Each month CIP invites an expert to pose an important question dealing with some aspect of inclusive policies.

We then invite all of you to participate in an on-line written discussion. At the end of the month, our expert will summarize the main results of that discussion in a blog. If you would like to pose a “question of the month” please write to us on our contact page.


What are the best and most practical steps that low and middle income countries can take to support persons with disabilities to cover the diversity of their disability related costs by 2030?


Daniel Mont

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    • #5668 Reply

      Persons with disabilities face disability related costs to achieve daily living activities and participation in community. Those costs are related to good and services that they may require in relation to health condition, functional difficulties, and the barriers in their environment. They can be direct costs such as assistive devices, using taxi because public transport is not available or accessible, sign language interpreters, rehabilitation… They can also be linked to loss of opportunity to earn income for their family members who may have to stop working to provide them support.

      The more persons with disabilities seek participation (going to school, working, taking part in community and public life…) the more costs they face (more transport, diverse assistive devices, greater need for interpretation and human assistance). Today in many low and middle income, most those costs are unaffordable for persons with disabilities and their families which contribute greatly to restriction of participation, isolation and poverty.

      Addressing disability related costs is therefore a pre-condition to significantly reduce inequalities and poverty as well as support access of persons with disabilities to health, education and employment by 2030.

      Removing barriers in the environment, for instance by making infrastructures, transport and services more accessible or ensuring that services and workplace provide reasonable accommodation would go a long way decrease disability extra costs faced by persons with disabilities and their families. While critical, such policies have impact in the long term and may be also challenging in contexts with higher informal economy where state regulations can have limited impact.

      Social protection has a key role to play in addressing those disability costs by providing support to individuals in different ways: cash transfer such as disability allowances, concessions such fee waivers, high subsidies on transportation, as well as provision of support services (see related question of the month). Together with Universal Health Coverage policies, it can address direct health care costs, including rehabilitation and assistive devices. However, while more countries are considering such support, in 2017 less than 20% of persons with significant disabilities were accessing disability benefits in low- and middle-income countries.

    • #5676 Reply
      Roy Yerkes

      We should have to create some nonprofit Organizations to help them LIKE TLC. 

    • #5716 Reply
      Chansamone chasuakao

      It’s still a long way to go, example in my country – Laos. the persons with disabilities still not included in the formal system support – means discriminations – they still not been covered in the social security fund as others. What about the consideration for adding extra cost for disability – it needs to go step by step – breaking the wall to create  opportunity first then go to the equal support as others then specific additional supports –

    • #5763 Reply

      Yes, Chansamone, discrimination is a problem, so also can be the unintended consequences of social protection policies that don’t take an inclusive approach. For example, defining disability as the “inability to work” creates an incentive to not work, and to strengthen the attitude that people with disabilities can’t work. Instead of thinking of disability benefits as “income replacement” they should be structured to support participation by covering the extra costs of disability. Determining those costs can be tricky. Here is a link to a paper of ours that talks about the methodology:


    • #5787 Reply
      Sophie Mitra

      There is evidence of higher costs for families with disabilities including higher health-related expenditures, assistance with daily care costs, and transportation costs. Universal health coverage policies, making public transportation more accessible and subsidizing care and transportation costs may be effective at reducing extra costs.

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