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Persons with disabilities and climate change in Nepal: Humanitarian impacts and pathways for inclusive climate action

Jennifer M'Vouama, Humanity & Inclusion (HI)
Mosharraf Hossain, Team Leader, Global Inclusion Consulting Ltd
Sukharanjan Sutter, IRG Development Services Limited
Mahesh Ghimire, local consultant, Nepal
August 2023

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Climate change is affecting every region on Earth and already causing irreversible impacts. While it is a global phenomenon, its negative impacts are felt more intensely by poorer countries and poor communities heavily reliant on natural resources and lacking coping and adaptive capacities to deal with a changing climate. Within those poor communities and countries, persons with disabilities are often amongst the most marginalized people. They experience attitudinal, physical and communication barriers that undermine their access to services and opportunities supporting their well-being and resilience. For this reason, they tend to be disproportionately vulnerable to climate impacts, including more frequent and intense disasters, as those exacerbate pre-existing vulnerabilities. Yet, while it is acknowledged that climate change will exacerbate inequity should we fail to ensure inclusive and participatory decision-making processes in climate governance, disability inclusion in climate action largely remains marginally addressed. Persons with disabilities have been historically left out of climate responses at various levels, from local and national country plans to global negotiations occurring at the UN Conferences of the Parties1 (COP).


Nepal is experiencing an increasing number of climate-related disasters, with a global study ranking it as the fourth worst hit country in the world by weather-related loss events in 20172. Urban floods, landslides, extreme heat, storms, drought, and wildfires are very common climate disasters affecting communities across the country, especially rural populations and their natural resource-dependent livelihoods. Nepal’s vulnerability to climate change lies in its varied topography marked by steep terrain and remoteness, its diverse geo-climatic system and social vulnerability, exacerbated by challenges to deliver effective and comprehensive disaster risk reduction and management strategies. To address this serious threat to economic development and prosperity, Nepal has put in place a rich overarching climate change policy framework early on, encompassing dedicated policies and plans, as well as sectoral planning processes integrating climate resilience. Nepal has also established various leadership, coordination, and stakeholder engagement mechanisms to guide climate change policymaking, articulate implementation across the government’s three-tier federal structure, and ensure dialogue with key stakeholders including civil society actors.

Endorsed in 2011, Nepal’s Framework on Local Adaptation Plans for Action (LAPA) is a particularly praised initiative, promoting a bottom-up, inclusive, and flexible approach for integrating climate adaptation and resilience aspects into local planning. This pioneering, community driven process, places the adaptation needs and opportunities of most vulnerable and highly vulnerable groups at the heart of the approach. Gender considerations factoring intersecting factors of marginalization such as age and ethnicity have been given priority in these processes, to address women’s increasing economic insecurity and workload due to climate change. But inclusion of women with disabilities, or persons with disabilities in general in local adaptation planning has not been strongly evidenced to date.


According to Nepal Census 2022, 2.2% of the Nepali Population have some form of disability, mainly a physical disability. However, other sources estimate this figure to be much higher. Nepal ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2008 and passed the Disability Rights Act in 2017, establishing constitutional directives to support persons with disabilities and making it illegal to discriminate based on disability. Yet, perception of persons with disability in Nepal remains generally negative, due to persistent and deep-rooted Hindu religious beliefs associating disability with sinning in a previous life. Women and girls with disability face greater marginalization and discrimination and tend to be hidden away by families. Nepal’s caste system also plays a role in shaping the vulnerability of persons with disabilities. Thus, widespread stigma compounded by the intersectionality of certain factors, combined with structural inaccessibility, create significant barriers to have equal access to resources and participate in decision-making. This tends to translate into poor socio-economic status, poor health outcomes, and no or low education levels, especially among women and girls. Persons with disabilities in Nepal can register under social welfare to access several disability-targeted benefit packages, including a Disability Grant. However, the process tends to be paved with barriers, leading to high exclusion rates.
It is in this context that HI sought to better understand the unique challenges and opportunities for persons with disabilities in the face of climate change in Nepal. This report is intended to inform how persons with disabilities understand and perceive climate change, what is their experience of dealing with climate extremes, what is the impact on their health, livelihoods and support system, and their actual level of inclusion in climate adaptation planning. To capture those perspectives, HI surveyed 388 persons with disabilities across Nepal’s 7 provinces, consulted 20 key informants from the disability movement, government institutions, and the aid sector, and conducted 8 targeted focus group discussions to hear from women, youth, and persons representing diverse disability types. This report is a contribution to the growing evidence base documenting the disproportionate impacts of climate change on persons with disabilities and calling for disability-inclusive climate action at all levels of governance.

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.

Beyond visibility: A learning Brief on Vulnerability Focal Point Approach

Humanity and Inclusion
January 2023

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This fact sheet presents the main lessons learned and the factors that helped and hindered the use of the intervention called the Vulnerability Focal Point (VFP) approach to improve access to and use of SRH services by people with disabilities.

The lessons learned from the VFP approach provide a reflection on what has worked and what has not. In addition, this note recommends ways to further improve the approach based on the experience and reflections of key stakeholders, including project beneficiaries (people with disabilities in the selected sites), VFPs, respective local government representatives, Humanity & Inclusion (HI) and its partners, and donors. The lessons learned will be crucial for making informed decisions about the continuation, scaling up, replication and sustainability of the VFP approach in the future.

Feeding and Disability Resource Bank

USAID Advancing Nutrition
November 2022

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The Feeding and Disability Resource Bank, compiled by USAID Advancing Nutrition, is a repository of materials that help nutrition and disability program managers, government leaders, and donor agency staff design and implement effective nutrition programs for children with disabilities. According to the United Nations Convention on the Rights of Persons with Disabilities (CRPD), children with disabilities can be defined as those who have, “long-term physical, mental, intellectual, or sensory impairments, and who may experience barriers that may hinder their full and effective participation in society on an equal basis with others.”

Training in Assistive Products (TAP)

WORLD HEALTH ORGANISATION (WHO)
November 2022

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WHO’s online Training in Assistive Products (TAP) is designed to prepare primary health and other personnel to fulfil an assistive technology role. This may include identifying people who may benefit from assistive technology; providing simple assistive products such as magnifiers and dressing aids; or referral for more complex products and other services. Appropriate to a broad range of contexts, TAP is targeted at primary health care and community workforce, as well as those providing services to people who need assistive products within other sectors. 

TAP is a practical tool to support countries to respond to the recommendations in the Global Report on Assistive Technology.

TAP includes a range of assistive products to support cognition, communication, vision, hearing, self-care, and mobility from WHO’s Priority Assistive Products List. TAP has a modular structure; personnel may select the modules that match their role and the needs of the local population. For each assistive product, an introductory and product-specific module will together cover key learning content to support the acquisition of skills to safely and effectively provide that product, through a four-step process: select, fit, use and follow up.

A Massive Open Online Course (MOOC) of the first TAP module, Introduction to Assistive Products, will run for a two-week period until 10 - 24 November 2022

 

Children with disabilities in the Middle East and North Africa: A statistical overview of their well-being

UNITED NATIONS CHILDREN'S FUND (UNICEF)
October 2022

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An estimated 21 million children with disabilities live in the Middle East and North Africa. Each of them – like every child in the world – has the right to be nurtured and supported through responsive care and education, to receive adequate nutrition and social protection, and to enjoy play and leisure time. Too often, however, such rights are denied. The reasons vary. They include stigma, lack of accessible services, institutionalization and physical barriers, but the consequences are sadly consistent. When marginalized from society, the chances for these children to survive and thrive are diminished, along with their prospects for a bright future.

Monitoring the inclusion of children with disabilities in development efforts has long been held back by the lack of reliable and comprehensive data. Recent years, however, have seen renewed efforts to fill these data gaps. The development of new data collection tools has resulted in a substantial increase in the availability and quality of data on children with disabilities, fostering new analyses and contributing to increased knowledge generation.

This report is a testament to these efforts. It includes internationally comparable data from four countries in the Middle East and North Africa and covers 18 indicators of child well-being – from nutrition, health and education to protection from violence, exploitation and discrimination. It also presents global and regional estimates of children with disabilities drawn from more than 1,000 data sources, including 95 from countries in the Middle East and North Africa.

The report’s objective is to promote the use of these data to make children with disabilities in the region more visible, bringing about a fuller understanding of their life experiences. It offers evidence crucial to decision-making to fulfill obligations, both moral and legal, to give every child an equal chance in life.

Inclusive Education Resources and Toolkit – Tools

CRESPI, Sylvia
LOSERT, Lynn
NEWMAN, Lorenzo
PELOSI, Alice
PONTOGOLIO, Silvia
September 2022

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Set of tools developed by Learn More consultancy firm within the Inclusive Education Resources and Toolkit. Available in 4 languages (Arabic, English, French, Spanish) the tools include:

 

Identifying children who are out of school or have dropped out
Making an Inclusive, Learner-friendly Classroom
Social and Emotional Learning in the Classroom
Accessible School WASH Checklist
Tip sheet: WASH for Children with Disabilities
Teachers Communities of Practice
Teacher Interview Guide: Personal Professional Development
A Lesson Plan Template
Universal Design for Learning
Organization and Management of School-community Liaison Committees
Elements of an Inclusive School Policy
Supporting Children’s Speech and Cognitive Development from Birth to Seven Years Old
Sparking grassroots coalition building
Disabled Peoples’ Organization (DPO) collaboration strategies
Stakeholder alignment workshop template

 

Published by Save the Children Italy, Save the Children Sweden

Inclusive Futures: Using social behaviour change to promote disability inclusion in development programmes

Inclusive Futures
Sightsavers
August 2022

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This brief focuses on the use of social behaviour change (SBC) in the Inclusive Futures programme. It includes an introduction to social behaviour change, followed by three examples of how it is being used in our Inclusive Futures work. These examples reflect emerging findings and our approaches as we go forward. The brief is designed to:
•Explain what SBC is and what it can be useful for – particularly when addressing disability stigma and discrimination
•Present examples of how SBC can be used in different ways to support disability inclusion in development programmes

Mainstreaming disability inclusive employment in international development

Mary Wickenden
Philip Mader
Stephen Thompson
Jackie Shaw
July 2022

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People with disabilities are under-represented in the global workforce, and this problem is often particularly acute inthe‘global south’. This is an editorial to a special issue that seeks to provide new perspectives on why this is the case. We deliberately wanted to place this collection in the Journal of International Development as a core development publication, rather than in a disability specific one, because we think it is important to ‘mainstream’ disability within development so that the international community can develop an increased understanding and awareness of disability dilemmas. The challenges faced by disabled people need to be tackled as part of all development thinking and programming.

Listen Include Respect: International Guidelines for Inclusive Participation

Inclusion International
June 2022

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The Listen Include Respect guidelines help organisations understand what they need to do to make sure people with intellectual disabilities are included in their work.

​They were written by Inclusion International and Down Syndrome International.

Over 1,500 people with intellectual disabilities and their families from almost 100 countries helped write them.

The Convention on the Rights of Persons with Disabilities (CRPD) tells us that all people with disabilities have the right to “meaningful participation.”

“Meaningful participation” is what happens when people with intellectual disabilities get everything they need to be fully included, participate equally, and feel valued.

These guidelines will help organisations to make this happen.

Assistive Technology in two humanitarian contexts: Bangladesh and Jordan

KETT, Maria
June 2022

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Despite increased focus on the need for assistive technology (AT), along with estimates of need and gaps in provision in humanitarian contexts, very little is actually known about how people who need AT are managing in these contexts. To address this need, this study explored four main questions: 

What do we currently know about the need for AT in humanitarian contexts?
How is this need currently met?
What gaps are there in the evidence about these needs?
What mechanisms are needed to ensure provision of AT in humanitarian contexts? 

It explored these questions through individual interviews with AT users and their families, as well as people working in the sector, in two humanitarian response contexts: Bangladesh and Jordan. In Bangladesh, we partnered with CBM Global and their local partner, the Centre for Disability in Development, and in Jordan, all those interviewed were beneficiaries of HelpAge International.

The questions focused on the areas identified as gaps in the initial literature review, and used qualitative methodologies to probe and gain further insight into gaps across the entire AT ecosystem.

Supporting young children with disabilities in humanitarian settings

BEILER, ROSALENGA BERMAN
ZUIDEMA, SUZANNE
BECKERLEGGE, FIONA
RODRIGUEZ GARCIA, DEBORAH MARIE
June 2022

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The rapid growth that occurs in the first years of life provides an opportunity to influence and improve developmental outcomes that may impact the entire course of an individual's life. Addressing the developmental needs of children with disabilities during this critical period is essential if they are to survive, flourish, learn, and be empowered (WHO, n.d.). 

Recognizing the importance of addressing all children's unique needs and acknowledging the influence of social stigma and misconceptions about disability that may lead to underdeveloped potential and social exclusion, we seek to advocate for and support the inclusion of young children with disabilities in Early Childhood Development in Emergencies programming. 

The webinar was moderated by Rosangela Berman Bieler, UNICEF’s Global Advisor on Disability, and included presentations on foundational concepts for disabilities-inclusive programming, and alternatives to address young children with disabilities needs in a resourceful, creative manner. 

Early detection tools for children with developmental delays and disabilities in the Middle East and North Africa

UNITED NATIONS CHILDREN'S FUND (UNICEF)
June 2022

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This technical brief was developed to support specialists in countries of the Middle East and North Africa (MENA) region to select which early detection tools best fit their needs and context by comparing various tools that have been used in theregion and lessons learned in using and adapting those tools to local contexts.

Barriers to inclusive employment for self-advocates and families

BIALIK, Kimber
MHIRI, Manel
June 2022

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This article is about the barriers to inclusive employment that people with intellectual disabilities and families face in Kenya, Uganda, Nigeria, and Bangladesh.

Through the Inclusion Works Project, we worked with our members in Kenya, Uganda, Nigeria, and Bangladesh to talk with self-advocates and family members about employment.

We had 3 consultation meetings with self-advocates and 3 consultation meetings with families – we talked to 54 self-advocates and 45 family members about access to inclusive employment in their countries.

Some of the barriers that they told us about were discrimination from employers, lack of access to education, unfair pay, issues with safety and security at work, and being pressured to choose self-employment.

This article explains some of the issues accessing inclusive employment that people with intellectual disabilities and their families told us they face in low- and middle-income countries.

The article also gives recommendations for how organisations doing work on inclusive employment can work towards addressing some of these barriers and being more inclusive.

 

 Journal of International Development, Volume 34, Issue 5

"We bear it and accept our fate” Perceptions of healthcare access from people with disabilities in Cox’s Bazar

PANELLA, Amanda
June 2022

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In November and December 2021, Ground Truth Solutions (GTS) and the International Organisation for Migration’s (IOM) Needs and Population Monitoring unit (NPM) conducted qualitative interviews with persons with mobility and vision impairments from Rohingya refugee and host community populations with the aim of better informing and supporting agencies in developing disability-inclusive programmes and engagement activities. These interviews focused on access to health services, aiming to gain insight into how people with disabilities experience engaging with healthcare services – as well as perceived barriers to access. It also looked at health information needs so that the humanitarian community will be better equipped to identify gaps in programming, deliver more equitable services, and build trust with this marginalised group. To weave tangible experiences into the narrative and bring findings to life, this research took a ‘user journey’ approach to create a set of ‘personas’ derived from key informant interviews with Rohingya and Host Community people with disabilities in Cox’s Bazar, resulting in this highly illustrative report.

From disability budget commitments to budget execution in Kenya: Matching disability approved allocations to actual spending and performance

Development Initiatives
May 2022

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This paper builds on previous analyses conducted by DI on disability budgeting. In this paper, we match budget commitments to implementation; first by mapping the extent to which disability-relevant budget implementation information is accessible, then by analysing financial and non-financial performance in Kenya over the financial years 2016/17 to 2020/21. We have analysed disability budget implementation in five counties (Baringo, Bungoma, Busia, Kakamega, and Vihiga) and two national sectors (Education and Social Protection).

Labour Market Assessment: Pakistan 2022

GLOW Consultants
May 2022

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This labour marker assessment has identified how the Pakistan market works and the possible entry points, so that youth with disabilities, are included in the benefits of growth and economic development. Initially the report focuses on analysing the macro-economic indicators and the sectoral contribution to GDP, followed by evaluation of labour market data, in order to identify employment rates and employment propensity of sectors and sub-sectors and to identify sectors with highest absorptive capacity. Priority subsectors were selected on the basis of the employment rate, GDP contribution and government prioritization. Value chain analysis of the selected priority subsectors was conducted to analyse possible entry point for people with disabilities in various stages of the value chain by identifying required skills and education. Subsequently, education stocks and flows were analysed to assess whether the demand of skills was coherent with the supply of skills. Existing systems were reviewed to assess the inclusion of people with disabilities in government initiatives and programmes. Likewise, government-formulated polices and legislation were appraised to understand their contribution in improving lives and safeguarding the rights of people with disabilities, followed by analyses of existing labour market information systems. Shortcomings and limitations in policies were identified, emerging issues were highlighted, and recommendations were provided to improve implementation of existing policies.

Global Report on Assistive Technology

WORLD HEALTH ORGANISATION (WHO)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
May 2022

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The WHO-UNICEF Global Report on Assistive Technology (AT) reveals that more than 2.5 billion people need one or more assistive products, such as wheelchairs, hearing aids, or apps that support communication and cognition. Yet nearly one billion of them are denied access, particularly in low- and middle-income countries, where access can be as low as 3% of the need for these life-changing products.

The Global Report provides the best available evidence about the barriers currently preventing access, how access can be improved, and how enabling environments and AT can enable persons with disabilities to enjoy their human rights while generating a tremendous return on investment for governments. The report also makes 10 key recommendations for concrete actions that will improve access to AT, for everyone, that needs them. 

Access to assistive technology for children with disabilities is often the first step for childhood development, access to education, participation in sports and civic life, and getting ready for employment like their peers. Children with disabilities have additional challenges due to their growth, which requires frequent adjustments or replacements of their assistive products.

Global disability financing in the context of Covid-19

Development Initiatives
March 2022

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The main objective of this analysis is to track global financing towards disability in near real time, which is an extension of our work on real-time data on aid before and during Covid-19 and financial tracking on disability investments. The current analysis assesses changes in global disability aid financing in the context of Covid-19 between 2019 and the third quarter (Q3) of 2021. The review uses data from the International Aid Transparency Initiative (IATI) and considers full calendar years for 2019 and 2020 and three quarters in the year 2021.

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