disability and mdgs

Technology and Society 1

Disability and MDGs

Indicators for Monitoring Inclusive MDG Implementation Expert meeting: Maputo, 4th March 2010

Arne H. Eide

Chief Scientist, SINTEF


Current situation

There is little international comparable statistical data on the incidences, trends and distribution of impairment and disability, and much nation-level data, particularly in the developing world, is unreliable and out-of-date (Moore 2003; Erb & Harris-White 2001; Yeo 2001). Comparative data on the situation of disabled people is even more scarce

The lack of high-quality statistics is serious in many ways and hampers all or most use of data to study the disability – poverty relationship (Yeo 2001)

What have existed in this region until quite recently is largely highly questionable estimates on the number of individuals with disabilities in each country, with a few exceptions found primarily in South Africa but also Namibia. Common for all this statistics is that it captures severe disabilities only and thus grossly underestimates the magnitude of disability.


The rationale

Data on the situation of disabled people in developing countries has been in demand for a long time (Standard Rules, the UN Convention, National Policies, etc); Policy development Monitoring Dialogue between DPOs, authorities, international organisations Resource allocation Research on disability and poverty Capacity building Empowerment Awareness raising Lobbying Disability and poverty Indicators


Existing data and initiatives

DISTAT ESCAP – the secretariat of of the Economic and Social

Commission for Asia and the Pacific IDB – Latin America Washington City Group National Censuses LC - studies


What kind of data do we need?

Relevant to the context High quality (reliable and valid), representative,

national Poverty related; indicators on living conditions, well-

being, social participation ICF based – to avoid impairment based disability

statistics Comparative – high potential for application Basis for policy development


ICF (WHO 2001)

ICF

HEALTH CONDITION

BODY ACTIVITY PARTICIPATIONFUNCTIONSAND STRUCTURE

ENVIRONMENTALFACTORS

PERSONALFACTORS


Design; National representative household surveys

Two-stage household surveys Based on national sampling frames Screening/listing of individuals with disabilities by means of

Washington City Group screening questions (and similar activity based instruments)

Including a control sample of non-disabled Comparative data: disabled/non-disabled, households with/without

disabled members, between countries (largely similar design across countries)

Questionnaire: Screening questions (WCG) General level of living questions (households) ICF; Activity limitations & restrictions in social participation (individuals) Disability component (individuals)


Studies on living conditionsHousehold surveys Namibia (2003) Zimbabwe (2003) Malawi (2004) Zambia (2006) South Africa (2006) Mozambique (2009) Lesotho (2010) Swaziland (2010) Botswana 2012 Angola 2014

Ethnographic studies Kenya (2005) Yemen (2006)


Partners

Southern Africa Federation of the Disabled (SAFOD) FAMOD, NCDPZ, ZAFOD, FEDOMA, NFDPN, DPSA, LNFOD, FODSWA

FFO (N) University of Stellenbosch University of Cape Town University of Namibia University of Malawi University of Zambia University of Swaziland University of Lesotho CSO – all countries


Some key characteristics of the studies

Following principles from participatory research tradition Design development/local adaptation: Comprehensive process

involving DPOs and other relevant stakeholders DPO control: Local organization, administration incl. economy,

recruitment, implementation, application Income possibilities for persons with disabilities Comprehensive training of interviewers (largely individuals with

disabilities) Collaboration with national unversities and central statistical offices;

establishing national networks Capacity building program; understanding of research and application

of results Followed by Awareness Building Campaign


A PARTICIPATORY APPROACH – WHAT DOES IT MEAN IN PRACTICE?

”Finding the balance” between researchers and DPOs DPOs control the funding (FFO – SAFOD) Contract between SINTEF and SAFOD regulates the management and

ownership of studies and data Organised nationally with DPO as resonsible and controlling the research

process Design development under the control of DPO involves all important

stakeholders DPO contracts national university and CSO ”Soft aspects”:

Development of a working relationship based on mutual respect and trust Close follow-up and continous communication Mutual learning

Capacity building to ensure ownership and application Long-term relationship between SINTEF and SAFOD ensures long-term

support and follow-up


Poverty

From A particularly low level of income

to The inability to achieve certain standards

Poor people often lack adequate food , shelter, education, and health care

They are poorly served by institutions of the state and society


DISABILITY AND POVERTY

Agreement on a (strong) relationship between disability and poverty

DISABILITY POVERTY

Weak research evidence for this relationship

Assumption: The complexity in this relationship has not yet been fully understood


THE POVERTY/DISABILITY CYCLE (Yeo 2003)

Limited access to education and employment Forced to accept hazardous working Limited access to conditions Higher risk ofChronic Exclusion land and shelter illness, accident Poverty Unhygienic, and impairment Poor sanitation owercrowded living conditions Excluded from political/ legal processes Lack of ability to Limited access to health assert rights care

Insufficient or Malnutrition, poor unhealthy food health and physically Income weak Discrimination &

Poverty Disability Exclusion and loss

of income


Millenium Development Goals

Eradicate extreme poverty and hunger Achieve universal primary education Promote gender equality and empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria and other diseases Ensure environmental sustainability Develop a Global Partnership for Development


MDGs

21 quantifiable targets, measured by 60 indicators

Example Goal 2: Target 2a: Ensure that all boys and girls complete a

full course of primary schooling2.1 Net enrolment ratio in primary education 2.2 Proportion of pupils starting grade 1 who reach last grade of primary 2.3 Literacy rate of 15-24 year-olds, women and men


Content/LC studies

Level of living Housing and infra structure Education Access to information Reproductive health Employment Economic indicators

Washington City Group Screening Questions ICF matrix and alternative measures on activity, participation, environmental barriers Disability component

Physical health including HIV/AIDS Mental health Education Employment Assistive technology Access to services, accessibility at home and in the community Income, grants, expenditure, etc. Role in the household Need for support in daily life


Service delivery gap

Services Received (of those who needed) (%)

Namibia Zimbabwe Malawi Zambia

Health 72.9 92.0 61.0 79.3Welfare 23.3 23.6 5.0 8.4Counselling for family 41.7 45.4 19.5 21.9 Assistive devices 17.3 36.6 17.9 18.4Medical rehabilitation 26.3 54.8 23.8 37.5Counselling for disabled 15.2 40.8 10.7 14.3Education 27.4 51.2 20.3 17.8 Vocational training 5.2 22.7 5.6 8.4Traditional healer 46.8 90.1 59.7 62.9


Access to information (% households without access)

Namibia Zimbabwe Malawi Zambia

dis. n/dis. dis. n/dis. dis. n/dis. dis. n/dis.

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Telephone 44.2 38.1 19.3 18.7 56.3 53.0 61.8 59.3

Radio 16.4 12.7 28.7 24.5 12.1 9.8 30.5 27.9

Television 68.2 59.7 62.5 60.9 66.8 62.0 60.4 58.3

Newspaper 71.7 58.8 57.6 53.2 74.1 66.6 70.0 69.1

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disability and mdgs

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