Disability-Inclusive Development:

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Disability-Inclusive Development Regional
Perspectives in Latin America and the Caribbean
Diane Alméras
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Contents

• Regional follow-up of CRPD
• Availability of disability statistics in LAC
• Policy priorities autonomy, independence and
  care

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I. Regional follow-up of CRPD

• Thirty countries out of 33 have signed and/or
  ratified the Convention, of which 22 have signed
  and 20 ratified its Optional Protocol.
• Most governments have established a national
  mechanism responsible for the follow-up of the
  Convention and are creating a growing body of
  national policies as well as of specific and
  generic legislation.
• Few of them can demonstrate that these mechanisms
  and policy instruments were elaborated with the
  active participation of representatives of the
  organizations of persons with disability.
• ECLACs contribution is oriented toward awareness
  raising, research and access to knowledge.
• Actual priorities of the Regional Commission are
  1) measuring the scale of disability 2)
  gathering information to assess national policy
  proposals 3) promoting social inclusion and
  autonomy and 4) support the formulation of a
  first regional agenda.

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II. Availability of disability statistics in LAC

• In spite of the increased activity of statistics
  collection, available data are not entirely
  comparable between countries and still presents
  difficulties for generating a reliable prevalence
  rate in the region, especially in the Caribbean.
• Estimates vary according to the degree of
  disability assessed using the questions contained
  in the various measurement instruments censuses,
  household surveys or specialized surveys.
• According to the latest available data from 33
  countries, between 2000 and 2011, 66 millions
  persons were living in some form of disability in
  Latin America and the Caribbean. More updated
  (unavailable) figures could easily exceed the 85
  millions estimated by the World Bank.
• Over 12 of the population 5.4 in the Caribbean
  and 12.4 in Latin America lives with some form
  of disability, although the criteria used to
  compile data is different depending of the
  countries.

Regional Perspectives in Latin America and the
Caribbean
Diane Alméras
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Implementation of the recommendations of the
Washington Group on Disability Statistics

• Countries which have already conducted their
  census for this round have all used the new
  approach with exception of Ecuador (2010),
  albeit with a few changes or using yes/no
  responses instead of including the four degrees
  of severity
• Latin America Argentina (2010), Brazil (2010),
  Costa Rica (2011), Mexico (2011), Panama (2010)
  and Uruguay (2011)
• The Caribbean Anguilla (2011), Antigua and
  Barbuda (2011), Aruba (2010), Belize (2010),
  British Virgin Islands (2010), Dominica (2011),
  Grenada (2011), Montserrat (2011), Saint Kitts
  and Nevis (2011), Saint Lucia (2010), Saint
  Vincent and the Grenadines (2011) and Trinidad
  and Tobago (2011).
• Methodological differences have a direct impact
  on figures and caution must be exercises when
  making comparisons.

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Scale of disability in Latin America and the
Caribbean

• Disability is more prevalent in countries with an
  older population. Based on estimates from UNFPA,
  the over-60 population currently makes up 10 of
  the total population of LAC and is expected to
  reach 20 shortly.
• In over half the countries, disabilities are much
  more prevalent among women than among men,
  especially when aged 60 and over.
• Population groups which are most economically and
  socially vulnerable exhibit higher rates of
  disability rural-dwellers, indigenous peoples
  and Afro-descendants in Latin America, and those
  with lower incomes.
• These groups register both a higher incidence of
  disability an a greater degree of disability
  owing to a lack of timely care households where
  there a more persons with disabilities also lack
  resources of access to services.

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Latin America and the Caribbean (31 countries)
prevalence of disability by sex (Number per
thousand)
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Latin America and the Caribbean (29 countries)
Population ageing and Disability
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Persons with disabilities are more concentrated
in older and low-income populations prevalence
of disability (all types) by age group and income
quintile in Chile, Costa Rica and Mexico(Per
1,000 inhabitants)
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III. Policy priorities autonomy, independence
and care

• Care policies for persons with disabilities
  should be geared towards enhancing their autonomy
  and dignity.
• Assistance and care requirements for persons with
  disabilities are rising in the region as well as
  the rest of the world. Reasons include
• Demographic transition, with its rising incidence
  of chronic and degenerative diseases
• Medical advances are boosting catastrophic injury
  survival rates
• Unhealthy lifestyles
• Poverty which continues to rise in absolute
  numbers if not in percentages in our region
• Armed conflicts, urban violence and gender
  violence are also important causes of disability
• Lack of policies for prevention and timely
  assistance
• Social inequalities are heightened by a lack of
  appropriate services since care and
  rehabilitation are often complex, costly and,
  when provided privately, available only for a
  small proportion of population.

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The concept of disability and care is evolving
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Living independently and being includedin the
community (Article 19 of CRPD)

• Autonomy refers to the ability to live in
  community with little or no help from others
  albeit with assistive technologies
• Independence is understood as the ability to take
  decisions and be responsible for their
  consequences according to personal preferences
  and environmental requirements, even if someone
  elses help and support is needed.
• Independent living includes family and community
  support, residential support services, respite
  services, information and advice.
• The need for support services is determined by
  individual functioning, health conditions, stage
  of life cycle and environmental factors.

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Living with different types and levels of
disability

• The same types of disability are prevalent
  throughout the 21 Latin American and Caribbean
  countries
• Visual impairment and trouble walking, going up
  stairs or moving the lower extremities are the
  most common disabilities, followed by
• Speech and hearing impairments in Latin America
• Mental impairments that have an impact on
  behaviour and reduced dexterity for self-care and
  using objects in the Caribbean.
• Persons with a visual disability have less
  difficulty in entering the school system and the
  labour force. Next come persons with auditory and
  motor disabilities.
• Persons with impairments in cognitive and mental
  functions have fewer opportunities for social
  integration and difficulties in looking after
  themselves.
• Available data confirm the rising incidence of
  multiple disability over the life cycle, which
  creates additional care problems, both because
  different kinds of support are needed and the
  growing dependence of these persons.

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Living and care arrangements

• Percentage of persons with disabilities who live
  alone is particularly high.
• The majority receive care and support from
  immediate family, especially women.
• This situation takes an heavy toll on the
  familys emotional and financial well-being and
  highlights the shortfall in the supply of care
  services provided by the State, the market and
  civil society organizations.
• Increasing number of countries of ALC are rolling
  out government programmes that provide support to
  family care-givers, home-care services and
  support for independent living.
• Actual public and private services in the region
  include help for shopping, cleaning and cooking
  and companionship.
• Some countries now offer a basic level of medical
  care in the home as well as the provision of
  technical aids and varying degrees of economic
  assistance to help pay for care, rehabilitation
  services and home adaptation.

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Accessibility as a barrier to independent living

• Accessibility must be framed in terms of not only
  physical access, but all barriers that either
  restrict or prevent persons with disabilities
  from participating in society, including access
  to information and attitudinal behaviours.
• Access must be viewed as multidimensional and
  cross cutting, which spans a broad range of
  support and services including access to
  education, employment, health, family, social and
  recreational participation.
• Physical environment is often a barrier to the
  physical mobility of persons with disabilities,
  in particular the absence of adequate
  transportation, ramps and special parking
  facilities.
• Architecture design often serve to restrict
  access to buildings, private and public spaces
  and services, including courts of law, police
  stations and polling stations.

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Autonomy and protection of economic and social
rights

• Persons with disabilities are overrepresented in
  the figures on poverty, unemployment, low
  educational achievement and discrimination.
• Access to inclusive education, employment and
  social security coverage for persons with
  disabilities should be viewed within the
  framework of social care governance.
• In addition to social inclusion, school
  attendance helps develop the capacity to express
  oneself and make decisions.
• Paid work is a source of empowerment and
  autonomy.
• Greater functional autonomy and independence
  allows for a greater capacity for self-care and
  defending our human rights.
• Public policies and interventions that are
  centered on solidarity, care, respect of human
  rights and autonomy are both an ethical and
  practical imperative.

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