Participative approaches

As the demand for social care services increases, policy-makers face the challenge of deciding which services are most needed, but also which are most effective, within a context of limited resources. Pressure from different sources can push governments into making quick decisions about developing services which may not be clearly linked to policy objectives, may not reflect good practice and may not meet the needs of the people they should be reaching. Traditional top-down approaches to service provision result in a similar outcome. Whether establishing new services, or expanding existing services, a participative approach to needs assessment can bring benefits both for the policy-maker and for the end recipient of the services.

A first key consideration for policy-makers is to formulate clear policy objectives. What is it that needs to be changed? This will generally be connected to increasing social inclusion and opportunities for more vulnerable groups of the population. For example, reducing the number of children being brought up outside of a safe family environment or increasing the opportunities for people with disabilities to participate in daily life. Quantitative analysis can help establish the extent of need and helps to establish a “baseline” from which indicators can be developed to measure the success of a service over time.

Finding ways of involving the people who are at the centre of the policy objective is crucial to increasing the likelihood that services will meet real needs. A family which has reluctantly had to place a child into alternative care often has the clearest idea of what kind of support could have prevented the placement. An adult with disability, or their carer, are very likely to be able to articulate what prevents participation in key areas of community, social and civic life. As well as identifying needs, participative needs assessment can help policy-makers develop qualitative indicators to measure the effect of new services. A carefully managed process of consultation beyond needs assessment and into service planning and monitoring continues to ensure the right services get to the right people.

Openness to innovation and collaboration among policy makers, service providers and service users is often critical and approaches to service delivery such as Community Based Rehabilitation (CBR), which capitalise upon the existence of formal and informal systems and resources alike, can be effective. The development of CBR is being supported by OPM as one aspect of service development in Tajikistan.