In the recently issued World Report on Disability (2011), The World Bank and the World Health
Organization (WHO) estimate that there are about one billion people with disabilities globally. Statistics
on the prevalence of disability in the Europe and Eurasia (E&E) region are notoriously unreliable. In fact,
a recent publication by the Social Transition Team (Galbraith, 2009) reported that estimates of the
prevalence of disabilities in the region ranged from 1 percent to 11 percent of the total population.
Nearly all official statistics related to disabilities are likely to be underestimates.
Across the E&E region, the socialist legacy of treatment of people with disabilities (PWD) (anyone with
a physical, sensory, intellectual, or mental/psychosocial disability) has created a largely invisible segment
of the population, confined to their homes or hidden away in institutions. Regardless of where they
reside, the majority of people with disabilities live on the margins of society. They are socially isolated,
denied basic human rights, unable to access basic services or treatment options, and stigmatized by the
non-disabled members of the population. Few community-based social services exist to provide
supports to people with disabilities and their families. Women with disabilities (WWD) are especially
disadvantaged and the intersection of their sex and disability status combines to create particular
barriers and challenges for this sub-group. Worldwide, women with disabilities are particularly likely to
experience a variety of negative outcomes including low levels of education, unemployment, poverty,
and sexual violence.
USAID Missions in the E&E region are increasingly interested in developing programming that supports
the fundamental human right of people with disabilities to participate fully and inclusively in their
societies and to improve their overall wellbeing and personal outcomes. Although this programming has
become more common across the region, little attention has been paid to two important matters: (a)
the special barriers confronting women with disabilities, and (b) how Missions could design programs to
address these barriers. This is a significant omission because most countries in the region have ratified
the UN Convention on the Rights of People with Disabilities and Article 6 of the Convention requires
signatories to address the issues experienced by women with disabilities.
The current study was undertaken to conduct a gender analysis of issues faced by people with
disabilities in the E&E region in order to elucidate the unique challenges facing women with disabilities, in
contrast with the challenges facing men with disabilities and women without disabilities. It includes an
analysis of gender in the context of disability in the sectors in which USAID typically works: health,
domestic or sexual violence, civil society, media, education, workforce development, and others.
The project methodology combined desk research with qualitative research in country conducted by
local researchers and analyzed by the chief consultant. Eighteen in-country researchers, many of whom
are active in civil society initiatives for disability and/or women’s rights, conducted their research in
thirteen E&E countries. They used uniform data collection instruments and protocols developed by the
chief consultant to gather relevant information using (a) telephone interviews, (b) focus groups, (c)
personal interviews, (d) published print and online sources, and (e) available statistical data. Of the 501
informants participating in the study, 375 are female and 126 are male.
The gender analysis of disability in the E&E region was conducted using the “The Six Domains of Gender
Analysis” framework elaborated by USAID’s Interagency Gender Working Group (IGWG), Office of
Women in Development, and Bureau for Global Health (USAID, 2011). The six domains are: (a) access
to assets; (b) knowledge, beliefs, and perceptions; (c) practices and participation; (d) time and space; (e)
legal rights and status; and (f) power and decision-making. The analysis also uses the concept of double
discrimination. For women with disabilities in the E&E region, the combination of their sex and disability
status creates unique barriers and challenges that place them at greater risk of violence, abuse, and
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exploitation by (DAWN Ontario, n.d.). It is possible to understand WWD as a particularly
disadvantaged subgroup with multiple minority status.
The limited nature of the existing research and a dearth of necessary statistical data do not allow for
definitive conclusions concerning the status of WWD in the E&E region. However, the desk research
and in-country data gathering did identify important trends that suggest that WWD in the E&E region
face significant disadvantages when compared with men with disabilities (MWD) and women without
disabilities. For example, participants in this study believed that WWD face more problems navigating
inaccessible and partially accessible environments, and in many countries, the education and employment
of WWD is seen as less important than for either MWD or other women. They also reported that
WWD appear to be more socially isolated than MWD and women without disabilities, and may be
more susceptible to domestic and sexual violence. Access to health care—especially gynecological
care—appears to be extremely limited for WWD in the E&E region.
The study findings suggest that the key areas where WWD appear to be particularly disadvantaged in
relation to MWD and women without disabilities include the following:
• Rights to sexuality, marriage, and motherhood. Access to these life activities seem to be the most
specifically gendered problem faced by WWD. The violation of WWDs’ rights to healthcare,
especially the dire lack of access to gynecological care, is closely related to these issues. These
issues cut across the domains of access, time and space, and power and decision-making.
• Social integration. Due to stigma and lack of accessibility, WWD are often more isolated than
MWD and women without disabilities. The discriminatory family structures and gender violence
that are a part of the patriarchal social systems in some of the E&E countries doubly marginalize
WWD. This isolation has ramifications for all areas of life and cut across the domains of time
and space, practices and participation, and power and decision-making.
• Employment. Although unemployment is high among all PWD in the region, the limited statistical
data and available anecdotal evidence, suggest that women with disabilities are less likely to be
employed than men with disabilities. WWDs’ access to employment may be especially curtailed
if they are mothers. Lack of employment opportunities for WWD is a gender issue that results
in women’s economic dependence and diminished personal autonomy. This issue cuts across the
domains of access, practices and participation, time and space, and power and decision-making.
Findings also indicate a level of need that suggests several clear imperatives:
• There is an urgent need for deeper investigation and data gathering regarding gender disparities
and disability so that the special needs of girls and women with disabilities can be better
understood. As statistics are generated it is imperative that the data are disaggregated by sex.
• It is vital to insure program sustainability by including stakeholders and their advocates (e.g.,
disabled persons organizations (DPOs), NGOs, diverse PWD) in program planning and
implementation and to design activities that strengthen partnerships and participation among
civil society, private market, and state actors.
• Programs to address disability and gender issues need to be designed for both maximum reach
and broad accessibility. Past disability programs, while helpful, often had so few beneficiaries that
PWD living outside major cities were often not involved and could not benefit from them. Also,
any information disseminated to PWD should be available in alternative, accessible formats.
Neglecting either reach or access considerably decreases a program’s potential to positively
impact and empower PWD.
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• Program designers must keep in mind that WWD are not a homogenous group. Women with
physical and sensory disabilities often have different needs than women with intellectual and
psychosocial disabilities. Women living in urban areas may have different priorities than women
in rural areas. Women in institutions have different challenges than women living in
communities. In other words, there are multiple ways in which disability and gender intersect,
including the reality that a significant number of women without disabilities are deeply affected
by caring for a family member with a disability.
This study includes recommendations for USAID Missions from which the following highlights are taken.
Four fundamental policy recommendations for furthering WWDs’ interests in development:
• Analyze programs and activities to determine why there is low participation by WWD or
differential accrual of benefits to WWD and MWD to determine how to adjust interventions to
increase equality.
• Include clear gender and disability indicators in all program-monitoring mechanisms.
• Systematically use program-monitoring data to support expanding inclusion of PWD and WWD.
• Insure that disability-related components are included in all mainstream programs by: (a)
involving PWD from the project planning phase, (b) designing specific interventions, (c) and
requiring that a portion of each award addresses disability issues.
Develop Stand-alone Programming Focused on Women with Disabilities, such as:
• Gender awareness trainings, rights awareness-raising, and empowerment programs to
encourage WWD to advocate for themselves and others.
• Summer camps of independent living tailored towards WWD or increasing the accessibility of
existing camp experiences for WWD.
• Legal training on the rights of PWD/WWD for medical personnel, lawyers, judges, prosecutors,
law enforcement, social workers, and other relevant professionals.
• Educational programs for parents, family members, and allies of WWD.
• Continuing education courses and job training for WWD to raise their qualifications for
employment.
• Entrepreneurship programs based on the specific needs of WWD, who are much less likely than
MWD and women without disabilities to engage in entrepreneurship.
• Initiatives designed to help mothers with disabilities to hold a job, such as free child-care, help
with housework, help with transportation.
• Programs to improve access to and quality of health care, especially gynecological care.
• Sensitivity trainings for health care service providers who examine and treat WWD.
• Infrastructure accessibility programs targeting WWD specifically.
• Media campaigns to educate the public about the challenges faced by WWD
• Training for reporters, talk show hosts, and others who would interview WWD on how to
ethically discuss family status.
• Partnership development support that enables DPOs to form partnerships with strong women’s
rights NGOs in order to facilitate training and other capacity building opportunities for WWD.
While some of the above recommendations may not appear specific to WWD, available research and
study participants indicated that assistance is needed in these areas to level the playing field for WWD
so that they may become more integrated in society and live more comfortable and fulfilling lives.
Integrate WWD in Gender Programs Focusing Broadly on Gender Equality or Women’s Empowerment
• Raise awareness among DPOs about gender issues.
• Educate women’s rights advocates about the situation of WWD.
• Integrate WWD into anti-violence programs.