2008年-世界发展银行全球_Workshop_on_Strengthening_Disability_Measurement_across_South_Asian_Countries_96页_3mb

Summary of the Workshop on Strengthening Disability Measurement across South Asian Countries

Workshop Overview

• Title: Workshop on Strengthening Disability Measurement across South Asian Countries
• Funded by: Trust Fund for Economically Sustainable Development and World Bank
• Location: Lebiau Hotel and the Dome at State Tower, Bangkok, Thailand
• Date: April 2–4, 2008
• Objective: To improve disability measurement in South Asian countries by exploring new methodologies, definitions, and practical implementation strategies.

Core Content and Key Themes

Disability and Development

• Disability is a significant barrier to poverty reduction and hinders the achievement of development goals (MDGs).
• It affects not only individuals but also their families, often leading to economic hardship and limited opportunities.
• Early interventions, education, vocational training, and infrastructure improvements can enhance productivity and participation.

Medical vs. Social Model of Disability

• Medical Model: Focuses on individual impairments and health conditions. It is limited in capturing the broader impact of disability.
• Social Model: Emphasizes the interaction between a person's functional status and environmental barriers. It encourages interventions that address both individual and societal factors.

International Classification of Functioning (ICF)

• ICF is a framework that categorizes functioning across three domains: Body Functions and Structures, Activities, and Participation.
• It is used to measure the impact of disability on a person's life and to assess how environmental factors influence their ability to participate in society.

Key Sessions and Discussions

Session 1: Introduction

• Highlighted the global prevalence of disability and the need for better data.
• Emphasized the importance of integrating disability into development analysis and policy.

Session 2: Definition of Disability – Questions for Discussion

• Discussed how disability is defined and measured, highlighting the importance of context.
• Presented vignettes to explore the nuances of disability based on functional limitations and environmental factors.
• Key questions included:
  • Should disability criteria be based on body functions, activities, or participation?
  • How do environmental factors influence the experience of disability?
  • How do assistive devices and societal support affect participation?

Session 3: New Thinking on Disability Measurement

• Introduced the ICF framework and its relevance to disability measurement.
• Explained the social model and its implications for policy and program design.
• Highlighted the need to move from a conceptual definition to an operational one that captures real-life barriers and opportunities.

Session 4: From Census to Surveys

• Discussed the limitations of census data and the need for more detailed survey modules.
• Presented the Short Set and Extended Set of disability questions, focusing on:
  • Basic Activity Domains: Vision, Hearing, Mobility, Communication, Cognition, Self-Care
  • Complex Activity Domains: ADL, Getting Along with People, Life Activities, Participation
  • Environmental Factors: Micro, Meso, and Macro environments
• The Short Set is used for censuses, while the Extended Set is designed for more comprehensive surveys.

Key Data and Prevalence Insights

• Global Prevalence: Estimated between 450–650 million people with disabilities worldwide.
• Poverty Link: About 260 million people with disabilities live in absolute poverty.
• Country-Specific Data:
  • South Asia:
    • Census/HH Survey: Bangladesh (1.6%), India (2.2%), Pakistan (2.5%)
    • Special Surveys: Bangladesh (89–13.3%), India (6.8%), Sri Lanka (40%)
  • Comparative Data: Brazil (14.5%), Zambia (13.1%), Ecuador (12.1%)

Practical Implementation and Training

• Survey Design: Importance of aligning survey questions with the purpose of measurement (e.g., service provision, monitoring functioning, equalizing opportunities).
• Cognitive Testing: Ensuring questions are clear and culturally appropriate.
• Training Needs: Emphasis on training enumerators and other stakeholders to collect accurate and meaningful disability data.
• Field Testing: Experience from India highlighted the need for pilot testing and iterative improvements.

Policy and Politics

• The use of better disability data can influence policy decisions and support the inclusion of people with disabilities in development programs.
• Case studies from Brazil and Vietnam illustrated the challenges and opportunities of integrating disability data into national policy frameworks.

Participants

• World Bank Staff:
  • Susan E. Hirshberg (South Asia Regional Disability Coordinator)
  • Daniel Mont (Sr. Economist)
  • Shaikh Ahmed (Economist)
  • Shonali Sen (Consultant)
• Presenters:
  • Jennifer Madans (National Center for Health Statistics)
  • Marguerite Schneider (Human Sciences Research Council)
  • Mr. Nguyen Phong (Vietnam)
  • Izabel Maior (Brazil)
• Country Delegates:
  • Bangladesh: Mainul Hasan, Kamal Abdul Naser Chowdhury, Khandoker M. Asaduzzaman, Mithu Alur, S. Mukherjee, S. K. Ray, S.K. Nath, R. C. Sethi, Anuradha Mohit, Richa Sharma, R. Rangasayee
  • Pakistan: Muhammad Arshad, Shafiq-uz-Zaman, Khalid Mahmood, Sajjad Haider Yaldaram, Kamran Akbar, Khalid Naeem, Khalid Jamil Akhtar
  • India: Dr. Mithu Alur, Mr. S. Mukherjee, Mr. S. K. Ray, Dr. S.K. Nath

Conclusion

• The workshop aimed to enhance the understanding and measurement of disability through a shift from the medical model to the social model.
• Emphasis was placed on the importance of well-designed survey questions and the integration of disability data into national policy frameworks.
• Participants were encouraged to develop a matrix of functioning and to identify training needs for effective data collection and interpretation.