PRSPs and Disabled People

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					The Disability Dimension in
 Economic Development
  and Poverty Reduction
     Strategy Papers
    The Experience of Members of the
International Disability and Development
           Consortium (IDDC)
 Exploratory Meeting on Global Partnership for
         Disability and Development,
               December 9-10, 2003, Rome

                   Sue Stubbs, Co-ordinator,
     International Disability and Development Consortium

Contents                                                                           Page

Executive Summary                                                                  3
1. What is the IDDC?                                                               5
2. Disability Dimension in Economic Development                                    6
3. Experience of IDDC members and PRSPs                                            10
4. Key Challenges and Opportunities in Disability and
   Development                                                                     11

ANNEX 1. Summary of IDDC member feedback on PRSPs and
economic strategies                               13
ANNEX 2. Disability and Development Trends.       16
ANNEX 3. Example from Mainstream INGO – Inclusive
Development                                       17

IDDC is a consortium, not an organisation, and as such consists of member agencies
with diverse perspectives and experiences. IDDC celebrates this diversity whilst
acknowledging the common commitment to Inclusive Development and the Rights of
Disabled Persons. The following paper does not claim to represent ‘the IDDC
perspective’, neither does it claim to represent the views of all individual member
agencies. In addition, the paper was compiled at short notice and several member
agencies will not have had time to contribute or comment to this paper. This does not
mean that they do not have substantial experience to share. The author has tried to
reflect the experience and perspectives of member agencies, but takes final
responsibility for the opinions and analysis presented in this paper, and is responsible
for any errors.

IDDC Member Agencies
1. ADD (Action on Disability and Development)                               UK
2. AIFO (Associazione Italiana Amici di Raoul Follereau)                    Italy
3. Basic Needs                                                              UK
4. CBM (Christoffel Blindenmission)                                         Germany
5. DCDD (Dutch Coalition on Disability and Development                      Netherlands
6. DSI (Danish Council of Organisations of Disabled Persons)                Denmark
7. FIDIDA (Finish Disabled People’s International Development Ass.)         Finland
8. Handicap International                                                   France
9. Healthlink Worldwide                                                     UK
10. Leonard Cheshire International                                          UK
11. NAD (Norwegian Association of the Disabled)                             UK
12. PHOS (Platform Disability and Development Cooperation)                  Belgium
13. OVCI La Nostra Famiglia                                                 Italy
14. Save the Children                                                       UK
15. SHIA (Swedish Org. of Disabled Person’s International Aid Ass.)         Sweden

Executive Summary

What is IDDC? IDDC is a consortium of 15 agencies from 10 countries. Its strength is its
diversity, its united common aim and its commitment to inclusive process and efficient
use of resources
Economic Development. It is important to keep a broad, comprehensive concept of
economy – core dimensions of poverty include social exclusion. Lack of access to basic
needs is central, economics is not just about finance and income
Disability Dimension. Particularly for disabled persons, the relationship between
poverty and exclusion is crucial. For example, 87% of the world’s disabled children live
in the South, and unless they and their families have access to basic, appropriate
rehabilitation, aids and equipment, they have no chance of participation.

Evolution of Disability and Development Policy and Practice. Over the last few
decades, there have been several broad strategies, e.g. the development of the
Disability Movement, high-cost low impact strategies such as special education,
specialist institutions, sponsorship, the ideally low-cost, high-impact strategy of CBR,
and Inclusive Education. In addition there have been many other approaches focusing
on single impairments, particular situations, particular age groups, and specific
technologies. A key problem has been that there has been little dialogue between the
key actors in these approaches, and there is now a danger that ‘the baby will be thrown
out with the bathwater’. There is something to learn from all of these initiatives.

Current Situation in relation to Disability and Economic Development. In relation to
a specific economic focus, the following are strategies supported by different IDDC
members: micro-credit programmes, sustainable livelihoods, economic empowerment
through investment and shares, employment quotas and national budgets. In the
broader economic framework, current strategy focuses on Mainstreaming (policy and
practice in different sectors), and specific Disability Focus including capacity building of
DPOs, focus on particular impairment groups, age groups, challenging situations. In
addition there are several over-arching strategies such as CBR (some examples),
information sharing and communications, and the development of particular

IDDC members and PRSPs. On the positive side, member agencies have engaged
with the PRSP process in several countries. Lobbying has resulted in more awareness.
There is an example of a national CBR programme (Uganda) being integrated into the
PRSP process. A booklet guiding NGOs and DPOs on PRSPs has been produced in
Mozambique. There are many, many challenges. Basically, disability is not addressed in
PRSPs. If it is mentioned at all, it tends to be seen as a social welfare issue, and
disabled people are not seen as economically active. DPOs are not involved or
consulted for many reasons – they lack capacity, accessible materials and are not
perceived as stakeholders. In general, governments are not motivated to engage civil
society. Real action to eliminate the poverty of the poorest does not happen. The macro-
economic frameworks are not up for debate.

Key Challenges and Opportunities. The main challenge continues to be to get
disability on the mainstream agenda in all sectors, and to recruit disabled persons in all
sectors. The Twin Track approach is essential to promote Inclusive Development, and
should be applied to budgeting, recruitment and to programmes.

Risks: There are many risks with today’s current trends; there could be a limited
concept of ‘rights’ that prioritises the civil and political and ignores the social/ economic,
or basic rights to food, life, clean water and sanitation. Mainstreaming alone will not
promote Inclusion – again there is a danger of losing the specific focus on disability, or
limiting this to the organisational and political empowerment of DPOs. It needs to include
basic rehabilitation and production of aids and equipment, to enable disabled persons to
develop basic life skills. There is a risk of the imposition of a North-based agenda – one
that does not take community into account, and is not really aware of poverty and
development issues. There is also a danger of ‘issue overload’ – disability needs to join
forces with other issues of diversity and discrimination and develop common strategies.
Opportunities. A ‘fleshed out’ twin track approach that builds on best practice from
previous decades would promote Inclusive Development. Inclusive processes should be
supported – participatory methodology, not quick fix with big money. Listening to smaller
and excluded voices. Awareness on poverty and development needs to happen in the
disability movement. Finally, maintaining a broad, comprehensive understanding of
poverty and economics in relation to disabled persons, not ‘throwing the baby out with
the bathwater’.
What is needed is a strong skeleton(clear understanding of Inclusive Development and
the Twin Track Approach), the Flesh: (cultural and contextual relevance – utilising and
unlocking local resources), and Life-blood (on-going participatory monitoring and
evaluation including all stakeholders, learning from past experience about particularly
vulnerable groups.) Inclusive Development incorporates the realisation of Rights for
Disabled Persons, but it is more than this, it is about creating a new type of society that
tolerates and celebrates all types of difference

1. What is the IDDC?

1.1. IDDC is a consortium of 15 international NGOs currently based in 10 different
European Countries. In addition, there is a wider network of south and north based
agencies and individuals who share information and experience through an email
mailing list, the website and participation in various IDDC seminars and meetings.

1.2. IDDC is very diverse. Members include DPOs, information-sharing networks and
national platforms, general development agencies, and disability and development
NGOs with specific areas of focus, e.g. capacity building of DPOs, mental health, visual
impairment, conflict/emergency situations.

1.3. IDDC Members are united by a common aim and core principles which include
        A Rights-based approach to disability and development
        Commitment to Inclusion – as a goal and process. Inclusion is everyone’s
         business – it is about creating a different sort of society, not just inserting one
         particularly group into the status quo.
        Partnership and collaboration – a commitment to work with disabled persons,
         their organisations and local communities.

1.4. What does IDDC do? IDDC’s core activities can be categorised under these 3
strategic objectives.
       i. Influence other agencies to integrate the disability perspective and promote
          inclusive development. For the last few years, this has been primarily through
          the work of the EU Influencing Task Group, which works in close collaboration
          with the European Disability Forum and HelpAge International.
      ii. Share experience, skills, knowledge in order to improve efficiency, quality and
          impact of member agency’s work at all levels. As a consortium, IDDC’s main
          activity has always been to ‘consort’, to come together to learn and share with
          each other. This is done through Members meetings (once or twice a year), the
          CBR Task Group, field-based seminars which promote collaboration between
          IDDC member’s staff and partner agencies at field level. Topics have included
          Inclusive Education and Disability and Conflict.
     iii. Produce and share quality information on disability and development. This has
          happened through the above activities and also through email mail lists, the
          website, publications, and open seminars on key topics such as disabled child

1.5. What is IDDC’s capacity and structure? Consortium’s have a tendency to either
end up being dominated by a small minority, over-reliant on a paid secretariat, or to
dissolve through lack of commitment and interest. IDDC’s success has been its ability to
maintain the active interest of all its members (80-90% attendance rate at all meetings)
through keeping a very efficient and small secretariat and being committed to ensuring
that everyone’s voice is heard, and that diverse views are respected. IDDC began in
1992 and was managed through a voluntary committee until 1999. Since then there has
been a paid co-ordinator (one day per week) and administrative support (1-2 days per
week). The roles of Chairperson, treasurer, task group leaders are all voluntary and
every effort is made to ensure that members are actively involved in areas that interest
them. The potential contribution of IDDC to disability and development is huge and as
yet largely untapped, and so in 2004, IDDC will become a registered international NGO
so that its capacity can increase, while maintaining its commitment to its principles.

2. The Disability Dimension in Economic Development
2.1. What is Economic Development? Economics is ‘the science of the
production and distribution of wealth’, with wealth referring to community resources,
goods and services as well as money.1 In practice, the term ‘economy’ is frequently
used to refer to money only. The opposite of wealth is poverty. What is poverty? Again,
there is a danger of narrow or culturally-specific definitions being used. In essence,
poverty is ‘multi-dimensional’ – income level is only one factor2. Other core dimensions
of poverty include; lack of access to good health, education, transport, clean water and
sanitation. Inequality and social exclusion are also core concepts in understanding
poverty. Poverty is not just about lack of resources, it is also about social relations (lack
of relationship with family, community, local infrastructures). This includes issues of
ownership, control, participation and access. World Bank experience in East Asia has
shown that reducing inequality lifts people out of poverty3.

Discussions on economic development, wealth and poverty must include the
issues of discrimination leading to exclusion and inequality and lack of access to
basic needs and services as well as income and employment.

2.2. The Disability Dimension. For disabled persons, more than for any other
marginalized group, the relationship between poverty and exclusion/discrimination is
crucial. 87% of the world’s disabled children live in the South, in economically poorer
countries. The majority have mild impairments and due to lack of information, skills,
resources and prejudice, are often denied the right to life, daylight (kept enclosed in
back rooms), basic food and the opportunity to develop basic living skills. For the ones
that survive and become adults, the on-going discrimination prevents participation and
access that would enable them to earn a living and contribute to society, keeping them
in the poverty trap. From birth, the disabled child is excluded from the ‘wealth’ of the
family and community. This is not a simple issue of discrimination – in my experience of
travel to over 30 countries globally, most families begin by seeking help and support for
their disabled child. The problem is that they lack access to appropriate, relevant
information and skills, and instead spend precious resources taking the child to local
traditional and religious healers, who also lack knowledge, and inadvertently cause the
child’s impairment to become worse through over-protection (keeping the child immobile
and indoors away from the community prejudice).

The disability dimension in economic development must focus on the disabled
person from birth onwards and acknowledge that disabled people are involved in
a complex cycle of poverty, ignorance and discrimination.

2.3. Evolution of Disability and Development Policy and Practice. The
following are examples of key approaches/strategies over the last few decades in
relation to disability and economic development. Often these have been happening in
parallel with each other, with very little dialogue between the key actors.
 Rise of the Disability Movement. The disability movement was developing globally,
    often influenced by the movement in more economically developed countries of the
    North, and particularly in Africa, by other civil rights movements. Arguably the focus
  Concise Oxford Dictionary
  DfID (2001) ‘Poverty: Bridging the Gap’ p20
  ibid, p21

   has been more on civil and political rights, addressing the macro-structures and
   policies. The initial leaders of this movement were often disabled persons who had
   acquired impairments later in life (after having received education and opportunities
   earlier) or who had benefited from special schools/institutions for a small proportion
   of disabled persons. In more recent years the challenge has been to establish a
   grass-roots constituency including the poorest disabled persons, all impairment
   groups, women and children.
 High-cost specialist input focused on an elite few of the disabled population –
   special schools, residential homes, individual sponsorship etc that have often
   produced leaders in the disability movement, or successful disabled people who
   ‘integrate’ and do not feel the need to be involved in disability issues. This approach
   was not unique to disability, it reflected thinking of the time – ‘centres of excellence’.
   What has been the economic impact of this approach in terms of the individuals and
   their subsequent roles and responsibilities in society and the disability movement? An
   interesting question.
 The launch and spread of ‘CBR’ (Community Based Rehabilitation) ideally as a
   low-cost, high impact strategy. The best CBR programmes used disability as a
   catalyst for inclusive community development, and enabled the poorest disabled
   persons to develop basic life skills that were a pre-requisite to any type of
   participation. These programmes often had very importance micro-economic benefits
   for individuals, families and communities.
 Inclusive Education. The education sector arguably more than any other sectors
   has experienced the shift in the disability paradigm, and has many examples of good
   and pioneering practice in a wide range of cultures. Although the argument that
   education is the best way out of poverty has many weaknesses, particularly in very
   poor communities with few jobs, it is still a key factor in economic development.
The above are examples of the key broad approaches to disability and development. In
addition there have been many other approaches focusing on
   i)       single impairments: prevention, rehabilitation and treatment (e.g. eye camps),
   ii)      particular situations and issues, e.g. conflict/refugee situations, landmines
   iii)     particular age groups and aspects of a disabled person’s life, e.g. early
        childhood development, employment and income generation
   iv)      Particular technologies – production of aids and equipment, rehabilitation

Over the last few decades, there have been several very different strategies
addressing disability in development. A key problem has been the lack of
relationship between these strategies, lack of collaboration/discussion between
key actors, and lack of an overall policy framework. The danger would be to reject
outright any of these strategies without assessing their real and potential

2.4.Current Situation in Relation to Disability and Economic
2.4.1. Specific Economic Focus. The following are examples of some key economic
approaches supported by IDDC members. There has not been time for a comprehensive
survey of IDDC member’s work in this area, and these are by no means the only
economic projects supported by IDDC member agencies

   Micro-credit programmes: Several IDDC members are involved in projects that aim
    to include disabled people in micro-credit schemes.

AKAY in the Philippines operates a group lending scheme targeting poor people,
women, disabled persons and their families. In 2002 nearly 20% of the loans were to
disabled persons and their families. (Leonard Cheshire International, UK)
In Vietnam, the Women’s Credit and Savings programme targeted disabled women and
women with disabled children. The results included; increase in disabled children
attending school and having access to essential treatment (cleft palate and eye
treatments), and families with disabled members receiving help with their harvest. (Save
the Children UK)
In Bangladesh, the famous Grameen Bank micro-credit scheme does not include
disabled persons. The campaign for inclusion started in 1997 and now there is a
Government micro-credit programme for disabled persons through the Social Welfare
dept. and 4 national commercial banks. (ADD Bangladesh)

  Sustainable Livelihoods. This is a comprehensive approach directly responding to
   poverty as a core feature of disabled persons lives. Sustainable Livelihoods
   approaches take account of people’s capabilities, assets, access to opportunities.
In India, Ghana, Sri Lanka, Tanzania and Uganda, creating Sustainable Livelihoods is a
core approach to work with people with mental health problems and their families.
Working with the whole family, consultation and choice are key components. It
incorporates access to appropriate training and access to credit, work in the home in the
society. (Basic Needs, UK)

   Economic Empowerment through Investment and Shares. In South Africa, a
    radical policy to transfer ownership, management and control of the country’s
    financial and economic resources to the majority of citizens is now beginning to
    include disabled persons
The DEC (Disability Employment Concerns) is an empowerment investment trust
established by 7 S African disability NGOs. DEC is now actively participating in the
Black Economic Empowerment policy framework of the S African government, and now
holds investments in gaming (lottery), banking and financial services, media, petroleum,
mining and manufacturing industries. These financial returns are used to sustain human
rights and development work programmes. (DSI, Denmark)

   Employment Quotas and National Budgets. Several countries have a policy to
    employ a certain percentage of disabled persons in the public sector
In Bangladesh, after substantial campaigning, there is now a policy of a 1% quota for
disabled persons in the public service sector. The national budget has been analysed
from a disability perspective and campaigns have resulted in an increase of the
allocation for poverty reduction for disabled persons. (ADD, Bangladesh)

2.4.2. Broader Economic Development. The above strategies are within the context of
broader trends in disability and development cooperation:
 Mainstreaming Policy4. This is the current primary focus and at this stage is
   reflected in Government policies and guidelines with some examples of
   implementation, but not yet on a large scale.

 European Disability Forum (2002), author Sue Stubbs, ‘Policy Paper on Development Cooperation and
Disability’. This paper focuses on mainstreaming and gives examples from current policy and practice on
mainstreaming. Available from and

National governments with policies/statements on mainstreaming disability include: UK,
Nordic Countries (Norway, Sweden, Denmark, Finland,) Italy, Australia, USA, South
Africa, Uganda. Each document has its own particular way of analysing mainstreaming

  Mainstreaming in Practice. There are an increasing number of pioneering practical
   examples of mainstreaming in different sectors, but these examples are happening in
   relative isolation and have not been pulled together and disseminated.
Mainstreaming according to different sectors:
Education: many examples of inclusive education including at national level, from
kindergarten through to secondary, but not so much in higher education.
Water and Sanitation: DfID is funding a research project to integrate disability into water
and sanitation service providers. Its aim is to improve knowledge and use of appropriate
and affordable aids, technologies and approaches.
Transport: DfID is also funding a research programme on mainstreaming disability into
the Transport sector, pilot programmes have been implemented in S Africa, Malawi,
Mozambique and India. A compendium of guidelines for transport planners will be
produced. 3 categories of barriers to access were identified: structural, social and
Political: Enabling disabled people to have access to elections has been successful in
several countries, particularly Kosovo and Bangladesh. The International Foundation for
Election Systems has a Disability Access project with funding from Finland.
Community Development: There are several examples of mainstreaming disability
awareness into grass-roots community development organisations, in India, Bangladesh
and Nepal. (Handicap International and CBM are jointly operating programmes in S
Asia). Many CBR programmes also take this approach of integrating a disability
component into general community development.

   Specific Disability Focus. To promote Inclusive Development requires a ‘twin-track’
    approach. In addition to removing the barriers in society, as described above, it is
    necessary to focus on disabled persons and their families themselves. These
    approaches include:
          o Capacity building of DPOs; some agencies focus on political and
              organisational capacity building (ADD), whilst others take a holistic
              perspective and also include ‘strengthening the individual’ (SHIA) and
              enabling them to access appropriate rehabilitation, aids and equipment.
              (Other agencies focusing on capacity building of DPOs: DSI, FIDIDA,
          o Particular impairments; focusing on persons with particular impairments,
              particularly the more excluded and marginalized groups; persons with
              mental health problems, deafblind persons, people with leprosy etc
              (BasicNeeds, SENSE, AIFO, CBM, SightSavers International
          o Age groups; focus on disabled children (Save the Children), or elderly
              persons (HelpAge international includes disabled elderly persons in their
              focus). Promoting self-advocacy and participation of these groups
          o Challenging situations: conflict and refugee situations (Handicap
              International). Leonard Cheshire International focuses on training and
              development with residential homes in many different countries, promoting
              disabled person’s participation in management and the community.

   General Strategies Supporting the Twin-Track approach. In addition to the
    above, there are other strategies that support both a specific focus on disability and
          o Information sharing, networking and raising awareness: DCDD and PHOS
              both work within their own countries to raise awareness on disability and
              development and to lobby their own governments to integrate disability
              concerns. Healthlink Worldwide specialises in disability resources and
              participatory communication strategies.
          o Specific technologies and resources: Motivation focuses on production of
              appropriate wheelchairs and seating. EENET produces and disseminates
              accessible, practical resources on Inclusive Education.
          o CBR programmes have the potential to really implement the Twin Track
              approach with a grass-roots basis. They can have a strong focus on the
              community and removing the barriers to participation and at the same time,
              work directly with disabled persons and their families, local DPOs, Parents
              Organisations, to help the disabled person develop the necessary life skills
              for participation. Agencies using the CBR strategy include AIFO, NAD,
              CBM, FIDIDA, Handicap International, Save the Children UK.

3. The Experience of IDDC members with PRSPs
3.1. What is this experience? Six IDDC member agencies contributed their experience
with PRSPs (not all IDDC members were available to reply in the short time-frame as
many people are away on field visits). See Annex 1 for a summary of responses.

Positive feedback
 Member Agencies have engaged with the PRSP process in Uganda, Mozambique,
  Zambia, Baltic countries, Bosnia, Sri Lanka and Bangladesh amongst others.
 The national CBR programme in Uganda (NAD) operates within the PRSP
  framework, and the procedures for planning, budgeting and reporting have been
  streamlined into the Poverty Action Fund Guidelines. Aim is for the programme to
  become a Priority Area and to receive a conditional grant
 ADD and HI actively lobbying in Bangladesh to ensure disabled person’s
  participation and for disability issues to be included in the final PRSPs of December
 In Mozambique, a booklet has been published on PRSPs in Portugese, to enable
  NGOs to understand the process, and encouraging civil society participation,
  including DPOs (supported by FIDIDA)
 More INGOs are getting involved in lobbying, raising awareness and challenging the
  lack of disability perspective in the PRSP process.

 In general, disability is not addressed in PRSPs
 If disability is mentioned, it is categorised as a ‘social welfare’ issue rather than
  seeing disabled persons as economically active. This can be a negative influence.
 DPOs are not consulted in the PRSP process. There are many reasons for this;
          o DPOs struggle with many issues, and often have limited education and
               lack of experience/ skills, and are not able to formulate their experience in
               competition with others.

    ‘Disabled people tend to get ‘drowned in the stream rather than mainstreamed!’

          o PRSP processes are not accessible, the materials/ communications are
              not in accessible formats such as Braille, tape, sign language.
          o Disabled Persons are not considered to be stakeholders and are not
              necessarily invited to participate
 Concrete actions to reduce poverty amongst the poorest persons are not happening,
  it remains at policy level
 Governments in weak democracies have no real motivation to involve civil society, it
  would probably be against their interests. Formal dialogues can take place, but real
  participation takes time and commitment.
 The larger macro-economic frameworks are not negotiable.

4. Key Challenges and Opportunities in Disability and
It is commonly acknowledged that there is currently a major shift happening in terms of
disability and development policy and strategy. This is described as being a shift from a
charity to rights approach, from a medical to a social model. (see annex 2). There is a
great danger during this shift of over-simplifying and of encouraging a pendulum swing
that then ‘throws the baby out with the bathwater’ and rejects core perspectives and
approaches that are necessary for Inclusive Development.

4.1. Challenges:
 To continue to get disability on the development agenda in all sectors (not just in
  social and health sectors)
 To ensure that disability is given specific mention, and not just subsumed under
  terms such as ‘vulnerable groups’
 To recruit disabled persons into decision-making roles in development, and to be
  involved in consultation
Twin-Track Approach
 To ensure that the Twin-Track approach is properly understood and implemented
 To apply the twin-track approach in budgeting – specific budgets and allocation
  within mainstream budgets
 To apply twin-track approach in roles and responsibilities – to raise awareness with
  civil servants and to also ensure that there are personnel with specific responsibility
  for disability
 To ensure that funding criteria and assessment reflects the twin-track approach

4.2. Risks
 Limited concept of ‘rights’. There could be a tendency to focus on civil and political
  rights only. Rights for poor disabled persons in the South, needs to focus on the
  basic rights to life, development, food, clean water and sanitation etc – the social and
  economic as well as civil and political rights. (see Annex 3)
 Mainstreaming alone will not produce the rights of disabled persons and inclusive
  development. There is a risk that the specific focus on disability that is needed to
  build capacity at a personal level (in the South, appropriate rehabilitation, aids and
  equipment etc are vital for disabled children and adults in order to enable them to

 Imposition of north-based disability rights agenda. There is a risk that the voices of
  the very poor disabled persons in the South, particularly women, children and those
  from groups marginalized within the disability movement, will not be heard. The
  South-based rights agenda would take account of community rather than just the
  individual, and of basic poverty and development issues.
 Issue-overload – competition with other issues of discrimination/difference. As donor
  agencies come under increasing pressure to include ‘issues of difference and
  discrimination’, there is a real danger of issue-overload and of lack of capacity to
  incorporate many different issues in competition with each other. Working together
  with agencies focusing on issues such as age, HIV/AIDs, gender, ethnicity etc could
  help develop common strategies to influence donors. Disability needs to get out of its
  ghetto into the Diversity arena.

4.3. Opportunities:
     A fleshed-out twin track approach will build on the best practice from the last few
      decades of experience and will increase the focus on creating inclusive societies and
      removing disabling barriers
     For the experience of inclusion from the disability perspective to become a catalyst
      for including all marginalized groups – links with other ‘issues of difference and
     Promoting Inclusive Process as an essential strategy in promoting inclusive
      development; accessible participatory methodology, tolerance/celebration of
      difference, collaboration, listening to smaller/excluded voices
     Raising awareness of poverty/development issues in the disability movement.
     Maintaining a comprehensive understanding of poverty and economics in relation to
      disabled persons – not ‘throwing out the baby’ by holding a limited perspective.

4.4. What is needed?
 The Skeleton: Very clear policy/principles. Clear definitions and understanding of
  Inclusive Development and the Twin-track approach
 The Flesh: Cultural and contextual relevance/ flexibility. Un-locking and using local
  resources (material, personnel, financial). Not drowning local initiatives in over-
  funding. Planned, collaborative input over long periods, using local knowledge and
 The Life-Blood: Accessible participatory monitoring, review, evaluation. Real
  accessible, participatory monitoring is difficult and time-consuming. But in the long-
  term, will be the main guarantee of sustainability, effectiveness and relevance. There
  is now a lot of knowledge about groups who are vulnerable to be excluded, even
  within the disability movement. It is possible to plan to include all stakeholders.

       Inclusive Development incorporates the realisation of Rights for Disabled
     Persons, but it is more than this, it is about creating a new type of society that
    celebrates all types of difference, does not tolerate discrimination, and listens to
                         all voices. It is everyone’s responsibility.

ANNEX 1: IDDC Member’s Experience with PRSPs and
Economic Strategies.

Norwegian Association of the Disabled
CBR and PRSPs in Uganda
 NAD supports a National CBR Programme in Uganda
 Decentralised system – focus on districts, sub-counties and community level
 Dependent on local ownership, NAD offers technical support
 CBR as part of local community development
 Within PRSP framework and advocates mainstreaming in all sectors
 Procedures for planning, budgeting and reporting have been streamlined within the
  Poverty Action Fund Guidelines issued by M of Finance, Planning and Economic
 Aim is for CBR to be included as one of the priority areas (currently 11) and then
  extended into all areas receiving conditional grants
 When CBR is a priority area, the cross-cutting element in other priority areas should
  be safeguarded – Twin-Track approach needed

SHIA (Sweden)
 Partners in Sri Lanka, Baltic countries and Bosnia have worked to influence their
  PRSP processes
 In general SHIA has very limited experience of work within the PRSP process
      o Local DPOs generally do not have access to these processes
      o It is not enough to receive an invitation
      o Accessible formats (Braille, sign etc) are important
      o Members have limited education and lack experience/ skills for participation
         and to be able to formulate their experience in competition with others
 SHIA does not have country representation – more difficult for local DPOs to get real
  chance to participate
 Needs to be an active request, plus capacity building of DPOs

DSI (Denmark)
   Black Economic Empowerment (BEE) programme in South Africa is a government
    policy framework. BEE originally targeted race, then gender, and now disability is
   DEC (Disability Employment Concerns) is an investment trust established by 7 major
    disability NGOs.
   DEC participates in BEE’s major investments such as the lottery, banking and
    financial services, media, health, petroleum, mining and manufacturing.
   In addition DEC is influencing the companies to employ disabled persons
   DEC is asking the WB to provide much needed investment capital.

Action on Disability and Development (UK)
Disability and PRSPs in Bangladesh
PRSP Process
 Disabled people were not involved in the consultation process of the drafting of the
   2002-03 PRSP. They were not considered stakeholders
 ADD took part in early discussions and raised the issue of DP’s participation
 ADD did advocacy – newspaper and broadcasting

   Interim PRSP has only brief mention of disability, but WB and IMF staff review of the
   I – PRSP was more progressive, advocating a comprehensive social protection
   strategy in the full PRSP
 ADD will be involved in the finalisation of the PRSP in December 20004, and will
   involve media and civil society to create pressure on the Government to involve DPs.
 Government of Bangladesh is static and DPOs are often not strong enough to
   analyse policies and to do advocacy
 WB can monitor governments to see if DP’s participation is ensured
Integrating Disability into Economic Development Strategies
 Micro-credit: Grameen bank programme does not include disabled persons.
   Campaign started in 1997 – Government has now started micro-credit programme for
   DPs through Social Welfare dept. and 4 commercial banks
 Budget Allocation: analysing national budget and campaigning for increase to include
   disabled persons is on-going ADD strategy. Has been increased for 03-04
 Employment: Previously prohibited for disabled persons to be employed in public
   service. After campaigns, there will now be a 1% quota for DPs in all public service
 ‘Hardcore Poor Project’ in two of the poorest districts of Bangladesh, designed by
   WB and financed through Social Development Fdn.

Handicap International (France)
Disability and PRSPs in Bangladesh – an analysis
 HI did research on disability in the IPRSP March 2003 for Bangladesh
 They found that disabled persons are not mentioned in the situation analysis,
   strategy or action plan of the document
 Disabled persons are mentioned in the section on Participatory Consultation, as a
   socially vulnerable group that had a lack of adequate participation in the process
 In Chapter 4 on Poverty Targets, disabled persons are not mentioned at all. In
   Chapter 5 on the strategy, disability is not mentioned as a cross cutting theme.In
   Chapter 6, improving education, vocational training and science and technical
   education are mentioned but disabled persons are not included.
 Physically disabled persons are mentioned under social protection – so they are only
   seen under the social sector, rather than as economically active.
 The PRSP Sourcebook conveys a wrong impression of DPs. It limits disability as a
   Social Protection issue – and this mention is actually a negative influence, and
   reduces the potential for disabled persons to be seen as economically active.
 HI gives a list of recommendations about how a PRSP could include disability in all
 Disabled persons should not just be included under ‘vulnerable groups’
 Socio-economic integration of disabled persons is not easy, but we should
   demonstrate that it is possible and the PRSP is a unique opportunity.

FIDIDA (Finland)
Positive steps
 Supporting NGOs including DPOs to get involved in PRSP processes in Zambia and
  Mozambique. KEPA (Finnish NGO network in Mozambique) is following the PRSP
  process in these countries

 Mozambique – the Finnish NGOs KEPA has published a simple booklet on PRSPs
  (PARPA in Portugese), stressing the necessity of civil society (including DPOs)
 DPOs have to some extent been involved in the national NGO networks concerning
 Some dialogue and lobbying of Government/donors on disability issues is happening,
  also observation of the participation processes.
 However, key problem is that concrete actions to reduce poverty amonst poorest
  people are not happening – remains at policy level. E.g. Zambia is not prioritising
  PRSPs in its budget. Implementation is the core challenge
 Getting the specific voice of disabled persons heard is another core challenge – tend
  to be mentioned amongst ‘vulnerable groups’ but have to compete for attention.
  Tendency to get ‘drowned in the stream’ rather than ‘mainstreamed’
 True mainstreaming for disabled people requires some additional measures
 Poor people do not understand what PRSPs are about – it is an abstract concept –
  very little educational material on PRSPs
 Governments in weak democracies have no real motivation to involve civil society – it
  would probably go against their interests. Formal meetings on ‘dialogue with civil
  society’ can take place, but there is no real participation, which would take time and
  commitment. WB funds governments, not poor people.
 In Zambia – government is not implementing the PRSP. Even when views of civil
  society are included in the PRSP, the important macroeconomic framework is not
  discussed – it is taken as given.
 DPOs are addressing many complex issues and there are no resources to educate
  and capacity-build DPOs on PRSP participation.

ANNEX 2             Disability and Development Trends

          Shifting from…                             Towards……
1. Medical model                          Social model
2. Charity model                          Human Rights
3. DPOs – urban-based, male               Developing grass-roots
   leaders,                               constituency, gender and child
4. High cost/ low impact (e.g.            Low cost/ high impact (e.g. CBR,
   special schools, institutions,         mainstreaming)
5. Professionals defining disability      Disabled people defining disability
6. Service delivery                       Partners in development
7. Segregated, ‘special’ education        Inclusive education
8. Working FOR disabled people            Working WITH disabled people and
   and their families                     their families. ‘Nothing about us
                                          without us’
9. Support to institutions                Alternatives and de-
10. Implementing programmes               Collaborating with other agencies
   (vertical approach)                    and mainstreaming
11. Special services for disabled         Access to the mainstream
12. Focus on the individual               Focus on the whole community
   disabled person
13. Disability is the responsibility of   Multi-sectoral collaboration
   the Health/Social Sector
14. Specialist or nothing                 Twin-track approach
15. Cause of impairment                   Cause of disability

ANNEX 3: Example from Mainstream INGO on Inclusive

               Focus on Poverty before Impairment!
         Moulynie’s story – everyone’s basic needs are the same.
                       Presented at IDDC Seminar,
                     Jonathon Flower, World Vision
                             November 2003

I met Moulynie when he was a couple of weeks old. My wife and I were living in
Mauritania in North West Africa. As was the usual practice in the town where we lived,
Moulynie’s mother had taken her mattress down to the local clinic and given birth there.
Moulynie’s feet were turned inwards. His mother inquired what could be done about
this and was told by the staff that nothing was possible. Moulynie’s mother was not
convinced and so she brought him to the local disabled people’s organisation where I
met her. I was not sure what to do, but with David Werner’s ‘Disabled Village Children’
in one hand I strapped Moulynie’s feet. I taught his mother how to do range of motion
exercises on Moulynie’s feet. Being a poor woman time was a premium, but she faithfully
carried out the exercises every time she breast-fed. My wife and I would return every
week to change the strappings and after six months the feet were beginning to
straighten. At this point the family went to visit their nomadic relatives in the desert.

More than a month passed before I saw Moulynie’s father again and he invited me round
for the usual three glasses of tea. ‘How are your family in the desert?’ I inquired. ‘Fine’ he
replied. ‘And your wife and son?’ ‘My wife’s fine, but Moulynie is dead,’ he said matter of
factly. It turned out that Moulynie had suffered from a bout of diarrhoea in the desert
and died of dehydration. I was devastated.

The NGO I worked with at the time were involved in teaching households how to make
up oral rehydrate solution (ORS). When I had met Moulynie I had seen his impairment
and sought to help. However, I failed to see the needs that he had in common with his
peers. If only we had taught his mother or father how to prepare ORS Moulynie may
have still been alive. Moulynie’s tragic death taught me that disabled children have the
same basic needs as all other children. They need to be vaccinated against the major
childhood diseases; they need to be breastfed exclusively for the first six months; they
need access to potable water; they need access to a quality education; their parents
need to practice the best agricultural techniques and find ways to increase the household
income. Since I have joined World Vision I have known the importance of promoting
inclusive development. Of course some disabled children have special needs that need to
be addressed, but this should never be at the expense of their most basic needs.