People with disabilities comprise 15% of the world’s population, with the majority living in low- and middle-income countries (ILO, IDA et al., 2019: 1). Social protection plays a critical role for people with disabilities, as they ‘face barriers to accessing employment, education, health care and disability-related services, and to earning enough income to cover both ordinary and disability-related costs, severely restricting their escape from poverty’ (ibid.: 4). What type of support is needed depends on ‘the type and severity of impairment, environment, age, gender, ethnicity, poverty and other grounds for discrimination’ (ibid.: 4). Disability intersects with other inequalities, meaning women with a disability and older people with a disability (for example) may need special consideration.
Disability is rising up the social protection agenda. However, while social protection frameworks (such as the social protection floors) recognise the needs and rights of people with disabilities to social protection, beyond identifying people with disabilities as a vulnerable group, there has been a lack of comprehensive strategies for their inclusion (Banks et al., 2017: 225). In 2019, the ILO, the International Disability Alliance (IDA) and others released the Joint Statement Towards Inclusive Social Protection Systems Supporting the Full and Effective Participation of Persons with Disabilities to guide and support future action to ensure that social protection systems take into account the rights of persons with disabilities and support their full and effective participation.
Kidd et al. (2019: iii) identify four relevant categories of social protection programmes for people with disabilities: ‘disability-specific schemes, for which only persons with disabilities are eligible; disability-relevant schemes, which are largely accessed by persons with disabilities (old age and veterans’ pensions); targeted mainstream schemes, for which “capacity to work” is a key criterion; and, mainstream schemes for which persons with disabilities are usually eligible on an equal basis to others’.
Social protection coverage of persons with and without disabilities is known to be low in most low- and middle-income countries, although limited data disaggregation means there is little accurate data on coverage of people with disabilities by mainstream social protection programmes. There is some evidence that coverage varies by type and severity of functional limitation, although this varies by country, with, for example, coverage slightly lower for those with the most profound functional limitations in South Africa (Kidd et al., 2019: iv). Failing to address barriers to inclusion (such as inaccessibility of administration and service procedures and centres, communication barriers, discriminatory attitudes of administrators, limited awareness of eligibility for programmes, targeting errors, among others) can lead to exclusion for people with disabilities (Banks et al., 2017: 225; Devandas Aguilar, 2017: 56). Barriers arise at policy, design and implementation levels (Kidd et al., 2019).
There is limited evidence on the impact of social protection schemes on persons with disabilities in low- and middle-income countries. A small number of disability-specific benefits have been evaluated (Kidd et al., 2019: v). These report some impact on consumption, education, health, livelihoods and psychosocial wellbeing.
Meanwhile, few mainstream social protection programmes adjust their poverty threshold for inclusion to account for the extra costs of disability, which can substantially deplete a household’s income and lower standards of living (Banks et al., 2017: 234; Devandas Aguilar, 2017). Similarly, country studies by the London School of Hygiene & Tropical Medicine highlight that the low value of transfers that do not cover disability-related costs, which are insufficient for achieving a minimum standard of living, let alone the development of stronger livelihoods (Vietnam study – Banks et al., 2018b), as well as the poor alignment of benefit content with the needs of people with disabilities (e.g. not covering disability-specific health-care services and devices) (among other issues) (Nepal study – Banks et al., 2018a).
Growing evidence shows that conditionality attached to CCTs can exclude people with disabilities owing to structural barriers (e.g. the lack of accessible information that impedes deaf people from participating in training or meetings with social services) (Devandas Aguilar, 2017: 58). While some CCT programmes have exempted people with disabilities from these conditionalities, supporting people with disabilities in meeting conditionalities can be an opportunity to invest in human capabilities to promote social inclusion and active participation (ibid.). This requires ‘an intersectoral intervention… to guarantee access to the required services by persons with disabilities and their families’ (ibid.)
To avoid ‘benefit traps’, income security and disability-specific assistance should be designed as separate but complementary interventions to get the right balance between labour inclusion and providing an adequate level of income security for people with disabilities (ibid.: 56).
Kidd, S., Wapling, L., Schjoedt, R., Gelders, B., Bailey-Athias, D., Tran, A., & Salomon, H. (2019). Leaving no-one behind: Building inclusive social protection systems for persons with disabilities (Working Paper). Orpington: Development Pathways.
How can social protection systems and schemes be more inclusive of persons with disabilities? This paper answers the question through a review of relevant literature, an analysis of household survey datasets and seven low- and middle-income country case studies: Brazil, India, Kenya, Mauritius, Rwanda, South Africa and Zambia.
Banks, L. M., Mearkle, R., Mactaggart, I., Walsham, M., Kuper, H., & Blanchet, K. (2017). Disability and social protection programmes in low- and middle-income countries: A systematic review. Oxford Development Studies, 45(3), 223–239.
This systematic review finds that in low- and middle- income countries people with disabilities’ ‘access to social protection appears to fall far below need’, with benefits ‘mostly limited to maintaining minimum living standards’ (p. 223). The review highlights the need for high-quality, robust evidence on this topic, in particular broader assessments of social protection outcomes, research that unpacks ‘disability’ by gender, age and impairment types, and comparative research of access to social protection between beneficiaries with and without disabilities.
Devandas Aguilar, C. (2017). Social protection and persons with disabilities. International Social Security Review, 70(4), 45–65.
This article by the United Nations Special Rapporteur on the rights of persons with disabilities sets out the potential of well-designed social protection programmes to directly improve persons with disabilities’ enjoyment of their rights, including by promoting active citizenship, social inclusion and community participation. However, many national social protection systems have embedded traditional charity and medical approaches, thereby ‘deepening the dependence, segregation and institutionalization of persons with disabilities’ (p. 46).
Banks, L. M., Walsham, M., Neupane, S., Neupane, S., Pradhananga, Y., Maharjan, M., … & Kuper, H. (2018a). Disability-inclusive social protection research in Nepal: A national overview with a case study from Tanahun district (International Centre for Evidence in Disability Research Report). London.
Banks, L. M., Walsham, M., Van Minh, H., Duy Kien, V., Quynh Mai, V., Thu Ngan, T., Bich Phuong, B., Ha Son, D., Bao Ngoc, N., Thi Thuy Duong, D., Blanchet, K., & Kuper, H. (2018b). Disability-inclusive social protection in Vietnam: A national overview with a case study from Cam Le district (International Centre for Evidence in Disability Research Report). London.
DFAT. (2014). Disability and social protection: Technical guidance note – 2014. Canberra: Department of Foreign Aid and Trade (Australia).
Rohwerder, B. (2014). Disability inclusion in social protection (GSDRC Helpdesk Research Report 1069). Birmingham: GSDRC, University of Birmingham. http://www.gsdrc.org/go/display&type=Helpdesk&id=1069
Development Pathways: The Disability Benefit Database.
Conference/seminar/webinar: Adapting the graduation approach for people with disabilities. (2017). Recorded by CGAP with Fonkoze, Trickle Up, & Pakistan Poverty Alleviation Fund. (1hr:31:11)
Conference/seminar/webinar: Why is social protection vital to ensure that no person with a disability is left behind? (2018). Development Pathways. (1h:32)