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This report draws on and expands previous work looking at disability stigma in developing countries (written for K4D) and information on stigma in the situational analyses and labour market assessments of the four Inclusion Works programme countries. Factors which contribute to disability stigma, differences in the extent of stigmatisation and issues measuring stigma are discussed. An overview of disability stigma in each of the specific countries (Kenya, Bangladesh, Nigeria and Uganda) is provided. Interventions to reduce disability stigma are outlined, including interpersonal, intrapersonal and governmental/institutional interventions.

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.

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: To explore the preferable way of use and design of a work ability prognosis support tool for insurance physicians (IPs) and labour experts (LEs), based on a prediction model for future changes in work ability among individuals applying for a work disability benefit.

Methods: We conducted three focus groups with professionals of the Dutch Social Security Institute (17 IPs and 7 LEs). Data were audio recorded and qualitatively analysed according to the main principles of thematic analysis.

Results: Clarity and ease of use were mentioned as important features of the tool. Most professionals preferred to make their own judgement during the work disability assessment interview with the claimant and afterwards verify their evaluation with the tool. Concerning preferences on the design of the tool, dividing work disability claimants into categories based on the outcome of the prediction model was experienced as the most straightforward and clear way of presenting the results. Professionals expected that this encourages them to use the tool and act accordingly.

Conclusions: The tool should be easy to access and interpret, to increase the chance that professionals will use it. This way it can optimally help professionals making accurate prognoses of future changes in work ability.

This labour market assessment (LMA) has been conducted to collect a baseline to inform the implementation of the Inclusion works project.  The LMA evaluated the economic trends and patterns and identified growth sectors and subsectors with a high propensity for job creation. Using value chain analysis, the LMA identified the kind of jobs available in the selected subsectors and the type of skills and educational qualifications required to fill them. The study also analysed the flows and stocks of education that the workforce possess to match the demand in the selected subsectors. Furthermore, the LMA assessed functionality of labour market coordination system and how existing policies and structures influence the labour market.

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.

This labour market assessment (LMA) was important to ensure the Inclusion Works programme interventions are strategic and provide the most optimal way to address unemployment challenges facing persons with disabilities. This LMA was designed to answer key questions associated with perspectives on: policy; coordination systems; employer; training and recruitment service providers; and job seekers. To address the questions, the assessment attempted to identify; the growing sectors and job opportunities in Lagos, Abuja and Jigawa States, the demand and supply of skills for enabling persons with disabilities to compete for current and future job opportunities, and understanding barriers for employers and persons with disabilities with regards to disability inclusive formal employment while focusing on both current and future opportunities in formal and informal sectors.

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: Participation in activities of everyday life is seen as main goal of rehabilitation after a stroke and return to work is an important factor to consider for the substantial number of persons having a stroke at working age. The current study aims to investigate whether returning to work would predict self-perceived participation and autonomy in everyday life after a stroke, from a long-term perspective.

Materials and methods: Persons with first-ever stroke at age 18–63 years in 2009–2010, Gothenburg, were included. As 5-year follow-up, the Impact on Participation and Autonomy questionnaire was sent out, investigating self-perceived participation/autonomy in five levels, and work status was investigated from national sick-absence registers. Prediction of work on participation/autonomy was investigated with logistic regression.

Results: A total of 109 participants (49%) responded to the questionnaire. The majority (69–94%) perceived very good participation/autonomy in all domains and 59% were working 5 years after stroke. Working was a significant predictor of high participation/autonomy in all domains of the questionnaire.

Conclusions: Being able to return to work after a stroke seems to be important for self-perceived participation/autonomy. This emphasizes the importance of work-oriented information and rehabilitation after a stroke at working age.

Purpose: To qualitatively investigate changes in employment status, barriers to and facilitators of (return to) work in breast cancer survivors 5–10 years after diagnosis.

Materials and methods: Women were eligible to participate in the focus groups if they were younger than 55 years and were employed at time of diagnosis. Data were analysed by two independent researchers using thematic content analysis.

Results: Nineteen women participated in three semi-structured focus groups, of whom 18 reported a change in employment status 5–10 years after diagnosis. Perceived barriers to (return to) work shortly after breast cancer diagnosis tended to be disease- and treatment-related, while 5–10 years later, they were personal- and work-related. Participants recommended open communication and support at the workplace, and comprehensive information from (occupational) health care professionals to facilitate dealing with breast cancer at work.

Conclusions: Breast cancer survivors still experience changes in employment status 5–10 years after diagnosis. (Occupational) health care professionals should be alert that perceived barriers for returning to work change over time. Future research should focus on increasing awareness (at work) of breast cancer survivors’ needs, providing adequate information and support to all involved, and developing interventions to sustain survivors’ work ability at the long term.

Purpose: In Kenya, the employment rate for persons with disabilities is about 1% compared to 73.8% for the general population, and the situation is even worse for persons with mental disabilities. Persons with mental disabilities are often regarded as “mad”, and stand little or no chance of employment. We undertook an exploratory study with employers and potential employers to understand factors that hinder or facilitate their employment and to gain insight into employers’ perceptions of mental disability.

Materials and methods: We adopted a mixed method study design, including in-depth interviews (n = 10) and questionnaires (n = 158) with (potential) employers in Kenya to explore the barriers and facilitators of employment for persons with mental disabilities.

Results: Out of the 158 employers who completed the questionnaire, only 15.4% had ever employed persons with mental disabilities. The perceptions that these persons are not productive and may be violent was associated with an unwillingness to employ them (OR: 10.11, 95%CI: 2.87–35.59 and OR: 3.6, 95%CI: 1.34–9.64, respectively). The possession of skills was the highest reported facilitator of employing persons with mental disabilities. Employers suggested that information about mental illness and the disclosure by prospective employees with mental disabilities are relevant for the provision of reasonable accommodation in the workplace.

Conclusion: Possession of skills and disclosure by persons with mental disabilities could improve their employability. Information targeted at all actors including employers, employees, government, and policymakers is necessary for balancing employers and employees expectations.