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‘These are not luxuries, it is essential for access to life’: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa

HANASS-HANCOCK, Jill
NENE, Siphumelele
DEGHAYE, Nicola
PILLAY, Simmi
2017

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Background: With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities.


Methods: This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs.


Results: A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices.


Conclusions: The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies.

Equal measures 2030: Policymakers survey

EQUAL MEASURES 2030
2017

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This report gives interim findings from results of a survey of 109 policymakers in five countries (Indonesia, India, Kenya, Senegal and Colombia), and seeks to shed light on:

  • How do policymakers perceive progress on gender equality in their countries?
  • What most needs to change in order to improve gender equality?
  • What data and evidence do they rely on to make their decisions?
  • How confident are they in their understanding of the major challenges affecting girls and women in their countries?

 

These findings will contribute to debates about data-driven decision making on gender equality, and raise attention to the gaps in accessible, reliable and relevant data and evidence needed to reach the SDGs by 2030.

Measuring Disability and Inclusion in relation to the 2030 Agenda on Sustainable Development

MADANS, Jennifer
LOEB, Mitchell
EIDE, Arne H
2017

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This paper explores the development of disability measures for use in censuses and surveys that can serve to monitor the UN Convention on the Rights of Persons with Disability (UNCRPD) and to disaggregate indicators identified through the 2030 Agenda on Sustainable Development and implementing the Sustainable Development Goals (SDGs). The need for data to implement policies and the challenges to the collection of valid and reliable disability data are presented, and the work of the Washington Group on Disability Statistics (WG) is provided as a means to the collection of internationally comparable disability data. By standardizing data collection instruments used to identify the population with disabilities it will be possible to provide comparable data cross-nationally for populations living in a variety of cultures with varying economic resources. The resulting data can be used to assess a country’s compliance with the UN Convention and the 2030 Agenda for Sustainable Development and, over time, monitor their improvement in meeting the established requirements.

 

Disability & the Global South (DGS), 2017, Vol. 4 No. 1

The profile of disability grant applicants in Bishop Lavis, Cape Town

GOVENDER, T
MJI, G
2014

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Background: Disability grants in South Africa increased from 600 000 in 2000 to almost 1.3 million in 2004. This rise can be attributed to the HIV/ AIDS epidemic, South Africa’s high rate of unemployment and possibly an increased awareness of constitutional rights. The Western Cape, which has a disability prevalence of 3.8%, has also experienced an influx of applications. The study was conducted at Bishop Lavis Community Health Centre (BLCHC) in the Cape Town Metropole, Western Cape.

 

The primary aim of this study was to establish the profile of adults applying for disability grants at Bishop Lavis. The secondary aim was the determination of the degree of activity limitation and participation restriction by means of the International Classification of Functioning, Disability and Health (ICF) shortlist of activity and participation domains.

 

Methods: A descriptive study was conducted with emphasis on identifying and quantifying the relevant factors. The population studied included all prospective adult (18–59-year-old females and 18–64-year-old males) disability grant applicants in Bishop Lavis over a two-month period (April–May 2007). A structured, self-compiled questionnaire was administered during face-to-face interviews with applicants. The questionnaire included the demographic details of the applicants, disability/chronic illness/condition, educational level and social/living conditions. The second part of the questionnaire was based on the ICF shortlist of activity and participation.

 

Results: There were 69 respondents over the period of data collection. Of the 69 applicants who participated in the study, 45 (65%) received a temporary disability grant, 6 (8%) received a permanent grant and 18 (26%) applications were rejected. The results demonstrated that most applicants were females over the age of 50, were poorly educated with chronic medical conditions and were living in formal accommodation with good basic services but with minimal or no disposable income. The ICF questionnaire responses showed that the majority of respondents had no difficulty in most domains, except for the general tasks and demands (multiple tasks), mobility (lifting and carrying, fine hand use and walking) and domestic tasks domains, which showed high percentages of severe to complete difficulty. However, further statistical analysis showed no association between degree of difficulty in the above domains and eventual outcome of type of grant received.

 

Conclusions: This study confirmed that unemployment and a lack of income are the factors influencing patients to seek assistance in the form of disability grants. Most applicants had a chronic medical condition and reported functional restrictions but only received a temporary grant. This may be an indication that most patients require further evaluation before a final decision can be made. There is a need for a standardised, objective assessment tool for disability grant applications. A campaign to educate patients about disability grants could save patients and hospital medical services time and money.

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