The previous section outlines the current situation faced by many people with disabilities across the world. It highlights the various different barriers in the different sectors which result in the exclusion of people with disabilities from society. Similar barriers also mean that people with disabilities are excluded from, or unable to access, mainstream development and humanitarian assistance programmes (there are estimates that only around four per cent of people with disabilities benefit from international cooperation programmes (Schulze, 2010, p. 173)).
Drawn together these barriers to disability inclusion can be grouped together under attitudinal, environmental, and institutional. People with disabilities may also internalise barriers which prevent their inclusion. Lack of participation of people with disabilities, inadequate data, statistics and evidence of what works, and inaccurate concerns over cost/difficulty of disability inclusion are further barriers to inclusion in development and humanitarian response.
Attitudinal barriers, which result in stigmatisation and discrimination, deny people with disabilities their dignity and potential and are one of the greatest obstacles to achieving equality of opportunity and social integration (Wapling & Downie, 2012, p. 21; UNICEF, 2013, p. 11; Heymann et al., 2014, p. 6; Bruijn et al., 2012, pp. 21-22). Negative attitudes create a disabling environment across all domains (WHO & World Bank, 2011, pp. 193, 262). They are often expressed through: the inability of non-disabled to see past the impairment; discrimination; fear; bullying; and low expectations of people with disabilities (DFID, 2000, p. 8; WHO & World Bank, 2011, pp. 6, 262; UNICEF, 2013, p. 11).
Attitudes towards people with disabilities in low- and middle-income countries can be more extreme and the degree of stigma and shame can be higher than in high-income contexts (Mont, 2014, p. 24). These attitudes can arise as a result of ‘misconceptions, stereotypes and folklore linking disability to punishment for past sins, misfortune or witchcraft’ (Groce & Kett, 2014, p. 5; Rimmerman, 2013; Burns et al., 2014, pp. 43-44). Multiple and intersectional discrimination can intensify attitudinal barriers. Development organisations’ staff may also have negative attitudes towards people with disabilities (Bruijn et al., 2012, p. 22).
Inaccessible environments create disability by creating barriers to participation and inclusion (WHO & World Bank, 2011, p. 263; Bruijn et al., 2012, pp. 22-23). Physical barriers in the natural or built environment ‘prevent access and affect opportunities for participation’ (Wapling & Downie, 2012, p. 21; DFID, 2000, p. 8; WHO & World Bank, 2011, p. 4). Inaccessible communication systems prevent access to information, knowledge and opportunities to participate (Wapling & Downie, 2012, p. 21; PPUA Penca, 2013, pp. 5, 11; WHO & World Bank, 2011, p. 4). Lack of services or problems with service delivery also restrict participation of people with disabilities (WHO & World Bank, 2011, p. 262).
Institutional barriers include many laws, policies, strategies or practices that discriminate against people with disabilities (Wapling & Downie, 2012, p. 21; DFID, 2000, p. 8; WHO & World Bank, 2011, pp. 6, 262; Bruijn et al., 2012, p. 23). For example, a study of five Southeast Asian countries found that electoral laws do not specially protect the political rights of persons with disabilities, while ‘some banks do not allow visually impaired people to open accounts, and HIV testing centers often refuse to accept sign language interpreters due to confidentiality policies’ (PPUA Penca, 2013, pp. 5, 11; Wapling & Downie, 2012, p. 21; Al Ju’beh, 2015, p. 87). Many countries still have restrictive laws, particularly affecting people with psychosocial or intellectual disabilities (Al Ju’beh, 2015, p. 87). Discrimination may not be intended but systems can indirectly exclude people with disabilities by not taking their needs into account (WHO & World Bank, 2011, p. 6).
Lack of enforcement and political support for policies can also limit the inclusion of people with disabilities (NCG, 2012, p. 85). For example an evaluation of Norway’s work on disability inclusion in development and humanitarian action found that its disability inclusion policy documents have been ignored, or at best forgotten, and disability has not been a priority theme for the government. This has resulted in ineffective mainstreaming and lack of coordination (NCG, 2012, pp. 85-87).
Sometimes internalised barriers can severely affect the participation and functioning of people with disabilities in society (Bruijn et al., 2012, p. 16). Stigma relating to people with disabilities results in their exclusion from societal interactions, which in turn can result in their ‘lack of pro-active behaviour in expressing their opinions and claiming their rights’, leading to further exclusion (PPUA Penca, 2013, pp. 12, 14-15). Low expectations of people with disabilities can undermine their confidence and aspirations (DFID, 2000, p. 8; WHO & World Bank, 2011, p. 6; Mont, 2014, p. 25).
Lack of participation
Inadequate data and statistics
The lack of rigorous and comparable data and statistics, combined with lack of evidence on programmes that work, often impedes understanding and action on disability inclusion (WHO & World Bank, 2011, p. 263).
Inaccurate concerns over cost/difficulty of disability inclusion
One of the most common reasons given for not including people with disabilities is perceived cost (Coe & Wapling, 2010, p. 884). Inadequate funding and allocations for implementing policies and plans can prevent the inclusion of people with disabilities (WHO & World Bank, 2011, p. 262). Other excuses relate to concerns that disability inclusion is too difficult and requires specialist knowledge, or that people with disabilities require special programmes (Bruijn et al., 2012, p. 22). Staff may also feel that they are overloaded and ‘don’t have time for an additional issue’ (Bruijn et al., 2012, p. 22), or that it is an issue that is only relevant in high income countries.
Experience from various development organisations shows that these excuses have to be tackled to establish commitment to disability inclusion (Bruijn et al., 2012, pp. 72-75).
Tackling misconceptions about the cost of disability inclusion
Including people with disabilities in mainstream programmes is not as costly as sometimes perceived, although reliable figures are not available (Bruijn et al., 2012, p. 47). A budget allocation of 2-7 per cent is recommended for development organisations to raise awareness and to make buildings, communication, and transport accessible (Bruijn et al., 2012, p. 47). This should be included at the design stage so it is not regarded as ‘additional’ costs (Coe & Wapling, 2010, p. 884). However, low/no-cost adjustments to how programme activities are carried out can also be made (Coe & Wapling, 2010, p. 884).
Cost effective and with wider long-term financial benefits
Several studies argue that inclusive approaches are more cost-effective than separate piecemeal disability interventions, which do not remove all the barriers people with disabilities face (Walton, 2012, p. 4; Bruijn et al., 2012, p. 73). The costs of including people with disabilities ‘are far outweighed by the long-term financial benefits to individuals, families and society’ (CBM, 2012, p. 10).
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- Mont, D. (2014). Employment policy approaches and multisectoral implementation in low-and middle-income countries. In J. Heymann, M. A. Stein, & G. Moreno (Eds), Disability and equality at work. New York: Oxford University Press.
- Nordic Consulting Group. (2012). Mainstreaming disability in the new development paradigm: Evaluation of Norwegian support to promote the rights of persons with disabilities. Oslo: NORAD. See document online
- Rimmerman, A. (2013). Social inclusion of people with disabilities: National and international perspectives. Cambridge University Press.
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- Walton, O. (2012). Economic benefits of disability-inclusive development (GSDRC Helpdesk Research Report 831). Birmingham, UK: GSDRC. See document online
- Wapling, L., & Downie, B. (2012). Beyond charity: a donor’s guide to inclusion – Disability funding in the era of the UN Convention on the Rights of Persons with Disabilities. Boston: Disability Rights Fund. See document online
- WHO & the World Bank. (2011). World report on disability. Geneva: WHO. See document online