|Theme: Statistics, Data and Evaluation,
Programme Monitoring and Evaluation; The Disability Perspective in the Context of Development
V. CONCLUSIONS AND RECOMMENDATIONS
A. Concluding remarks
As noted in the introduction, this report has emphasized five approaches to topics explored here. The viewpoints have consisted of historical, mainstreaming, definitional, practical and case studies perspectives. A final revisiting of these viewpoints prior to a discussion of the recommendations will help to place them in perspective,
First, the long-range historical review has indeed documented dramatic changes in thinking on disability. Also documented was a tendency in the last quarter of the twentieth century for certain brief periods to mark intensive policy development in the area of disability. The 1975-1976 period witnessed the adoption by the General Assembly of the Declaration on the Rights of Disabled Persons and the declaration of 1981 as the International Year of Disabled Persons. Both the World Programme of Action concerning Disabled Persons and the United Nations Decade of Disabled Persons (1983-1992) were adopted by the General Assembly in 1982. As stressed in this report, the 1992-1994 period saw the adoption of 3 December as the International Day for the Disabled, the Standard Rules on Equalization of Opportunities for Persons with Disabilities (General Assembly resolution 48/96, annex), the Salamanca Framework and Plan for Action on Special Education, and the Long-term Strategy to Implement the World Programme of Action.
It would appear that there is a tendency in international disability policy for there to be periods of policy adoption, implementation and review and appraisal, followed by periods of strong activity. While it is to early to claim success, what could make the 1992-1994 policy efforts different appears to be a sustained effort to include disability issues in other United Nations efforts in the period from 1994 to the present. If this trend continues and disability issues are considered in efforts as routinely as issues related to children, women and poverty, the 1990s could be viewed by future historians as the decade in which disability issues were themselves truly mainstreamed.
This moves into the second issue of the incorporation of disability policies into the full range of policy initiatives. While it is clear that much promising work has begun on such mainstreaming in the development of policy, much remains in the area of policy implementation. Hence, a focus on monitoring policy implementation is a critical component to promoting the actual implementation of those mainstreaming policies. Such integration implies a stress not only on improving outcomes, but an emphasis on changing the environment and enhancing access. This emphasis means that monitoring must occur in these areas, as well.
As this report has discussed issues related to policy development, implementation and monitoring, as well as those related to the development of indicators, it is clear that focus must be placed on the definitions employed for disability. Indeed, in some respects, issues related to socio-economic outcomes tended to have a clearer formulation than those related to the basic question - exactly what is disability? While this report has not and should not have answered this question, it is clear that this issue will continue to be critical in the coming years. An emphasis on this issue should not be employed as a mechanism to justify a lack of progress on disability issues. Rather, the clear identification of disability definitions and their operationalization should be used to promote clarity in policy formulation, execution and appraisal. Definitional ambiguity can be addressed forthrightly in a clear and practical way.
This moves to the fourth issue of the use of data and indicators as tools for effective Programme implementation. Here at least three sources of tension was revealed: (a) between the desirability to have a true set of international standards for all people and to respect country and cultural differences, (b) between the need to adjust to changes over time and the need to have comparable data over time and (c) between the need for data on access and the environment at a time when such data are not readily available. As with the issue of definition of disability, it has been argued that these tensions need not form insurmountable obstacles but need rather to be addressed practically and clearly.
One way to address these issues is to consider the strengths and resources of countries, as in the case studies approach employed here. While this approach revealed the problems in analyzing data over time, it also addressed great potential for indicator development. Here, a loop back to the first theme of a long-term historical perspective is important. It was a case studies approach that showed that disability data could be collected routinely and this resulted in the creation of DISTAT. DISTAT has been a tool that has encouraged interest not only in disability data issues but interest in the entire disability field. This interest allowed DISTAT to be employed to choose three countries as case studies to look at disability data over time, an activity that was virtually impossible at the time the Programme was adopted. In this sense, the field of disability may be viewed as being at a state of the art where the field of labour force may have been forty years ago. The case studies, although pinpointing problem, do indicate that development of data for monitoring and indicators is feasible and desirable.
The data obtained so far indicate that during the next five years, many trends will have impacts on the prevalence of disability within the population and on persons with disabilities. As infant mortality declines, children who otherwise may never have died prematurely will live longer lives. As the population ages, the number of older persons with disabilities will increase. Many persons may find themselves caring for a disabled child and a disabled parent. As persons with disabilities grow and develop and age, the trends just mentioned will influence their transition through life. It is thus likely that the importance of promoting the disability perspective will increase.
The demonstrated association between population ageing and the prevalence of Impairment and Disability, combined with population ageing implies that both the number and prevalence of older persons with disabilities will increase in the future. This trend has immediate and important implications for policy design. There is an urgent need to explore alternatives to change environments to make them accessible to all. Moreover, it is critical that alternative frameworks to organize and deliver essential services in the year 2000 and beyond be developed. These frameworks must be community-based and have the capacity to support independent living, to respond to changes over the life cycle and to involve beneficiary input in the determination of service needs, alternatives and cost-recovery measures.
Despite these issues, data available for this review and appraisal suggest widespread policy-level support for the goals and objectives of the World Programme of Action. Policy implementation experience since the end of the United Nations Decade of Disabled Persons would suggest that both the Standard Rules and the Long-term Strategy provide useful frameworks both for advocacy and for the design and assessment of disability policy alternatives.
Three lessons from this experience are: (1) the need to integrate disability issues in the context of overall development and human rights, (2) the expansion of constituencies concerned with disability issues and (3) the continued validity of the goals and objectives of the World Programme of Action.
The mainstreaming of disability issues has been discussed in depth. This mainstreaming, however, does raise important issues of empowerment and of the consideration of the environment, which facilitate or impede involvement in development by all. The inclusion of disability issues within the broader human rights framework is indicative of the increased recognition that the rights of all are advanced when the rights of persons with disabilities are addressed in a comprehensive manner.
In addition to Government actions, which traditionally are addressed in international development policy instruments, the non-governmental community and the private sector, including foundations, have increased their involvement in the disability field. This trend suggests that when instruments to further the objective of equalization of opportunities are designed, they should accommodate short-term differences in policy preferences between entities interested in development and promote local initiative and flexibility in decisions on alternatives for implementation.
These trends complement the continued validity of the substantive content and the multidimensional character of the World Programme of Action. Governmental policies and selected country cooperation frameworks of the United Nations Development Programme reflect the Programme's goals and objectives. Even after the end of the United Nations Decade of Disabled Persons (1983-1992), the Programme continues to provide an effective framework for addressing emerging issues and trends.