Escaping Stigma and Neglect

Working paper 164 – forthcomingGiuseppe Zampaglione Mirey Ovadiya Africa Human Development 2With support from the Disability and Development TeamWorld Bank

People with Disabilities in Sierra Leone

Objective of the Policy Note

a) Provide a diagnosis on the scale and nature of the problem;

b) Analyse current public policies in support of People with Disabilities;

c) Review public and private programs and;

d) Propose policy options to policy makers and development partners.

A. Diagnosis

Poverty a cause and consequence of disability

Source: “Disability, Poverty and Development”, UK Department for International Development (DFID), London, UK, February 2000.

A. Prevalence of Disability in Sierra Leone

2004 Census prevalence of disability at 2.4% Likely to be underestimated – Census only

captures severe physical disability not including mental disability

Reasonable global estimate is 10-12% prevalence

Estimated 5% of HHs have one or more disabled person

A. Nature of Disability

% of population

% of People with Disabilities

Share of People with Disabilities 2.40 100.00 Type of disability* Physical 0.90 37.54 Visual 0.64 26.69 Hearing/Speech 0.35 14.51 Mental 0.13 5.25 Other 0.38 16.01 Cause of disability Disease/illness 1.09 45.65 Accident/injury 0.40 16.46 Congenital 0.29 11.93 Aging 0.28 11.84 War 0.23 9.58 Others 0.11 4.54 Gender Male 2.60 52.60 Female 2.21 47.40

Source: 2004 Census * Physical: loss or limited use of limbs or back spine; visual: blindness, sight difficulty; hearing and speech: loss or impairment of hearing and speech; Mental: mental retardation and illness; other: epileptic, rheumatism, others.

A. Geographic Distribution

Incidence of People with Disabilities higher in the South and East, and more pronounced in rural areas than in urban ones. – People with Disabilities more concentrated in the

Southern (2.9%) and Eastern regions (2.8%), followed by the Northern (2.2%) and the Western (1.7%) regions.

A. Access to Basic Services and Employment

Access to Health Access to Education Access to Transport/Mobility Income and employment

B. Policy Framework in support of PWD

Legal Framework

Institutional Environment and Policies – Constitution– Parliament– TRC– Human Rights Commission of SL– Ministry of Social Welfare, Gender and Children Affairs– NaCSA

C. Public and Private Programs in support of PWD

Public Programs NGO implemented programs Successes to date Challenges

– Funding– Involve more CSO – communities– Strenghten DPOs– Definition

B. Definition beyond the emergency

From: People made disabled by an act of violence during the war/ People with a preexistent or war unrelated disability

To : All Sierra Leoneans were disabled by the war and all people with a disability were victims of the war

D. Policy Options

Grouped as:

– (i) measures that will specifically target people with disabilities and

– (ii) measures that will work to mainstream disability issues through sector programs.

D. Policy Options (2)

The recommended measures are grouped under three categories: – (i) knowledge building and analysis; – (ii) strengthening of the legal and institutional

framework; and – (iii) amelioration of public and private service

coverage and financing

D. Knowledge building

Knowledge building and analysis

No or low cost

Medium cost

High cost By whom

Educational, training and employment opportunities for young people with disabilities

X Ministries: Education; Welfare

Health needs of people with disabilities X Ministry of Health

Human rights aspects of the “begging industry”

X Ministry of Welfare

Cost analysis of excluding people with disabilities from society and the economy

X Ministry of Welfare

Cost analysis of the implementation of the draft legislation

X Ministry of Welfare

Improve statistical and other data with Central Statistics Office and line ministries to assist with identification and targeting of people with disabilities to benefit from “free basic services such as health and education” and overall access to assistance programs by a larger majority of people with disabilities

X CSO

Finance survey of existing programs, expenditures and analysis of their impact on livelihoods of people with disabilities with specific attention on the existing social protection schemes

X Ministry of Welfare

D. Coverage and financing

Improving Public and Private Program Coverage and Financing

No or Low cost

Medium cost

High cost By whom

Ensure the draft legislation and policy are fully costed and considered within national budget

X Ministry of Welfare; DPO

Accelerate and strengthen resource mobilization efforts so that the Truth and Reconciliation Commission recommendations for the War Victims Reparations Program (among other priorities) are implemented

X Ministry of Welfare; DPO

Support scale-up of successful NGO programs (to be identified) to improve coverage of people with disabilities and improve access to basic services

X NGO; DPO; Donors

Support all sector ministries to integrate disability issues, needs, and priority expenditures into their annual sector budgets

X Council of Ministers

Advocate inclusiveness and community integration in all sector ministry programs targeting people with disabilities especially health, HIV/AIDS, education, skills training, and housing

X Ministry of Welfare; DPO

Enhance dedicated technical capacity on disability issues in key ministries such as education, health, transport, and others

X Ministries: Education, Science and Technology; Health and Sanitation; Transportation

Support MEST to increase enrollment and school attendance of children with disabilities via scaling up successful inclusive education programs

X Ministry of Education, Science and Technology; Donors

Support Ministry of Health to scale-up successful rehabilitation programs

X Ministry of Health and Sanitation; Donors

Support Ministry of Social Welfare, Gender, and Children’s Affairs to scale up successful skills training and employment schemes

X Ministry of Welfare; Donors

Advise all donors to include disability issues on all donor financed/implemented projects

X Ministry of Welfare; Council of Ministers; Donors

D. Legal and Institutional Framework

Improving Legal and Institutional Framework

No or Low cost

Medium cost

High cost By whom

Improve, finalize and enact the draft legislation on people with disabilities

X Ministry of Welfare

Ratify pending international conventions or legislation

X Ministries: Foreign Affairs; Justice; Welfare

Support adoption of disability policy/action plans by all ministries

X X Council of Ministers

Clarify roles and responsibilities of lead institutions in this area

X Office of the President, Council of Ministers

Operationalize the monitoring and implementation of the draft Act

X Council of Ministers

Strengthen DPO involvement in consultations, monitoring and implementation

X DPO

Implement outreach and training for the Parliamentary Human Rights Committee

X Parliament

Provide technical assistance to the Ministry of Social Welfare, Gender, and Children’s Affairs to lead the finalization of the draft Act including outreach in Parliament and Cabinet

X Donors

Provide NaCSA support to be more engaged on issues of people with disabilities within its mandate

X Donors

Thanks!