51798 August 2009 . Number 9 U LOCKI G THE ECO OMIC POTE TIAL OF PERSO S WITH DISABILITIES I M A Gustavo Demarco1 access, income protection, and medical care, rehabilitation and support services ­ including Introduction: According to the World health assisting devices. Organization (WHO), there are currently more than 650 million People with Disabilities (PWD) Employability - Barriers to Getting Jobs: Unequal globally. Their numbers grow daily due to chronic access to education and training programs are a diseases, illness, injuries, violence, and aging. Of major challenge that needs to be resolved. There are further note is the fact that, in general, PDWs have also prejudices or misperceptions on the productive education attainment rates well below national capacity of PWDs. At the same time, low self averages, while illiteracy among children is well esteem among PWD and overprotective families above national averages. Overall, there are low also act as barriers to greater inclusion, as do incentives to hire PWDs, especially in the private negative attitudes arising from ignorance, myths, sector, and often income protection and stereotypes and fear. There are also issues of rehabilitation programs are not extended in the ensuring acceptance by workplace colleagues. In degree to which they would meet their needs. general, there is little legislative support and where there are laws and regulations in place there is a Impact: PWDs and the challenges they confront general lack of enforcement. There are areas where impact negatively on equity and social inclusion technology can provide some recourse, such as the and cohesion in their societies. Significant internet for blind people to deal with barriers to challenges are also faced on the broader agenda for communication and information Systems, but these human rights and the more immediate issue of are rarely available. Also scarce on the ground are poverty. However, with the right policies and appropriate databanks for job seeking and support mechanisms in place, disabled people have matching purposes the potential to make significant contributions to economic growth and poverty reduction. GDP loss There are also risks related to the design, choice, due to disabilities is estimated at 2 trillion US$ and eligibility criteria of disability income worldwide. programs, which may create work disincentives as PDWs opt for social welfare, social insurance, and The link to poverty of PWDs is well established. mandated private pensions, etc. Support for job However, the agenda is to move beyond challenges incentives is critical but policy remedies for greater in a manner that would emphasize achieving participation will affect both the supply and independence, unlocking their economic potential demand for workers with disabilities (individual and employing and keeping PDWs active longer. preferences, demand for leisure, low productivity, low wages, and disability benefits). Social Protection Agenda for PWDs: The outcomes sought are social inclusion, equal opportunity and Employability of PWDs ­ Actionable Steps: These poverty prevention and alleviation. The means to can be categorized into three steps: (i) skills achieve these outcomes include an agenda focusing development policies; (ii) vocational guidance and on employability, inclusive education, universal training; and (iii) employment services and promotion. 1 Gustavo Demarco, MNSSP. Inclusive Education: The focus here is on some key Income protection through Social Insurance: An principles such as (i) all children should have the important issue is that of workers who become same access to education; (ii) children learn best disabled in the course of their careers and are when learning together; and (iii) recognizing and covered by social security/social insurance celebrating diversity and enhancing opportunities programs. The goal here should be to ensure that for equal participation. these programs and/or systems provide income protection in the case of partial or total incapacity Inclusive Education ­ Measures/actions to Improve as well as assistance in employing and keeping Access: An important part of the process is the workers with disabilities active for a longer time. It training of teachers and ensuring that inclusive is also important to have programs in place to help education is an integral part of school reforms. It is rehabilitate disabled workers. also important to mobilize and train parents and develop resource centers to provide needed Income Protection - Social Insurance in MNA: training and materials. There is also a need to Disability pensions and work related injuries are enhance the capacity of community based not a major focus of Social Insurance reforms in rehabilitation programs. For full efficiency and MENA. In general, social security systems in the effectiveness, the focus should be on a region suffer from low coverage, financial decentralized funding process within a unified disequilibria, (lack of financial sustainability) system of service delivery. administrative inefficiencies, and poor governance. In many cases, discretionary disability assessment Universal Access - Challenges: Infrastructure is a key procedures result in excessive protection to some barrier to improving access. Inaccessible buildings (i.e. with low degree of incapacity) and little or no and facilities remains a major issue in most protection to others (i.e. the really disabled). Also, countries. Aside from hard infrastructure, there are inadequately designed assessment procedures may also access issues on the policy/soft side of the result in abuse and overlap with other social equation. For example, pension reforms need to insurance programs. Note that all this is in the include disability pensions. Disability programs context of a fairly young population across the need to be comprehensive to include preparing region; however, as populations age, disability disabled workers to return to jobs in addition to the rates will also increase. usual monetary compensations. Also needed are measures to avoid adverse selection and moral Income Protection Outside of Social Safety Net hazard challenges. Policymakers need to consider Programs: The target populations here are those the inclusion of PWD as a target criterion of Social not covered by social security/social insurance Safety Nets programs. Other significant challenges programs such as: children, youth, dependents, include the reluctance of employers to provide workers in the informal sector. The objective is to facilities and infrastructure in workplaces. Not an provide income protection in the case of partial or easy issue to grapple with but not impossible either total incapacity of groups of population not with the right set of policies and incentives at hand. reached by formal social insurance/social security. Challenges on this front include group versus Access to Transportation, Housing and Assistive individual targeting (category versus means Devices: Inaccessible transportation remains a key testing) with the danger of possible perverse issue, particularly to and from workplaces. A incentives against rehabilitation and employability number of policy and funding issues need to be of PWD. addressed to move towards resolution in this critical area. Lack of suitable housing, especially Social Protection for disabled persons in MENA - near workplaces is another challenge for disabled Actions: Disability programs need to be people. Another issue is the lack of access to comprehensive to include preparing disabled assistive devices, technology and support. All of workers to return to jobs in addition to the usual these can make a critical difference in providing an monetary compensations, and include Measures to easy transition to employment and a productive avoid adverse selection and moral hazard issues. life. Areas to focus on to improve access in all these Pension reforms will need to include disability areas include legislation, but also making the funds pensions. Countries will also need to consider the available to ensure that there is adequate inclusion of PWD as target criterion of SSN infrastructure, and the sensitization and education programs. needed to change the behavioral environment in which disabled people live and work. August 2009 Number 9 2 Medical care, Rehabilitation and support services: Contact MNA K&L: Social Insurance programs mostly focus on income Emmanuel Mbi, Director, MNA Operational Core protection while medical care is part of most Health Services Unit Insurance programs. However, rehabilitation David Steel, Manager, MNA Development Effectiveness Unit programs and support services are almost absent in many programs. Many of the MNA programs also Regional Quick Notes Team: suffer from lack of coordination and unclear Omer Karasapan, Dina El-Naggar, Roby Fields, responsibilities between the Health, Social Security Najat Yamouri, and Aliya Jalloh and Social Development programs as well as those Tel #: (202) 473 8177 that focus on rehabilitation and support services. The MNA Quick Notes are intended to summarize Conclusions - Improving integration of PWD: lessons learned from MNA and other Bank Knowledge and Learning activities. The Notes do not Progress in this arena requires a Comprehensive necessarily reflect the views of the World Bank, its policy framework, which would include the points board or its member countries. outlined below: · Preventive care - both for mothers through nutritional interventions, and infants through nutrition and basic immunization coverage; · Identifying people with disabilities as soon as possible; · Early intervention and getting all children with special needs into school and giving them the skills to fully participate in family and economic life; · Improve societal attitudes to people with disabilities by relying on public-private partnerships; · Institute employment and skills development policies to enhance employability of PWD; · Extend and improve Social Insurance mechanisms; · Extend networks for Medical attention, rehabilitation and support services. August 2009 Number 9 3