評価結果要約表（英文）1. Outline of the ProjectCountry: The People’s Republic of China

Sector: Support for Persons with Disabilities
Department in-charge:
Human Development Department
Periodof R/D: Apr.21, 2008
Cooperation Five years from Apr.1, 2008 to
Mar. 31, 2013

Project title:
Project for Human Resource Development of
Rehabilitation in the Central and Western Region in
China
Cooperation scheme: Technical Cooperation
Project
Project cost :(as of Nov. 19, 2012) 390 million yen
Implementing organization in the partnercountry: China Disabled Persons’ Federation, China
Rehabilitation Research Centre(CRRC), Shaanxi
Disabled Persons’ Federation, Chongqing Disabled
Persons’ Federation and Guangxi Disabled Persons’Federation
Supporting organization in Japan:
National Rehabilitation Center for Persons with
Disabilities, International University of Health andWelfare, Japanese Physical Therapy Association andJapanese Association of Occupational Therapists

1-1. Background and summary of the ProjectIn the People’s Republic of China (hereinafter simply referred to as “China”), the number of disabled
people is said to have rapidly increased to some 80 million due to structural changes of diseases andinjuries, in turn caused by economic development and the progressively aging society. According to a
WHO forecast, the population of elderly in China will reach 250 million by 2020, suggesting a massive
increase of the rehabilitation need. In the face of such need, the Government of China introduced in 2002
the strategic target of “providing a universal rehabilitation service by 2015” and has since been earnestly
expanding the rehabilitation service nationwide, including the establishment of local rehabilitation centres.
However, the number of workers engaged in the rehabilitation service is small and significantly falls shortof meeting the actual need. As such, the development of manpower for the rehabilitation service has
become an important challenge for China.
Japan has been providing assistance for China in this field for more than 20 years, achieving some tangible
results. The construction of the China Rehabilitation Research Centre (CRRC) with grant aid in the 1980’s
was followed by two technical cooperation projects. As a result, a system has been developed whichallows the disabled, particularly those in Beijing, to have access to an appropriate rehabilitation service.
Meanwhile, there is still a large gap between the centre and local areas in terms of both the quantity andquality of the human resources of the rehabilitation service. Against this background, the Government ofChina made a request to the Government of Japan for the implementation of “Project for Human
Resources Development of Rehabilitation in the Central and Western Regions in China” (the Project) as atechnical cooperation project aimed at disseminating the technical capacity and knowledge accumulatedby the centre through past cooperation projects to rehabilitation workers inland (Central and Western
Regions). In response to this request, the Government of Japan commenced the five-year Project in April,2008.
In the Project, remote education systems were installed at CRRC and rehabilitation centers at targetedsites; Shaanxi province, Chongqing city, Guangxi Zhuang Autonomous Region. Curricurams andeducation materials for the training for rehabilitation workers at the centres in the targeted sites weredeveloped. One year training programs consist of live lectures and Web Based Training (WBT) are
undertaken by lectureres at CRRC.
1-2. Project Overview(1)Super Goal
Improvement of the quality of the rehabilitation service provided and increase of the number of disabled
people receiving the said service in the Central and Western Regions of China(2) Overall Goal

Improvement of the quality of the rehabilitation service provided and increase of the number of disabled
people receiving the said service at three target sites(3) Project Purpose
Establishment of a new model system for human resources development for the rehabilitation service
serving three target sites with the CRRC acting as the core base(4) Outputs
1) Establishment of a provincial level human resources development system through the establishment
and utilisation of an integrated remote education system operating at the CRRC and three target sites2) Improvement of the a) theoretical knowledge, b) technical skills and c) problem solving capacity ofprovincial human resources involved in the rehabilitation service
3) Training of core personnel at the provincial level to equip them with excellent guidance ability toprovide guidance for base level personnel engaged in the provincial rehabilitation service4) Improvement of awareness of the importance of the rehabilitation service, including the importanceof related knowledge, among base level personnel(5)
Inputs (as of November, 2012)
1) Japanese Sidea) Experts: Six long-term experts, including two specialising in rehabilitation education andeducation administration, and one chief advisor (also acting as a physiotherapist), have been
dispatched by the time of the present evaluation. The total number of short-term experts
dispatched during the same period is 40, including the chief advisor.
b) Provision of equipment: Remote education equipment, equipment for technical training on
rehabilitation and other types of equipment have been provided at a total cost of 56,820,000 yen.
c) Training in Japan: 61 project-related Chinese personnel have been trained in Japan by the time ofthe present evaluation.
d) Local cost: 39,560,000 yen to cover general administration expenses, business trip expenses, costof supplies, interpretation and translation expenses and others
2) Chinese Sidea) Appointment of counterpart personnel (C/Ps): Chinese counterpart personnel have been deployedat all stakeholder organizations and the three target sites in China.
b) Office space for the JICA expert team and provision of equipment: The project office and theremote education system management office have been set up at the CRRC while the remoteeducation office has been set up at the rehabilitation centre at each of the three target sites.
c) Local cost: 11,539,000 Yuan to cover the cost of establishing a suitable environment for
project-related activities, network connection expenses and miscellaneous expenses at the CRRC
and the three target sites.
2. Outline of the Terminal Evaluation Team
Members
Ms. Mitsuko Kumagai, Deputy Director General. and Group Director for Higher
Education and Social Security, Human Development Dept., JICA Team leader
Mr. Masami Akai, National Rehabilitation Center for Persons with Disailities
Mr. Hitoshi Maruyama, Professor, International University of Health and Welfare
Mr. Tomohiro Kuwabara, Deputy Assistant Director, Social Security Division,
Human Development Dept., JICA
Mr. Toshihiro Nishino, Consultant, International Development Center of Japan Inc.
Nov. 4, 2012 to Nov. 20, 2012
Type of Evaluation: Terminal Evaluation
3. Results of the Terminal Evaluation
3.1
Verification of Project Performance(1)
Status of Output Achievement
Output 1: Achieved
Even though the procurement/delivery of some equipment for the remote education system was delayed bysome four months compared to the original plan, this delay was not substantial enough to adversely affectthe progress of the training courses. As far as the implementation of the training courses is concerned, asystem has been developed at the CRRC to facilitate trainer training and other training courses. The wellplanned and executed preparatory work included a lecture on guidance techniques for the training oftrainers by a professor of the Capital Medical University (CMU) in Beijing. Four textbooks were preparedalong with the training curricula and the provincial personnel training course and central personnel
training course have so far been held three times and twice respectively with 85 staff members of the
CRRC comprising the core teaching staff for these courses.

Output 2: Achieved
The provincial personnel training course has so far been attended by 156 people. The trainees at the threesites and other people related to this training course have shown an extremely high regard for the effective,
efficient and systematic teaching of theoretical knowledge through the remote education system. Based on
the improved theoretical knowledge through remote education, many of the trainees have undergone
practical training at their respective sites and training in Japan to learn more advanced professional skills
as well as approaches and ideas for social systems for rehabilitation and rehabilitation work. Suchadditional training has equipped the trainees with an improved ability to practice their rehabilitation workin general. To the eyes of the Japanese experts, trainees are now fully aware of the necessity to properly
understand not only their own specialist fields but also specialist knowledge in other related fields. The
newly acquired know-how and skills have been actively utilised by all of the former trainees at theirworkplaces at the three sites along with their participation in academic conferences and for the writing ofacademic papers.
Output 3: Achieved
Sixty-one people have so far participated in the core personnel training course. The improved guidance
ability of these trained core personnel is the result of the significant contribution made by the process ofreconfirming newly acquired knowledge and skills. To be more precise, this process includes preparations
for and the practice of teaching as well as providing guidance for base level personnel and other related
persons.
Under the Project, base level personnel training has been organized seven times. In addition, many morebase level personnel training sessions have been held by the federation and rehabilitation centre at eachsite. The training of personnel of stakeholder organizations has also been conducted along with other typesof training. There has been a strong need for the training of base level personnel and the high rating of the
training contents is illustrated by the numerous enquiries regarding forthcoming training sessions andoffers for the trainees to obtain practical experience. The actual contents of the base level personnel
training attended by the Japanese experts are generally satisfactory.
Output 4: Achieved
At the three target sites, 11 booklets and seven volumes of training materials, etc. were prepared and havebeen actively used for training and guidance at each site. The quality of these booklets, etc. prepared withthe assistance of the Japanese experts and CRRC officials is high and they have proved to be very popular
at each site. The number of base level personnel who have undergone guidance is satisfactory.
The positive effects of the training and booklets include a) development of the ability of base level
personnel to accurately judge those disabled people requiring rehabilitation, b) sufficient dissemination of
information on projects and facilities where those disabled people requiring rehabilitation can receive therehabilitation service and c) development of the critical foundations for the facilitation of capacity building
at the base level as a result of accelerated exchanges and networking between local rehabilitation centres
and base level personnel using the training as an opportunity.
(2)
Status of Project Purpose Achievement: Achieved
The project purpose of developing a new human resources development model at the three sites has been
sufficiently achieved by fulfilling the set indicators. The Project was intended to training leading personnel
at provincial rehabilitation organizations by means of utilising the human resources and know-how of the
CRRC which is the leading body for the training of rehabilitation personnel in China. The actual processes
conceived under the Project to train such leading personnel at the provincial level are a) systematiclearning of theoretical knowledge through a remote education system, b) learning of practical skills,
including clinical skills, through on-the-job training at the project sites, c) learning of highly professional
skills and also of social system, concept and ideas of rehabilitation through training in Japan and d)
strengthening of the problem solving and guidance capacity through the practical application of the newly
acquired knowledge and skills and actual practice as training instructors.
Throughout the project period, constant review and improvement of the training contents, etc. have been
conducted to build up the basic know-how based on the actual experience of the preceding training
sessions. The relevant issues here include a) method and contents of assistance for the capacity building ofindividual trainees, b) desirable human resources development where a number of methods to assist
capacity building are packaged to produce a synergy effect, c) desirable way to develop an environment
for smooth capacity building typified by the offer of incentives for enrolment in training and d) desirable
operation management method for the entire remote education system. Through these processes, a model
has been developed where central level personnel train provincial level personnel while provincial corepersonnel train basic level personnel in a given province. In regard to the development of suitable training
models for different types of human resources, the CRRC has concluded that the various human resources
development efforts and activities implemented under the Project to suit the characteristics of the threesites can provide important lessons for future efforts to disseminate these models to various areas in theCentral and Western Regions. Such evaluation of the Project by the CRRC suggests that the developmentof suitable training models for different types of human resources has been achieved to a certain extent.
(3)
Status of Overall Goal Achievement.
The planned improvement has been achieved at a certain level and further progress is likely to take place.
The training of base level personnel by provincial core personnel, in turn trained under the Project, hasproduced the effect of widely disseminating the details of (a) the activities of rehabilitation-relatedorganizations employing base level rehabilitation personnel, (b) outline of the national project to provide afree rehabilitation service and (c) screening method for disabled people requiring rehabilitation.
Consequently, state of the rehabilitation service under the national project has changed from being
under-subscribed to being over-subscribed, indicating the positive contribution of the Project to increasing
the number of recipients of the rehabilitation service. Other progress made under the Project includes anincrease of the number of recipients of the rehabilitation service provided by each centre and theestablishment of community level organizations by the federations. A positive effect of the improved
rehabilitation service has also been observed in many other forms. One example is that the active
utilisation of the newly acquired know-how has led to the acceptance of severely and/or multiple disabled
people who found it difficult to receive the rehabilitation service in the past. Another example isconsiderable improvement in terms of both guidance for family members and actual rehabilitation effects
in relation to rehabilitation at home.
In regard to the super goal, i.e. utilisation of the new model in other provinces in the Central and Western
Regions, it is too early to evaluate the achievement status of this goal. While the issue of disseminating themodel to other provinces will be examined by the China Disabled Persons’ Federation (CDPF) in due
course, some relevant actions have been taken at the sites, including a preliminary attempt to find a way tocollaborate with hospitals in other provinces.
3.2

Summary of the Evaluation Results(1)
Relevance: HighRehabilitation for the disabled people has been a priority issue since midway through China’s 7th Five Year
National Economic and Social Development Plan and its importance is again stressed in the latest 12th
Five Year Plan (2011 – 2015). Meanwhile, the Project can be classified in the category of “realisation ofsound social development” under the priority issue of “assistance for reform and liberalisation” of the
Economic Cooperation Program for China (2001) of the Government of Japan. The Project is, therefore,highly relevant to the official policies of both the Government of China and the Government of Japan. The
high level of relevance is also confirmed by a) the selection of this sector by Japan for technicalcooperation, b) the introduction of remote education, c) the selection of a counterpart organization and d)
the selection of target sites. This judgement is supported by such relevant facts as a) the existence of an
extremely large number of rehabilitation specialists and the accumulation of rehabilitation know-how inJapan, b) the excellent prospect of remote education performing well when the number of target sites
increases, c) the status of the CRRC as the highest training organization for rehabilitation specialists with
abundant experience of cooperation by the JICA and d) the prospect of the three target sites with different
backgrounds and specialities becoming reference sits for the continuation of human resource development
on rehabilitation by the Chinese side after the completion of the Project in the Central and Western
Regions where economic development relatively lags behind that of other regions.
(2)
Effectiveness: HighAs described earlier, the project purpose has been achieved and it is clear that the successful outputs havecontributed to the fulfilment of the project purpose. Outputs related to a) institutional development, b)
improved knowledge, skill and capacity regarding rehabilitation, c) improved guidance ability and d)development of human resources at the base level have become important components and the status ofeach component has been reviewed and improved throughout the project period. Other reviewed andimproved issues are a) desirable method and contents of assistance for the capacity building of individual
trainees, b) desirable human resource development where a number of methods to assist capacity building
are packaged to produce a synergy effect, c) desirable way to develop an environment for smooth capacity
building and d) desirable operation management method for the entire remote education system. The
framework for the training of core personnel through remote education and the training of base level
personnel by trained core personnel has been realised as originally planned and the basic components ofthis framework should effectively function in future efforts to disseminate the training model to otherprovinces.

(3)Efficiency: High
Both the Japanese side and the Chinese side have made sufficient inputs in terms of human resources,
equipment and funding, contributing to the successful achievement of the planned outputs. These inputs
are highly evaluated by all of the stakeholders. From the viewpoint of input-output relations, the Project isjudged to have been efficiently implemented. Even though the progress of some activities had been slow,
there has been no adverse impact on either the implementation schedule of the training courses or on theachievement of the planned outputs.
(4)
Impact: HighAs described earlier, the Project has made an excellent contribution to the achievement of its overall goal
and is expected to make further contributions. One particularly notable impact of the Project is that local
centres have commenced their role of being core rehabilitation centres in their respective provinces as
capacity building efforts have evolved from individual exercises to organizational exercises and activities.
Such development has only been made possible by the simultaneous training of many people based on acommon training framework and method at each centre and this organizational impact is truly significant.
One district of Chongqing has seen new efforts to check children of 0 to 6 years of age for any disability
using the screening booklet. The fact that the Project has made this and other social impacts is highly
evaluated.
(5)

Sustainability: High

1) Institutional Aspect
The Government of China has firmly maintained its policy of prioritising rehabilitation and is expected tocontinue and develop related policies to fulfil its obligation to the people of China. Because of the fact thatthe target persons of the Project are working people, emphasis has been placed on the provision of
appropriate incentives. When the scope of trainees is expanded to include those working at
rehabilitation-related organizations other than the targeted centres in the same as well as other provinces in
the coming years, the provision of incentives may well be crucial for the success of the training. It is,therefore, necessary to continue the efforts to provide concrete incentives.
For the continuation and further development of the human resources training model using the remoteeducation system as established under the Project, the collaboration of stakeholder organizations is
indispensable, including collaboration between the CDPF and provincial federations and also collaboration
between provincial federations and other organizations at the base of the administrative hierarchy with astake in the rehabilitation of the disabled persons. It is hoped that efforts to consolidate such collaboration
will continue.
2) Financial Aspect
Funding to cover the communication cost, which is the direct cost for the continuous use of the remoteeducation system introduced under the Project at the three sites, is currently secured without any problems.
The rehabilitation-related budget is said to be on the increase while other permanent costs, including thepersonnel cost, appear to be secured. As such, there are no special problems to note in regard to thefinancial aspect of the Project.
3) Technical Aspect
Some of the people involved in the Project at the target sites have expressed a desire for more advanced
training courses. It is hoped that the CRRC will determine an appropriate response to this request throughfull consultation with the organizations concerned. It is also hoped that technological innovation of theequipment for remote education will be made in due course as part of the constant efforts to develop abetter remote education system.
(6)

Promoting and Impeding Factors Regarding the Realisation of the Planned Outputs

1)

Promoting Factorsa) The Project has been implemented at a time when the Government of China has been actively
promoting the nationwide development of the rehabilitation service for the disabled people.
b) The human resources and accumulated know-how at the CRRC, which have become valuableassets for Japan-China cooperation over many years, have been effectively utilised along with theuse of the collaborative relationship between the CRRC and Japanese stakeholder organizations.
c) There has been a synergy effect of three elements of the Project: (i) systematic learning of
knowledge through remote education, (ii) improvement of skills through the provision of guidance
for individual trainees by experts and (iii) promotion of the understanding of systems and ideas
through training in Japan. As training in Japan has facilitated the understanding of rehabilitation onthe part of the participating senior officials of the target provinces, their active assistance has beenobtained for the implementation of the Project and the development of the local rehabilitation
service.
d) At every site or centre, the fact that each target person for training is in the position of being
assigned to an important post or a post responsible for new business development in line with the
expansion or development of the organization has proved to be a strong incentive for theircommitment to capacity building.
e) In view of the fact that the target persons of the training under the Project are working people,
careful arrangements are made to provide incentives for the participants. These incentives include
the awarding of a certificate of training course completion and the awarding of provincial level
adult education credits at some sites to those who have completed the training course.
2) Impeding Factors
While some of the people selected for training in Japan were unable to attend the training because ofprocedural problems, etc., their absence has not had any major negative impact on the Project. No othermajor impeding factors regarding the Project have been observed.
3.3

Conclusions and Recommendations(1)
Conclusions
The Project is quite ambitious in that it aims at expanding human resources development for the
rehabilitation service to the base level through the effective utilisation of the assets of the CRRC
accumulated under past cooperation projects to train core personnel at the provincial level. It is also an
innovative project as it combines a remote education system with practical guidance in the field to ensurecomprehensive capacity building.
As a result of the Project, core personnel at the provincial level have been trained and some positive
results have been achieved in terms of the training of base level personnel, an improved rehabilitation
service at the base level and an increase of the number of recipients of the rehabilitation service. The
Project has also built the momentum for each centre to actively pursue the launch of new rehabilitation
work, reorganization of the service and collaboration with other organizations in view of providing a solid
rehabilitation service. It is noteworthy that the Project has had a strong impact on the innovation andfurther development of rehabilitation work in the target areas. It is relevant to terminate the Project asplanned since the Project Puropse has been achieved(2)
Recommendations
1) Both the CDPF and CRRS should utilise the model established under the Project to actively
disseminate the model to other provinces in the Central and Western Regions while selecting anappropriate system in view of the constant technological innovation of equipment for remoteeducation. It will be crucial for such efforts to establish good collaboration/cooperation with therelevant organizations at the three target sites of the Project.
2) The actual contents of the rehabilitation service can vary depending on the socioeconomic conditionsof a given locality. As such, China should seek to develop its own rehabilitation service whichreflects the unique socioeconomic circumstances of the country as well as each locality.
3) As the technological innovation of equipment for remote education is rapid, it is essential toconstantly review the technical aspect and educational contents of remote education after the
installation of a system, taking such innovation and associated expenses into consideration.
4) The acceptance of remote education results as credits for national adult education and the awardingof some kind of certified qualification as incentives for remote education have not yet been realised.
It is hoped that the awarding of national adult education credits to those completing a rehabilitation
personnel training course will become a reality in the future through continual efforts, including the
introduction of a new design for the training curriculum, to make such awarding easier.
5) As the demand for excellent human resources is very strong at each centre, there will be a continuous
need for remote education. There is also a strong demand at each centre for an advanced course
aimed at those who have completed a basic course.
6) The teaching materials for the remote education developed by central level were written only by the
CRRC staff members. In previous JICA project with the CRRC, the materials for undergraduate
courses had been developed in conjunction with the outside influential individuals, and thesematerials have been in utilized for the rehabilitation specialist training courses at more than 1000
schools nationwide. Such collaboration is worth considering.

3.4

Lessons Learned(1) When selecting a target site for training, it is necessary to establish not only the characteristics of thearea but also the likely number of trainee candidates in advance so that a sufficient number oftrainees can be continually secured.
(2) Even though no sufficient data is available on the likelihood of the success of efforts to expand thetraining course to include people working outside the centre, there are discussions at some sites toexpand the scope of the participants of the remote education courses to include those working atuniversities, provincial/district organizations and hospitals. The underlying idea is that such
expansion is feasible if suitable working arrangements are made with these bodies to allow their staff
members to take a course. It is assumed that the provincial federation will play a central role inmaking such arrangements. As this expansion is desirable in principle, suitable efforts should bemade taking the special circumstances of a particular site into consideration.
(3) Some of the core personnel trained under the Project have expressed the opinion that Internet
facilities to enable the downloading of the training contents freely will assist their learning at home,etc. as well as the training of base level personnel. Before introducing such environment, it isessential to develop rules for the secondary use of the contents as well as strict rules for the
management of personal information, i.e. privacy rules.