Livelihood interventions appear to improve outcomes for people with disabilities
A range of programming approaches reported improvements in livelihood outcomes for people with disabilities in low- and middle-income countries (LMICs). However, confidence in study findings is low, due to methodological limitations in the research.
What is this review about?
More than 1 billion people have some form of disability. People with disabilities are frequently excluded from livelihood opportunities, including employment, social protection and access to banking and loans. Among people with disabilities over the age of 15, 36% are employed, compared to 60% for people without disabilities.
Livelihood interventions are therefore needed for people with disabilities. These include interventions aiming to improve access to financial capital (e.g., social protection), human capital (e.g., health and education/training), social capital (e.g., support) and physical capital (e.g., accessible buildings).
What is the aim of this review?
This review examines whether interventions for people with disabilities in LMICs result in improved livelihood outcomes, including acquisition of skills for the workplace, access to the job market, employment in formal and informal sectors, income and earnings from work, access to financial services such as grants and loans, and access to social protection programmes.
What studies are included?
This review includes studies that evaluate the effects of interventions on livelihood outcomes for people with disabilities in LMICs. The authors found nine interventions which used eligible study designs. Countries represented are Bangladesh, India, Nigeria, Ethiopia, Brazil, China and Vietnam. All included studies have some important methodological weaknesses.
What are the main findings of this review?
All included studies reported positive impacts on livelihoods outcomes. However, due to variation between studies, we did not conduct as analysis of effects across studies. As such, it is hard to draw firm conclusions about what works, for whom and how.
Most studies focused on improving access to the workplace. For example, people without disabilities were involved in programmes to improve their social attitudes to working with people with disabilities. People with certain disabilities were provided with wheelchairs. And some people with disabilities were placed in supported employment.
Studies examined the effects of vocational training programmes, a ‘motivation to work’ programme, community-based rehabilitation and social skills training. All of these approaches showed positive impacts on livelihood outcomes, including finding employment and gaining social skills for work.
The included studies all reported that their programmes improved outcomes related to the livelihoods of people with disabilities, including acquisition of skills for the workplace, access to the job market, employment in formal and informal sectors, and access to the formal and informal social protection measures.
Future research should evaluate these approaches with more rigorous study designs. This would develop a firmer evidence base, which would also inform the delivery of interventions at scale.
What do the findings of the review mean?
In general, there is not a great deal of evidence on interventions to improve livelihood outcomes for people with disabilities in LMICs, so more studies are needed. Researchers should work with organisations of persons with disabilities and other non-governmental organisations to identify priority interventions to evaluate. For instance, online and community-based delivery of livelihood interventions could be explored, to bridge gaps in coverage of programming and reach rural populations (who were underrepresented in this review).
There are other specific research gaps that need to be filled. The geographic scope of studies should be expanded. There were no studies from Europe, Central Asia, the Middle East or North Africa.
Programmes should integrate impact evaluations to improve the evidence base. Research evaluating programmes for people with disabilities other than those with physical impairments are needed.
Overall, there is a need for more and better data to inform policy and practice, including data on a broader range of impairment types.
How up-to-date is this review?
The review authors searched for studies up to February 2020.