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Why do we need evidence on disability?

In this step, I will try to answer the question, why do we need evidence on disability? Disability has historically been a neglected issue. But that changed a lot in 2011 with the publication of the World Report on Disability by the WHO and the World Bank. This landmark report brought together all the available evidence on disability and helped bring global attention to disability. One very important piece of evidence provided by the report is that there are 1 billion people with disabilities globally, equating to one in seven people. This evidence shows how important disability is, because of the large number of people affected. The report also shows that disability is more common among older people, women, and people who are poor.
Moreover, it gave evidence that 80% of people with disabilities live in low middle income countries. This evidence shows us who is most affected by disability and where we should focus our efforts. The report brought together all the existing evidence on the impacts of disability. It showed evidence that people with disabilities had worse health on average than their peers without disabilities. They also have on average lower levels of education and employment, higher levels of poverty, and frequently face exclusion, discrimination, and violence. Providing evidence on inequalities experienced by people with disabilities is important. This evidence highlights the large impact of disability on people and their families.
These exclusions and deprivations are a violation of the rights of people with disabilities as set out in the United Nations Convention on the Rights of Persons with Disability, which was in 2006, and in the laws of most countries. Furthermore, the evidence highlights that we may fail to reach the Sustainable Development Goals and other development targets without a focus on disability, as it is a large and excluded group. Evidence is helpful as long as it triggers productive action. Evidence on disability can be used to reduce the inequities facing people with disabilities in a number of ways. First of all, evidence can be used to help advocate for action.
Here is an example from the World Health Organisation, who advocate for better health for people with disability by showing that there is a large group who face difficulties in health care access. For example, the World Report quoted the World Health survey, which showed that disabled people are twice as likely to find health care provider skills or equipment inadequate to meet their needs, three times as likely to be denied care, and four times as likely to be treated badly as non-disabled people. Evidence can also show us where we should take action to make sure that people with disabilities are not left behind. For instance, should we focus on employment, education, poverty, attitudes, or health care?
It is very important that the voices of people with disabilities are central when planning actions to make sure that these activities are appropriate and wanted. Evidence also helps us to decide which intervention we should implement. For instance, children with disabilities are more likely to be out of school, and often have poorer educational outcomes than children without disabilities. There are lots of things that can be done to try to overcome this inequity, such as teacher training, providing assistive technologies, or making toilets accessible. We, therefore, need evidence on which actions are effective to help us choose what to do. But there are still lots of evidence gaps.
The International Centre for Evidence in Disability and the Campbell Collaboration made an evidence in gap map to show what evidence is available on the effectiveness of pensions to improve the lives of people with disabilities in low middle-income countries. This graph shows that we only found 100 studies, which is similar to the number found for quite specific topics like peacebuilding and far smaller than for broader topics like wash. Half of the studies that we did find out about disability focused on health. That means that very little information is available on what interventions are effective to improve education, livelihood, social inclusion, and so on for people with disabilities.
Another important gap is that many of the studies evaluating the impact of interventions that we found were of poor quality. This means that we cannot be sure that the findings were accurate. Our conclusion from the evidence and that map were, therefore, that we need more data which is good quality and investigates a broad range of interventions for us to be able to make recommendations on disability-inclusive development.
In summary, you should now understand that it is important to collect evidence on disability, as it can help us to advocate for a focus on disability. It can also help us to plan interventions to improve the lives of people with disabilities. And evidence can also show us where the interventions are effective. Currently, there are still large evidence gaps about disability and problems with the quality of evidence available. We, therefore, need more evidence, and it should be better quality. And we hope that the lessons in this MOOC will help towards this ambition.

In this step, Professor Hannah Kuper will describe why it is important to collect evidence on disability. Professor Kuper will describe three key areas where evidence can be used – in advocacy, to plan interventions, and to see whether interventions are effective. You will hear about the landmark report The World Report on Disability (2011) which drew together a lot of existing evidence from the field, and highlighted a range of existing gaps.

We would love to hear your thoughts on the presentation. Did anything surprise you?

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Global Disability: Research and Evidence

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