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Inclusive Design and Accessibility in Medellín, Colombia. AT2030 Inclusive Infrastructure Case Studies

PATRICK, M
MULDOWNEY, A
ARRUBA PALACIO, M
AGUIRRE, M
McKINNON, I
August 2023

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

Medellín, Colombia is the sixth and final case study city under the Global Disability Innovation Hub (GDI Hub) led and UK Aid funded AT2030 Inclusive Infrastructure sub-programme. Colombia’s second largest city, Medellín is well-known for its progress in urban development in the last 20 years, moving forward from its violent history. Medellín has been designated a district of innovation and is known for innovative urban projects such as its cable cars and electric escalators that connect higher altitude, low-income communities on the peripheries of the city. This case study explores the current state of accessibility and inclusion in the city for persons with disabilities and helps understand whether such urban innovations are inclusive for all the city’s residents.

Medellín is home to nearly 80,000 persons with disabilities and Colombia does have strong legal frameworks in place to support persons with disabilities. However, this case study found that the numerous laws and regulations are not always well implemented and there is also a need to consider more diverse disabilities in city planning and design.

The research took place in 3 phases between December 2022 and May 2023, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk-based research and interviews. Phase 2 captured the lived experience of persons with disabilities through interviews, photo diaries and co-design activities. Phase 3 then synthesised the findings, running multiple in-person workshops to validate and create actions towards the creation of more inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life for persons with disabilities including, poverty, transport, housing, healthcare, public spaces and recreational activities. Quotes from participants are interwoven throughout the report and strengthen the concluding actions. The report recognises what has worked in Medellin as well as areas for improvement.

Listen Include Respect: International Guidelines for Inclusive Participation

Inclusion International
June 2022

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The Listen Include Respect guidelines help organisations understand what they need to do to make sure people with intellectual disabilities are included in their work.

​They were written by Inclusion International and Down Syndrome International.

Over 1,500 people with intellectual disabilities and their families from almost 100 countries helped write them.

The Convention on the Rights of Persons with Disabilities (CRPD) tells us that all people with disabilities have the right to “meaningful participation.”

“Meaningful participation” is what happens when people with intellectual disabilities get everything they need to be fully included, participate equally, and feel valued.

These guidelines will help organisations to make this happen.

A Global Agenda for Inclusive Recovery: Ensuring People with Intellectual Disabilities and Families are Included in a Post-COVID World

Inclusion International
June 2021

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This report documents the experience of exclusion of people with intellectual disabilities and their families during the COVID-19 pandemic. These experiences reveal pre-existing structural inequalities that affected the lives of people with intellectual disabilities and their families before COVID-19, during the pandemic, and beyond, and this report raises up the voices of those most excluded in a time of global crisis and demands an inclusive COVID-19 recovery.

 

This report includes the experiences of people with intellectual disabilities and families across eight different issue areas. Across these themes, we examined how and why people with intellectual disabilities were left out and excluded in pandemic responses, what pre-existing conditions and inequalities contributed to their vulnerability and exclusion, and how future policy structures could begin to address both this immediate and systemic exclusion.

 

Together, these experiences and policy solutions form our global agenda for inclusive COVID-19 recovery, an action plan to ensure that government efforts to ‘build back better’ are inclusive of people with intellectual disabilities and their families.

Product Narrative: Prostheses. A market landscape and strategic approach to increasing access to prosthetic devices and related services in Low- and Middle-Income Countries

LIAO, Cynthia
SEGHERS, Frederick
SAVAGE, Margaret
FINEBERG, Alison
AUSTIN, Vicki
HOLLOWAY, Catherine
OLDFREY, Ben
April 2020

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While about 1.5 million people undergo amputations every year, WHO estimates that only 5-15% of amputees who need prosthetic devices in LMICs have access to them. High prices of prosthetic services in lower- and middle-income countries (LMICs), combined with high indirect costs for users (for example to travel to service points), make prosthetic services unaffordable to many of the people who need them. 

Prosthetic services can be made more affordable by: 1) increasing the number of service units (in particular, by leveraging decentralised service models and the innovative technologies that enable them); 2) establishing reimbursement schemes that encapsulate all costs to the user; and 3) leveraging alternative forms of financing for both capacity-building and user financing.

An opportunity exists to transform access to prosthetic services and products in LMICs, but this will require a coordinated effort between: 1) governments to expand service capacity; 2) global stakeholders to provide guidance on products and technologies; 3) suppliers to expand market presence and offerings; and 4) donors to support these activities. 

Five strategic objectives are proposed to accelerate access to prosthetic services in LMIC

Disability considerations during the COVID-19 outbreak

WORLD HEALTH ORGANISATION (WHO)
March 2020

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This overview gives actions for the disabled persons and their household, for governments, for healthcare workers , for disability service providers and for the community to mitigate the effects of the COVID-19 outbreak.

Zero Project Report 2020: Inclusive education. 75 Innovative Practices and 11 Innovative Policies from 54 countries

BUTCHER, Thomas
et al
January 2020

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There are several sections in this report:

  • Executive summary
  • Impact of the Zero Project: Survey results
  • Innovative policies and practices: Factsheets and life stories
  • The Zero Project Impact Transfer accelerator programme
  • An analysis of ICT supporting innovations in inclusive education
  • SDGs, Data and inclusive education
  • Summary of report in Easy Read. 

Themes were:

  • Early childhood and preschool
  • Formal education (primary and secondary education)
  • Universities (tertiary education)
  • Vocational education and training
  • Non-formal education
  • ICT-driven solutions related to education/digital skills

Wheelchair Product Narrative: A market landscape and strategic approach to increasing access to wheelchairs and related services in Low and Middle Income Countries

SAVAGE, Margaret
CLINTON HEALTH ACCESS INITIATIVE
August 2019

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This product narrative was developed to support identification of activities that will increase and sustain access to appropriate, affordable wheelchairs. The market landscape, context, assessment and challenges is described. Four strategic approaches to market shaping are made.

United Nations Disability Inclusion strategy

UNITED NATIONS
June 2019

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The United Nations Disability Inclusion Strategy provides the foundation for sustainable and transformative progress on disability inclusion through all pillars of the work of the United Nations: peace and security, human rights, and development.
 
The Strategy enables the UN system to support the implementation of the Convention on the Rights of Persons with Disabilities and other international human rights instruments, as well as the achievement of the Sustainable Development Goals, the Agenda for Humanity and the Sendai Framework for Disaster Risk Reduction.

The Strategy includes a policy and an accountability framework, with benchmarks to assess progress and accelerate change on disability inclusion. The policy establishes a vision and commitment for the United Nations system on the inclusion of persons with disabilities.

 

The strategy is based on three over-arching approaches to achieve disability inclusion: twin track approach; intersectionality; and coordination

There are four core areas of responsibility: leadership, strategic planning and management; inclusiveness; programming; and organisational culture

Digital Accessibility Toolkit

CBM
May 2018

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The purpose of this toolkit is to share a selection of tools and recommendations pertaining to the accessibility of Information and Communication Technologies (ICT). Based on international standards and a scan of available technologies, these tools and recommendations are intended to contribute to the social and economic inclusion of persons with disabilities by ensuring that information is equitably accessible.

The goals of this toolkit are:

  • To outline the key international frameworks around digital accessibility and why it is critical for inclusion of persons with disabilities.
  • To link people with tools, practice examples, free online training, and other resources so that their practice is digitally accessible.
  • To ensure that digital accessibility is an inherent aspect of daily practice.
  • To align the practices of those working with and for CBM. 

This toolkit is intended to be used as a guide and practice resource by people working with and for CBM so that we produce accessible digital content and communications, and place accessibility at the centre of our ICT procurement processes. We hope that the toolkit will be a resource for the wider community of persons with disabilities, Disabled People’s Organisations (DPOs), and nongovernmental organisations (NGOs).

A new way to measure child functioning

UNICEF
WASHINGTON GROUP
May 2017

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"In recognizing the need for a set of questions that would produce internationally comparable data on children, the Washington Group formed a subgroup in 2009 that is chaired by the National Statistical Office of Italy (ISTAT). UNICEF joined the subgroup in 2011.

The first main activity of the subgroup was the development of a short set of questions to reflect current thinking on child functioning for inclusion in censuses and surveys. The new module uses the ICF-CY as the conceptual framework and relies on a functional approach to measuring disability.

The Washington Group/UNICEF Module on Child Functioning, finalized in 2016, covers children between 2 and 17 years of age and assesses functional difficulties in different domains including hearing, vision, communication/comprehension, learning, mobility and emotions. To better reflect the degree of functional difficulty, each area is assessed against a rating scale. The purpose is to identify the subpopulation of children who are at greater risk than other children of the same age or who are experiencing limited participation in an unaccommodating environment. The set of questions is intended for use in national household surveys and censuses"

The module is being translated into multiple languages. Supporting documentation, including a concept note, tabulation plan, templates for reporting, guidelines for interviewers and training materials are also available.

Able to include

INCLUSION EUROPE
February 2017

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"The ABLE TO INCLUDE solution improves the quality of life of people with intellectual or developmental disabilities (IDD) and similar conditions such as people affected by dementia or any kind of cognitive impairment. To achieve this, the project integrates a set of already-developed technologies to create a context-aware accessibility layer that, by being integrated with existing and future ICT tools, can improve the day-to-day life of people with IDD by understanding their surroundings and helping them to interact with the information society. The project focuses on the most important areas that a person needs to live independently and find fulfilment as an individual: to socialize in the context of the web 2.0, to travel independently and be able to work.

Three key technologies are used as a framework to develop everyday tasks:

Text and content simplifier
A pictogram-to-text, text-to-pictogram and pictogram-pictogram translation tool
Text-to-speech functionalities

These technologies are utilised to create an accessibility layer for people with IDD in everyday tasks within the framework of the information society. The accessibility layer is accessed through an open and free API that foster the introduction of an assistive technologies layer for people with IDD in any software development."

Greece: Refugees with Disabilities Overlooked, Underserved

HUMAN RIGHTS WATCH
January 2017

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Refugees, asylum seekers, and other migrants with disabilities are not properly identified and do not enjoy equal access to services in reception centres in Greece.  On the basis of research carried out in mainland Greece and on the Greek islands in October 2016 and January 2017, and follow-up phone interviews in December 2016 and January 2017, Human Rights Watch found that asylum seekers and refugees with disabilities are not properly identified in Greece, in part because of a rushed registration process and the need for better guidance for staff. Without an adequate understanding of the scale and needs, aid agencies cannot respond effectively. Problems with equal access to water and sanitation services, food distribution, shelter, and health care including mental health and psychosocial support are reported.

Report of the Special Rapporteur on the rights of persons with disabilities (theme: access to rights-based support for persons with disabilities)

DEVANDAS, Catalina
December 2016

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In her report, the Special Rapporteur provides an overview of the activities undertaken in 2016, as well as a thematic study on access to support by persons with disabilities. The study includes guidance for States on how to ensure the provision of different forms of rights-based support and assistance for persons with disabilities, in consultation with them. In preparing the study, the Special Rapporteur convened a regional expert consultation in Addis Ababa in September 2016 and analysed the responses to a questionnaire sent to Member States, national human rights institutions, agencies of the United Nations system, civil society organisations and persons with disabilities and their representative organisations. As at 5 December 2016, she had received 114 responses. 

Guidelines for integrating gender-based violence interventions in humanitarian action: Reducing risk, promoting resilience and aiding recovery

WARD, Jean
LAFRENIERE, Julie
et al
2015

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The purpose of these Guidelines is to assist humanitarian actors and communities affected by armed conflict, natural disasters and other humanitarian emergencies to coordinate, plan, implement, monitor and evaluate essential actions for the prevention and mitigation of gender-based violence (GBV) across all sectors of humanitarian response. Part One presents an overview of GBV, provides an explanation for why GBV is a protection concern for all humanitarian actors and outlines recommendations for ensuring implementation of the Guidelines. Part Two provides a background to the ‘thematic areas’ in Part Three. It also introduces the guiding principles and approaches that are the foundation for all planning and implementation of GBV-related programming. Part Three constitutes the bulk of these Guidelines. It provides specific guidance, organized into thirteen thematic area sections: camp coordination and camp management; child protection; education; food security and agriculture; health; housing, land and property; humanitarian mine action; livelihoods; nutrition; protection; shelter, settlement and recovery; water, sanitation and hygiene; humanitarian operations support sectors. The importance of cross-sectoral coordination is highlighted in each section. It is also recommended that sector actors review the content of all thematic area sections. The Guidelines draw from many tools, standards, background materials and other resources developed by the United Nations, national and international non-governmental organizations, and academic sources. In each thematic area there is a list of resources specific to that area, and additional GBV-related resources are provided in Annex 1. The importance of indicators being disaggregated by sex, age, disability and other vulnerability factors is highlighted throughout.

Information and communications for development 2012 : maximizing mobile

THE WORLD BANK
2012

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"This report analyzes the growth and evolution of applications for mobile phones, focusing on their use in agriculture, health and financial services, as well as their impact on employment and government. It also explores the consequences for development of the emerging "app economy", summarizing current thinking and seeking to inform the debate on the use of mobile phones for development. It’s no longer about the phone itself, but about how it is used, and the content and applications that mobile phones open"

Accessible ICTs and personalized learning for students with disabilities : a dialogue among educators, industry, government and civil society

UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION (UNESCO)
2011

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"The use of technology in education plays a particularly vital role by enabling flexible curriculum development and assisting students with disabilities to participate as equals in the learning experience. The recommendations contained in this report target teachers, policy makers and administrators. The main recommendations centre on a number of core themes that include maximising the use of the myriad of accessibility features in mainstream ICTs such as personal computers, tablet PCs, mobile phones etc. already in use in classrooms; empowering students to learn their own preferences and settings when using technology for learning and removing attitudinal barriers to the use of technology for inclusive education, in particular those of teachers who may struggle with modern ICTs"
Collaborative Expert Meeting Report
UNESCO Headquarters, Paris
17 -18 November 2011

Making mobile phones and services accessible for persons with disabilities

NARASIMHAN, Nirmita
LEBLOIS, Axel
2011

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"This report contains references to the new legislative and regulatory framework set by the Convention on the Rights of Persons with Disabilities, an important resource for policy makers. It also covers practical elements required for a successful implementation of those programs and policies: technical accessibility features for handsets, accessible and assistive applications and services as well as business cases of companies which have implemented significant accessibility programs...(T)his report will be a useful resource for telecom regulators, mobile operators, organizations of persons with disabilities and other mobile stakeholders to develop successful accessibility policies and programs in their respective countries to equally serve persons of all abilities"

The world health report 2007 - a safer future : global public health in the 21st century

World Health Organization (WHO)
August 2007

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"This report dicusses...current challenges to global health secturity and asks: How can a safer future be acheived? It looks at the potential new tools for collective defence, particularly the revised 'International Health Regulations' (2005) which came into force [in 2007]...[It] concludes with recommendations intended to provide guidance and inspiration towards cooperation and transparency in the effort to secrure the highest level of global public health security"

Drinking and driving : a road safety manual for decision makers and practitioners

WORLD HEALTH ORGANIZATION (WHO)
et al
2007

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"The purpose of this manual is to inform readers of practical ways to develop coordinated and integrated programmes to reduce drinking and driving (including riding motorcycles) within a country. The manual is aimed at addressing drinking and driving among drivers. Commercial drivers are an especially important group to address in terms of drinking and driving because of the large number of passengers they can carry and/or the number of kilometres they are likely to travel. While impaired pedestrians are acknowledged as a problem, this issue is not addressed here.
The manual is aimed at policy-makers and practitioners, and draws on experience from countries that have succeeded in reducing drinking and driving. It provides the background evidence to start a drinking and driving programme, and takes the user through the steps needed to undertake a problem assessment in a country. It then explains how to plan and implement a programme, including setting up a working group, developing a plan, examples of laws and enforcement needed, how to develop public education and publicity campaigns, and finally how to evaluate the programme.
In developing this manual the authors have drawn on case studies from around the world to illustrate "good practice". Examples from low and middle-income countries are given wherever possible, but it is a reflection on the lack of attention given to the issue in many countries that most examples are from highly motorized countries"

Helmets : a road safety manual for decision makers and practitioners

WORLD HEALTH ORGANIZATION (WHO)
2006

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"This manual provides practical advice to road safety practitioners on how to achieve a much higher proportion of users of two-wheeled vehicles wearing helmets. It follows on from the World report on road traffic injury prevention, which described evidence that setting and enforcing mandatory helmet use is an effective intervention for reducing injuries and fatalities among two-wheeler users. The manual is one of a series of documents produce by an informal consortium (WHO, the Global Road Safety Partnership, the World Bank, and the FIA Foundation for the Automobile and Society) that aims to provide guidance to countries on how to implement some of the recommendations identified within the World Report, and thus improve their overall road safety record"

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