Sessions on Advancing Social Protection in West Africa for an Inclusive Society – Day 3: Exploring Inclusive Policies and Challenges for Persons with Disabilities

Introduction

The third day of the “Advancing Social Protection in West Africa – Smart Solutions Developed by H-BRS Alumni for an Inclusive Society” event, organised by master’s degree in Social Protection of Hochschule Bonn-Rhein-Sieg (H-BRS) University of Applied Sciences and held at the University of Cape Coast (UCC) in Ghana. The day featured robust discussions and provided significant insights into the challenges and opportunities within social protection systems in West Africa, particularly for persons with disabilities. This report, the second in a series of three blog posts, provides insights from Day 3, following the report on Days 1 and 2.

 

The University of Cape Coast (UCC) – Host Venue

Established in 1962, UCC is Ghana’s leading university, with over 78,000 students across a 5,766-square-mile campus. UCC supports students with disabilities through accessible housing, educational assistance, and awareness campaigns. It also offers scholarships based on financial need and academic performance.

 

Keynote Speech: Inclusive Social Protection in West Africa – Challenges and Opportunities

Gertrude Oforiwa Fefoame, Chair of the United Nations Committee on the Rights of Persons with Disabilities (CRPD), delivered the keynote address, delving into the complexities of social protection systems in West Africa.

Barriers to Accessing Social Protection for Persons with Disabilities

Chair Fefoame underscored several critical obstacles that hinder the access of persons with disabilities to social protection, including:

• Adequacy of Support: Current programmes often fail to address disability-related costs, such as transportation, assistive devices, and medical care, placing an undue financial burden on families, especially when family members must leave their jobs to provide care. A one-size-fits-all approach overlooks the diverse needs within the community.
• Poor Identification and Needs Assessment: The process of identifying persons with disabilities is often seen as too costly, resulting in inaccurate data.
• Stigma and Discrimination: Particularly women with disabilities, face significant stigma and discrimination, further limiting their access to essential services.
• Employment Challenges: Employment for persons with disabilities is often linked to the loss of social protection benefits, or they are offered poor schemes that fail to address their specific needs, leaving them vulnerable.

Rethinking Social Protection

Chair Fefoame stressed the need to rethink social protection by shifting away from a narrow focus on incapacity to work. Instead, the focus should be on creating inclusive labour markets and promoting economic empowerment. Education, healthcare, and rehabilitation services must also be tailored to meet the diverse needs of persons with disabilities, ensuring they are fully integrated into society. Provided supports should go beyond the family unit to include community-based services.

Conclusion: Towards an Inclusive Society

The keynote address calls for comprehensive policies and laws to include persons with disabilities in social protection systems, with budgetary allocations prioritising their needs and measures promoting their full societal participation.

 

Panel Discussion: Towards Inclusive Social Protection in West Africa

The panel discussion, moderated by Prof. Masauso Chirwa, featured insights from Sabrina Brown (University of Frankfurt), Robert Osei-Tutu (UNICEF Ghana), Friederike Römer (Handicap International), and Shishembwe Mwale (Government of Zambia).

 

Barriers to Inclusive Social Protection and The Role of Academia - Sabrina Brown

Sabrina Brown highlighted key barriers to inclusive social protection for persons with disabilities, including:

• Disconnect between policy and implementation
• Poor communication between stakeholders, leading to duplication and inefficiency.
• Lack of disaggregated data on persons with disabilities, impeding accurate needs assessment.
• Discrimination and funding limitations, restricting access to services.

Sabrina Brown highlighted academia’s role in linking research and policy, advocating for better engagement with civil society and policymakers. She suggested simplifying academic outputs and using visual aids like graphs.

 

UNICEF’s Role in Inclusion - Robert Osei-Tutu

Robert Osei-Tutu outlined UNICEF's role in advocating for disability inclusion policies in West Africa by:

• Collaborating with governments to ensure persons with disabilities are included in laws and policies.
• Advocating for adequate funding and analysing disability-related GDP expenditure.
• Partnering with Ghana's Ministry of Gender and Social Protection, including the National Council for persons with disabilities.
• Supporting pilot programmes to generate evidence for future policies.

Robert Osei-Tutu noted that fragmented and inconsistent data on persons with disabilities complicates the development of unified social protection approaches, leading to inadequate programme designs that ignore severity and diversity of disabilities.

 

Handicap International’s Community-Level Work - Friederike Römer

Friederike Römer described the Handicap International’s community-level efforts, including advisory support and advocacy. She noted that resource constraints and financial limitations challenge these efforts and highlighted that care support services are often overlooked, leaving caregivers inadequately supported. She also mentioned that medical assessments for disability eligibility often fail to reflect actual needs and do not ensure equal access to services.

 

Zambia’s Approach to Disability Inclusion - Shishembwe Mwale

Shishembwe Mwale described Zambia’s approach of reserving 10% of job vacancies for persons with disabilities and allocating resources for disability costs. However, challenges persist with data collection and ensuring support services reach the most vulnerable persons with disabilities. Shishembwe Mwale echoed data management concerns, explaining that in Zambia, each ministry operates its own management information system, and none of them is effectively targeting persons with disabilities.

The panel also discussed the potential to learn from Southern Africa, where several countries have introduced “cash plus” programmes, providing cash transfers and offering additional services like food support and access to healthcare. In Zambia, the Cash Plus initiative provides access to the National Health Insurance Scheme and assistive devices, covering disability-related costs.

 

Recommendations and Conclusion

The panel concluded with several important recommendations for improving inclusive social protection in West Africa:

1. Standardisation of Data Collection: Emphasise the need for a standardised approach to collecting data on persons with disabilities across countries, ensuring consistent and up-to-date definitions and criteria.
2. Interoperable Systems: Highlight the importance of creating interoperable systems to enable effective data sharing between government ministries and organisations.
3. Inclusive Programme Design: Call for greater involvement of persons with disabilities and their representative organisations in designing social protection programmes to address the diverse needs of the disability community.
4. Multidisciplinary Approach: Stress the need for a multidisciplinary approach, addressing inclusive social protection from various angles, including education, healthcare, employment, and community support.

Virtual Keynote Speech: Approaches to Measuring Disability-Related Costs for Inclusive Social Protection

Dr. Daniel Mont, CEO of the Center for Inclusive Policy, discussed methods for assessing disability-related costs to inform social protection policies.

Cost Categories

1. Indirect Costs: Foregone earnings due to barriers to education and employment, as well as support responsibilities of family members, reducing the income and consumption of the household.
2. Direct Costs: Expenditures on goods and services due to needs associated with having a disability. These elevate the cost of participation and diminish the portion of income available for meeting basic needs.

Measuring Methods

Dr Mont identified three main methods for assessing disability-related costs:

1. Consumption Patterns: Compare households with and without persons with disabilities using national data to estimate differences in consumption and wealth.
2. Goods and Services Used: Quantitative surveys collected from persons with disabilities to capture their specific expenditures.
3. Goods and Services Required: Assess unmet needs and their costs, informing social protection policy on goods and services needed.

Conclusion

Effective measurement requires a combination of methods to capture both direct and indirect costs, ensuring comprehensive support for persons with disabilities. Different disabilities incur different costs, and social protection programmes need to account for this variation and move beyond "one-size-fits-all" approach to disability transfers.

Ghana in Focus – Research Made at H-BRS

Moderated by Abdul-rahimsidiq Rajab, Ministry of Health Tanzania

Inclusive Education for Wheelchair Users in Ghana: Reality or Illusion? - Samuel Eduaful

Samuel Eduaful, a disability specialist and social protection expert, presented on the state of inclusive education for wheelchair users in Ghana.

The Concept of Inclusive Education (IE) aims to integrate all students into a single, supportive classroom environment, as outlined in the UN Declaration of Human Rights (1948) and UNESCO's Salamanca Statement (1994). This approach values every student and seeks to adapt learning environments to meet diverse needs. In Ghana, similarly, inclusion definition focuses on access and learning for all children, including those with disabilities.

However, persons with disabilities continue to face exclusion due to several barriers:

• Environmental: Inaccessible infrastructure, such as schools and public transport.
• Attitudinal: Negative stereotypes and poor understanding, leading to social isolation.
• Institutional: Financial constraints and a preference for special schools over inclusive public facilities.

Recommendations for Improvement

1. Systems: Political will, leading to commitment and sufficient funding to support inclusive education initiatives.
2. Support: For teachers and students working and learning in inclusive environment
3. Cultural Change: Promote respect for diversity and participatory learning.
4. Partnership: Engage parents, teachers, and disability organisations.
5. Monitoring: Regularly assess and ensure the effectiveness of inclusive practices.

 

Demands of Organisations of Persons with Disabilities: Enhancing Community Inclusion in Ghana - Solomon Hadi Achulo

Solomon Hadi Achulo, PhD Student University of North Carolina, focused on the intersection of disability and poverty. persons with disabilities often experience higher levels of poverty, exacerbated by additional costs related to their disability, such as assistive devices.

Extra Costs of Disability Estimates suggest that extra costs for persons with disabilities can be 6-160% of household income, creating financial strain for families. These costs necessitate choosing between essential needs and undermining well-being.

Recommended Strategies

1. Remove Environmental Barriers: Enhance accessibility based on the Act of 2006 on persons with disabilities.
2. Financial Support: Implement universal asset-building policies for persons with disabilities, such as Child Development Accounts (CDAs) with initial deposits and matching incentives. For instance, with a 1:1 ratio, if a family saves $10, the government matches this amount by contributing an additional $10. The accumulated funds will be accessible after a specified age.

Recommended Design Features for CDAs

• Automatic enrolment with initial deposit for all children with disabilities.
• Additional deposits for low-income families at milestones e.g., starting school.
• Incentivise deposit for low-income children by providing subsidies matched at a rate.
• Targeted Investment Options: Programme deposits could target specific purposes, such as healthcare, education, etc, restricting withdrawals.

 

Inclusive Health Coverage in Ghana: Options for Reform - Rebecca Odonkor

Rebecca Odonkor from Friedrich-Ebert-Stiftung explored the challenges and potential reforms in Ghana’s health coverage for persons with disabilities.

Current Situation

• Exclusions: Current health insurance schemes exclude essential services for persons with disabilities, such as rehabilitation services beyond physiotherapy and the provision of assistive devices like prosthetics.
• Disability Assessment Centres: These centres, necessary for evaluating disabilities, are not evenly distributed across the country, making them inaccessible.
• Gaps in Social Protection Inclusion: The qualification criteria for determining who is classified as poor are overly restrictive, limiting access to vital benefits.
• Gaps in Environment and Information Accessibility: Public facilities remain largely inaccessible, and available information is not tailored to the needs of persons with disabilities, creating further barriers.

Policy Options

To address these gaps, Rebecca Odonkor proposed several reform options:

1. Management Information System (MIS): Create an MIS that provides disaggregated data on persons with disabilities, ensuring accurate targeting and needs assessment.
2. Data Collection and Assessment Instruments: Standardising the instruments used to assess and collect data on persons with disabilities, providing consistent and reliable information across the country.

Implementation Plan

To implement these reforms, a coordinated approach involving multiple stakeholders is required:

1. Baseline Data: Collect initial data.
2. Stakeholder Identification: Engage relevant stakeholders.
3. Design of MIS and Programme Tools: Develop management information systems and programme tools.
4. Standard Disability Assessment Criteria: Adopt internationally recognised disability assessment criteria, such as those proposed by the World Bank.
5. Political Commitment: Secure funding and support.

 

Conclusion

H-BRS alumni highlighted the significant challenges faced by persons with disabilities in Ghana, particularly in inclusive education, community inclusion, and health coverage. The research underscores the urgent need for systemic reforms. Overcoming barriers like environmental inaccessibility, negative attitudes, and financial constraints requires coordinated efforts. By prioritising inclusive policies, standardising data collection, and securing political and financial commitment, Ghana can progress towards a more inclusive society where persons with disabilities are fully supported and empowered.

 

*This blog post is part of the ‘Advancing Social Protection in West Africa – Smart Solutions Developed by H-BRS Alumni for an Inclusive Society’ series, which covers discussions based on insights and data from the groundbreaking five-day alumni event organised by Hochschule Bonn-Rhein-Sieg (H-BRS) University of Applied Sciences in Cape Coast and Accra, Ghana. The event received funding from the Federal Ministry for Economic Cooperation and Development (BMZ) of Germany and was co-organized with the local partner the University of Cape Coast.

Please note that the views and opinions expressed in this blog post are those of the author and do not necessarily reflect the official policy or position of the Federal Ministry for Economic Cooperation and Development (BMZ) of Germany, H-BRS University of Applied Sciences, University of Cape Coast, Ghana’s National Council on Persons with Disability (NCPD), or Ghana’s Ministry of Gender, Children and Social Protection. The information provided here is for informational purposes only.