This report finds that more than a billion people, about 15 per cent of the world’s population, are estimated to live with some form of disability. It synthesises the evidence on how to address the barriers they face in health, rehabilitation, support and assistance, environments, education and employment. It argues that many of the barriers are avoidable, and that the disadvantages associated with disability can be overcome. Multiple, systemic interventions are needed.
Disability disproportionately affects vulnerable populations. Results from the World Health Survey indicate a higher disability prevalence in lower income countries than in higher income countries. People from the poorest wealth quintile, women, and older people also have a higher prevalence of disability. Further, the number of people with disabilities is growing. This is because populations are ageing – older people have a higher risk of disability – and because of the global increase in chronic health conditions associated with disability.
People with disabilities experience lower levels of health (greater vulnerability to preventable secondary conditions, co-morbidities, and age-related conditions), education, employment and income than their peers without disabilities. They are also isolated and dependent on others. In addition, there are many barriers to participation for people with disabilities. These include inadequate policies and standards, prejudice, inadequate services and funding, insufficient consultation, lack of accessibility in built environments, and a lack of data on disability. Evidence indicates that the following action can be taken to address such problems:
- Addressing barriers to health care: Making all levels of existing health care systems more inclusive and making public health care programmes accessible to people with disabilities will reduce health disparities and unmet need.
- Addressing barriers to rehabilitation: Policy responses should emphasise early intervention, the benefits of rehabilitation to promote functioning in people with a broad range of health conditions, and the provision of services as close as possible to where people live.
- Addressing barriers to support and assistance services: Transitioning to community living, providing a range of support and assistance services, and supporting informal caregivers will promote independence and enable people with disabilities and their family members to participate in economic and social activities.
- Creating enabling environments: Requirements for addressing accessibility and reducing negative attitudes are access standards; cooperation between the public and private sector; a lead agency responsible for coordinating implementation; training in accessibility; universal design for planners, architects, and designers; user participation; and public education.
- Addressing barriers to education: The inclusion of children with disabilities in mainstream schools promotes universal primary completion, is cost-effective and contributes to the elimination of discrimination.
- Addressing barriers to employment: This is likely to require antidiscrimination laws, and tax and other financial incentives for employers. In addition to mainstream vocational training, peer training, mentoring, and early intervention show promise in improving disabled people’s skills.
The interventions needed to overcome the disadvantages associated with disability are multiple and systemic, varying with the context. While many countries have started taking action to improve the lives of people with disabilities, much remains to be done. General recommendations include the following:
- Enable access to all mainstream services and invest in specific services for people with disabilities, such as rehabilitation, support services, or training.
- Adopt a national disability strategy and plan of action. Their development, implementation and monitoring should bring together the full range of sectors and stakeholders.
- Involve people with disabilities. Disabled people’s organisations may need capacity building and support to empower people with disabilities and advocate for their needs.
- Improve human resource capacity by integrating training on disability and human rights into curricula and accreditation programmes.
- Provide adequate funding for services and improve the affordability of goods and services for people with disabili¬ties.
- Increase public awareness and understanding of disability. Surveying attitudes to disability can help identify education and public information needs.
- Improve disability data collection. International methodologies for collecting data on people with disabilities need to be developed and tested cross-culturally. Research is essential for informing disability policy and programmes and for efficiently allocating resources.
See also the full ‘World Report on Disability’ (pdf, 10.5 MB) and other resources at http://www.who.int/disabilities/world_report/2011/en/.
