DFID’s approach to disability in development
Around one in six people in developing countries live with a disability. As a group, they tend to be poorer, and suffer more discrimination, exclusion and violence than the rest of the population. Without measures to include people with disability in development, the ambition of the Sustainable Development Goals to ‘leave no one behind’ will not be attained. This insight was at the core of an April 2014 report on disability and development by the International Development Committee, which urged DFID to become more ambitious in its approach to disability inclusion in its aid programming.
The UK government was a significant member of the international coalition that succeeded in including disability as a central concern of the Sustainable Development Goals in 2015. But DFID has been slower in systematically including the concerns and challenges facing people living with disability in its own development and humanitarian programming. The department created a disability framework in 2014, and renewed it in 2015, but a major change of emphasis only came in late 2016, when the secretary of state announced an aim to establish DFID as “the global leader in this neglected and under prioritised area”.
Since then, DFID has moved more forcefully to mainstream disability inclusion across the department, and has called a global disability summit for July 2018. In view of this increased attention to disability, ICAI decided to undertake a rapid review of DFID’s progress, and shed light on potential improvements DFID can pursue as this portfolio develops.
An ICAI rapid review is a short, real-time review of an emerging issue or area of UK aid spending that is of particular interest to the UK Parliament and public. We examine the evidence to date and comment on issues of concern, but do not draw final conclusions on performance or impact. Rapid reviews are therefore not scored.
Relevance: Has DFID developed an appropriate approach to disability and development?
DFID has made a useful start, and is scaling up activities ahead of the global disability summit, but a step change is needed to mainstream disability across the department
Disability is not the same as impairment. A disability arises only if individuals with impairments are prevented from participating in society on an equal basis with others. A strategy for disability inclusion is therefore about removing the barriers that prevent participation. In 2009, the UK ratified the UN Convention on the Rights of Persons with Disabilities, committing to ensure that its development programmes would be inclusive of people with disabilities.
DFID’s 2014 and 2015 disability frameworks made a start at mainstreaming disability inclusion, but anticipated that the process would take time. There were commitments and activities from the centrally located disability team and sectoral policy teams, but there were no timelines, no indicators, no financial targets and no commitments from country offices.
From late 2016 onwards, DFID senior management has provided clear leadership. A 2017-18 disability inclusion action plan set out appropriately ambitious outputs and outcomes, but its brevity (a one-page diagram) precluded guidance on outputs, targets or milestones. There is no dedicated funding to cover the start-up costs of mainstreaming – as Australia’s department responsible for development has for disability, and as DFID had for disaster resilience.
DFID has put a range of mandatory requirements into its programme management processes. In particular, staff are required to mark all programmes as to whether they target disability. They must also consider disability in all new business cases and take into account the ‘leave no one behind’ agenda in programme annual reviews. These requirements have caused DFID departments to consider disability inclusion. But in practice they have been too broad, with insufficient monitoring arrangements, to ensure that programmes have practical elements relevant to disability inclusion and that these elements are implemented in the field. By February 2018, only 22% of DFID’s 1,161 programmes were provisionally marked as containing deliberate activities to support disability inclusion and only six programmes as having disability inclusion as the primary objective. This demonstrates that DFID is starting from a low base and has a considerable distance to go to meet the secretary of state’s ambition to put disability inclusion at the heart of everything DFID does.
Disability inclusion requires specialist skills. The experience of comparable donors with similarly high levels of ambition to mainstream disability suggests that DFID should invest in more staff with technical expertise and experience. The disability team has done well on drawing on external advice, and the department’s network of social development advisers are knowledgeable about inclusion in general, but DFID would benefit from stronger in-house expertise on disability mainstreaming.
Only 6.4% of DFID home civil service staff, and 1.4% of locally engaged staff in country offices, self-identify as having a disability. This compares with 6.7% in the UK home civil service as a whole – which has an objective to be the most inclusive employer in the UK by 2020. DFID’s influence as a global advocate for disability inclusion would be strengthened if it is seen to practise what it advocates. Employing staff with disabilities raises the awareness and confidence of their colleagues to work to include disability in aid programmes. It signals a shift from perceiving people with disabilities as vulnerable individuals to perceiving them as colleagues and professionals whose insights and contributions include but are by no means restricted to disability issues.
While the disability mainstreaming process only started in earnest in late 2016, and could not be expected to be concluded at this stage, we find that more detailed planning, stronger disability expertise and faster implementation are now needed for DFID to achieve its mainstreaming ambition.
DFID’s disability-targeted programming in key sectors is too modest in scale and reach to be likely to deliver transformational results
DFID drafted an overall theory of change for disability inclusion in 2017, which identifies some of the barriers to disability inclusion and some steps that different actors might take to remove those barriers. However, this theory of change has not been used – by country offices or centrally – to guide the planning of disability inclusion activities. The one-page action plan lists some important steps towards disability inclusion (such as inclusive education systems and economic opportunities) and identifies some key actors. As part of the preparations for the global disability summit, there is now an increased focus on the private sector, and DFID country offices are more active in their efforts to influence governments in partner countries – but both start from a low base. DFID has developed appropriate value for money principles for disability, ensuring that value for money is about how best to include people with disabilities, not whether they should be included, but practice is not yet consistent.
DFID rightly emphasises the importance of disabled people’s organisations, whose advocacy activities have contributed to governments making significant policy changes on disability inclusion. But DFID’s main mechanism of support, the Disability Rights Fund, operates in only eight of DFID’s 32-plus priority countries. We did not find that country office engagement with local disabled people’s organisations would usually extend to consultation on the design and implementation of programmes.
We examined DFID’s programming in five sectors. Of these, the education sector was most advanced, and the new 2018 education policy explicitly prioritises disability inclusion. Experience in the humanitarian field was more mixed. But in the last three areas identified in the 2015 disability framework as requiring more work across the department – economic empowerment, stigma and discrimination, and mental health and intellectual disabilities – DFID’s range and scale of activities were too modest to deliver the sort of transformational results anticipated in the framework and action plan.
DFID is a leader in promoting disability in the global development agenda
DFID is widely recognised as one of the main actors promoting disability in the global development agenda. Despite the limited resources spent on international influencing, DFID has made successful use of focused campaigns with clear objectives and good coordination with like-minded partners such as the International Disability Alliance of disabled people’s organisations. In addition to helping ensure that disability was included as a central concern in the Sustainable Development Goals, DFID was central to the establishment of the inter-agency Global Action on Disability (GLAD) network and has been at the forefront of efforts to create an international consensus on the collection and use of disaggregated data on disability.
DFID is working effectively with multilateral agencies. Considering the department’s role as a major multilateral donor, its efforts have the potential to significantly influence how multilaterals approach disability inclusion globally. DFID has influenced the World Bank’s disability inclusion and accessibility framework, and included disability in its Payment by Results approach to 11 agencies within the United Nations system. DFID could do more through its executive directors on the boards of the World Bank and other organisations: if projects were rejected due to lack of disability inclusion, this would prompt action.
A global disability summit in July 2018, to be hosted in London with the government of Kenya and the International Disability Alliance, is an opportunity to push for a step change in global disability inclusion efforts. Positive outcomes are expected in terms of awareness and commitments to action by donors, multilaterals, the private sector, developing country governments and civil society.
Learning: How well is DFID identifying and filling knowledge and data gaps on disability and development?
DFID has previously funded little research on disability, but is now planning a substantial Disability Inclusive Development programme, modelled on the What Works programme on violence against women and girls, which is delivering valuable results. Given the paucity of knowledge on what works for disability inclusion, investing in evidence and research is appropriate and underscores DFID’s willingness to take leadership of the agenda.
For research to effectively feed into programming choices, it is necessary to have a research strategy that identifies and addresses the most important evidence gaps. DFID is beginning to develop such a strategy. It is important that it is completed in time to influence the design phase of the planned investment in research and evidence gathering. It is not clear how far people with disabilities will be involved in steering DFID’s disability research. This is important, given the principle of participation in the UN Convention on the Rights of Persons with Disabilities.
There is no plan to mainstream disability into broader research, despite the positive experience of an earlier cross-cutting disability research programme. Such cross-cutting research is particularly relevant because many people with disabilities also encounter other forms of discrimination and exclusion due to their gender, race, age, sexual orientation, religion or other characteristics.
DFID staff have limited guidance on how to address disability in programming. A helpdesk is to be introduced in 2018; experience elsewhere suggests that this is likely to be useful. The proposed Disability Inclusive Development programme will promote research uptake, but could be complemented by a structured exchange of learning between country offices on the more practical aspects of mainstreaming disability, a community of practice of staff working on disability and a plan for evaluations.
DFID is also addressing the data gap created by the lack of robust and consistent methods for counting the number of people with disabilities. DFID is working closely with Australia’s Department of Foreign Affairs and Trade and other international actors towards reaching international agreement on using the so-called Washington Group Questions to collect this data. DFID has linked some of its core funding of UN agencies to the disaggregation of key results by disability.
Conclusions and recommendations
DFID has taken a leadership role internationally, and has rightly focused investment on research and on filling a key data gap. But its own mainstreaming efforts have been proceeding slowly until recently. Although activities to integrate disability into programming have been scaled up considerably ahead of the global disability summit, DFID does not yet have a thorough plan to mainstream disability inclusion across the department in a manner consistent with its stated ambition.
DFID should adopt a more visible and systematic plan for mainstreaming disability inclusion. The plan should be time-bound with commitments and actions at the level of programming, human resourcing, learning, and organisational culture.
DFID should increase the representation of staff with disabilities at all levels of the department, and increase the number of staff with significant previous experience in working on disability inclusion.
DFID country offices should develop theories of change for disability inclusion in their countries. These should propose a strategy for the country office, with a particular focus on influencing and working with national governments.
DFID should engage with disabled people’s organisations on country-level disability inclusion strategies, advocacy towards partner governments, capacity building, and the design of programmes, including research programmes.
In order to deliver its existing policy commitments, DFID should increase its programming on (i) tackling stigma and discrimination, including within the private sector, and (ii) inclusion of people with psychosocial disabilities and people with intellectual disabilities, noting that these are two different groups who face different sets of challenges.
DFID should create a systematic learning programme, and a community of practice, on the experience of mainstreaming disability into DFID programmes.
Any attempt to end extreme poverty in the world must tackle disability: 18% – more than one in six – of adults in developing countries are estimated to have a disability. People with disabilities are poorer than the average, not just in income but also in health, education, employment and social inclusion. Furthermore, there is evidence that this gap widens as developing countries become richer: “The development process is not inclusive by default.”
A report by the International Development Committee (IDC) on disability and development, published in April 2014, found that DFID was not sufficiently ambitious in its work on disability inclusion, given the UK government’s considerable international efforts to promote a ‘leave no one behind’ agenda for the Sustainable Development Goals. The IDC report noted that if “DFID is serious that no one should be left behind in future work, a strong commitment to disability will be essential”. DFID responded with a disability framework in late 2014, and began to put in place staff and structures. The process was accelerated after a December 2016 speech by the then secretary of state, given on the International Day of Persons with Disabilities, which promised to “make disability a global priority”. Ministerial commitment to the issue has continued under the current secretary of state, Penny Mordaunt, who in a November 2017 speech promised to put disability at the “heart of everything” DFID does.
This is a moment of major attention to disability, both within DFID and internationally. The global disability summit, called by the secretary of state for July 2018, is an opportunity to set in motion a step change in global – as well as the UK’s own – efforts to include disability as a central concern across development and humanitarian assistance programming. It is therefore an appropriate time for ICAI to take stock of DFID’s activities in this area. We have conducted a rapid review, reflecting the fact that this is a relatively recent priority for DFID. The 2014 disability framework stimulated only piecemeal action: visible DFID investments, both in staffing and in programming, have mainly taken place after 2016, with a scale-up of efforts in recent months, in preparation for the global disability summit. It would therefore be premature to judge the effectiveness of this work. Instead, a rapid and real-time review provides DFID with an early assessment of the suitability of its approach to disability in development assistance. By assessing what is working and what could be done better in this emerging area, we can help shape the direction of this approach.
Box 1: What is an ICAI rapid review?
ICAI rapid reviews are short reviews carried out in real time to examine an emerging issue or area of UK aid spending. Rapid reviews address areas of interest for the UK Parliament or public, using a flexible methodology. They provide an initial analysis with the aim of influencing programming at an early stage. Rapid reviews comment on early performance and may raise issues or concerns. They are not designed to reach final conclusions on effectiveness or impact, and therefore are not scored.
Other types of ICAI reviews include impact reviews, which examine results claims made for UK aid to assess their credibility and their significance for the intended beneficiaries, performance reviews, which assess the quality of delivery of UK aid, and learning reviews, which explore how knowledge is generated in novel areas and translated into credible programming.
Box 2: What is disability?
Disability is not the same as impairment. Many individuals have impairments of some kind – for example physical or intellectual impairments. A disability arises only if individuals with impairments are prevented from participating in society on an equal basis with others. A strategy for disability inclusion is not about tackling the impairment. It is about removing the barriers that prevent participation. This was made clear in DFID’s first disability framework, which quotes the UN Convention on the Rights of Persons with Disabilities: “Disability results from the interaction between people with impairments and attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others.”
The term psychosocial disability is used to describe people who have or are perceived to have mental health support needs and who have experienced discrimination (including but not limited to infringements on their liberty, autonomy, and effective participation) based on their needs or presumptions about their needs. The term is used to replace phrases such as ‘mentally ill’ and ‘mental illness’, that were in common use previously, but are now seen as derogatory or stigmatising.
The term intellectual disability is used to describe people who have or are perceived to have cognitive/ developmental support needs and who have experienced discrimination (including but not limited to infringements on their liberty, autonomy, and effective participation) based on their needs or presumptions about their needs. It replaces terms such as ‘mentally retarded’ that are now seen as derogatory and stigmatising.
The review assesses DFID’s work on disability in development assistance since the publication of the 2014 IDC report. We look at DFID’s approach to mainstreaming disability across the department as a whole, designing programmes that address barriers to disability inclusion, and building international coalitions. Little is known internationally about the most effective ways to include people with disabilities in development and humanitarian programming. We therefore examine DFID’s activities to build more evidence on what works and to share it both within DFID and outside. Since there is a global shortage of data about disability, we look at DFID’s efforts to promote filling the evidence gaps and data gathering. Table 1 sets out the review questions.
Table 1: Our review questions
|Review criteria and questions||Sub-questions|
|1. Relevance: Has DFID developed an appropriate approach to disability and development?||• Does DFID have a suitable approach to mainstreaming disability issues into its programming across the department?
• In DFID programmes that include disability-related activities, is the approach likely to deliver meaningful results?
• Is DFID adopting a suitable approach to promoting disability in the global development agenda?
|2. Learning: How well is DFID identifying and filling knowledge and data gaps on disability and development?||• Does DFID have an appropriate strategy for building its knowledge on what works in improving conditions for people with disabilities?
• How well is DFID addressing data gaps on disability in development within its own programming and at national and international levels?
• Does DFID have an appropriate strategy for sharing new knowledge and evidence both internally and externally?
For this rapid review, we adopted an approach over two phases (see Figure 1). In Phase 1, we developed overviews of DFID’s disability inclusion strategy and of the research literature on disability in development. We held a stakeholder workshop with civil society and academics to identify key issues, and conducted initial interviews with DFID staff, outside experts, and other donors.
In Phase 2, we conducted more in-depth investigations into DFID’s disability approach in five sectors: stigma and discrimination, economic empowerment, mental health and intellectual disabilities, humanitarian, and education. In addition, we:
- assessed the extent to which DFID has an overall strategy and theory of change about disability
- conducted a sectoral analysis of DFID’s disability marking of programmes
- compared 2014 country operational plans with 2016 country business plans
- mapped DFID’s employment of people with disabilities against UK civil service commitments to equal opportunities. We were also invited to observe the annual general meeting of the Disability Network of DFID staff with disabilities, and we spoke with members of the Listening Network of DFID staff with mental health challenges.
The approach also included a strong comparative element. We compared DFID’s approach to mainstreaming disability inclusion with that of other bilateral agencies, particularly Australia’s Department of Foreign Affairs and Trade, which has had a substantial disability emphasis since 2009. We also used DFID’s own previous mainstreaming experiences as points of comparison, particularly in two areas: disaster resilience and measures to combat violence against women and girls.
Figure 1: The review’s methodology
With the help of the Bond Disability and Development Group, we administered a questionnaire to disabled people’s organisations in countries where DFID has a presence, focusing on DFID’s approach to disability. We received responses from 16 organisations in eight countries. As such, the sample is too small to draw statistically valid conclusions, but it provides useful illustrations. The same is true of the 14 responses to a separate questionnaire sent to the offices of British non-governmental organisations working on disability in nine countries.
In November 2017, 59 of DFID’s 1,145 programmes were registered as spending at least 10% of their budget on disability-related activities. We undertook desk reviews of a sample of 14 of these programmes, looking at four out of the eight programmes focused on research on disability, and ten out of the 51 programmes delivering activities on the ground.
In all, we conducted semi-structured interviews with 53 DFID staff, 15 experts and 31 representatives from other government departments, civil society organisations, other bilateral donors, UN agencies and the World Bank. Annex 3 provides a list of interviewees organised according to institutional affiliation.
Box 3: Limitations to our methodology
While DFID’s disability framework was produced in 2014, the emphasis was greatly increased at the end of 2016. As a result, almost all substantive programmes are relatively recent – five of the 14 programmes in our desk review had not reached their first Annual Review – and so it is too early to assess effectiveness in delivery, let alone impact. Meanwhile, policy and implementation are evolving, with the risk that a finding may refer to a policy now outdated. We have mitigated against this by triangulating documentation with key informant interviews.
If DFID is serious that no one should be left behind in future work, a strong commitment to disability will be essential
Disability and Development, International Development Committee, April 2014.
The UN Convention on the Rights of Persons with Disabilities provides the legal framework for disability inclusion in UK aid
In December 2006, the Convention on the Rights of Persons with Disabilities was adopted at the United Nations. The convention describes people with disabilities not as objects of charity and social protection, but as subjects with rights who are active members of society. The UK ratified the convention in June 2009, committing itself to implementing the rights and obligations that it sets out. The convention should therefore be central to any approach to disability.
Box 4: The UN Convention on the Rights of Persons with Disabilities
The eight principles of the convention are:
- respect for inherent dignity and individual autonomy, including the freedom to make one’s own choices, and independence of people
- full and effective participation and inclusion in society
- respect for difference and acceptance of people with disabilities as part of human diversity and humanity
- equality of opportunity
- equality between men and women
- respect for the evolving capacities of children with disabilities, and respect for the right of children with disabilities to preserve their identities.
The implications of these principles are spelt out in the convention. For example, on nondiscrimination, states are required to prohibit discrimination on the basis of disability, and “take all appropriate steps to ensure that reasonable accommodation is provided”. Participation means that states have an obligation to consult people with disabilities through their representative organisations in the development and implementation of legislation and policies. For accessibility, states need to undertake audits in consultation with disabled people’s organisations, and devise and implement plans to remove barriers.
Of particular significance to this review, the convention’s Article 32 requires that states ensure that “international cooperation, including international development programmes, is inclusive of and accessible to persons with disabilities”, and calls for capacity building to enable organisations to do so. Article 11 extends that to situations of risk and humanitarian action.
There has been little progress globally on disability inclusion in development assistance
There is little robust evidence, in any sector, about what works for disability inclusion in aid programming. This was true in a 2011 overview, and surveys since have confirmed the lack of information on disability inclusion in fields as varied as employment, education and violence against women and girls. The World Health Organization and World Bank did not follow up their 2011 World Report on Disability with a research programme, despite the report’s substantial list of research recommendations.
It is widely agreed that a twin track approach is needed. On one track, all development programmes across sectors should be designed in a manner that does not exclude people with disabilities – so that, in other words, they ‘leave no one behind’. On the other track, specific disability-targeted programmes are needed, to support the empowerment of people with disabilities and to remove barriers that prevent their inclusion in society. Yet progress is limited. The experts we interviewed confirm that development actors tend to revert to relatively small, disability-targeted programmes, which have proved easier than incorporating people with disabilities into sectoral programmes.
The first movers on disability inclusion in development assistance have been Finland, Norway, Sweden, Germany and Australia. Australia has had two five-year strategies since 2009, and has played a major advocacy role. Its programme implementation is largely through non-governmental organisations; an evaluation noted that the focus on gender and on disability “has a positive effect on the sector as a whole… [and has] elevated the profile of these themes amongst in-country partner organisations, which could potentially have far-reaching effects”. Elsewhere, however, evaluations have not been encouraging. A 2012 evaluation of NORAD concluded that the “policy and guidelines on mainstreaming disability in Norwegian development initiatives have not translated into concrete action by development partners”. In 2013, Germany adopted an action plan to systematically mainstream disability in development cooperation, but a 2018 evaluation rated its achievements as low to moderate. Likewise, a 2016 evaluation of disability-inclusive development at UNDP noted its failure to live up to its potential role, owing to limited capacity and resources committed.
The Sustainable Development Goals have given a new impetus to disability inclusion
As the 2014 IDC report noted, people with disabilities were left behind in progress towards the Millennium Development Goals. This changed with Agenda 2030 and the Sustainable Development Goals, partly as a result of a civil society campaign and lobbying by some governments, including the UK. The Agenda says: “As we embark on this great collective journey, we pledge that no one will be left behind… And we endeavour to reach the furthest behind first.”
Box 5: Disability inclusion and the Sustainable Development Goals
The Sustainable Development Goals (SDGs), otherwise known as the Global Goals, are a universal call to
action to end poverty, protect the planet and ensure that all people enjoy prosperity and peace.
Related to this review
The Agenda 2030 document, which launched the SDGs, makes clear that the needs of people living with disabilities, together with other vulnerable, marginalised and hard-to-reach groups, must be reflected if the ambition to end poverty and ensure prosperity for all is to be attained. Within this ‘leave no one behind’ agenda, we find explicit disability-specific targets for six of the SDGs.
SDG 1, to end poverty in all its forms, notes the need to include people with disability, alongside other marginalised and vulnerable groups, in social protection systems.
SDG 4, to ensure inclusive and equitable quality education, commits to providing equal access to education for the vulnerable, including people with disabilities, and “to build and upgrade education facilities that are child, disability and gender sensitive”.
SDG 8, on sustainable economic growth and decent work for all, commits to achieving full and productive employment for all, including people with disabilities, and equal pay for work of equal value.
SDG 10, to reduce inequality within and among countries, highlights the need to empower, and promote the inclusion of, people with disability.
SDG 11, to make cities inclusive, safe, resilient and sustainable, includes a commitment that safe and affordable transport, as well as green and public spaces, should be available to people with disabilities.
SDG 17, to strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development, notes that capacity building to attain the SDGs should include increasing “significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts”.
DFID’s attention to disability inclusion began in 2014
Our Prime Minister made a promise… to fulfil the pledge of the Global Goals for Sustainable Development to leave no one behind. Ensuring people with disabilities benefit equitably from international development is central to this promise
Justine Greening, Introduction to the 2015 Disability Framework, DFID, December 2015.
In April 2014, the International Development Committee released a report on Disability and Development, arguing that DFID needed to step up its efforts in this area to correspond with its ambitions for the SDGs. Up until then, disability had not been a prominent topic within DFID. It was not mentioned in the 2013 results framework, and the key staff member working on disability at the time told us that there “was no political appetite”.
The 2014 disability framework committed to “systematically and consistently” include a focus on disability in all of DFID’s work. Despite this commitment, it had a limited ambition. It outlined sectoral work-streams and organisational capacity, and laid out some basic principles of inclusion. But it focused on inspiring, rather than directing, DFID staff to increase their focus on disability.
Figure 2: Timeline of DFID and disability
The framework was renewed and expanded in 2015, this time with an introduction by the secretary of state. In addition, a topic guide was produced for staff, though not as official policy. Despite the increased high-level attention to the topic, the November 2015 UK aid strategy did not explicitly mention disability, nor did the September 2016 single departmental plan. The Civil Society Partnership Review (November 2016) and the Research Review (October 2016) made no mention of disability.
The priority given to disability accelerated in late 2016
In December 2016, the secretary of state announced that DFID would aim to lead a “step-change in the world’s efforts to end extreme poverty by pushing disability up the global development agenda” and “establish DFID as the global leader in this neglected and under prioritised area”. Disability inclusion has been a clear priority for DFID ever since, beginning with the Bilateral Development Review of December 2016, which repeated the disability framework’s commitment to systematically and consistently include people living with disabilities in UK aid, and went on to make more specific commitments on education, employment, stigma and discrimination, and data. The Multilateral Development Review (December 2016) had three limited references to disability, the most significant being that “[h]alf of all the agencies reviewed should do more to ensure that disadvantaged social groups, such as people with disabilities, benefit from their work”.
The prioritisation of disability inclusion was confirmed by the incoming secretary of state in November 2017; who promised that DFID “will put disability at the heart of everything that we do”. The December 2017 single departmental plan stated that “DFID is committed to ‘leave no one behind’, including by transforming the lives of people living with disabilities.”
Relevance: Has DFID developed an appropriate approach to disability and development?
In this sub-section, we examine DFID’s work to mainstream disability across the department. We then turn to individual programmes and ask whether DFID’s approach to programming is likely to lead to disability inclusion. And we assess DFID’s influencing activities to strengthen global efforts to deliver for people with disabilities.
DFID’s disability framework was not enough to get the mainstreaming of disability off the ground
The 2015 disability framework stated an ambition to mainstream disability in policies and programmes and to support disability-targeted programmes. Its actions were focused on centrally located disability and policy teams, but they were not accompanied by commitments from the country offices or multilateral departments that control most programming. Nor did the framework contain targets.
A disability team with (at the time) three staff members was established within the Inclusive Societies Department. The team’s primary role was to support, inspire, catalyse and share good practice, building the confidence of colleagues. It was also to engage in international advocacy, and “take a proactive approach” to disability inclusion in three areas: economic empowerment, mental health and intellectual disabilities, and stigma and discrimination.
In addition, policy teams set out disability-related commitments in a range of sectors: education, data, humanitarian, social protection, water, sanitation and hygiene (WASH), infrastructure, climate and environment, violence against women and girls, gender, research and evidence, and DFID’s own employment practices. Box 6 sets out the commitments developed by the education policy team as an example.
Box 6: Education commitments in the 2015 disability framework
We will build on progress we have already made on inclusive education by:
- continuing to ensure that all school building directly funded by DFID adheres to our policy on accessible school construction
- working closely with the Global Partnership for education to ensure they include a specific strategy for children with disabilities as criteria for assessing education sector plans and data on disability in their reporting
- working with the UNESCO Institute of Statistics and Education for All Global Monitoring Report to ensure they regularly report on education indicators disaggregated by disability
- collating and disseminating lessons learnt from our disability-focused education programmes such as Zimbabwe, Pakistan and Tanzania from the UK’s Girls’ Education Challenge.
Staff disagree on whether DFID is doing enough
DFID conducted a baseline questionnaire on diversity and inclusion in the summer of 2017, with responses from over 400 staff. As Figure 3 shows, 41% agreed that “DFID is doing enough on disability”, while 26% disagreed. However, among the 30 staff responding who had disabilities themselves, only four (13%) said that DFID was doing enough.
Figure 3: DFID staff views
DFID staff response to the question: “Is DFID doing enough on disability?”
Note: This was the wording of the question, but it is possible that staff interpreted it as applying only to DFID’s employment policy. Source: Diversity and inclusion update (13 December 2017), Annex 2 – Disability in DFID, unpublished.
From late 2016 onwards, disability inclusion became a clearer priority, but DFID’s disability mainstreaming plans are not sufficiently detailed and practical
Following the then secretary of state Priti Patel’s speech in December 2016, DFID produced a onepage disability inclusion action plan. The plan had three desired outcomes, each arrived at through a number of outputs, as summarised in Table 2. It recognised the scale of the challenge of disability mainstreaming in its list of outputs. Its success criteria are reasonable, and accompanied by an explanatory sentence for each outcome. But as a one-page diagram, the action plan provided little detail, and there was no column showing the activities that were intended to deliver the outputs. For example, it had an output of “country office and policy scale-up”, with the explanatory sentence that “secretary of state ambition is rolled out to all country offices and policy teams across DFID”. But there was no information on how this was to be done. Neither the action plan nor the earlier disability framework contained a phased plan with a timeline, targets or milestones for a process of mainstreaming disability across DFID.
Table 2: Summary of outcomes and outputs of the Disability Inclusion Action Plan 2017-18
|Government policies and DFID programmes are inclusive of people with disabilities||• Country office and policy scale-up.
• Alliances forged across the government.
• Senior leadership, technical cadres and programme managers are inspired and informed.
• DFID internal systems report progress.
|The international system delivers for people with disabilities||• Disaggregated data collected.
• Partnerships developed with the private sector to deliver economic opportunities such as through Aid Connect.
• Global moments produce concrete deliverables, including Commonwealth Heads of Government Meeting, leading up to a global summit.
• Work to create a global coalition.
|The government delivers and communicates evidence and impact for people with disabilities||• High-quality communications build support for disability inclusion.
• High-quality research delivers robust evidence.
• Continue funding disabled people’s organisations and support rights.
This lack of a phased plan stands in contrast to the recent mainstreaming of resilience against natural disasters that ICAI identified as on the whole successful. For resilience, DFID had an approach paper, providing a list of seven minimum measures for the country offices to implement in order to mainstream resilience into their programming. The country offices were divided into three tiers, with those offices most eager and ready to start the process making up Tier 1, and Tiers 2 and 3 following in succession. There is no equivalent strategy for disability inclusion to reach country offices.
DFID’s approach to mainstreaming its programme on violence against women and girls was also more systematic.27 Within a year of the issue being given priority, DFID produced a theory of change, which became widely referenced and used by DFID staff as a starting point for developing programmes in specific country contexts. The theory of change was followed by a rigorous mapping of DFID programmes. Again, we found no equivalent for disability at this level of acceptance or rigour.
In February 2018, a paper presented to DFID’s departmental board proposed to update DFID’s disability framework to reflect the new and expanded approach, to launch ambitious new commitments, and to form the basis for accountability across DFID in the future. We welcome this.
Introduction of a disability marker showed that two thirds of programmes do not target disability
In April 2017, DFID introduced a disability marker in its management information systems to allow tracking and analysis of the mainstreaming effort. The senior responsible officers for programmes across DFID were asked to mark all their programmes according to the degree to which they included disability objectives. Programmes could be marked as:
- principal, where inclusion and empowerment of people with disabilities is the primary objective
- significant, where the project contains deliberate activities or mechanisms to support the inclusion and empowerment of people with disabilities
- not targeted, where the project does not have a deliberate focus on the inclusion of people with disabilities.
The introduction of the marker has been an important step in enabling DFID to gain a better understanding of current programming on disability inclusion, and has helped to identify both areas of good practice and gaps. Our review of the disability marker found that, as of February 2018, 68% of programmes across DFID did not target disability, 22% of programmes were marked “principal” or “significant”, while the remaining 10% had not been marked one way or another. Only six of a total of 1,161 programmes were marked “principal”.
There was some sectoral variation in the proportion of programmes marked “principal” or “significant”, as Figure 4 shows. Most were in the 21 to 29% range, but education and social protection programmes were notably higher. On the other hand, despite the emphasis given in the 2015 disability framework to economic empowerment, only 13% of economic development programmes and 7% of agriculture programmes were marked “significant”. The lowest percentage was for climate and energy programmes.
The disability marker reveals another dimension in which DFID mainstreaming of disability has some way to go. Box 7 gives some examples of programmes that in February 2018 were marked “not targeted” by their programme manager, but where, in fact, disability inclusion would be relevant. We understand that two of these cases have since been marked as significant.
Figure 4: The focus on disability in DFID’s programmes
Shows proportion of DFID programmes marked as having a “principal” or “significant” focus on disability, by sector
Box 7: Examples of programmes with “not targeted” disability marker
The following programmes are examples of programmes marked “not targeted” by their programme manager in February 2018, but where, in fact, disability inclusion would be relevant:
- UNCD: Investment in the UN Development System to Achieve Agenda 2030 – Agenda 2030 explicitly includes people with disabilities.
- Global Statistics: Monitoring the SDGs – six of which have indicators for disability inclusion.
- DFID Nepal: Market development programme to increase the incomes of poor and disadvantaged people – people with disabilities face particular barriers of access to markets.
- Research: Education technology research to deliver learning outcomes for all children – “all children” includes children with disabilities, with specific interventions needed.
- DFID Sierra Leone: Support for adolescent girls’ empowerment – girls with disabilities face particular discrimination.
Australia has a different method of assessing progress towards mainstreaming
Box 8 describes the method that Australia’s Department of Foreign Affairs and Trade (DFAT) uses to assess and monitor progress towards mainstreaming disability in its aid programme. By asking whether the programme identifies barriers to inclusion, and whether disabled people’s organisations are involved, it is more clearly addressing mainstreaming than DFID’s disability marker with its focus simply on whether a programme includes activities (of whatever size) to support inclusion.
Box 8: Australia’s method of assessing disability inclusion
The Australian government uses annual Aid Quality Checks to assess the performance of their aid investments of $3 million and above. The checks include two sub-questions on disability inclusion. In 2015, investment managers used them to rate disability inclusion as follows:
- In 46% of programmes: “The investment actively involves disabled people’s organisations in planning, implementation and monitoring and evaluation.”
- In 56% of programmes: “The investment identifies and addresses barriers to inclusion and opportunities for participation for people with disability.”
- These are self-assessments by managers, so the Office of Development Effectiveness was planning an independent review of their accuracy.
Source: 2016 Disability inclusive development: Phase 1 – Strategic evaluation, Australian Department of Foreign Affairs and Trade, Office of Development Effectiveness, 18 August 2016, unpublished.
Senior management is providing leadership
We found good engagement from DFID senior management. A director-general has chaired monthly meetings on disability. The disability team has presented at senior civil service conferences. The quality assurance unit, which has the power to reject and request resubmission of business cases for large, novel or contentious programmes, has challenged programme proposals for insufficient attention to disability. Key informants told us that this was a step change from the situation before 2017, when senior management had been more cautious in light of competing priorities.
There is no specific finance for the transaction costs of mainstreaming
Mainstreaming has start-up costs. In March 2016, Australia’s official development agency, DFAT, launched a fund to provide technical assistance and funding over four years to assist country programmes to strengthen disability inclusion in their aid investments, build the evidence base, and enhance staff capacity. Likewise, DFID’s resilience programme had a £4.1 million Catalytic Fund to cover such costs, which the ICAI review found mostly effective. DFID has no direct equivalent for disability, although the planned Disability Inclusive Development programme includes dedicated funding for evidence generation, uptake and advice to staff.
DFID has incorporated disability into management systems, but this in itself will not be enough to mainstream disability inclusion
DFID has put a range of mandatory requirements into its programme management processes. In particular, staff are required to give all programmes a disability marker (as noted above), and to consider disability in all new business cases. Heads of department must include disability in their annual departmental reports, and in the return for the Public Sector Equality Duty. We found evidence that these mandatory requirements have prompted departments to consider what actions to take.
The Public Sector Equality Duty requires public bodies to have due regard to the need to eliminate discrimination and to advance equality of opportunity. In March 2017, to take an example from one central team, DFID’s Growth and Resilience Department made an interim assessment of its departmental performance in this regard, noting that: “Analysis and targeting of disability is in very early stages. Better understanding of barriers, evidence of what works and a clearer implementation plan will be important.(…) our strategy on disability needs further development and agreement.”
Business cases are required to “outline any measures to ensure that people with disabilities will be included”, but there is no explicit requirement that programmes have to include such measures. Nor, importantly, is there a requirement to consider how people with disability might be excluded if no action is taken. DFID has just amended the annual review template for its programmes to include for the first time mention of disability. But the requirements are only (i) that monitoring data, evidence and learning should consider the ‘leave no one behind’ agenda, including disability, and disaggregate data as far as possible, and (ii) that the assessment of value for money should include equity and hence disability.
Commitments on disability made in the business case are not always carried through into terms of reference for fund managers and suppliers, or into implementation. We found an example in an education programme in Kenya, where a partner constructing school buildings was not following universal design principles. DFID’s code of conduct for suppliers mentions people with disabilities only in an annex and as one of a number of vulnerable groups whose rights need to be protected. There are no specific expectations to be monitored for compliance – for example on the employment of people with disabilities or the use of universal design principles. A review of USAID projects shows that such requirements make a difference: inclusive programming only happened when the project terms of reference contained specific language requiring the inclusion of people with disabilities throughout all components of the project.
However, our desk review shows a recent increase in disability focus introduced after the business case. In four of the ten programmes we studied, disability activities or indicators that had been absent from the business case were added in the design or tendering phase, or after the latest annual review. This may reflect the increased emphasis within DFID on disability. As an interviewee told us, “the priorities of the programme have evolved, and given the emphasis on equity, the programme will strive to target people with disabilities”.
DFID has too few staff with specific expertise, or long experience of work, on disability inclusion
Disability inclusion is a specialist area. There is a particular legal framework in the Convention on the Rights of Persons with Disabilities, with varied implementation by governments around the world. Engagement with disabled people’s organisations is essential, yet complex, as explored below. There are challenges regarding which organisations representing disabled people and which international non-governmental organisations have relevant experience for different types of programming.
DFID needs to be able to access this experience and expertise. Disability is in the competency framework for DFID social development advisers, and there is a learning programme underway for them, but they have a wide range of responsibilities beyond disability and it was clear from our interviews with social development advisers that knowledge is patchy and they still lack the confidence that comes with experience.
The central disability team in DFID is the obvious place for DFID staff to seek out such knowledge. The team does not currently include any staff who came to DFID with disability inclusion expertise. Interviewees strongly appreciated the support of the DFID disability team, while noting that the current team does not have the length of experience of some of the previous staff. This is an enduring problem: the 2014 IDC report commended “the dedication of DFID’s current disability team”, but was concerned over the lack of full-time disability specialists.
The DFID disability team has wisely drawn on external expertise, from non-governmental organisations, academics and the International Disability Alliance – for example to help draft a guide on value for money, a strategy for influencing the World Bank, and the theory of change for the upcoming global disability summit. However, DFID’s use of outside expertise would be more effective if DFID’s own team included a stronger element of in-house specialist interlocutors.
Other development agencies with a disability focus have recognised this need. The Australian disability team has a mix of public service and technical skills around disability. By contrast, an evaluation of Finnish development cooperation expressed concern about insufficient disability expertise and experience in the Finnish ministry that oversees development cooperation. An evaluation of the German Ministry of Economic Cooperation and Development, BMZ, noted that staff resources proved to be inadequate, even though GIZ, the closely associated implementation agency, had a sector team of six disability advisers.
DFID’s commitment to disability inclusion also requires more staff with disabilities
Across DFID in June 2017, 6.4% of home civil service staff and only 1.4% of staff appointed in country had self-identified as having a disability. This compares with 6.7% in the UK home civil service as a whole.
The UN Convention on the Rights of Persons with Disabilities requires that states “closely consult with and actively involve” people with disabilities in the “development and implementation of legislation and policies”, and calls on state parties to “employ persons with disabilities in the public sector”. The DFID disability framework acknowledges the demand of many disabled people’s organisations: “Nothing about us, without us”. The business case for the planned Disability Inclusive Development programme notes: “Best practices for disability inclusion in development and humanitarian work include actively and meaningfully involving people with disability in the process of forming policies and programmes”. DFID’s plausibility as a global advocate for disability inclusion will be strengthened to the extent that it is seen to practise what it advocates.
Research and our own interviews highlight that employing more staff with disabilities will likely improve programming by increasing the pool of competent people and having a positive impact on the attitudes of other DFID staff. In two country offices, we heard that the presence of a staff member with disabilities had raised both the awareness and the confidence of their colleagues in working on disability. Such a shift in perception is important. It shows non-disabled people that people with disabilities are not just vulnerable and dependent, but colleagues who contribute their subject matter expertise (which may or may not be disability-specific).
The UK civil service has a goal to be the most inclusive employer in the UK by 2020. We were told that DFID is preparing a new Diversity and Inclusion Strategy with the aim of supporting this goal and turning DFID into one of the most diverse and inclusive places to work across the civil service. Publishing this strategy, with a timeline and an implementation plan, would be an essential part of DFID’s commitment to disability inclusion.
To be the most inclusive employer, a culture change is needed
To be an inclusive employer, it is key to provide a safe environment where staff with disabilities can raise issues and be treated with respect. We found evidence of a shortfall of trust among staff with disabilities towards DFID managers. In a baseline diversity and inclusion questionnaire, conducted in 2017, some staff told DFID that they do not feel comfortable discussing their disability with their line manager. This was reinforced by views we heard from the three networks in DFID related to disabilities: the DFID Disability Network of staff with disabilities, the network of parents of children with disabilities, and the Listening Network, which is concerned with psychosocial disabilities. People with disabilities are often unwilling to declare a disability for fear of discrimination, and there is statistical evidence that this is true within DFID: the anonymous People Survey, conducted in October 2017, recorded 12% of UK-based staff and 4% of locally hired staff as disabled – considerably higher than the 6.4% and 1.4% that have self-declared.
Figure 5: Disability among DFID staff compared to the UK civil service and the UK population as a whole
Figure 6: Disability among DFID staff: Comparison between UK-based and locally hired staff and between staff who self-declare their disability and the results of an anonymous survey
The three networks of staff concerned with disabilities were consulted by DFID in 2017 and asked how DFID could improve its organisational culture to make it more diverse and inclusive. They called for changes in the department’s organisational culture. These included shifting the mindset towards what people with disabilities can contribute (and away from only looking at their needs), recognising the individuality of people with disabilities and facilitating a “culture change where disability is no longer a ‘hidden’ topic”. One area where DFID is succeeding in changing the culture is in attitudes towards staff with mental health challenges. Box 9 describes the Listening Network.
Box 9: The Listening Network
A Listening Network in DFID has created a safe space for staff to speak confidentially about any issues they are dealing with, including psychosocial disabilities. It was set up on the initiative of five staff members, with the support of their director. To date, 70 staff are volunteer listeners, and 46 staff are mental health first-aiders, trained to support each other in dealing with stress, anxiety, depression and other mental health conditions. As well as offering confidential support, the network also shares personal stories and blogs. These help others realise that they are not alone, giving them confidence to share their own experiences and reduce the stigma of talking about mental health issues. In the two years since the launch of the network, volunteers have supported over 50 colleagues.
The current approach to mainstreaming is too cautious to match DFID’s ambition
We conclude on mainstreaming that to achieve the secretary of state’s ambition to place disability at the heart of all DFID activity would involve a step change across the department – in staff, skills, systems and processes and in organisational culture. That in turn would require DFID to put in place an explicit and structured plan with timelines, backed with technical expertise and finance for transactions costs.
DFID does not have an agreed global theory of change to guide programming
DFID lacks a fully articulated theory of change about how disability inclusion might come about in the world, and thus of what DFID’s role might be in encouraging positive change. Staff preparing for the new research programme on disability did produce in 2017 a diagram of a meta-theory of change, outlining what might be needed globally to achieve disability inclusion. It helpfully starts by listing barriers to inclusion – legislative, institutional, attitudinal, social and environmental – and concludes with people with disabilities being fully included within society. However, it has not been debated externally, or agreed internally. It is neither widely known nor used as a guide for programming.
Country contexts differ widely, and country-level theories of change would be essential complements to a global one. They would encourage DFID country offices to identify important barriers, the potential forces to remove those barriers, and where DFID could most usefully intervene. However, there is no guidance for a country-level theory of change. At least six DFID offices have made a disability stocktake of their existing programmes, but we came across none that have drafted a theory of change. Encouragingly, as part of a new diagnostic exercise examining what is needed to reduce poverty in Nepal, DFID Nepal is planning to commission research to assess the critical challenges facing people living with different types of disabilities, and to present options for how DFID can contribute to addressing these.
In the absence of an agreed global theory of change, the disability framework and the one-page action plan for 2017-18 provide the main overall guidance. They list some important steps towards disability inclusion (such as inclusive education systems and economic opportunities) and identify some key potential actors. But it is less clear what might cause the actors to act, and how barriers could be overcome.
To date, there has been a lack of attention to the role of the private sector
Many institutional and other barriers to the inclusion of people with disabilities lie in the private sector. For example, discrimination or lack of accessibility can prevent people with disabilities from being employed, or being able to trade. Conversely, there are benefits to inclusion: evidence from high-income countries presents a business case for hiring people with disabilities, including higher retention rates, lower absenteeism and equal performance.
The private sector can act to remove barriers. Some large companies are important actors in the global north in identifying and removing obstacles to employment and tackling stigma, and could do the same in the south. There are cases of donors working with the private sector in developing countries – for example the International Labour Organization and Canada with the Bangladesh Employers Federation, encouraging firms to recruit people with disabilities. Donors can also insist that the firms they contract follow good practice. A business interviewee suggested to us that areas of donor engagement with the private sector could include procurement, technology, education, working practices and employment. Box 10 sets out a range of market-based interventions, aimed at small enterprises as well as large ones.
Yet the private sector did not appear in DFID’s meta-theory of change. In the action plan it was limited to delivering economic opportunities, and only as a consortium member in the new UK Aid Connect centrally managed programme. Ahead of the global summit, DFID has now commissioned urgent investigative work on the role of the private sector. A draft theory of change for economic empowerment indicates roles for different elements of the private sector. Private sector actors are invited to the summit, and a list of ‘asks’ of the private sector has been prepared.
Box 10: Market-based interventions to promote inclusion
In 2016, a research programme involving ADD International, the Coady Institute, the Institute of Development Studies and other experts concluded:
“Market-based solutions can deliver at scale. …[T]he most effective approaches not only supported individuals to access markets but also sought to make markets themselves more accessible. The examples ranged from supporting marginalised seaweed farmers in the Philippines to linking individuals on the autism spectrum with job opportunities in IT. Yet across this diversity, we identified a small number of underlying strategies that seemed to show consistent promise. These included: turning marginalised individuals’ disadvantage into advantage by identifying particular skills or assets that gave them a niche; organising collectively amongst the most marginalised; linking highly marginalised people to other less marginalised economic actors in the same community; and working with employers to help marginalised people access in-demand roles.”
There is also insufficient attention to policy dialogue with national governments
The disability framework and the action plan suggested three main routes to influence governments in developing countries. These routes are appropriate, but all have limitations:
- advocacy by disabled people’s organisations – but disabled people’s organisations generally do not have much political weight on their own
- evidence from civil society organisations about what works, which governments can then scale up – but evidence alone rarely induces action
- attendance at the global disability summit – which could galvanise efforts, but will require follow-up.
There is only one mention in the disability framework of a fourth route – the potential role of DFID country offices in policy dialogue with governments, especially in partnership with disabled people’s organisations. Nevertheless, we identified examples of a DFID country office having effective influence on national policy – for example on social protection and the census in Rwanda and on education policy in Nigeria. We understand that DFID country offices have convened meetings with governments and other donors to identify potential commitments on disability ahead of the global disability summit.
Box 11: DFID Rwanda and disabled people’s organisations in policy dialogue with the national government
DFID Rwanda supported the redesign of the Vision Umurenge social protection programme to integrate a stronger focus on disability. DFID Rwanda supported the National Union of Disabled Organisations of Rwanda to carry out participatory research to inform and influence government. The research highlighted that:
- The programme involved only households where the head was a person with disability – ignoring the burden on carers of a child with disability. The guidelines were changed as a result.
- People with disabilities could participate in public works programmes if appropriate work was on offer. As a result, a new scheme of less labour-intensive work has been put in place.
Source: ICAI interview with DFID Rwanda staff.
DFID rightly emphasises the importance of disabled people’s organisations, but provides limited support
The Convention on the Rights of Persons with Disabilities obliges states to consult with organisations representing people with disabilities. There is also evidence that the advocacy activities of disabled people’s organisations have contributed to governments making significant policy changes on disability inclusion, and to some extent pushing governments to implement their policies. A substantial Norwegian study concluded that the most relevant and effective NORAD interventions were those supporting advocacy and capacity building of disabled people’s organisations.
At the global level, DFID engages well with disabled people’s organisations through the International Disability Alliance (IDA), which co-chairs the donor Global Action on Disability (GLAD) network with Australia and will co-host the global disability summit with the UK and Kenyan governments. IDA is an alliance of networks bringing together over 1,100 organisations representing people with disabilities and their families. While some smaller organisations fall outside the IDA umbrella, IDA is the obvious international interlocutor for DFID.
However, in developing countries, DFID is at an early stage of engaging with disabled people’s organisations. The most substantive funding is provided through the US-based Disability Rights Fund. Evaluations of the Fund have been generally positive. Our desk review suggests that the Fund has enabled national disabled people’s organisations to press governments to incorporate the UN Convention in their policy considerations, though it has been less effective in pushing for implementation. But in 2017, its funding reached only eight of DFID’s more than 32 priority countries: Ghana, Malawi, Rwanda, Uganda, Bangladesh, Indonesia, Burma and Haiti. The Fund is part of DFID’s Disability Catalyst programme, which also supports the International Disability Alliance and the UN Partnership on the Rights of Persons with Disabilities (see Box 17) – but neither of those provide medium-term capacity-building support to disabled people’s organisations at country level.
Box 12: Disabled people’s organisations’ advocacy in Bangladesh
In 2012, the Bangladesh government was drafting a disability rights act. With funding from the Disability Rights Fund, the Access Bangladesh Foundation and other disabled people’s organisations arranged a dozen workshops and meetings, including national consultations with government officials and relevant policy makers, to advocate for the review of the draft act. Their recommendations are reflected in the final revised act, which stipulates 21 rights of people with disabilities, including rights to national identity cards and inclusion in the voter list.
DFID country offices have engaged with disabled people’s organisations to varying extents. Our questionnaire distributed to disabled people’s organisations showed that they engaged DFID country offices in seven of the eight countries from which we received a response. However, interviews and the focus group with staff from DFID country offices suggest that, in most cases, DFID country office engagement is at the level of conversations rather than detailed consultation during the design and implementation of programmes. This is confirmed by our desk review of delivery programmes. Only two out of the ten programmes we studied involved substantial engagement with disabled people’s organisations – and both of those programmes related to the funding of the Disability Rights Fund described above. In the remaining eight programmes, disabled people’s organisations were partially involved in three programmes at the design stage; of those three, two had disabled people’s organisations still involved at the implementation stage, and only one at the evaluation stage. As described in paragraph 4.68 below, the preparations for the global disability summit are stimulating more country office engagement with disabled people’s organisations.
While engagement with disabled people’s organisations is essential, donors should take into account important challenges, including:
- Capacity: the vast majority operate at quite low capacities and are under-resourced.
- Inclusivity: a particular set of disabled people’s organisations may not represent all significant impairment groups; some do not represent women well, while some tend not to include the poor.
These challenges emphasise the need for DFID country offices to access and share their experience on relating to disabled people’s organisations. When it comes to supporting them and building their capacity, DFID will do well to also make use of expert intermediaries such as the Disability Rights Fund (offering to fund it to expand the number of DFID’s priority countries in which it operates), umbrella associations of disabled people’s organisations, or relevant non-governmental organisations.
It is difficult to judge the likely effectiveness of programming with disability inclusion aims
There is general agreement, sector by sector, that we have little rigorous evidence about what works for disability inclusion. This makes it hard to judge whether the approach that DFID takes in a particular sector is likely to deliver meaningful results. We examined five sectors – two (humanitarian and education) where DFID has more experience, and so there should be more indication of success, and three that were highlighted in the 2015 disability framework.
The education sector is the most advanced, with ambitions taken even further in the 2018 education policy. One of its three priorities is targeted support to the most marginalised and especially children with disabilities. Disability is also incorporated into the other priorities of investing in teaching, and system reform. We found examples of impactful education programmes in Nigeria, Rwanda and Zimbabwe (see Box 13). But not all initiatives have been successful. On occasion, DFID’s policies have run contrary to national government priorities, for example when governments have overridden DFID’s requirement for universal design in schools.
Box 13: An effective education programme
From 2013 to 2016, DFID’s Education Sector Support Programme in Nigeria helped six state governments introduce inclusive education policies and deliver changes at school and community level that have brought more of the most excluded children into education. Its activities included:
- awareness-raising campaigns for children with disabilities to be enrolled in local schools; messaging that children with disabilities do not only have to attend special schools
- enrolment drives with a strong focus on disability, gender and ethnicity
- training teachers in supporting children with disabilities, such as training in sign language, Braille and attitudes to disability
- conducting of out-of-school surveys to identify which groups of children are commonly out of school
- small-scale efforts to bring special schools and mainstream schools closer together
- small-scale funding of equipment for schools to support disabled learners.
Source: Education Sector Support Programme in Nigeria (ESSPIN) Inclusive Education Review, Helen Pinnock, ESSPIN, June 2016.
In the humanitarian sector, the situation is more mixed. Our desk review of three humanitarian programmes found small but promising disability elements. We understand that other DFID humanitarian programmes and DFID-funded research have included mental health support and treatment for people affected by disasters and conflict. However, the 2017 DFID humanitarian reform policy makes only four mentions of people with disabilities, seeing them as passive – among the “most marginalized and vulnerable in times of crisis”. By contrast, the UN’s 2015 Sendai Framework for Disaster Reduction also identifies the active role that people with disabilities can play in disaster preparedness and disaster response. Internationally, DFID supported the development of the Minimum Standards for Age and Disability Inclusion in Humanitarian Action, and the (non-binding) Charter on Inclusion of Persons with Disabilities in Humanitarian Action. Disappointingly, the multi-stakeholder Grand Bargain that emerged from the 2016 World Humanitarian Summit was weak on disability.
At the current pace and scale of programming, DFID is unlikely to achieve results at scale for the three areas highlighted in the disability framework
We examined three areas where the 2015 disability framework had announced “a proactive approach to further enhancing DFID’s work”: economic empowerment, stigma and discrimination, and mental health and intellectual disabilities. The latter two were also specific recommendations of the 2014 IDC report.
For economic empowerment, we judge that DFID’s current approach is too small to be effective at scale. We found programmes that combine a number of the micro-approaches recommended in the literature as best practice. But they benefit a small proportion of the number of people with disabilities in a country, and constitute a small proportion of DFID’s investment in economic development. For example, the Burma Business for Shared Prosperity programme has a disability sub-project on micro-finance intended to benefit 1,000 people with disabilities, at a cost of £500,000. It funds the Myanmar Centre for Responsible Business to produce guidance on employing people with disabilities, and it hopes to include people with disabilities in a £500,000 grant for micro-insurance, and in work on textiles. But these are a small part of the £55 million budget for the total programme. It is of course entirely appropriate to pilot approaches, but we would have expected a DFID programme to plan to take successful pilots to scale – as the planned Disability Inclusive Development programme is likely to do.
Looking at the macro level, the International Labour Organization estimated the cost of excluding people with disabilities from the workforce as 3 to 5% of GDP.50 DFID has expressed doubts regarding the International Labour Organization’s econometrics, but has commissioned no alternative work. DFID’s chief economist’s office told us that some actions changing social norms on disability could influence the overall economic growth path and have a long-term payoff, but this has not fed through as a reason for DFID to focus on social norm change.
The disability framework was right to emphasise stigma and discrimination, given that the UN Convention requires governments to ensure the full realisation of all human rights and fundamental freedoms for all people with disabilities without discrimination of any kind on the basis of disability. DFID’s action plan has a goal to tackle stigma and discrimination at all levels, but its only indicators refer to the Disability Rights Fund which, as noted above, operates in few countries. We found few DFID programmes with a major focus on addressing stigma and discrimination against people with disabilities. From eight delivery programmes in our desk review, only the two supporting the Disability Rights Fund tackled stigma and discrimination. Only three of the 61 programmes with more than 10% of spend on disability mention discrimination in their short project descriptions, though some others – for example supporting civil society engagement – are likely to include elements to tackle stigma and discrimination. There is no guidance note on changing social norms, as there is for DFID’s commitment to reduce violence against women and girls. We were told that DFID is reluctant to commit to media and communications campaigns in developing countries, whereas key informants suggested they can be influential, especially showing journeys of change of people who had engaged in stigmatising and discriminating behaviour, but changed their attitudes and behaviours as a result of targeted actions. Returns on investment may be less tangible than in other areas, as social norms are often deeply embedded and social change can be hard to measure. This should not be a barrier to investment, however, because tackling the issues around stigma and discrimination requires a long-term perspective.
Box 14: Tackling stigma and discrimination in Kenya: the role of fathers
Under DFID’s Girls Education Challenge programme, Leonard Cheshire Disability ran a programme in the Lakes region of Kenya to address some of the deeply entrenched socio-cultural norms around girls with disabilities. The project team identified and trained 250 male mentors – usually fathers or care givers of girls with disabilities – to encourage them to support the education of girls with disabilities socially, psychologically and financially. They were encouraged to become more involved in their children’s lives and to become role models for other men. The men were trained in a range of subjects including disability issues, parenting skills, stigma and discrimination, gender stereotyping, adolescence, community participation and education. Focus group discussions at the end found that the training positively impacted the men’s awareness and understanding about disability issues, in particular the specific challenges faced by girls.
Source: Pioneering Inclusive Education for Girls with Disabilities in the Lakes Region, Kenya: Research Brief, Leonard Cheshire Disability, 2017
People with mental health challenges (psychosocial disabilities) or intellectual disabilities are more likely to be left behind than people with other disabilities. We found only one DFID-funded programme – support to the Disability Rights Fund – focusing specifically on intellectual disabilities, although the planned Disability Inclusive Development programme may also do so. We were told that DFID is looking to do more within the 2018 education strategy, although the strategy document itself does not distinguish intellectual disabilities from other disabilities. For mental health, DFID’s approach is primarily medical, seeking to provide mental health services to individuals. This was true of the two desk reviews in this sector, and of a 2017 humanitarian guidance note on mental health and psychosocial support. The medical approach does tackle the inclusion of people with disabilities in health services. But the remit of the UN Convention on the Rights of Persons with Disabilities is much broader, recognising the rights of people with psychosocial disabilities to participate fully in society. This is picked up in DFID’s 2016 Mental Health Scoping Study, which states that mental health is a multisectoral issue that cannot be addressed by health systems alone, and which includes proposed actions to promote human rights. Australia has a formalised policy statement with a focus on inclusion (see Box 15).
Box 15: The approach to mental health and intellectual disabilities in Australia’s aid programme
“We recognise that some groups within the disability community are at heightened risk of marginalisation, particularly those with psychosocial and intellectual disabilities. People with these types of disability can be rendered invisible and left out of disability-inclusive development efforts. Psychosocial and intellectual disabilities are commonly less understood, leading to greater stigmatisation. We will give greater attention to people with psychosocial and intellectual disabilities by:
- encouraging partner governments to provide appropriate and accessible support services to meet people’s basic needs
- supporting greater inclusion, participation and empowerment, enabling people to be contributors, leaders and decision makers in all areas of public life, such as education, health and employment
- promoting awareness of psychosocial and intellectual disabilities to reduce stigma.”
Extract from Development for All 2015-2020: Strategy for strengthening disability-inclusive development in Australia’s aid program.
The obligations set out in the UN Convention on the Rights of Persons with Disabilities have implications for mental health services. People with disabilities retain their full legal capacity, so involuntary admission to mental health facilities and involuntary treatment are no longer permissible, and free and informed consent is required. DFID has supported the UN Special Rapporteur on the Rights of Persons with Disabilities to research deprivation of liberty in this context, with a grant to the University of Galway. Good practice at the international level suggests that DFID’s mental health research programmes need to have policies on these issues aligned with the convention.
DFID policy applies appropriate value for money principles to disability inclusion, but practice is not uniform
Equity is now incorporated into DFID’s value for money framework as a fourth ‘E’ (alongside economy, efficiency and effectiveness). DFID’s value for money objective is to maximise the return on its investment, while taking into account its commitments to ‘leaving no one behind’. Our recent review of DFID’s approach to value for money notes that DFID is giving greater attention to reaching marginalised groups, even if this entails higher unit costs. This is also our finding on disability. Both the disability team and the economist in the inclusive societies team actively promote a focus on equity, and the DFID staff we interviewed consistently told us that they were not seeking to maximise beneficiary numbers or promote lower unit costs at the expense of including people with disability. We saw an example of a recent assessment by DFID’s quality assurance unit that the additional costs of including children with disabilities in an education project were justified on value for money grounds.
However, this understanding has not yet reached all of DFID’s fund managers and partners. We found some instances where concerns about cost per beneficiary or the overall number of beneficiaries had led to decisions not to address disability. A report on one of the programmes in our sample said that “partners have expressed that value for money considerations have at times influenced the inclusivity of activity design. For example, inclusion of ramps in hand pump rehabilitation can be costly and thus is not done in all hand pump rehabilitation, but only where there is observed needs and where budgets permit.” DFID’s commitment means that it should not trade off ramps with the total number of people reached. Rather, it should look for the most cost-effective way of providing facilities that are genuinely inclusive.
The implication is that while DFID’s approach to value for money no longer presents a barrier to programmes that seek to address disability, equity is yet to become as widely understood a requirement as economy or efficiency. DFID programme staff are not yet under an obligation to demonstrate that programmes do not unintentionally exclude people with disabilities. DFID’s value for money assessments would be strengthened by more data and analysis on the long-term costs to society of failing to address disability.
DFID has been a key actor in promoting disability inclusion in the global development agenda
DFID was recognised by interviewees as promoting disability within the Sustainable Development Goals, for example through the report of the high-level panel chaired by the then UK prime minister, David Cameron. To do this DFID worked in conjunction with a range of like-minded countries. Indeed, the ability to build positive coalitions to achieve outcomes was vital to the success of this process.
Since the introduction of the Sustainable Development Goals, DFID has had an increasing focus on disability inclusion at the highest level, set within the context of ‘leaving no one behind’. This has been emphasised in speeches made by the secretary of state and senior managers. The key objective has been a general one of promoting greater global political commitment to disability inclusion, supported by increased investment by all donors.
DFID has allocated few resources to international influencing, but other donors, civil society and independent experts all recognised DFID as one of the main actors on disability globally. DFID has achieved significant progress and profile through focused interventions with clear objectives by specific staff members. These included:
- The launch of the inter-agency Global Action on Disability (GLAD) network in December 2015, working with Australia and the International Disability Alliance of disabled people’s organisations. GLAD has become the primary focus of donors’ discussion of disability, although without any representatives from developing countries.
- Data disaggregation and the use of the Washington Group Questions to acquire data – identified as a focus area for international work in the 2014 disability framework. DFID has pushed its partners, including the UN statistical division, to generate disaggregated data. DFID has linked funding of ten UN agencies (IOM, UNHCR, OCHA, WFP, UNICEF, CERF, WHO, UNDP, UN Women and UNFPA) to the collection of data on disability.
- The campaign for the Development Assistance Committee (DAC) of the OECD to adopt a disability marker which would be applied in all its member countries’ bilateral development programmes. DFID submitted a proposal to a formal meeting of the DAC Working Party on Development Finance Statistics in June 2017. This has gained widespread support and is now being taken forward by the DAC.
It was only in April 2017 that DFID outlined an overall approach for its influencing work, with objectives, indicators and activities for a range of agencies. This was strong in terms of specifying activities, but lacked an overarching strategy and clear indicators. The objectives and key messages are set out in Box 16.
Box 16: DFID influencing objectives and key messages on disability
- For too long, decision makers have overlooked people with disabilities – the UK is committed to change this.
- The Global Goals have the potential to be transformative for people with disabilities. But achieving our goals will take actions, not words.
- Our actions will set the tone and pace for the next 15 years. So we all need to aim high and be ambitious. While we cannot do everything immediately, we can all do more right now.
- If you are committed to delivering the promise of the Global Goals to ‘leave no one behind’, the UK is on your side and we will work with you. To be successful we need:
- further action towards delivery of the promise to ‘leave no one behind’, critical to the success of the Global Goals
- greater political will and national-led and international action to address all forms of disability inclusion
- increased investment globally to address the huge gaps in sustainable financing and data on disability-inclusive development.
- No one should be denied the opportunity to realise their full potential and no one should have their interests systematically overlooked. By working together we can ensure that people with disabilities are no longer neglected in international development and humanitarian efforts.
DFID is working effectively with multilateral agencies
DFID’s influence on multilaterals has the potential for major impact on the approach to disability inclusion globally. DFID is working closely with the World Bank, with a strategy framed around five priority areas: leadership and political will, accountability, staff resources, data collection, and negotiation of the replenishment of the World Bank’s concessional arm (IDA19). The World Bank confirmed to us that they drew on DFID’s disability framework for its own disability inclusion and accessibility framework. On the other hand, interviewees argued to us that DFID could do more through its executive directors on the boards of the World Bank and other organisations: if projects were rejected due to lack of disability inclusion, this would prompt action.
DFID frequently raises disability with UN agencies, and has included disability in its Payment by Results approach to four development and seven humanitarian agencies within the United Nations system – 30% of DFID’s core grants to these agencies are now covered by Payment by Results. DFID pushed for disability to be strongly reflected in the new four-year strategic plans for UN Women, UNDP, UNICEF and UNFPA. Since 2016, DFID has also supported two key actors on disability inclusion within the UN system: the UN Special Rapporteur on the Rights of Persons with Disabilities, and the UN Partnership on the Rights of Persons with Disabilities (see Box 17).
Box 17: Collaboration between UN agencies, national governments and disabled people’s organisations
Under the United Nations Partnership on the Rights of Persons with Disabilities (UNPRPD), nine UN agencies can apply to a trust fund to work on advancing rights in line with the Convention on the Rights of Persons with Disabilities. Proposals are required to demonstrate consultation with disabled people’s organisations, and must involve these organisations as well as national governments in the implementation of activities. A 2016 evaluation reported strong outcomes.
In South Africa, for example, one key outcome of the UNPRPD programme was the development of a white paper on the rights of people with disabilities approved by the cabinet and involving representative disabled people’s organisations at key points. UNDP also supported the development of a national monitoring and evaluation framework for disability rights, the disability disaggregation of the country’s National Development Plan, and a study on the economic impact of disability at the household level. A key ingredient for success was strong government ownership and leadership.
Source: UNPRPD Value for money assessment, Wapling, L and Brady, R, 2016. Connections: Building partnerships for disability rights, UNPRPD, 2016.
The global disability summit is an opportunity to galvanise a wide range of actors
The global disability summit, to be hosted in conjunction with the government of Kenya and the International Disability Alliance in London in July 2018, provides a unique opportunity for promoting disability on the global agenda. Most of the interviewees we spoke to welcomed this DFID initiative and proposed to engage to the greatest possible extent. Positive outcomes are expected in terms of awareness and commitments to action by donors, multilaterals, the private sector, developing country governments and civil society.
Calling the summit has already had an impact on other agencies. The fact that the UN Secretary General is to attend is reported to have mobilised UN agencies. Other high-level attendees, such as the president of the World Bank, can be expected to have a similar impact on their agencies’ focus on disability inclusion. Several bilateral donors who have not hitherto had a focus on disability have also indicated that they will attend.
The preparations for the summit have also galvanised DFID’s own country offices. They have been charged with convening meetings with national governments and donors in country. DFID Pakistan has provided a grant to a disabled people’s organisation to build in-country support for the summit, and to consult all key stakeholders to formulate commitments. DFID India reached out to the National Disability Network for a series of ‘disability dialogues’ to help build in-country support for the summit and to lobby for the implementation of India’s 2016 Rights of Persons with Disabilities Act. DFID Zimbabwe hosted a Zimbabwe shadow disability summit in April 2018. The planning of this shadow summit has helped DFID Zimbabwe deepen and broaden its engagement with local disabled people’s organisations.
DFID has formed a broadly based group of bilateral, multilateral, civil society and private sector partners to help plan for the summit. They have worked together on developing DFID’s first theory of change for disability influencing work, including outputs, outcomes and impact under three strands:
- political will for inclusion is catalysed (with reference to the UN Convention)
- evidence and data drive innovation and scale-up
- people with disabilities have leadership and representation.
We judge these to be appropriate objectives, but it will be important for DFID also to generate indicators of progress that can be monitored and evaluated.
In support of these objectives, DFID has developed a long list of ‘asks’ that could be made of national governments, other donors, civil society and the private sector. They are substantial and wide-ranging. On stigma and discrimination, for example, national governments could be asked to announce equitable executive, legislative and judicial appointments to investigate discrimination and put in place enforcement mechanisms for non-compliance; donors could be asked to announce funding for social norm change programmes; and the private sector could be requested to establish a code of conduct to set the minimum standards needed to protect the rights of people with disabilities in hiring, procurement and other key considerations. It is too early to know how these ‘asks’ will be received, let alone implemented, but they represent an ambitious agenda.
One problem has been that the Foreign Office has reduced its capacity in this area, and currently has no officer responsible for disability issues. We judge this to be a significant weakness in the UK government’s capacity to make progress on disability in a range of international forums and events. We were told that the FCO was not planning any engagement with the global disability summit, though we understand that all FCO posts were subsequently requested to engage with host country ministers.
One issue is how to encourage, register and then monitor meaningful commitments that will lead to change, particularly by developing country governments. At present no specific pledging exercise is planned. The disability team has learnt from the 2014 Girl Summit that a separate follow-up process would improve accountability but risks duplicating existing reporting mechanisms.
Learning: How well is DFID identifying and filling knowledge and data gaps on disability and development?
In this sub-section, we look at whether DFID has an appropriate strategy for building its knowledge on what works in improving conditions for people with disabilities, and for sharing this knowledge both internally and externally. We also assess how well DFID addresses data gaps on disability in development within its own programming and at the national and international levels.
DFID is appropriately scaling up its investment in research on disability
Hitherto, DFID has funded little research on disability. Total research on disability inclusion was in January 2017 estimated at £16 million spread over 12 programmes and several years.59 Disability was not mentioned in DFID’s 2016 research strategy.
DFID is now scaling up its research investment. A new six-year Disability Inclusive Development (DID) programme is now being planned, to test and scale up innovative approaches to disability inclusion with dedicated funding for rigorous research, including impact evaluation. Research will also be part of the UK Aid Connect centrally managed programme, providing around £12 million each for one or more consortia of research institutions, the private sector, civil society and other organisations to work on disability.
We judge this emphasis on research and evidence gathering to be appropriate because, as noted, there is widespread agreement across all sectors about the lack of evidence on what works for disability inclusion. There are very few other research funders. The Disability Inclusive Development programme is modelled on the £25 million What Works programme on violence against women and girls (see Box 19), which is delivering valuable results.
Given the priority of disability in DFID’s agenda, there would be a case for allocating substantial DFID research resources to disability. DFID’s total annual spending on research is £390 million; planned spending on research on disability is not yet known. We were told that only two research and evidence staff work specifically on disability, each for only 10% of their time, although other research staff do work on programmes that include disability-focused research.
DFID has not yet aligned its research agenda with its policy priorities
A key issue for a research strategy is to identify the most important evidence gaps and focus research on them. DFID has made a start on collecting data for this. The meta-theory of change, noted above, was developed as part of a policy evidence mapping exercise in order to identify the key actions for which research was needed. In 2017, DFID commissioned the Campbell Collaboration, known as global experts on impact evaluation, to produce a map of the effectiveness of interventions for people with disabilities in low- and middle-income countries, based on impact evaluations and systematic reviews. However, there is no equivalent mapping of research using other methodologies. DFID intends to complete the policy evidence mapping exercise in time to use it to refine the agenda of the planned Disability Inclusive Development programme during its design phase.
The Disability Inclusive Development programme is planned to focus on DFID’s priority countries, but not necessarily its priority sectors. It has a thematic focus on “education, jobs/livelihoods, healthcare, and particularly in conflict and humanitarian settings”. Reduced stigma and discrimination is stated as an objective, but research on stigma and discrimination appears to be optional: programmes are required only to consider the role of stigma and discrimination and ideally assess the impact of intervention on it. Yet stigma is a theme of the global disability summit, and can be researched in its own right.
Box 18: Randomised controlled trials
Randomised controlled trials (RCTs) are planned as a major part of the impact evaluation element of the Disability Inclusive Development programme. Any proposal for an RCT should be assessed carefully, because several key informants warned of the impossibility, in their view, of matching disability impairment and household dynamics in control groups. A position paper for the US National Center for the Dissemination of Disability Research notes that RCTs can be worthwhile for some classes of intervention, but “for many of the current research problems in disability, the usual or optimal solution will not be a large RCT”. It notes:
- Disability is “extremely diverse. Interventions typically must be highly individualized, or client centered, and tailored to particular configurations of impairment or to personal and contextual factors.”
- “Many of the major issues concern large social systems that cannot be manipulated experimentally (eg universal design, accessibility, public attitudes, legal rights, effects of culture, economic factors). These contextual effects are not readily incorporated into current evidence grading systems.“
All informants thought that stigma is hard to measure and therefore may not be suitable to use as an outcome measure in RCTs. And yet stigma is vital to exclusion: there is a risk that prioritising particular methodologies could drive the focus away from what needs to be researched.
Source: . The challenge of evidence in disability and rehabilitation research and practice: A position paper, Johnston, MV, et al, for the NCDDR Task Force on Standards of Evidence and Methods, 2009, Austin, TX: SEDL.
There is no plan to mainstream disability into broader research
From 2009 to 2014, DFID had a Cross-Cutting Disability Research Programme (CCDRP), which provided additional funding to four existing research consortia to incorporate disability into their investigations. Topics ranged from WASH to urban agriculture. CCDRP’s external evaluation was positive, despite the difficulty of adding disability into research already underway. We heard of no plans to build on this experience, or require new research proposals to include disability, except that partners in all health research are now required to disaggregate data by disability, and to report all peer-reviewed journal articles published on disability issues.
Such cross-cutting research is particularly relevant because many people with disabilities also encounter other forms of discrimination and exclusion due to their gender, race, age, sexual orientation, religion or other characteristics. They are particularly likely to be marginalised – important in the context of ‘leave no one behind’. Such multiple discriminations are referred to as intersectionality. Box 19 gives an example of DFID research that has looked at disability in the context of such intersectionality.
Box 19: Research on violence against women and girls with disabilities
DFID’s work to end violence against women and girls has a research programme known as What Works. It has published an evidence review on preventing violence against women and girls with disabilities.
This concludes that women with disabilities are at least twice as likely as non-disabled women to be victims of rape, sexual abuse and intimate partner violence. However, there is very limited evidence on effective approaches for preventing violence against women and girls with disabilities in lower- and middle-income countries.
The review makes four recommendations:
- Use an intersectional approach to understand the multiple, compounding oppressions faced by women and girls with disabilities.
- Foster partnerships with disabled people’s organisations to understand the specific risks and needs of women and girls with disabilities.
- Make relevant research accessible to women and girls with disabilities.
- Monitor the participation of people with disabilities in violence prevention programmes to help ensure inclusion in these contexts.
Source: ‘Preventing violence against women and girls with disabilities in lower- and middle-income countries’, van der Heijden, I and Dunkle, K, What Works Evidence Review, September 2017.
It is likely that DFID’s research will be taken up by external users
The Disability Inclusive Development programme plans to involve policy makers and practitioners, particularly disabled people’s organisations, throughout the period of its research component – which is agreed to be best practice.64 All three of our desk reviews of knowledge programmes that are already underway showed evidence of influence on policy and/or the wider community working on disability. Other previous and ongoing disability research programmes involved users, with some evidence of influence on policy.
DFID has not yet been specific on how far people with disabilities will be involved in steering research
The impact of the planned Disability Inclusive Development evidence programme will depend in part on its relationship to people with disabilities and their representative organisations. The principle of ‘Nothing about us, without us’ also applies to research. This is particularly important because historically there has been a firm body of opinion among people with disabilities that research on disability can be oppressive and disempowering – particularly when researchers saw disability purely as a medical issue, or failed to give sufficient weight to the views of people with disabilities.
We have yet to see how DFID intends people with disabilities or their representative organisations to have decision-making capacity within the planned Disability Inclusive Development programme. They will not necessarily be on the executive steering committee. However, they will be consulted. The programme’s terms of reference require bidders to have “appropriate representation of people with disabilities within consortium and in design”. When it comes to implementation, the indicative key performance indicators included in the terms of reference judge only the “extent to which Supplier is responsive and flexible to DFID and stakeholder needs”, without singling out people with disabilities among the stakeholders.
There is also to be an independent advisory group comprising researchers, practitioners and representatives from disabled people’s organisations and civil society organisations. Its primary function is to give advice, but it is also to endorse projects to be tested through the programme. In all, though, we would like to see further specificity on the role of disabled people and their representative organisations within the research programme.
Internally, DFID staff have limited guidance on how to address disability in programming
There is demand among DFID staff for advice: our two focus groups emphasised the need for knowledge about what works, as did other DFID interviewees. A country office informant said that, in the absence of a central checklist for different points in the programme cycle, her country office is thinking of drafting its own.
DFID’s Violence Against Women and Girls (VAWG) programme shows the value of guidance if well publicised. ‘How To’ notes have been created for five sectors, including, most recently, on achieving social norm change. More than 5,000 people accessed these VAWG resources on the external website in 2015-16. On disability, DFID has circulated a 45-page topic guide on disability inclusion, and sectoral guidance is available for education, social protection, infrastructure and the humanitarian sector. Our interviews suggest that, as yet, they are not well known.
A helpdesk is planned in 2018 as part of the proposed Disability Inclusive Development programme. Experience elsewhere suggests that this is likely to be useful. Australia has one. A DFID VAWG helpdesk was established in May 2013, and by November 2015 had handled 95 enquiries, of which 34 were from DFID country offices.
There are weak systems for staff to learn from the experience of other DFID programmes in the field
Since action on disability is relatively new to DFID offices, there are benefits to be gained by DFID staff learning from each other rather than proceeding independently. Four DFID country offices – Bangladesh, Nepal, Rwanda and Zimbabwe – volunteered to be trailblazer country offices for the broad ‘leave no one behind’ agenda. They have an active and valued community of practice, with a facilitator at the centre. But there is no equivalent community of practice beyond those four countries. By comparison, the community of practice on violence against women and girls has 134 members. There were 15 internal disability expert advisers mentioned in the 2015 disability framework “to help us to give technical assistance to less experienced advisers and colleagues”. But there is no longer such a formal network.
DFID similarly has not had a structured mechanism for learning between programmes. Since so little is known about what works, it might be expected that DFID programmes would incorporate substantial learning elements, but only two of the ten delivery programmes in our desk review did so. The proposed Disability Inclusive Development programme includes a research update component that would be able to share evidence generated by some DFID programmes. The disability team maintains a disability teamsite with a space where countries can share experiences. There is room for more structured sharing of learning on mainstreaming disability between country offices, with more learning built into programmes.
“Disability is largely invisible in DFID evaluations”, we were told by the relevant DFID staff. The five evaluation reports that reference disability on the Research for Development website were all published before 2014. This has been recognised: in January 2018, specific training was provided to DFID’s monitoring and evaluation advisers by a disability inclusion expert to support them in designing and delivering disability-inclusive evaluations. Further training for monitoring and evaluation advisers and other staff is planned in 2018.
DFID is addressing a key data gap – the number of people with disabilities
Target 18 of SDG 17 calls for high-quality, timely and reliable data, disaggregated by, among other things, disability. We approached leading disability experts including the Washington Group on Disability Statistics, the United Nations Special Rapporteur on Persons with Disabilities and civil society partners. All these respondents championed the Washington Group Questions as the most appropriate tool for obtaining these statistics.
Box 20: Washington Group Short Set of Questions
- Do you have difficulty seeing, even if wearing glasses?
- Do you have difficulty hearing, even if using a hearing aid?
- Do you have difficulty walking or climbing steps?
- Do you have difficulty remembering or concentrating?
- Do you have difficulty washing all over or dressing?
- Using your usual language, do you have difficulty communicating?
Each question has four categories of response, indicating the severity of the activity limitation.
The Washington Group Questions ask about limits to activity, rather than impairments, in order to avoid under-reporting due to stigma. They have shown much higher prevalence rates than in surveys asking about impairments or disabilities.
DFID has pursued this vigorously. DFID actively promotes the use of the Washington Group Questions for disaggregated results monitoring, working closely with Australia’s Department of Foreign Affairs and Trade and other international actors. DFID does not yet have a systematic approach at a national level, but it has influenced some censuses, including in Rwanda, Burma and Malawi.
DFID is not yet generating much disaggregated data from its own programmes. All programmes reporting on the single departmental plan were asked to include indicators disaggregated by disability. As of September 2017, only 5% of programmes had done so. However, there is a major effort underway to change this, with a data disaggregation plan and a guide and training on the Washington Group Questions for statisticians and those supporting country offices. All partners have been asked to disaggregate fully by 2022.
A number of key informants pointed out that the Washington Group Questions are critical but are not sufficient for monitoring the extent of disability inclusion. They establish the disability status of individuals, enabling disaggregation of other results information by disability, but not the quality of inclusion, the extent to which particular barriers have been removed, or other data that is needed to assess the success of any individual programme. It is important that, as programmes are put in place, DFID’s emphasis on the Washington Group Questions does not distract from collecting this other data too.
DFID responded to the 2014 IDC report with the 2014 and 2015 disability frameworks. But disability was one priority among many, and DFID was slow to allocate staff resources. This changed in late 2016 with the then secretary of state’s speech. Since then, there has been appropriate senior leadership, and growing engagement across the department. DFID has made consideration of disability mandatory in various management systems, and adopted an appropriate (if not fully practised) approach to value for money. However, the current level of activity and effort is not commensurate with DFID’s ambition to mainstream disability inclusion across programming.
The IDC report identified the shortage of data and the lack of evidence about what works as key constraints. From 2015, DFID has driven forward the data agenda, leading an international effort to adopt the Washington Group Questions as a key tool in achieving the SDG goal of disaggregated data. In 2017, DFID acted on the need for new evidence, with approval for a substantial new programme to test and scale up effective approaches to disability inclusion, alongside rigorous research and impact evaluation. This is larger than any other research effort on disability in development, and can be expected to have global influence. On the other hand, there is no plan to mainstream disability into DFID’s broader research agendas.
DFID has established a leadership position on the world stage, with a series of initiatives that have been widely welcomed. It has brought influence to bear on multilaterals, and worked closely with other bilaterals interested in disability. DFID has a good working relationship with the International Disability Alliance, which pulls together disabled people’s organisations at the global level – particularly important given the obligation under the UN Convention on the Rights of Persons with Disabilities to closely consult with and actively involve people with disabilities. The global disability summit in July 2018 provides an opportunity to engage a wide range of actors, including the private sector, and to invite country-level commitments to action.
At the programme level, however, we found limited progress on integrating disability, especially in the three areas highlighted in the 2015 disability framework as requiring more work – mental health and intellectual disabilities, stigma and discrimination, and economic empowerment.
There are a number of ways in which DFID’s practice currently falls short of the current secretary of state’s ambition to put disability at the heart of everything DFID does. A mindset of disability inclusion requires constant attention to:
- organisational capacity, for example in recruitment and human resource policies and organisational culture
- programming, for example that people with disabilities are involved in design and implementation, and that business cases specify actions to ensure people with disabilities are not excluded across the whole programme
- advocacy, engaging with national governments on their implementation of the Convention on the Rights of Persons with Disabilities.
The following recommendations are intended to address these problems.
DFID should adopt a more visible and systematic plan for mainstreaming disability inclusion. The plan should be time-bound with commitments and actions at the level of programming, human resourcing, learning, and organisational culture.
- DFID’s current planning does not include targets or timelines.
- An update to DFID’s disability framework is needed. It is therefore welcome that a February 2018 paper presented to DFID’s departmental board proposed updating its disability framework to reflect the department’s new and expanded approach.
- The three networks of staff concerned with disabilities have advocated the need to shift DFID’s mindset to what people with disabilities can contribute (away from only looking at their needs), and called for a “culture change where disability is no longer a ‘hidden’ topic”.
DFID should increase the representation of staff with disabilities at all levels of
the department, and increase the number of staff with significant previous experience in working on disability inclusion.
- Only 6.4% of UK-appointed staff, and 1.4% of staff appointed in country, have informed DFID that they have a disability, compared with 6.7% across the whole UK home civil service. This is too low, given the civil service’s ambition to be the UK’s most inclusive employer, DFID’s positive experience when staff with disabilities are employed, and the need to practise what DFID is advocating to others.
- The disability team currently lacks specialist staff with significant previous experience of working on disability inclusion.
DFID country offices should develop theories of change for disability inclusion
in their countries. These should propose a strategy for the country office, with a particular focus on influencing and working with national governments.
- There is no analysis of the barriers to disability inclusion in each country and how disability inclusion might come about, and therefore where DFID’s interventions might be most effective.
- Before 2018 and the preparations for the global disability summit, DFID country offices rarely engaged with national governments about disability. The improved engagement that has occurred in recent months needs to be sustained after the summit.
DFID should engage with disabled people’s organisations on country-level disability inclusion strategies, advocacy towards partner governments, capacity building and the design of programmes, including research programmes.
- Effective disabled people’s organisations are critical to countries achieving disability inclusion, but DFID’s main means of support for them, the Disability Rights Fund, does not operate in most DFID priority countries.
- DFID country office engagement with disabled people’s organisations is mostly at the level of conversations rather than planning.
- DFID has not been clear how far it expects people with disabilities to have any decision-making capacity within research programmes.
In order to deliver its existing policy commitments, DFID should increase its programming on (i) tackling stigma and discrimination, including within the private sector, and (ii) inclusion of people with psychosocial disabilities, and people with intellectual disabilities, noting that these are two different groups who face different sets of challenges.
- Few DFID programmes have major elements tackling stigma and discrimination. While there is a shortage of evidence about what works with regards to disability, there is relevant knowledge from tackling other forms of stigma and discrimination.
- People with psychosocial disabilities (mental health challenges) and those with intellectual disabilities are more likely than people with other disabilities to be left behind. DFID’s programmes have focused on access to mental health treatments, rather than inclusion more broadly.
DFID should create a systematic learning programme, and a community of practice, on the experience of mainstreaming disability into DFID programmes.
- DFID country offices and other departments lack experience on promoting disability inclusion, and there is strong staff demand for knowledge about what to do and how to do it.
- The proposed Disability Inclusive Development programme will promote research uptake, but could be complemented by a structured exchange of learning between country offices on the more practical aspects of mainstreaming disability, and a plan for evaluations.
Annex 1 Disability-specific targets in the Sustainable Development Goals
Goal 1: End poverty in all its forms everywhere
1.3. Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable.
Indicator 1.3.1. Proportion of population covered by social protection floors/systems, by sex, distinguishing children, unemployed people, older people, people with disabilities, pregnant women, newborns, work-injury victims and the poor and the vulnerable.
Goal 4: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
4.5. By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including people with disabilities, indigenous peoples and children in vulnerable situations.
4.a. Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all.
Goal 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
8.5. By 2030, achieve full and productive employment and decent work for all women and men, including for young people and people with disabilities, and equal pay for work of equal value.
Goal 10: Reduce inequality within and among countries
10.2. By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
Goal 11: Make cities and human settlements inclusive, safe, resilient and sustainable
11.2. By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, people with disabilities and older people.
11.7. By 2030, provide universal access to safe, inclusive and accessible, green and public spaces, in particular for women and children, older people and people with disabilities.
Goal 17: Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development
17.18. By 2020, enhance capacity-building support to developing countries, including for least developed countries and small island developing States, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts.
More detail is available in: Disability indicators for the SDGs, UN DESA/DSPS/Secretariat for the Convention on the Rights of Persons with Disabilities, October 2015.
Annex 2 List of programmes reviewed
|Department||Title||Disability %||Budget||Start date|
|Inclusive Societies||Disability Inclusive Development||100||Not currently public||May 2017|
|Research||PRIME Improving Mental Health in low-income countries||100||£8 million||May 2011|
|Emerging Policy (EPIC)||Amplify Open Innovation for Development||13||£11 million||November 2013|
|Research||Humanitarian Innovation and Evidence||12||£5 million||October 2012|
|Department||Title||Disability %||Budget||Start date|
|Inclusive Societies||Disability Rights Fund||100||£3 million||April 2013|
|Inclusive Societies||Disability Catalyst||100||£8 million||October 2016|
|Pakistan||Sindh Education Non-State Actors||100||£13 million||August 2016|
|Pakistan||Multi-Year Humanitarian Programme||15||£100 million||June 2014|
|Rwanda||UK Support to Access to Finance||10||£105 million||June 2016|
|Uganda||Strengthening Education Systems||10||£46 million||April 2015|
|Jordan||Access to Mental Health and Protection||100||£2 million||October 2016|
|Private sector||Pilot use of Development Impact Bonds||40||£6 million||April 2017|
|Nigeria||NE Nigeria Transition to Development||15||£300 million||May 2017|
|Nepal||Emergency Support to Vulnerable Households – PostEarthquake Housing||10||£5 million||October 2017|
Annex 3 Interviews for this review
53 DFID staff were interviewed for this review.
15 academics or independent experts were interviewed.
We also interviewed representatives from the following types of organisation – in some cases more than one person from each:
This includes those present at the stakeholder workshop and the two focus groups. Some of these interviewees were interviewed more than once.