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Game-changing new data on disability-inclusive Official Development Assistance – and how to get at it


by Polly Meeks

Official Development Assistance (ODA – also known as aid) has huge potential as a resource to realise the rights of persons with disabilities.

While national governments have primary responsibility for allocating budgets that uphold the UN Convention on the Rights of Persons with Disabilities (CRPD), other states’ policies on financing for development also have a role to play. This includes ODA: its scale (153 billion US dollars in 2019 alone) and – at least in principle – its sensitivity to the rights of persons with disabilities mean it can be an important complement to national resources in the short term. In fact, research in some countries has found ODA to be a much bigger source of finance for the rights of persons with disabilities than domestic government budgets. With the COVID crisis urgently calling for additional public resources to ensure a disability-inclusive response and recovery, access to CRPD-compliant ODA is now more pressing than ever.

Cover of the new guide


But is ODA delivering on its potential as a resource to realise the CRPD? This year for the first time, the Organisation for Economic Cooperation and Development (OECD)’s has released data that gives important insights into this question. The OECD’s ODA database now contains a ‘disability marker’,
which allows individual items of ODA spending to be classified depending on whether or not they aim to be disability inclusive. Now, for any bilateral ODA provider and for any country receiving ODA, advocates can go to a single respected source, and analyse how much ODA was reported as being disability-inclusive. This could be a game-changer for accountability – but only if advocates from the disability movement make the most of the new data.

To help with this, CIP is launching a short guide on ‘Getting the data’ (WordPDF). The guide gives step-by-step advice on how to use the OECD’s ODA database; how to do basic analysis on the data; and how to recognise the limitations and strengths of the data when presenting the results. We chose to publish this initial version of the guide at an early stage, to support advocates to access the new data in its first year. But because the disability marker is new, its use is evolving fast.

We will release a revised and enhanced version of the guide in 2021, to take into account the possible developments as OECD expects to publish more detailed reporting advice on the disability marker in late 2020.

One major weakness of the OECD’s database is that it is not accessible for screen-reader users. To work around this, we have reached out to web accessibility experts in the disability movement, to look into developing an alternative way for screen-reader users to access the data, outside what the OECD currently makes possible. We will include an update on this work in the next version of the guide.

If you have any feedback, please feel free to get in touch with Polly Meeks, who authored the guide, on: polly.meeks@gmail.com. We want to make the guide as useful as possible to advocates in the disability movement around the world, in their work to ensure all public resources – including ODA – live up to their full potential for the rights of persons with disabilities.

An initial overview of specific social protection measures for persons with disabilities and their families in response to COVID 19 crisis

Overview SP covid 19
Download here

Considering the inequalities and barriers faced by persons with disabilities and their families before the crisis, an inclusive social protection response and recovery is critical to mitigate their further impoverishment and marginalisation.

The COVID 19 crisis “has revealed once again the devastating consequences of systemic shocks for societies and economies in the absence of universal and adequate social protection”[i]. Exchanges between leaders of organisations of persons with disabilities from more than 40 countries[ii] highlighted severe issues of inaccessible information and the lack of attention to specific support requirements of persons with disabilities. They reflected on the weaknesses of their national social protection systems which undermine state response capacity. The few countries which have more comprehensive social protection systems, including national disability registry, universal disability schemes and publicly-funded community support services have been in a better position to provide urgent support to persons with disabilities than countries with meager social protection systems.

Building on the UNPRPD brief on Disability-Inclusive Social Protection Response to COVID19 crisis, this paper is a first attempt to review the type of social protection measures taken by governments to support persons with disabilities and their families. An initial review, it is primarily based on the living paper “Social Protection and Jobs Responses to COVID-19: A Real-Time Review of Country Measures” [iii] updated every week, with some additional data collection for few countries. This complements the ILO Social Protection Monitor Dashboard.

Update monthly, this paper will be augmented by further analysis, with country case studies, documentation of interesting practices, and accompanied by thematic briefs to support stakeholders’ efforts to build back better by developing sustainable, universal, and inclusive social protection systems, including floors.

[i] ILO May 2020, Social protection responses to the COVID-19 pandemic in  developing  countries: Strengthening resilience by building universal social protection
[ii] Consultations carried out through 4 webinars organized with the International Disability Alliance in April May 2020 http://www.internationaldisabilityalliance.org/covid19-sp-newsletter
[iii] https://www.ugogentilini.net/

Budget advocacy is needed for a chance of an inclusive new normal

Budget advocacy
An initial manual to support DPOs’ budget advocacy

The COVID-19 crisis has magnified the significant barriers and inequalities faced by persons with disabilities all over the world. Everywhere the lack of accessibility of information and essential services, including health care, has put persons with disabilities at greater risk.

In high-income countries, while extensive social protection mechanisms allow for mitigating the impact of the crisis, an overreliance on residential care institutions has led to dramatic outcomes for many persons with disabilities, especially among older persons. In addition, in most Low and Middle-Income Countries (LMICs), a lack of support services and the low coverage of social protection schemes have severely limited the capacity of central and local governments to support persons with disabilities.

Even before COVID-19, low levels of public resources were allocated to the inclusion of persons with disabilities in most LMICs. Simply maintaining pre-crisis spending will thus be insufficient to prevent their impoverishment and further marginalization. For instance, while recent global estimates consider that a basic universal disability benefit[1] would require an average 0.5% of GDP investment in LMICs, less than ten LMICs invest more than 0.3% of GDP on disability-related social protection compared with an average 1.4% of GDP[2] for high-income countries[3] (OECD).

An inclusive recovery will require both increasing public resources dedicated to social protection and support services as well as ensuring that all public funds across sectors are spent in an inclusive way.

However, as governments’ relief expenditures and loss of revenue due to lockdown increase public deficit and debts, there is a significant risk of fiscal consolidation and political decisions leading to austerity measures that would hit persons with disabilities as it did in high-income countries after the 2008 financial crisis.

The recent UN Secretary-General policy brief calls for COVID-19 response and recovery that “have a strong focus on building more equal, inclusive and sustainable economies and societies.” It also calls for “National and sub-national economic models and assumptions need to be critically reviewed to identify gaps that disproportionately impact persons with disabilities and take into account the cost of underinvestment in disability-inclusion”.

Ensuring that in the new normal, governments spend more and better for inclusion will require strong advocacy by DPOs. To support their engagement, a first manual has been developed with several DPOs of Asia-Pacific which presents their experience in budget advocacy, and some key lessons learned. A second manual is being prepared to provide further insight and guidance on technical issues related to budget analysis and advocacy.

While this initial document was developed before the crisis, its objective has never been more relevant.  We hope that it will be a source of inspiration and will support leaders of the movement to engage further with governments and other civil society coalitions to ensure that the COVID-19 recovery contributes to more inclusive, equitable and progressive mobilization and use of public resources.

[1] ILO 2019. Calculations are based on the payment of a periodic disability benefit at 100 percent of the full national poverty line, granted to persons with any severe disabilities.
[2] Development pathways,  2019, Leave no one behind: building inclusive social protection systems for persons with disabilities.
[3] OECD, 2020, Public spending on incapacity (indicator). (Accessed on 10 February 2020). The figure has been calculated by subtracting OECD average expenditures related to sickness from the OECD average total public expenditures on incapacity

Clarification needed: Measuring Extra Costs of Disability

As we mentioned in our October 2017 blog entry, a growing body of qualitative and quantitative research confirms what is well known to people with disabilities – living with a disability entails extra costs. Not accounting for these costs leads the inadequacy of social protection programs or other programs designed to promote inclusion, an issue growingly acknowledged in recent years, especially by social protection programs and professionals.

However, we realized during our training and advising work that there is a risk of confusion in understanding issues around extra costs and related measurement methodologies. The key issue being: Are we measuring the current economic impact of disability on individuals and their families, or are we estimating the cost and expenditures that would be required for them to participate on equal basis with other members of the community. This is a critical difference that we would like to reiterate and explore a bit further in this blog.

Different type of costs: Some disability related cost are indirect costs – such as foregone income of people with disabilities who face barriers to employment or foregone income of family members who have added family responsibilities. Others are direct costs, that is expenditures on things like medical care, assistive devices, personal assistance, transportation, etc. This blog focuses on the how to estimate those direct costs.

Different measurement methods exist for estimating the direct costs of disability. Two methods seek to estimates the current disability related cost faced by individuals and their families.

  • Good and services (GS): One way is to ask people with disabilities to report on their disability related  expenditures as well as resource allocation they made due to disability. Getting good, representative data this way is often expensive.  It involves long interviews and/or focus groups with skilled interviewers. Also, it could be that people need goods and/or services that aren’t available, so the expenditures they report may be low not because they don’t have needs but because there is no way to meet them.
  • Standard of living methods (SOL): An much cheaper alternative is  the Standard of Living (SOL) approach which has been the basis of most of the rearsch conducted on the subject in LMICs. While it has the advantage of being much easier to implement – and while it can be very useful – it is important to understand its limitations and how it should be used. In the SOL, the assumption is that families with and without disabilities who have the same level of income, same number of people living in the household, are living in the same geographic are, etc. should have the same standard of living. If they don’t, then the gap in the SOL must be due to the disability related extra expenses as well as resource allocation choices mady by households with member(s) with disability . This gap in the standard of living is measured by the difference in assets. For a technical explanation of how this is done you can see the article listed at the end of this blog.  The key thing, though, is that this method basically seeks to estimate the extra expenditures that households with disabled members currently make.

Often outcome of SOL method analysis is referred to as the extra costs of disability, without much explanation as to what exactly is being measured. This may be misleading (we have done it ourselves and realized the confusion it can create!). As the article I reference explains, the SOL methods seeks to measure current disability related expenditures made by households. In reality these are most likely to be much less than the disability related expenditures required for equal participation, especially for households in the lower part of the income distribution. More expenditures may be needed for goods and services that are not available today or that are available but not affordable, or, maybe families choose not to spend their limited resources in a manner to support inclusion of their family member(s) with disabilities.  In that sense, the SOL approach (as the good and service method) should be considered as method that estimates a lower bound on what costs are needed to ensure full inclusion and should not be used alone to setup a benchmark for social protection or other programs.

A risk exists that the SOL method could be used alone to establish a benchmark without further analysis of the gaps in spending needed to ensure full participation, because SOL is a straightforward, inexpensive and frequently referred to as measuring extra “costs” as opposed to extra “expenditures currently being made.” There is a difference between what is being spent and what should be spent to ensure inclusion.

To estimate the disability related expenditures required for equal participation and inclusion, a different method is needed: the good and services required (GSR). The GSR asks people through surveys and/or focus group what they currently use and what additional expenditures, if any, they would need to participate equally (employment, family and community life…). These expenditures are   priced out in their given context (not only nationally but taking into regional differences). Getting good quality, representative data in this fashion is also resource intensive. It proposes certain methodological challenges, as well.  People may not know what types of goods or services are potentially available. Prices may differ dramatically by where people live. However, it is a necessary investment in order to build policy responses that truly contribute to support participation and inclusion.

So, the SOL measure is still important and useful, but best used in conjunction with the other methods. The SOL is inexpensive and easy to use once good quality questions identifying people with disabilities – preferably the Washington Group questions – are included on standard household income and expenditure surveys. These surveys are routinely done by most countries, so those estimates can be produced every time those surveys are fielded (typically every one to three years). Because they are nationally representative and typically involve thousands if not tens of thousands of households, results can be broken down by type of disability, region, age, gender, or other characteristics to see how extra expenditures vary by people’s situations.

Combined with more detailed studies are done on actual expenditures as reported by households with disabled members, the accuracy and variability of the SOL estimates could be better understood. And then if studies were also done on determining what would actually be needed to equalize standards of living (again, on a less often basis) the expenses needed could be compared to those made to see (a) are the extra costs of living with a disability being met, and (b) does the adequacy of those expenditures vary by type of disability, region, age, gender, etc. These more detailed studies could be done on a much less frequent basis because the relationship between SOL estimates and reported expenditures probably does not change rapidly.

By using different methodologies together – and appropriately – we can combine the lower resource needs and large-scale data collection power of the SOL approach with the higher resource needs but more in-depth and detailed approach of the other methodologies to leverage their respective advantages to get an accurate, comprehensive picture of the extra costs of disability.

Disability inclusive or CRPD compliant budgeting?

In recent years, there has been a growing interest on the role of public budget in supporting inclusion of persons with disabilities. The terms inclusive budgeting, disability budgeting, disability responsive budgeting, are used interchangeably. But do they mean the same?

The UN Convention on the Rights of Persons with Disabilities (CRPD) – which explicitly sets out states’ obligations to ensure the realization of all  the civil, political, cultural, social and economic rights of all persons with disabilities – was adopted in 2006 and has now been ratified by 177 countries worldwide.[1] According to the 2011 World Report on Disability (World Health Organisation and  World Bank), national implementation of the CRPD requires policy reforms, social innovation, pilot programs and scaling up of successful local practices for most countries and in most policy areas.[2] This in turn requires, in all countries, better and often greater mobilization and use of public resources for inclusion.

In recent years, interest has been growing on the role of public budget in supporting the inclusion of persons with disabilities. The terms inclusive budgeting, disability budgeting, disability responsive budgeting, have been used interchangeably. But do they mean the same?

Inclusive budgeting is probably the broadest concept. It implies that government revenue generation and expenditures will contribute to inclusive development, involving and benefitting all people in their diversity. This includes persons with disabilities among others and pays attention to the impact of revenue generation and expenditures on the most marginalized. It ensures that all marginalized groups are meaningfully consulted in budget processes. For all its strengths, one weakness is that this approach can miss the specific requirements of different groups, particularly the most marginalized within each constituency, such as services that would be needed for persons with deafblindness for instance.

incl2Disability budgeting and disability responsive budgeting are an echo of gender responsive and child responsive budgeting, with a focus on persons with disabilities.  The issue is that such approaches are not specific enough and can create confusion. For instance, governments, in a good faith, might consider as disability responsive budgeting, the fact to increase, increase expenditures on items like primary prevention (e.g., immunization, demining or mine risk awareness). While worthwhile, these actions don’t promote inclusion. Worse, under the heading of “disability responsiveness” they might undertake expenditures directly at odds with the CRPD, such as spending on residential institutions, segregated education or psychiatric hospitals who may practice forced treatment and coercion in contradiction with the CRPD.

CRPD compliant budgeting is more specific and clearly sets expectations for budget analysis and advocacy. While the CRPD Committee has not yet developed a specific guidance on the subject, one could elaborate few basic elements in line with CRPD Article 3 (general principles) and Article 4 (general obligations):

  • The overall public finance management system contributes to the realization of all human rights of all persons with disabilities as specified in the CRPD, using all public financial management instruments (transfers, public procurement, grants, contracts, tax expenditures…)
  • Public resources do not finance programs and services that are in contradiction with the CRPD principles and provision:
    • Plans are implemented for the reform, transition and reallocation from non-CRPD compliant to CRPD compliant policies, services and programs.
    • This applies also to services that are publicly funded and/or regulated but delivered by private entities
  • All spending are done in ways that prevent the creation or perpetuation of barriers with strong emphasis on accessibility and non-discrimination requirement in public procurement, among other specific measures. Too often, investments in infrastructure, services and programmes are likely to inadvertently create more barriers for persons with disabilities, which ultimately produce unnecessary costs to overcome them further down the line, impairing effectiveness of domestic and international resources.
  • Public resources should be used to:
    • Sustain and ensure universal access to effective national policies, programs and services compliant with CRPD
    • Scale up effective local programs, services and initiatives compliant with CRPD
    • Allow for development of new policies addressing gaps in required services for inclusion
  • Specific attention should be paid so that those spending support inclusion of most marginalized groups among person with disabilities
  • Maximum available resources, including domestic and international, are mobilized across sectors and at central and local government level. In many countries, the largest spenders of public resources for disability inclusion are, in descending order: the ministry of social affairs, the health and education ministries, and sometimes the ministry of labor. Most ministries do not have a specific allocation that would contribute to making their services and programs inclusive of persons with disabilities.
  • Money follows responsibilities: in some countries, responsibilities for service delivery have increasingly been transferred to local governments, but with no commensurate transfer of resources from the central level, which increases competing priorities at local level.
  • Revenue generation including taxation is progressive and takes into consideration the extra costs faced by persons with disabilities
  • The principle of non-retrogression is fully applied and prevents disproportionate and arbitrary cuts in resources allocated for inclusion of persons with disabilities. Austerity measures that have weakened standards of support across Europe since the 2008 crisis are an illustration of such negative policies.
  • Budgeting processes and reports are transparent, with agreed upon indicators for monitoring the progress of CPRD compliant budgeting, including not only budgetary obligations but expenditures, as well.

As mentioned, countries irrespective of their level of income or economic development have to use maximum available resources to meet CRPD commitments,[3] but the way this should be done varies according to context.

For some countries, mostly members of the Organisation for Economic Cooperation and Development (OECD) or some former socialist countries, which already have substantial spending on disability (albeit not always sufficient to meet their obligations in full, and subject in recent years to damaging austerity policies), it implies first reallocation of some expenditures towards CRPD-compliant programmes and policies, such as deinstitutionalization and the development of community-based services, with the unavoidable cost of transition.

Most LMICs have been spending very little for inclusion of persons with disabilities, therefore implementing the CRPD implies overall significant increase of budget allocation in different sectors, education, social protection, especially with regards to development of support services. However, CRPD compliant budgeting is very much about ensuring that there are effective regulations ensuring non-discrimination and accessibility across mainstream sector investments to make the most of existing expenditures for inclusion. Inclusive infrastructure is estimated to only increase construction costs by 1-3%. Also, a social clause in public procurement may also be used to promote the employment of persons with disabilities, where appropriate, in line with CRPD article 5.4 (on achieving substantive equality) for instance by favoring companies which hire meaningfully persons with disabilities above the existing quota.

CIP has been collaborating with Equals CPSJ in Tamil Nadu and the Pacific Disability Forum, continuing work initiated with the International Disability Alliance. Supporting DPOs in engaging in budget analysis and advocacy at local and national level is critical for implementation of the CRPD and inclusive SDGs. Experience with DPOs so far have shown that it is of utmost importance, beyond numbers, that DPOs must have a clear and common understanding of what kind of policies and services would significantly contribute to CRPD implementation so that they can frame the data collected in budget analysis and their subsequent demands.

For further elements, please consult our discussion paper prepared with Polly Meeks.

[1] United Nations, Convention on the Rights of Persons with Disabilities [accessed 20 July 2018]

[2]  http://whqlibdoc.who.int/publications/2011/9789240685215_eng.pdf P.65.195.214.267.275

[3] UN Committee on Economic, Social and Cultural Rights, General Comment No. 3, Center for Economic and Social Rights, 2012, The OPERA Framework.

 

Looking back: the unsteady path towards inclusive development Policy

If international development actors and national governments are to embrace the promise of Agenda 2030 To Leave No One Behind, ensuring public policies and programs are truly inclusive is an obvious strategy.

If international development actors and national governments are to embrace the promise of Agenda 2030 To Leave No One Behind, ensuring public policies and programs are truly inclusive is an obvious strategy. Considering the diversity of understanding of the concept of inclusive development, or inclusive growth, it is worth revisiting the evolution of some of the theories and perspective that have underpinned development policies.

Early Models of Economic Development

Following World War II, due to considerations of political stability and the growing recognition of free trade as an engine of growth, the nations of the world transitioned to a more cooperative, trade-oriented approach to economic development, as evidenced by deals such as the Bretton Woods Agreement (Judt 2005, Piketty 2014). While the questions of who holds the power in and who benefits from these global systems have been hotly debated, GDP growth has historically been considered the primary metric of development success.

Continue reading “Looking back: the unsteady path towards inclusive development Policy”

Measuring cost of disability …

Researchers, advocates, and policymakers often cite statistics about the relative income of people with and without disabilities. The idea being that barriers to participation in the labor market limit the ability of people with disabilities to secure an adequate level of economic well-being. However, direct comparisons of income levels between people with and without disabilities can mask many of the factors and dynamics that influence well-being, leading to an underestimate of the well-being gap. This blog concentrates on one of these factors – the extra costs of living with a disability.

Poverty lines are drawn to represent a minimum level of well-being. Typically, they are based on the costs of an adequate diet plus other basic necessities. The problem is that people with disabilities have additional necessities. They often require assistive devices, personal assistance, additional medical care or transportation expenses, and more.[1] Without these things, even if they have the same level of income as a person without a disability, they have a lower level of well-being. A person with a disability at the official poverty line, in reality is living below the minimum level of well-being that that poverty line was meant to establish.

Continue reading “Measuring cost of disability …”

Cost benefit vs. cost effectiveness

Advocates for inclusive policy are often asked to make the “business case” for inclusion, often being pressed for a cost-benefit analysis of various policies, since a cost benefit study attempts to estimate the dollar value of the benefits accruing to a program or policy relative to the costs of implementing it. In a world with limited resources, it makes sense that policymakers desire that resources are spent to provide the biggest benefit possible. However, there are several problems with the cost-benefit approach when it comes to evaluating inclusive policy.

Colloquially speaking, a cost-benefit analysis asks “What is the bang for the buck?” A major problem is how does one put a dollar value on human rights, dignity, sovereignty and other concepts? How does one even quantify such things in a meaningful way? How much is it worth to you to make decisions over your own life – your schooling, your career, your living situation, and even things as basic as when to go to the toilet? When people have various rights – say, the right to vote – do we question whether to spend money on very remote polling places is worth the cost, even if it probably won’t change the outcome of any election? No, the right of the individual to vote and the value of living in a fully democratic society are accepted in many places as fundamental. The same is true for the right for all children to receive an education, regardless of disability.

Continue reading “Cost benefit vs. cost effectiveness”