Policies, Regulations and Management

Registration and Certification Procedures

In Jordan, Libya, the State of Palestine, Saudi Arabia and Yemen, public institutions hosting persons with disabilities are not required to go through an official registration process because they are established and funded by the government. 

For private institutions, registration procedures vary. In Lebanon and the State of Palestine, registration is approved by their interior ministries, while in Iraq, Jordan, Saudi Arabia and Yemen, licenses are granted by their social/labour ministries. In Jordan, the approval of the Civil Defense Department is also needed while in Saudi Arabia the approval of the Ministry of Health is also required. Yemen also requires the approval of the Welfare and Rehabilitation Fund for the Disabled for registration, and the private institutions are required to submit reports regularly in order to maintain certification. 

Morocco requires all institutions to follow specific registration steps in order to get a permit. In 2018, Morocco adopted Law 65-15, updating previous legislation regulating the management of social welfare institutions, which requires directors of institutions to submit annual budgets and action plans to maintain certification.

Reporting and Inspection Procedures

All institutions in Bahrain, Iraq, Jordan, Lebanon, Morocco, Oman, Saudi Arabia, the State of Palestine, Tunisia, Yemen, and Syria are required to submit reports to the government about different aspects of their development. In Bahrain, Morocco and the State of Palestine, institutions are funded by their respective governments on the basis of these progress reports. In Iraq, Jordan and the State of Palestine, public and private institutions send reports about their activities to ministries, typically of social affairs. Syria’s institutions are expected to report on a monthly basis to directorates of labour/social affairs in governorates and quarterly to the ministry. 

In Iraq, activity reports are sent on a yearly basis, and in case of any irregular finding or a violation in the normal flow of procedures, the institution is closely observed and will be asked to submit monthly reports while under review. In Morocco, under Law 65-15, institutions are also required to report on their activities on a yearly basis and create internal “surveillance committees” to facilitate their inspection. At least two residents of the institution (or beneficiaries of services in the case of non-residential centers) are required to sit on the committee. 

In Jordan, institutions are expected to send monthly reports on their activities and certain demographic data pertaining to beneficiaries (e.g., number of residents, types of activities, programmes followed). In the State of Palestine, the Sultanate of Oman, Saudi Arabia, Tunisia and Yemen, public institutions must file a quarterly report to concerned ministries. 

All directors reported that their institutions were officially registered and regularly inspected, though few clarified specific standards for inspection. The majority of directors stated that their institutions were registered and certified by the local government, primarily the local branches of social/labour ministries. 

Both private and public institutions were inspected by government agencies at frequencies ranging from weekly to annually. Commonly, inspections were conducted by representatives from ministries of social affairs and ministries of health. A director in Libya mentioned his public institution audited by the Libyan Audit Bureau. The director of an institution in Yemen stated that in addition to inspections by the Ministry of Social Affairs and the Ministry of Health, her institution was inspected by Yemen’s Higher Council for the Rights of Persons with Disabilities. 

While the majority of the directors stated that they regularly report on their programmes and activities to the government, some in Egypt and Iraq stated that they do not report to the government. 

Support and Funding

In Bahrain, Iraq, Morocco, Qatar, Saudi Arabia, Syria and Tunisia, all public institutions for people with disabilities are funded by national ministries. In Lebanon, the State of Palestine and Yemen, all non-profit institutions are funded by national ministries. Lebanon has no public residential institutions for persons with disabilities, so the Government supports its private, non-profit institutions with allocations that depend on the type of disability. According to one report, 60 per cent of the budget from the child protection programme of the Ministry of Social Affairs is allocated to support residential institutions.[1]

While private, for-profit institutions in Jordan are not funded by the public budget, they have signed agreements with the Government to accommodate persons referred to them by public institutions: if an individual comes from a disadvantaged socio-economic background and state-run centers are at capacity, the Government will cover the cost of private institutionalization at a lower monthly rate. In Iraq and Saudi Arabia, the Government does not support private institutions. 

The criteria for public institutions to receive government funding include a number of factors. The governments of Bahrain, Lebanon and Tunisia generally fund institutions for persons with all types of disabilities. Iraq, Saudi Arabia, and the Sultanate of Oman tend to fund institutions catering to the needs of persons with severe or multiple disabilities. Yemen prefers to support institutions that deal with physical impairments, and Jordan those supporting persons with cognitive or intellectual disabilities. Saudi Arabia and Yemen consider the number of enrolled residents, the age group, the services provided and the size of the institution in allocating funding. 

The cost of stay at an institution and the amount of government funding provided varied depending on the type of the institution (private or public) and the level of assistance required. Public institutions were free of charge. The cost of stay at private, non-profit institutions was covered by donations only, except in Lebanon and the State of Palestine, where the government and donations cover costs. The majority of directors expressed dissatisfaction with amount of government support they received. For example, a director of a private institution in Jordan stated that they were not able to secure enough money to carry out an urgent surgery for one resident. 

Payment for most private, for-profit institutions came from a combination of family contributions and charities.  The majority of directors of for-profit institutions reported that without assistance, many families were unable to keep up with costs, which can be very high. For example, in Jordan, the majority of families default on their payments to for-profit/private institutions, which can be as high as US $3,000 per month. 

Challenges in Managing Institutions

Government officials and institution directors mentioned different challenges in managing institutions. In the State of Palestine, Syria and Yemen, the demand for institutionalization is higher than what institutions can accommodate. In the case of Yemen, this demand is mainly for the purpose of education. 

In the State of Palestine and Tunisia, financial challenges were among institutions’ reported problems. Saudi Arabia was the only country to report challenges pertaining to health issues, such as the spread of infections and epidemics amongst residents. In Libya, Syria and Yemen, safety and security due to conflict were major concerns. In Syria, reported challenges also included a lack of trained staff, outdated infrastructure and curricula, and having to relocate institutions to unsuitable temporary facilities.

In Iraq, Lebanon, the State of Palestine, Syria and Yemen, officials stated that there had been no reports of abuse in institutions. The Yemeni official elabourated by stating that there have been no reports of abuse because staff are professionals employed by the Ministry of Social Affairs and the Ministry of Education. Bahrain and Saudi Arabia each had a single incidence of abuse referred to court. In Bahrain, the institution’s services were suspended. In Saudi Arabia, criminal charges were filed.