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Who is disabled? On whether the functional definition of disability targets the same individuals as the subjective definition

Judith Baart
Willem Elbers
Alice Schippers
May 2023

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With the increased attention to disability as a vulnerability criterion in the Sustainable Development Goals, international organizations and NGOs within the international development sector have started to pay explicit attention to persons with disabilities, including the collection of data on persons with disabilities. The Washington Group Short Set of Questions, which focuses on functional limitations, has been gaining popularity as an assessment tool for disability. This set of questions reflects a categorization of disability that does not necessarily correspond with subjective disability assessments, such as the yes/no question (“do you have a disability?”) which many development actors have used in their assessment tools when they collect disability data This study compares the subjective and the functional limitations assessment tools for disability to answer the question: do they identify the same individuals as persons with disabilities? Based on a survey carried out amongst persons with disabilities in Cambodia, we included both the Washington Group Short Set and a subjective question asking respondents to self-identify their disability type. We find that, although all respondents self-identified as disabled, not all respondents would be considered disabled according to the Washington Group Short Set of questions. In addition, there is little overlap between specific disability types according to a subjective classification method and the domains of functioning measured through the Washington Group methodology. Our findings affirm that categorization as abled or disabled depends on the tool used. This is important, as the assessment approach chosen by those collecting disability data can shape the design choices of policies and programs, and determine who benefits.

Are persons with disabilities included in the effort to leave no-one behind? Mapping disability data in development in Asia and the Pacific

CBM GLOBAL’S INCLUSION ADVISORY GROUP
February 2022

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In the Asia Pacific region, UNFPA and partners work together to implement the Incheon Strategy to “Make the Right Real” for Persons with Disabilities. The Incheon Strategy is the region’s first set of disability-specific development goals to track progress towards the fulfilment of rights of persons with disabilities.

In the region, it is estimated that there are over 650 million persons with disabilities. However, without accurate, timely and disaggregated data, countries are unable to develop effective policies and programmes, monitor the wellbeing of persons with disabilities and evaluate the equity and impact of development efforts. This endangers country commitments to ‘leave no one behind’ and undermines their obligations to the Convention on the Rights of Persons with Disabilities.

This groundbreaking report demonstrates the importance of ensuring data is inclusive and provides recommendations for immediate action in order to improve the collection, analysis and reporting of disability data

Engagement with Organizations of Persons with Disabilities. Learning about meaningful engagement in public health emergencies, including COVID-19

UNITED NATIONS CHILDREN'S FUND (UNICEF)
December 2021

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This report was produced under a United Nations Partnership on the Rights of Persons with Disabilities (UNPRPD) project to support countries in designing and implementing disability-inclusive response and recovery planning for COVID-19. Throughout this project, UNICEF documented examples of good practice and learnings from partnerships with organizations of people with disabilities (OPDs) in public health emergencies, including COVID-19. The objectives of this initiative were to gain a better understanding of the factors that facilitate effective partnerships between humanitarian actors and local, regional, and national OPDs, and the challenges to be addressed.

This report presents the findings from a ‘deep dive’ undertaken by UNICEF East Asia and the Pacific Regional Office to consider the experiences in Cambodia, Indonesia, the Lao People’s Democratic Republic, Malaysia, Myanmar, the Philippines and the Pacific. The target audience for this report includes OPDs and humanitarian actors at global, regional, and country levels.

Accessible to All: Creating learning materials for children with disabilities in Cambodia, Kenya, Rwanda, and Tajikistan

EducationLinks
December 2020

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Examples are outlined of how good practices in the provision of accessible learning materials are being put into practice by USAID in partnership with organisations addressing the education needs of students with disabilities:

  • Expanding access through Universal Design for Learning in Cambodia: All Children Reading
  • Applying a user-centered design approach in Kenya: eKitabu and Deaf-led Sign Language Video Stories
  • Promoting sustainable accessible standards in Rwanda: Soma Umenye
  • Supporting underserved languages in accessible formats: The Global Digital Library
  • Fostering parental involvement in Tajikistan: USAID Read with Me

 

Covid-19: Violence risk and loss of income among persons with disabilities

ADD International
October 2020

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This report presents findings from telephone interviews with 87 members from Disabled People’s Organisation (DPO) partners and 10 DPO/Self-Help Group (SHG) leaders from organisations with 1,998 members in 10 districts across 7 provinces of Cambodia, to ask about the impact of the COVID-19 pandemic on persons with disabilities.

 

Three patterns emerge from these interviews: there is a pattern of compounding vulnerability to violence; a pattern of significant livelihood loss that is felt differently by disability type and gender; and a link between livelihood loss and pronounced increase in economic and psychological violence against women and girls with disabilities.

 

Evidence from these interviews suggests that, during the COVID-19 pandemic, some women with disabilities are at increased risk of violence and suffering a dramatic loss in household earnings. Reported violence risk increase is mostly psychological and economic, higher among older respondents and most pronounced among those who already experienced medium to high risk of violence before COVID-19.

Safe futures. Reducing violence against women and girls with disability in Cambodia.

ADD INTERNATIONAL
2020

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In Cambodia, women and girls with disability face multiple, compounding challenges. Work is being carried out to strengthen the capacity of groups of people with disability - self-help groups and Disabled People’s Organisations - to prevent violence and identify and refer survivors of violence to appropriate services - including legal services, counselling, health care, and physical and emotional rehabilitation services. The intervention has completed its first year, and this is a learning paper of key observations. It is too early to consider these reflections as indications of patterns to replicate

Final evaluation report project for ASEAN hometown improvement through disability-inclusive communities model

MEKONG INSTITUTE (MI)
May 2019

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This report covers the objectives, process, findings and recommendations of final evaluation on APCD Project for ASEAN Hometown Improvement through Disability‐Inclusive Communities Model. The project reached to the end of implementation in its second year and required a final evaluation to assess its achievements and non-achievements in against of its desired objectives from this project. The final evaluation has assessed the relevance, effectiveness, efficiency, impact and sustainability of the project. This report provides analysis of its findings from literature review and field visits during the evaluation and provides country-specific as well as overall recommendations for further implementation of this kind project in future. 

Mainstreaming inclusive education: Sharing good practices

KABANI, Maliha
HEIJNEN-MAATHUIS, Els
LIGNELL, Mats
et al
May 2019

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The primary aim of this documentation is to provide a deeper understanding of how Save the Children projects have applied more inclusive concepts in not only changing the lives of children with disabilities, those living in poverty or children from ethnic minority populations, their families and communities, but in catalysing changes in policies and practices to the education system to benefit all learners. The stories follow a common structure describing the background of the project, a description of an approach that has worked especially well in the project, followed by stakeholder and partner engagement, participation of children, key milestones and significant challenges, scalability and sustainability, recommendations for replication and contact links for project tools and materials. A selection of practical tools and models have been attached as annexes.

ASEAN hometown national guidelines compilation

Asia-Pacific Development Center on Disability (APCD)
March 2019

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The National Guidelines for the Project for ASEAN Hometown Improvement through DisabilityInclusive Communities Model: A Compilation is a consolidation of policies from 7 ASEAN countries, namely, Cambodia, Indonesia, Malaysia, Myanmar, Philippines, Thailand, and Vietnam, to provide a technical guiding document in the planning and implementation of an inclusive Hometown Improvement process.

 

Policies for each country are reported and topics covered include: situation of persons with disabilities; disability inclusive governance; accessibility for persons with disabilities; disability inclusive business; hometown improvement model; and partnership amongst ASEAN

 

Communication Matters!

Light for the World
January 2019

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The research Communication Matters! shows which obstacles persons with disabilities face in accessing public information and services. The research took place in three districts in the province of Pursat. 1171 persons with disabilities in 229 villages are reached.

Due to the research, many persons with disabilities were able to share their stories for the first time. Many persons were also found for the first time, because the team made an effort to visit everyone in the village.

More at risk: how older people are excluded in humanitarian data

TANYANG, Gaynor
VENTURES, Lumina
2019

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This report evaluates existing policies and practices on how older people have been excluded from data in disaster preparedness and humanitarian responses in Bangladesh, India, Nepal, Pakistan, Sri Lanka, Cambodia, Indonesia, Myanmar, the Philippines, Thailand and Vietnam.

In order to evaluate existing policies and practices in the collection of inclusion data, the research employed two main methods: a review of documents and a survey. The review of documents was conducted in three stages: a global literature review, followed by a policy review and a practice review. The survey analysed the responses of 72 respondents from 10 countries .

Insights from ASEAN hometown improvement project: Towards improved practice

Asia-Pacific Development Center on Disability (APCD)
2019

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The ASEAN Hometown Improvement Project, aimed to tackle challenges emerging from urbanization and the rise of the ageing population in the ASEAN region by attempting timely and relevant improvements to disability inclusive ‘hometowns’. 

 

Three approaches were utilized:

1) Promotion of an inclusive business through capacity building of persons with disabilities

2) Promotion of accessibility features in the community and other public places, as well as to information, communication, and transportation

3) Promotion of cooperation with government sector via discussions to find solutions to improve the livelihood of persons with disabilities

 

The sections, arranged per country in alphabetical order, contain the following: Hometown Improvement Project description and backgrounder; Capacity Building Workshop details; Key Partners and Stakeholders; Training Results; Challenges; Framework for Good Practice; and Way Forward and include:

  • Cambodia: Phnom Penh Center for Independent Living's Bakery by Persons with Disabilities
  • Indonesia: Batik Design and Marketing Management at Kampung Peduli
  • Malaysia: Branding and Marketing Management for Bakery and Handicraft by Persons with Disabilities at CBR Semenyih
  • Myanmar: Mushroom Production by Persons with Disabilities with Shwe Minn Tha Foundation
  • Phillipines: Sustainable Inclusive Urban Micro-Gardening and Community-Based Cooperative at Barangay 177
  • Thailand: Earthworm Casting and Cactus Farming at Farm D
  • Vietnam: Fermented Dry Bamboo Waste Fertilizer at Bamboo Dana Co. Ltd

 

 

Creating an inclusive school environment

DOUGLAS, Susan
Ed
2019

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This publication draws together research and learning from around the world, in papers which highlight the need for inclusive education and some of the steps being taken to implement it. 

The settings brought to life here reveal the work of teachers, leaders and policy makers in geographically and culturally diverse situations. In each of the chapters we see the challenges they face and the significant efforts they make to ensure access to, and engagement with, a quality education for all children. The collection includes 15 case studies:

 

Special educational needs and disability section:

  • Teaching for All: mainstreaming inclusive education in South Africa
  • Successful inclusive education starts with teachers: what have we learned? A multi-country case study
  • Teaching English as a second language to the visually impaired in disadvantaged contexts: a case study from Chiapas, Mexico
  • The Theatre of the Classroom

Displaced populations section

  • Teaching on the run: safe learning spaces for internally displaced persons
  • Developing resilience through English language teaching in youth centres across Iraq
  • Capacity building for inclusive classrooms: the Living Together training
  • Integrating Syrian refugee children and their parents into Lebanese early education systems

Gender and inclusion in the classroom section

  • A gender equality and social inclusion approach to teaching and learning: lessons from the Girls’ Education Challenge
  • Teacher development and gender equality in five Nigerian states
  • Creating gender-inclusive schools in Turkey: the ETCEP project in action
  • Education, English language, and girls’ development: exploring gender-responsive policies and practices in Nepal

Minority ethnic groups in the classroom

  • Social inclusion and the role of English language education: making a transition from school to higher education in India
  • Storytelling for diverse voices
  • Inclusive education in marginalised contexts: the San and Ovahimba learners in Namibia

 

Innovate for Inclusion. Four cases of application of the social innovation lab methodology to enhance disability inclusion in mainstream settings

MAARSKE, Anneke
NEDERVEEN, Matthijs
BAART, Judith
2019

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This publication reflects back on four co-design processes undertaken by Light for the World’s Disability Inclusion Lab during the past few years. These different journeys in solution development have demonstrated the power of this methodology to create genuine inclusion in livelihood programming while striving to empower persons with disabilities to achieve economic success. In this publication the social innovation lab methodology is described as a unique approach to inclusive programming, highlighting four cases: The Livelihood Improvement Challenge in Uganda, the lab in the EmployAble programme in Ethiopia, the AgriLab in Cambodia, and the InBusiness pilot in Kenya. Lessons learnt are described.

An integrated approach to victim assistance in Cambodia & the role of Australia as supporting state

De BEAUPUIS, Gaetan
HOTTENOT, Elke
November 2018

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The objective of this case study was to review how Cambodia, as an affected state, and Australia as a donor, promote the provision of victim assistance in sectors including health, rehabilitation, disability, socio-economic development and poverty reduction. It documents promising practices and proposes next steps to ensure the sustainability of victim assistance provision in the near and long-term future. This study aims to inspire the mine action community in both affected and donor states to increase its contribution to victim assistance. This case study focuses on both prongs of the integrated approach to victim assistance by describing: i) Broader multi-sector efforts that reach casualties, survivors and indirect victims; and ii) Specific victim assistance efforts to improve victims’ quality of life deployed by mine action stakeholders, other actors in charge of coordinating victim assistance in Cambodia, and Australia as a donor state. An analysis of these specific efforts revealed that they fall into one of two of the following categories: a) Bridging gaps in data collection and service provision, or b) Advocating for, and facilitating, a multisector response.

 

Humanity & Inclusion (HI) and the Cambodian Mine Action and Victim Assistance Authority (CMAA) conducted the study in November 2017 in seven provinces. The methodology comprised three steps: a desk review of project documents, national plans and policies from a range of sectors with a focus on programmes funded by Australia; interviews with key personnel from the mine action and the disability sectors; and a field survey comprising 31 individual indepth interviews with 19 survivors and 12 other persons with disabilities (23 male and 8 female), 12 focus group discussions as well as field visits to observe the initiatives described in this publication. 

 

 

Scaling up inclusive employment: Interventions in Cambodia

GARTRELL, Alexandra
October 2018

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This report presents findings from a study, based in Cambodia, designed to investigate barriers which hinder employers from employing people with disabilities and to identfy employer perspectives on the changes needed to open up more job opportunities to people with disabilities. A total of 32 people participated in in-depth semi structured interviews as part of this study: 9 employers, 10 people with disabilities and 12 representatives of NGOs working in this field. The broader context for these inclusive employment initiatives of the current and projected Cambodian economic growth, labour market needs and skills gaps is analysed.

Compliance with standards of practice for health-related rehabilitation in low and middle-income settings: development and implementation of a novel scoring method

PRYOR, Wesley
NEWAR, Pushpak
RETIS, Chiara
URSEAU, Isabelle
April 2018

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Purpose: To (A) develop a method for measuring compliance with standards, and (B) implementation of the method in 12 rehabilitation centers in six low and middle-income countries (LMICs).

 

Methods: In part A, existing standards were compiled and operationalized into scores, organized into 5 ‘scorecards’ and 15 ‘sub-scorecards’, then tested and refined in an iterative process. In part B, 12 rehabilitation centers in 6 countries implemented the standards using the new method, revealing relative performance between centers, and across different standards. Internal consistency of scores within domains was computed using Chronbach’s alpha.

 

Results: A standardized method for scoring compliance with standards for rehabilitation was developed. The method evaluated compliance with standards in five domains of practice: user focused approach, service outputs, finances, staff, and general management. Multiple standards within domains were strongly related, with Chronbach’s alpha >0.80 for all but the equipment and supplies domain. Overall, in the 12 rehabilitation centers examined, 36% of standards were met or exceeded. Compliance within each scoring domain was 56% (user-focused approach), 38% (service outputs), 27% (financial management), 30% (staff management), and 33% (general management). Two out of 12 (17%) of centers met more than two-thirds of the standards, 3 (25%) met more than one-third of standards, while the remaining 7 (58%) met less than one-third of standards.

 

Conclusions: A new, standardized method for measuring performance of rehabilitation services in LMICs was developed. The method examines standards in five rehabilitation practice domains, and can be used to understand barriers to quality performance, particularly in resource-constrained settings. Implementation of the method demonstrated that current compliance with standards is modest. Ongoing interest in new standards for rehabilitation practice should be accompanied by measures to ensure they are used to strengthen quality in an emerging rehabilitation sector.

Strengthening environmental sustainability and inclusion in health and other development programs. Practical guidance for environmental sustainability, accessibility, gender, safeguarding and disaster risk reduction

CBM
2018

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The purpose of this booklet is to promote discussion and innovation for strengthening environmental sustainability and inclusion in health and other development activities. The case studies and checklists are designed to foster creative thinking and the ongoing gathering of evidence related to these topics. The booklet will be useful to anyone seeking high quality outcomes from health and other development programs. The information was first compiled for CBM’s engagement in the General Assembly of the International Agency for the Prevention of Blindness 2016, however will be useful for advancing sustainable development with inclusion in any context.

The case sutdies are: Environmental Sustainability in Eye Health, Caritas Takeo Eye Hospital (CTEH), Cambodia; and  Strengthening Accessibility and Inclusion in Eye Health. UMC Kissy Eye Hospital, Freetown, Sierra Leone, West Africa

Supporting inclusive movements: Funding the rights of women with disabilities

DOBSEN, Christen
October 2017

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This brief explores funding at the intersection of women’s rights and disability rights and offers steps donors can take to ensure that their grantmaking is more inclusive of women with disabilities and to support this emerging movement. Background is provided by recent mapping by Women Enabled International about the state of advocacy by women with disabilities, the amount of funding in 2014, sample grants and example use of them. Tips from peer donors and women with disabilities are given.

Disability and HIV

UNAIDS
August 2017

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This report highlights existing key evidence on the relationship between disability and HIV. It discusses the concrete steps needed for a person-centred, disability-inclusive HIV response that allows for increased participation of people with disabilities and integrates rehabilitation within the continuum of HIV care. Globally, it is estimated that 1 billion people (15% of the world’s population) have a disability. Of those aged over 15 years, approximately 110–190 million (2.2–3.8%) experience significant disabilities. Disability is increasing in prevalence due to ageing populations, trauma, accidents and the increase in chronic health conditions, including HIV. Persistent discrimination against and exclusion of people with disabilities, in particular women and girls with disabilities, increases their vulnerability, including their risk of HIV infection.
 

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