Disability, poverty and development

1 IssuesDFIDD epartment forInternationalDevelopmentDisability, povertyanddevelopmentThe Department for International development (DFID) is the British government department responsible for promotingdevelopment and the reduction of poverty . The government elected in May 1997 increased its commitment to developmentby strengthening the department and increasing its policy of the government was set out in the White Paper on International development , published in November central focus of the policy is a commitment to the internationally agreed target to halve the proportion of people livingin extreme poverty by 2015, together with the associated targets including basic health care provision and universal accessto primary education by the same seeks to work in partnership with governments which are committed to the international targets, and seeks to workwith business, civil society and the research community to encourage progress which will help reduce poverty .

2 We also workwith multilateral institutions including the World Bank, United Nations agencies and the European Commission. The bulkof our assistance is concentrated on the poorest countries in Asia and sub-Saharan are also contributing to poverty elimination and sustainable development in middle income countries, and helping thetransition countries in Central and Eastern Europe to try to ensure that the widest number of people benefit from the processof well as its headquarters in London and East Kilbride, DFID has offices in New Delhi, Bangkok, Dhaka, Kathmandu,Nairobi, Dar-es-Salaam, Kampala, Harare, Pretoria, Suva and Bridgetown. In other parts of the world, DFID works throughstaff based in British embassies and high for International DevelopmentiDFID February 2000iiDFID February 2000 ContentsPageIntroduction1 disability & poverty2 What is disability ?

3 The International development TargetsPoverty: a cause & consequenceThe costs of disabilityRights & social exclusionDifferential needsThe international framework6 Approaches and good practice7 PreventionThe social model of disabilityCommunity-based rehabilitationAreas for action and the role of development co-operation11 The twin-track approachPolicyEconomic, social and human developmentInfrastructureConflict and humanitarian assistanceEmpowermentMedia and communicationsGaps in knowledgeMeasuring progressAnnex: United Nations Standard Rules on the Equalisation of Opportunities for Persons with Disabilities16 disability , poverty and development1 DFID February 2000 disability is both a cause and consequence of world poverty is unlikely to be achieved unlessthe rights and needs of people with disabilities are takeninto to the United Nations, one person in 20 has adisability.

4 More than three out of four of these live in adeveloping country1. More often than not they are amongthe poorest of the poor. Recent World Bank estimatessuggest they may account for as many as one in five of theworld s poorest2. disability limits access to education andemployment, and leads to economic and social people with disabilities are caught in a vicious cycleof poverty and disability , each being both a cause and aconsequence of the large proportion of disability is preventable. Achievingthe international development targets for economic, socialand human development will undoubtedly reduce thelevels of disability in many poor countries. However,general improvements in living conditions will not beenough. Specific steps are still required, not only forprevention, but also to ensure that people with disabilitiesare able to participate fully in the development process,obtain a fair share of the benefits, and claim their rights asfull and equal members of integrated approach is required, linking preventionand rehabilitation with empowerment strategies andchanges in attitudes.

5 This paper assesses the significanceof disability as a key development issue, and its importancein relation to poverty , human rights, and the achievementof internationally agreed development targets. It alsosets out ways in which development co-operation,including DFID s own work, can help incorporate therights and needs of people with disabilities into themainstream of poverty reduction work and theachievement of human Helander, Prejudice and Dignity; an introduction to community based rehabilitation, UNDP, 1992. One in 20 is a conservative estimate, with some sourcessuggesting that as many as one in ten of the world s population may be defined as having a Elwan, poverty and disability ; a background paper for the World development Report, World Bank, October February 2000 What is disability ?Defining disability is complex and controversial.

6 Thougharising from physical or intellectual impairment, disabilityhas social implications as well as health ones. A fullunderstanding of disability recognises that it has a powerfulhuman rights dimension and is often associated with socialexclusion, and increased exposure and vulnerability topoverty. disability is the outcome of complex interactionsbetween the functional limitations arising from a person sphysical, intellectual, or mental condition and the socialand physical environment. It has multiple dimensions andis far more than an individual health or medical this basis, the working definition of disability adoptedin this paper is long-term impairment leading to socialand economic disadvantages, denial of rights, and limitedopportunities to play an equal part in the life of thecommunity .The International development TargetsThe international community is committed to an agreedset of development targets, aimed at significantly reducingpoverty and accelerating the pace of economic, social andhuman development .

7 These are summarised in Box international development targets are directlyrelevant to women, men and children with disabilities inpoorer countries. Their needs and rights cannot be fullyaddressed unless the underlying causes of poverty aretackled, unless they are empowered to gain access toeducation, health services, a livelihood and participatefully in social life. Given the high proportion of peoplewith disabilities among the poor, it is unlikely that thesetargets can be properly achieved without specific efforts totackle : a cause and consequencePoverty is both a cause and consequence of and disability reinforce each other, contributingto increased vulnerability and majority of people with disabilities find their situationaffects their chances of going to school, working for aliving, enjoying family life, and participating as equals insocial life.

8 It is estimated that only 2% of people withdisabilities in developing countries have access torehabilitation and appropriate basic & PovertyBox 1: The International development TargetsThe UK Government is committed to a set of internationally agreed development targets:Economic Well-being a reduction by one-half in the proportion of people living in extreme poverty by 2015 Human and Social development universal primary education in all countries by 2015 demonstrated progress towards gender equality and the empowerment of women by eliminating genderdisparity in primary and secondary education by 2005 a reduction by two-thirds in the mortality rates for infants and children under age five by 2015 a reduction by three-quarters in maternal mortality by 2015 access through the primary health care system to reproductive health services for all individualsof appropriate ages as soon as possible and no later than the year 2015 Environmental Sustainability and Regeneration the implementation of national strategies for sustainable development in all countries by 2005.

9 So as toensure that current trends in the loss of environmental resources are effectively reversed at both globaland national levels by 20153 Leandro Despouy, 1993, Human Rights and disabled Persons(Study Series 6), Centre for Human Rights Geneva and UN New February 2000 Poor nutrition, dangerous working and living conditions,limited access to vaccination programmes, and to healthand maternity care, poor hygiene, bad sanitation,inadequate information about the causes of impairments,war and conflict, and natural disasters all cause disability (see Figure 1). Many of these causes are to estimates by the World Health Organisation(WHO), as many as 20 million women a year sufferdisability and long-term complications as a result ofpregnancy and childbirth. The most common causes ofmotor disability are injuries from accidents on the road, athome, or the workplace; war and violence, includinglandmines; birth trauma; and infectious diseases such aspolio and leprosy.

10 Children are often disabled as a result of turn, disability exacerbates poverty , by increasingisolation and economic strain, not just for the individualbut often for the affected family as well. Children withdisabilities are more likely to die young, or be neglected,malnourished and poor. people with disabilities who aredenied education are then unable to find employment,driving them more deeply into poverty . Breaking out of thevicious cycle of poverty and disability becomes more andmore difficult (see Figure 2).The result of the cycle of poverty and disability is thatpeople with disabilities are usually amongst the poorest ofthe poor and their literacy rates are considerably lower thatthe rest of the population. Women with disabilities suffer adouble discrimination, both on the grounds of gender andof impairment; their literacy rates are lower than their malecounterparts.