing aids from the Fund covered a number of areas. Although associations exist to represent the needs of the deaf, the Fund has not consulted such groups on hearing aids before procurement decisions are made. This was described as an unfortunate example of out-dated attitudes of the able-bodied deciding what is best for the disabled. This lack of consultation is given added significance by the problems experienced by beneficiaries. Anecdotally, there were reports that the Fund supplied hearing aids that: “in many cases… do not fit”, “they do not work for the deaf person” and “deaf people need to be trained in how to use them but no training is given”; “these are the cheaper ones that cost around $200 but they are useless, compared to the good ones that cost $1200”. When users raised a complaint and wanted to return the faulty hearing aid, the response from the Fund was



that a large purchase of the same type had been made and “this is all we have – this is what you get”. One referral letter on this subject took 3-4 months to be brought before the Medical Committee at the Fund, and one year later, the Association had still not received a decision

The actual extent of user dissatisfaction was beyond the scope of this study. But given these experiences, there is an understandable sentiment that Fund staff are focused on “ticking a box” that a hearing aid has been “supplied”, and not whether it has improved the hearing of a deaf person.

This disinclination to consult with and listen to feedback from individuals and associations, and critically self-evaluate, was commented on by a number of respondents, and is clearly blocking performance improvement.

3.5.5 Rehabilitation and Training (RTD)

RTD is responsible for the assessment and approval of applications for funding by Associations, NGOs and institutions. Given the Fund‟s mandate to support training and rehabilitation in its various forms, RTD will approve funding for operating costs, staff salaries, courses, conferences, sports and leisure activities for the disabled. Its function is therefore to assess whether applying organisations (90% of whom are DPOs) meet the legal criteria to benefit from support, and once approved, the reviewing of activity reports and annual budget submissions. The core activities of the Department were described as

Approval of projects and activity plans

Project monitoring and control in all fields of vocational and rehabilitation training

Capacity development of associations

Ensuring fair and equal treatment for applicants - working to get rid of “good offices”

Making the systems accessible to all eligible associations

A team of nine Administrators are responsible for covering a number of Governates, carrying out these reviewing and processing tasks for currently 107 approved societies. The Head of the Department is an experienced social services professional in the field of disability, but the bulk of the staff lack technical and sectoral skills. The two exceptions are a Community Based Rehabilitation (CBR) specialist and an Administrator responsible for emergencies and urgent demands for assistance. It is worth noting that the Head of RTD was appointed to a Recruitment Committee set up to improve the suitability of candidates provided by the Civil Service Ministry and probably has greater influence in obtaining suitable staff for RTD than some of her fellow Directors, but there still remained a wide discrepancy between job specifications and the person appointed to fill the role. The lack of subsequent training did nothing to improve this situation.

User feedback suggested respect and appreciation for the work of the RTD, which is indicative of commitment and effort, but the low level of technical skills and qualifications among staff prevented a specialist work breakdown and allocation of tasks according to strengths. As one beneficiary organisation noted “Even when staff want to help they don‟t have the knowledge or experience to know what to do.” The skills most required, but absent, were those relating to:

Dealing with the disabled



21

Computer skills, especially administrative tasks and compiling and using databases (and assisting beneficiary organisations in database use)

Facilitating workshops

Monitoring and evaluation methods linked with budget allocations (the current forms in use were adaptations of those developed by another organisation)

There is also an attitudinal issue, where a “mother and son” sentiment pervaded the way in which some Fund staff related to the Associations.

This limitation in skills is exacerbated by the poor resources available to the team, with only an internal telephone line, a broken photocopier, a broken fax, and no computers (with the exception of the Director‟s personal laptop).

In order to fulfil their function the team should be working closely with associations and have a good working knowledge of their activities from a number of sources – not only the activity reports and budgets submitted by the associations. Nor is there a workload reason for this not to be the case, with an average caseload of around 12 associations per Administrator. But the department rarely carried out routine field visits with only one taking place since 2007. Normally, field visits were only undertaken in response to complaints or formal requests to investigate. Associations also reported that they always received prior notice of any Fund visit so any benefits of “spot-checks” were nullified. As a result of this disconnectedness, it was possible for associations to receive funding when completely non-operational.

As with other Departments, RTD was administratively meeting objectives by producing reports on time (monthly, 6 monthly and annually) but these were of questionable value if the basic accuracy of information cannot be verified.

The failure to consult with Associations is illustrated in Fig 8 above indicating survey responses from Association members. Given the physical resources limitations of RTD it is difficult to see how the unit can carry out the checks and cross-referencing necessary when this is done manually and with no IT, networking and communication facilities. Moreover, this deficiency will negate the benefits to be derived from potentially valuable work. The CBR

0

2

4

6

8

10

12

14

Yes No

Fig. 8: Fund Consultation with Associations

on Needs of Disabled



specialist is reportedly preparing much-needed studies on the operating costs of societies in the field, but it is far from clear how this information can be utilised by the Fund, given its minimal information processing capability.

Together with this resource issue, the single area of greatest concern was the very limited attention devoted to capacity building in the societies and associations. This is one of the most important roles of the Fund and capacity building of the voluntary sector is integral to policy approaches, but the resources of the RTD are totally inadequate to begin to address this need.

3.5.6 Public Relations and Publications

The PR unit is headed by a journalist with substantial experience in the field of mass communication. However the unit carries out an eclectic mix of functions. It has the vital role of information management and dissemination on disability issues (press and media releases, website management, and the production of publications) as well as organising events. It also gathers data and archives material on Fund activities and disability issues.

Four technical staff as well as seven Administrators staff the unit, but the criticism remains that, as the informed “voice” of disability awareness, prevention, advocacy and policy in Yemen, the Fund‟s effectiveness in creating visibility was low, leaving an information vacuum that no other agency was filling. We would have expected to see a wide range of regular and ad hoc publications and other material informing the public about disability issues – particularly in relation to preventative measures.

One of the potential causes of this failure of the PR unit to meet information expectations is its lack of focus. Staff appeared to be used on an ad hoc basis to take on roles that were deemed not be carried out satisfactorily by other departments. So, the department had recently taken on the role of Secretariat of the Medical Committee, organising meetings, appointments, producing case reports and processing these through the organisation – a function that would seem to be a core activity of either PSD or SWD. It is difficult to see any reason for this part of the core process of client assessment to be carried out by the PR department, and it clearly is a distraction from their very important information and knowledge management role.

It is not unusual for a PR and media function to drift into an internally-focused component of the Chief Executive‟s unit, producing more information and press releases about the organisation itself than the population it was established to serve. In this sense it may fulfil its public relations role, but where it is mandated to carry out a vital public information role, it is imperative that such a unit is primarily focused on this task and adequately resourced to do so. It is extraordinary that computing resources are available to maintain a website for the organisation, while ICT is far from fully utilised in most other aspects of services for the disabled at the Fund, and a central Disability Register does not exist.

3.5.7 Inspection and Control

Inspection and Control‟s role covers areas such as quality assurance, internal audit, complaint resolution and compliance. It is staffed by four Administrators who carry out investigative and control tasks in the broad categories of physiotherapy, hospital treatment, tenders and referred cases (largely emanating from the Administration Director). It was noted that although the nominal staff roll was four, three of the team were absent at the time of the review.



23

This role is unusual, in that Inspection (as opposed to monitoring) is usually carried out by a body separate to the one that commissions/funds for transparency. Also, inspection of, say, disability services and financial audit are quite separate things requiring very different skills. But this point has not been explored too deeply, given the changes that have taken place subsequent to field work in 2010.

This team, almost above any other, required staff with technical knowledge and skills in various fields of disability and interventions. In fact, the only specialist member of staff was a psychiatrist who was also responsible for assessing the qualifications and services of suppliers of physiotherapy, special education and speech therapy. So, it would be reasonable to state that the Department lacks specialist skills in many essential areas of medical procedures and disability. Physiotherapy and hearing aid assessment were two areas where volumes were great and it was impossible for the Department to carry out its function on behalf of patients without technical skills, which it did not possess.

Similarly, there was no evidence of relevant accounting and audit skills, and the administrative capability required to manage potential legal casework requiring integrity of evidence. Anecdotally, we were informed that complaints about services were not dealt with speedily e.g. a case of complaint by one user involved a 2 months delay for a reply, and a further one year before the case was referred to the Medical Committee. It was in the light of this type of experience that we noted comments such as “A disabled person could die simply waiting for a reply from the Fund”. Such complaints are probably always a feature of organisations such as the Fund, and we would hope that they are the exception rather than the rule17. We were unable to find stipulations in legislation in terms of complaints procedures, e.g. alternative channels that people can pursue if the internal procedure fails to respond. Disability Convention (Art33.2): “Parties shall, in accordance with their legal and administrative systems, maintain, strengthen, designate or establish within the State Party, a framework, including one or more independent mechanisms, as appropriate, to promote, protect and monitor implementation of the present Convention”.

A schedule of field visits and routine inspection protocols was produced and this was clearly desirable, however, the unit lack the staff, mechanisms or tools to work in this way. So, in practice, the Department is largely reactive to complaints, but as we learnt from user groups responses, this complaint handling was viewed as being unresponsive, lengthy and ineffective18.

3.5.8 Strategic Financial Management

The vision for any financial management system is „to provide timely and accurate financial information to support management decision making‟. Financial management is not an end in itself and is merely a process to allocate and account for resources to achieve the Fund‟s vision. The financial management of the Fund is weak with an over-reliance on cash transactions, lack of follow-up to debtors and creditors, inadequate internal controls, ineffective auditing framework, incomplete and untimely financial reporting, insufficient cash management and limited budgeting capacity. Therefore, management is not currently in a position to assess the financial position of the Fund. The budget was presented two months into the financial year for 2010 and identified relevant and planned expenditure but did not match this with identified revenue streams. It assumed that the Government (Ministry of

17

The Union have proposed a Box for Suggestions and Complaints

18 The Fund Management subsequently has informed the OPM team that changes in this area have

been made following this Report. This is as a result of a decree of the Cabinet Council disbanding the Department of Inspection and Control and replacing it with an Internal Auditing Department.



Finance) would fund the difference without confirming this. To assess the financial position of the Fund, we developed terms of reference for the engagement of an accounting firm to undertake a financial audit of the Fund as a basis of moving forward with the implementation strategy (Annexe H).

The income generation activities of the Fund were reviewed. The primary income source for the Fund is from duties raised on cigarette, cinema and airline seat sales, and some investment revenue. In terms of income generation possibilities, these income sources can represent a reliable source of income for the Fund. Cigarette duty would remain a consistent source of revenue for the Fund irrespective of whether the economy is expanding or in recession. If there economy is expanding, there could be higher levels of income through cinema and, more importantly, airline ticket sales. The key issue is that the Ministry of Finance is collecting all income duties and passing those funds to the Fund. We were not resourced to pursue this issue further with the Ministry of Finance.

The Fund could also manage its investments better. The Fund currently has almost YER5 billion in a bank account held at the central bank. As we understand it, this account does not pay any interest. We strongly suggest that the Fund negotiates with the Central Bank to provide an interest bearing account. Furthermore, there is a lack of follow-up to both debtors and creditors. As we understand it, as at the end of July 2010, the Fund has outstanding debts to the Government Hospital of approximately YER48 million. When pressed on this issue, the Fund did not think that it was its responsibility to follow up on these debts.

The other side of the strategic financial management is to focus on managing, if not reducing, expenditure by the Fund. As mentioned before, Tines19 has deduced that 39% of the Fund‟s total budget is spent on wages, salaries, rewards and incentives to staff who provide services; transportation and debt repayment. Management could consider reviewing some internal expenditure to provide greater resources for beneficiaries. About YER 2.4 billion being provided to beneficiaries including associations and NGOs. The breakdown of expenditure by activity/beneficiary is shown in Fig 9 below for 2009

19 Tines, J. Report on the Consultation Workshop for the Rehabilitation Fund and Care of Handicapped Persons in Yemen. Aug 2008

Medical & surgical procedures

17%

Medicines 31%

Financial services 4%

In-kind services 4%

Educational services 10%

NUAD Ass 1%

Qualifications 9%

Institutional Support 9%

Other 2%

Instructor expenses 13%



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Fig. 9: Breakdown of DF External Funding (2009)

The Fund could also consider reviewing the range of services and equipment currently provided to beneficiaries to streamline services, reduce expenditure and limit discretionary behaviour. Within this overall breakdown, the current payments to beneficiaries, associations and non-government organisations (NGOs) include the following:

Associations/ Centres for the Disabled/ NGOs

Operational running costs including bonuses for staff employed by the Associations, Centres for the Disabled and NGOs; fuel costs, transportation costs (hire and rent); curriculum, stationery, training materials, vocational tools and devices; clothing for teachers, trainee costs; asset expenditure including buses, televisions (for education and learning) and furniture and building maintenance costs.

Individual Beneficiaries

Equipment including wheelchairs, crutches, electric wheelchair, hearing aids, glasses, speech therapy, blind acoustics, floats, suction devices, prosthesis, mattresses, car modification, car repairs and maintenance contribution

Education including primary education costs of transportation/ bus fares, tuition, books, private school costs; under-graduate university costs (board, accommodation, university fees), transportation, laptops, research fees, graduation expenses, dictionaries, PhD costs, Doctor of medicine costs (including stethoscope and BP devices).

Health services including check-up, diagnosis, operations, medicines (whether related to the disability or not), physiotherapy, cerebral palsy treatment and on-going management, IVF treatment (authorised private hospital with medical committee authorisation for treatment).

Recreation benefits including camping trips, attendance at local and international courses, subscription fees, funding cultural events

Micro-finance loans, materials and equipment to set up a business, assistance with setting up a business

Repairs and maintenance costs for homes of the disabled

Contribution to births, deaths and marriage of the disabled

As can be seen by the above list, the remit of the provision of goods and services is very wide, but there are other Fund roles, such as capacity building, which appear to rate little attention. Given that resources are limited, we would suggest that clearer guidelines are developed to provide a more narrow range of support equipment and services to PWDs. Consequently, the Fund would be able to reach more PWDs in Yemen.

In terms of the Fund‟s partnerships with support organisations and project management, the Fund will need to improve the accountability processes to ensure that funding support is maximised and that partners meet their performance objectives in support of the Fund‟s vision.

The Terms of Reference required us to consider self-sustainability for the Fund. However, the current income streams for the Fund provide a reasonable level of self-sustainability as long as the Ministry of Finance has appropriate systems in place to capture all duties on cigarettes, cinema and airline tickets. We have also recommended that the Fund manages it investments more effectively. To be totally self-sufficient from the Government would require substantial investment, a shift to some form of service charge and potentially a shift to



private sector health insurance model which is outside the scope and resourcing of this review.

The Finance Department is the single largest in the Fund with 30 staff, all of whom were reported to be accountancy graduates, but these basic qualifications were not, in the main, complemented by more advanced and specialist skills . As shown on the Fund organogram, the Finance Department is divided into Procurement, Accounts, and Maintenance sections.

The financial management of the Fund is weak. We believe that there is scope to improve the financial management reporting to the Board, although, this will take time and resources to improve.

3.5.9 Branches Department

It would be fair to say that this Department is operational in name only, and is headed by a Director with no previous experience of managing a national branch network. More importantly, this is an important new development for the Fund and the Director has no experience of establishing such a network. The current five Branches in the Governates vary enormously in activity and quality of services provided, but this is viewed as beyond the scope of the current Branches Department. Quite simply, it acts as a “post box” for the processing of requests and applications emanating from the Branches, forwarding these requests on to the relevant department.

There are issues of “ownership”, management and resourcing of the Branches that need to be addressed, but it is clear that if the Fund is to develop a decentralised model of service delivery – and this is at the heart of much of the new Disability Strategy – this will require a level of strategic management and drive from the Fund that was not evident during this assessment. Also, the management of the Branch network will be a critical function and will require a skilled and experienced Director positioned and empowered to lead this shift.

3.5.10 Administration (HRM)

The Administration Director and seven staff are responsible for HRM, payroll, legal affairs and IT with an archives section handling training and qualification of staff and PDOs. The core skills required were described as business management, accounting and administration, with payroll clearly the biggest task, although no technical HR skills existed. The IT unit is not positioned within the Admin Department, as is often the case, but is affiliated to the technical office of the Executive Director.

This was a “young and energetic” team but the Department seems to have little decision-making authority and is positioned at a low level within the organisation and the responsible Director although having worked in the field for many years, did not appear to have had any recent training or awareness of the strategic importance of manpower planning and development.

With the Ministry of Civil Service and Insurance carrying out the recruitment function, only a minimal amount of transactional tasks need to be carried out by HR officers. An annual performance appraisal process existed but all respondents regarded this as a meaningless exercise with all staff rated as “Excellent”. No simple performance improvement activities had been undertaken, such as a training needs analysis. So, the Department lacks the technical skills to act as a strong enabling function. This weakness is an area of concern for any organisation needing to plan and implement change.



27

3.5.11 Planning

The profile and reported activities of the Planning Department were puzzling in that it is currently staffed by a civil engineer, a statistician and a project officer, together with 2 support staff. And the competencies required were described as “architects, engineers, civil engineers”, as well as programme planning and reporting. The team produces plans, reports and budgets for the Fund‟s investment projects and follows up special projects undertaken by associations.

No activity was reported in promoting improved access to the built environment so the basis for the immediate requirement for property/construction specialists was not apparent. Nor was the demarcation clear between the roles and responsibilities of this department and that of say, Finance, Inspection and Control, and RTD, who all seem to have responsibilities for covering one or more of these areas. The risk is that this generates duplication and confusion, or, more likely, that gaps exist where no department has taken ownership of a task.

It is ironic that the organisation dedicated to the needs of the disabled with civil engineering expertise in its employ, is still operating in premises that are inaccessible, above the ground floor, to those with mobility impairments.

3.5.12 Processes and Accountability

Departmental processes, in a general way, were in place for virtually all key activities but these were not mapped in any technical way. So, process working as a mechanism to ensure that tasks were carried out to a consistent standard by staff that knew and understood the linkages and dependencies did not exist. There were differing opinions on process steps and decision-making, even within the same department. And while there was anecdotal evidence that some cross-departmental processes worked well on a bilateral basis (PSD and RTD), many others did not. Where this occurs there tends to be a lack of cross-functional ownership of the processes that will directly impact the end-user

This lack of process ownership is both a result and a feature of the fact that no genuine authority has been delegated to the management team. The lack of delegated authority has the unintended consequence of creating a sense of staff feeling un-empowered and not responsible for the quality of service delivery. While there were exceptions to this lack of ownership, in some cases there was more emphasis on identifying external reasons for performance weaknesses than seriously examining areas of self-improvement.

As we have observed, tasks and processes are defined in some areas, such as the registration of PWD through the PSD, and this has created a capacity to handle greater volumes. This is a very positive step, but final decision-making is still centralised with the Executive Director. So, while defined tasks are carried out and processes completed, decisions are not made consistently and transparently but at the discretion of one person. Because decisions cannot be justified on the basis of consistent and uniformly applied criteria, the Fund lays itself open to charges of rent-seeking, nepotism, and favouritism. As just one example of this problem, rules that would preclude clinicians on the Medical Committee from personally benefiting by a diversion of applicants to institutions or private practices with which they were connected, were either non-existent, not monitored or not enforced, yet this is a common and almost accepted practice unless effectively controlled (see Governance recommendations)

The lack of systems, reporting, and accountability means that the DF is not in a position to attract or utilise external funding. There was some collaboration with International Committee



of the Red Cross in a project implementation but other than this, there appeared to be little appetite for attracting capacity building funding if this required some degree of conditionality. This insularity has without doubt slowed the institutional development of the DF in contrast to an agency that has embraced external assistance, such as the Social Welfare Fund.

3.6 Human Resource Capability

The Fund is, in essence, a knowledge organisation and its value lies in the skills and experience of its staff, so heavy focus was placed on this area of review. It was a widespread belief that the Fund did not have enough people with the appropriate knowledge, skills and attitudes for the jobs they were carrying out. This cannot be confirmed by performance data, as virtually none is collected, but evidence and interview data confirmed that the human resource capability of the Fund, in relation to its functions, is limited. This is not a surprise when the HRM function is positioned within the Administration Department, which undertakes only the most basic of transactional HR activities. There was no evidence of any people management strategy or processes. As we have noted, appointments were made through the Ministry of Civil Service and Insurance and frequently, the appointment criteria supplied by the Fund were ignored and wholly unqualified people were appointed. This was a cause of general dissatisfaction among senior managers and this inability to select staff on the basis of fit for the job has an impact on staff capability and motivation.

This situation is longstanding, but it has yet to prompt the Fund to produce job descriptions, which would be useful ammunition in defining vacancy needs to the Civil Service Ministry. Given the number and nature of the Fund‟s roles, this is not a large task and we were assured that job descriptions were “in preparation”.

From the various data gathering exercises, the following points emerged:

1. The Senior Management Review revealed more problems in the recruitment and selection of appropriately qualified people. In the first place, the Fund‟s talent requirement would ideally include previous relevant experience as well as technical qualifications. Quite simply, low risk hiring involves selecting people who have had demonstrable success in a closely matching role earlier in their career. It was the Executive Director‟s view that there was a very limited pool of suitably qualified candidates when recruiting for the Fund, particularly at a senior level, representing a national Skills Shortage rather than an organisational Skills Gap.

2. The composition of the existing management team is lacking in strategic level

experience in the specific areas of policy development, operational planning and advocacy. It was also clear that a lack of in-depth specialization among a section of the management team was contributing to weak strategic planning of their activities and of the organisation as a whole.

3. There is no succession planning in place, nor risk assessment associated with

institutionally critical roles. There are clearly areas in the organisation where critical skills and experience are found in just one individual; creating a high level of vulnerability should they decide to move. Any talent management activity requires creativity given the current employment regimen, however, succession plans need to be put in place as a matter of urgency

4. In most departments, there was little evidence of conventional man and task

management. There is little planning or objective setting, no measurement of individual performance, minimal training, and low motivation of staff. The result is



29

that work-rates that can be measured (e.g. case handling) are relatively low, and quality of output is not measured systematically. Bottom-up ideas do not appear to be encouraged. Based on interviews with stakeholders, it appears that some managers lack the practical problem-solving and initiative competencies to see beyond the lack of resources and utilise their staff productively, focusing on what can be done. There is energy, enthusiasm and talent at practitioner level but the lack of delegation and empowerment in the organisation is negatively affecting initiative and motivation. Adding resources, such as telephones, computers, printers, etc., will help. It will not, in itself, transform the situation. Real transformation will also need a considerably more empowering and supportive style of management.

5. The competency levels among staff members were generally reported by managers and clients to be: “willing but not trained”. Indeed there was exasperation among some client/beneficiary groups at the complete absence of knowledge and skills about disability and the needs of PWD among Fund staff.

6. The Fund clearly experiences great difficulties in recruiting to the profiles that they have identified. In many ways, they are completely dependent upon the decisions of the Ministry of Civil Service and Insurance. As the Fund is an autonomous entity, this lack of control over staffing is difficult to justify, and clearly has detrimental effects on competency levels

7. There has been virtually no formal professional training, or induction to convert

generalists into a professional cadre of disability service officers. This activity has been carried out, if at all, “on the job” so it is wholly reliant upon attentive and committed managers and supervisors. This happens in high performing teams, but it is not institutionalised at the DF. Also, this method of training has an inbuilt ceiling of the existing skill level of those already in supervisory posts – effectively creating “cloned” skills but doing nothing to build capability in new areas or to raise levels of competence. This requires a combination of reinforcement of the workforce through targeted recruitment and focused training of individuals who can rapidly leverage new learning within the rest of the organisation. All respondents reported a lack of training in the past, a high degree of need, and awareness that suitable courses and events were available to them locally if there was management support. Fig 10 below indicates the feedback from staff on their evaluation of their “training needs”. This list is interesting but self-assessment of this type is of minimal value in assessing actual skill gaps and training needs

No formal Training Needs Analysis (TNA) has taken place to accurately assess whether performance issues can realistically be addressed by training, and the scope and nature of any training investment requirement. It was very surprising for an organisation with a remit to build capacity for its clients, that no training and development of Fund staff was reported by any respondent.



Fig. 10: Disability Fund Administrators: Prioritised self-assessed Training Needs

Our investigations revealed many well-intentioned staff at the Fund, with potential for development and growth who are currently not being developed, and under these circumstances there is a strong risk that the most talented and able will leave. The levels of pay contribute to low morale and motivation. However, a reward structure where bonuses exceed salary is unlikely to create appropriate incentives, nor to control manpower costs. The Fund may be constrained in its ability to engineer changes in this area because employment terms and conditions are dictated by MoSAL, but more creative reward strategies are possible

8. The working conditions in the Fund Head Office are poor and there is a ”temporary”

approach to resources and facilities that is adversely affecting service-users and providers. The most obvious case of this is the telephone system, where an exchange has not been functional for some months but there is an unwillingness to invest in a system when the Fund will relocate to new premises “next year”. Most client-facing departments do not have an external phone line. A client-orientated organisation that aspires to be accessible and “close” to its users, would find this situation intolerable for even a few weeks.

9. Because the Fund does not think or act as one organisation, it is difficult to ascribe

certain values to the organisation as a whole. On the positive side there are individuals and teams who are passionate about disability and treating PWDs with total respect and dignity. On the negative side, there persists an old-style civil service culture where absenteeism, lack of punctuality, disregard for the feelings of clients, low standards and inactivity are accepted and tolerated. The Fund must be seen to embody the shift from the medical model of disability to the social inclusive model ethos in everything it does. As part of the strategic planning for the Fund, some time could be dedicated to addressing the question of articulating core values, and determining how these can be institutionalised into habitual behaviours, as well as coming to an agreement on other values. (A typical values programme is included in Annex E and a typical Code of Ethics is attached as Annex F)

0 1 2 3 4 5 6 7 8 9

Dealing with PWD

Sign language

English

Computers

Administrative

Accounts

Technical products and services

Public health

Training and Qualifications

M&E methods

Audit



31

3.7 Networking and Advocacy

The former Disability Directorate of MoSAL, now the General Directorate of Social Rehabilitation, and the Fund have no authority to impose a disability agenda of other areas of Government but they both have an implicit role in encouraging and influencing other line Ministries such as Ministry of Public Health and Population, Ministry of Education, Ministry of Public Works and Highways, and the Ministry of Transport to ensure that disability considerations are mainstreamed into policies and programmes. The Resolution of 2006 explicitly states in Article 3 a whole set of objectives for the Fund around raising awareness of disability prevention measures, integrating PWD into society as fully as possible, and working to raise the level of services available to the disabled, which seem to command little attention.

The National Strategy document contains many observations of the need for the Fund and DPOs to develop “more of an outward looking, advocacy approach…to develop a national advocacy presence”, and went on to criticise the Fund for its failure to work more closely with other agencies such as the SWF. This networking and outreach role would normally be led by the PR/Communications Department, which has the technical skills for such activity, but all core departments would be active in forming linkages and sharing information with other agencies. The organisation of a small number of events, or attendance, does not fulfil this role. On the same theme, the policy objective of increasing access to Fund services in the rural areas has in no way been met by the small number of Branches that have been established. The role and functions of these Branches were very underdeveloped or “un-activated” and there was an evident lack of ownership of this initiative. The involvement of the Governates in these Branches appeared to have created a situation of unwelcome complexity, requiring a different model of management. The relationship between the Branches and Head office was reported to be “difficult”, which raises concerns when we consider the decentralised service delivery model set out in the National Strategy. Clearly, the Fund management have yet to develop an organisational strategy on how to deliver Fund services through a national network of Branches/Agencies and such a move to decentralise will affect the size and role of Head Office. As far as we could see, if the Fund is to function as a decentralised agency through branches in all Governates, no planning had taken place on how this should they be managed and financed. This is a major strategic change in the Fund‟s “national footprint” and will require extensive new cooperation with the Governates, and a shift in the nature and management of the Fund‟s operations. We were concerned that no formal feasibility or planning process for this shift had been documented, perhaps by the Fund‟s Planning Department, for scrutiny by the Board and shared with other stakeholders.

The government agencies interviewed during this project had contact with and knowledge of the Fund‟s activities. But there is still a low level of collaboration between the Fund and the Ministries, Departments and Agencies (MDAs) on the areas set out in the Act. There is no evidence of collaboration with professional bodies as envisaged. There appears to be little evidence of the Fund applying influence and effort to supporting other MDAs in mainstreaming disability – in other words, seeking to obtain the volume gains to be generated by the main-line Ministries rather than carrying out work themselves.



3.8 Summary of Organisational Findings

The Fund is carrying out essential functions and delivering services on behalf of the disabled and this activity is a major advance on services available to the disabled before the Fund came into existence. By most of the normal organisational effectiveness criteria, however, it is failing to demonstrate that it is functioning effectively and efficiently because the standard management indicators are not in use and it lacks the governance institutional and human resource strength to adapt and grow into a new role defined by the vision of “A Society for All” incorporated in the National Strategy.



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4 National Union of Disabled Associations

4.1 Overview

The Union is the apex organisation for associations of the disabled and is viewed as an essential component in providing a powerful “voice” of the disabled in national fora and on decision-making bodies. As with the Fund, this study conducted meetings with key role-holders in the Union, in particular with the Chairman and the Finance Director, and semi-structured interviews were held with a number of the member Associations. The Union is a voluntary non-state actor in the typography of support for the disabled, but the same questions were investigated to give us a view of its organisational effectiveness

4.2 Mandate

The Union was created under the law of Associations and Foundations No. (2) 2001 with a mandate to carry out the following tasks: a. Coordinate the interests and tasks of DPOs b. Develop policies to promote the interests of PWD c. Support the establishment of member societies and their development d. Support DPOs in their role of promoting and defending the rights of the disabled In addition to these membership-focused tasks, the Union was also tasked with e. Managing the candidate aspect of the annual recruitment round of disabled persons to

meet public sector employment quota targets f. Organising the annual National Disability Day This describes a clear, coherent and necessary role for the Union and is very much aligned with the ethos of encouraging and supporting PWD and DPOs to set the agenda and take initiatives in improving the lives of PWD. But as with the Disability Fund, when actual workload was analysed, the advocacy, capacity building and policy aspects of the Union‟s mandate commanded less attention than implementation tasks, routine fire-fighting and support for individual members encountering problems. While these activities are clearly valuable, the advocacy/policy space is weakened by the limited activity of the Union in this area. Its main activities were categorized as:

Intervening on the part of societies to solve problems, particularly with the Fund

Supervising in the elections of member Associations

Providing “technical assistance”, although very little capacity building appeared to take place

Managing the employment quota for PWD (probably 80% of Union efforts are directed here)

4.3 Strategy

The Union had not articulated an organisational strategy, nor was it clear how the Union reached policy positions. With its current focus, this may not be too significant but the management were conscious of the need to be less reactive and random in the services provided so much so that it is collaborating with SFD to sharpen its focus at the time of this study.



The consultants are keen not to prejudice this ongoing work, indeed, the findings of this review reinforce the need for the Union to develop a strategy that is fully aligned with the National Strategy, the activities of the Fund, and exactly how the Union can be most effective in the framework of national disability support.

It is important to point out that an organisational strategy is not a lengthy or complex process but an agreement on what is it going to do, and how – rather than being driven by responses to individual requests for assistance. It also has a bearing on the governance issues facing the Union

4.4 Management and Governance Structure

As a non-state actor, the Union has 15 “staff” members, the bulk of whom are volunteers, who draw expenses or benefits in kind to support their contribution. The exceptions were the accountant, secretary and the security staff. A system of member subscription fees was in place but seemingly very few organisations paid these fees, so the Union was highly reliant on its income from the Disability Fund, which covered rent and utilities. Currently, it operates through six regional Branches.

The picture that emerged from this study is of a functioning voluntary agency with governance and processes in place to carry out core tasks. However, concerns surfaced over whether the systems and practices at the Union are aligned with the significant responsibilities allocated to it. For example, we see

1. Incongruence between an entirely voluntary agency where Union officials are elected representatives who were carrying out professional and specialist tasks (see organogram below Fig 11). The Union has powers to change lives through its decisions e.g., the employment committee will effectively determine who will be employed by the Government and who will not. The Committee uses criteria and processes but there are clearly risks of pressure and influence being brought to bear. There are Human Resources Management standards of selection and placement that practically demonstrate fairness, transparency and protect decision-makers from pressure, and would remove such personal pressure. Similarly, there appeared to be no reason for a travel request to the Fund to have to go through the Union, but this is the practice.

2. Similar concerns arose over demonstrable fairness and transparency among the members who were given the most active support. All associations interviewed reported that their treatment by the Fund had been dependent on some sort of intermediation by the Union. So the perception is strong that with no formal system of ensuring an even-handed approach for all members and limited resources there is unfairness in treatment. The Union has come to represent a sort of “gatekeeper” to Fund resources, and in this way it may have created an additional barrier rather than increased access for DPOs.

This type of informal intermediation in support of member associations or individuals is rooted in the discretionary nature of ultimate decision-making in the Fund, described above. If the Fund had consistent, robust, fair, processes in place that were well-communicated to the Union, its member DPOs, and other stakeholders, intermediation would only be needed and useful when there were cases of clear deviation or non-compliance with operating procedures. For this reason, we believe that the role and activities of the Union have been distorted by the weak and inconsistent institutional processes within the Fund.



Fig 11: National Union of Disabled Associations Organisational Chart (Draft)

General

Conference

General

Assembly

Inspection

Committee

Head of

the Union

Secretary

Deputy Head

of the Union

Secretary

General

Executive Board

Organisational Women and

Children

Health and

Social

Legal Culture and

Mass communications

Training and

Qualifications Sports

Statistics and

Planning

Branches

Finance and Administration

Voluntary part-time responsibilities



This intermediation role in relation to the Fund also has the unfortunate effect of compromising the Union‟s position as a wholly independent voice advocating for the rights of those with disabilities and providing valuable inputs to policy-makers

4.5 Processes

A process-mapping workshop (see Annex B) confirmed the view that the Union has processes and capabilities in place to carry out a complex, nationwide manpower selection process through communication channels with its members. And similarly, the National Day of the Disabled is managed through a structure and planning process that reflects very favourably on the commitment and energy of the Union.

Processes to support individual member associations were considerably less clear and while activities could be cited, there appeared to be no strategic plan and prioritisation of resource allocation for this component of the Union‟s work. Nor was there a clear process for how capacity building was prioritised and delivered. The intermediation “process” is largely invisible and relies wholly on the personal discretion of the Chairman of the Union and the Executive Director and Directors at the Fund.

4.6 Resources and Capability

As an independent Association, accountable to its Members, the Union can in most senses, shape itself and determine its strategy, this study questioned whether it has the resources and capability to effectively carry out the substantial role that has been allocated to it. The findings suggested that while the Union carries out a valuable function, the following issues could be constraints:

1. Voluntary commitment was very valuable, but it must be recognised that the ability of the Union to assist its members is dependent on the quality of technical skills at its disposal. The need for high levels of skill in areas such as lobbying, advocacy, the rights of the disabled including access, inclusive education, and health, and dissemination of information was not reflected in the staffing of the Union. While the Union had contributed to deliberations on matters of access and education, the point remains that improving subject matter knowledge and expertise in these areas would build its capability and effectiveness.

2. There was little evidence of strategic thinking to address generic disability issues, such as ensuring that employment quotas in the private sector were met.

3. The Union offers training in accounts, management of associations, and leadership for its members but the quality, quantity and relevance of this training was not held in high regard by Associations, nor could the Union be described as an exemplar organisation. The Union recognises the need for improving their skills but lack of funding has been a barrier.

4. The Union is not a fund-holder but as with the Fund, it is an important agency with national responsibilities and the current manual accounting system and lack of a computerised database of members are major barriers to efficiency and growth.

5. The Union had no website and no internet access. Communication with societies is by letter, and by using fax and phone to Branches. With such limited communication and information handling capability, it is difficult to see how the Union can establish and maintain close links with all its Members, and other stakeholders in the field of disability.



37

4.7 Summary of Organisational Findings

The Union carries out a limited set of valuable functions satisfactorily. Its volunteer staffing is a cause of concern and we cannot see how the technical quality of outputs can be controlled or improved on this basis, nor the range of its work. In a reversal of what is implicit in the constitution of the Union, associations choose to lobby and advocate individually on behalf of their membership, by-passing the Union, and only use the Union in order to support applications with the Fund.

This has two consequences that require attention. Firstly, despite the Union being involved in meetings with the House of Representatives, Shura Council and the Cabinet, the fact remains that it has not fully taken up its lobbying and advocacy role in the policy sphere has created a void that no other organisation is in a position to fill. The management are clearly more comfortable dealing with operational issues. Secondly, there is justifiable unease among associations at the relationship between the Union and the Fund on several grounds: the Union acts as a barrier rather than a facilitator for its members; where Fund decisions are seen as arbitrary and inconsistent, the role of the Union lacks transparency; and its position to press the Fund on improving services is compromised by a need to maintain a favourable standing with key decision-makers in the Fund. As already observed, the way that the Union operates has been altered, over time, by the discretionary nature of much of the decision-making at the Fund, but the National Strategy initiative can effectively draw a line under previous practices. Unless the role of the Union changes, there will be an increasing need for an independent, national level advocacy and monitoring body as disability moves up the development agenda and follows disability conventions.



5 Analysis

The key issues to be considered as part of this review are as follows:

1. The ambiguities in the 2002 Act and subsequent Resolutions give the Fund an extraordinary level of detail on structure and tasks, which are largely ignored, but lacking in a clear legal basis for allocating limited resources to meet an expanding need. So, while all must play their parts, there is no clear statement of the responsibilities and lines of demarcation between the Fund and the main implementing Ministries. The current legislation fails to set the work on the Fund and Union within a context of other State and non-State providers. In isolation, it would appear to place an unrealistic burden on the Fund to meet every entitlement of PWD and DPOs, even when such entitlements are enshrined in mainline Ministry policies e.g. Education for All. Conflicts of interest have been created where bodies that are appointed to hold the Fund to account are also direct beneficiaries. The earlier legislation, and more recently the National Strategy, has failed to communicate a simple and “workable” definition of disability for Yemen. This will have serious implications for the scope of the work of the Fund and the Union and needs to be addressed in all future legislation. While there are large areas of discretionary judgement on eligibility, no funding organisation can be deemed to be acting consistently and transparently. While ambiguity and lack of clarity are certainly problems, there is also a major question mark over the degree to which entities comply with their statutory duties towards the disabled, with minimal attention to monitoring and enforcing compliance.

2. The damaging effect of a lack of direction and governance from the Board. We consider

that current structure and practice of the Board allows a potential conflict of interest in that the role of the Executive Director is to manage the Fund to achieve Board mandated strategic objectives. Yet the Executive Director is able to influence the direction that the Board is taking, which is not the role that this position should be empowered with. Furthermore, with the secretarial responsibilities tasked with the Executive Director, this allows this position to influence the strategic direction of the Fund and to reflect this influence in the minutes. The irregular meetings of the Board, the lack of attendance of senior members, and time pressures that may militate against Directors giving Board affairs diligent attention similarly reduce the ability of the Board to adequately hold the executive management of the Fund to account.

3. The lack of any organisational strategy in the Fund is directly contributing to:

A lack of focus so that Fund tries to be “all things to all men” and cover too much ground. Activities tend to be reactive, gratifying factions who can exert the most pressure, and risks encroaching on the core work of other providers The Fund supplies an extraordinarily wide range of goods and services, and staff are frequently quoted as saying “The Fund does everything” as a term of pride. While it may wish to ensure that all the needs of the disabled are met, the desire to be all things and extend activities wherever there is a visible demand, has created an activity load for the Fund that is very different from that envisaged by the drafters of the original legislation. It is also very different in ethical tone from the National Strategy



39

There is no hierarchy of objectives, and so no management of the competition between its service delivery-based and policy and advocacy-based activities

Ad hoc resource allocation. Given the resources available to PWD it is vital that every item of expenditure has real impact and that activities generate a cumulative value. Without planning work (and „working the plan‟) there is a major risk of funds being dissipated on one-off initiatives that, while valuable in themselves, will not create the organisational forward momentum that DPOs need, or the basis for truly mainstreaming disability issues and integrating PWD as much as possible into everyday society

No high level understanding of how objectives will be achieved and the timeframe for their realisation, e.g. the route map for ensuring that all PWD have access to advice and support

4. The structure of the Fund does not have the benefit of being designed around a strategic

plan so that it fails to be focused on client needs, is fragmented in its operations along “silo” lines, and yet is highly centralised in its decision-making. The Fund exists to meet the needs of PWD and related associations therefore the structure must reflect this client-facing focus. There are four areas of immediate concern:

Need for two new positions directly below the Executive Director - an Operations Director with the authority to revitalise the service delivery functions of the Fund, centrally and through the expanding Branch network, and a Corporate Services Director responsible for the management of the enabling departments. These positions are needed to relieve the Executive Director of much of the micro-management of the organisation and allow him to fully contribute to the national policy initiative.

If the National Strategy is to be implemented and the Fund is to play its full part, decentralisation will be required in the Fund, which will require a capability to manage remote teams and achieve results through third parties in a way that will be new to the Fund Management and staff.

Currently processes zig-zag between Departments with consequent delays and lack of ownership. The creation of a Registry/Reception unit in the form of PSD has been a major step forward, but further work in this area is required to enable PSD to be linked seamlessly with RTD and SWD. Clearly mapped processes do far more than simply describe a flow of tasks. They guide all employees in what must be done, who is accountable, the time periods involved, the relationships with other departments and individuals. The whole reason for processes is so that many people carry out actions consistently. It is clear that where there is poor training or frequent staff movements, the need for clear processes is doubly important to ensure that the right staff with the right skills are carrying out the right tasks. The quality and cycle time issues that exist at the Fund will continue to do so until this area is given serious attention. Similarly, the tendency to work within departments rather than across the organisation will persist.

The need for a repositioned Communications and Advocacy Department is essential to assume the substantial information and awareness-raising role for the fund, a role strongly linked with capacity-building responsibilities. repositioning, a policy function added, and a general strengthening of the Corporate Services Department in order to develop professional management of key functions. A revised structure is proposed (see Fig.14)

5. Weak controls and processes exist throughout the Fund. There may be an Inspection and Control Department but this study found no evidence of any genuine curiosity about quality of service and degrees of compliance with processes and standards at



senior management level. Clients were generally grateful for the services that they were able to access through the Fund so there was a natural reluctance to express dissatisfaction, and fear that complaining would be “punished” by withdrawal of services. This is a legacy sentiment, but the Fund is doing little to encourage or educate PWD to be more assertive and confident in obtaining services that are theirs by right. But more importantly, the Inspection and Control Department exists as a cost centre of the Fund tasked specifically with dealing with complaints. It appears to be failing to do so, and it is also failing to internalise complaints and audit issues into an institutional knowledge base to generate performance improvements, and an effective escalation process.

6. The profile of the management team is a major cause for concern. All Directors have

public administration backgrounds and social protection experience in some cases, but particularly in SWD and RTD, there has been no training to develop this talent. Managers freely admitted to “feeling their way” and borrowing ideas from other organisations, in the absence of good technical management development. And felt unable to strategically drive their departments. With only general management experience, for the most part, they appeared to lack real conviction about „where‟ they were going, „why‟ and with the route maps for getting there. With the best of intentions, they had not carried out these tasks in the past and with a track record of success

The Executive Director faces a circular dilemma where he feels unable to delegate routine decisions to the Directors, but he is failing to training them to a level where such delegation would be risk-free. Some direct results of the absence in any sort of development over many years are that:

Very few individuals had experienced personal growth

Employees were de-motivated

Employees felt ignorant about the very disability issues that they were employed to champion

There are pockets of organisational effectiveness where individuals or small teams carry out tasks consistently and well, despite the lack of equipment and resources. The areas of high performance at the Fund are directly linked to the good match between the job specification and the competency profile of the jobholder. Regrettably, the corollary is also true and the low performing areas are more prevalent.

7. The management control structure is centralised with only a few key officers, primarily the Executive Director, having the authority to contractually commit the Fund to financial transactions, whether it be for individual services to beneficiaries or long term contracts for the provision of pharmaceuticals20. Coupled with the broad range of the type of goods and services (including car repairs and IVF treatment), eligibility criteria that appears flexible, a predilection for cash payments, and strong discretionary decision making, the management control framework does not provide the necessary checks and balances to ensure that financial transactions meet the goals and objectives of the Fund

20

Larger contracts are tendered through the Government Procurement Unit and signed off by the Minister.



41

8. Severe resource issues exist covering a variety of constraints including unsatisfactory recruitment through the Ministry of |Civil Service, poor selection and placement decisions, no performance management system of any kind, inadequately trained staff and management, employment conditions that inhibit measures to move, motivate, recruit or reward staff effectively. To this we must add, poor equipment, telephone and IT facilities‟ and an unfit for purpose Head Office building. But many of these issues are the direct result of executive decisions on resource allocation and can be solved by taking alternative decisions.

9. A long-standing culture of doing things “for” the disabled, based on the medical model

of disability. This prevailing culture is apparent in the standards by which employees make judgements about tasks and set priorities in their daily work. These prioritisation decisions are made by employees at every level. So, if the Fund seriously intends to embody a right-based approach in all it does, then it will need to reflect this change in new values and behaviours

10. The radical shift in the Fund‟s operations to a decentralised model through Branches

does not appear to have been fully absorbed. So the small Branch network that does exist is in addition to a central function at Head Office. Once activated, a Branch network should require less and different resources at the Head office level,, and entails delegating decision-making to a local level.

The Union‟s attention is focused upon intermediation with the Fund, reflecting a perceived need among members. The opportunity cost of this activity is a loss of focus and resources available for the lobbying and advocacy activities that are urgently required.



6 Recommendations

6.1 Action Points

In the light of the analysis of findings of this review and conclusions drawn, it would be reasonable to propose a long list of remedial activities, along the lines of the EFQM exercise at the Fund. Given the existing management resources of the Fund, the Union and the MoSAL, we believe that the change management costs of such an approach are unsustainable. We therefore propose a smaller number of interventions that we believe will each address a number of issues and generate the leverage for sustainable change. In summary, the immediate recommendations21 will seek to:

Gain greater focus by restricting the scope of the Fund‟s activities, and;

change critical factors to build its capability to carry out those activities This is by no means an easy option and will require political will, commitment of resources by stakeholders and some external support. It should be noted that with limited management resources, there is no central mechanism for identifying, planning and implementing the organisational change interventions that are necessary. These interventions are focused on the following “road-map”:

21

In the longer term, we believe there is potential to involve the private health insurance sector in carrying out basic functions, but this will require further investigation.

MosAL established select task force to develop new legislation to clarify

MANDATE of Fund

Amended Act establishes, Fund roles, definition of disability and ELIGIBILITY

criteria

Board approves new Organisational Structure and MANAGEMENT framework

Recruitment process for new Fund Director posts

Board changes rules of Medical Committee members to ensure independence and no

conflict of interest

Decentralisation Plan

Organisational Strategy developed

External Audit

Training Needs Analysis

Additional ICT resources

Board adopts new by-laws to improve Fund GOVERNANCE on: Frequency of Meetings Attendance Minutes Role of Exec Director

Statement of interests

Eligibility criteria incorporated in Fund processes and delegated decision-making in

HO and Branches

HR capacity building based on PMS and TNA

Fig 12: Recommendations Road Map (Some steps may take place concurrently)

Additional ICT resources (communication and

member database

Capacity building Advocacy and lobbying Recruitment best practices

Union Organisational Strategy developed



43

In this way we expect a rationalised cycle of: registration/application – referral – procedure/service (preferably at Government facility) – invoice direct to fund – fund pays invoice.

6.2 Mandate change

Essential amendments to the legislation will need to be driven through to enable the Fund to rationalise the goods and services supplied so that it can focus on funding rather than implementing. The changes in legislation will define the commissioning role of the Fund, carried out on behalf of the MoSAL, and by which implementing agencies must provide necessary services to PWD at a required quality, and for an agreed fee or premium; establishing a legal definition of disability, and clear criteria for receipt of benefits. The legislation will also need to include the means by which the Fund can cost-effectively establish a nation-wide Branch network in coordination with other MDAs. The process of continually adding amendments and passing resolutions over a long period has now reached the stage where further fine-tuning is probably having an overall negative impact on the coherence of the disability service framework. To move forward, we propose that MoSAL will need to draft simple new legislation, on the back of the National Strategy and do whatever is necessary to achieve rapid closure on this issue.

Our recommendations are:

Immediate

MoSAL should work closely with the Union and other informed bodies to set up a Task Force to consolidate all the required amendments into one comprehensive document and submit it to the relevant Parliamentary Committee. The Task Force will be required to exert pressure to pass the Amendment Bill into law.

Legal advice will need to be sought on the extent to which changes in the Governance of the Fund may be achieved through Board by-law changes.

6.3 Corporate governance: the role of the Board

The corporate governance role of a Board is conventionally described as encompassing four groups of tasks:22

Setting strategic direction;

Establishing and upholding policies and procedures;

Monitoring performance;

Providing accountability.

These all apply to the Board of the Fund but changes are needed for these roles to be fulfilled in practice. The Board minutes and all associated reports and documents will need to be provided to members at least five working days before the meeting is due to meet. The draft board minutes should be finalised two working days after the conclusion of the meeting and distributed to all members for comment. Once all responses have been received and

22

See for example R. Ian (Bob) Tricker (2008), Corporate Governance: Principles, Policies and Practices (Oxford: OUP).



the minutes have been amended, the chair and the board secretary should sign off on the minutes. The approved board minutes will be distributed with the agenda for the next meeting. There is no justification for the Public Relations Manager to be signing the minutes as that position does not have any formal responsibility to the Board. The board meeting agenda should contain a standing item for the declaration of interests that may be relevant to the business to be discussed at the meeting. Those who are aware there is a conflict of interest should take the opportunity to make known that there is a possible conflict. This will help to ensure transparency and avoid any accusations of impropriety.

We suggest that board meetings are held quarterly rather than monthly at a fixed time each quarter. We have also suggested that the Minister commits to attending one meeting which will be the designated the „Annual General Meeting‟ and be responsible for approving the budget, the annual plans and the draft financial statements. At this meeting, we would expect the auditors to present an interim report on their findings for the previous financial year. We would also expect that members would provide an annual declaration of interests on an approved form. The remaining three quarterly meetings may or may not be attended by the Minister. However, her appointed deputy would attend in the capacity of acting chairman. This approach manages the kudos attached to having a minister on the Board at the same time recognising that government business and political cycle will often preclude attendance.

Excessive authority rests with the Executive Director and we are suggesting that the Board considers a number of options. The Board could consider changing the organisation bylaw (Number 2: 2006) to remove the Executive Director as member and reinforce the role that the Executive Director reports to the Board. Our preference is that the Executive Director remains on the Board as a non-voting member. We would also suggest that another Board member is appointed to role of Board Secretary with the responsibilities of, on behalf of the Chair and Chief Executive, to lead the design and ongoing development of a governance and assurance framework for the Fund and to ensure that it meets the standards of good governance. This role would be the key link to the auditors and look to providing a resource to board members in terms of guiding the Board in the responsible and effective conduct of its role, providing, where appropriate, a discreet, challenging and independent voice in relation to Board deliberations and decision making key recommendations.

We note that the current bylaws do not appear to provide term limits for board members. It is important that the Board is constantly able to take on new ideas and harness the energy, enthusiasm and experience of members. It is also critical that the fiduciary duty of the members is not compromised. The general approach to this is to introduce term limits for members such that there is a regular injection of new ideas and experience into the Board and the level of accountability to the Board increases. We would recommend that terms limits are introduced for members. Whilst this would apply to all members, it would primarily impact on the business men and representatives of the disability organisations, as the political representation is changing regularly anyway as part of the political cycle.

We would consider that these recommendations and suggestions would also apply to the Medical Committee.


Immediate

Board meetings are held every quarter rather than every month at a set time

Minister to make one „annual‟ meeting each year with the remaining quarterly meetings chaired by the Deputy Minister



45

Board agenda and supporting reports are circulated to members at least 5 working days before the meeting.

Board minutes are circulated to all members after the meeting within 3 working days for comment and correction. Once finalised, the minutes are to be issued within 2 working days.

Minutes are to be signed by one recognised member of the Board and the Chairperson

Each member is to declare an annual statement of interests

Medium term

The Executive Director to be a non-voting member of the Board

Term limits for board members and medical committee members

Training on “Being and Effective Board Member” for all Directors

Medical Committee to be revitalised with members that do not, whether directly or indirectly, have a conflict of interest

6.4 Eligibility Criteria and Fund Services

As previously argued, the lack of strong internal controls and the discretionary decision making leaves the Fund open to the appearance of excessive personal control for those with the authority to make decisions. Clearly, the Fund cannot continue under this structure and the Executive Director was supportive of efforts to clarify the eligibility criteria for the disabled and to tighten the range of goods and services that the Fund currently provides.

We support any initiatives that will clarify the eligibility criteria and, at the same time, the level and breadth of support provided by the Fund. The definition of “disability” can be problematic, as we discussed in Section 2.2, but we would recommend the adoption of a simple description that could be understood by all, e.g. the UK‟s Disability Discrimination Act provides a definition:

"A physical or mental impairment which has a substantial and long term adverse effect on his/her ability to carry out normal day-today activities"

or the UN Disability Convention:

“….those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others”(Art 1).

Each element of these definitions of disability has a specific legal meaning and each element must be met. We would also suggest, concurrently with efforts to tighten up the eligibility criteria, that a policy and procedures manual is developed that clearly identifies the accountability structure and the checks and balances within the various systems; and that resources are committed to rapidly developing a computerised National Disability Register with each PWD allocated a unique identification number.

The range of services and equipment provided by the Fund was discussed in section 3.5.8 Financial Management and it is worth repeating some of this. Essentially, the Fund was providing:



Equipment including wheelchairs, crutches, electric wheelchair, hearing aids, glasses, speech therapy, blind acoustics, floats, suction devices, prosthesis, mattresses, car modification, car repairs and maintenance contribution

Education including primary education costs of transportation/ bus fares, tuition, books, private school costs; under-graduate university costs (board, accommodation, university fees), transportation, laptops, research fees, graduation expenses, dictionaries, PhD costs, Doctor of medicine costs (including stethoscope and BP devices).

Health services including check-up, diagnosis, operations, medicines (whether related to the disability or not), physiotherapy, cerebral palsy treatment and on-going management, IVF treatment (authorised private hospital with medical committee authorisation for treatment).

Recreation benefits including camping trips, attendance at local and international courses, subscription fees, funding cultural events

Micro-finance loans, materials and equipment to set up a business, assistance with setting up a business

Repairs and maintenance costs for homes of the disabled

Contribution to births, deaths and marriage of the disabled

The Fund was also providing for the operational running costs including bonuses for staff employed by the Associations, Centres for the Disabled and NGOs; fuel costs, transportation costs (hire and rent); curriculum, stationery, training materials, vocational tools and devices; clothing for teachers, trainee costs; asset expenditure including buses, televisions (for education and learning) and furniture and building maintenance costs. This was without any independent accountability for these payments. Our perspective is that the Fund could be doing more with existing financial resources if it considered a more appropriate range of services and equipment designed for PWDs to actively participate in the workplace.

We would suggest that the Fund only provides medical equipment and that, before any replacement is provided, the old equipment is returned. We would also suggest that the Fund provides primary education costs to disabled children and/ or the children of disabled parents upon production of receipts and a statement of attendance from the School. We would further suggest that access to university places is by scholarship and is restricted to under-graduate level.

With regards to provision of health services, we would suggest that this is restricted to those costs associated with the treatment of the disability at a Government facility and the integration of that person into the workplace. We would suggest that the provision of IVF treatment, whilst laudable, is an expensive privilege for the few and should be ended. The Fund may use any savings from IVF treatment to support more direct patient health services.

The Fund‟s support for recreation and cultural events should be restricted to those cultural events that highlight the needs of the disabled in the community and the benefits of the Fund. We would suggest that the Fund‟s contributions to repairs and maintenance of the homes and the support to setting up a business are ended. Finally, we do not believe that the Fund should be contributing to the births, deaths and marriage of the disabled. This is a private cost that is borne by all members of the community, not just the disabled. Rationalising services will have the incidental benefit of simplifying decentralised decision-making in the Branches


Immediate



47

An external audit is undertaken which includes a review of the internal controls and identifies weaknesses

Review the eligibility criteria (to reflect strategic priorities?)

Review the provision of goods and services with a view to limiting those services to meeting the needs of the disabled to manage their disability

Negotiations with the central bank to provide an account that earns some interest on the account balance. The possibility of having a working account and an interest bearing account provides a minimal risk option.

Develop a policy and procedures manual

Develop a computerised National Disability Register

6.5 Management Framework and HR Capability

The structure of the Fund may appear logical but as we have observed, it is ignored when convenient, shadow or parallel processes are routine, and managerial responsibility and accountability is absent when decision-making is highly centralised in the role of the Executive Director. The recommended mechanism for relieving the Executive Director of an excessively large spread of direct reports, and operational decision-making is a restructuring of the organisation along the lines shown in Fig. 14.

The two new senior roles will have the following objectives:

1. Operations Director – responsible for all disability-focused services, encompassing the current work of SWD. RTD, Branches, and PR and Publications and with clear personal objectives to manage a growing Branch network, raise service quality, productivity, and user satisfaction

2. Corporate Services Director – responsible for all the departments delivering “enabling” services to the client-focused functions (Finance, IT, Inspection and Control, Planning, Admin/HR, etc) with clear objectives to impose effective and transparent processes, controls, and consistency.

Other structural changes include the amendment of responsibilities for

Inspection and Control, which should be revitalised as an Audit and Accountability unit

23, and a clear distinction made between technical and financial monitoring,

which will require different skill profiles

Procurement to become Procurement and Contracting with a stronger role in providing outsourcing support – not merely in tendering processes but rigorous specification of goods and services, and supplier management.

PR and Publications becomes a unit more focused on information, awareness and advocacy initiatives, and less a unit to promote the work and image of the Fund. We also see the Department as having an important role in the capacity building function of the Fund and the Union by taking an integrated approach to communicating information and awareness about disability issues

23

The Fund has subsequently initiated some organisational re-structuring and this may have been achieved through the changes noted earlier to establish an Internal Auditing Department



It is also vital to position the Medical Committee as an appropriately independent body with no conflict of interests concerning issues of eligibility or treatment.

Two related points need to be noted. First, it is probable that selection and placement decisions will be phased so that senior appointees are able to define their teams, and that flexibility and creativity will be needed in transitioning employees into new positions, where this may be necessary.

The skills gaps that exist at all levels within the Fund must be addressed as a matter of urgency. The training needs information received by this study has given us a broad picture (see Fig 10) but this is in no way adequate to justify the substantial training investment that we believe will be required. We therefore propose an accelerated production of Job Descriptions using a standard format and rapid Training Needs Analysis to identify priority learning and development programmes aligned with organisational objectives and the new Job Descriptions. However we are confident that an immediate roll-out of a Values and Dealing with Disability programme would be of value to all Fund employees.


Immediate

Approval is sought from the Board on the new structure and the budgetary implications.

Development of Job Descriptions for all posts

The recruitment and selection process is begun to appoint new senior Directors to the roles of Operations Director and Corporate Services Director. These roles require substantial technical knowledge and skills as well as strong change management expertise in the public sector so we think it unlikely that such posts will be satisfactorily filled through the normal Civil Service Ministry process.

A consultation takes place with MoSAL to review the recruitment process provided by the Civil Service Ministry to the Fund. Without creating a new and costly recruitment capability function within the Fund, which would be a misguided use of funds, a third party agency is needed to carry out this function. If the Civil Service Ministry cannot offer an improved service, we would suggest investigating other agencies.

Fig. 13 Integrated Communications and Information Functions

Research Information &

Communications Capacity Building

Creating relevant, timely and objective information and knowledge

Multi-media ―packaging‖ and dissemination of information in user-friendly formats for maximum access

Development of critical awareness and understanding for interpreting and utilising information to manage activities, influence and challenge policy



Board

Rehabilitation

and Training

Branch

Network

Finance

Director Corporate

Services

Director

Operations

Information

Public Services / Registry

Communications

and Publications

Procurement &

contracting

Webmaster /

IT

Executive Director

Capacity

Building

Medical

Committee

Social Welfare

Media and PR

Fig 14: Disability Fund (Proposed) Structure

Secretariat

Planning

Audit and

Accountability

Admin / HR

Training &

Qualifications Accounting

Health Education

Management Committee Members



Commissioning of a rapid TNA exercise to produce priority training plans (within one month)

Medium term

Once in place, the Operations Director and the CSD will be responsible for engineering other departmental changes. This will require additional, external HRM support

6.6 Strategy and Decentralisation

The strategic options open to the Fund are highly linked with the organisation‟s mandate and decentralising service delivery, that is what services it delivers to PWDs and how. This will ensure that beneficiaries are better able to receive a service that reflects their individual needs, helps them to remain in their own community, if appropriate, and makes it easier for assistance to be provided in time to prevent severe difficulties rather than react to them. Typically, where functions are transferred to local Government level, such as the Governates, these depend heavily on the central organisation transferring authority and decision-making, if not direct expenditure. Any development must be mindful of the fact that an organisation that is failing to operate well at a central location is unlikely to be able to effectively manage remote operations. At this stage, we would favour a stage one situation where Branches were responsible for registration of applicants and approvals, with invoicing from the actual service provider to DF Finance for payment. But this process requires further detailed examination. We would recommend that an organisational strategy is developed by the Fund as a matter of urgency to articulate its focus and operational priorities, to include how it intends to meet the challenges of decentralisation. Immediate

The Fund be assisted through an immediate one day workshop to develop and articulate an organisational strategy for creating nationwide accessibility to Fund services, and which will also include an articulation of the Fund‟s focus and organisational structure

A clear articulation of the Fund, the Union and all other government agencies‟ core areas of responsibility in disability service provision – what they can and cannot do well, and managing the interface with other agencies accordingly.

Medium term

A computerised national Disability Register will facilitate a decentralised service delivery while allowing Head Offices of the Fund and Union to maintain visibility of need. to support applications handling from the point of registration to final service provision, as well as generating and tracking data for awareness, information and advocacy and compliance programmes

The consultative preparation of detailed operational plans for a nationwide Fund Branch network.


51_________________________________________________________________________________________________©

Oxford Policy Management, February 2011

6.7 The Union

As we have observed, the major area of concern for the consultants is the evidence of the Union acting as an unofficial “gatekeeper” to the Fund and access to its services, for individuals and members associations. This was always an aberration. As the Fund adopts news ways of working, with more rigorous processes and clearer eligibility criteria, the temptation to play this type of role will diminish, however the Union itself will need to retain its focus. Work is underway with the Union under the sponsorship of the SFD at the time of this study to build capability in key areas. In the light of the distortion in the Union‟s activities in relation to the Fund, we recommend an Organisational Strategy review to re-focus Union activities on those areas defined in the National Strategy and aligned with member wishes. There is likely to be a new and very important role in consultative research and advocacy – specifically, these two being legitimate and necessary activities as opposed to „intervening‟ and other current methods of influencing. Following preparatory work, we would anticipate such a strategy being put to the AGM of the Union for general approval and adoption. When new strategic objectives are agreed, a targeted capability development plan can be rapidly implemented to ensure that the Union has the competencies and resources to meet these objectives. These will include updating the “unfit for purpose” communication and administration system at the Union, with an acceptable degree of computerisation, developing its capability in advocacy and lobbying, and its capability to push the boundaries of mainstreaming disability issues Immediate

The Union be assisted in developing an organisational strategy that will support the National Strategy and the interests of member Associations through a facilitated workshop

The Union membership adoption of an enhanced role as an independent, national level advocacy and monitoring body in line with international disability conventions

A workshop to share best practices in recruitment and selection for Employment Committee members

Medium term

A computerised membership register with a web-site and web-access for improved communication

Delivery of Programmes to build capability in advocacy and lobbying (e.g. improving the employment rate of PWD in the private sector)

6.8 Alternative Disability Funding Models

The consultants‟ review of other national disability fund models did not identify options that could be directly imported to Yemen and generate dramatic improvements. In countries such as Chile a “hybrid” system involving the Government and private insurance has been introduced, which would have limited applicability in Yemen, and it has been subject to much criticism. The incentives for risk selection in insurance markets are a key issue affecting efficiency and equity. Insurer‟s profits hinge strongly on risk discrimination and the avoidance of high risk clients. In Chile, the



involvement of the private sector has allowed and encouraged risk selection (Titelman, 2000), and the private sector also tends to develop into a provider of high complexity services. There was a consensus that not enough empirical evidence is yet available to assess the benefits and drawbacks of outsourcing some elements of the management of disability services to the private sector or NGOs, as opposed to direct public service provision. However we found no reason why some form of outsourcing the process of determining individual eligibility and access to health services to private sector insurance providers, using a premium per disabled person system should not be more fully investigated We would also question whether the strong regulation and oversight structure that must be in place to manage the technical quality of outsourced provision, and avoid the risks endemic health care markets are possible at this time in Yemen. We were therefore not encouraged in looking to the private sector to an immediate solution to the operational and service failings of the Fund. However, this option may justify a far more detailed review than was possible in this study. Immediate

We would strongly recommend commissioning of a specialist study to advise on the most appropriate funding model to implement the Yemen National Disability Strategy.


53_________________________________________________________________________________________________©


7 Conclusion

In many organisational reviews, it quickly becomes clear that one key factor represents a blocker to change or performance improvement, and attention in this one area will achieve major results. In the case of the Disability Fund, many factors are limiting its effectiveness, and in the case of the Union, we have grave concerns that the focus of activity is misguided and is not matched by appropriate governance or skills. As we have noted, the existence and mandate of both organisations have been a strong force for good among PWD where comparisons are made between life for PWD before 2002 and now, the result is very positive and the MoSAL should be encouraged by this fact. Now, the prevailing view of disability has changed in Yemen and this has recently been articulated (in the National Strategy, June 2010), so there is little value in comparing capability with the former mandate, The key questions revolve around, using the data on current operations, how the Fund meets the capability requirements that are dictated by the National Strategy, and how the role of the Union will play its part.

In the Fund, a number of important organisational components are missing or broken. So while there are many aspects that function, albeit less than optimally, we have focused on the major factors that are creating „disabilities‟ rather than capabilities, and will need to be reformed. These factors are:

1. Weaknesses in the original and secondary legislation

2. Mainline MDAs failure to fully comply with their responsibilities towards PWD

3. The lack of direction and governance from the Board

4. The lack of any organisational strategy

5. A structure that is missing key components

6. Weak controls and processes

7. Constrained management capability

8. A complete centralisation of power and decision-making in the Sana‟a Head office and in the role of the Executive Director

9. Severe HR and physical resource issues

10. A long-standing culture of doing things “for” the disabled, based on the medical model of disability

In the case of the Union, we believe the main area of concern is not capabilities, although further training is needed, but a misallocation of effort and resources into an inter-mediation role with the Fund to the detriment of providing the conventional services of an apex organisation to its members and society.


55_______________________________________________________________________________________________

__© Oxford Policy Management, February 2011

Annex A Terms of reference

IV. Appendices

Appendix A—Description of the Services

(Terms of Reference)

For

Organizational Development Consultancy for Care and Rehabilitation

Fund of Disabled & the National Union of Disabled associations

Purpose: To assist and advise I. the Care and Rehabilitation Fund of Disabled

and II. The National Union of Disabled associations in the field of organizational development

Needed Expertise: Technical Advisor/Consultant for Organizational Development (“the Consultant”)

Timeframe: Initial visit (12/6/2010-25/6/2010)

(24/7/2010-30/7/2010)

Tentatively: During the period of (5/6/2010-30/7/2010)

The amount of working days is 03 working days

The need for follow up visits to be mutually discussed between SFD and the Consultant.



The Consultancy will be coordinated and facilitated by the Social Fund for Development (SFD). The Consultant will be accompanied by a nominated person identified by the SFD and other relevant staff depending on the need.

The visit to Yemen in general and any travel within the country in particular will be prepared, security checked and coordinated by SFD, in close cooperation with the consultant.

CBM acts as a facilitator and advises on the contents of the consultancy, the consultant is however directly responsible to SFD. SFD agrees to provide CBM with the OD report and relevant recommendations.

General Information

Social Fund for Development (SFD)

Yemen‟s Social Fund for Development (SFD) was established in 1997 as an administratively and financially autonomous agency to help implementing national social and economic plans. The SFD‟s main goals are to reduce poverty and improve living conditions for poor people by increasing access to basic services, while also providing an example of an effective, efficient and transparent institutional mechanism. The SFD approach to work for groups with special needs focuses on improving the quality of life of the most underprivileged and vulnerable groups as well as those at risk.

The SFD pursues its goals through four main programs:

Community Development Program: Increasing access to basic social and economic infrastructure and services.

Capacity Building Program for local partners (incl. e.g. communities, NGOs and Governmental Stakeholders)

Small and Micro Enterprise Development Program

Labor –Intensive works Program

Currently, the SFD is involved in the development of three national strategies: Social Protection, Disability (together with the Ministry of Social Affairs and Labor) and a Care and Rehabilitation Fund of Disabled.

Future major strategic directions of the SFD are Community Based Rehabilitation, Promotion of inclusion and inclusive education, as well as outreach programs. In the field of health, SFD supports the Ministry of Health (MoH) in achieving the Millennium Development Goal's, focusing on primary health care, maternal & child health, health education, and Mental health.

In addition, the SFD is in the process of developing a Child Protection Policy and Manual.

The organization is interested in developing quality, sustainable disability and development programs in Yemen. It works on a national level, is well connected with various line ministries, has major influence, promotes local/ national ownership and has financial resources available for investing in infrastructure development, equipment as well as for capacity building of national stakeholders.


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Care and Rehabilitation Fund of Disabled24

The Care and Rehabilitation Fund of Disabled (DF) was established according to the Law (2) in (2002). The DF provides financial assistance according to two main levels:

Institutional level: in which the DF provides financial assistance to the activities of non-governmental organizations (NGO), disabled persons organizations (DPO) which target persons with disabilities (PWD) and other rehabilitation centers working in the field of disability.

Individual level: in which the DF provides financial assistance to persons with disability (PWD) in health, education, training, and assistive devices.

According to the Law 2/2002, the DF has a set of financial resources consisting of sources such as customs declarations, flight tickets, packet of cigarettes, and cinema tickets as well as the returns of the fund investment earnings. However, the cigarettes‟ returns are considered the main source of revenue for the DF since they formed, for instance, around (%77.97) of the DF‟s total revenue in 2007. In addition, the DF‟s investment portfolio still relies on the returns of the treasury bonds only. In 2007, these returns were nearly YR 543 millions.

The DF provides its services and supplies through a network of branches in (5) governorates in addition to the head office in Sana'a. Also, it has developed partnership relations with a network of NGOs, DPOs and rehabilitation centers spanning (19) governorates.

The number of the PWD served by the DF and its partners has significantly increased from (24,278) in (2002) to (147,556) in (2007). Likewise, the number of NGOs, DPOs and other centers funded by the DF has increased from (25) in (2002) to (92) in (2007).

The DF is managed by a Board of Directors headed under the chairmanship of the Minister of Social Affairs & Labor. The board members represent governmental and non-governmental organizations, NGOs, DPOs as well as persons with disabilities.

The National Union of Disabled associations

The NUAD was created in accordance with the provisions of the law of civil associations and foundations no. (2) For the year 2001. The NUAD aims to:

Coordination efforts and common interests between the member associations to develop and improve the service areas provided to people with disability belonging to those associations nationwide.

Encourage the establishment of the various associations with regard to disability, activate their roles, and consolidate their efforts.

Guide the member associations in achieving its goals and defending the rights and interests of people with disability set out in the current legislation and laws.

Craft strategic policy for the Union and its member associations in line with the public policy in order to enhance the social activities of the member associations to contribute effectively to the country overall development process.

24

Source: Qube: Report on Organizational Self Assessment - DF Final Report



The management system governing the work of the Union issued under the law of civil associations and foundations No. (2) For the year 2001.

Disability-Related Data for Yemen25

The number of persons with disabilities in Yemen can only be categorized as an estimate at best. Different estimates range from 0.4% to 12%. There is a lack of consistency across different studies regarding the prevalence of disability in urban and rural communities: According to one study (YDC, 2003) it is suggested that the number of persons with disabilities is 3.3 times higher in rural areas than that of urban areas whereas, most recently in the World Bank Social Protection Report Phase I (2007) it is reported that the highest rates of disabilities are found in governorates of Aden (11%), Sana'a (10.5%), Taiz (8.5%) and Sana‟a City (8%); whereas in other regions such as Al-Mahara (3%) and Al-Mahweet (3.5%) the disability rates are considerably lower.

Possible reasons for such discrepancies between urban and rural areas may be that: (a) there has been a movement of households with persons with disabilities to major cities in order to gain access to services; and (b) lower reporting of disability in some regions (Al-Mahweet and Al-Mahara) because of the social stigma associated with it or the fact that many impairments (e.g. learning disabilities and rheumatism) will not necessarily be considered as impairments leading to disabilities. Low prevalence rates can also be a sign of low survival rates which in turn are an indication of poor health care and other serious poverty factors.

25

Source: CBM Disability Profile Yemen, 2009


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In general, poverty and cultural values are two important causes of disability in Yemen. Some research suggests that 30% of disabilities result from congenital conditions and problems of delivery (YDC, 2003) as a result of inadequate pre-, peri- and post-natal health care. The 2005 HBS identified congenital conditions and illness as representing the highest causes of disability resulting in between 50% and 77% of the reported causes.

Likewise, communicable diseases, malnutrition, road-related and work-related accidents as well as early and consanguineous marriages also contribute to high disability incidence



rates. Cultural values, such as those that influence women accessing male health service providers, are also believed to be determinants of disability, particularly in rural areas.

The OD consultancy

Rationale

The Social Fund for Development is one of the main stakeholders involved in Disability and Development (D&D) in Yemen. On request of Governmental stakeholders, they have been asked to develop strategies for improving the D&D work in Yemen by aligning mandates and actions of other involved parties and investing in infrastructure and capacity development.

For an improved service infrastructure in Yemen, it will be important to define and agree upon the key objectives of all major stakeholders, develop organizational visions and strategies and build their organizational capacities.

Major stakeholders involved in D&D in Yemen, the Care and Rehabilitation Fund of Disabled and the National Union of Disabled associations, need to be provided with external support to help them with defining their vision and key objectives, developing a strategy incl. a capacity building plan for their staff.

Ensuring the development of quality services provided by 1.) The Care and Rehabilitation Fund of Disabled and 2.)The National Union of Disabled associations in the medium-term is critically important to the implementation D&D Services in Yemen.

A first self assessment of the Care and Rehabilitation Fund of Disabled facilitated through the Centre for Quality & Business Excellence (Qube) has taken place in March 2009.

SWOT Analysis of the National Union of Disabled associations facilitated through the Centre for Quality & Business Excellence (Qube) has taken place in August 2009

However, the institutional analysis needs to be further transferred into an institutional development process, including development of structural and institutional systems.

Scope and Focus

The process will focus on the Organizational Development processes of two entities, namely:

Care and Rehabilitation Fund of Disabled

The National Union of Disabled associations

Assessment of the organizational development needs in the following areas:

Management and governance structures

Human Resource Development

Internal communication, regulations and procedures

External communications, PR–print and web-based information sharing, sale of product, techniques and technologies


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Succession planning

Strategic financial management, including:

Income generation possibilities

Partnership development with support organizations

Project funding

Self-sustainability

Knowledge management and organizational learning processes (accountability, learning and planning systems)

Support the team of each organization in taking necessary steps to implement intervention strategy

Assist in formation of OD team

Lead and advise on implementation of intervention sub-projects

Advise on the development of standards, protocols and procedures and follow-up implementation

Support both organizations in monitoring and evaluation

Monitoring of mutually identified milestones

Evaluation within specified and targeted timeframe

Methods

1. Proposed approach and methodology

This assignment entails conducting a detailed independent review of the DF and the NUAD with reference to the newly defined requirements of the SFD. As specified in the terms of reference (TORs), this assignment is expected to cover all aspects of the institutions: their mandates, governance and management systems, strategies, policies and planning, financial management, processes and human resources. Emphasis will be placed on developing “fit for purpose” functionality in both institutions, which will clearly entail an analysis of the structures, key skills and key posts. On the basis of the information and insights that will be drawn from the review process, recommendations for practical interventions will be developed for consideration. The analysis will be grounded upon an understanding of the disability and development (D&D) services infrastructure in the country. It is our understanding that having carried out useful earlier diagnostic exercises, the SFD are now seeking evidence-based analysis and concrete recommendations that can be readily integrated into the major strategic planning process covering D&D provision in Yemen by mid-2010. In order to successfully carry out this analysis and achieve the objectives of this assignment in the most cost-effective way, the propose undertaking the following sets of activities, broken down into 4 stages:



Stage 1 – Literature / document review and developing the methodology (UK-based);

Stage 2 – Data gathering and field work (in country);

Stage 3 – Data analysis and preparation of the report (in country/UK);

Stage 4 – Presentation, discussion of findings, and final report (Yemen).

Stage 1 – Developing the methodology

In order to develop a working methodology for undertaking the OD analysis, a review of studies, reports and other relevant documentation will be made. This review will be guided by the following objectives:

To draw up a comprehensive picture of the demand and supply side of D&D services in the country, and identify peer groups (e.g. in terms of size / scale of operations; geographical disparities; regulatory status or type; target market orientation; etc.

To identify the core capabilities required of both organizations by their mandate and the increasingly large and complex role they will need to play in the future, in order to define priority areas of investigation

To identify the issues relevant to the way capacity is developed within the institutions so that recommendations for development will be readily operationalised, sustainable, and create the framework for organic growth to meet unforeseeable demands.

At the end of the review process, a detailed methodology will be drafted, which will provide the framework for understanding the “capability stock”, the “capability gaps”, and the “capability lags” in the DF and NUAD. The methodology will also include the questionnaires that will be used in the data gathering. Following this review process, the methodology will be presented for discussion with the SFD. The methodology will be discussed in a meeting with the DF and NUAD officials prior to finalizing work plans

This meeting would:

(a) help inform the participants about the scope and content of the review, based on our experience of standards and practices appropriate to D&D support institutions;

(b) to gather opinions and feedback to ensure that our methodology reflects the local context and the specific conditions in the delivery of D&D services in Yemen

Immediately after the workshop, the proposed methodology and questionnaires will then be refined and adjusted to reflect the insights drawn from the stakeholders present at the workshop, and preparations will be made for carrying out the fieldwork. A schedule for completing the interviews and/or gathering all completed questionnaires will be specified in Stage 1.

Stage 2 – Field work

Once the survey materials have been finalized and agreed upon, pilot interviews will then be undertaken by the OPM Team, with assistance provided by SFD, in the course of carrying out the pilot interviews, it is anticipated that two national researchers (to be confirmed by S


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FD and OPM after the inception meeting in Stage 1 in order to ensure that adequate and appropriate data gathering resources are available at lowest cost.)

Data gathering will focus primarily upon information provided by the institutions, particularly the five to six Government Departments actively working in this sector, other stakeholders active in the field and beneficiary organizations and individuals,. plus “bundles” of performance data to yield the detail and accuracy necessary for informing policy, strategy and organizational development recommendations. During the field work, interviews with other key informants may also be undertaken, including (i) relevant government agencies; (ii) donors and international organizations involved in D&D initiatives; and (iii) support institutions – especially those engaged in capacity building initiatives in the sector (e.g. apexes or associations).

To meet the relevant stakeholders, conduct interviews and gather all the relevant information on both organizations, the entire fieldwork is expected to cover a period of roughly 2 weeks.

(This includes provision for making follow–ups with institutions that may require more time to complete questionnaires or whose representatives may not be readily available to participate in an interview).

Stage 3 – Data analysis and preparation of the draft report

The results of the desk–based review and the fieldwork will then be synthesized and organized by the OPM consultants. Key findings and issues will be drawn and fed into a brainstorming meeting involving all those local representatives who have taken part in data gathering

Stage 4 – Presentation and discussion of findings

Upon receipt of the comments on the first draft of the report, the report will be revised and

preparations will be made for presenting the findings in a proposed workshop / meeting with key stakeholders and potentially to a larger audience. Further feedback from this meeting with stakeholders will then be reflected in the final report.

Activity (Work) Schedule

1st, 2nd, etc. are weeks from the start of assign

1st 2nd 3rd 4th 5th 6th 7th 8th 9th

10th

11th

12th

Activity (Work)



Developing methodology

Field work (data gathering)

Data analysis and preparation of draft report

Awaiting comments on draft report

Presentation of findings and preparation of final report

Outcomes

A restructuring that takes into consideration transferring the current roles of the two organizations from being implementation organizations to the following :

Defining and developing the policies of services providing and covering.

Advocacy and rights issues as well as the coordination between the DPO's.

A conception of the job description and required qualifications for the organizations' staff according to the new proposed structure

Guarantee employing those organizations as tools of implementing the Social Protection Strategy and the Disability Strategy taking into consideration working in the frame work of the Local governance Strategy.

A conception of the financial system that suits the new structure.

A conception of the Monitoring and Reporting System.

Increase in the long-term sustainability of the organizations´ programs.

Strategic assessment of the organizations‟ current situation available (Strengths, Weaknesses, Opportunities and Threats)

Recommendations on the organizations‟ future roles and changes necessary for successful implementation of their strategy available

Agreement on 2-Year Action Plan (Log frame with objectives, expected outcome, criteria, budget)

Intervention Strategy defined (e.g. on Internal Standards, Procedures, Monitoring and Reporting System, Internal Communication / MIS)


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Intervention Strategy developed and implemented along with in-house team and any necessary external support

Development of a monitoring system for the implementation and adjusting of plans if necessary

Increase in the long-term sustainability of the organizations´ programs

Clear guidelines and strategy for leadership succession and transfer

Requirements of the Technical Advisor / Consultant

Professional Experience

Organizational Development and experience as OD Consultant with other NGO

Program / Project Management

Financial Management

Human Resource Management and HR Development

Training / Capacity Building of Local Organizations

Experience in handing over responsibilities to appropriate partners

Building up sustainable (organizational and financial) services

Skills Needed

Ability to promote atmosphere of trust, reliability and constructive criticism between the Care and Rehabilitation Fund of Disabled, the National Union of Disabled associations, the Social Fund for Development and CBM

Open-minded, patient and determined

Excellent communication, negotiation and people skills

Ability to cope with conflicts/ manage conflict situations

Adept at ensuring ownership of the process at each organization

Experience regarding working in the field of Development Cooperation/ in Developing Countries

c. Responsibilities

The Consultant shall be responsible himself/ herself for adequate insurances.

The Consultant shall perform his/ her duties independently and on his/ her own responsibility and is also responsible for informing the revenue authorities about the fee received, as well as for paying corresponding social security and other contributions (e.g. health insurance,



unemployment insurance). Furthermore, the consultant shall make sure to have adequate liability insurance.

The Consultant is responsible to register with his/her embassy in Yemen for security reasons.

Critical Factors

Full participation and involvement of internal stakeholders (Board, leadership, key staff) especially for the Care and Rehabilitation Fund of Disabled and the National Union of Disabled associations

External moderation and facilitation

Ensuring atmosphere of trust and positive / constructive criticism, with freedom for all to express themselves

Commitment of the organizations leadership to the process and to positive consideration of recommendations towards actual implementation

Availability of human, financial and technical resources in the medium-term to implement the process

The role in monitoring and evaluation of the Care and Rehabilitation Fund of Disabled and the National Union of Disabled associations through the SFD


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Annex B Process Mapping Workshops Outputs

Please note: The mapped processes are based on reported experience, not the regulation or procedure that may exist only on paper.


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Annex C Example Definition of Disability

Extracted from the UK Disability Discrimination Act.

Definition of disability in the Disability Discrimination Act

The DDA does not have a list of conditions which are covered by the DDA but uses the following definition: a disabled person is an individual “with a physical or mental impairment which has a substantial and long term adverse effect on their ability to carry out normal day-to-day activities.”

Each element of the DDA definition of disability has a specific legal meaning and each element must be met. The definition of Disability as stated in the DDA is:

" A physical or mental impairment which has a substantial and long term adverse effect on his/her ability to carry out normal day-today activities"

Definition of Disability

“impairment” has its usual meaning and debate is more likely around whether the effects of the impairment are sufficient to meet the definition rather than if an impairment is present at all. The cause of an impairment is not relevant.

“substantial” is defined as more than minor or trivial

“long term” refers to a period of more than 12 months. If there is medical/statistical evidence to show that a condition is episodic or likely to recur or that the condition is progressive then it is not necessary for the individual to have been disabled for 12 months. The effect of the impairment in an episodic condition need not necessarily be the same (for example an individual with Bipolar disorder may experience a period of depression followed by a period of stability only to have the condition reoccur as a period of mania). It is important to remember that tribunals will look at the recurrence of the impairment and not the condition.

“adverse effect” covers not only being unable to carry out a task but taking an unreasonable time to carry out a task, fatigue or pain caused by the activity or where medical advice has been given not to undertake a certain activity. The impact of medical treatment is ignored when assessing adverse effect.

“normal day-to-day activities” -ability in one or more of the following eight areas must be affected: mobility, manual dexterity, physical co-ordination, continence, ability to lift, carry or otherwise move everyday objects, speech, hearing or eyesight, memory or ability to concentrate, learn or understand or perception of the risk of physical danger. Specific hobbies or work activities are not covered unless they fall within one of the day-to-day activities listed above.

Receipt of incapacity benefit or blue badge holder status for example, do not necessarily mean that the person is disabled as defined above.


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Excluded conditions

There are certain excluded conditions: hayfever, addiction to alcohol or non prescribed drugs, tendency to set fires/steal/physically or sexually abuse others, exhibitionism and voyeurism.

"Passported" conditions

In the addition to the excluded conditions there are conditions automatically covered by the act. These are referred to as “Passported Conditions ”.

These conditions are HIV/AIDS, cancer, multiple sclerosis, and individuals who are registered blind or partially sighted.

For all other progressive conditions it must be shown that that the condition has had some effect already and they will meet the definition in the future i.e. the condition will last longer than 12 months and that it will lead to a substantial effect on day to day activities.

Past disabilities

Individuals who have been disabled in the past are covered by the DDA as long as they met the definition above i.e.: they had a mental or physical impairment that lasted more than 12 months and had a significant effect on their day to day activities.



Annex D References/Bibliography

Central Statistical Organization (CSO) 2005. Household Budget Survey (HBS 2005). Ministry of Planning and International Cooperation. Republic of Yemen: Sana‟a. Coleridge, Peter (2004). The Social Fund for Development: A review of its Disability

Programme. Sana‟a: Yemen.. ESCWA Policy Brief, Looking the Other Way: Disability in Yemen, World Bank, Washington,

D.C. 2009, International Labor Organization (ILO) 2002. Disability and Poverty Reduction Metts, Robert L. Yemen National Disability and Poverty Study and Action Plan. Final Report. World Bank: Washington, D.C. 2006. Mont, Daniel, Measuring Disability Prevalence World Bank. 2007 Riddell, Roger C. Poverty and Disability and Aid / International Development Cooperation

2009 Unpublished report. . SINTEF Health Research This is my Life – Living with a Disability in Yemen: A Qualitative

Study. (Lisbet Grut and Benedicte Ingstad) World Bank: Washington, D.C. (2006). Social Fund for Development, Annual Report for 2008. Sana‟a: Yemen. Turmusani. Majid, Yemen: Disability Profile, World Bank, 2004 World Health Organization (WHO). International Classification of Functioning, Disability and

Health: ICF. World Health Organization, Geneva. World Health Organization (WHO). Yemen Country Profile 2009. Minister of Social Affairs and Labour and Chairman Board of Directors The Resolution No ( ) 2006 of the Chairman of the Board of Directors regarding the issuance of the Organizational Bylaw and the Administrative Structure of the Rehabilitation Fund and Care of Handicapped Persons. Yemen, 2006

Ministry of Social Affairs and Labour, National Disability Strategy, June 14 2010, Yemen

Centre for Quality & Business Excellence (Qube) ,Report on Organizational Self Assessment of the Disability Fund, Social Fund for Development, Yemen ,March, 2009

Tines, Jeffrey, Report on the Consultation Workshop for the Rehabilitation Fund and Care of Handicapped Persons in Yemen, August 2008


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Annex E List of Consultations and Organisations Visited

Name Title

Mr. Ahmed Abu Bakr Bazara Chairman, Shamil Bank of Yemen, Board member, Disability Fund

Mr. Ibrahim Md. Yahya Jahaf Financial and Administrative Officer, National Union of Yemeni Handicapped Societies

Mr. Ottman Executive Director, National Union of Yemeni Handicapped Societies

Dr. Abdullah A. Al Hamdani Executive Director, Disability Fund

Mr. Hameed Al-Othaib General Director, Independents and Funds, Ministry of Finance

Mr. Hamad Saqaf Director, Physiotherapy Centre

Mr. Hassan Yahya Head of Debtors Section, Al-Jumhuri Hospital Sana‟a General Hospital??

Mr. Mustafa Khalail Representative of Sana‟a General Hospital??

Mr. Bashir Abdullah Head of Procurement, Disability Fund

Dr. Amat al-Razaq Hummed The Hon. Minister for Social Affairs and Labour, Chairperson of the Disability Board

The Deputy Minister

Tareq Saeed Al-Mathhgi Asst Deputy Director Technical Office, Ministry of Planning and International Cooperation

Head and sample staff/committee members

Al-Aman Ass.


Al Tahadi Ass


Al Eman Institute

Essam A Al-Fa

Apex Consulting

Abdulkarim A Salah Social Welfare Fund

Chairman and Committee Members Deaf Association

Abdulaziz A Balhaj Yemeni Society for Care and Quality of Blind Ass

Ali A Sharafudin Qube Consulting

All line Directors and a sample of staff members

Disability Fund

An invited sample of Committee Members

Union


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Annex F Disability Fund Values Orientation

A 1-Day Workshop

Objectives To convey an understanding of the key drivers and principles inherent in the Fund‟s mission, to identify the major change factors; and develop their own perspective on how the organisation‟s service and quality values can be lived out on a daily basis in their work. Audience All employees invited on a diagonal slice basis. Rationale An organisation‟s values are only a reflection of the values of all employees and the way they make decisions about the way they work, on a daily basis. If we seek to shift existing values to a desired model, each person must understand the desirability of change and how this can be achieved through different behaviours. Content Defining what we mean by a rights-based approach towards PWD, the Fund “Way of Working” and why it is so important Fund Values – how they fit our operating model How can we interpret these values into behaviours and working practices? How the values can be expressed - Personally in working habits - Team-wise in working practices - Fund in policies, procedures and practices What this all means to our co-workers, PWD, DPOs and other agencies How do we assess how well we are living out the values?



Annex G Example Code of Ethics

I (name)……………………………………..commit to

Execute my duties efficiently and without fear or favour

Treat all people with dignity and respect, as I want to be treated

Uphold the principles of equality, fairness and basic human rights

Not to take improper advantage of my position

In all my actions, uphold the values and the spirit of the Disability Policy of the Government of Yemen

DATED AT _____________ THIS _____DAY OF __________ 20__

___________________________


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Annex H Draft Terms of reference for a Financial Audit of the Fund

Draft Terms of Reference for the financial audit of the Care and Rehabilitation Fund for the Disabled on behalf of the Social Fund for Development (SFD)

1.0 Background

The Care and Rehabilitation Fund for the Disabled (otherwise known as the Disability Fund) was established by Public Law No. 2 of 2002, following on from major legislation (Public Law No. 61/1999), which “defined persons with disabilities and entitled them to rights of education, employment, health and rehabilitation services”.

This entitlement lacked any means of fulfilment until the Fund was created to provide funding to government programs that targeted persons with disabilities (PWD). The Fund was structured to provide direct support to PWD including equipment and prosthetic devices, education, health services and some recreational and cultural activities. The Fund also provides indirect support through funding disability organisations. In practice the Fund carries out six core functions– verified by members of the Fund Management Team at a workshop in August 2010 – that can be broadly categorised as follows:

To act as a registration centre for individuals to establish an identify as a PWD within the legal sense of the term in Yemen, and for groups, as associations providing services for the disabled

The assessment of need for individuals and institutions

The identification of solutions and fulfilment activities

Contracting and procurement of services for the disables

Management of income and disbursement of funds

Building capacities of institutions supporting the disabled

The Fund has an annual income from taxes raised on cigarette, cinema and air line seat sales, and investment revenue of YER2.7 billion26 (US$11.3 million27) in 2008, with about YER2.4 billion being provided to beneficiaries including associations and NGOs.

SFD is planning to engage an accounting firm to conduct an external audit on the Care and Rehabilitation Fund of Disabled (the Fund) for the Year ended 31 December 2009 and to provide an analysis of the internal control framework. SFD has deemed it necessary to conduct an external audit of the Fund to determine its financial position.

2.0 Specific Objectives of the Audit

The objectives of the financial audit of the Fund are as follows:

1. To express an opinion on whether the financial statements for the period 1 January 2009 to 31 December 2009 are prepared, in all material aspects, in accordance with the national

26

YER Yemen Rials

27 Based on an FX rate of 240YER to 1USD as at 1 September 2010.



accounting standards of Yemen and the Government of Yemen financial management legislation and procedures.

2. To express an interim opinion on the financial position of the Fund as at 30 June 2010, including an analysis of all assets and liabilities.

3. To provide an observation on the extent to which the financial statements of the Fund are prepared, in all material aspects, in accordance with International Accounting Standards.

4. To evaluate whether internal controls are appropriate and are operating efficiently and effectively, including the composition of the medical committee and eligibility criteria.

3.0 Scope of Services

3.1 Entry interview with the Social Fund for Development (SFD).

3.2 Entry interview with the Care and Rehabilitation Fund for the Disabled (the Fund).

3.3 Conduct an audit to provide reasonable assurance as to whether the Financial Statements are free from material misstatement. Examine, on a test basis, the evidence supporting the amounts and other disclosures in the 2009 Financial Statements.

3.4 Comment on the accounting policies and their compliance, in material aspects, with the Government of Yemen financial management legislation and procedures, the national accounting standards of Yemen and international accounting standards.

3.5 Based on the interim balance sheet for the 30 June 2010, express an opinion on the financial position of the Fund. Consider the current assets and liabilities of the Fund.

3.6 Evaluate the adequacy of internal control framework, including the composition of the medical committee and eligibility criteria for accessing services provided by the Fund.

3.7 The audit should confirm that monthly bank reconciliations are being conducted, are accurate and authorised and are supported by appropriate source documentation.

3.8 Prepare an audit report which includes the following:

a. Auditor‟s opinion on the 2009 financial statements

b. Auditor‟s interim opinion on the financial position of the Fund for 2010

c. Comment on the applicability of accounting standards to the Fund

d. Summary on the adequacy of internal controls

e. Summary on the medical committee and the eligibility criteria for accessing services provided by the Fund.

f. Comment on Bank Reconciliation

4.0 Duration and Resourcing

The interim audit will be conducted during September and October 2010. A draft report will be provided to SFD by 20 October 2010. After comments are received the consultants will have three days to finalise the report.

It is expected that the audit will take up to five weeks with two audit seniors full-time and the Audit Manager providing up to three weeks input.

organizational development and restructuring for the yemen

Documents