R Lang

Disability and Poverty: the need for a more nuanced understanding of implications for development policy and practice

Abstract The international development community is beginning to recognise that people with disabilities constitute among the poorest and most vulnerable of all groups, and thus must be a core issue in development policies and programmes. Yet the relationship between disability and poverty remains ill-defined and under-researched, with few studies providing robust and verifiable data that examine the intricacies of this relationship. A second, linked issue is the need for—and current lack of—criteria to assess whether and how disability-specific and disability ‘mainstreamed’ or ‘inclusive’ programmes work in combating the exclusion, marginalisation and poverty of people with disabilities. This article reviews existing knowledge and theory regarding the disability–poverty nexus. Using both established theoretical constructs and field-based data, it attempts to identify what knowledge gaps exist and need to be addressed with future research.

Community-based rehabilitation and health professional practice: developmental opportunities and challenges in the global North and South

Purpose. This article examines the politically-charged and hotly contested issue of the role of professionals can and should play in the provision of disability services in both the global North and South, with specific reference to Community-Based Rehabilitation (CBR). Method. A discursive theoretical discussion of the issues regarding the current and normative power relations that exist between disabled people and professionals working in the health sector is undertaken, by drawing upon contemporary debates in disability studies, rehabilitation, development studies and political science. This article provides an historical analysis of the development and subsequent critique of the underlying principles of CBR. Reference is then to the social model of disability and how it relates to client–professional relationships and subsequently analyses what impact and implications this has for professional practice. Results. The normative relationships that exist between disabled people and health professionals remains a contested area. Political imperatives for increased user involvement and public sector reform necessitate the reconfiguration of client–professional relationships. However, there is scant agreement on precisely how this should take place. Conclusion. The article concludes by suggesting practical strategies on how health and care services can be provided in a manner that embraces the positive characteristics of the social model of disability, and which enables professionals, such as occupational therapists, rehabilitation professionals and physicians to act as facilitators in extending the human rights and responsibilities of disabled people.

Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development

The critical importance of unrestricted access to clean drinking water and basic sanitation for all is highlighted in Millennium Development Goal 7, which calls for the reduction by half of the proportion of people without such access by 2015. Unfortunately, little attention has been paid to the needs of such access for the one billion people living with a disability worldwide, despite the fact that the right to equal access for all international development initiatives is guaranteed in the new United Nations Convention on the Rights of Persons with Disabilities. In this paper, we review what is currently known about access to water and sanitation for persons with disabilities in low- and middle-income countries from the perspective of both international development and global health, and identify existing gaps in research, practice and policy that are of pressing concern if the water and sanitation needs of this large - and largely overlooked - population are to be addressed.

Policy Development: An Analysis of Disability Inclusion in a Selection of African Union Policies Inclusive

Contemporary debates in international development discourse are concerned with the non-tokenistic inclusion and participation of marginalised groups in the policy-making process in developing countries. This is directly relevant to disabled people in Africa, which is the focus on this article. The United Nations Convention on the Rights of Persons with Disabilities delineates the principles of inclusion in society. Furthermore, the African Union (AU) plays a key role in advising its Member States and with regard to disability issues, whose advice should be reflected in disability-inclusive policies. This paper analyses nine policy or strategy documents produced by the AU, covering the policy domains of education, health, employment and social protection that are crucial to the development of disabled people. These were analysed according to seven discrete elements (rights, accessibility, inclusivity, implementation plans, budgetary allocations, enforcement and disaggregated management information systems) using a rating scale of one to four with four being the highest level of inclusion. The process (for example, level of consultation), the context (for example, the Millennium Development Goals and the Sustainable Development Goals) and actors involved in the policy development were reviewed as far as was possible from the documents. None of the policies reached even 50% of the total possible score, indicating poor levels genuine of inclusion. Rights scored a highest rating but this is still at a low level. This suggests that there is recognition of the rights of disabled people to inclusion, but this is not generally integrated within inclusive implementation plans, budgetary allocations, enforcement mechanisms and disaggregated management information systems for monitoring. The limited socio-economic inclusion of disability within AU policies is indeed a lost opportunity that should be reviewed and rectified. The findings have broader ramifications for the non-tokenistic and genuine involvement of poor and marginalised groups in the international policy-making arena.