Many projects are working on a more integrated or inclusive approach, according to the needs of the child and the available local resources. A pilot project is also in the planning stages to identify ways for CBR projects to work more effectively with the Special Education Unit. Providing opportunities for income generation and vocational training is a challenge, with the high general rate of unemployment and poverty. Some projects have their own skills training programmes, and also provide employment opportunities themselves, while others use a more integrated approach by linking up with other organisations who can help with training. Provision of care facilities relates mostly to day care facilities in urban projects, whereas in the rural areas it is hard to provide such facilities due to difficulties in travel through the hilly terrain.
Some projects provide some residential care, mostly linked to training.
A common experience is that if someone is moved away from his family home and social support, then it becomes difficult for him to return there later. The idea of respite care is not widely known or used in Nepal. Effective management systems are vital for good services at all levels. In Nepal, in the NGO sector, management is an area where many projects experience problems. One of the aims of the original CBR national networking for project co-ordinators which was started in 1994, was to develop higher standards of management.