Disability and development and the world bank

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Estimating Poverty for Small, Vulnerable Populations

Poverty estimates are generally not available for small vulnerable groups, primarily because of data limitations. This absence of poverty information for highly vulnerable groups acts as obstacle to full attention to vulnerable groups in the. PRSP processes.

This grant will develop and employ recently developed techniques for the estimation of poverty rates for such groups, including disabled people, orphans, child-headed households, widows, and those in old age.
Most household surveys do not have an adequate sample size to measure and analyze poverty among relatively small groups. Censuses that can be used to identify the prevalence of these groups, generally do not contain enough information for uncover their experience with poverty.
Using techniques developed for poverty maps, we can statistically link information in household surveys and censuses, for a more complete understanding of poverty among vulnerable populations.
Experience in applying small area welfare estimation techniques to welfare prediction for small vulnerable groups is limited. Though most methodological issues have been solved, there remains an empirical issue as to the accuracy of welfare estimates under various circumstances. Current methods are likely to provide an under- or overestimation of poverty. A better understanding of the degree of this mis-estimation is needed, along with the conditions under which it takes place.
A deeper understanding of poverty among vulnerable groups – and their contribution to overall poverty – will help the Bank better target and develop anti-poverty programs.

(2) Expected Outputs/Results:

A major report on poverty among the vulnerable populations mentioned above in various regions ECA (Albania), Africa (Kenya, Madagascar, Malawi, Tanzania, Uganda, Zambia), Latin America (Nicaragua) and East Asia (Lao, Vietnam). This report will also assess the reliability and usefulness of the new techniques used, including a focus on the questions used to identify vulnerable group members.

Brief notes will be written, outlining the extent of poverty among vulnerable groups in each of the countries included in the analysis.
A review of the PRSPs in all of these countries – including an analysis of the information base available at the time they were written -- will be made in light of these findings to assess how well targeted that strategy is to the various groups that comprise the poor.
A dissemination workshop, including training materials, will be held as well.

(3) Expected Key Performance Indicators (Maximum of 4 Indicators)
Poverty estimates for small vulnerable groups (i.e., disabled people, orphans, widows, child-headed households, the aged).
Attachment 4:
Development of Qualitative Survey on Disability and Living Standards

Terms of Reference

September 10, 2004

The Problem

To sustain and promote economic growth and well-being, it is essential to incorporate the concept of human functioning into development programs. People’s functioning levels vary significantly -- whether in relation to physical capabilities, intellectual capabilities, sensory abilities (hearing and vision), or the impact of mental health. Not accounting for these differences can seriously limit the effectiveness of programs designed to promote economic and social well-being.

When individuals with different levels of functioning encounter barriers to health services, education, employment, public services, and infrastructure, they are disabled. That is, disabled in the sense that their ability to participate in economic activities and lift themselves from poverty suffers. Disability is thus an interaction between human functioning and an environment which does not account for different levels of functioning. In other words, people with physical or mental limitations are often disabled not so much because of their functioning level, but because they are denied access to education, labor markets, and public services. This exclusion leads to poverty, and in a vicious circle, poverty can lead to more disability by making people more vulnerable to malnutrition, disease, and unsafe living and working conditions.
According to estimates by WHO, approximately 10 percent of the population has a disability, and this is probably a conservative estimate. Within developing countries, this population numbers at least 400 million, and they are among the poorest of the poor.
Furthermore, the effects of “disability” go beyond those with functional impairments themselves. Family members must often absorb extra responsibilities that inhibit their participation in the economic and social life of their communities. And of course, the less productive any citizen is, the less economic growth is possible. Even for those people not classified as “disabled,” different levels of human functioning can have an impact on their access to the economy and the community.
Unfortunately, due to limited data collection in this area we do not have good data on the relationship between poverty and disability. At present, there is a growing effort to obtain quantitative data that can provide prevalence estimates and general links between poverty and disability. However, there is scant information on the dynamics of how the presence of impairments affects the economic and social life of people in developing countries.

Consultant Responsibilities and Expected Output

The consultant will develop a methodology for a qualitative study of the relationship between functional impairments and poverty. The purpose of this methodological approach will be to uncover the mechanisms by which various types of impairments interact with barriers in the environment to limit or influence the economic and social life of disabled people and members of their households. This methodological instrument will be a template that can be adapted to particular country circumstances.

A number of quantitative studies are being planned for next year. Our plans are to implement a qualitative study in some of these countries to create a fuller picture of the lives of disabled people and the impact of disability on poverty.
The consultant will:

  1. Prepare a methodological paper containing

    1. Recommended goals and scope of such a survey.

    2. An approach to defining disability and capturing how barriers impact upon social and economic activity.

    3. A specific methodology for achieving the aforementioned goals, possibly including focus groups, structured interviews, or any other qualitative approach.

  2. Prepare a qualitative data collection instrument

  3. Field test that instrument in a developing country and report back on preliminary results of that field test.

Consultant Qualifications

The consultant must have a PhD in demography, economics, disability studies or a related field with demonstrated expertise in the areas of research design. Extensive experience within the area of disability is required.

Timing, Duration, and Compensation

Deliverable Date Compensation

  1. Methodological Paper

    1. First draft December 1, 2004 $10,000

    2. Final draft January 15, 2005 $10,000

  2. Qualitative Data Instrument April 1, 2005 $10,000

  3. Field Test

    1. Data collection June 1, 2005 $10,000

    2. Final report June 30, 2005 $10,000

Total Compensation: $50,000

Attachment 5:

Terms of Reference

Service Delivery and Disability in Indonesia

1.Objective and main features of proposed activity

The objectives of this project are threefold: 1) To support the Indonesia Poverty Analysis Program (INDOPOV); 2) To demonstrate the importance of incorporating disability issues in poverty reduction and service delivery activities; and, 3) To serve as a model for other country studies on how to include disability.

According to a recently commissioned report for the East Asia and Pacific Region (EAP), poverty is the underlying cause of disability, whether through malnutrition, lack of health services, unsafe living and working conditions, or other reasons. Furthermore, in a vicious circle, people with disabilities face barriers in attitudes, education, employment, and public services that prevent their escape from poverty.
INDOPOV is a three-year program that aims to achieve a major expansion in the analytical foundations for the actions and policy changes needed to reduce poverty in Indonesia. It represents a major effort to enhance the understanding of poverty, its determinants, and its dynamics across a range of stakeholders. At present, though, it does not incorporate the issue of disability. EAP and the Indonesia country team are interested in changing this, as witnessed by the report mentioned above, their recent hiring of a consultant to review regional operations for opportunities to incorporate disability issues, and their support of this proposal.
This project will not only help in the establishment of a poverty reduction program, but will serve as an important vehicle for expanding the Bank’s ability to incorporate disability. Activities will be timed in such a way as to serve as inputs in the INDOPOV program.
Since 2002 the efforts of the Disability Advisor and her team combined with the support of the NTFDD6, CTFs, and PCF support have helped expand the Bank’s commitment to working on disability issues. [Annex A: 2002-2003 annual report] Slowly disability is being recognized as something not incidental to development but fundamental to achieving elimination of poverty and the Millenium Development Goals.
The lack of quality data on disability, however, has hampered our ability to accurately document the effectiveness of service delivery to ameliorate the relationship between disability and poverty. Our gap in understanding undermines program design and implementation.
The World Bank has been working on these issues with the UN Statistical Division and the Washington Group on Disability Measurement established by the UNSD. This group consists of representatives from over 50 countries and international agencies. The main goals of this group are to devise census and survey questions on disability that will improve the quality of data on disability – which is a difficult concept to capture – and make that data more internationally comparable. This project will be an extension of their work.
Indonesia provides the opportunity for such analysis due to the detailed data on functional capacity in a country with a large household survey. A study on disability, poverty, and service delivery in Indonesia would not only inform development work in that country, but would demonstrate the importance of addressing disability issues in all developing countries. Work on methodological issues that will be addressed in this project -- such as devising monitoring instruments for service delivery and survey design – will greatly benefit future country studies on disability and poverty.

                  1. Strategic fit with identified focus areas

This project will increase the understanding and knowledge of the extent and impact of the vulnerabilities of disabled persons on human development, poverty reduction and social inclusion. It will improve our ability to design effective public action on how to redress these vulnerabilities: what policies and services are needed, how they should be organized, and how much they cost; and will assist in integrating issues related to disabled people into macro level, multi-sectoral, and sectoral policy making. In addition, it will build in-country capacity for further study and monitoring of people with disabilities.

2.Data and methodology

An outline of the analytical work follows:

I. Country Study. Because disability is a cross-sectoral issue, a comprehensive review of disability issues in Indonesia will be undertaken. This study will document the demographics of the disabled population, the causes and types of disability, and their relation to individual, family, and community variables, such as: family status and structure, gender, ethnicity, education, occupation (for those who have worked), individual income, labor force participation and employment, and region of residence. Data from SUSENAS will be the primary source of quantitative information. In relation to the INDOPOV, we will also focus on documenting the kinds of policies and services that now exist in Indonesia to monitor and assist disabled persons. This policy & services review would entail interviews with appropriate government officials at the national and local levels, as well as representatives from DPOs. It also will entail visits to facilities (e.g., government offices, health centers, schools) themselves to assess the constraints to serving disabled persons. These visits would help ascertain the constraints to access for disabled persons, and develop an instrument that government might use for monitoring service delivery for disabled persons.
II.) Development of Information System for Monitoring Basic Services. Building on the work in the country study, we will design a monitoring instrument for assessing the effectiveness of basic service delivery systems for reaching people with disabilities. This will be used to determine the extent to which people in different localities have access to basic services and the quality of those services.
III.) Primary Data Collection and Analysis. A disability module building on the work of the Washington City Group on Disability Measurements recommendations for census and survey questions will be designed in concert with the national statistical agency in Indonesia. This survey will be implemented in localities where basic services have been evaluated. We will examine the links between disability and poverty in these communities and assess the effectiveness of different types of basic services at ameliorating those links.
IV) Dissemination The results of this study will be shared in technical reports, notes, and workshops.

3.Management/Bank Involvement

The activities will involve different types of counterparts.

Bank staff: Pamela Dudzik (HDNSP) will be the team leader for the overall work in conjunction with Judith Heumann (Advisor for Disability and Development). Either or both will represent the Bank at Steering Committee meetings and liaise with the partners. The technical work on data issues will be lead by Elizabeth King (EAP), Daniel Mont (HDNSP), and Jehan Arulpragasam, from the Indonesia country office, with the additional collaboration of Menno Prasad Pradhan, and Vivi Alatas, as well as the EAP regional working group on disability.

4.Timeline for Output

Activities will be conducted over FY05
Preliminary outline of Country Study March 15 $10,500
Final Country Study April 30 $15,000
Development of Information System for

Monitoring Basic Services June 30 $29,500

Presentation of Preliminary Analytical

Results September 1 $5,000

Primary Data Set and Analytical Report October 31 $45,000

G. Description of expected outcomes (include information on who will benefit from the expected outcomes and what it will contribute to)
The overall outcomes of the proposed activities are a detailed analysis of basic service delivery in Indonesia and its relation to the links between poverty and disability in Indonesia. This study can serve as a model for similar studies in other developing countries, as well as continued monitoring in Indonesia. A detailed study such as this does not exist in a developing country, and will be an important milestone in development community’s efforts to mainstream disability.

1     I have discussed the informational basis of ethical principles and social choice in "On Weights and Measures: Informational Constraints in Social Welfare Analysis," Econometrica, 45 (October 1977), and "Informational Analysis of Moral Principles," in Ross Harrison, ed., Rational Action (Cambridge: Cambridge University Press, 1979).

2     John Rawls, A Theory of Justice (Cambridge, MA: Harvard University Press, 1971), pp. 60-5).

3     Aristotle, Nicomachean Ethics, translated by D. Ross (Oxford: Oxford University Press, revised edition, 1980), book I, section 5, page 7.

4     Wiebke Kuklys, "Amartya Sen's Capability Approach: Theoretical Insights and Empirical Applications," Ph.D. dissertation, Sidney Sussex College, Cambridge University, 2004; see particularly Table 5.9, p. 125.

5     Development as Freedom (New York: Knopf, 1999).

6 NTFDD has enabled examples of what could be done. It has been an effective, demand-driven trust fund that, with the input of the Disability Advisor and the Trust Fund Administrator, produces high quality, useful products and paves the way for further activities in disability at the World Bank.
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