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The first World Report on Disability

Boy in wheelchair writing on blackboard World Disability: first UN Report

The United Nations published in June 2011 its first comprehensive report on disability. Perhaps that is not before time, given that they estimate that there are a billion disabled  people around the world.

Though the World Report on Disability·is new, the general findings - for example that disabled people experience barriers and that it is important to make accessibility a mainstream issue - will not come as a surprise. However the report (published jointly by the World Health Organisation and the World Bank) is a comprehensive overview of the situation and policies in many parts of the world, and·does make clear the UN's commitment to disability as a social issue.

At the WHO website you can download the full report, or individual·chapters. There are also down-loadable versions in EasyRead and in DAISY format, and information about the launch, including an introduction by Stephen Hawking.

This·rest of this ·article is adapted from World Health Organisation's Factsheet about the Report

Main messages and recommendations

The World Report on Disability gives guidance on putting into practice the United Nations Convention on the Rights of Persons with Disabilities (CRPD). It gives an extensive picture of the situation of disabled people, their needs and unmet needs, and the barriers they face to taking part in their societies. There are chapters on·data; health; rehabilitation; assistance and support; enabling environments; education; and employment.

For each area, the Report highlights a range of good practice examples which Governments and civil society can copy, to help establish an inclusive and enabling society in which disabled people can flourish.

The main messages of the report:

There has been a big shift in approaches to disability. In recent decades the move has been away from a medical understanding towards a social understanding. Disability arises from the interaction between people with a health condition and their environment. The CRPD reflects this emphasis on removing environmental barriers which prevent inclusion.

Disability prevalence is high and growing. There are over one billion disabled people in the world, of whom between 110-190 million experience very significant difficulties. This is about 15% of the world’s population and is higher than previous World Health Organization (WHO) estimates, which date from the 1970s and suggested a figure of around 10%.

The general level of disability is growing due to the ageing population and the global increase in chronic health conditions. Patterns of disability in a particular country are influenced by trends in health conditions and trends in environmental and other factors – such as road traffic crashes, natural disasters, conflict, diet and substance abuse*.

Disability disproportionately affects vulnerable populations. Disability is more common among women, older people and households that are poor. Lower income countries have a higher prevalence of disability than higher income countries.

However, the disability experience varies greatly and not all disabled people are equally disadvantaged. School enrolment rates differ, with children with physical impairments generally doing·better than those with intellectual or sensory impairments. Those most excluded from jobs are often those with mental health difficulties or intellectual impairments.

Disabled people face widespread barriers in accessing services (health, education, employment, transport as well as information). These include inadequate policies and standards, negative attitudes, lack of service provision, inadequate funding, lack of accessibility, inadequate information and communication and lack of participation in decisions that directly affect their lives.

Disabled people have worse health and socioeconomic outcomes. Across the world, disabled people have poorer health, lower education achievements, less economic participation and higher rates of poverty than non-disabled people.

Many of the barriers disabled people face are avoidable and the disadvantage associated with disability can be overcome.

What does the report recommend?

1: Enable access to all mainstream systems and services. disabled people have ordinary needs, which can and should be met through mainstream programmes and services. Mainstreaming is the process by which governments and other stakeholders address the barriers that exclude persons with disabilities from participating equally in any service intended for the general public, such as education, health, employment, and social services.This requires changes to laws, policies, institutions and environments. Mainstreaming not only fulfils the human rights of persons with disabilities, it can also be more cost effective.

2: Invest in programmes and services for disabled people. Some disabled people may require access to specific measures, such as rehabilitation, support services, or vocational training, which can improve functioning and independence and foster participation in society.

3: Adopt a national disability strategy and plan of action. All sectors and stakeholders should collaborate on a strategy to improve the well-being of disabled people. This will help improve coordination between sectors and services. Progress should be monitored closely.

4: Involve disabled people. In formulating and implementing policies, laws and services, disabled people should be consulted and actively involved. At an individual level, disabled people are entitled to have control over their lives and therefore need to be consulted on issues that concern them directly.

5: Improve human resource capacity. Human resource capacity can be improved through effective education, training and recruitment. For example training of health professionals, architects and designers should include relevant content on disability and be based on human rights principles.

6: Provide adequate funding and improve affordability. Adequate and sustainable funding of publicly provided services is needed to remove financial barriers to access and ensure that good quality services are provided.

7: Increase public awareness and understanding about disability. Mutual respect and understanding contribute to an inclusive society. It is vital to improve public understanding of disability, confront negative perceptions, and represent disability fairly.

8: Improve the availability and quality of data on disability. Data need to be standardized and internationally comparable to benchmark and monitor progress on disability policies and on the implementation of the CRPD nationally and internationally. At the national level, disability should be included in data collection. Dedicated disability surveys can also be carried out to gain more comprehensive information.

9: Strengthen and support research on disability. Research is essential for increasing public understanding about disability, informing disability policy and programmes, and efficiently allocating resources. More research is needed, not just about the lives of disabled people, but also about social barriers, and how these can be overcome.

* MDF note: published statistics on disability are also strongly affected by the way they are collected and reported: for example, in societies where care of disabled people is largely carried out by immediate families there is much less reason to record disability than where help from the state is available .