Abstract
BackgroundPeople with disabilities are at increased risk of poverty, particularly in low-and middle-income countries. However, recent evidence suggests that this association is more nuanced than previously anticipated and that we need better data to understand the opportunity and out-of-pocket costs that diverse groups of people with disabilities may experience.ObjectiveThis paper discusses if disability is associated with opportunity cost and loss of income both on the individual and household level in South Africa, and if these costs differ depending on disability type and severity.MethodsFor this purpose, the paper analyses General Household Survey 2011 data (people between 15 and 59) using descriptive statistics disaggregated via disability type and severity. The paper also assesses if social grants counteract these costs and reduce economic vulnerability.ResultsThe analysis of the data reveals that people with disabilities are affected by issues relating to multidimensional poverty such as lower educational attainment and fewer employment opportunities. In addition, households of people with disabilities (with the exception of milder visual problems) earn significantly less than households without people with disabilities, and this particularly applies to households with people with severe disabilities. This vulnerability also varies by disability type. The country’s social protection mechanisms, in terms of social grants, counteract economic vulnerability to some extent but do not consider the nuanced economic impact of diverse conditions nor the increased out-of-pocket costs related to disability.ConclusionsThis calls for more equitable social protection mechanisms that include accessible services, livelihood programmes and disability benefits.
Highlights
It has been estimated that one billion people or 15% of the population worldwide have one or more disabilities and that this number is increasing, in resource-poor settings (World Health Organisation & World Bank 2011)
South Africa has a history of social security instruments targeting people with disabilities; an investigation of the impact of current practice on the economic vulnerability of people with disabilities in this country serves as an example for other middle-income countries (MICs)
The country provides a variety of social security grants (Figure 1) including the Old age grant (OAG), disability grant (DG), foster care grant (FCG), care dependency grant (CDG), child support grant (CSG) and grant-in-aid (GIA)
Summary
Extending social protection programmes to LMIC has become a focus of poverty alleviation strategies in the last decade (Frye 2005; Hagemejer & ILO 2009; Kabeer 2009; International Labour Office & International Disability Alliance 2015). This article uses a model of disability-driven economic vulnerability developed by Hanass-Hancock and Deghaye in 2014, as a guiding framework (South African Department of Social Development 2016) In this model, economic vulnerability is understood to be created through disabilityrelated opportunity costs (lack of education, employment opportunities, days out of role) and out-of-pocket costs (increased cost of healthcare, assistive devices and support, transport, etc.) that both influence available household income negatively. The GHS is a nationally representative household survey that is conducted annually to measure the level of development and performance of various government programmes and projects (Stats SA 2012) It collects socio-demographic information (gender, race, age, education, employment), contains questions on health and disability and access to social grants and basic services (housing, water, sanitation, electricity, refuse removal, transport, health and food supplies) as well as income (including source of income) for each individual. We include a disaggregated analysis of disability in this paper, highlighting the difference in outcomes for people and households with regard to the six different disability types measured in the WG set of questions
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