Social inclusion of people with disabilities in poverty reduction policies and instruments: initial impressions from Malawi and Uganda
Social inclusion of people with disabilities in poverty reduction policies and instruments: initial impressions from Malawi and Uganda
Abstract and Keywords
This chapter reviews the importance of people with disabilities being included in the process of national and international development, and of them being substantial beneficiaries of this process. It begins by briefly considering the case for social inclusion in international development work in low-income countries. The chapter then reviews the internationally agreed targets set out in the Millennium Development Goals (MDGs) and how these may be restated in terms that are more inclusive of people with disabilities. It also describes an important policy instrument – the Poverty Reduction Strategy Paper (PRSP) – which has a critical role in achieving these goals at the level of individual countries. The major analysis is drawn from initial impressions of the extent to which people with disabilities have had a meaningful role in the formulation of PRSPs in Malawi and Uganda.
This chapter reviews the importance of people with disabilities being included in the process of national and international development, and of them being substantial beneficiaries of this process. We begin by briefly considering the case for social inclusion in international development work in low-income countries. We then review the internationally agreed targets set out in the Millennium Development Goals (MDGs) and how these targets may be restated in terms that are more inclusive of people with disabilities. Next we describe an important policy instrument – the Poverty Reduction Strategy Paper (PRSP) – that has a critical role in achieving these goals at the level of individual countries. Our major analysis is then drawn from initial impressions of the extent to which people with disabilities have had a meaningful role in the formulation of PRSPs in Malawi and Uganda.
Disability and social inclusion
The degree to which people with disabilities are weighed down in their daily lives by illness or impairment determines the extent to which they experience social inclusion or exclusion. The more they are weighed down, the greater the disadvantage they experience in accessing health, education, communication, housing and other social services. The purpose of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is to promote and ensure the full enjoyment of all human rights and fundamental freedoms by people with disabilities, who currently represent 10% of the estimated six billion of the world's population. It is estimated that 20% of the world's poorest people are disabled (Thomas, 2005), and that up to 80% or more of an estimated six hundred million (p.16) people with disabilities throughout the world live in low-income countries (Mandesi, 2004).
Disability also has a disproportionate burden on women and children. Unicef (2002) estimates that 30% of street children have a disability, while UNESCO states that 90% of children with disabilities in low-income countries do not attend school. The UN Development Programme (UNDP) also estimates that globally only 3% of adults with a disability are fully literate (UNDP, 1989). While we recognise that the definition of disability is contested, this chapter adopts the view expressed in the International Classification of Functioning, Disability and Health (ICF), that ‘… a person's functioning and disability is conceived as a dynamic interaction between health conditions (diseases, disorders …) and contextual factors’ (WHO, 2001, p 10). However, we also want to stress the strong participatory element of the right to ‘involvement in life situations’ (p 191) that is also recognised. The UN Convention seeks to safeguard and advance basic rights and human dignity with the ultimate aim of improving the social life and development of people with disabilities on an equal basis with others in society.
The concerns of many governments and representatives of disabled people's organisations (DPOs) often include general principles such as non-discrimination, equal opportunities, equality, reasonable accommodation, positive measures, affirmative action, treatment, accessibility and universal design, self-determination, full participation, full inclusion, independent living, international responsibility/cooperation, disability inclusive development, empowerment of people with disabilities, as well as human dignity and respect for difference and acceptance of disability as part of human diversity and humanity (UN Enable, 2007). These concerns and a commitment to establish equal rights for people with disabilities are now enshrined in the UNCRPD. Article 32 of the Convention states that development programmes should be inclusive and accessible to people with disabilities. This is because disability is regarded as a mainstreaming issue that should be considered in all development programmes rather than as a stand-alone issue (UN Enable, 2007). The Convention calls for organisations for and of people with disabilities at international, regional and national levels to participate in all development programmes.
Other aspects of the UN Convention include general obligations of states such as the need at national level to undertake all appropriate steps to eliminate discrimination based on disability; to promote international cooperation; and to undertake measures for the progressive realisation of economic, social and cultural rights for the benefit of people with disabilities in each country that has ratified the Convention. Thus mainstreaming disability issues into all economic and social development policies and programmes has been included in the UNCRPD under the provisions of general obligations. Equality legislation includes requirements in relation to making reasonable accommodation for people with disabilities and allows positive action in relation to people with disabilities. It is important that these requirements are fully respected and integrated into international development initiatives and strategies.
The MDGs and targets emanate from the Millennium Declaration, signed by 189 countries, including 147 heads of state and government (UN, 2000), and from further agreement by member states at the 2005 World Summit (UN, 2005). The goals and targets are interrelated and should be seen as a whole. They represent a partnership between low and high income countries to create an environment – at the national and global levels alike – which is conducive to development and the elimination of poverty (Thomas, 2005). However, these goals are incomplete if they do not explicitly address the aspirations and rights of people with disabilities. To this effect, the former World Bank president, James Wolfensohn, remarked:
The failure of the international community to explicitly incorporate disability in the MDGs is problematic in that it may be taken as reflecting the neglect and exclusion of people with disabilities from the major international development instrument of our time. However, we prefer to see this as an opportunity to illustrate the relevance of disability across all these goals, rather than to argue for the seclusion of disability into a new additional MDG. This recognises the importance of disability as an interdisciplinary, intersectoral and interministerial issue and of the experiences of people with disabilities being a good probe to evaluate how well services are integrated in this ‘inter-land’ (MacLachlan et al, 2009a). We now consider how the eight MDGs may be reinterpreted in terms of people with disabilities.
Unless disabled people are brought into the development mainstream, it will be impossible to cut poverty in half by 2015 or to give every girl and boy the agreed to goals by more than 180 world leaders at the UN Millennium Summit in September 2000.
(quoted in Thomas, 2005)
Goal 1: Eradicate extreme poverty and hunger for people with disabilities and their families
Qualitative evidence suggests that people with disabilities are significantly poorer in low-income countries than their non-disabled counterparts. Many people with disabilities are denied or have limited access to healthcare, education or jobs; their impairment may require continuing care and support, which may drain already scarce household resources.
Goal 2: Achieve inclusive education
Very often there are insufficient provisions for children with disabilities to be included in education; they get frustrated with school and may drop out. Children who repeat classes or drop out of school may have emotional or intellectual disabilities. It is impossible to achieve the goal of universal primary education unless educational institutions become more inclusive.
Women with disabilities are more likely to be victims of sexual abuse. Violence against women causes psychological disabilities, and some disabilities – such as those affecting the female reproductive system (obstetric fistula) – are particularly stigmatising.
Goal 4: Reduce the mortality of children with disabilities
Many children with disabilities are at higher risk of dying because of associated health conditions, but also because of a lack of access to public services, and intense stigma – even within their own homes.
Goal 5: Improve maternal health for women with disabilities and achieve the rights of children and families
This is important for disability prevention. Women with disabilities have less access to public health information, which would enable them to make informed decisions about health promotion, including preventive interventions. Lack of information places them at greater risk of unwanted pregnancies and HIV/AIDS.
Goal 6: Combat HIV/AIDS, malaria and other diseases to which people with disabilities may be more vulnerable
AIDS and other contagious diseases can, in and of themselves, be disabling. However, most significantly, efforts to halt the spread of these epidemics frequently do not encompass people with disabilities, putting this group at higher risk of contracting such diseases.
Goal 7: Ensure environmental sustainability and accessibility for people with disabilities
Environmental dangers can lead to the onset of many types of disabilities, and inaccessible environments prevent people with disabilities from taking part in economic and social activities.
Goal 8: Develop a global partnership for development that is inclusive of DPOs
Partnership implies inclusion, which means everyone.
Each of the above eight goals are guided by specific targets and indicators for monitoring progress for the general population. Yet there are no similar targets and indicators set for people with disabilities. The disability-specific MDGs described above are a result of a draft memo on mainstreaming disability in MDGs and other development goals tabled for debate in the UN Assembly (GPDD, 2009). We have made some modifications to these to further emphasise disability.
The MDGs are seen as key goals to strive for, but they do not indicate how they should be achieved. A critical step in the ‘how to’ process is creating national development policies that are inclusive, both in how they are developed, and in (p.19) what they recommend should happen in practice. We now consider one of the major policy instruments used for poverty reduction and national development planning in low-income countries, PRSPs.
Policy instruments for addressing poverty
In low-income countries realising the rights of people with disabilities, as stipulated by the UN Convention, presents a significant challenge. International aid assistance is often directed at achieving the targets set out in a document, drawn up by governments in consultation with others that indicate a country's development priorities, the PRSP. However, disability issues rarely feature in PRSPs. Without getting disability on the agenda of these documents it is hard to channel funding to address the particular challenges faced by people with disabilities.
The World Bank has contributed significantly to putting disability on the development radar particularly through its recognition of the double imperative of human rights and the economic potential of people with disabilities. Translating the MDGs into action requires an operational framework at the national level. In more than 70 low-income countries, this operational framework is increasingly being provided by a country-led PRSP. In designing these strategies, individual countries should incorporate those aspects of the MDGs that fit their own situations and reflect the aspirations of a broad range of the country's citizens.
After several cycles of PRSPs, there is still scant evidence of disability being meaningfully incorporated into national plans. Nonetheless, in some African countries disability has a higher profile than in others, including ministries specifically addressing disability issues. However, even where this is the case, disability has not necessarily permeated into PRSPs in a satisfactory way. On occasions DPOs, whose participation in the PRSP consultation may have served to legitimise the process, have been frustrated by little, or no, subsequent inclusion of disability in the resulting PRSP; elsewhere this consultative process has not even been undertaken.
Getting disability on the policy agenda
The obvious challenge of the stated instruments lies in who formulates them and the consultative processes involved, in terms of how widely civil society and in particular the disability community were consulted or asked to contribute. It becomes difficult to get disability on the policy agenda, and subsequently, to achieve poverty reduction, sustained economic growth and social development, if the prevention of disabling living conditions and the participation of people with disabilities are not explicitly addressed in poverty reduction strategies (Barnes, 2009). Mainstreaming steps are required to ensure that people with disabilities are able to participate fully in the development process and claim their rights as full and equal members of society (Butler and McEwan, 2007). The involvement of people with disabilities from grass-roots level up to the policy implementation (p.20) level cannot be an option, but an obligation for both national and international development. We now consider our initial impressions of the social inclusion of people with disabilities in PRSPs in Malawi and Uganda, arising from a study entitled ‘African Policy on Disability and Development’ (A-PODD) (www.a-podd.org).
A-PODD brings together three partners: the Secretariat of the African Decade of Persons with Disability, the Centre for Rehabilitation Studies, Stellenbosch University and the Centre for Global Health, Trinity College Dublin, and benefits from the input of a number of leading international advisers, across civil society, government and academic research. It is a three-year project (2009–11)focusing on Sierra Leone, Ethiopia, Malawi and Uganda, and is funded by Irish Aid, through the Health Research Board (Ireland). The project is documenting and analysing factors and processes that contribute to realising the rights of people with disabilities, promoting their health and well-being and unlocking their economic potential, within governmental strategies aimed at poverty alleviation, in particular PRSPs.
PRSPs have become the planning tools and catalysts used by most low-income countries to fight poverty. They are used to describe the country's macroeconomic, structural and social policies as well as related external financing requirements and key sources of financing (ODI, 2004). They design programmes that run for three years or longer to promote broad-based growth and poverty reduction. Without getting disability on the agenda of these documents it is hard to channel funding to address the particular challenges faced by people with disabilities. This implies that people with disabilities should not be targeted, but also actively engaged in poverty reduction processes (MacLachlan and Swartz, 2009).
In 2005, government ministers from low, medium and high income economies met in Paris to reform the way in which aid was delivered and managed to achieve the MDGs. One of the recommendations of the resulting ‘Paris Declaration on Aid Effectiveness’ was that donor countries base their overall support on their recipient partner's national development strategies (AFRODAD, 2002). National development strategies usually take the form of PRSPs, mechanisms designed by the World Bank and the International Monetary Fund (IMF), by which highly indebted poor countries (HIPCs) can get debt relief, and become eligible for renewed financial aid (Dube, 2005). Countries receiving aid and loans have to develop national PRSPs – a plan that provides a framework for IMF lending, and for the World Bank's Country Assistance Strategy (CAS) papers, which cover the World Bank's medium-term business plan and its projected lending options (AFRODAD, 2002). This plan has to articulate the government's commitment to, and strategy for, poverty reduction, showing how the government would utilise the savings created by debt reduction. A comprehensive PRSP includes poverty diagnostics based on good indicators of poverty (AFRODAD, 2002). Donor countries would then base their financial aid on these PRSPs. Hence anything that is not written into the PRSP is difficult to subsequently get funding or resources for. Thus, the development of policy instruments such as PRSPs constitutes a (p.21) critical challenge for the disability community to get its agenda included – PRSPs present a nexus for the inclusion of disability in ‘development’.
PRSP process in Malawi
Malawi is a landlocked country and considered one of the poorest in the world. Like most low-income countries, the PRSP has been used to guide the country's poverty reduction programmes. Malawi has followed its own process of formulating a PRSP and subsequent policy documents, and the PRSP has evolved into the Malawi Growth and Development Strategy (MGDS), reflecting the country's economic and political environment. The MGDS document can be considered a variation of the generic PRSP process, described above. However, it is not clear what processes were followed to include and/or exclude disability issues in the stated policy documents.
Discussions with some key stakeholders suggest that the PRSP in Malawi was first conceived by international donors, such as the IMF and the World Bank. Others suggest the PRSP was actually inspired by the Malawi ‘Vision 2020’ document, which, they assert, had little to do with international donors. It was clear that Malawi's economic and political course and its relationship with external donors played a major role in shaping the PRSP process. The development of Malawi's PRSP started in the latter part of 2000. Initially, the process was not consultative as civil society and a number of bilateral donors were excluded from the exercise (Booth, 2003), let alone DPOs. Booth (2003) suggests that there were territorial battles between the National Economic Council and the Ministry of Finance Economic Planning, now known as the Ministry of Development Planning and Cooperation (MDPC) as to who would be the custodian of the document. It now seems clear that the MDPC is the custodian of the MGDS. The initial process of the PRSP formulation relied on previous policy framework papers, which were poorly assembled into a PRSP under the direction of a small group of officials working with World Bank staff members.
When the government began the PRSP preparatory process in 2000, it ran into resistance from civil society almost immediately. The organisational structure for developing the PRSP was perceived as government-dominated, and led by MDPC and the National Economic Council. The consultation process was designed as a series of one-day workshops, to which various ‘sectors’ of civil society were invited so that they would voice their views.
PRSP Thematic Working Groups (TWGs), formed to draft sectoral and issue-based components for the PRSP, were launched. These included representatives from civil society and donors; however, notably, disability groups were excluded from this process. Some TWGs included Members of Parliament (MPs) from relevant parliamentary committees.
The background documents distributed to TWGs contained a reasonably clear statement of the key objectives of the PRSP approach. International donors and the government agreed that the key feature of the PRSP would be its (p.22) implementable, prioritised plan of action. District consultations were planned by the PRSP Technical Committee, with input from the National Steering Committee (principal secretaries), who formed three teams that covered between them the 31 districts in Malawi. The district workshops were dominated by local officials, such as district councillors, the police, district health officers, traditional authorities, as well as other influential people within the districts. The first PRSP was formulated between 2001 and 2002 for a four-year period. After the 2004 General Elections, the Ministry of Economic Planning and Development was given the task of formulating the MGDS. This time, there seems to have been wider consultation between ministries, non-governmental organisations (NGOs) and the private sector. During the formulation of ‘Vision 2020’, the Ministry of Women and Child Development was responsible for disability and they had one sweeping statement regarding their commitment to disability issues. Consequently, the initial PRSP did not include anything on disability.
The government established a Ministry of Persons with Disabilities in 1998, which is now known as the Ministry of Disability and the Elderly, whose main aim was to oversee the implementation and mainstreaming of disability in policy and development programmes in all government ministries. The formation of this ministry was also inspired by ‘Vision 2020’.
One informant suggested that when considering issues of disability inclusion, the first point of discussion and contention should be the Constitution of Malawi, which is largely silent on disability issues except for some guidance it gives on the rights of people with disabilities. As the situation stands in Malawi, the same key informant stated: “frogs and grass have more rights than people with disabilities.” This is because the protection of wildlife and natural resources is enshrined in the constitution of Malawi, while the rights of people with disabilities is not. The section where disability is included in the Constitution is not enforceable by law. By implication, people with disabilities may not be defended by the laws of Malawi. Thus, it is likely that the minimal inclusion of disability in the MGDS may have been influenced by the Constitution of Malawi, which barely incorporates the subject.
A common theme in our discussions with key stakeholders was that people with disabilities and DPOs, including some statutory organisations such as the Malawi Council for the Handicapped (MACOHA), were significantly marginalised in the formation of Malawi's initial PRSP and the subsequent MGDS paper. Despite this, some people from representative groups were invited to participate during the review process of the MGDS. Disability seems to have been included at the last minute, and its presence in the document reflects the ‘charity model’, characterised by a provision of handouts; thus failing to meet the aspirations of people with disabilities in Malawi.
A World Bank official who was interviewed in this study suggested that the PRSP was never implemented fully before it was changed to the Malawi Growth and Economic Strategy (MGES) and later to the MGDS, which was launched in 2007. The aim of the PRSP was to try and get government and NGOs to focus (p.23) on medium and long-term development goals. They created 16 working groups to carry out annual reviews of the MGDS. As disability is a social protection policy issue in the MDPC, perhaps this is where it will be most strongly reflected. The role of development agencies is to provide financial and technical support to manage the PRSP process using various development partners and experts who assess the impact, challenges and gaps.
Disability seems to be grouped together with other vulnerable groups in the review meetings, and disability-specific issues seem to be rarely raised. It was suggested that the Federation of Disability Organisations in Malawi (FEDOMA), which is the umbrella body of all DPOs in the country, needs to develop a clear strategy on how to meet the needs of people with disabilities. However, there are few data or statistics for/on people with disabilities, perhaps a pre-requisite for FEDOMA to undertake this task. Our initial analysis suggests that DPOs and minority groups are not sufficiently proactive in advocating for their inclusion in government development plans. However, it is also the responsibility of the parent ministry to involve FEDOMA, and the strengthening of this link should be supported.
In conclusion, some of the reasons expressed for the exclusion of disability in the PRSP/MGDS include that people with disabilities themselves are not empowered enough to understand what they are striving for and to be consistent in their efforts. Another challenge is that people with disabilities are not present at senior levels in the Ministry of Disability and the Elderly. Furthermore, the government does not look at disability policy for guidance in implementing development programmes; rather, it is informed by its own policy priority areas, as stipulated in the MGDS paper and the MDGs, especially Goal 1 on poverty reduction. The government does not seem to appreciate that disability mainstreaming means increasing funding to central ministries to enable them to implement disability-specific programmes as well as increasing funding to DPOs to facilitate programme implementation at that level. Therefore, there is a need for disability policy awareness-raising activities among both civil society and government in Malawi. The proposal for a national coordinating committee on disability issues could play an important role here by addressing how to translate policy into programmes.
PRSP process in Uganda
Uganda is also a landlocked agrarian country, located in East Africa, bordered by Sudan to the north, Kenya to the east, Tanzania and Rwanda to south and the Democratic Republic of Congo to the west. Out of its estimated total population of 29.6 million, about 31% live on less than US$1 a day (in 2006); the population is predominantly rural (about 85%) and agrarian, with up to 70% of all economically active Ugandans working in agriculture and fishing (World Fact Book, 2009).
In 1997, Uganda adopted the Poverty Eradication Action Plan (PEAP) as the overall development framework, aimed at reducing income poverty and (p.24) inequality, improving human development and increasing gross domestic product (GDP) growth. The PEAP, which aims to reduce poverty to 10% by 2017, has four fundamental goals of: creating a framework for economic growth and transformation, ensuring good governance and security, directly increasing the ability of the poor to raise their incomes and directly increasing the quality of life of the poor (MFPED, 2002). The PEAP's ambition is beyond the MDGs' target of halving the proportion of people living below the poverty line in 1990 by 2015. Since the launch of the PEAP, GDP growth has averaged about 6% per year, and it is claimed that the country is well on course to meet the MDG targets on poverty reduction.
The PRSP consultation process in Uganda started in December 1999 and ended in May 2001. This process coincided with the tabled revision of Uganda's own PEAP, which was developed with the active participation of civil society organisations (CSOs). Consequently, the Uganda PEAP was endorsed as the PRSP by the executive boards of the World Bank and IMF in May 2000. During the PRSP process, a clear timetable of events and activities were developed and CSOs developed a work plan for that purpose. The Ugandan Debt Network (UDN) was invited to participate in the PRSP process as one of the three national networks and was subsequently selected by CSOs to be the lead organisation to coordinate civil society inputs into the process.
Gariyo (2002) confirms that UDN mobilised more than 60 national NGOs, research institutions and other civil society groups to participate in the consultation process. Furthermore, approximately 600 individuals representing farmers, women, youth, elders and opinion leaders participated in district consultations organised to collect inputs from the people at grass-roots level, at numerous workshops held for that purpose. Other interested stakeholders, for example, those involved in human rights and conflict resolution, and environmental groups, organised their own stakeholder meetings and submitted their contributions through the UDN for inclusion in the PEAP process.
Approximately 600 individuals representing farmers, women, youth, elders and opinion leaders participated in district consultations organised to collect inputs from the people at grassroots level, at numerous workshops held for that purpose. Other interested stakeholders, for example, those involved in human rights and conflict resolution and environmental groups, organised their own stakeholder meetings and submitted their contributions through the UDN for inclusion into the PEAP process. Furthermore, Gariyo (2002) confirms that UDN mobilised more than 60 national non-governmental organisations, research institutions and other civil society groups to participate in the consultation process. This was done through workshops, seminars and media events. These platforms were used to solicit information from the public and to inform them about progress of the PEAP process. UDN reported that all written reports from these consultative forums were submitted to the PEAP technical drafting team in the MFPED (Gariyo, 2002). This allowed stakeholders to establish direct links with the PEAP (p.25) committee so that all additional information received was immediately passed onto this committee.
The implementation of the PEAP has been aided by the decentralised system of governance adopted in the mid-1990s, in which administrative responsibility is shared between the central government and the local government at district and sub-county levels (MFPED, 2008). Uganda is divided into 81 districts and 897 sub-counties, giving a total of 978 local governing bodies, which undertake much of the delivery of social services using resources allocated from the centre, while the central government takes care of policy formulation and resource mobilisation. The decentralised system has been useful in accessing and expanding key services, including primary healthcare, universal primary education, water and sanitation services, community policing and feeder roads to remote locations.
The PEAP was revised in 2000 to bring the voices of civil society, particularly the poor, who had been left out of the initial document. Thus, the government, NGOs, academic institutions, donors, and civil society participated in the revision process. This was informed by the sector-wide approaches and the Uganda Participatory Poverty Assessment Project (UPPAP). The second UPPAP was conducted in 12 districts, under the theme of deepening the understanding of poverty gained in the first UPPAP, and gathering people's experiences with government policies (MFPED, 2002). Therefore, the 2000 PEAP process was highly participatory through general consultative forums, with wide circulation of PEAP drafts supervised by a steering committee.
The revision process went into more than the 1997 document on the actions that promote private sector development, and therefore contributed indirectly to poverty reduction. The preparation of the 2000 PEAP was highly participatory, with a wide circulation of drafts supervised by a steering committee, strong involvement from civil society, general consultative workshops, the receipt of written comments and regional and political consultations.
Despite the efforts described above, it is of great concern that the disability movement did not participate in the preliminary PEAP formulation until the second revision in 2002. The disability movement then made a coordinated effort to ensure that people with disabilities were incorporated in mainstream poverty eradication programmes (NUDIPU, 2003). During the process of revising the PEAP, the government invited various stakeholders, including DPOs, to participate in the process. This invitation resulted in the National Union of Disabled Persons of Uganda (NUDIPU) mobilising DPOs to participate and input into the process. Nonetheless, due to a lack of resources and capacity, not all of them participated. This is to be regretted because it is crucial for NUDIPU to bring all the voices of various DPOs to ensure that the government takes their concerns into consideration and to give legitimacy to the role of NUDIPU as an inclusive and nationally representative body (Dube, 2005).
Currently, disability concerns in Uganda have reached a level where they are part and parcel of the country's general concerns, which have to be addressed in national policies and programmes. A number of legal provisions, such as the (p.26) Parliamentary Elections Statute 1996, the Children Statute 1996, the Local Government Act 1997, the Land Act 1998, the Uganda Communication Act 1997, the Traffic and Road safety Act 1998, the Uganda National Institute for Special Education (UNISE) Act 1998 and the Movement Act 1998, attempt to address the needs of people with disabilities (Dube, 2005). Each of these pieces of legislation mainstreams disability and provides regulations aimed at improving access of services to people with disabilities. However, the fact remains that many DPOs are not well equipped to engage at all levels in these consultation processes and so the extent to which their contribution is taken on board varies considerably (NUDIPU, 2003).
In June 2008 PEAP was replaced by the National Development Plan (NDP). As part of implementing some poverty reduction strategies under NDP, Uganda is currently at the planning stage of introducing social protection provisions for its poorest citizens. As a proactive measure, NUDIPU organised a workshop in March 2009 where various stakeholders, including DPOs, CSOs and NGOs, met to raise their concerns over the proposed government scheme on social protection in relation to people with disabilities. A-PODD researchers attended this workshop. It was clear that there was inadequate involvement of DPOs in designing the social protection scheme. Most delegates at this workshop were not aware of social protection plans, particularly for people with disabilities. The discussions raised a number of issues and concerns that were to be fed into the proceeding workshop on the next day, where representatives from the Ministry of Gender, Labour, and Social Development (MGLSD), the ministry that is also responsible for disability issues, would be present to presumably take on board the recommendations from the workshop. However, some delegates were pessimistic regarding the impact their workshop's deliberations would have on the government officials and ultimately on the social protection agenda. This impact remains to be seen.
The preliminary visit to Uganda brought to light some of challenges facing DPOs in the participation of PRSP processes. These were identified through informal discussions with DPOs, individual people with disabilities, CSOs, the Department of Disability and the Elderly Affairs, and in disability-related research reports. The common constraints highlighted included human and financial capacity, time, DPOs' access to information and their ability to influence decision makers (Dube, 2005). Countries undertaking PRSPs are both poor and profoundly indebted. It is therefore predictable that they will be severely limited in their competence to undertake a comprehensive, participatory consultation exercise, bearing in mind the need for human and financial resources. Although civil society can add to government efforts if called on to do so, it is also most likely that CSOs and NGOs in poor countries are among the most poorly resourced to do so.
There is a need to build the capacity of DPOs if they are to have a greater impact on policy planning, implementation, monitoring and evaluation. Capacity building entails having adequately trained personnel to execute any strategic programmes. Those working in relevant government ministries should also have their capacity (p.27) built, particularly regarding their knowledge and competence around disability advocacy, and they should have the ability to form sustainable partnerships with DPOs (Gariyo, 2002). DPOs must also build the capacity of grass-roots people to participate in monitoring policy implementation.
The need to get the PRSP to meet set deadlines so that debt relief can be applied certainly creates considerable pressure that is likely to undermine the quality of the process itself. As indicated earlier, PRSPs are developed in circumstances marked by inadequate funding, insufficient human capacity, insufficient research-based evidence and insufficient time, among many other constraints. Participatory approaches require thoughtfulness and interpersonal sensitivity, they are naturally expensive and time-consuming, and the quality of their outputs is no doubt related to the quality of their inputs.
In the case of Uganda, there was pressure to quickly complete the PRSP process and to produce the document for funding. As a result, the PEAP process, in which civil society had been meaningfully involved, became constricted and civil society found themselves, to some extent, squeezed out (AFRODAD, 2002). The whole process that clearly had good intentions ended up being ‘microwaved’ in order to meet deadlines.
Given the diversity of the DPOs needing access to information regarding PRSP and related processes, the means by which information is transmitted is highly relevant. Relevant documentation that informed the PRSP process was not in accessible formats or multiple languages (Uganda has multiple different ethnic languages). In Uganda, as in many other countries, illiteracy and language differences present barriers when disseminating information, particularly to people with disabilities (Dube, 2005). Even for people who can read, printed documents may be expensive and difficult to disseminate widely, while internet access is still quite narrowly confined. Television or radio usually reach more people, but are not accessible to the majority of people with disabilities. As a result, this communication challenge can seriously compromise the PRSP process.
Another challenge to increasing the influence of DPOs may be that some government officials still regard DPO and CSO participation in policy development as a means to legitimise the PRSP process, while viewing their criticisms with distrust. While DPOs need capacity building to influence government policy, they also need to fully understand and analyse the agenda of donors contributing to such processes. Donors have a very strong influence over budgetary and other policy plans in Africa because in many cases they contribute a large portion of the government budget (Gariyo, 2002). In the case of Uganda, the activities of NUDIPU (and other CSOs) to date illustrates that DPOs have the capacity to influence governments in planning poverty alleviation programmes and in developing policies.
The idea of inclusive development is widely accepted in theory, but in practice there are many challenges to achieving it. The absence of disability in the MDGs is a stark example of the invisibility of perhaps the most impoverished and disadvantaged group in society. We cannot leave social inclusion to good intensions, even when these do exist. It is important to identify how disability can be put on the development agenda by understanding the factors that have affected its inclusion or exclusion from PRSPs, and related development instruments. A-PODD seeks to explore the extent to which evidential factors (for instance, research evidence initiatives; see MacLachlan et al, 2009b) and non-evidential factors (for instance, advocacy, networking or time pressure) influence what gets on the development agenda. Through the initial impressions of the PRSP process in Malawi and Uganda described above, along with further work in each of these countries and in Ethiopia and Sierra Leone, we hope to identify the most effective tactics that the disability community can use to influence development so that people with disabilities are clear beneficiaries of it and it does actually help them to move out of poverty.
AFRODAD (African Forum and Network on Debt and Development) (2002) Civil society participation in the Poverty Reduction Strategy Paper (PRSP) process, AFRODAD.
Barnes, C. (2009) ‘Disability in a majority world context: a materialist account’, Paper presented at the ‘Disability and Economy: Creating a Society for All’ Todai Conference, 29–30 April, Manchester Metropolitan University (www.read-tu.jp/english/Forum2009/paper/colinbarnes.doc).
Booth, D. (ed) (2003) Fighting poverty in Africa: Are PRSPs making a difference?, London: ODI.
Butler, R. and McEwan, C. (2007) ‘Disability and development: different models, different places’, Geography Compass, vol 1, no 3, pp 448–66.
Dube, A.K. (2005) Participation of disabled people in the PRSP/PEAP process in Uganda, Disability Knowledge and Research, South Africa.
Gariyo, Z. (2002) Participatory Poverty Reduction Strategy Papers (PRSPs): The PRSP process in Uganda, Kampala: Uganda Debt Network.
GPDD (Global Partnership on Disability and Development) (2009) List serve, GPDD Discussion Forum.
MacLachlan, M. & Swartz, L. (eds) (2009) Disability and international development: Towards inclusive global health, New York: Springer.
Mji, G., MacLachlan, M., Melling-Williams, N. and Gcaza, S. (2009b) ‘Realising the rights of disabled people in Africa: an introduction to the special issue’, Disability & Rehabilitation, vol 31, no 1, pp 7–13.
(p.29) MacLachlan, M., Mannan, H., Schneider, M., Eide, A.H., Swartz, L., McAuliffe, E., Mji, G., van Rooy, G., Amin, M., Munthali, A. and Dube, A.K. (2009a) Disability as a systems probe for evaluating health, development and equity, Working Paper, Dublin: Centre for Global Health, Trinity College Dublin.
Mandesi, G.K. (2004) Progress report on UN Disability Rights Convention (www.disabilityworld.org/09-11_04/news/progressreport.shtml).
MFPED (Ministry of Finance, Planning and Economic Development) (2002) Uganda Poverty Reduction Strategy Paper progress report, Kampala.
MFPED (2008) Uganda Participatory Poverty Assessment Process (UPPAP) national report: Disability and poverty in Uganda – Progress and challenges in PEAP implementation 1997–2007, Kampala.
NUDIPU (National Union of Disabled Persons of Uganda) (2003) Participation of Organisation and Partners for Persons With Disabilities in the PEAP, Revision.
ODI (Overseas Development Institute) (2004) Second generation poverty reduction strategies., London: ODI.
Thomas, P. (2005) Disability, poverty and the Millennium Development Goals: Relevance, challenges and opportunities for DfID, Disability Knowledge and Research (www.disabilitykar.net).
UN (United Nations) (2000) Disability and the Millennium Development Goals.
UN (2005) Resolution adopted by the General Assembly, 60/1, 2005 World Summit Outcome (www.unpan1.un.org/intradoc/groups/public/…/un/unpan021752.pdf).
UN (2008) Convention on the Rights of Persons with Disabilities, New York: UN (www.un.org/disabilities/convention/facts.shtml).
UN Enable (2007) Relationship between development and human rights (www.un.org/esa/socdev/enable/disa5861e.htm).
Unicef (2004) Fact sheet (www.unicef.org/voy/explore/rights/3743.htm).
WHO (World Health Organization) (2001) The International Classification of Functioning, Disability and Health, Geneva: WHO.
World Factbook (2009) Uganda 2009. CIA World Factbook (www.geographic.org/wfb2009/uganda/index.html). (p.30)