Toolkit Inclusive Social Protection

Social protection can serve as a means to alleviate poverty and vulnerability, and can help enhance the living conditions and livelihoods of low income households. Social protection programs also address the major risks that threaten people’s well-being and livelihoods, including lifecycle risks, economic risks, natural and ecological risks, and health risks. Social protection has become increasingly important in the international development agenda over recent years, including the 2030 Development Agenda, and is increasingly a major component of poverty reduction strategies and programmes across the developing world.

The relationship between disability and poverty is complex and multi-dimensional. Disability can be a cause of poverty, for example through the barriers persons with disabilities often face in obtaining an education, a vocation or social independence. It can also be a consequence of poverty as many disability risk factors such as malnutrition, poor sanitation and hygiene, and dangerous work environments are associated with poverty. An environment that enables persons with disabilities to participate equally in all areas of life – cultural, social, economic and political – can reduce or eliminate many of the risks and vulnerabilities they face. Nonetheless, there is evidence that in low income countries, persons with disabilities are at particular risk of poverty and it is therefore essential to ensure that social protection systems are inclusive of their need¹ However, evidence on the access of persons with disabilities to social protection is still scarce. Within the scope of the BMZ Action Plan for the Inclusion of Persons with Disabilities BMZ therefore mandated GIZ to commission a study to analyse how effective existing social protection programmes are in realizing the inclusion of persons with disabilities, and to generate practical recommendations on how to design inclusive social protection projects and programmes in the future.

Research design and partners

The study took place in 2014 in Peru and Tanzania, two countries where GIZ has been providing long-term support on social protection and related issues. In both locations, the researchers analyzed the overall policy framework related to social protection and disability at national level, and the implementation of a specific social protection programme at field level – the JUNTOS cash transfer programme in Peru and the Community Health Funds (CHF) in Tanzania – to investigate the extent to which these policies and programmes are inclusive of persons with disabilities.

The research was undertaken by a consortium of the London School of Hygiene and Tropical Medicine and the Technische Universität München along with national partners: SODIS and CRONICAS in Peru, REPOA in Tanzania.

The key objective of the project was to scientifically analyse how social protection systems should be designed to adequately and systematically include persons with disabilities, and to develop a toolbox for project implementers, containing practical recommendations and guidelines on the basis of the research data. The research methods included:

• analysing the existing literature and data regarding the inclusion of persons with disabilities in social protection;
• estimating the real prevalence of disability in selected geographical areas and their representation in social protection programmes;
• identifying the specific conditions of exclusion of persons with disabilities and their needs for social protection;
• assessing the policy framework for inclusion of persons with disabilities;
• and investigating how planning, implementation and evaluation of social protection programmes can be made more inclusive of persons with disabilities and their organisations.

The study design in each country included a literature review and policy analysis, a population based survey to estimate disability prevalence, a nested-control study to compare the situations of persons with disabilities to persons without disabilities, and qualitative data collection to generate deeper insights into the underlying issues. Gender was incorporated as a cross-cutting theme into the quantitative and qualitative data collection and analysis in both research sites.

In this section, the concepts of social protection and inclusion of persons with disabilities are presented and discussed, along with related terms and definitions.

Underlying the concept of inclusive social protection is the principle of a rights-based approach to development, in-line with the United Nations Convention of the Rights of Persons with Disabilities (CPRD) of 2006 and other related conventions such as the Convention on the Elimination of all Forms of Discrimination against Women. Further information on the rights-based approach to development within German Development Cooperation can be found here:

• Human rights (overview)
• BMZ Inclusion Strategy
• Guidelines

Social protection is about protecting individuals, households and communities from major risks that may lead to or exacerbate poverty and promoting longer-term investments in productive assets, human capital and livelihoods.

There is no single internationally agreed definition of social protection. Several definitions or frameworks have been proposed which cover a wide spectrum of approaches. Some definitions focus narrowly on tax financed, government-led programmes to protect people against specific risks and address poverty; others have a broader focus and consider some essential services – such as health and education – as well as supportive policies and legislation – such as labour market regulations – to be within its scope.

This conceptual debate has not prevented social protection from occupying an increasingly important role in global, regional and national approaches to poverty reduction and pro-poor growth. For example, the ILO’s ‘social protection floor’ initiative, which has secured widespread support at both global and national levels, aims to support the introduction of nationally defined basic social protection guarantees aimed at preventing or alleviating poverty, vulnerability and social exclusion. Social protection can therefore be broadly understood as strategies designed to prevent, mitigate or cope with levels of vulnerability, risk, and deprivation which are deemed unacceptable in a given society.

Social protection ‘instruments’ include labour market policies, insurance and pensions, social assistance and efforts to ensure access to basic services. These policies and programmes can be public or private in nature, contributory or non-contributory, and designed to address temporary or longer-term risks. They may be targeted – for example by poverty or geographical location – or they may be universal for all those who fit the basic criteria, for example a universal pension for people over 60. They may be delivered as stand-alone projects or programmes to address particular risks, or they may be integrated into government systems and strategies as a component of overall approaches to poverty reduction.

Social protection programmes need to be careful to address specific vulnerabilities – such as those related to gender and age – and to take into account the issues faced by groups who may otherwise be marginalised or excluded, which includes the particular needs of persons with disabilities.

References / key documents:

• Social Protection for Equitable Development (BMZ 2017)
• Inclusive Social Protection Checklist (GIZ 2020)
• Recommendation 202: Recommendation Concerning National Floors of Social Protection (ILO, 2012)
• Social security for all: Building social protection floors and comprehensive social security systems (ILO, 2012)
• Resilience, Equity, and Opportunity: The World Bank 2012-2022 Social Protection and Labor Strategy (World Bank, 2012)
• Integrated Social Protection Systems: Enhancing equity for children (UNICEF, 2012)
• GIZ: social protection

In recent decades, the understanding of disability has shifted from a medically-based focus on the perceived deficiencies of individuals to an acknowledgement that disability is a socially constructed phenomenon resulting from the interaction of impairment(s) – generally functional limitation(s) – and a person’s environment. This approach takes into account the heterogeneity of disability: both the multitude of physical, mental, intellectual and sensory impairments; and that the disabling effects and barriers that people with these impairments experiences can differ greatly from person to person depending on their circumstances, environment and life conditions.

This shift in attitudes towards disability provided the basis for the development of WHO’s International Classification of Functioning, Disability and Health (ICF) released in 2001 and its emphasis on the physical, institutional and attitudinal barriers that affect a disabled person’s participation in society – rather than on their ‘medical rehabilitation’ needs – made it clear that the inclusion of persons with disabilities in society is a human rights issue. This in turn informed the thinking behind the development of the UN Convention on the Rights of Persons with Disabilities with its focus on the equal participation of persons with disabilities in all areas of life, including education, culture, work, health and political representation.

Despite these developments, the inclusion of persons with disabilities remains a global challenge. The World Report on Disability (WHO, 2011) estimated that over one billion people live with a moderate or severe, sensory, motor or intellectual impairment leading to disability, of whom between 110 and 190 million are living with severe disabilities. Eighty per cent of all persons with disabilities worldwide live in developing countries and the evidence suggests that women, the elderly and the poor are disproportionately affected. A recent systematic review found a significant association between disability and economic poverty in 80% of studies in low- and middle-income countries, concluding that widespread exclusion from education, employment and health-care are key factors in the perpetuation of the ‘disability-poverty cycle’ (LSHTM, 2014).

The right to social protection on an equal basis for persons with disabilities is enshrined in several human rights instruments, including:

• the Universal Declaration of Human Rights (Art. 25, the right to social security for disabled persons);
•  the UN General Assembly’s ‘Standard rules on the equalisation of opportunities for persons with disabilities’ (No. 8, income maintenance and social security);
• and the UN Convention on the Rights of Persons with Disabilities (Art. 28, adequate standards of living and social protection).

While many countries have ratified these agreements and may already have introduced national legislation and policies to support their implementation, this does not always translate into concrete actions on the ground. Transforming attitudes towards disability from a ‘charity’ mentality to a rights-based discourse takes time and political will. Many development organisations and civil society partners therefore advocate a ‘twin-track’ approach in which the rights of persons with disabilities are adequately addressed within mainstream programmes in various thematic fields and contexts; while at the same time additional initiatives are undertaken to address any specific needs that persons with disabilities may have.

It is also important when considering the inclusion of disabled people in social protection programmes, to be aware of the heterogeneity of disability. People with different types and severity of disabilities may face different barriers and have different needs. For example, information in Braille (or training on how to read and use Braille) may assist people with visual disabilities, and easy-language documents or wheelchair ramps may assist people with cognitive disabilities and physical disabilities respectively. Certain mental health conditions or disabilities caused by specific conditions such as leprosy or albinism may also be more stigmatised than others, which can exclude people from programmes if either service providers or other clients maintain stigma.

In addition, gender is a factor of particular concern in designing inclusive social protection programmes given that women and men might face different risks and vulnerabilities. This may be as a direct result of their gender or due to gender discrimination and inequality, which puts them at greater risk. Women or girls with disabilities often face a double-burden of discrimination that has to be acknowledged, understood and addressed if programmes are to be made truly inclusive.

A review of evidence on disability and social protection conducted by LSHTM during this project found a limited evidence-base within the academic literature on disability inclusive social protection. It identified only 15 peer-reviewed journal articles, of which 8 (53%) were conducted in South Africa and focused on the country’s Disability Grant. However, despite these limitations, the review concluded that the evidence that does exist suggests access to social protection likely falls far below need among persons with disabilities. Further, it indicates that benefits from participation are mostly limited to maintaining minimum living standards rather than more ambitious objectives related to long-term individual and societal social and economic development.

References / key documents:

• United Nations Convention on the Rights of Persons with Disabilities
• World Report on Disability (WHO & World Bank, 2011)
• BMZ Inclusion Strategy 2019
• Include us! A study of disability among Plan International’s sponsored children (LSHTM & Plan International, 2013)

The two country studies – in Peru and Tanzania – took place in 2014. The countries were selected because they are implementing significant social protection programmes and have been receiving long-term support from GIZ in related areas. The research was undertaken by a consortium of the London School of Hygiene and Tropical Medicine and the Technische Universität München along with national partners (SODIS and CRONICAS in Peru, REPOA in Tanzania).

The basic methodology was the same in both countries but the research tools were adapted to the specific context. In each country, there were four main elements to the study:

1. a policy analysis was conducted to understand the legal and policy framework for social protection and disability through a literature review and interviews with key informants;
2. a quantitative household survey was used to establish the prevalence of disability among the general population and within key social protection programmes;
3. an in-depth case-control study was carried out to compare the experiences of persons with and without disabilities and understand the specific conditions of inclusion or exclusion;
4. qualitative interviews were conducted with all persons with disabilities identified to explore issues in greater depth as well as with local authorities and social protection programme staff.

In Peru, the study took place in Morropón district and focused on the inclusion of persons with disabilities in the ‘JUNTOS’ programme, a conditional cash transfer programme with health and education conditionalities. In Tanzania, the districts of Nachingwea, Muheza and Mbeya were selected and the research investigated ‘Community Health Funds’, voluntary insurance schemes for the informal sector that are managed at the district level.

The findings for each country are available here [hyperlink to Tanzania and Peru pages]. Many common issues and themes emerged from the two project sites and these informed the development of the tools and guidance in the ‘toolbox’ for inclusive social protection on this website. Among the key findings from the two studies were the following:

• Surveys in both countries found significant gaps between persons with disabilities and the general population in key socio-economic indicators (health, literacy, employment, poverty etc.);
• Despite greater need, neither country had intentionally attempted to design or implement social protection programmes that are inclusive of persons with disabilities;

The additional barriers and costs incurred by persons with disabilities are not being addressed by the social protection system, nor are persons with disabilities being assisted to access either mainstream or specialized health and rehabilitation services.

In Peru, the study was carried out by the London School of Hygiene and Tropical Medicine and local research partners Sociedad y Discapacidad (SODIS) and Centre of Excellence in Chronic Diseases (CRONICAS). Through the coordination of Contra Viento y Marea[1], the project worked closely with various organizations of persons with disabilities such as the National Confederation of Persons with Disabilities of Peru, the Peruvian Down Syndrome Society and the Blind Women Committee among others.

The research focused on the inclusion of persons with disabilities into JUNTOS, a conditional cash transfer programme for poor households with children. Data collection was conducted in Morropón district between July 2014 and January 2015. The workshop findings were discussed at a national dissemination workshop in Lima in January 2015 attended by representatives from government and civil society as well as international development partners.

There were four key elements to the study: a policy analysis, a population-based survey, a case-control study and qualitative interviews. In addition to qualitative interviews with households with members with disabilities enrolled in JUNTOS, interviews were conducted with persons with disabilities enrolled in Pensión 65 to explore the experience of older persons with disabilities in social protection programmes.

Key findings from the research included:

• The National Strategy for Development and Social Inclusion which sets out the framework for social protection programmes does not give specific consideration to persons with disabilities, nor does the national poverty targeting system (SISFHO);
• Mainstream social protection programmes have not been adapted to the needs of persons with disabilities and data on coverage is lacking, although the Ministry of Development and Social Inclusion has since initiated work on this area;
• In the survey district, 7.9% of people had a disability in 21.6% of households, and persons with disabilities had lower rates of literacy, were more likely to be seriously ill and were less likely to be in employment;
• Despite higher needs, there were no significant differences in enrolment in social protection programmes between persons with disabilities and the general population, except among households with a child with a disability in JUNTOS (but this was not the result of programme design).

[1] Against All Odds.

The full findings from the study are available here:

• Peru Quantitative Research
• Peru Qualitative Research
• Peru Policy Analysis

In Tanzania, the study was carried out by the London School of Hygiene and Tropical Medicine and local research partner Research on Poverty Alleviation (REPOA). The researchers were supported by Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT), the largest indigenous provider of disability services in Tanzania, and the Tanzania Federation of Disabled People’s Organizations (SHIVYAWATA), an umbrella organisation bringing together ten national Disabled People’s Organisations (DPOs).

The research focused on the inclusion of persons with disabilities into the Community Health Funds, contributory health insurance schemes run by local authorities at district level. Data collection was conducted in three districts (Lindi, Mbeya and Tanga) between July and September 2014. The workshop findings were discussed at a national dissemination workshop in Dar es Salaam in December 2014 attended by representatives from government, social protection programmes and civil society as well as academics and international development partners.

In addition to the four key elements common to both country studies (the policy analysis, population-based survey, case-control study and qualitative interviews) an additional survey of Community Health Fund members was carried out to investigate the functioning of the scheme. This was necessary to ensure sufficient data was collected on the Community Health Funds because enrolment rates in the scheme were relatively low.

Key findings from the research included:

The legal framework for disability has improved and is in-line with the UN Convention of the Rights of Persons with Disabilities, but implementation is extremely limited in all sectors;

No specific consideration has been given to the inclusion of persons with disabilities within the Community Health Funds;

Data on disability is being collected by the Tanzania Social Action Fund (TASAF), - a flagship social protection programme - but is not being used to inform programme development;

In the survey districts, 3.2% of people had a disability in 13.3% of households, and persons with disabilities had lower rates of literacy, were more likely to be seriously ill and were more likely to be in poverty.

The full findings from the study are available here:

• Tanzania Social Protection
• Tanzania Qualitative Research
• Tanzania Policy Analysis

The tools and guidance provided here are based on the findings from the research project along with products related to the inclusion of persons with disabilities and social protection developed by GIZ in other contexts and a range of other organisations globally. They have been organised in-line with the project cycle to make it easy to identify appropriate tools for each stage of the planning, implementation and monitoring process. Individual tools will, however, need to be adapted to the specific context in most cases.

For projects and programmes to be truly inclusive of persons with disabilities, it is important to engage with this issue as early as possible in the project cycle. Ideally, consideration of the needs of persons with disabilities should be incorporated into the analysis and preparation stage of the planning process to ensure that project goals, objectives and indicators take disability into account.

Whatever the approach adopted, persons with disabilities should be fully involved in the process, reflecting the principle that nothing should be decided without the full and direct participation of persons with disabilities affected by that decision.

Whether you are designing a new social protection programme or seeking to make an existing programme more inclusive of persons with disabilities, it is essential to begin by developing a thorough understanding of the existing situation. It is important to analyse the situation both internally (within your own organisation or project) and externally (the current legal and policy framework for disability and the existing social protection system). This will enable you to build on any existing work that has been conducted by your own organisation or by others, to identify major gaps and challenges that need to be addressed, and to develop a knowledge base that can be used for project design. Where high quality data on disability is lacking, it may also be necessary to directly collect data on disability prevalence in selected areas, as well as on the social protection needs of persons with disabilities, to inform the project planning process.

Internal situation analysis

The first question that needs to be addressed is what existing activities have been undertaken within your own project or organisation with respect to persons with disabilities. Does your organisation have a policy on disability? Is there a focal person within the team or group that has responsibility for coordinating activities related to persons with disabilities?

Regardless of whether these activities directly relate to social protection, it is important to do this first to make sure that any work done previously is not repeated, that potential synergies are identified, and that opportunities to collaborate or build on existing relationships with disabled people’s organisations are maximised.

The following check-lists provide a helpful starting point for this kind of self-assessment:

Simple matrix to capture relevant project activities / reports / existing relationships with DPOs etc – project output (PDF)

Inclusion Grows Toolkit on disability mainstreaming for the German Development Cooperation

Light for the World: Inclusion Score Card

If your organisation has existing social protection projects or activities underway, it is important to evaluate the extent to which these are disability inclusive. For example, were people with disability involved in the design process? If the programme is targeted, do the eligibility criteria take disability into account? Do persons with disabilities face any additional challenges in accessing the benefits of the programme? The following checklist can be used to perform a basic assessment of the inclusivity of existing social protection activities:

Social Protection Checklist Adapted from CBM ‘Inclusion made easy (PDF)

To validate the results of this exercise and provide inputs and advice going forward, it may be helpful at this stage to establish a task-team or steering group of people who combine expertise on social protection and disability. As this might include colleagues from a variety of sectors and professional backgrounds, it may be necessary to begin the meeting with a presentation on the importance of inclusive social protection. Slides for this can be adapted from the following PowerPoint presentation:

PowerPoint presentation on inclusive social protection – project output

External situation analysis

Unless most of this information is already available through an existing report or data source identified during your internal analysis, it will be necessary to conduct a situation analysis to understand the current state of play with regard to disability and social protection. This will provide the necessary knowledge base to inform discussions during the project planning phase.

Key information that needs to be gathered includes:

1. the overall legal, policy and institutional framework in relation to persons with disabilities and social protection;

2. the availability of data on disability at different levels (national, regional, district);

3. the specific conditions of exclusion of persons with disabilities and their needs for social protection; and

4. the kinds of social protection programmes that exist, the benefits they provide and to whom they provide them.

The following policy analysis framework can help to structure both the collection and analysis of this information:

Policy analysis framework – project output (PDF)

While some of this information can be gained through a desk review of existing literature and reports, interviews with key stakeholders from government, DPOs and the disability movement and development partners are likely to be an important source of information at this stage. A stakeholder mapping exercise will help to identify all the key organisations and individuals within the disability and social protection sectors and their relationships with each other; it will also provide a useful basis for managing communication and coordination with different actors at the planning and implementation stage.

Collecting Data on Disability and Social Protection

Although it may be relatively easy to collect information on the legal and policy framework, gathering data on disability that is of sufficient quality to inform project planning at the regional or district level will often prove to be a significant challenge. In this case, it may be necessary to directly collect data in order to:

- estimate the prevalence and types of disability within the regions or districts in question

- establish the degree to which persons with disabilities are included within social protection programmes

- explore the exclusion and social protection needs of persons with disabilities in relation to the general population.

The following research methodology and survey tools are based on those used in the Tanzanian and Peruvian research sites and combine both quantitative and qualitative research methods. While the overall approach is broadly applicable, both the tools and the methodology will need to be adapted to the specific context and based on a realistic assessment of the available resources. Further information on applying the methodology in practice can be found in the reports on the research findings from Peru and Tanzania.

Research methodology – project output (PDF)

Quantitative survey questionnaire – project output (PDF)

Qualitative survey questions – project output: more information here and here (PDF)

The questions on disability within the quantitative survey were based on the Washington Group on Disability Statistics ‘short set of questions’ which were designed to provide comparable data on disability for populations living in a great variety of cultures with varying economic resources. Focusing on limitations in basic activity functioning, they aim to provide a simple, brief and practical set of questions that are compatible with the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF). Further information on the ‘short set of questions’ and an e-learning tool to introduce the ICF can be found here:

Washington Group on Disability Statistics

ICF e-learning tool

Once you have developed a sound understanding of the internal and external situation regarding disability and social inclusion within your organisation and the context in which it works, you can begin to plan an inclusive social protection programme. However, if you do not already have one you should first establish an organisational plan on mainstreaming disability before beginning to plan for a specific project. This section therefore briefly covers mainstreaming disability at an organisational level, before focusing specifically on planning inclusive social protection programmes.

Mainstream disability in your organisation

A key first step to mainstreaming disability and planning inclusive programmes is to make sure that all of your programme staff are fully committed to making your organisation inclusive. Prevailing attitudes and stigma towards disability can be very negative and very widespread, so take time to make sure that all staff participate in a disability awareness training before working together on making the organisation inclusive. It is important that all staff have a good knowledge of disability issues and a human rights approach to disability and inclusion.

The training is aimed at international development staff with no or minimum prior disability training, and it is recommended that employees of all levels from management to field staff be involved for the best outcome. The manual contains training activities and role plays as well as practical tips for conducting training, and can be used either as a stand-alone one-day training or in modules.

There are also a number of manuals and documents available which will help you to mainstream disability within your organisation and ensure that your policies and practices at an organisational level are inclusive. An organisational commitment to disability, including the recruitment of persons with disabilities, creating an accessible and inclusive work environment and a commitment to mainstreaming disability in all programmes (whether disability specific or not) is an important step to take before designing new inclusive programmes.

The manual below provides practical guidance on mainstreaming disability within your organisation and creating an inclusive action plan:

VSO Handbook on Mainstreaming Disability

Building the agenda for inclusion

In some countries there may be no legal and policy framework on persons with disabilities and social protection; or the existing one may be not enforced. In these cases, there is a need to strengthen knowledge about disability and ensure it is high on both public and government agendas – including the formal policy agenda of presidents, ministers, and parliamentarians – and to raise awareness about the importance of developing inclusive social protection laws, policies and programmes.

Stakeholders such as public officials, disabled people’s organisations and the disability sector can play an important role in engaging policy-makers and ensuring that the inclusion of persons with disabilities is formally addressed in social protection policies and schemes. It is only when issues become important topics among the general public, and individuals or groups begin to take actions with clear objectives and based on strong evidence, that decision-makers begin to address them as critical issues in the political and policy agenda. There are a variety of ways to raise awareness about the rights of persons with disabilities to social protection, including public-information campaigns, media coverage, public hearings, written submissions to policy consultations, and other direct actions. These will usually be more effective if they involve a broad coalition of organisations, including disabled people’s organisations and pro-disability organisations, development partners and broader civil society groups.

Further ideas and guidance on advocacy for disability rights that can be adapted for advocacy on the right to social protection is available in this manual from Action on Disability and Development:

Disability Rights Advocacy

Planning for an inclusive social protection project

When planning an inclusive social protection project, it is important to consider who to involve from outside of your organisation. It is crucial that you involve disabled people along with other key stakeholders in social protection (who can be identified through a stakeholder analysis as described in ‘analysis and preparation’). These include national and regional government officials, representatives from Disabled People’s Organisations and disability service providers.

A good way to begin is with a planning workshop, in which key stakeholders can participate and share ideas on how best to design a programme that meets community needs and priorities. Collaborative planning tools will help you to get the most out of a meeting, ensuring that everyone can contribute their expertise and experience.

The tool below (developed as part of the ‘Make Development Inclusive’ project on mainstreaming disability in development cooperation) can help you, in collaboration with persons with disabilities and other stakeholders, to identify specific needs and potential barriers faced by disabled people and other community stakeholders in a participatory way:

Inclusion Grows Toolkit on disability mainstreaming for the German Development Cooperation

You must ensure that any venue you use for the planning workshop is accessible and that information is shared in an accessible way with sign language interpreters or Braille versions as needed. The tool below provides straightforward guidance on inclusive and accessible meeting practices:

Handicap International Guide to Improve Accessibility for Persons with Disabilities: For Inclusive Meetings!

Remember that the barriers faced by disabled people are diverse and that the programme will not be truly inclusive if these are not considered from the outset. Moreover, budgeting for inclusion during project design has been shown to be much more cost-efficient than making adaptations once the project has begun. As a general rule, budgeting for inclusion should incur between 5-7% of operational costs and 1-3% of administrative costs[1]. This brochure contains further guidance on budgeting for inclusion:

CBM Disability Inclusive Development Toolkit

It is crucial that you also specifically consider the gender dimension of inclusion, and in particular the “double burden” of barriers faced by women with disabilities. Women can often be marginalised from development processes, and women with disabilities can therefore face double discrimination. Empowering women in general, and women with disabilities in particular, and including them in all elements of a development project (from planning to implementation and results) is critical to achieving universal access and inclusion. The gender and disability mainstreaming analysis tool below provides a framework for gender and disability inclusion at the macro, meso and micro level.

DIWA Gender and disability Mainstreaming Analysis Tool

Based on the outcomes of your planning workshop, you should create a log frame to outline your goal, purpose, outcomes and activities. This will also help you develop indicators of achievement and identify potential risks. You should check through each stage of the log frame to make sure that it is inclusive. For example, if there is a public works component to the programme, could this exclude people with physical impairments? Where programmes are targeted, do the eligibility criteria for the programme take disability into account and, if so, how is this determined? If there are conditions for beneficiaries to meet, is additional support provided to assist persons with disabilities to meet them? Or, if you are planning a health insurance scheme, how will you provide information on the scheme to people with communication impairments and does the benefit package reflect their needs and those of other persons with disabilities?

The checklist below provides some key considerations to check as you create your log frame and finalise your plan for an inclusive social protection programme. This can also help to create a framework for developing inclusive Monitoring and Evaluation indicators, which is an important part of project planning.

Social Protection Checklist Adapted from CBM ‘Inclusion is easy’ doc – project output

Finally, if you or colleagues have experience with community-based rehabilitation (CBR) projects, or are interested in incorporating the principles of CBR into your social protection activities, the livelihood component of WHO’s CBR guidelines contains a whole chapter on social protection

Community-Based Rehabilitation Guidelines: Livelihood Component (WHO, 2010)

This stage of the project cycle involves putting the plans that you have developed into action to achieve desired results. It is important to refer back to your project log frame at regular intervals and ensure that you are carrying out your activities in an inclusive way and in line with your desired outcomes, with resources being implemented as planned. Developing a detailed work plan is imperative to monitor project progress and identify issues quickly.

It is also important to be flexible with your work plan if your assumptions have not been correct or if results are not being achieved. For example, in many rural settings deaf people do not have access to sign language. Providing sign language interpreters during programme activities will therefore not be helpful, and you might need to reconsider the best way to communicate with people who are deaf and cannot sign (e.g. are they literate, can you write information on a chalk board?). Through consistently checking back to your aims and objectives, you can adapt your work plan to best suit the needs of participants.

Implementing a truly inclusive project involves ensuring that disability mainstreaming is included in every aspect of the project cycle in a non-tokenistic way. It is important that you engage in inclusive practices in each area of implementation. For example, you should ensure that recruitment of staff and field team members, or community representatives, is inclusive of persons with disabilities and is gender sensitive. If there is a service delivery component, you must make sure that programme facilities are accessible and that transport is available for those unable to attend on foot. If you are setting up an insurance scheme, you must be aware of additional health expenditures related to disability and ensure that staff at health facilities have received appropriate training and treat insured clients with disabilities with respect.

Be aware that some persons with disabilities may not independently present at a project venue for a number of reasons: they may not be aware of the project because the information was not accessible, they may be aware but unable to get to the project either due to mobility or cost, they may be worried about stigmas and cultural exclusion and think they are not welcome at the project. It is especially important to work with persons with disabilities and DPOs throughout implementation and to support them in identifying other people with disabilities in the community who may benefit from the project.

Physical accessibility is also an important concern in this regard and all facilities – both new and existing – should be assessed to ensure that persons with disabilities are able to access them fully.

Handicap International Access Audit Checklist

Monitoring systems should be established at the outset of implementation to provide on-going information on how the project is progressing and whether it is progressing in an inclusive way. Monitoring will help to guide your implementation process and ensure it maintains concordance with your objectives and goals. See the section on Monitoring and Evaluation for more information on how to design inclusive monitoring and evaluation indicators.

This section includes guidance on how to conduct monitoring and evaluation of inclusive social protection programmes. It builds on the principles and materials provided in the sections on Planning and Implementation which should be read first if you are in the process of establishing an inclusive social protection programme.

Key to the success and learning of any project is monitoring and evaluation of progress towards goals and objectives. You should follow the SMART guidelines in developing indicators that are Specific, Measurable, Attainable, Relevant and Timely.

Monitoring an inclusive social protection programme

Monitoring should be undertaken through the project life cycle, using indicators determined in the planning phase. Indicators must reflect the results that you are hoping to achieve, and allow you to identify as you go along which activities are working as anticipated and which need to be amended to ensure that all the desired results are met. You should be clear not just on what the indicators will be but also how you are going to measure and record them. For example, if you want to measure the representation of persons with disabilities in your programme, how will you measure disability and how will you record and store the results in a systematic way?

The survey tools developed in the research project can be adapted to measure disability inclusion within social protection programmes, both by incorporating disability questions into routine data collection and by undertaking specific surveys on disability inclusion where necessary.

Quantitative survey questionnaire – project output (PDF)

Evaluation of an inclusive social protection programme

Evaluation should take place at specific time points – perhaps half way through and at the end of the project, and even some time after the project has ended, to reflect on whether the outcomes and goals outlined in the project’s work plan have been achieved and whether the situation and context (based on initial stakeholder analysis) have changed. Evaluation will also provide learning for future programmes on what worked well and what can be improved both in terms of social protection and in terms of mainstreaming disability. The five key components of an evaluation are Relevance, Efficiency, Effectiveness, Impact and Sustainability.

An evaluation is an important opportunity to consider the representation, participation and impact of your project on people with disabilities and the inclusion of people with disabilities generally in the community. It is also important to evaluate whether there were differences in the experience for men and women with disabilities, and people with different types of disabilities. Methods for evaluation will depend on the budget available but at a minimum must be transparent, clear and focused.

The project indicators that you have already developed will provide the primary basis for an evaluation and inclusive social protection projects will have specific indicators related to disability as well as incorporating disability into routine data collection. However, an evaluation provides an opportunity to review and assess the inclusion of persons with disabilities as a whole. As you develop the terms of reference for an evaluation, you may therefore want to incorporate additional questions and issues from the following checklist into your evaluation questions and methodology

Social Protection Checklist (Adapted from CBM ‘Inclusion is easy’) – project output (PDF)

Where evaluations involve a qualitative component, such as community feedback sessions or focus group discussions, it is obviously critical to ensure that persons with disabilities are able to fully participate in the process

Handicap International Guide to Improve Accessibility for Persons with Disabilities: For Inclusive Meetings!

In some cases, projects may have been collecting routine data on disability for a long-period of time without adequately analysing it, for example where questions on disability are included within eligibility questionnaires but core project goals and indicators do not take disability into account. In these cases, it may be necessary to undertake a specific study to analyse the data so that it can be used to inform planning for future project phases. In the following report, an analysis was conducted using an already existing dataset to better understand the challenges faced by children with disabilities

          Include us! A study of disability among Plan International’s sponsored children

Findings from project evaluations and other similar studies can be used to reinforce the evidence base for advocacy on inclusive social protection. For example, the findings may be provided to the national independent mechanism for monitoring the implementation of the UN Convention on the Rights of Persons with Disabilities.

London School of Hygiene and Tropical Medicine (LSHTM)

LSHTM was founded more than 100 years ago and is an internationally renowned school of public health policy, teaching and research. The International Centre for Evidence in Disability at the LSHTM was launched in June, 2010 with the aim of establishing LSHTM as an international centre with expertise and competence in disability research and teaching in the context of public health and development. LSHTM was responsible for the collection and analysis of data and for the management of the in-country projects, together with the two national co-ordinators. Dr Karl Blanchet was principal investigator for the project and the research team included Dr Hannah Kuper, Matthew Walsham, Morgon Banks and Rachel Mearkle.

Technische Universität München (TUM)

TUM was chosen as one of the first Universities of Excellence in Germany. Research and teaching are conducted in interdisciplinary contexts and networks exist with companies and research institutions worldwide. Professor Dr Elisabeth Wacker is chair of Sociology of Diversity within the Department of Sports and Health Sciences at TUM and her team conducts research and teaching activities in the fields of diversity, disability and rehabilitation and has previously undertaken several applied research projects on the social inclusion of persons together with Disabled People’s Organizations and other associations. Professor Wacker acted as a special advisor to the research project.

Sociedad y Discapidad (SODIS)^[1]

SODIS is a leading institution on disability law and policy in Peru. Founded in 1997 by Congressman Javier Diez Canseco, who was a prominent human rights defender, it aims to build inclusive societies where all persons with disabilities fully exercise their rights. SODIS promotes the respect of the rights of persons with disabilities, provides technical support for their empowerment and organization, conducts research and training, and elaborates policy proposals. SODIS led the research in Peru. Alberto Vásquez Encalada led the research team from SODIS.

Centre of Excellence in Chronic Diseases (CRONICAS)

CRONICAS is part of the Universidad Peruana Cayetano Heredia in Lima, recognized as one of the most prestigious institutions dedicated to research in South America. CRONICAS is one of the foremost research groups in Peru focusing on chronic and non-communicable diseases. In addition to the recognition and support of various institutions internationally, CRONICAS has been awarded “Centre of Excellence” status by the National Heart Lung and Blood Institute in the framework of the Global Health Initiative. Researchers from CRONICAS supported SODIS by leading on the quantitative elements of the study.

Policy Research for Development (REPOA)

REPOA is an independent Tanzanian research institution which creates and utilises knowledge to facilitate socio-economic development. REPOA produces high quality research, provides training, facilitates knowledge sharing and promotes the use of accurate information in policy development. Its primary research agenda is concerned with pro-poor growth and poverty reduction. REPOA led the research in Tanzania. Flora Myamba led the research team from REPOA.

The REPOA researchers were supported in their role by Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT). Set up in 1994, CCBRT was established as a community-based rehabilitation programme searching for people with cataract in Dar es Salaam. Since then they have grown to become the largest indigenous provider of disability services in Tanzania. Fredrick Msigallah represented CCBRT in the project.

Involvement of Disabled People´s Organisations (DPOs)

In Peru, through Bárbara Ventura Castillo from Contra Viento y Marea^[2], the project worked closely with various organizations of persons with disabilities such as the National Confederation of Persons with Disabilities of Peru, the Peruvian Down Syndrome Society and the Blind Women Committee among others.

In Tanzania, the Tanzania Federation of Disabled People’s Organizations (SHIVYAWATA), an umbrella organisation bringing together ten national DPOs, was involved throughout to inform each step of the research process. SHIVYAWATA assigned Felician Mkude (Secretary General) to work on the project.

Advisory Board

To provide overall guidance and expert input on disability, inclusion and social protection, an advisory board for the research project was established by BMZ with the following experts from research and practice:

• Prof. Dr. Katja Bender, Bonn-Rhein-Sieg University of Applied Sciences
• Andreas Gude, Plan International Deutschland e.V.
• Prof. Dr. Swantje Köbsell, Alice Salomon University of Applied Sciences
• Dr. Markus Loewe, German Development Institute
• Dr. Iris Menn, Christoffel-Blindenmission Deutschland e.V.
• Prof. Dr. Lisa Pfahl, Humboldt-Universität zu Berlin
• Dinah Radtke, Interessenvertretung Selbstbestimmt Leben in Deutschland e.V.
• Dr. Johannes Schädler, University of Siegen
• Gabriele Weigt, Disability and Development Cooperation

The advisory board met three times in the course of the project and provided advice to the research consortium regarding, inter alia,

• the scientific relevance, including the research design and the implementation of the research;
• the analysis and use of the results;
• the content of the toolbox and the recommendations based on the results;
• the operational relevance of the on-going research activities for international cooperation.

There are a wide range of additional resources available on disability inclusive development. Users who wish to explore these issues further might be interested in the following websites and publications:

• UN-Enable website
• Making It Work website (Handicap International)
• Disability and Development (Handicap International / AFD)
• Inclusion Made Easy (CBM)
• Inclusive Local Development (Handicap International)
• Inclusion Grows Toolkit on disability mainstreaming for the German Development Cooperation