House of Commons - Disability and development - International Development Committee

Disability and development - International Development Committee Contents

3 Strengthening DFID's commitment to disability

DFID's current work on disability

14. DFID currently funds a diverse range of projects and programmes designed to benefit disabled people (Box 1).[37] These include a good balance of both targeted programmes that respond to disabled people's specific needs—for example, supporting DPOs' campaigns for rights; and 'mainstream' programmes designed to be accessible for disabled people.[38] In addition, the Ministerhas expressed a particular interest in disability, and recently announced several new commitments. These include a pledge that all new DFID-funded school construction will be accessible to disabled children; initiatives to gather better data; and renewed support to the Disability Rights Fund (DRF), which helps small DPOs in developing countries.[39] Many submissions to the inquiry said these were very positive steps.

15. However, while valuable, these programmes make up only a small proportion of DFID's total portfolio. Available data indicates that in 2012-13 DFID spent £195 million on programmes designed to benefit disabled people—a little over 5% of its total bilateral programme expenditure.[40]

Box 1 Examples of DFID funded disability programmes. DFID supplied us a list of 112 programmes[41] that aim to benefit disabled people. This Box provides some examples to illustrate their diversity. For full details, please see DFID(DIS0054) and DFID's written evidence, Annex B (DIS0074)

Targeted interventions to respond to disabled people's specific needs:

-  Support to the Disability Rights Fund (£2 million from 2013—2016): providing small grants to help disabled people in 27 developing countries advocate for their rights.
-  Funding for International Committee of the Red Cross rehabilitation programmes in regions affected by conflict[42]
-  Support to the NGO Basic Needs to provide mental health services and advocacy support in Ghana and India(£3 million for a range of programmes between 2010 and2018)[43]
-  A new £2 million research programme to examine links between disability and poverty, and how they can best be tackled

'Mainstream' programmes designed to be accessible to disabled people:

-  Helping disabled girls attend school in Kenya, Sierra Leone and Uganda, as part of the Girls' Education Challenge Programme
-  Working with the Government of Ethiopia to develop accessible water, sanitation and hygiene (WASH) facilities, and develop statistics on disabled people's WASH needs
-  Developing a cash transfer programme in Uganda (£10.6 million, 2009—2015): 12% of the beneficiaries are estimated to be disabled people
-  Supporting Handicap International and HelpAge International to provide specialised advice on disabled and older people's needs following Typhoon Haiyan in the Philippines (over £300,000).

DFID's future work on disability

16. Under the leadership of the current Minister , disability is gaining a higher profile within DFID. DFID recently issued new guidance on business cases, which requires authors to consider how programmes affect disabled people.[44] DFID told us the Ministerrefused to approve some business cases until they increased their emphasis on disability, for example a £106 million water, sanitation and hygiene programme in Ethiopia.[45] We understand from DFID that the Minister has also challenged country offices to increase their work on disability.[46]

17. These are very welcome steps. However their effectiveness is partly dependent on the current Minister's interest in disability—and on the assiduousness with which aspirations in the business case are subsequently monitored. DFID's current Country Operational Plans indicate the Department's commitment to disability is not yet consistent: we reviewed 27 Plans, and found only two mentioned substantive objectives for disabled people.[47]

18. Many witnesses gave their views on the sustainability and consistency of DFID's work on disability, and two key points emerged: DFID should produce a disability strategy;[48] and should strengthen itsreporting processes to ensure greater accountability.[49] We discuss below why we think these recommendations are important. DFID disagrees with us about the first point , so we consider it in some detail before exploring the second.

A DISABILITY STRATEGY

19. One of the most consistent recommendations witnesses argued for in the inquiry was that DFID needs a disability strategy. A diverse range of experts all agreed on this recommendation—including the Executive Director of the Harvard Law School Project on Disability; a large number of NGOs and DPOs; and the UN Special Rapporteur on Disability.[50] A disability strategy would have several benefits. It would make DFID's work on disability more systematic, by allowing it to set outobjectives and timescales, and to allocate appropriate resources.[51] And, perhaps even more importantly, a strategy would be a visible signal of DFID's commitment to disabled people.[52] Bob McMullan told us about his experience of introducing a disability strategy for Australian aid:

20. We were therefore surprised that the Minister ruled out the possibility of a disability strategy in her evidence to us.[54]

A potential objection—"Too many strategies"

21. Explaining why DFID was reluctant to introduce a disability strategy, the Ministersaid that "overloading our offices with lots of strategies means a lot more paperwork. [...]To have a list of different [vulnerable] groups all the time means it is quite difficult to answer this strategy on that, or that strategy on another".[55] Rather than considering disability as a separate issue, DFID's preferred approach is to consider, on a country-by-country basis, all the different risks of exclusion in the round. For example, an office would consider whether disabled people were vulnerable to poverty at the same time as considering the risks to women, children, ethnic minorities, LGBT[56] communities, and others. DFID calls this a 'social appraisal' approach.[57]

22. This approach is intuitively appealing. It appears to provide a simple framework which deals with all groups equally and comprehensively, and allows for the fact that different groups may experience exclusion in different contexts.[58] It provides space to consider overlaps between different groups—for example, the fact that disabled women often experience 'double discrimination'.[59]DFID also argues that social appraisal helps it devise more integrated responses to exclusion, rather than a string of "smaller special interest projects".[60] Some submissions to the inquiry agreed with DFID that social appraisal was the right approach to take, although they were in the minority.[61]

23. However, on balance, the evidence persuades us that social appraisal does not work for disabled people, unless it is accompanied by a more specific checks.Submissions repeatedly said that, in practice, donors tend to focus on the most obvious groups, and people with disabilities get forgotten.[62] As one witness, a former DFID consultant, told us: "People have talked about social exclusion for a long time, and disabled people have not been included, so there is something that is still needed in order to persuade people who are working on social-exclusion or inclusion issues that disability is part of that debate."[63] An expert on humanitarian relief told us how, in emergency situations, social appraisals tend in practice to focus on women and children.[64] Another witness recalled a discussion of World Bank programmes in Bangladesh:

24. If some DFID country offices are already conducting thorough social appraisal analyses that include disabled people, a disability strategyshould not mean substantial additional work for them, although we accept there will be some extra paperwork. On the other hand, if other offices have not fully considered disability in their analysis, our proposal provides a safeguard to ensure disabled people do not fall between the cracks—a safeguard that will ensure DFID's commitment to disability is sustained even as key personnel change. Nor does our proposal imply that DFID should respond to disability with 'small, special interest projects'—on the contrary, as outlined in paragraph 44 and Chapter 5, we would expect DFID's strategy to foster linkages between different marginalised groups, and to ensure disabled people were fully accommodated within wider 'mainstream' programmes.[66]

25. We recommend that DFID introduce a disability strategy.Disability should be a priority for DFID. Its current approach to social impact appraisal, which considers the risk of exclusion across a wide range of marginalised groups, is valuable—but not enough. There remains a danger that disabled people's interests will be lost among those of groups who are more visible - all the more after the current Minister moves roles. By publishing clear objectives, and timetables, as it has done for gender, the Department can signal its commitment to disability, and help ensure this commitment endures even as key individuals move on. We also recommend that the disability strategy be supported by clear references to disability in all Country Operational Plans, and in the next Bilateral Aid Review.

A second objection—"Too little data"

26. DFID says that "much of [the evidence on development work with disabled people] is related to single programmes within specific countries and includes limited information about long term outcomes, which limits the ability to scale up or replicate programmes."[67] In principle, we support DFID's commitment not to rush into large-scale programmes without firm evidence.We recognise that better data would make for more targeted programmes, and could help persuade more sceptical partners why disability is a priority.[68]

27. However, DFID's caution risks lack of ambition.We asked several of our expert witnesses whether there was enough data for DFID to embark on large-scale programmes, and they agreed that there was.[69] There is evidence that'scale up' is not out of reach : for example, Handicap International highlighted DFID's inclusive education work in Rwanda, which it is currently piloting at district level with a view to national level scale up.[70] In addition, DFID's current, stringent, evidence requirements risk ruling out programmes which could have substantial benefits. One NGO specialising in deafness told us:

28. In addition, there is a risk that, if too much emphasis is placed on data gathering, research can easily become a substitute for action.[72] One academic described her experience undertaking an expensive disability survey for a multilateral organisation in Iraq, only to find the results were never used for programming.[73] DFID has specifically designed some of its research programmes with a view to putting the results into action.[74] However, one of our witnesses, who recently led a DFID-funded research programme, said that some DFID teams took more interest in the results of disability research than others.[75]

29. We welcome DFID's research into disability, and support its commitment to evidence-based programming. However, as we found in our report on Violence against Women and Girls, DFID should strike a balance between building an evidence base on disability, and implementing programmes. The scale and urgency of the challenge are such that DFID cannot wait for perfect data before embarking on large-scale disability programmes. Rather, DFID should take an ambitious but flexible approach. We recommend that DFID set challenging milestones for implementing more large-scale programmes. It should begin these programmes by piloting, as it has done in Rwanda, so that it can stop any projects that are not working, and rapidly scale up those that are. Similarly, we recommend DFID take a pragmatic approach to funding applications from disability-focussed civil society organisations, and should not let imperfect data prevent it funding promising projects with a clear potential—albeit unproven—benefit. We recommend that DFID continue to undertake research on disability, and monitor closely whether the research is put into practice by DFID and its partners.

Ensuring the strategy reaches the most marginalised

30. Several submissions to the inquiry emphasised that, even among disabled people, some groups are particularly prone to be marginalised. These include people with intellectual or psychosocial disabilities. These people are particularly exposed to stigma, violence and poverty.[76] A witness from Palestine told us how, while children with physical disabilities could often access school, many with intellectual disabilities could not.[77]

31. We also heard that there are significant overlaps between disability and ageing. First, older people suffer more from disability than any other age group: it is thought that 46% of people over the age of 60 are disabled.[78] Yet their conditions may be dismissed as part of the ageing process, and not even recognised as disability;[79] and they tend to be under-represented in the disability movement.[80] Second, even if they do not have impairments, older people face many of the same barriers as disabled people. Compared with younger age-groups, they are less able to escape poverty; less likely to access basic services such as healthcare and micro-finance; more vulnerable to abuse; and more exposed to the effects of conflict and disaster.[81]

32. We recommend that DFID's disability strategy state specifically how DFID will reachpeople with intellectual and psychosocial disabilities through its programmes. We further recommend that DFID cover ageing in the same strategy as disability, given the strong overlaps between the two issues. It should, though, recognise that not all disabled people are older people, to ensure the focus on older people does not eclipse the priorities of disabled children or younger adults.

STRONGER REPORTING AND ACCOUNTABILITY

33. A disability strategy is unlikely to be effective unless it is backed by a strong mechanism to ensure accountability. A stark example comes from DFID's work on education for disabled children. In 2010, DFID published a detailed guidance note for country offices, supplemented by a one-page summary in 2011. In 2012, NGOs surveyed usage of the guidance across six country offices in Africa. They found that only one office had put the guidance note into practice; three had not even read it. When asked why, one office explained that they faced many competing demands, and "they had not been asked to report on actions taken".[82]

34. Many submissions recommended that the best way to hold programmes accountable is by requiring them to disaggregate the numbers of disabled beneficiaries.[83]The Prime Minister has already signalled his commitment to disaggregated reporting, when he said that the new post-2015 development framework should include targets disaggregated by disability.[84] DFID is currently supporting international efforts to develop such data in the education and WASH[85] sectors—including WASH data broken down by type of disability.[86] It will be important for it to make use of this data as soon as possible in key internal monitoring processes such as Annual Reviews, Project Completion Reviews and logframes.[87] It is unclear, however, how DFID plans to gather data on disabled beneficiaries in sectors other than education and WASH. Moreover, DFID's Results Framework, which summarises DFID's most important targets, does not include any disability-disaggregated targets, whereas itdisaggregates many targets by gender.[88] Gathering data on disability is notoriously difficult,[89] but some of our expert witnesses recommended that the UN's Washington Group questions (Box 2) would offer a 'quick and dirty' approach in the short term.[90]Box 2: The Washington Group questions on disability

The Washington Group questions identify disability by asking whether individuals have difficulty performing certain basic tasks. Respondents specify the level of difficulty that they experience, on four-pointscale from 'no difficulty' to 'completely unable'.

1. Do you have difficulty seeing, even if wearing glasses?
2. Do you have difficulty hearing, even if using a hearing aid?
3. Do you have difficulty walking or climbing steps?
4. Do you have difficulty remembering or concentrating?
5. Do you have difficulty with self-care, such as washing all over or dressing?
6. Using your usual (customary) language, do you have difficulty communicating (for example, understanding or being understood by others)?

The questions have their limitations: for example, they focus on medical conditions rather than environmental and social barriers that lead to disabled people's exclusion.

However, they are relatively quick, allow international comparisons, and avoid the trap of asking directly whether people are disabled - a question which tends to lead to under-reporting.[91] As such, some key experts recommend the questions are a good pragmatic way to measure how far programmes are successfully reaching disabled people.

Source World Health Organisation/World Bank, World Report on Disability, Geneva, 2011, Box 2.2; Q102 [Dr Shakespeare], Dr Sophie Mitra (DIS0094) para 14, Leonard Cheshire Disability Annex A (DIS0077) para 2.

35. We welcome the Prime Minister's commitment to reporting disaggregated data on the number of disabled people who benefit from development programmes. We also commend the steps DFID is taking to make better data available. We recommend that DFID report results disaggregated by disabilityin all Annual Reviews, Project Completion Reviews and logframes. We also recommend that it disaggregate targets in its Results Framework by disability, as it does for gender. We recognise that collecting data on disability is not straightforward, and teams have many other demands on their time, so recommend a pragmatic approach in the short term—for example, using theWashington Group questions. In the medium term, we recommend DFIDdevelop more precise data disaggregatedby type of disability.Wherever possible, we recommend that DFID report results disaggregated to show people who belong to several marginalised groups at once (e.g. disabled women), to help tackle the 'double discrimination' that such people face.

Announcements in the pipeline

36. The Minister told us that DFID's approach to disability is "work in progress".[92] During our evidence session, she indicated that DFID plans to announce further programmes to reach disabled people in more key sectors of its work.[93] She indicated these plans might affect both DFID's bilateral programmes, and those delivered through multilateral organisations.[94] DFID has subsequently provided some additional information on these plans:

We welcome the news that DFID plans to introduce further programmes aimed at disabled people. We trust DFID will take our recommendations into account as it develops these plans, and we look forward to hearing an update in the Government's response to this report.

37 DFID Annex B (DIS0074) Back

38 This so-called 'twin-track' approach was endorsed by many of the submissions that we received, e.g. from the UN Special Rapporteur on Disability (DIS0086) para 6, Prof Michael Stein (DIS0053) para 10, Bond Disability and Development Group (DIS0011) para 7.3. Back

39 DFID (DIS0054) para 7 Back

40 DFID Annex B (DIS0074), National Audit Office (NAO), Briefing to Support the International Development Committee's inquiry into the Department for International Development's Annual Report and Accounts 2012-13, 2013, Figure 1 [total bilateral expenditure, less debt relief and technical cooperation]. Actual result = 5.5%, but this is probably a slight under-estimate, due to limitations in the data that DFID holds centrally. The new commitment on school buildings, while symbolically significant, is unlikely to change this percentage materially. Back

41 This excludes disability prevention programmes Back

42 DFID (DIS0054) Para 41 Back

43 See also Basic Needs (DIS0056). Back

44 DFID Annex C (DIS0075) Back

45 DFID Annex D (DIS0092) para 3 Back

46 As above. Back

47 DFID, 'Operational Plans and Summaries 2013', accessed 22 March 2014. The two countries are Afghanistan, the Occupied Palestinian Territories. A further 7 include implicit or secene-setting references, but not explicit objectives.. The scarcity of objectives on disability may partly reflect that disability was not a criterion in the 2011 Bilateral Aid Review, when DFID decided on the priorities for its country-specific work. Back

48 Philippa Thomas (Disability, Poverty and the Millennium Development Goals: Relevance, Opportunities and Challenges for DFID, Cornell, 2005 pp11-12) notes that 'policy' is an ambiguous term within DFID - sometimes it is more a piece of research, than a definite statement of the Department's intent. Here we are using the latter definition: we would expect the policy to make clear commitments and to set out how they will be implemented. Back