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This annotated bibliography provides an overview and outlines key messages from a selected range of academic and practioner literature looking at gender and disability in low- and middle-income countries, which may help with planning for gender inclusion in programmes and projects. The papers included here are not intended to be an exhaustive list of all the relevant literature. A focus is placed literature looking at the main areas of work of the Disability Inclusive Development programme: stigma, livelihoods (which also applies to the Inclusion Works programme), education, and health, as well as humanitarian contexts. Literature which focuses solely on one of these areas has been included in the relevant sections, and those which address multiple areas are included in the first, overarching section on gender and disability. As is often the case, the literature on gender and disability in low- and middle-income countries has a tendency to focus mainly on the experiences of women and girls with disabilities. There is a lack of evidence relating to gender and disability in low- and middle-income countries, although more evidence is emerging as awareness of the importance of the issue grows.

People with disabilities face exclusion and discrimination on the grounds of both their gender and their disability, as well as other intersecting factors such as age, race, class or poverty. The intersectional nature of discrimination and inequality impacts all areas of life, from access to services, personal security, livelihoods and leisure, through to individual choice and autonomy. Women and girls with disabilities are more likely to face discrimination and exclusion than people without disabilities and compared with men and boys with disabilities. Their participation in education, livelihoods, and healthcare is challenges by barriers including stigma and cultural practices resulting in discrimination and prejudice, lack of accessible services, and lack of support from family, teachers and institutions - all of which are exacerbated by poverty. Women with disabilities are also at greater risk of physical, mental and sexual abuse and because of stigmatisation, have lower marriage prospects. Therefore, it is important to ensure the meaningful inclusion of women and men with disabilities in programming.

The annotated bibliography is broken down into;

1. Gender and disability in LMICs

2. Gender, disability, stigma, and violence

3. Gender, disability, employment and livelihoods

4. Gender, disability, and education

5. Gender, disability, and health

6. Gender, disability, and humanitarian response

7. Report information

The Inclusion Works programme (2018–2022), funded by the UK Department for International Development, aims to improve employment rates for people with disabilities in Bangladesh, Kenya, Nigeria, and Uganda. 

Disability Inclusive Development (DID), also funded by the UK Department for International Development, aims to improve the long-term well-being and inclusion of people with disabilities through increased equitable access to: Quality health services and health outcomes, Quality education and educational attainment, Jobs/self- employment and improved livelihoods and a reduction in negative stereotyping and discrimination in Bangladesh, Kenya, Nigeria, Tanzania, Jordan and Nepal.

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Purpose: 

This article critically examines user-involvement in the service delivery process for assistive activity technology.

Methodology:

Data were collected in semi-structured interviews with 44 end users of assistive activity technology and in focus group interviews with 11 professionals at Norway’s Assistive Technology Centre. Data was analysed according to a stepwise deductive–inductive approach.

Findings: 

Flawed organisational principles like division of responsibility, unclear regulations, and a lack of competence with assistive activity technology among service professionals have hindered user involvement in the service delivery process.

Conclusion:

 A missing knowledge of assistive activity technology among professionals and the current organisation of services creates barriers for a positive collaboration with users in the service delivery process of assistive activity technology.

Purpose: Many children with autism spectrum disorder do not have symbolic play skills. The purpose of this study was to evaluate the effects of a training procedure on the acquisition, maintenance, and generalization of object-substitution symbolic play in children with autism spectrum disorder.

Methods: A single-case experimental design (multiple-probe across four behaviors) was used. One girl (5 years) and two boys (4–5 years) participated in this study. The training procedure involved withdrawing necessary items in play activities, supplying multiple substitutes, and providing hierarchical assistive prompts. Each child’s symbolic play responses across baseline, intervention, and follow-up conditions were recorded and graphed. Data analysis involved visual inspection of graphs.

Results: The results indicated that the procedure effectively increased and maintained object-substitution symbolic play. Generalization to untaught play activities occurred in all children, and symbolic play increased in the free play setting for one child.

Conclusions: Arranging play activities with missing items increased opportunities for children to engage in symbolic play. The training procedure can be used in clinical and educational settings as an initial step to establish and improve complex play behavior in children with autism spectrum disorder who lack such skills.

Today’s society promises that people with disabilities can access anything, but in practice there are numerous obstacles, and the ways in which people deal with them can be easily missed or taken for granted by policy makers. This article draws on a project in which researchers ‘go along’ people with disabilities in Sweden who demonstrate and recount accessibility troubles in urban and digital settings. They display a set of mundane methods for managing inaccessibility: (a) using others, (b) making deals and establishing routines, (c) mimicking or piggybacking conventions, (d) debunking others’ accounts and performing local politics. The employment of these shared but tailored methods shows the difficulties to be accepted that people with disabilities still face, as well as the wide-ranging tension that exists between the grand rhetoric of inclusion and modest results. The tension implies that people with disabilities are required to be creative.

• Declarations and policies often say that people with disabilities should have access to anything, but in practice this is not the case.
• This study investigates what people with disabilities actually do when they have trouble accessing various places or resources. The results show their common and practical ways, and these ways are often taken for granted, overlapping, and combined.
• People with disabilities ask others to support them when they face troubles to access places or resources, they make deals with important actors and they develop routines. They also observe, imitate and follow others’ actions, to pick out precisely those ways that suit their needs.
• When people with disabilities find their ways in today’s society they also act with words. They argue against other people’s excuses or justifications for not providing access.
• The study has found a lot of frustration among people with disabilities who get blocked, excluded or delayed. This gives them motives to engage in politics.

Purpose: This study’s purpose was to explore how people on sick leave manage societal norms and values related to work, and how these influence their perspectives of themselves throughout the rehabilitation process.

Materials and methods: This was a longitudinal interview study with a narrative approach, comprising 38 interviews with 11 individuals on long-term sick leave. Data collection was conducted in two phases and analysed iteratively through content analysis.

Results: The results suggest that work ethics and societal norms influence individuals’ views of themselves and the sick leave and rehabilitation process. Conforming one’s personal values to the work norm can create internal conflicts and cause feelings of shame for not being able to live up to the established norm. The strong work norm may create unrealistic expectations, which in some cases may result in constraining the return to work process.

Conclusion: To transform a sick leave narrative into a positive one, societal norms and their influence on identity needs to be recognised. Stakeholders involved in the process can contribute to a positive transformation by not only supporting return to work, but also to acknowledge and help people manage their self-image as having a disability that limits their ability to work.

This Gender Assessment Tool has been developed by ADD, based on existing good practice in the development sector, to support capacity building with DPOs in the following ways:

• To support discussion/ awareness raising of gender issues and practical action which can be taken to promote gender inclusion
• To analyse gender inclusion issues and practice within the organisation in a systematic way
• To identify specific areas for improvement on gender inclusion
• To identify CB support needed from ADD/other sources to address the issues raised
• To track progress on gender inclusion over time

NB: this tool replaces previous versions and has been updated based on input and discussion at the global MEL meeting in July 2016.

The opinions expressed are those of the authors and do not necessarily reflect the views or policies of the UK government or members of the Inclusion Works consortium.

Shy children can present challenges for teachers aiming at inclusive classrooms. Their educational attainments can be lower than their peers, they may have difficulties in adjustment to school and they can be at risk of meeting clinical criteria for social anxiety disorder. One recurrent finding is that they are often quiet across a range of school situations. The study reported here focused on teachers’ strategies to engage shy students in frequently occurring oral activities, such as group work, in elementary school classrooms. Data were gathered through post-observation stimulated-recall interviews with eight teachers who had experience of success with shy students and three focus groups with 11 similarly experienced teachers. The analysis examined teachers’ actions with these children to enhance their visible engagement in activities that require oral participation. The findings suggest that although teachers attended to the psychosocial aspects of student engagement, there was little emphasis on the pedagogic purposes of oral activities with these children. We conclude that more attention should be paid to the academic aspects of oral activities when aiming at inclusion for shy children.

Purpose: The purpose of this study is to provide a description of the learning environment at Folk High School for participants with high-functioning autism and to examine their learning experience at Folk High School.

Methods: A qualitative interview study was conducted with 21 participants who were enrolled at Folk High School which had been adapted to suit young adults with high-functioning autism. The interviews were analysed by means of a thematic content analysis which resulted in the identification of 6 themes related to learning experiences at Folk High School.

Results: The participants enjoyed themselves and felt secure at Folk High School. They felt that they and their academic endeavours were suitably recognised, acknowledged, and understood. They reported that the teaching was suitably adapted for them and they felt that they could succeed in their studies. A frequent report that they made concerned their experience of clear structures in the teaching process and its predictability. The participants stated that Folk High School has the ability to satisfy each participant’s needs, which entailed lower levels of perceived stress than what they had experienced in their previous schooling. The participants experienced personal development during their time at Folk High School.

Conclusions: Folk High School, and its special character, is able to successfully satisfy the needs of participants with high-functioning autism. Many of the participants, for the first time in their lives, experienced a sense of inclusion in an educational system and felt that they could succeed in their studies. However, there exists a risk that they become institutionalised, which entails that the participants function well primarily in Folk High School’s safe and caring environment.

In order to fully encapsulate the principles of ‘Nothing About Us without Us’ within development efforts, a strong knowledge base from programmes worldwide is needed to identify effective ways to promote the meaningful inclusion of people with disabilities in the design and delivery of programmes.

Development programmes need to move beyond passive consultations and seek meaningful engagement from people with disabilities from the early stages of programming right till the end so that the solutions and lessons learned are inclusive and representative for people with disabilities worldwide.