Children with Disabilities
HRBA, Equity and Inclusive Development
Challenges & Opportunities for UNICEF
WHO ARE THE
‘BENEFICIARIES’ OF
DEVELOPMENT?
AND WHO
ARE THE
EXCLUDED?
Convention on the Rights of Persons with Disabilities
Article 1 - Purpose
To promote, protect and ensure the full and equal enjoyment of all
human rights and fundamental freedoms by all persons with
disabilities, and to promote respect for their inherent dignity.
Persons with disabilities include those who have longterm physical, mental, intellectual or sensory
impairments which in interaction with various barriers
may hinder their full and effective participation in
society on an equal basis with others.
CRPD
• 153 signatories
• 110 ratifications
Optional Protocol
• 90 signatories
• 63 ratifications
UNICEF’s Mandate
UNICEF’s mission statement:
- priority to the most disadvantaged children;
- identifies CWD as being among the most
disadvantaged ;
- requiring special protection.
CRC, together with CRPD and CEDAW:
- UNICEF foundation to uphold the civil, cultural,
economic, political, and social rights of all girls, boys and
women in the world, including those with disabilities.
Disability Terminology
The CRPD institutes:
- PERSON(S) WITH DISABILITIES
Also Correct:
• individual(s) with disability or disabilities
• people with disabilities or disability
Disabled People also acceptable.
Traditional Model
I will kill you
so you stop
suffering
Disabilities as:
- Will of God/test from God
- Divine punishment
- More humane to end “life of pain/suffering”
Charity Model
People with disabilities considered:
•
•
•
•
inferior, useless, dependent
A burden to society, live on charity, lower social status
Families hide them out of shame
Objects of pity, humiliated in relationships with others
Medical or Biological Model -- Post WW II
Problem belongs to individual: disability results directly
from impairment of the person.
 Disability considered only a
health problem, medical issue
 Solutions decided by
"experts”, based on diagnosis
 Focus in elimination or cure
of disability, “normalization”
(includes pre-natal genetic
testing & selective abortion)
EMPLOYMENT
We will rehabilitate
you so you can
overcome all barriers
The 70’s : Disability Movement & Social Inclusion
 People with disabilities are part of society and inclusion must
be promoted (health, education, training, work…)
 Independent living movement is born
 PwD are organized,
get stronger
 Sectors of society,
especially “disability
professionals”,
see this as cause to
worry
MEDICAL MODEL
He cannot vote
because he is
disabled.
SOCIAL MODEL
He cannot vote because the
stairs prevent him from
reaching the ballot box.
From MEDICAL to SOCIAL model
Human Rights Model
The main issue is in society rather than in the individual
 Recognizes that disability is a
part of society
 More comprehensive and
global. Considers:
- Civil and political rights
(voting, freedom of expression )
- Economic, social and cultural
rights (health, education ...)
- PwD and their families
reclaim their place as PERSONS,
with rights and duties.
Equal opportunities
and full participation
in political and social life.
IMPAIREMENT & DISABILITY
Anyone at any time can acquire an IMPAIRMENT of any
kind and can become permanently or temporarily
DISABLED. Impairment relates to the way people function
in their environment and in society.
It may be present from birth or it may develop during a
lifetime, through malnutrition or disease, accident, violence
or abuse, or environmental conditions. As people age, so
too does the possibility of acquiring a visual, hearing,
physical or other type of impairment.
Different kind of IMPAIRMENTS may generate different
kinds and levels of FUNCTIONING LIMITATIONS but, if we
can eliminate barriers in society, these limitations may not
necessarily become a DISABILITY.
IMPAIREMENT & DISABILITY
Whether an individual will be considered “disabled”
is strongly related to the enabling or disabling
environments that surround that specific person,
including society’s attitudes and social norms.
If barriers are eliminated and there is positive interaction
between the person and the broader environment, so
there will be greater opportunities for personal
empowerment, social participation and inclusion.
If the individual may not be able to overcome the existing
societal barriers, even with support and specific
accommodations, this interaction will reinforce stigma,
discrimination and lead to disempowerment and
exclusion.
Equity issue becomes clear when
1+1= minus 2
Gender + disability
Minorities + disability
Indigenous + disability
Race + disability
Refugees + disability
Orphans + disability
Poverty + disability
and other associations, including all of the above
INVISIBILITY – STIGMA - EXCLUSION
most excluded are the ones with multiple factors combined
Equity = Equal Opportunities
To guarantee a fair
selection, all will
have the same exact
test – climb up on
that tree.
Functioning Diversity
Environment
HOW IS DISABILITY DEFINED AFTER THE CRPD?
Interaction between persons with different
levels of functioning
and
an environment that does not take those
differences into consideration.
Disability= Functioning limitation x Environment
Note: we are using “functioning limitation” as a synonym of “impairment”.
Environment Impact in the relation
between disability and functioning
FL 1 x E 0 => 0 Disability
FL 5 x E 0 => 0 Disability
FL 1 x E 1 = 1 Disability
FL 5 x E 5 = 25 Disability
FL: FUNCTIONING LIMITATION
E: ENVIRONMENT
Disability is part of each and every individual’s life cycle
Beyond the typical areas of impairments (physical, sensory,
intellectual and mental), people in general face ‘disabling’
conditions in a society that is unprepared for diversity.
Every day, new causes of disability…
Advances in medicine
= higher life expectancy.
HIV-AIDS survivors =
People living with AIDS potentially living with disability
associated with, or as consequence of, medication.
Also, PwD at risk of
contracting STI, HIV-Aids
due to greater vulnerability
to sexual abuse, and lack of
access to information,
communication and services.
This could be the SAME person at
different times of their life
Why not make life
easier for all?
INCLUSIVE DESIGN
None of
them
would be
able to
open that
door…
INCLUSIVE DESIGN
A HUMAN-CENTERED DESIGN
Inclusive & Sustainable Public Policies
All principles, actions and components should be
conceived under an inclusive approach, from
design to implementation.
Persons with
disabilities
should be
visible and
actively engage
in all phases
It is estimated that the
additional costs to bring inclusive access to
infrastructure is lower than 1% in the stage
of designing and planning
Poverty & Disability
WHO/WB estimate approximately 15 percent of world’s
population has a disability. This translates into over a million
people, at least 200 million being children with disabilities
(CWD), 80% of them living in developing countries.
Vicious cycle between poverty and disability
Poverty not only from economic perspective,
Causes of Impairments
About 80% of disabilities have causes associated to poverty.
An estimated 130 million people globally acquired a disability due to malnutrition.
Disability, Employment and Social Protection
About 80-90% of persons with disabilities are unemployed
or outside the work force. Most of those who have jobs receive
little or no monetary remuneration.
In Ecuador,
84% of
persons with
disabilities
have no
insurance
benefits.
Disability and Conflict
High prevalence of
disability amongst
conflict-affected
populations: excombatants,
civilian and
refugees.
Refugees with disabilities face double vulnerability of being a refugee
and having a disability.
Disability in Emergency Situations
Emergencies - conflict or natural disaster:
In the short-term:
- injury and malnutrition,
leading to disability.
Haiti, 2010
In the longer term:
- destruction of health and
education services
- higher rates of disease
- all resulting in disability.
- PwD must be included in the planning of humanitarian responses
(providing shelter, sanitation, health-care, food and education).
Poverty & Disability
UK:
Poverty rate:
PwD = 23.1%
Non-disabled people = 17.9%
If extra expenses associated with
being disabled added,
Poverty rate disabled people =
47.4%
(Amartya Sen)
Disability and Education
Estimated 40 million of 115
million out-of-school children have
disabilities.
UNESCO: 90% of children with
disabilities in developing countries
do not attend school; therefore
absent in school data sets, and
invisible on national policy agenda.
Estimated 30% of world’s children who live on the street are
children with disabilities.
Disability, Child Mortality and Child Protection
In Kazakhstan, 80% of
fathers are reported to
abandon their wife and
family upon the birth of a
child with a disability
(ADB). The situation is
similar elsewhere.
Mortality for children with disabilities may be as high as 80% in
countries where under-five mortality, as a whole, has fallen to below
20%.
In some cases, it seems as if disabled children are being “weeded
out.” (DfID, UK)
Disability Data in Mozambique
• Nearly a third (26%) of the total number of households have one or more
members with disabilities, while just 6% of people have participated in the
2009 INE/SINTEF survey have a disability.
• Given the methodological procedures of the research, the prevalence of
disability in Mozambique for this study is estimated at 6.5%.
• The proportion of women and men in the group was almost the same,
5.3% and 6.5% respectively.
• Generally, PWDs in Mozambique have an average age of 35 years of age
while those without disabilities have an average age of 21 years.
• 36 households (5.8%) had more than one member with disabilities.
• Half of people with disabilities (52%) reported that their disability was due
to a disease. However, no medical check was made to find out types of
diseases. Over a fifth (24%) reported disability from birth.
PWDs Living Conditions Study in MOZ
• Education: A higher proportion than normal of PWD who have never
attended school; or have a low frequency; or high dropout rate. Men with
disabilities have a higher proportion of school dropout than women (65%).
• A higher proportion of women with disabilities have never attended school
(53%) - twice than of women without disabilities, as well as men with and
without disabilities.
• The proportion of PCD who can write was higher than the general population
(24% versus 15%). Almost a quarter of PCD cannot write while in the general
population the proportion is less than 1/6. The number of women/men with
disabilities who cannot write was higher than that of the general population.
• Communication and information: availability and accessibility to telephone,
radio, television, internet, banking facilities, newspapers, post office and
library. PWDs have significantly limited access to different forms of
communication and information compared to the general population.
Access to Services
Incidence of low and moderate
disabilities is higher than severe
disabilities.
Most cases can be attended at the
community level, with simple,
cost-effective interventions.
Without necessary attention, low functional limitation,
can become severe disability, generating high risk of
social and economic exclusion.
Inclusive and Sustainable Public Policies
Cost of special services to address the specific needs of each
group in society is much higher and less cost effective than of
those of public policies and programs designed and implemented
for all.
Inclusive Development
Based on Human Rights and Equity Approaches:
Recognizes DIVERSITY as fundamental aspect in process of
socioeconomic and human development.
Recognizes the contribution that each human being can make
to development process.
Promotes an integrated strategy benefiting society as a whole,
rather than implementing isolated policies and actions.
Is an effective approach for overcoming social exclusion,
combating poverty and ensuring social and economic sustainability.
Sustainable Development means Inclusive Development!!!
Strategies for Promoting Inclusive Development
Across all MTSP FAs:
• Build on existing opportunities; propose inclusive strategies
in initiatives already being implemented;
• Develop capacities among different actors to advocate and
negotiate for inclusive policies, programs, humanitarian actions;
• Establish mechanisms for participation and collaboration of
PwD,CwD & families in design, implementation, M&E of policies,
programs and humanitarian actions.
• Invest in public discourse & communication to change
attitudes towards people with disabilities.
Selected Examples
for
MTSP Focus Areas
MTSP 1: Young Child Survival and Development
• all projects, including ECD, health promotion, social protection:
consider CwD & families among their clients
• all projects related to health, nutrition, WASH, prevention, etc.:
adopt outreach efforts towards CwD and their families; ensure
access to information, communication & social services
(including transportation & access to surrounding areas)
• all YCSD initiatives: address attitudes of service providers &
community; incorporate inclusive components e.g. appropriate
services & approaches for parents and CwD, accessibility, and staff
training on CBR.
MTSP 2: Basic Education and Gender Equality
- all teacher training : inclusive education perspective;
address attitudes towards CwD
- CFS & quality education initiatives: promote inclusive
education
- life skills & sexual/reproductive health initiatives: equal
access to children and young PwD
- policy advocacy: mainstreaming of CwD in formal &
non-formal education
- all gender mainstreaming efforts should include girls and
boys with disabilities
MTSP 3: HIV-Aids & Children
- all sexual & reproductive health initiatives, including prevention & provision
of services: specifically include girls, women, boys and men with
disabilities as direct clients & as service providers
- all public education materials & initiatives: accessible to & inclusive of
children & adults with wide range of disabilities
PREVENTION: ALL OF US HAVE A ROLE TO PLAY
MTSP 4: Child Protection
• all family services (e.g. child care, parenting education): include
families of CwD; address attitudes towards PwD
• training of service providers, alternative care/foster care
providers: include building understanding of CwD & how to care for
them
• capacity building to prevent, detect & manage
abuse/exploitation: include building understanding & skills to
cope with different types of disability
• engagement with community & faith based organizations:
address stigma & discrimination
MTSP 5: Policy Advocacy & Partnerships for Children’s Rights
• Advocate for & facilitate dialogue on rights-based approach to
CwD; promote ratification, implementation & monitoring of CRPD
• Strengthen DPO capacity to effectively advocate for ratification of
CRPD & monitor its implementation: focus on rights of CwD
• Support national statistical offices/government agencies to include
disability in census & household surveys, and disaggregate
data to include CwD
• Support participation of CwD & their families in design/revision &
monitoring of policies & legislation, & development of inclusive
strategies for systems strengthening
NOTHING ABOUT US WITHOUT US!
THANK YOU!
Rosangela Berman Bieler
Chief, Disability Unit
Gender, Rights and Civic Engagement Section
Program Division
UNICEF
Three United Nations Plaza, Room 452, New York, NY 10017
Tel: 212-824-6067 - Fax: 212-735-4420
e-mail: rbermanbieler@unicef.org – web site: www.unicef.org