review of related literature on inclusive education

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Understanding the value of inclusive education and its implementation: A review of the literature

• Published: 07 September 2020
• Volume 49 , pages 135–152, ( 2020 )

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• Anthoula Kefallinou 1 ,
• Simoni Symeonidou 1 , 2 &
• Cor J. W. Meijer 1  

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European countries are increasingly committed to human rights and inclusive education. However, persistent educational and social inequalities indicate uneven implementation of inclusive education. This article reviews scholarly evidence on inclusion and its implementation, to show how inclusive education helps ensure both quality education and later social inclusion. Structurally, the article first establishes a conceptual framework for inclusive education, next evaluates previous research methodologies, and then reviews the academic and social benefits of inclusion. The fourth section identifies successful implementation strategies. The article concludes with suggestions on bridging the gap between inclusive education research, policy, and practice.

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Ainscow, M. (1999). Understanding the development of inclusive schools . London: Falmer.

Google Scholar  

Ainscow, M. (2020). Promoting inclusion and equity in education: Lessons from international experiences. Nordic Journal of Studies in Educational Policy, 6 (1), 7–16.

Ainscow, M., Booth, T., & Dyson, A. (2004). Understanding and developing inclusive practices in schools: A collaborative action research network. International Journal of Inclusive Education, 8 (2), 125–139.

Ainscow, M., Dyson, A., Goldrick, S., & West, M. (2012). Making schools effective for all: Rethinking the task. School Leadership & Management, 32 (3), 197–213.

Ainscow, M., & Sandill, A. (2010). Developing inclusive education systems: The role of organisational cultures and leadership. International Journal of Inclusive Education, 14 (4), 401–416.

Allan, J. (2014). Inclusive education and the arts. Cambridge Journal of Education, 44 (4), 511–523.

Baer, R. M., Daviso, A. W., Flexer, R. W., McMahan Queen, R., & Meindl, R. S. (2011). Students with intellectual disabilities: Predictors of transition outcomes. Career Development and Transition for Exceptional Individuals, 34 (3), 132–141.

Baker, E. T., Wang, M. C., & Walberg, H. J. (1994/95). The effects of inclusion on learning. Educational Leadership, 52 (4), 33–35.

Båtevik, F. O., & Myklebust, J. O. (2006). The road to work for former students with special educational needs: Different paths for young men and young women? Scandinavian Journal of Disability Research, 8 (1), 38–52.

Bele, I. V., & Kvalsund, R. (2015). On your own within a network? Vulnerable youths’ social networks in transition from school to adult life. Scandinavian Journal of Disability Research, 17 (3), 195–220.

Bele, I. V., & Kvalsund, R. (2016). A longitudinal study of social relationships and networks in the transition to and within adulthood for vulnerable young adults at ages 24, 29 and 34 years: Compensation, reinforcement or cumulative disadvantages? European Journal of Special Needs Education, 31 (3), 314–329.

Benz, M., Lindstrom, L., & Yovanoff, P. (2000). Improving graduation and employment outcomes of students with disabilities: Predictive factors and student perspectives. Exceptional Children, 66 (4), 509–529.

Blatchford, P., Russell, A., & Webster, R. (2012). Reassessing the impact of teaching assistants: How research challenges practice and policy . Abingdon, OX: Routledge.

Blatchford, P., Russell, A., & Webster, R. (2016). Maximising the impact of teaching assistants: Guidance for school leaders and teachers (2nd ed.). Abingdon, OX: Routledge.

Booth, T. (2009). Keeping the future alive: Maintaining inclusive values in education and society. In M. Alur & V. Timmons (Eds.), Inclusive education across cultures: Crossing boundaries, sharing ideas (pp. 121–134). Los Angeles, CA: Sage.

Campbell, C. (2011). How to involve hard-to-reach parents: Encouraging meaningful parental involvement with schools . Nottingham: National College for School Leadership.

Carlberg, C., & Kavale, K. (1980). The efficacy of special versus regular class placement for exceptional children: A meta-analysis. The Journal of Special Education, 14 (3), 295–309.

Cimera, R. E. (2010). Can community-based high school transition programs improve the cost-efficiency of supported employment? Career Development and Transition for Exceptional Individuals, 33 (1), 4–12.

Cimera, R. E. (2011). Does being in sheltered workshops improve the employment outcomes of supported employees with intellectual disabilities? Journal of Vocational Rehabilitation, 35, 21–27.

Cobb, R. B., Lipscomb, S., Wolgemuth, J., Schulte, T., Veliquette, A., Alwell, M., et al. (2013). Improving post-high school outcomes for transition-age students with disabilities: An evidence review (NCEE 201 3–4011) . Washington, DC: National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences.

Cobigo, V., Ouelette-Kuntz, H., Lysaght, R., & Martin, L. (2012). Shifting our conceptualization of social inclusion. Stigma Research and Action, 2 (2), 74–84.

Council of Europe Commissioner for Human Rights (2017). Fighting school segregation in Europe through inclusive education: A position paper . rm.coe.int/fighting-school-segregationin-europe-throughinclusive-education-a-posi/168073fb65.

Council of the European Union (2018a). Council recommendation on promoting common values, inclusive education and the European dimension of teaching . https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018H0607(01)&from=EN .

Council of the European Union (2018b). Council conclusions on moving towards a vision of a European Education Area . https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52018XG0607(01)&rid=5 .

CRPD [United Nations Committee on the Rights of Persons with Disabilities] (2016). General comment no. 4 (2016), Article 24: Right to inclusive education . https://www.refworld.org/docid/57c977e34.html .

Day, C., Gu, Q., & Sammons, P. (2016). The impact of leadership on student outcomes: How successful school leaders use transformational and instructional strategies to make a difference. Educational Administration Quarterly, 52 (2), 221–258.

de Graaf, G., Van Hove, G., & Haveman, M. (2013). More academics in regular schools? The effect of regular versus special school placement on academic skills in Dutch primary school students with Down syndrome. Journal of Intellectual Disability Research, 57 (1), 21–38.

De Vroey, A., Struyf, E., & Petry, K. (2015). Secondary schools included: A literature review. International Journal of Inclusive Education, 20 (2), 109–135.

Dessemontet, R. S., Bless, G., & Morin, D. (2012). Effects of inclusion on the academic achievement and adaptive behaviour of children with intellectual disabilities. Journal of Intellectual Disability Research, 56 (6), 579–587.

Dweck, C. (2006). Mindset: The new psychology of success. How we can learn to fulfil our potential . New York, NY: Ballantine Books.

Dyson, A., Howes, A., & Roberts, B. (2002). A systematic review of the effectiveness of school-level actions for promoting participation by all students. In Research evidence in education library . London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=276 .

Dyson, D., Howes, A., Roberts, B., & Mitchell, D. (Eds.) (2005). What do we really know about inclusive schools? A systematic review of the research evidence. In Special educational needs and inclusive education: Major themes in education . London: Routledge.

Dyssegaard, C. B., & Larsen, M. S. (2013). Evidence on inclusion. Danish clearinghouse for educational research. Copenhagen: Department of Education, Aarhus University.

Erskine, H. E., Norman, R. E., Ferrari, A. J., Chan, G. C., Copeland, W. E., Whiteford, H. A., et al. (2016). Long-term outcomes of attention-deficit/hyperactivity disorder and conduct disorder: A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10), 841–850.

European Agency for Development in Special Needs Education (2003). Inclusive education and classroom practice: Summary report . Odense, Denmark. https://www.european-agency.org/sites/default/files/inclusive-education-and-classroom-practices_iecp-en.pdf .

European Agency for Development in Special Needs Education (2013). Organisation of provision to support inclusive education – Literature review . Odense, Denmark. https://www.european-agency.org/resources/publications/organisation-provision-support-inclusive-education-literature-review .

European Agency for Special Needs and Inclusive Education (2015). Agency position on inclusive education systems . https://www.european-agency.org/sites/default/files/PositionPaper-EN.pdf .

European Agency for Special Needs and Inclusive Education (2016a). Raising the achievement of all learners in inclusive education—Literature review (A. Kefallinou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/raising-achievement-all-learners-inclusive-education-literature-review .

European Agency for Special Needs and Inclusive Education (2016b). Early school leaving and learners with disabilities and/or special educational needs: A review of the research evidence focusing on Europe (A. Dyson & G. Squires, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/early-school-leaving-and-learners-disabilities-andor-special-educational-0 .

European Agency for Special Needs and Inclusive Education (2017a). Early school leaving and learners with disabilities and/or special educational needs: To what extent is research reflected in European Union policies? (G. Squires & A. Dyson, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/early-school-leaving-and-learners-disabilities-andor-special-educational .

European Agency for Special Needs and Inclusive Education (2017b). Raising the achievement of all learners in inclusive education: Lessons from European policy and practice (A. Kefallinou & V. J. Donnelly, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/raising-achievement-all-learners-project-overview .

European Agency for Special Needs and Inclusive Education (2018a). Evidence of the link between inclusive education and social inclusion: A review of the literature (S. Symeonidou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/evidence-literature-review .

European Agency for Special Needs and Inclusive Education (2018b). Key actions for raising achievement: Guidance for teachers and leaders (V. Donnelly & A. Kefallinou, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/key-actions-raising-achievement-guidance-teachers-and-leaders .

European Agency for Special Needs and Inclusive Education (2018c). Supporting inclusive school leadership: Literature review (E. Óskarsdóttir, V. J. Donnelly and M. Turner-Cmuchal, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/supporting-inclusive-school-leadership-literature-review .

European Agency for Special Needs and Inclusive Education (2019a). Preventing school failure: A review of the literature (G. Squires & A. Kefallinou, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/preventing-school-failure-literature-review .

European Agency for Special Needs and Inclusive Education (2019b). Preventing school failure: Examining the potential of inclusive education policies at system and individual levels (A. Kefallinou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/preventing-school-failure-synthesis-report .

European Union Agency for Fundamental Rights (2020). Fundamental rights report —2020. https://fra.europa.eu/sites/default/files/fra_uploads/fra-2020-fundamental-rights-report-2020_en.pdf .

Farrell, P., Alborz, A., Howes, A., & Pearson, D. (2010). The impact of teaching assistants on improving pupils’ academic achievement in mainstream schools: A review of the literature. Educational Review, 62 (4), 435–448.

Farrell, P., Dyson, A., Polat, F., Hutcheson, G., & Gallannaugh, F. (2007). Inclusion and achievement in mainstream schools. European Journal of Special Needs Education, 22 (2), 131–145. https://doi.org/10.1080/08856250701267808 .

Article   Google Scholar  

Faubert, B. (2012). A literature review of school practices to overcome school failure. OECD Education Working Paper no. 68. Paris: OECD. http://dx.doi.org/10.1787/5k9flcwwv9tk-en .

Flecha, R. (2015). Successful educational actions for inclusion and social cohesion in Europe . Cham: Springer.

Flexer, R. W., Daviso, A. W., Baer, R. M., McMahan Queen, R., & Meindl, R. S. (2011). An epidemiological model of transition and postschool outcomes. Career Development and Transition for Exceptional Individuals, 34 (2), 83–94.

Florian, L., & Black-Hawkins, K. (2011). Exploring inclusive pedagogy. British Educational Research Journal, 37 (5), 813–828.

Francis, B., Archer, L., Hodgen, J., Pepper, D., Taylor, B., & Travers, M. C. (2017). Exploring the relative lack of impact of research on ‘ability grouping’ in England: A discourse analytic account. Cambridge Journal of Education, 47 (1), 1–17.

Fullan, M. (2002). The change. Educational Leadership, 59 (8), 16–20.

Gill, M. (2005). The myth of transition: Contractualizing disability in the sheltered workshop. Disability & Society, 20 (6), 613–623.

Göransson, K., & Nilholm, C. (2014). Conceptual diversities and empirical shortcomings—A critical analysis of research on inclusive education. European Journal of Special Needs Education, 29 (3), 265–280.

Gross, J. M. S., Haines, S. J., Hill, C., Francis, G. L., Blue-Banning, M., & Turnbull, A. P. (2015). Strong school–community partnerships in inclusive schools are “part of the fabric of the school… we count on them”. School Community Journal, 25 (2), 9–34.

Haines, S. J., Gross, J. M., Blue-Banning, M., Francis, G. L., & Turnbull, A. P. (2015). Fostering family–school and community–school partnerships in inclusive schools: Using practice as a guide. Research and Practice for Persons with Severe Disabilities, 40 (3), 227–239.

Harris, A. (2012). Leading system-wide improvement. International Journal of Leadership in Education, 15 (3), 395–401.

Hattie, J. A. C. (2009). Visible learning: A synthesis of 800+ meta-analyses on achievement . Abingdon, OX: Routledge.

Hehir, T., Grindal, T., Freeman, B., Lamoreau, R., Borquaye, Y., & Burke, S. (2016). A summary of the evidence on inclusive education . Cambridge: ABT Associates.

Hill, N. E., & Tyson, D. F. (2009). Parental involvement in middle school: A meta-analytic assessment of the strategies that promote achievement. Developmental Psychology, 45 (3), 740–763.

Jeynes, W. H. (2005). A meta-analysis of the relation of parental involvement to urban elementary school student academic achievement. Urban Education, 40 (3), 237–269.

Jeynes, W. H. (2007). The relationship between parental involvement and urban secondary school student academic achievement: A meta-analysis. Urban Education, 42 (1), 82–110.

Kalambouka, A., Farrell, P., Dyson, A., & Kaplan, I. (2007). The impact of placing pupils with special educational needs in mainstream schools on the achievement of their peers. Educational Research, 49 (4), 365–382.

Kinsella, W., & Senior, J. (2008). Developing inclusive schools: A systemic approach. International Journal of Inclusive Education, 12 (5–6), 651–665.

Kools, M., & Stoll, L. (2016). What makes a school a learning organisation? OECD Education Working Paper no. 137. Paris: OECD. https://doi.org/10.1787/5jlwm62b3bvh-en .

Kvalsund, R., & Bele, I. V. (2010a). Students with special educational needs—Social inclusion or marginalisation? Factors of risk and resilience in the transition between school and early adult life. Scandinavian Journal of Educational Research, 54 (1), 15–35.

Kvalsund, R., & Bele, I. V. (2010b). Adaptive situations and social marginalization in early adult life: Students with special educational needs. Scandinavian Journal of Disability Research, 12 (1), 59–76.

Lang, R., Kett, M., Groce, N., & Trani, J. F. (2011). Implementing the United Nations Convention on the rights of persons with disabilities: Principles, implications, practice and limitations. ALTER-European Journal of Disability Research/Revue Européenne de Recherche sur le Handicap, 5 (3), 206–220.

Lin-Siegler, X., Dweck, C. S., & Cohen, G. L. (2016). Instructional interventions that motivate classroom learning. Journal of Educational Psychology, 108 (3), 295.

Looney, J. W. (2011). Integrating formative and summative assessment: Progress toward a seamless system? OECD Education Working Paper no. 58. Paris: OECD.

Loreman, T., Forlin, C., & Sharma, U. (2014). Measuring indicators of inclusive education: A systematic review of the literature. Measuring Inclusive Education, 3, 165–187.

Lunt, N., & Thornton, P. (1994). Disability and employment: Towards an understanding of discourse and policy. Disability & Society, 9 (2), 223–238.

Mitchell, D. (2014). What really works in special and inclusive education: Using evidence-based teaching strategies . London: Routledge.

Muskin, J. A. (2015). Student learning assessment and the curriculum: Issues and implications for policy, design and implementation. In-Progress Reflection no. 1. Geneva: UNESCO International Bureau of Education (IBE).

Myklebust, J. O. (2006). Class placement and competence attainment among students with special educational needs. British Journal of Special Education, 33 (2), 76–81.

Myklebust, J. O. (2007). Diverging paths in upper secondary education: Competence attainment among students with special educational needs. International Journal of Inclusive Education, 11 (2), 215–231.

Myklebust, J. O., & Båtevik, F. O. (2005). Economic independence for adolescents with special educational needs. European Journal of Special Needs Education, 20 (3), 271–286.

Myklebust, J. O., & Båtevik, F. O. (2014). Economic independence among former students with special educational needs: Changes and continuities from their late twenties to their mid-thirties. European Journal of Special Needs Education, 29 (3), 387–401.

OECD (2012). Equity and quality in education: Supporting disadvantaged students and schools . Paris: OECD.

Oh-Young, C., & Filler, J. (2015). A meta-analysis of the effects of placement on academic and social skill outcome measures of students with disabilities. Research in Developmental Disabilities, 47, 80–92.

Pagán, R. (2009). Self-employment among people with disabilities: Evidence for Europe. Disability & Society, 24 (2), 217–229.

Pallisera, M., Vilà, M., & Fullana, J. (2012). Beyond school inclusion: Secondary school and preparing for labour market inclusion for young people with disabilities in Spain. International Journal of Inclusive Education, 16 (11), 1115–1129.

Priestley, M. (2000). Adults only: Disability, social policy and the life course. Journal of Social Policy, 29 (3), 421–439.

Rea, P., Mclaughlin, V., & Walther-Thomas, C. (2002). Outcomes for students with learning disabilities in inclusive and pullout programs. Exceptional Children, 68 (2), 203–223.

Rowe, N., Wilkin, A., & Wilson, R. (2012). Mapping of seminal reports on good teaching (NFER Research Programme: Developing the Education Workforce) . Slough: National Foundation for Educational Research.

Ruijs, N. M., & Peetsma, T. T. D. (2009). Effects of inclusion on students with and without special educational needs reviewed. Educational Research Review, 4 (2), 67–79. https://doi.org/10.1016/j.edurev.2009.02.002 .

Salend, S. J., & Garrick Duhaney, L. M. (1999). The impact of inclusion on students with and without disabilities and their educators. Remedial and Special Education, 20 (2), 114–126.

Sebba, J., Brown, N., Steward, S., Galton, M., & James, M. (2007). An investigation of personalised learning approaches used by schools . Nottingham: Department for Education and Skills Publications.

Shandra, C. L., & Hogan, D. (2008). School-to-work program participation and the post-high school employment of young adults with disabilities. Journal of Vocational Rehabilitation, 29 (2), 117–130.

Sharma, U., & Salend, S. J. (2016). Teaching assistants in inclusive classrooms: A systematic analysis of the international research. Australian Journal of Teacher Education, 41 (8), 118–134.

Simplican, S. C., Leader, G., Kosciulek, J., & Leahy, M. (2015). Defining social inclusion of people with intellectual and developmental disabilities: An ecological model of social networks and community participation. Research in Developmental Disabilities, 38 , 18–29.

Skjong, G., & Myklebust, J. O. (2016). Men in limbo: former students with special educational needs caught between economic independence and social security dependence. European Journal of Special Needs Education, 31 (3), 302–313.

Swann, M., Peacock, A., Hart, S., & Drummond, M. J. (2012). Creating learning without limits . Maidenhead: Open University Press.

SWIFT [Schoolwide Integrated Framework for Transformation] (2017). Equity as a basis for inclusive educational systems change, research to practice brief . Lawrence, KS: Sailor Wayne.

Symeonidou, S., & Mavrou, K. (2019). Problematising disabling discourses on the assessment and placement of learners with disabilities: Can interdependence inform an alternative narrative for inclusion? European Journal of Special Needs Education, 35 (1), 70–84.

Szumski, G., Smogorzewska, J., & Karwowski, M. (2017). Academic achievement of students without special educational needs in inclusive classrooms: A meta-analysis. Educational Research Review, 21, 33–54.

UNESCO (2009). Policy guidelines on inclusion in education . Paris: UNESCO. https://unesdoc.unesco.org/ark:/48223/pf0000177849 .

UNESCO (2017). A guide for ensuring inclusion and equity in education . Paris: UNESCO. https://unesdoc.unesco.org/ark:/48223/pf0000248254 .

UNICEF (2017). Inclusive education: Including children with disabilities in quality learning: What needs to be done? https://www.unicef.org/eca/sites/unicef.org.eca/files/IE_summary_accessible_220917_brief.pdf .

United Nations (2006). Convention on the rights of persons with disabilities . www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/convention-on-the-rights-of-persons-with-disabilities-2.html .

United Nations (2015). Transforming our world. The 2030 agenda for sustainable development . https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf .

Vescio, V., Ross, D., & Adams, A. (2008). A review of research on the impact of professional learning communities on teaching practice and student learning. Teaching and Teacher Education, 24 (1), 80–91.

Waldron, N. L., & McLeskey, J. (2010a). Inclusive school placements and surplus/deficit in performance for students with intellectual disabilities: Is there a connection? Life Span and Disability, 13 (1), 29–42.

Waldron, N. L., & McLeskey, J. (2010b). Establishing a collaborative school culture through comprehensive school reform. Journal of Educational and Psychological Consultation, 20 (1), 58–74.

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Kefallinou, A., Symeonidou, S. & Meijer, C.J.W. Understanding the value of inclusive education and its implementation: A review of the literature. Prospects 49 , 135–152 (2020). https://doi.org/10.1007/s11125-020-09500-2

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The development of inclusive education practice: A review of literature

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Review of Literature: Inclusive Education 

This brief review of relevant literature on inclusive education forms a component of the larger Inclusive School Communities Project: Final Evaluation Report delivered by the Research in Inclusive and Specialised Education (RISE) team to JFA Purple Orange in October, 2020. 

Suggested citation for full evaluation report: 

Jarvis, J. M., McMillan, J. M., Bissaker, K., Carson, K. L., Davidson, J., & Walker, P. M. (2020).  Inclusive School Communities Project: Final Evaluation Report. Research in Inclusive and Specialised Education (RISE), Flinders University. 

https://sites.flinders.edu.au/rise  

Introduction 

Inclusive education has featured prominently in worldwide educational discourse and reform efforts over the past 30 years (Berlach & Chambers, 2011; Forlin, 2006). Inclusive schools are critical to providing a strong foundation for young people with disabilities to access, participate in and contribute to their communities and lead fulfilling lives (Hehir et al., 2016). Schools also represent a key condition for the development of thriving, inclusive communities for all citizens. Yet, as reflected in submissions to the current Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, and consistent with recent South Australian reports (Parliament of South Australia, 2017; Walker, 2017), many students living with disability (and their families) continue to report negative experiences of education. While progress has been made, traditional educational structures and practices often run counter to inclusive goals (Slee, 2013), and inconsistencies occur between theory and policy and the implementation of inclusive principles and practices in schools (Carrington & Elkins, 2002; Graham & Spandagou, 2011). In addition, both preservice and practicing teachers consistently report feeling underprepared to teach students with disabilities and special educational needs (Jarvis, 2019; OECD, 2019). 

Despite legislation and policy imperatives related to inclusive education, there remains a lack of consensus in the field about the definition of inclusion and associated models of inclusive practice (Ainscow & Sandill, 2010; Kinsella, 2020). Multiple conceptualisations of inclusion and theoretical approaches to fostering inclusion in schools may contribute to confusion and uncertainty for educators and policymakers. With schools facing growing accountability and teachers expected to educate an increasingly diverse student population (Anderson & Boyle, 2015), it is vital that the concept of inclusive education is demystified for practitioners. Against this backdrop, initiatives such as the Inclusive School Communities (ISC) project that aim to deepen understandings of inclusion and increase the capacity of school communities to provide an inclusive education, are particularly important. 

Inclusive Education 

Inclusive education is based on a philosophy that stems from principles of social justice, and is primarily concerned with mitigating educational inequalities, exclusion, and discrimination (Anderson & Boyle, 2015; Booth, 2012; Waitoller & Artiles, 2013). Although inclusion was originally concerned with ‘disability’ and ‘special educational needs’ (Ainscow et al., 2006; Van Mieghem et al., 2020), the term has evolved to embody valuing diversity among all students, regardless of their circumstances (e.g., Carter & Abawi, 2018; Thomas, 2013). Among interpretations of inclusion, common themes include fairness, equality, respect, diversity, participation, community, leadership, commitment, shared vision, and collaboration (Booth, 2012; McMaster, 2015). The United Nations Convention on the Rights of Persons with Disabilities (CRPD), to which Australia is a signatory, defines inclusive education as:  

. . . a process of systemic reform embodying changes and modifications in content, teaching methods, approaches, structures and strategies in education to overcome barriers with a vision serving to provide all students of the relevant age range with an equitable and participatory learning experience and environment that best corresponds to their requirements and preferences. (United Nations, 2016, para 11)

Consistent with this definition, inclusive education now generally refers to the process of addressing the learning needs of all students, through ensuring participation, achievement growth, and a sense of belonging, enabling all students to reach their full potential (Anderson & Boyle, 2015; Booth, 2012; Stegemann & Jaciw, 2018). Inclusion is concerned with identifying and removing potential barriers to presence (attendance, access), meaningful participation, growth from an individual starting point, and feelings of connectedness and belonging for all students and community members, with a focus on those at particular risk of marginalisation or exclusion (Ainscow et al., 2006; Forlin et al., 2013). 

Critically, the view of inclusion described above moves beyond considerations of the physical placement of a student in a particular setting or grouping configuration. That is, while physical access to a mainstream school environment is essential to maintain the rights of students living with disabilities to access education “on the same basis” as their peers (consistent with legislation and human rights principles), it is not sufficient to ensure inclusion. Rather, inclusion can be considered a multi-faceted approach involving processes, practices, policies and cultures at all levels of a school and system (Booth & Ainscow, 2011). Inclusive education is responsive to each child and promotes flexibility, rather than expecting the child to change in order to ‘fit’ rigid schooling structures. The latter approach reflects integration, and inclusion is also inconsistent with segregation, in which children with disabilities are routinely educated separately from others. 

Considerable research has focused on the implementation of inclusive school processes, practices and cultures that are sustainable over time. Although a number of frameworks to achieve sustainable inclusive practice have been proposed, key elements are consistent across approaches and well supported by research (Booth & Ainscow 2011; Azorín & Ainscow, 2020). These interconnected elements are summarised in Figure 1 and considered fundamental to the process of achieving whole-school (and systemic) cultural change towards more inclusive ways of working. Of particular relevance to the Inclusive School Communities project are the concepts of a whole school approach, leadership, school values and culture, building staff capacity, and multi-tiered models of inclusive practice. 

Inclusion as a Whole School Approach 

Adopting a whole of school approach to inclusive education is fundamental to ensure efficacy and sustainability (Read et al., 2015). The process of developing inclusive schools is complex and multi-faceted, requiring time, commitment, ongoing reflection, and sustained effort. For inclusion to truly take root in schools, changes must be made from the inside out; a strong foundation must be built from inclusive school values, committed leadership, and shared vision amongst staff to support whole school structural reforms to policy, pedagogy, and practice (Ekins & Grimes, 2009). Whilst challenging, “it is necessary to unsettle default modes of operation” in schools (Johnston & Hayes, 2007, p.376), as inclusive education requires new, more efficient and effective ways of supporting student participation and achievement. This is made possible by implementing flexible, planned whole school support structures, such  as multi-tiered systems of support (MTSS), where teachers work collaboratively with specialist staff to identify, monitor, and support students requiring varying levels and types of intervention at different times, and for different purposes (Sailor, 2017; Witzel & Clarke, 2015). This contrasts to the more traditional, ‘categorical’ and segregated approach of general educators referring identified students with additional needs to special educators, to devise and administer further education in isolation from the regular classroom (Sailor, 2017). 

Figure 1. Interconnected elements in sustainable inclusive education, derived from research.

Even at the classroom level, inclusive planning and teaching practices must be supported by school policies, practices, and culture in order to be sustainable (Sailor, 2017). Barriers to inclusive classroom practice can include lack of effective professional learning and support for teachers; teachers’ lack of willingness to include students with particular needs; attitudes that are inconsistent with inclusive practices; teacher education that fails to address concerns about inclusion; and, a lack of accountability for the implementation of inclusive teaching practices (Forlin & Chambers, 2011; Forlin et al., 2008; van Kraayenoord et al., 2014). Addressing each of these relies on targeted, coordinated support. The complexity of embedding inclusive practices such as differentiated instruction or Universal Design for Learning (UDL) into classroom work is often underestimated, and these practices have the greatest chance of becoming embedded when they are reinforced by a shared vision and collaborative effort (McMaster, 2013; Sailor, 2015; Tomlinson & Murphy, 2017). 

Sustainable, whole school change cannot be achieved via focus on a single element of inclusion in isolation, as components do not function in isolation. Rather, the core elements of inclusion including leadership, school culture, building staff capacity, and inclusive practices are parts of an interdependent system. Hence, key elements of inclusion must be considered collectively and accounted for in advanced planning to ensure they function harmoniously and are integrated into the developing inclusive fabric of the school (Alborno & Gaad, 2014). 

Leadership for Inclusion 

The importance of leadership for determining the success of school reforms or changes to practice is well established in the literature (McMaster & Elliot, 2014; Poon-McBrayer & Wong, 2013). Becoming a more inclusive school often requires significant shifts in school values, culture, practices, and organisational systems; thus, leadership is critical to ensuring sustainable inclusive change in schools (Ainscow & Sandill, 2010; McMaster, 2015; Poon-McBrayer & Wong, 2013). School leaders are highly influential figures whose values, beliefs, and actions directly affect the culture of the school, expectations of staff, and school operations (Slater, 2012; Wong & Cheung, 2009). It is critical that school leaders are committed to embodying inclusive principles, establishing and modelling a standard of behaviour that promotes the development of inclusion within the school community. 

Organisational change on the scale often required for inclusion requires leadership across multiple levels (Jarvis et al., 2016; Tomlinson et al., 2008). It is likely to be most effective when facilitated through models of distributed leadership across roles and levels within a school, and when the case for change is underpinned by a broader, shared vision specifically related to student outcomes (Harris, 2013). Research has established the relationship between distributed leadership practices and the implementation of effective, inclusive school practices (Miškolci et al., 2016; Mullick et al., 2013; Robinson et al., 2008; Sharp et al., 2020). Leaders should consider utilising inclusive styles of management, replacing hierarchical structures with leadership teams (Ainscow & Sandill, 2010; McMaster, 2015). Effective school leadership enables shared responsibility, vision, and consistency within the school community, which is vital for the successful implementation of inclusion (Poon- McBrayer & Wong, 2013). 

Fostering Inclusive School Cultures 

Developing an inclusive school culture is a fundamental component of developing sustainable inclusion in schools (Dyson et al., 2004; McMaster, 2013). The culture of a school is made up of the shared values, attitudes, and beliefs of the school community (Booth, 2012). Transitioning to a truly inclusive culture requires close attention to attitudes and general support of the inclusive values being adopted, particularly by staff, but also by students and the broader school community (Dyson et al., 2004; Forlin & Chambers, 2011). 

A whole school approach to inclusion prompts a school to reflect on and embrace values based on inclusive principles, such as equality, diversity, and respect. This process cannot be imposed, but should be a collaborative exercise with school leaders and staff, to ensure any pedagogical philosophies or practices based on outdated ideas or past assumptions are not operating by default (Johnston & Hayes, 2007; Schein, 2004). Evaluating and redefining existing school values also requires professional learning, to facilitate a collective reconceptualisation of inclusion specific to the unique context of the school; the meaning, aims, and expectations of inclusion must be clarified for the school community, to encourage a shared understanding, vision, and responsibility for supporting the inclusive changes unfolding within the school (Horrocks et al., 2008; Symes & Humphrey, 2011). Finally, it is vital that school policies and practices are regularly revised, to ensure that they reinforce the inclusive values and culture of the school; otherwise, they can act as a potential barrier to the development of sustainable whole school inclusion (Dybvik, 2004; McMaster, 2013). 

Building Teachers’ Capacity for Inclusive Practice 

Building the knowledge and capacity of teachers and other school staff is crucial to developing sustainable inclusion in schools. The evolution of an inclusive school culture depends on aligning the attitudes and behaviour of staff (McMaster, 2015). Teachers must be knowledgeable about how inclusive education has progressed over time, particularly how the meaning of inclusion has changed and what it means in their school context. Understanding the concepts and values behind inclusion can help teachers appreciate its significance, prompting reflection of their own practice and how they see their students (Anderson & Boyle, 2015; Skidmore, 2004). This can allow any unhelpful assumptions or beliefs that may have been unconsciously informing their teaching practice, particularly in relation to students living with disability, to be challenged and revised (Ashby, 2012; Ashton & Arlington, 2019). 

While attention to attitudes, values, and broad understandings is fundamental, the goals of inclusion will only be achieved when principles are consistently enacted in daily classroom practice. At the classroom level, inclusion relies on teachers’ willingness and capacity to apply evidence-informed inclusive practices, such as Universal Design for Learning (UDL) and Differentiated Instruction (Van Mieghem et al., 2020). UDL is a planning framework for learning activities designed to maximise curriculum accessibility for all students by offering multiple opportunities for engagement, representation, and action and expression (CAST, 2018; Sailor, 2015). Differentiated Instruction (DI) is a holistic framework of interdependent principles and practices that enables teachers to design learning experiences to address variation in students’ readiness, interests and learning preferences (Tomlinson, 2014). UDL is primarily focused on inclusive task design, although the model has been expanded in recent years to include greater attention to pedagogy. Differentiation encompasses elements of planning (clear, concept-based learning objectives; formative  assessment to inform proactive decision-making for diverse students), teaching (strategies to differentiate by readiness, interest and learning preference; ensuring respectful tasks and ‘teaching up’), and learning environment (flexible grouping, classroom management, establishing an inclusive culture) (Jarvis, 2015; Tomlinson, 2014). 

The application of UDL and DI principles and practices by skilled teachers enables diverse students to access curriculum content in multiple ways (Kozik et al., 2009; McMaster, 2013), at appropriate levels of challenge and support to ensure learning growth, and in ways that support motivation, engagement, and feelings of connection and belonging (Beecher & Sweeney, 2008; Callahan et al., 2015; van Kraayenoord, 2007; Stegemann & Jaciw, 2018). These complementary frameworks apply to all students and define general, flexible classroom practices that also reduce the need for individualised adjustments for students with identified disabilities and specialised learning needs. However, in inclusive classrooms, teachers must also develop the knowledge and skills to make and implement reasonable adjustments and accommodations that enable students with identified disabilities and more complex needs to engage with curriculum and assessment ‘on the same basis’ as their peers, as defined within the Disability Standards for Education (Davies et al., 2016). 

While inclusive teaching and classroom practices are non-negotiable, the challenge for some teachers to master the necessary skills and achieve the significant shift away from traditional teaching practices is often underestimated (Dixon et al., 2014; Tomlinson & Murphy, 2015). It is well-documented that teachers often find it difficult to apprehend both the conceptual and practical tools of DI and to embed differentiated practices into their daily work (Dack, 2019), particularly when they are not adequately resourced or supported to do so (Black-Hawkins & Florian, 2012; Brigandi et al., 2019; Fuchs et al., 2010; Mills et al, 2014). Perhaps related to teachers’ perceived lack of competence and confidence, the past 5-10 years have seen an enormous increase in the employment of teacher aides to work alongside students with disabilities in mainstream classrooms, despite limited evidence for its effectiveness and often in the context of inadequate planning and oversight (e.g., Sharma & Salend, 2016). 

Engagement in targeted professional learning (PL) is fundamental to supporting the shift towards inclusive teaching. Yet, traditional approaches to PL have been criticised for a lack of systematic evaluation and inadequate adherence to principles of effectiveness (Avalos, 2011; Merchie et al., 2018). Research on effective professional learning for teachers has established common principles and practices that are associated with changes in practice, and these also align with teachers’ stated preferences (Walker et al., 2018). These include: 

• professional learning is embedded in teachers’ own work contexts, and requires teachers to engage with content that is highly relevant to their daily practice, and closely linked to student learning (Desimone, 2009; Easton, 2008; Spencer, 2016; Van den Bergh et al., 2014); 
• professional learning enables teachers to learn together with colleagues, such as in communities of practice (Gore et al., 2017; Voelkel & Chrispeels, 2017); 
• professional learning activities are supported by robust school leadership and linked to broader school values and goals (Carpenter, 2015; Frankling et al., 2017; Sharp et al., 2020; Tomlinson et al., 2008; Whitworth & Chiu, 2015); 
• professional learning is provided over extended periods, is led by facilitators with expert knowledge, and includes timely follow up activities such as mentoring and coaching to embed changes in practice (Desimone & Pak, 2017; Grierson & Woloshyn, 2013; Tomlinson & Murphy, 2015). 

Multi-tiered Approaches to Whole School Inclusive Practice 

Multi-tiered system of supports (MTSS) is an overarching term for a whole school inclusive framework that can be used to structure the flexible, timely distribution of resources to support students depending on their level of need (Sailor, 2017). As reflected in the generic depiction of MTSS in Figure 2, models generally utilise three tiers of intervention and teaching, where the intensity of the support is increased with each level or tier (McLeskey et al, 2014; Witzel & Clarke, 2015). Tier 1 includes core differentiated instruction and universal, evidence-based strategies for support that all students in the class receive. Tier 2 provides additional, targeted support to certain students for a specified purpose and period of time, usually in a small group format, while Tier 3 represents the most intensive and individualised support (Webster, 2016). The MTSS approach requires assessing all students regularly to assist in the early identification of needs requiring additional support, to enable prompt delivery of targeted interventions (McLeskey et al., 2014). MTSS is concerned with supporting the holistic development of students, by targeting their academic progress, behaviour, and socio-emotional well- being (McMillan & Jarvis, 2017). 

When implemented with fidelity, MTSS is an effective whole school inclusive framework as teachers, therapists, and other support staff work collaboratively to assess, monitor, and plan interventions to support students (Sailor, 2017). Student progress is frequently monitored and data are evaluated by the support team to determine whether alternative interventions are required. MTSS additionally encourages the use of evidence-based practices to be implemented across the tiers of support. Some common examples of MTSS include Response to Intervention (RTI) and Positive Behaviour Interventions and Supports (PBIS) (Webster, 2016). RTI is focused on supporting students academically, while PBIS is concerned with emphasising behavioural expectations in a positive manner, naturally supporting the social and emotional development of students. MTSS models have also been applied in whole-school mental health promotion, prevention and intervention (McMillan & Jarvis, 2017) and inclusive approaches to academic talent development for more advanced students (Jarvis, 2017). 

MTSS approaches to contemporary inclusive practice stand in contrast to traditional, categorical models whereby students were either ‘in’ or ‘out’ of special education services. The focus is on determining and responding to what students need when they need it, as opposed to focusing on a specific diagnosis or inflexible program options. In the MTSS framework, the tiers do not represent students or their placement, but the flexible suite of supports and interventions that may be provided. The implementation of MTSS approaches fundamentally reconceptualises the role of the classroom teacher, who must work collaboratively with specialist staff and other professionals to define and address individual student needs in ongoing ways, rather than relying on a specialist teacher or even a teacher aide to take responsibility for the education of students with identified special needs. While MTSS requires substantial changes to school operations (and must therefore be supported by leadership and culture in deliberate, coordinated ways), the general framework provides an organisation and structure to support the development of sustainable, contemporary inclusive schools (McLeskey et al., 2014). 

Figure 2. Multi-tiered System of Supports (MTSS) framework. 

Conclusion 

Ultimately, developing sustainable and effective inclusion in schools is a challenging but worthwhile undertaking, requiring shared vision, commitment, ongoing reflection, and patience. Changes in practice, particularly in teachers’ daily planning and pedagogy, take time and will be supported by ongoing, well designed and embedded professional learning in the context of strong leadership and an inclusive school culture. By utilising a whole school approach, key areas including leadership, school values and culture, building staff capacity, and coordinated frameworks for inclusive practice, can be considered collectively and planned for in advance.  

References 

Ainscow, M., & Sandill, A. (2010). Developing inclusive education systems: The role of organizational cultures and leadership. International Journal of Inclusive Education, 14 (4), 401–416. https://doi.org/10.1080/13603110802504903 

Ainscow, M., Booth, T., & Dyson, A. (2006). Improving Schools, Developing Inclusion. Routledge. 

Alborno, N., & Gaad, E. (2014). Index for Inclusion: A framework for school review in the United Arab Emirates. British Journal of Special Education, 41 (3), 231–248. https://doi.org/10.1111/1467-8578.12073 

Anderson, J., & Boyle, C. (2015). Inclusive education in Australia: Rhetoric, reality and the road ahead. Support for Learning, 30 (1), 4–22. https://doi.org/10.1111/1467-9604.12074 

Ashby, C. (2012). Disability studies and inclusive teacher preparation: A socially just path for teacher education. Research and Practice for Persons with Severe Disabilities, 37 (2), 89–99. https://doi.org/10.1177%2F154079691203700204 

Ashton, J. R., & Arlington, H. (2019). My fears were irrational: Transforming conceptions of disability in teacher education through service learning. International Journal of Whole Schooling, 15 (1), 50–81. 

Askell-Williams, H., & Koh, G. (2020). Enhancing the sustainability of school improvement initiatives. School Effectiveness and School Improvement. https://doi.org/10.1080/09243453.2020.1767657 

Avalos, B. (2011). Teacher professional development in teaching and teacher education over ten years. Teaching and Teacher Education, 27, 10–20. https://doi.org/10.1016/j.tate.2010.08.007 

Beecher, M., & Sweeney, S. M. (2008). Closing the achievement gap with curriculum enrichment and differentiation: One school’s story. Journal of Advanced Academics, 19 (3), 502–530. https://doi.org/10.4219/jaa-2008-815 

Berlach, R. G., & Chambers, D. J. (2011). Interpreting inclusivity: An endeavour of great proportions. International Journal of Inclusive Education, 15, 529–539. https://doi.org/10.1080/13603110903159300 

Black-Hawkins, K. & Florian, L. (2012). Classroom teachers’ craft knowledge of their inclusive practice. Teachers and Teaching: Theory and Practice, 8 (5), 567–584. https://doi.org/10.1080/13540602.2012.709732 

Booth, T. (2012). Creating welcoming cultures: The index for inclusion. Race Equality Teaching, 30 (2), 19–21. http://doi.org/10.18546/RET.30.2.07 

Booth, T., & Ainscow, M. (2011). Index for Inclusion: developing learning and participation in schools (3rd ed.). Centre for Studies on Inclusive Education. http://www.csie.org.uk/resources/inclusion-index-explained.shtml 

Brigandi, C., Gibson, C. M., & Miller, M. (2019). Professional development and differentiated instruction in an elementary school pull-out program: A gifted education case study. Journal for the Education of the Gifted, 42 (4), 362–395. https://doi.org/10.1177/0162353219874418 

Callahan, C. M., Moon, T. R., Oh, S., Azano, A. P., & Hailey, E. P. (2015). What works in gifted education: Documenting the effects of an integrated curricular/instructional model for gifted students. American Education Research Journal, 52, 137–167. https://doi.org/10.3102/0002831214549448 

Carpenter, D. (2015). School culture and leadership of professional learning communities. International Journal of Educational Management, 29 (5), 682–694. https://doi.org/10.1108/IJEM-04-2014-0046 

Carrington, S., & Elkins, J. (2002). Bridging the gap between inclusive policy and inclusive culture in secondary schools. Support for Learning, 17 (2), 51–57. 

Carter, S., & Abawi, L. (2018). Leadership, inclusion, and quality education for all. Australasian Journal of Special and Inclusive Education, 42 (1), 49–64. https://doi.org/10.1017/jsi.2018.5 

CAST. (2018). Universal Design for Learning Guidelines Version 2.2. http://udlguidelines.cast.org 

Davies, M., Elliott, S., & Cumming, J. (2016). Documenting support needs and adjustment gaps for students with disabilities: Teacher practices in Australian classrooms and on national tests. International Journal of Inclusive Education, 20 (12), 1252–1269. https://doi.org/10.1080/13603116.2016.1159256 

Desimone, L. M. (2009). Improving impact studies of teachers’ professional development: Toward better conceptualizations and measures. Educational Researcher, 38 (3),181–199. https://doi.org/10.3102/0013189X08331140 

Desimone, L. M., & Pak, K. (2017). Instructional coaching as high-quality professional development. Theory Into Practice, 56 (1), 312. https://doi.org/10.1080/00405841.2016.1241947 

Dixon, F. A., Yssel, N., McConnell, J. A., & Hardin, T. (2014). Differentiated instruction, professional development and teacher efficacy. Journal for the Education of the Gifted, 37 (2), 111–127. https://doi.org/10.1177/0162353214529042 

Dybvik, A. C. (2004). Autism and the inclusion mandate: What happens when children with severe disabilities like autism are taught in regular classrooms? Daniel knows. Education Next, 4 (1), 42–49. 

Dyson, A., Farrell, P., Polat, F., Hutcheson, G., & Gallanaugh, F. (2004). Inclusion and pupil achievement. Department for Education and Skills. 

Easton, L. B. (2008). From professional development to professional learning. Phi Delta Kappan, 89, 755–761. https://doi.org/10.1177/003172170808901014 

Ekins, A., & Grimes, P. (2009). Inclusion: Developing an Effective Whole School Approach. McGraw Hill Open University Press. 

Forlin, C. (2006). Inclusive education in Australia ten years after Salamanca. European Journal of Psychology of Education, 21 (3), 265–277. https://doi.org/10.1007/BF03173415 

Forlin, C., & Chambers, D. (2011). Teacher preparation for inclusive education: Increasing knowledge but raising concerns. Asia-Pacific Journal of Teacher Education, 39 (1), 17–32. https://doi.org/10.1080/1359866X.2010.540850 

Forlin, C., Chambers, D. J., Loreman, T., Deppler, J., & Sharma, U. (2013). Inclusive education for students with disability: A review of the best evidence in relation to theory and practice. The Australian Research Alliance for Children and Youth. https://www.aracy.org.au/publicationsresources/command/download_file/id/246/filename/Inclusive_education_for_students_with_disability_-_A_review_of_the_best_evidence_in_relation_to_theory_and_practice.pdf73 

Forlin, C., Keen, M., & Barrett. E. (2008). The concerns of mainstream teachers: Coping with inclusivity in an Australian context. International Journal of Disability, Development and Education, 55 (3), 251–264. https://doi.org/10.1080/10349120802268396 

Frankling, T. W., Jarvis, J. M. & Bell. M. R. (2017). Leading secondary teachers’ understandings and practices of differentiation through professional learning. Leading and Managing, 23 (2), 72–86. 

Fuchs, D., Fuchs, L. S., & Stecker, P. M. (2010). The ‘blurring’ of special education in a new continuum of general education placements and services. Exceptional Children, 76 (3), 301–323. https://doi.org/10.1177/001440291007600304 

Gore, J., Lloyd, A., Smith, M., Bowe, J., Ellis, H., & Lubans, D. (2017). Effects of professional development on the quality of teaching: Results from a randomised controlled trial of Quality Teaching Rounds. Teaching and Teacher Education, 68, 91–113. https://doi.org/10.1016/j.tate.2017.08.007 

Graham, L., & Spandagou, I. (2011). From vision to reality: Views of primary school principals on inclusive education in New South Wales, Australia. Disability & Society, 26 (2), 223–237. https://doi.org/10.1080/09687599.2011.544062 

Grierson, A. L., & Woloshyn, V. E. (2013). Walking the talk: Supporting teachers’ growth with differentiated professional learning. Professional Development in Education, 39 (3), 401–419. https://doi.org/10.1080/19415257.2012.763143 

Guskey, T. R. (2000). Evaluating professional development. Corwin Press 

Harris, A. (2013). Distributed leadership: Friend or foe? Educational Management, Administration & Leadership, 4 (5), 545–554. https://doi.org/10.1177/1741143213497635 

Hehir, T., Pascucci, S., & Pascucci, C. (2016). A summary of the evidence on inclusive education, Instituto Alana, 2. https://files.eric.ed.gov/fulltext/ED596134.pdf 

Horrocks, J. L., White, G., & Roberts, L. (2008). Principals' attitudes regarding inclusion of children with autism in Pennsylvania public schools. Journal of Autism and Developmental Disorders, 38, 1462–1473. https://doi.org/10.1007/s10803-007-0522-x 

Jarvis, J. M. (2015). Inclusive Classrooms and Differentiation. In N. Weatherby-Fell (Ed.), Learning to Teach in the Secondary School (pp. 154–171). Cambridge University Press. 

Jarvis, J. M. (2019). Most Australian teachers feel unprepared to teach students with special needs. The Conversation. https://theconversation.com/most-australian-teachers-feel-unpreparedto-teach-students-with-special-needs-119227 

Jarvis, J. M., (2017). Supporting diverse gifted students. In M. Hyde, L. Carpenter & S. Dole (Eds.), Diversity, Inclusion and Engagement (3rd ed., pp. 308–329). Oxford University Press. 

Johnston, K., & Hayes, D. (2007). Supporting students’ success at school through teacher professional learning: The pedagogy of disrupting the default modes of schooling. International Journal of Inclusive Education, 11 (3), 371–381. https://doi.org/10.1080/13603110701240666 

Kinsella, W. (2020). Organising inclusive schools. International Journal of Inclusive Education, 24 (12), 1340–1356. https://doi.org/10.1080/13603116.2018.1516820 

Kozik, P., Cooney, B., Vinciguerra, S., Gradel, K., & Black, J. (2009). Promoting inclusion in secondary schools through appreciative inquiry. American Secondary Education, 38 (1), 77–91. 

McLeskey, J., Waldron, N. L., Spooner, F., & Algozzine, B. (Eds.). (2014). Handbook of effective inclusive schools: Research and practice. Taylor & Francis. 

McMaster, C. (2013). Building inclusion from the ground up: A review of whole school re-culturing programmes for sustaining inclusive change. International Journal of Whole Schooling, 9 (2), 1–24. 

McMaster, C. (2015). Inclusion in New Zealand: The potential and possibilities of sustainable inclusive change through utilising a framework for whole school development. New Zealand Journal of Educational Studies, 50 (2), 239–253. 

McMaster, C., & Elliot, W. (2014). Leading inclusive change with the Index for Inclusion: Using a framework to manage sustainable professional development. Journal of Educational Leadership, Policy and Practice, 29 (1), 82–93. https://doi.org/10.1007/s40841-015-0010-3 

McMillan, J., & Jarvis, J. M. (2017). Supporting mental health and well-being: Promotion, prevention and intervention. In M. Hyde, L. Carpenter & S. Dole (Eds.), Diversity, inclusion and engagement (3rd ed., pp. 65–392). Oxford University Press. 

Merchie, E., Tuytens, M., Devos, G., & Vanderlinde, R. (2018). Evaluating teachers’ professional development initiatives: Towards an extended evaluative framework. Research Papers in Education, 33 (2), 143–168. https://doi.org/10.1080/02671522.2016.1271003 

Mills, M., Monk, S., Keddie, A., Renshaw, P., Christie, P., Geelan, D. & C. Gowlett, C. (2014). Differentiated learning: From policy to classroom. Oxford Review of Education, 40 (3), 331–348. https://doi.org/10.1080/03054985.2014.911725 

Miškolci, J., Armstrong, D., & Spandagou, I. (2016). Teachers' perceptions of the relationship between inclusive education and distributed leadership in two primary schools in Slovakia and New South Wales (Australia). Journal of Teacher Education for Sustainability, 18 (2), 53–65. https://doi.org/10.1515/jtes-2016-001 

Mullick, J., Sharma, U., & Deppeler, J. (2013). School teachers' perception about distributed leadership practices for inclusive education in primary schools in Bangladesh. School Leadership & Management, 33 (2), 151–168. https://doi.org/10.1080/13632434.2012.723615 

OECD (2019). TALIS 2018 Results (Volume I): Teachers and School Leaders as Lifelong Learners. OECD Publishing. https://doi.org/10.1787/1d0bc92a-en. 

Parliament of South Australia. (2017). Report of the select committee on access to the South Australian Education System for students with a disability. https://apo.org.au/sites/default/files/resource-files/2017-05/apo-nid94396.pdf 

Poon-McBrayer, K., & Wong, P. (2013). Inclusive education services for children and youth with disabilities: Values, roles and challenges of school leaders. Children and Youth Services Review, 35 (9), 1520–1525. https://doi.org/10.1016/j.childyouth.2013.06.009 

Read, K., Aldridge, J., Ala’i, K., Fraser, B., & Fozdar, F. (2015). Creating a climate in which students can flourish: A whole school intercultural approach. International Journal of Whole Schooling, 11 (2), 29–44. https://doi.org/1710-2146 

Robinson, V. M. J., Lloyd, C. A., & Rowe, K. J. (2008). The impact of leadership on student outcomes: An analysis of the differential effects of leadership types. Educational Administration Quarterly, 44 (5), 635–674. https://doi.org/10.1177/0013161X08321509 

Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. (2019). Issues Paper: Education and Learning. https://disability.royalcommission.gov.au/system/files/2020-07/Issues-paper-Education-Learning.pdf 

Sailor, W. (2015). Advances in schoolwide inclusive school reform. Remedial and Special Education, 36, 94–99. https://doi.org/10.1177/0741932514555021 

Sailor, W. (2017). Equity as a basis for inclusive educational systems change. The Australasian Journal of Special Education, 41 (1), 1–17. https://doi.org/10.1017/jse.2016.12 

Schein, E. (2004). Organizational culture and leadership (3rd ed.). Jossey-Bass. 

Sharma, U., & Salend, S. (2016). Teaching assistants in inclusive classrooms: A systematic analysis of the international research. Australian Journal of Teacher Education, 41 (8), 118–134. 

Sharp, K., Jarvis, J. M., & McMillan, J. M. (2020). Leadership for differentiated instruction: Teachers' engagement with on-site professional learning at an Australian secondary school. International Journal of Inclusive Education, 24 (8), 901–920. https://doi.org/10.1080/13603116.2018.1492639 

Skidmore, D. (2004). Inclusion: The dynamic of school development. McGraw-Hill Education. 

Slater, C. L. (2012). Understanding principal leadership: An international perspective and a narrative approach. Educational Management Administration & Leadership, 39 (2), 219–227. https://doi.org/10.1177/1741143210390061 

Slee, R. (2013). How do we make inclusive education happen when exclusion is a political predisposition? International Journal of Inclusive Education: Making Inclusive Education Happen: Ideas for Sustainable Change, 17 (8), 895–907. https://doi.org/10.1080/13603116.2011.602534 

Spencer, E. J. (2016). Professional learning communities: Keeping the focus on instructional practice. Kappa Delta Pi Record, 52 (2), 83–85. https://doi.org/10.1080/00228958.2016.1156544 

Stegemann, K., & Jaciw, A. (2018). Making it logical: Implementation of inclusive education using a logic model framework. Learning Disabilities: A Contemporary Journal, 16 (1), 3–18. 

Symes, W., & Humphrey, N. (2011). School factors that facilitate or hinder the ability of teaching assistants to effectively support pupils with autism spectrum disorders (ASD) in mainstream secondary schools. Journal of Research in Special Educational Needs, 11 (3), 153–161. https://doi.org/10.1111/j.1471-3802.2011.01196.x 

Thomas, G. (2013). A review of thinking and research about inclusive education policy, with suggestions for a new kind of inclusive thinking. British Educational Research Journal, 39 (3), 473–490. https://doi.org/10.1080/01411926.2011.652070 

Tomlinson, C. A. (2014). The differentiated classroom: Responding to the needs of all learners (2nd ed.). Association for Supervision and Curriculum Development. 

Tomlinson, C. A., & Murphy, M. (2015). Leading for differentiation: Growing teachers who grow kids. Association for Supervision and Curriculum Development. 

Tomlinson, C.A., Brimijoin, K., & Narvaez, L. (2008). The differentiated school: Making revolutionary changes in teaching and learning. Association for Supervision and Curriculum Development. 

Van Den Bergh, L., Ros, A., & Beijaard, D. (2014). Improving teacher feedback during active learning: Effects of a professional development program. American Educational Research Journal, 51 (4), 772–809. https://doi.org/10.3102/0002831214531322 

van Kraayenoord, C. E. (2007). School and classroom practices in inclusive education in Australia. Childhood Education, 83 (6), 390–394, https://doi.org/10.1080/00094056.2007.10522957 

van Kraayenoord, C. E., Waterworth, D., & Brady. T. (2014). Responding to individual differences in inclusive classrooms in Australia. Journal of International Special Needs Education, 17 (2), 48–59. 

Van Mieghem, A., Verschueren, K., Petry, K., & Struyf, E. (2020). An analysis of research on inclusive education: A systematic search and meta review. International Journal of Inclusive Education, 26 (6), 675–689. https://doi.org/10.1080/13603116.2018.1482012 

Voelkel, R. H., Jr., & Chrispeels, J. H. (2017). Understanding the link between professional learning communities and teacher collective efficacy. School Effectiveness and School Improvement, 28, 505–526. https://doi.org/10.1080/09243453.2017.1299015 

Waitoller, F. R., & Artiles, A. J. (2013). A decade of professional development research for inclusive education: A critical review and notes for a research program. Review of Educational Research, 83 (3), 319–356. https://doi.org/10.3102/0034654313483905 

Walker, P. M., Carson, K. L., Jarvis, J. M., McMillan, J. M., Noble, A. G., Armstrong, D., . . . Palmer, C. (2018). How do educators of students with disabilities in specialist settings understand and apply the Australian Curriculum framework? Australasian Journal of Special and Inclusive Education, 42 (2), 111–126. https://doi.org/10.1017/jsi.2018.13 

Webster, A. (2016). Utilising a leadership blueprint to build the capacity of schools to achieve outcomes for students with autism spectrum disorder. In G. Johnson & N. Dempster (Eds.), Leadership in diverse learning contexts (pp. 109–127). https://doi.org/10.1007/978-3-319-28302-9_6 

Whitworth, B. A., & Chiu, J. L. (2015). Professional development and teacher change: The missing leadership link. Journal of Science Teacher Education, 26 (2), 121–137. https://doi.org/10.1007/s10972-014-9411-2

Inclusive School Communities Project Phone: (08) 8373 8333 Email:  [email protected] Address: 104 Greenhill Road, Unley SA 5061

Enhancing Nepal’s Education System for Safe and Inclusive Learning Environments

Nepal faces significant challenges in ensuring the rights and well-being of children, particularly in protecting them from violence in educational settings. Despite constitutional prohibitions and government efforts, violence against children, especially in schools, persists. According to UNICEF data (2014), a substantial number of school-going children in Nepal experience alarming levels of physical and psychological violence, often perpetrated by teachers and peers.

The project aims to ensure that all learners, particularly girls and those who are especially vulnerable, benefit from safe and inclusive educational environments that support their health, well-being, and learning potential. This aligns with the SESP (2022-2032) and Nepal's Equity Strategy.

As part of system strengthening, a series of capacity-building trainings will be conducted for provincial and local government bodies, education officers, and school leaders. These trainings will address the identified needs to strengthen and institutionalize efforts to combat school-related gender-based violence (SRGBV) in its various forms. This project will be implemented in the Bansgadi, Shahidnagar, and Rautamai municipalities of Nepal.

Transforms Nepal’s education system to ensure a healthy, safe, and inclusive learning environment for all learners. 

Enhance systems, policies, and practices to ensure equitable access to quality education.    

Promotes healthy lives and responsible global citizenship. Ensure safe learning environments and address educational barriers.  

The aim is to create a systematic change in Nepal’s education system by addressing SRGBV. 

Key Activities

Conduct a desk-based review, supplemented with key informant interviews, to assess the status of current systems, policies, and programs.

Organize a national workshop/consultation with key stakeholders for assessment, planning, and programming.

Develop, adapt, review, or update relevant guidance and tools, training and learning materials, and classroom/online training courses.

Conduct workshops/training courses to train key stakeholders based on identified needs (e.g., policymakers, curriculum developers).

Develop locally relevant advocacy and communication materials (e.g., publications, policy/technical briefs, factsheets, presentations, social media content) by adapting existing global/regional resources.

Conduct orientation/advocacy events (e.g., roundtables, seminars, symposiums, workshops, social media campaigns) involving key stakeholders at national and/or sub-national levels.

Related items

• Gender equality
• Country page: Nepal
• Region: Asia and the Pacific
• UNESCO Office in Kathmandu
• SDG: SDG 4 - Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
• See more add

This article is related to the United Nation’s Sustainable Development Goals .

More on this subject

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• Open access
• Published: 21 August 2024

Financing pandemic prevention, preparedness and response: lessons learned and perspectives for future

• Nicaise Ndembi 1 ,
• Nebiyu Dereje 1 ,
• Justice Nonvignon 1 ,
• Merawi Aragaw 1 ,
• Tajudeen Raji 1 ,
• Mosoka Papa Fallah 1 ,
• Mohammed Abdulaziz 1 ,
• Benjamin Djoudalbaye 1 ,
• Aggrey Aluso 2 ,
• Yap Boum II 3 ,
• Gwen Mwaba 4 ,
• Olive Shisana 5 ,
• Ngashi Ngongo 1 &
• Jean Kaseya 1  

Globalization and Health volume  20 , Article number:  65 ( 2024 ) Cite this article

Metrics details

The attainment of global health security goals and universal health coverage will remain a mirage unless African health systems are adequately funded to improve resilience to public health emergencies. The COVID-19 pandemic exposed the global inequity in accessing medical countermeasures, leaving African countries far behind. As we anticipate the next pandemic, improving investments in health systems to adequately finance pandemic prevention, preparedness, and response (PPPR) promptly, ensuring equity and access to medical countermeasures, is crucial. In this article, we analyze the African and global pandemic financing initiatives and put ways forward for policymakers and the global health community to consider.

This article is based on a rapid literature review and desk review of various PPPR financing mechanisms in Africa and globally. Consultation of leaders and experts in the area and scrutinization of various related meeting reports and decisions have been carried out.

The African Union (AU) has demonstrated various innovative financing mechanisms to mitigate the impacts of public health emergencies in the continent. To improve equal access to the COVID-19 medical countermeasures, the AU launched Africa Medical Supplies Platform (AMSP) and Africa Vaccine Acquisition Trust (AVAT). These financing initiatives were instrumental in mitigating the impacts of COVID-19 and their lessons can be capitalized as we make efforts for PPPR. The COVID-19 Response Fund, subsequently converted into the African Epidemics Fund (AEF), is another innovative financing mechanism to ensure sustainable and self-reliant PPPR efforts. The global initiatives for financing PPPR include the Pandemic Emergency Financing Facility (PEF) and the Pandemic Fund. The PEF was criticized for its inadequacy in building resilient health systems, primarily because the fund ignored the prevention and preparedness items. The Pandemic Fund is also being criticized for its suboptimal emphasis on the response aspect of the pandemic and non-inclusive governance structure.

Conclusions

To ensure optimal financing for PPPR, we call upon the global health community and decision-makers to focus on the harmonization of financing efforts for PPPR, make regional financing mechanisms central to global PPPR financing efforts, and ensure the inclusivity of international finance governance systems.

The health systems in Africa, already limited in capability and capacity, face the daunting challenge of addressing emerging and reemerging public health emergencies [ 1 ]. This challenge is set against a backdrop of economic vulnerabilities, including significant debts and populations with generally low socioeconomic status and health literacy. Infectious diseases still have a severe impact on the African continent, accounting for over 227 million years of healthy life lost every year and producing an annual productivity loss of over $800 billion [ 1 ]. Compounding this situation are the disproportionate impacts of climate change on public health and the ongoing wars and conflicts in various regions of the continent [ 2 ]. Such circumstances severely impede Africa’s ability to effectively engage in pandemic prevention, preparedness, and response (PPPR).

Building strong, resilient health systems in Africa that can adequately handle public health emergencies is crucial. However, the severe underfunding of health systems, as evidenced by the low domestic investments of African governments, contrary to the commitments of the Abuja declaration, specifically on spending 15% of the budget on health, could further worsen the already weak health systems [ 3 ]. The attainment of global health security (GHS) goals and universal health coverage (UHC) will remain a mirage unless African health systems are adequately and efficiently funded to improve resilience to emerging and reemerging public health emergencies. GHS agenda mainly targets infectious disease prevention and control while the UHC prioritizes universal, timely, and quality access to essential healthcare services for everyone [ 4 , 5 ]. However, both initiatives have impacts on strengthening one another. A strong health system built by the UHC can significantly contribute to the success of the GHS agenda and vice-versa [ 4 , 6 , 7 ]. To ensure this, various scholars indicated the need for integration (building capacity for GHS within the comprehensive UHC framework), investment (unified financing to strengthen the overall health system), building a resilient health system, and addressing the inequity gaps [ 4 , 5 , 6 , 7 , 8 , 9 ]. This is critical in Africa where the infectious disease burden is high and resources are limited.

As we anticipate the next pandemic, improving investments in health systems and building a solid buffer to adequately finance PPPR promptly, ensuring equity and access to medical counter-measures is crucial, and mechanisms must be placed in the ongoing Pandemic Agreement negotiations [ 10 , 11 ]. The pandemic financing system is a fundamental element to ensure the realization of the envisioned safe and equitable world for everyone by the Pandemic Agreement [ 11 ]. In this article, we analyzed the African and global pandemic financing initiatives and put ways forward for the consideration of policymakers and the global health community.

This article is based on a rapid literature review and desk review of financial mechanisms implemented to address the pandemic prevention preparedness and response in Africa and globally. We used Google, Google Scholar, PubMed Central, and Web of Sciences to search for relevant documents, reports, and published journal articles stating PPPR financial mechanisms. We also made consultations with prominent experts and leaders of various institutions such as the Africa Union, Africa CDC, World Bank, Afriexim Bank, and Pandemic Action Network to get their perspectives and insights into the financing mechanisms. Moreover, we searched various institutions’ websites that are relevant to our topic of inquiry such as the World Bank website for PPPR financial initiatives including the Pandemic Fund, the Africa Union website for the COVID-19 Response Fund, and the Epidemic Intelligence Fund. We scrutinized various meeting reports and decisions to support our analysis of the financial mechanisms.

African Union initiatives to Finance the PPPR

With the challenges presented by public health emergencies such as the West African Ebola outbreak and the COVID-19 pandemic, the African continent has learned important lessons that need to be translated into policy and action as part of PPPR. The West African Ebola outbreak exposed African health systems’ fragility and reliance on international expertise and support to respond to the outbreak – underscoring the overwhelming urgent need for building local capacity to effectively mobilize domestic resources (health workforce, finance, and leadership) [ 12 ].

The recent COVID-19 response unveiled serious global inequities regarding access to medical countermeasures (vaccines, diagnostics, and therapeutics), and Africa was left far behind. The global financing systems utterly failed to fulfill the demands of the countries as evidenced by an alarmingly more than 100-day gap between the first COVID-19 vaccination in low-income countries (LICs) and high-income countries (HICs) [ 13 ], and an average daily testing capacity of 6.07 tests per 1000 people in HICs as compared to 0.08 tests per 1000 people in LICs [ 14 ]. The African Union (AU) initially dealt with the COVAX (COVID-19 Vaccine Global Access) - Access to COVID-19 Tools Accelerator (ACT-A) to address the vaccine access gap. However, the COVAX facility is said to have been severely delayed in ensuring that vaccines are optionally supplied to Africa and other LMICs [ 15 ]. ACT-A was an unprecedented global coordination mechanism co-chaired by South Africa and Norway, which raised 24 billion dollars, distributed over vaccines, diagnostics, therapeutics and other essential medical products. Notwithstanding its phenomenal success, there were serious and life-costing pitfalls: it took too long to raise the financing, vaccine deployment was delayed by issues of export bans and other geopolitical tensions, the diagnostics and therapeutics pillars did not meet their targets, and the health systems connector pillar did not operationalize adequately and failed to meet its mandate, compromising critical last mile capabilities (Table  1 ). As a result, the ACT-A fell short of delivering equity, as evidenced by the fact that today, the world average for vaccination is 67%, while low-income countries only average 27%[ 16 ]. According to the ACT-A external evaluation, a similar platform for future pandemics should have, inter alia, better coordination on R&D, that there should be available contingent funding on Day Zero of the next pandemic, that there should be a ‘strong representation of regional actors’ in the governance structure, and a stronger emphasis on technology transfer [ 17 ].

During the pandemic, the African Union acted swiftly to mitigate inequities, including by creating a pooled vaccine and medical supplies procurement platforms, Africa Vaccine Acquisition Trust (AVAT) and Africa Medical Supplies Platform (AMSP) – successfully delivering medical countermeasures to the AU Member States (Table  1 ).

The AMSP is a digital platform that unlocks immediate access to an African and global base of vetted manufacturers and enables AU Member States to purchase certified medical equipment and clinical management devices with increased cost-effectiveness and transparency. The platform is a unique interface enabling volume aggregation, payment facilitation, and logistics and transportation to ensure equitable and efficient access to critical supplies for African governments. The AVAT is a special-purpose vehicle created to facilitate the pooled procurement mechanism and act as the interface between AU member states and vaccine manufacturers. The procurement of COVID-19 vaccines through AVAT was supported by a $2 billion financial guarantee issued by the African Export-Import Bank (Afreximbank). AVAT negotiated and executed a vaccine supply contract with Johnson & Johnson (J&J) for 220 million vaccine doses on a committed basis (at a cost of $7.5 per dose for a total of USD 1.65 billion) with an option to trigger an additional 180 million vaccine doses subject to demand from AU Member States. With the backing of a payment guarantee from Afreximbank, AVAT was able to meet all its financial obligations to the vaccine manufacturer J&J. All J&J invoices for supplies made by J&J were settled by AVAT on behalf of AU Member States. As of 8th May 2024, 158.3 million doses have been shipped to the participating countries (42 African countries plus 6 Caribbean Community and Common Market (CARICOM) countries). A further quantity of 30.3 million doses has been accepted by the countries and in the process of being prepared for shipment. Strong strategic partnerships and collaborations with institutions and organizations like the World Bank, Mastercard Foundation, Africa CDC, UNICEF, and MTN amongst others who worked with AVAT’s pooled procurement mechanism initiative a success.

This guarantee provided payment assurance to the vaccine manufacturers [ 18 ]. However, financial constraints and reduced vaccine uptake in Member States after the end of the declaration of COVID-19 as a Public Health Emergency of International Concern (PHEIC) challenged the initiatives.

The COVID-19 Response Fund was another significant AU initiative, that demonstrated the role of public-private partnership (PPP) in strengthening domestic capacity to mitigate the impact of the pandemic. The partnership aimed to raise an initial $150 million for immediate needs to prevent the spread and up to $400 million to support sustainable medical response to the COVID-19 pandemic by pooling the resources required for the procurement of medical supplies and commodities, supporting the deployment of rapid responders across the continent as well as providing socio-economic support to the most vulnerable populations in Africa.

Capitalizing on lessons learned from this initiative, heads of state of the AU member states converted the fund into the African Epidemics Fund (AEF), which was envisioned to support the African continent’s sustainable and self-reliant PPPR efforts. The AEF is set to be mobilized from various sources, including contributions from the Member States, private sectors, philanthropies, and international stakeholders. Unlike other ear-marked and vertical funding, this fund received through the AEF shall be used flexibly to accommodate the continent’s evolving needs, thereby continually strengthening Member States’ capability towards effective and timely PPPR efforts.

The other AU initiative, the African Risk Capacity (ARC), aims to support AU Member States in improving their capacities to better plan, prepare, and respond to weather-induced events and disease outbreaks [ 19 ]. ARC is the parametric sovereign insurance policy that is contributed by Member States so that the insurance supports outbreak response efforts of Member States by providing predictable funding at the early response phase of the outbreak or epidemic. To date, 39 AU Member States have ratified the APC treaty and signed membership, and 62 policies have been signed by the Member States for cumulative insurance coverage of US $720 million to protect 72 million vulnerable populations in participating countries [ 20 ]. Strengthening these domestic financing mechanisms is essential for creating a sense of ownership in the countries and ensuring sustainable funds for PPPR.

The global financing initiatives for PPPR

As diseases do not respect international borders, it is a must for global communities to make concerted and collaborative efforts to ensure global health security. The COVID-19 pandemic has practically demonstrated that ‘no one is safe until everyone is safe’. Under this premise, several global initiatives, including the Pandemic Fund, have been established to finance the PPPR. The Pandemic Fund seeks to channel critical investments to strengthen PPPR capacities at national, regional, and global levels, particularly in low- and middle-income countries – envisioning a resilient world. The Pandemic Fund has been contributed by donor countries, co-investors, and foundations, and hosted by the World Bank as a trustee [ 21 ].

The World Bank has been indeed engaged in various initiatives to support pandemic response, such as the response to the 2014–16 Ebola outbreak in West Africa and the establishment of the Pandemic Emergency Financing Facility (PEF) to fund outbreak responses (started in 2016 but now ceased operation in April 2021). These initiatives of the World Bank were instrumental in providing the required support for the response to the outbreaks, although they were criticized for their inadequacy in building resilient health systems that can go beyond the emergency period. Particularly, the prevention and preparedness items were ignored in these initiatives [ 22 ]. The PEF comes to its end following the recommendation of the International Working Group of the World Bank, underscoring the need to strengthen and scale up investments in global health security as an urgent priority [ 23 ].

To address the gaps in financing PPPR in countries, the World Bank established an International Working Group in Financing Pandemic Preparedness in 2016, with a mandate to propose how national governments and partners can ensure optimal and sustainable financing for actions to strengthen PPPR [ 23 ]. In May 2017, the World Bank International Working Group in Financing Pandemic Preparedness proposed strategies to finance preparedness and response capacities for pandemics and other health emergencies, particularly underscoring the need for national governments to increase domestic finances, development partners to capitalize on the existing bi-lateral and multilateral collaborations to finance preparedness and response, and the World Bank and International Monitory Fund (IMF) to place strategies to incentivize countries to invest in preparedness [ 23 ]. In 2019, the Center for Strategic and International Studies (CSIS) recommended new multilateral PPR financing, underscoring the need for the U.S. government to establish a Pandemic Preparedness Challenge at the World Bank to incentivize countries to invest in their preparedness. These initiatives and recommendations were critical in shaping the global financing architecture for PPPR [ 24 ]. Following the declaration of COVID-19 as a Public Health Emergency of International Concern (PHEIC) in 2020 by the World Health Organization (WHO), global leaders realized the vitality of having a strong and sustainable financing mechanism for PPPR to ensure global health security. In January 2021, G20 nations established a High-Level Independent Panel (HLIP) to recommend financing the global commons for PPPR. The HLIP strongly recommended countries make substantial investments, more than ever committed, to avoid the next pandemic – further pronouncing the critical need for increased domestic financing (up to an additional 1% of the GDP), increased additional international financing of up to $15 billion per year, and addressing the critical gap in global health governance architecture by integrating key actors, both from the global health and financing systems [ 25 , 26 ].

Drawing from these evolving outbreak response lessons and consultations, the Pandemic Fund has come to its realization (Fig.  1 ). The Pandemic Fund has adopted a multilateral common goods financing approach to address persistent global health challenges, as demonstrated by the establishment of the Global Fund to combat HIV/AIDS, Tuberculosis and Malaria, and GAVI, the Vaccine Alliance [ 27 ].

Prominent global milestones in the journey to support PPPR

The global PPPR requires an estimated $31.1 billion annual investment. Considering the existing and potential international and domestic financing for PPPR, it is estimated that at least an additional $10.5 billion per year in international financing will be needed to fund a fit-for-purpose PPPR, with a substantial gap in the LICs [ 26 ]. However, only $1.9 billion was pledged for the Pandemic Fund by donors and partners as of May 2023, and only $300 million was disbursed in the first round of pandemic funding – which was too far from the demand from LMICs that exceeded $7 billion [ 28 ]. This demand for funds requested from LMICs, with aims to strengthen their disease surveillance and early warning systems, laboratory systems, and health workforce development, implies their commitment and intense desire to prepare for the next pandemic. However, only five African countries were funded in the first round of the fund, and there was no consideration of regional entities from Africa. Moreover, the Pandemic Fund has been criticized for its suboptimal emphasis on the response aspect of public health emergencies [ 29 ]. More importantly, the governance structure of the Pandemic Fund needs to be all-inclusive, whether in high-income or low-income countries, rich or resource-constrained settings [ 25 , 26 , 27 , 29 ]. Surge financing from Day Zero has been proposed by the G7 countries, to ensure the immediate release of pre-arranged finance for countermeasures at the onset of the next pandemic [ 30 ]. Notably, 60–75% of the delay in COVID-19 vaccine access to LMICs was attributable to their signing procurement agreements later than high-income countries, which placed them further behind in the delivery line [ 17 ]. While supporting the cruciality of availing pre-arranged funds for immediate release, we also advocate that the initiative must be designed to ensure timely and equitable access to countermeasures to all countries.

Other remarkable initiatives such as the Global Health Initiatives (Global Fund, PEPFAR, World Bank and GAVI), established in 2002 to raise and disburse funds to address infectious diseases, immunization and strengthen the health systems in LMICs, have made several strides to support global health security and universal health coverage. However, due to the changes in global health needs, financing and governance, reshaping global health architecture is critical to building a more robust and resilient health system that can cope with emerging public health threats while enhancing everyone’s access to essential healthcare services [ 31 ].

Under these premises, delegates from multi-sectoral organizations (funders, governments, global health organizations, civil society, and the research and learning community) had 14 months of engagements to develop strategic shifts on GHIs to address the challenges of UHC and global health security sustainably. These engagements resulted in the “Lusaka Agenda” which proposes five strategic shifts – make a more substantial contribution to primary health care (PHC) by effectively strengthening systems for health; play a catalytic role towards sustainable, domestically-financed health services and public health functions; strengthen joint approaches for achieving equity in health outcomes; achieve strategic and operational coherence; coordinate approaches to products, research and development (R&D), and regional manufacturing to address market and policy failures in global health. To realize this strategic shift, a more inclusive and transparent governance system, monitoring the impacts of the initiatives, and working closely with government systems are required [ 31 ].

A call to action

As we are in the season where pandemics emerge and reemerge more frequently and spread more quickly, it is imperative to place mechanisms that ensure effective and sustainable financing for PPPR. As such, we call upon the global health community and decision-makers to focus on the harmonization of financing efforts for PPPR. The proliferation of (multiple) financing mechanisms for pandemics does not focus efforts but diverts attention and resources. Moreover, fragmented multiple financing mechanisms make financial and programmatic monitoring complex and challenging [ 32 ]. Thus, it is critical to make financial investments harmonized in a way that contributes to building comprehensive and resilient health systems to address current and future public health emergencies.

There is an urgent need to make regional financing mechanisms central to global PPPR financing efforts. The inequity we experienced with the COVID-19 response can only be addressed with regional financing that can optimally support PPPR initiatives such as geographically diversified and sustainable production of countermeasures. So, for equity in access and flexibility, AEF and other regional efforts need to be the focus and perhaps entrenched in global PPPR financing discussions. AEF can serve as a financing entity to support African Union member states in their efforts for pandemic PPR. The global entities, funders, partners, and philanthropies can provide direct financial support to this initiative. Notably, countries have easier access and a sense of ownership to regional mechanisms than global ones.

It is a must for the local and global financing mechanisms to adequately and proportionally align to support the public health threats, and the international finance governance systems ensure the inclusivity of all the key actors, irrespective of their development status to ensure global health security. The engagement of private sectors and philanthropies in the financing efforts must be considered.

We need to fortify our defenses against future pandemics by investing in comprehensive Pandemic Prevention, Preparedness, and Response strategies. Financial support is crucial to developing robust health systems, advancing research for rapid diagnostics, vaccines, and treatments, and establishing resilient supply chains for critical medical supplies. We must build a safer world by being part of the shield protecting humanity from the next health crisis.

As we are in the season with enormous emerging and reemerging public health threats, it is imperative to place mechanisms that ensure equity, and effective and sustainable financing for PPPR. Lessons learned from the continental and global financing initiatives, particularly during the COVID-19 pandemic, must be translated as we prepare for the next pandemic. Therefore, we call upon the global health community and decision-makers to focus on the harmonization of financing efforts for PPPR, make regional financing mechanisms central to global PPPR financing efforts, and ensure the inclusivity of international finance governance systems. This can be realized through provisions that can be included in the Pandemic Agreement.

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

Africa Epidemic Fund

Africa Medical Supplies Platform

Africa Vaccine Acquisition Trust

African Union

Coronavirus Disease

High-income Countries

Low-income Countries

Pandemic Emergency Financing Facility

Pandemic Prevention, Preparedness and Response

World Health Organization

Nkengasong JN, Tessema SK. Africa needs a new public health order to tackle infectious disease threats. Cell. 2020;183(2):296–300.

CAS   PubMed   PubMed Central   Google Scholar  

Kaseya J, Dereje N, Raji T, Ngongo AN, Fallah MP, Ndembi N. Public health emergencies in war and armed conflicts in Africa: what is expected from the global health community? BMJ Glob Health. 2024;9(3):e015371.

PubMed   PubMed Central   Google Scholar  

African Union. Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases. 2001. Chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj https://au.int/sites/default/files/pages/32894-file-2001-abuja-declaration.pdf

Wenham C, Katz R, Birungi C, et al. Global health security and universal health coverage: from a marriage of convenience to a strategic, effective partnership. BMJ Glob Health. 2019;4(1):e001145.

Debie A, Khatri RB, Assefa Y. Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature. Health Res Policy Syst. 2022;20(1):50.

Erondu NA, Martin J, Marten R, Ooms G, Yates R, Heymann DL. Building the case for embedding global health security into universal health coverage: a proposal for a unified health system that includes public health. Lancet. 2018;392(10156):1482–6.

PubMed   Google Scholar  

Ooms G, Beiersmann C, Flores W, et al. Synergies and tensions between universal health coverage and global health security: why we need a second ‘Maximizing positive synergies’ initiative. BMJ Glob Health. 2017;2(1):e000217. https://doi.org/10.1136/bmjgh-2016-000217 .

Assefa Y, Hill PS, Gilks CF, et al. Global health security and universal health coverage: understanding convergences and divergences for a synergistic response. PLoS ONE. 2021;15(12):e0244555. https://doi.org/10.1371/journal.pone.0244555 .

CAS   Google Scholar  

Lal A, Erondu NA, Heymann DL, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. Lancet. 2021;397(10268):61–7.

CAS   PubMed   Google Scholar  

World Health Organization. Governments agree to continue their steady progress on proposed pandemic agreement ahead of the World Health Assembly. Published 2024. https://www.who.int/news/item/10-05-2024-governments-agree-to-continue-their-steady-progress-on-proposed-pandemic-agreement-ahead-of-the-world-health-assembly

Ndembi N, Dereje N, Rahman FA, et al. The pandemic agreement: achieving an African win for health security inequity. J Public Health Afr. 2024;15(1):618.

Fallah MP. To beat Ebola in Uganda, fund what worked in Liberia. Nat Published Online 2022:427.

Duroseau B, Kipshidze N, Limaye RJ. The impact of delayed access to COVID-19 vaccines in low-and lower-middle-income countries. Front Public Health. 2023;10:1087138.

Narayanasamy S, Okware B, Muttamba W, et al. Global inequity of COVID-19 diagnostics: challenges and opportunities. J Epidemiol Community Health. 2022;76(12):972–5.

Google Scholar  

Pushkaran A, Chattu VK, Narayanan P. A critical analysis of COVAX alliance and corresponding global health governance and policy issues: a scoping review. BMJ Glob Health. 2023;8(10):e012168.

World Health Organization. WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/

Agarwal R, Reed T. Finance Vaccine Equity: funding for Day-Zero of the next pandemic. International Monetary Fund; 2022.

Fallah MP, Raji T, Ngongo AN, et al. The role of Africa Centres for Disease Control and Prevention during response to COVID-19 pandemic in Africa: lessons learnt for future pandemics preparedness, prevention, and response. BMJ Glob Health. 2024;9(2):e014872. https://doi.org/10.1136/bmjgh-2023-014872 .

African Risk Capacity. African Risk Capacity: Sovereign Disaster Risk Solutions. Published 2024. https://www.arc.int/about

African Risk Capacity. Impact Published 2024. https://www.arc.int/impact

The World Bank. The Pandemic Fund. https://fiftrustee.worldbank.org/en/about/unit/dfi/fiftrustee/fund-detail/pppr

Brim B, Wenham C. Pandemic emergency financing facility: struggling to deliver on its innovative promise. BMJ. 2019;367.

The World Bank. From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at a National Level . https://www.worldbank.org/en/topic/pandemics/publication/from-panic-neglect-to-investing-in-health-security-financing-pandemic-preparedness-at-a-national-level

Ayotte K, Gerberding J, Morrison JS. Ending the cycle of Crisis and Complacency in US Global Health Security: a report of the CSIS Commission on Strengthening America’s Health Security. Center for Strategic & International Studies; 2020.

Micah AE, Bhangdia K, Cogswell IE, et al. Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026. Lancet Glob Health. 2023;11(3):e385–413.

Panel HLI. A global deal for our pandemic age. Report of the G20 High Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response , https://pandemic-financing.org/report/ foreword . Published online 2021.

Reid-Henry S, Lidén J, Benn C, Saminarsih D, Herlinda O, Venegas MFB. A new paradigm is needed for financing the pandemic fund. Lancet. 2022;400(10349):345–6.

The World Bank. Demand for funding from Pandemic Fund exceeds expectations with requests totaling over $7 billion. https://www.worldbank.org/en/programs/financial-intermediary-fund-for-pandemic-prevention-preparedness-and-response-ppr-fif/brief/demand-for-funding-from-pandemic-fund-exceeds-expectations-with-requests-totaling-over-7-billion

Boyce MR, Sorrell EM, Standley CJ. An early analysis of the World Bank’s Pandemic Fund: a new fund for pandemic prevention, preparedness and response. BMJ Glob Health. 2023;8(1):e011172. https://doi.org/10.1136/bmjgh-2022-011172 .

U.S. DEPARTMENT OF THE TREASURY. G7 Finance Ministers and Central Bank Governors’ Communiqué. Published 2024. https://home.treasury.gov/news/press-releases/jy2371

Future of Global Health Initiatives. The Lusaka Agenda: Conclusions of the Future of Global Health Initiatives Process. 2024. https://futureofghis.org/final-outputs/lusaka-agenda/

Brown GW, Rhodes N, Tacheva B, Loewenson R, Shahid M, Poitier F. Challenges in international health financing and implications for the new pandemic fund. Global Health. 2023;19(1):97.

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The write-up of this manuscript is supported by Africa Centres for Disease Control and Prevention (Africa CDC) through funding from the Mastercard Foundation.

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Nicaise Ndembi, Nebiyu Dereje, Justice Nonvignon, Merawi Aragaw, Tajudeen Raji, Mosoka Papa Fallah, Mohammed Abdulaziz, Benjamin Djoudalbaye, Ngashi Ngongo & Jean Kaseya

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NN and ND conceptualized the study and drafted the original manuscript, JN, MA, TR, MPF, MA, BD, AL, YB, GW, OS, ANN, and JK critically reviewed the manuscript, and all the authors have reviewed and approved the final version of the manuscript.

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Ndembi, N., Dereje, N., Nonvignon, J. et al. Financing pandemic prevention, preparedness and response: lessons learned and perspectives for future. Global Health 20 , 65 (2024). https://doi.org/10.1186/s12992-024-01066-4

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Received : 18 April 2024

Accepted : 31 July 2024

Published : 21 August 2024

DOI : https://doi.org/10.1186/s12992-024-01066-4

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