Are disabled people served by conditional cash transfers (CCTs)? Should they be subject to the same conditionalities, and do programmes address the particular needs that disabled people may have in meeting these conditionalities? This paper from the World Bank raises structural and theoretical concerns about disabled people’s participation in CCT programs and examines four basic approaches to dealing with disability.
Coupling CCT programs with policies to make service delivery more inclusive will have the best outcomes for disabled people. However, this strategy requires extensive collaboration, a long term focus, and an understanding of disability issues by all actors. This paper recommends increased attention on collecting information relating to disability so that planning can better incorporate a vulnerable population.
The way in which disability is defined and conceptualised has implications for the form which disability-related services should take. Not addressing the particular needs of disabled people within the design of CCT programmes could undermine the well-being of disabled people who are in more need of support. In addressing which strategies might be most appropriate for dealing with disability, it is important to consider the following factors:
- Disability prevalence is quite significant and disabled people are disproportionately poor and uneducated
- Unemployment rates are higher for disabled people than for non-disabled people
- CCT programs with health and nutrition components contribute to the prevention of disability
- A social model of disability which caters for the full range of human functioning would allow people with functional limitations to participate fully in society
- The heterogeneous nature of disability means that the interventions needed to accommodate disabled people can vary dramatically, ranging from quite minor to very significant
- Transfer programs which conceive of disability as a condition that prohibits employment can create work disincentives.
There are four basic approaches to dealing with disability, each with advantages and drawbacks:
- Treat disabled people exactly like non-disabled people under the current system: This may encourage disabled people who have previously abstained due to stigma and low expectations to use services. However, it particularly excludes the most severely disabled from receiving benefits because of inaccessible services.
- Exempt disabled people from the conditions associated with CCT Programs: This provides short-term poverty reduction to disabled people, especially to those who cannot comply with conditions. However it is administratively complex and re-enforces low expectations of disabled people’s ability to comply with conditions. It also removes an incentive for reforms to make services more inclusive.
- Provide additional assistance to disabled people to help them comply with CCT requirements: This provides short term and long term poverty reduction to disabled people through increased utilisation of services. However it is administratively complex, can be less efficient, and does not address inclusive services in a systematic fashion.
- Couple CCT programs with policies to make service delivery more inclusive: This addresses both short and long term poverty among disabled people. Inclusion can be more co-ordinated and efficient. However it requires the highest level of collaboration and the longest time horizon. Good practices in this area are only beginning to be developed.
