Unlocking Economic Potential of Persons with Disabilities in MENA Gustavo Demarco Senior Economist, World Bank

1. Unlocking Economic Potential of Persons with Disabilities in MENAGustavo DemarcoSenior Economist, World Bank MENA Disability Learning Event "Making Growth Inclusive--Promoting Accessibility and Employment Opportunities for Persons with Disabilities" June 17 2009

2. Why should disability be high in the agenda of social policy for developing countries? • Evidence: • More than 650 million live with disabilities (WHO), and the number grows due to chronic diseases, injuries, violence and ageing. • Education attainment rates of PWD are well below national averages • Illiteracy among children is well above national averages • Low incentives to hire PWD, especially in the private sector • Income protection and rehabilitation programs are not extended • Impact: • Human rights, equity • Social inclusion and cohesion • Poverty • Disabled people have the potential to make a valuable contribution in the labor market (GDP loss estimated in 2 trillion US$ worldwide)

3. Disability and poverty alleviation • Link to poverty well established • moral, human, and socio-economic impact of disability • economic and social costs associated with disability • Moving beyond poverty • focusing on achieving independence • unlocking economic potential • employing and keeping PWD active longer

4. Objectives of the Social Protection agenda for PWD • Social inclusion, • Equal opportunities and • Poverty prevention and alleviation • through… • Employability • Inclusive education • Universal Access • Income protection • Medical care, Rehabilitation and support services (including assisting devices)

5. 1. Employability: Barriers to get jobs • Unequal access to education and training programs, • Prejudice or misperception on the productive capacity of PWD • Low self esteem among PWD and overprotective families • Negative attitudes arising from ignorance, myths, stereotypes and fear, • Acceptance by workplace colleagues, • Barriers to Communication and Information Systems, such as the Internet for blind persons • Low support of legislation, or lack of enforcement of existing legislation and regulations • Lack of databank for job seeking and matching purposes

6. Employability of PWD: Challenges • Risks related to design, choice, eligibility criteria of disability income programs may create work disincentives (social welfare, social insurance, mandated private pensions, private insurance) • Support for job incentives critical but policy remedies for greater participation affects both the supply and demand for workers with disabilities (individual preferences, demand for leisure, low productivity, low wages, disability benefits

7. Employability of PWD: Actions • Skills development policies • Vocational guidance and training • Employment services and promotion

8. 2. Inclusive Education • Principles: • All children should have the same access to education • Children like best when learning together • Recognize diversity, enhance strengths for equal participation

9. Inclusive Education – Measures/actions • Training teachers • Inclusive education as part of school reforms • Mobilizing and training parents • Developing resource centers • Enhancing capacity of community based rehabilitation programs • Decentralized funding within a unified system of service delivery

10. 3. Universal access: challenges • Infrastructure: • Inaccessible buildings • Reluctance of employers to provide facilities and infrastructure at workplace, • Transportation: • Inaccessible transportation, particularly to and from workplaces • Housing: Lack of suitable housing, especially near workplaces • Lack of access to assistive devices, technology and support

11. Universal access: actions • Legislation • Infrastructure and Environment

12. 4. a. Income protection through Social Insurance • Target population: workers covered by social security/social insurance programs • Objectives: • Provide income protection in the case of partial or total incapacity of workers • Assist in employing and keeping workers with disabilities active for a longer time • Rehabilitate disabled workers.

13. Income protection – Social Insurance in MENA • Disability pensions and work related injuries not major forces of Social Insurance reforms in MENA • Low coverage, financial disequilibria or non sustainability, administrative inefficiencies, poor governance • Discretionary disability assessment procedures result in excessive protection to some (i.e. with low degree of incapacity) and little or no protection to others (i.e. really disabled) • Inadequately designed assessment procedures may result in abuse and overlapping with other social insurance programs • As population ages, disability rates will increase

14. 4.b. Income protection through Social Safety Net programs • Target population: population not covered by social security/social insurance programs such as: children, youth, dependents, workers in the informal sector. • Objective: Provide income protection in the case of partial or total incapacity of groups of population not reached by formal social insurance/social security. • Challenges: • Group vs. individual targeting (category vs. means test) • Possible perverse incentives against rehabilitation and employability of PWD.

15. Social Protection for disabled persons in MENA: Actions • Pension Reforms need to include disability pensions • Disability programs need to be comprehensive to include preparing disabled workers to return to jobs in addition to the usual monetary compensations • Measures to avoid adverse selection and moral hazard • Consider the inclusion of PWD as target criterion of SSN programs

16. 5. Medical care, Rehabilitation and support services • Social Insurance programs mostly focus on income protection • While medical care is part of most Health Insurance programs, rehabilitation programs and support services are almost absent. • Lack of coordination and unclear responsibilities of Health, Social Security and Social Development programs in MC, Rehabilitation and Support services.

17. Conclusions:Improving integration of PWD Comprehensive policy framework including: • 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 • Getting all children with special needs into school and giving them the skills to participate fully in family and economic life • Improve societal attitudes to people with disabilities, relying on public-private partnerships • 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