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Disability and MDGs

Disability and MDGs. Indicators for Monitoring Inclusive MDG Implementation Expert meeting: Maputo, 4th March 2010 Arne H. Eide Chief Scientist, SINTEF. Current situation.

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Disability and MDGs

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  1. Disability and MDGs • Indicators for Monitoring Inclusive MDG Implementation • Expert meeting: Maputo, 4th March 2010 • Arne H. Eide Chief Scientist, SINTEF

  2. Current situation • There is little international comparable statistical data on the incidences, trends and distribution of impairment and disability, and much nation-level data, particularly in the developing world, is unreliable and out-of-date (Moore 2003; Erb & Harris-White 2001; Yeo 2001). Comparative data on the situation of disabled people is even more scarce • The lack of high-quality statistics is serious in many ways and hampers all or most use of data to study the disability – poverty relationship (Yeo 2001) • What have existed in this region until quite recently is largely highly questionable estimates on the number of individuals with disabilities in each country, with a few exceptions found primarily in South Africa but also Namibia. Common for all this statistics is that it captures severe disabilities only and thus grossly underestimates the magnitude of disability.

  3. The rationale • Data on the situation of disabled people in developing countries has been in demand for a long time (Standard Rules, the UN Convention, National Policies, etc); • Policy development • Monitoring • Dialogue between DPOs, authorities, international organisations • Resource allocation • Research on disability and poverty • Capacity building • Empowerment • Awareness raising • Lobbying • Disability and poverty • Indicators

  4. Existing data and initiatives • DISTAT • ESCAP – the secretariat of of the Economic and Social Commission for Asia and the Pacific • IDB – Latin America • Washington City Group • National Censuses • LC - studies

  5. What kind of data do we need? • Relevant to the context • High quality (reliable and valid), representative, national • Poverty related; indicators on living conditions, well-being, social participation • ICF based – to avoid impairment based disability statistics • Comparative – high potential for application • Basis for policy development

  6. ICF (WHO 2001) • ICF HEALTH CONDITION BODY ACTIVITY PARTICIPATION FUNCTIONS AND STRUCTURE PERSONAL FACTORS ENVIRONMENTAL FACTORS

  7. Design; National representative household surveys • Two-stage household surveys • Based on national sampling frames • Screening/listing of individuals with disabilities by means of Washington City Group screening questions (and similar activity based instruments) • Including a control sample of non-disabled • Comparative data: disabled/non-disabled, households with/without disabled members, between countries (largely similar design across countries) • Questionnaire: • Screening questions (WCG) • General level of living questions (households) • ICF; Activity limitations & restrictions in social participation (individuals) • Disability component (individuals)

  8. Studies on living conditions Household surveys • Namibia (2003) • Zimbabwe (2003) • Malawi (2004) • Zambia (2006) • South Africa (2006) • Mozambique (2009) • Lesotho (2010) • Swaziland (2010) • Botswana 2012 • Angola 2014 Ethnographic studies • Kenya (2005) • Yemen (2006)

  9. Partners • Southern Africa Federation of the Disabled (SAFOD) • FAMOD, NCDPZ, ZAFOD, FEDOMA, NFDPN, DPSA, LNFOD, FODSWA • FFO (N) • University of Stellenbosch • University of Cape Town • University of Namibia • University of Malawi • University of Zambia • University of Swaziland • University of Lesotho • CSO – all countries

  10. Some key characteristics of the studies • Following principles from participatory research tradition • Design development/local adaptation: Comprehensive process involving DPOs and other relevant stakeholders • DPO control: Local organization, administration incl. economy, recruitment, implementation, application • Income possibilities for persons with disabilities • Comprehensive training of interviewers (largely individuals with disabilities) • Collaboration with national unversities and central statistical offices; establishing national networks • Capacity building program; understanding of research and application of results • Followed by Awareness Building Campaign

  11. A PARTICIPATORY APPROACH – WHAT DOES IT MEAN IN PRACTICE? ”Finding the balance” between researchers and DPOs • DPOs control the funding (FFO – SAFOD) • Contract between SINTEF and SAFOD regulates the management and ownership of studies and data • Organised nationally with DPO as resonsible and controlling the research process • Design development under the control of DPO involves all important stakeholders • DPO contracts national university and CSO • ”Soft aspects”: • Development of a working relationship based on mutual respect and trust • Close follow-up and continous communication • Mutual learning • Capacity building to ensure ownership and application • Long-term relationship between SINTEF and SAFOD ensures long-term support and follow-up

  12. Poverty • From • A particularly low level of income to • The inability to achieve certain standards • Poor people often lack adequate food , shelter, education, and health care • They are poorly served by institutions of the state and society

  13. DISABILITY AND POVERTY • Agreement on a (strong) relationship between disability and poverty DISABILITY POVERTY • Weak research evidence for this relationship • Assumption: The complexity in this relationship has not yet been fully understood

  14. THE POVERTY/DISABILITY CYCLE (Yeo 2003) Limited access to education and employment Forced to accept hazardous working Limited access to conditions Higher risk of Chronic Exclusion land and shelter illness, accident Poverty Unhygienic,and impairment Poor sanitation owercrowded living conditions Excluded from political/ legal processes Lack of ability to Limited access to health assert rights care Insufficient or Malnutrition, poor unhealthy food health and physically Income weak Discrimination & Poverty Disability Exclusion and loss of income

  15. Millenium Development Goals • Eradicate extreme poverty and hunger • Achieve universal primary education • Promote gender equality and empower women • Reduce child mortality • Improve maternal health • Combat HIV/AIDS, malaria and other diseases • Ensure environmental sustainability • Develop a Global Partnership for Development

  16. MDGs • 21 quantifiable targets, measured by 60 indicators • Example Goal 2: • Target 2a: Ensure that all boys and girls complete a full course of primary schooling 2.1 Net enrolment ratio in primary education 2.2 Proportion of pupils starting grade 1 who reach last grade of primary 2.3 Literacy rate of 15-24 year-olds, women and men

  17. Content/LC studies • Level of living • Housing and infra structure • Education • Access to information • Reproductive health • Employment • Economic indicators • Washington City Group Screening Questions • ICF matrix and alternative measures on activity, participation, environmental barriers • Disability component • Physical health including HIV/AIDS • Mental health • Education • Employment • Assistive technology • Access to services, accessibility at home and in the community • Income, grants, expenditure, etc. • Role in the household • Need for support in daily life

  18. Service delivery gap Services Received (of those who needed) (%) Namibia Zimbabwe Malawi Zambia Health 72.9 92.0 61.0 79.3 Welfare 23.3 23.6 5.0 8.4 Counselling for family 41.7 45.4 19.5 21.9 Assistive devices 17.3 36.6 17.9 18.4 Medical rehabilitation 26.3 54.8 23.8 37.5 Counselling for disabled 15.2 40.8 10.7 14.3 Education 27.4 51.2 20.3 17.8 Vocational training 5.2 22.7 5.6 8.4 Traditional healer 46.8 90.1 59.7 62.9

  19. Access to information (% households without access) Namibia Zimbabwe Malawi Zambia dis. n/dis. dis. n/dis. dis. n/dis. dis. n/dis. __________________________________________________________ Telephone 44.2 38.1 19.3 18.7 56.3 53.0 61.8 59.3 Radio 16.4 12.7 28.7 24.5 12.1 9.8 30.5 27.9 Television 68.2 59.7 62.5 60.9 66.8 62.0 60.4 58.3 Newspaper 71.7 58.8 57.6 53.2 74.1 66.6 70.0 69.1 __________________________________________________________

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