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Disability-related stigma and discrimination in sub-Saharan Africa and south Asia: a systematic literature review

VIRUNDRAKUMAR, Bhavisha
STEPHEN, Kathy
JOLLEY, Emma
SCHMIDT, Elena
May 2021

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This systematic literature review was undertaken to understand the extent, quality and findings of published and unpublished literature on interventions designed to tackle disability-related stigma and discrimination in sub-Saharan Africa and south Asia.

The primary focus of this review was to identify studies that describe the effectiveness of interventions to tackle disability-related stigma and discrimination. The secondary set of objectives focused on understanding the individual, interpersonal, organisational, community and public policy factors that are associated with stigma and discrimination.

Persons with disabilities and their representative organisations in Iraq

March 2021

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Iraq has one of the largest populations of persons with disabilities in the world. Despite this, there has been little consultation among persons with disabilities and their representative groups by government and humanitarian and development agencies. Persons with disabilities and their representative organisations in Iraq: Barriers, challenges and priorities aims to improve the understanding of the barriers experienced by persons with disabilities, including the key challenges and priorities of their rep­resentative organizations, in order to inform humanitarian and development programming. The report is based on interviews conducted with 81 representatives of 53 Organiza­tions of persons with disabilities across 18 governorates in Iraq.

Persons with disabilities and their representative organisations in Iraq

INTERNATIONAL ORGANISATION FOR MIGRATION (IOM) IRAQ
March 2021

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Iraq has one of the largest populations of persons with disabilities in the world. Despite this, there has been little consultation among persons with disabilities and their representative groups by government and humanitarian and development agencies. Persons with disabilities and their representative organisations in Iraq: Barriers, challenges and priorities aims to improve the understanding of the barriers experienced by persons with disabilities, including the key challenges and priorities of their rep­resentative organizations, in order to inform humanitarian and development programming. The report is based on interviews conducted with 81 representatives of 53 Organiza­tions of persons with disabilities across 18 governorates in Iraq.

Covid-19 Income loss, risk of violence and the response of persons with disabilities and their representative organisations in Uganda

ADD International
November 2020

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Findings from this report show evidence that some persons with disabilities face multiple types of jeopardy during Covid-19: they are at an increased risk of violence and are suffering a dramatic loss in household earnings. They are also taking action: many plan to adapt their livelihood and are mobilising resources for their communities. Persons with disabilities ask government and NGOs to do more and to be more inclusive in their response to the crisis.

● Three of four respondents report increased risk of violence since the pandemic began. 77% of women and 80% of men report an increase in economic, physical, psychological and/or sexual violence after Covid-19.

● One in three women respondents report experiencing an increased risk of physical and/or sexual violence.

● Livelihood support could reduce violence risk. Three in four (76%) of respondents say livelihood support, such as start up capital for small business, would be very or extremely useful to them in order to reduce their risk of experiencing violence during Covid-19.

● Respondents report losing 64% of their monthly household income since the outbreak. After adjusting for purchase power parity, this is the equivalent of falling from 181 GBP to 65 GBP per month.

● Covid-19 support is unequal and insufficient for many. Where support has been distributed, one in two report that they do not receive the same protection support (ie PPE) as others; one in four report that they do not receive the same Covid-19 survival support (ie food); one in three report they do not receive the same Covid-19 information; and one in three say that support does not meet need.

● Most respondents will try something new. 59% indicate that they will start something new to make ends meet if the situation continues.

● OPDs are obtaining food support through lobbying, providing vital psychosocial support and information.

● Some OPDs are not able to respond because they are capacity-constrained.

● Government and NGOs can do more.


From these interviews and findings, some recommendations emerge for government and NGOs:

● Support livelihood to reduce violence risk and increase survival strategies.

● Increase access to capital.

● Meaningfully engage persons with disabilities and their respective organisations in response planning and implementation.

● Ensure distribution of support reaches persons with disabilities, more specifically the underrepresented groups.

● Change attitudes toward and increase knowledge about persons with disabilities.

Self-reported barriers to activities of daily living of persons with disabilities living in IDP sites in northwest Syria

UNHCR INCLUSION TECHNICAL WORKING GROUP, SYRIA PROTECTION CLUSTER (TURKEY)
November 2020

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This brief aims to describe the lived experience of persons with disabilities in northwest Syria and highlight needs and key barriers to engagement in personal, domestic and community-based activities of daily living, which includes access to and engagement with humanitarian organisations. The analysis of these difficulties forms the basis of key pragmatic recommendations for humanitarian actors

Disability Inclusive Development - Kenya Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Kenya?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Kenya. It will be helpful for anyone interested in disability inclusion in Kenya, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Disability Inclusive Development - Bangladesh Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Bangladesh?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Bangladesh. It will be helpful for anyone interested in disability inclusion in Bangladesh, especially in relation to stigma, employment, education, health, and humanitarian issues.

Disability Inclusive Development - Nigeria Situational Analysis

THOMPSON, Stephen
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nigeria?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nigeria. It will be helpful for anyone interested in disability inclusion in Nigeria, especially in relation to stigma, employment, education, health, and humanitarian issues.

Disability inclusion in Nigeria : A rapid assessment

WORLD BANK
June 2020

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According to the World Health Organization, in 2018, about 29 million of the 195 million people who comprise Nigeria’s national population were living with a disability. Data from the 2018 Nigeria Demographic and Health Survey reveal that an estimated 7 percent of household members above the age of five (as well as 9 percent of those 60 or older) have some level of difficulty in at least one functional domain, seeing, hearing, communication, cognition, walking, or self-care; and 1 percent either have a lot of difficulty or cannot function at all in at least one domain. These estimated rates, while significant, are probably even higher because currently available data likely underestimate the prevalence. This rapid social assessment was undertaken to document the current socioeconomic status of persons with disabilities in Nigeria. Findings indicate that persons with disabilities lack access to basic services and that attitudinal barriers represent a major impediment to their socioeconomic inclusion. Inclusive policies are either nonexistent, weak, or inadequately implemented. 

The impacts of COVID-19 on people with disabilities: a rapid review. Disability Inclusion Helpdesk Query No: 35

MEANIE-DAVIS, Jessie
LEE, Harri
CORBY, Nick
April 2020

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There is currently very limited data and evidence on the impacts of COVID-19 on people with disabilities and pre-existing health conditions, with no disability-disaggregated data on mortality rates available in the public sphere. However, reports from the media, disability advocates and disabled peoples’ organisations (DPOs) point to several emerging impacts, including primary and secondary impacts including on health, education, food security and livelihoods.  Most of the available data is from high income countries (HICs) though reports from low- and middle-income countries (LMICs) are likely to emerge. Evidence was gathered by a rapid desk based review. Gaps are identified. 

 

The section concerned with lessons drawn from similar epidemics draws heavily on lessons learned from the Ebola outbreak in West Africa in 2014-2016, and touches on lessons from the Zika outbreak in 2015-2016 and the SARS pandemic in the early 2000s.10 It also touches briefly on SARS, MERS and H1N1 (swine flu). 

 

Primary and secondary impacts of COVID-19 on people with disabilities are reviewed.


People with disabilities are disproportionately impacted by COVID-19 not only because it can exacerbate underlying medical conditions, but because of attitudinal, environmental and institutional barriers to their participation in and benefit from the pandemic response. For example, inaccessible public health messaging and healthcare facilities, and stigma and discrimination.

Aid Connect Inclusion Works (NIGERIA) Qualitative Formative Research

BBC Media Action
April 2020

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BBC Media Action is implementing a Department for International Development (DfID) funded project aimed at increasing action and investment from private, public and civil society actors to enable economic inclusion for women and men with disabilities through employment, with focus on FCT, Lagos and Kano states. The formative research provides insights to help (re)shape the design and implementation of media capacity strengthening activities on the project.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Persons with disabilities in a just transition to a low-carbon economy

HASAN, Maria
November 2019

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Implementing a just transition to a low-carbon economy that aims to leave no one behind will require a context-specific and locally determined mix of legal standards, social protection, skills development and attitudinal transformation that create an enabling environment for green jobs to perpetuate and decent work opportunities for persons with disabilities to proliferate. If done right, a just transition towards environmentally sustainable economies and societies for all can contribute to the goals of achieving social justice, decent work, social inclusion and the eradication of poverty. At this unique time that climate action is accelerating and the transition to green economies has started to take form, a just transition - that is inherently disability-inclusive - represents a unique opportunity to shape a future that works for all.

 

Topics discussed include: Persons with disabilities in a world of work confronted by climate change; Understanding the future of the world of work; Existing frameworks to guide action; An inclusive transition to a low-carbon economy; Key recommendations

Disability stigma in the Inclusion Works programme countries: an overview of the evidence

ROHWERDER, Brigitte
November 2019

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This report draws on and expands previous work looking at disability stigma in developing countries (written for K4D) and information on stigma in the situational analyses and labour market assessments of the four Inclusion Works programme countries. Factors which contribute to disability stigma, differences in the extent of stigmatisation and issues measuring stigma are discussed. An overview of disability stigma in each of the specific countries (Kenya, Bangladesh, Nigeria and Uganda) is provided. Interventions to reduce disability stigma are outlined, including interpersonal, intrapersonal and governmental/institutional interventions.

 

The Inclusion Works programme (2018–2022), funded by the UK Department for International Development, aims to improve employment rates for people with disabilities in Bangladesh, Kenya, Nigeria, and Uganda.

 

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Agriculture and mobile-based interventions for smallholder farmers: best practice on disability inclusion, Disability Inclusion Helpdesk Research Report No. 14

AHLENBÄCK, Veronica
LEE, Harri
COE, Sue
May 2019

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This rapid review addresses the questions: What is current best practice in addressing disability and including people with disabilities within agricultural development programming? What is current best practice in mobile agriculture programming (i.e. mobile-based interventions targeted at smallholder farmers) to include smallholder farmers with disabilities as well as empower them and address key barriers they are facing? 

Working with persons with disabilities in forced displacement

UN HIGH COMMISSIONER FOR REFUGEES (UNHCR)
2019

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This note has been updated from its 2011 release and provides UNHCR and partners with specific guidance on meeting the protection needs of a diversity of persons with disabilities. While the document refers mainly to refugees, it applies to all of UNHCR’s persons of concern, including refugees, asylum seekers, internally displaced persons, returnees, and stateless persons.

This note provides guidance on: who persons with disabilities are; key principles (rights based approach, inclusion, participation and non-discrimination) and cross-cutting actions. 

DFID’s strategy for disability inclusive development 2018-23

December 2018

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The UK Department for International Development (DFID)'s vision is a world where all people with disabilities, women, men, girls and boys, in all stages of their lives, are engaged, empowered and able to exercise and enjoy their rights on an equal basis with others, contributing to poverty reduction, peace and stability. A world where no-one is left behind.

Over the next five years DFID will prioritise four strategic pillars for action: (i) inclusive education, (ii) social protection, (iii) economic empowerment, and (iv) humanitarian action. To complement this focus DFID are adopting three cross-cutting areas, vital to disability inclusion, which will be consistently and systematically addressed in all of their work: (v) tackling stigma and discrimination; (vi) empowering girls and women with disabilities; and (vii) access to appropriate assistive technology.

DFID have introduced a new set of standards for all DFID business units to meet. The standards require all country offices and departments to; review their leadership and culture, engage with people with disabilities, influence others, adapt programming and improve data and evidence.

Children with disabilities in situations of armed conflict - a discussion paper

THOMAS, Edward
et al
November 2018

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During armed conflict, children with disabilities are caught in a vicious cycle of violence, social polarization, deteriorating services and deepening poverty. Global estimates suggest there are between 93 million and 150 million children with disabilities under the age of 15.Given that disability is often not reported due to stigma there is reason to believe actual prevalence could be much higher. Although efforts to ensure the fulfilment of their rights have improved, girls and boys with disabilities continue to remain among the most marginalized and excluded segment of the population. This is amplified during situations of armed conflict. The barriers to full participation they face on a day-to-day basis are intensified and compounded when infrastructure is destroyed, and services and systems are compromised and made inaccessible. This results in the further exclusion and marginalization of children with disabilities, and prevents them from accessing schooling, health and psychosocial support, or a means of escape from conflict.

 

When systems and services break down, children are also left more susceptible to violence. Injuries sustained by many children during armed conflict may also lead to long-term impairments. There are six grave violations of children’s rights and protection in armed conflict that are on the agenda of the United Nations (UN) Security Council; killing and maiming, recruitment and use of children, rape or other sexual violence, abduction, attacks on schools or hospitals, and denial of humanitarian access. Governments around the world have committed themselves to respect, promote, and fulfil the rights of children with disabilities, including in situations of armed conflict, and progress is being made. Efforts by a broad range of actors to implement the CRPD, CRC and other human rights instruments include the development of standards to address the rights and needs of persons with disabilities in humanitarian crises, and guidance on making humanitarian response, development and peacebuilding more inclusive. Efforts to improve the collection and use of data concerning children and adults with disabilities are also underway. Yet, as this discussion paper makes clear, much more needs to be done. Investments in disability-inclusive humanitarian action and recovery from crises will pay off, contributing towards a dividend of peace built on greater equality, tolerance and justice. 

Young persons with disabilities: Global study on ending gender-based violence, and realising sexual and reproductive health and rights

McCLOSKEY, Megan
MEYERS, Stephen
July 2018

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This study provides an analysis on the situation of young persons with disabilities concerning discrimination and gender-based violence, including the impact on their sexual and reproductive health and rights. It also provides an assessment of legal, policy and programming developments and specific good practices in service delivery as well as best-standard prevention and protection measures. Finally, policy and programming recommendations are provided to assist in greater promotion of the rights of young persons with disabilities, with a particular emphasis on preventing and responding to gender-based violence, and realizing sexual and reproductive health and rights.

Disability stigma in developing countries

ROHWERDER, Brigitte
May 2018

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This K4D helpdesk report, commissioned by UK DFID, answers the question "What are the core drivers behind stereotypes, prejudice (including pity/shame etc), and harmful practices against persons with disabilities in developing countries and what promising strategies/pathways for addressing these drivers have been identified?" using desk research.

 

Across the world stereotypes, prejudice, and stigma contribute to the discrimination and exclusion experienced by people with disabilities and their families in all aspects of their lives. This rapid review looks at available evidence on the drivers of disability stigma in developing countries, and promising strategies for addressing these. Most of the available evidence uncovered by this rapid review comes from Sub-Saharan Africa, and is from a mix of academic and grey literature. Evidence gaps remain. The available literature has focused more on studying the victims of stigmatisation than the stigmatisers. 

Disability inclusion in disaster risk management - Promising practices and opportunities for enhanced engagements

GUERNSEY, Katherine
SCHERRER, Valerie
April 2018

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Disaster risk management aims to address vulnerability in order to reduce risk and therefore needs to consider the full range of vulnerability drivers, including those that affect persons with disabilities. This report presents the results of comprehensive review of the state of practice in disability-inclusive Disaster risk management (DRM) undertaken by GFDRR (Global Facility for Disaster Reduction and Recovery). The report is intended to help World Bank staff incorporate persons with disabilities and a disability perspective into their ongoing DRM work. The report will also be of interest to other development actors and stakeholders working on DRM.

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