Including Women and Girls with Disabilities in World Bank Operations Toolkit | March 2023 Source: Shutterstock. Acknowledgements 4 contents Key Messages 5 Toolkit Purpose and Scope 6 Acronyms 8 Chapter 1 Why and How to Strengthen the Inclusion of Women and Girls with Disabilities 9 1. Understanding Multiple Discrimination of Women with Disabilities 10 2. What Are World Bank Group Commitments to Women with Disabilities? 19 References 24 Chapter 2 Taking the Next Steps to Achieve Socioeconomic Inclusion of Women and Girls with Disabilities – A Checklist for Task Team Leaders 27 1. Preliminary Phases (Systematic Country Diagnostic and Country Partnership Framework) 29 2. Identification Phase (Project Concept Note) 32 3. Preparation Phase (Project Appraisal Document) 36 4. Implementation Phase (Implementation Status and Results Report) 38 5. Evaluation Phase (Implementation Completion and Results Report) 40 References 41 Chapter 3 What Are the Key Barriers for Women and Girls with Disabilities, and How is the World Bank Group Addressing Them? 42 1. Key Barriers and Solutions across World Bank Group Sectors 43 2. The Importance of Disaggregated Data to Inform Policies and Projects 47 3. The Critical Role of Disability-Inclusive Laws and Policies 51 4. Sector-Specific Barriers and Solutions 58 a. Education 58 b. Employment and Entrepreneurship 61 c. Social Protection 65 d. Gender-Based Violence 68 e. Health 70 f. Digital Development 73 g. Water 75 h. Transport and Urban Planning 77 i. Fragility, Conflict, and Violence and Disaster Risk Management 80 References 82 Useful Quick Resources 87 Acknowledgements This toolkit was prepared as a knowledge product for World Bank staff by a team led by Julia Constanze Braunmiller (senior private sector development specialist), with Danai Angeli (consultant), Marie Dry (consultant), and Diana Beth Samarasan (consultant). The toolkit builds on recently published research on the rights of women with disabilities by the Women, Business and the Law team supported by Operations Policy and Country Services. Support for this project is provided by the Human Rights, Inclusion, and Empowerment Umbrella Trust Fund. The team would like to thank Charlotte McClain-Nhlapo (global disability advisor) for her invaluable advice and comments throughout the conceptualization, drafting, and publication process of this toolkit. The team also acknowledges and thanks peer reviewers Hanna Alasuutari (senior education specialist); Narae Choi (senior urban development specialist); Karla Dominguez Gonzalez (senior gender specialist); and Maria Elena García Mora (senior social development specialist). The team received useful insights from consultations with Diana Jimena Arango (senior gender-based violence and development specialist); Fatima Arroyo Arroyo (urban mobility specialist); Helle Buchhave (senior social development specialist); Kamila Galeza (social development specialist); Margarita Puerto Gomez (senior social development specialist); Azada Hussain (operations officer); Mari Helena Koistinen (consultant); Giang Tam Nguyen (social development specialist and gender focal point); M. Yaa Oppong (sector leader); Deepti Samant Raja (social development specialist); Inaam Ul Haq (senior health specialist); and Varalakshmi Vemuru (practice manager). The team obtained valuable contributions for case studies from Asalifew Amedin, Dibabe Bacha, Miyeon Kim, Yewon Kim, Jieun Lee, Sooyeon Lee, Gebre Teshome, and Yelekale Hasabe Widneh. The authors would like to thank the Women, Business and the Law team for data collection and analysis vital to better understanding laws and policies for the inclusion of women with disabilities. Sue Kovach provided excellent editorial assistance. JC Ospino assisted with the design and layout of the publication. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 4 Key Messages ✚ One in every 5 women—20 percent of the female population—has a disability. ✚ Women with disabilities experience the same barriers as nondisabled women: discriminatory social norms and practices; legal restrictions; exposure to violence and harassment; lack of access to health services, education, assets, and employment; and severe underrepresentation in public and private sector leadership. However, the two overlapping grounds of disability and gender aggravate their experience of discrimination and exclusion. ✚ Women with disabilities face more severe obstacles to socioeconomic participation, compared with other women and men with and without disabilities, because of multiple discrimination and environmental barriers. Women with disabilities are more likely to have unmet health care needs and be excluded from education, and they are less likely to be employed and work in leadership positions than men with disabilities. Gaps are even larger compared with nondisabled persons. Women with disabilities experience gender-based violence at much higher rates than nondisabled women. ✚ The World Bank Group (WBG) has corporate commitments to gender equality and commitments to inclusion of persons with disabilities. ✚ Key WBG instruments address both gender and disability inclusion. These include but are not limited to: ⊕ Environmental and Social Framework (ESF) ⊕ ESF Good Practice Notes on nondiscrimination and disability and on gender, and ESF Guidance Note 10, ESS10: Stakeholder Engagement and Information Disclosure ⊕ Bank Directive: Addressing Risks and Impacts on Disadvantaged or Vulnerable Individuals or Groups ⊕ The WBG Gender Strategy for fiscal years 2016–23, World Bank Group Gender Equality, Poverty Reduction, and Inclusive Growth (currently being updated for fiscal year 2024) ⊕ Disability and Inclusion Accountability Framework (as updated in 2022) ⊕ WBG’s 10 commitments on disability-inclusive development ⊕ IDA19 and IDA20 funding commitments ✚ This toolkit is born of the need for a specific guide on the intersectionality of gender and disability to guide WBG operations how to increase the socioeconomic inclusion of women with disabilities. Good practices are drawn from successful WBG operations across a variety of sectors and from international standards and other external organizations that address the issue of intersectionality. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 5 Toolkit Purpose & Scope The toolkit is intended for a World Bank internal audience, especially to inform task team leaders (TTLs) how to design disability and gender-inclusive operations. The toolkit highlights World Bank Group (WBG) commitments relevant to women and girls with disabilities, examples of law and policy reform, and key barriers and solutions across several World Bank sectors, and it includes a checklist for TTLs to use throughout the project cycle. TTLs will benefit from the toolkit’s key questions (focused on data collection, policy frameworks, and program development) and suggested indicators aimed to increase inclusion of women and girls with disabilities across WBG projects and a set of resources for additional support. The toolkit is a collaborative effort of the World Bank’s Social Sustainability and Inclusion Global Practice and the Women, Business and the Law project team in the Development Economics Department. It is based on primary legal data collection, desk research, and literature review, along with in-person interviews with WBG TTLs across various sectors and other experts in disability inclusion. The authors designed this publication’s content based on what they identified as critical to addressing the main gaps in the socioeconomic participation of women with disabilities. This is not an exhaustive how-to guide, but it showcases many good practices that were derived through interviews with TTLs who were successful in promoting gender and disability inclusion in a specific context. Often, personal initiative drove efforts toward the inclusion of women with disabilities. The World Bank Group in 2018 made 10 commitments on disability-inclusive development. Under commitment 4, the World Bank committed to exploring opportunities to focus more deliberately on the economic empowerment of women and girls with disabilities. Women with disabilities Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 6 are among the world’s most marginalized investment in inclusive growth. It aims to groups, facing barriers to their socioeconomic foster inclusive and resilient societies in which participation based on their gender and citizens have voice and governments respond. disability status. Supporting the inclusion of This includes supporting people in overcoming women with disabilities is a key aspect of the obstacles that prevent them from fully WBG’s twin goals, and such support is required participating in society—regardless of their for the development of resilient, cohesive gender, race, religion, ethnicity, age, sexual societies that can thrive in the long term. orientation, or disability—through operations and analytics. This toolkit aims to provide Reliable cross-country comparable data knowledge to regional and country-level task are largely missing. But emerging evidence teams beyond the Social Sustainability and suggests that women with disabilities face Inclusion Global Practice and truly highlight higher rates of violence and harassment and the need to address gender and disability lower rates of access to health care services, across the World Bank’s investment and education, assets, and employment, compared operational portfolio. with nondisabled women and compared with men with and without disabilities. This requires This toolkit is intended as a practical tool operationalizing gender-aware disability for WBG task teams, summarizing the main inclusion into mainstream development work. issues to consider and easy identification of entry points, highlighting good practices under Legal recognition of and support for the international human rights law, providing human rights of women with disabilities is examples of law and policy reform, and a vital first step to address and ultimately compiling best practices from WBG operations enforce protection from discriminatory that have successfully advanced the inclusion practices. In 2022, the WBG’s Women, of women with disabilities. It recognizes the Business and the Law project published importance of additional resources and invites a new data set on the legal barriers that teams to delve deeper through its resource list, women with disabilities face when accessing which attempts to provide solutions for various economic opportunities in 190 economies. situations in the development context and The new data suggest that only one-quarter lists many relevant documents. It addresses of economies worldwide explicitly protect measures to promote the socioeconomic and promote the right to nondiscrimination inclusion of women with disabilities across of women with disabilities. Similar gaps are several critical sectors for World Bank highlighted in legal protections of the respect operations: education; employment and for family life, labor market inclusion, and a entrepreneurship; social protection; gender- life free from violence, emphasizing the need based violence; health; digital development; for good practices to guide regulatory reform. water and sanitation; transportation and Research recognizes that although laws are an urban planning; fragility, conflict, violence; and important aspect of achieving the full inclusion disaster risk management. It seeks to support of women with disabilities, they need to be WBG task teams in inclusive approaches to implemented effectively to achieve results. the design, implementation, and evaluation The Social Sustainability and Inclusion Global of all projects to better support women Practice is working to strengthen the WBG’s and girls with disabilities and address their focus on excluded groups and increase intersectional needs. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 7 Acronyms CEDAW United Nations Convention on the Elimination of Discrimination Against Women CMU World Bank Country Management Unit CRPD United Nations Convention on the Rights of Persons with Disabilities CRC United Nations Convention on the Rights of the Child DPL Development policy lending GBV Gender-based violence ESF Environmental and Social Framework ESS Environmental and Social Standard IDA International Development Association IPF Investment project financing OPD Organization of persons with disabilities TTL Task team leader WBG World Bank Group WG - SS Washington Group on Disability Statistics Short Set of Questions on Functioning WHO World Health Organization WHS World Health Survey (World Health Organization) Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 8 Source: World Bank. CHAPTER 01 Why and How to Strengthen the Inclusion of Women and Girls with Disabilities Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 9 1 What is gender? Understanding Gender interacts with but is different from sex, which refers Multiple to biological and physiological Discrimination of Women with characteristics. Gender refers to socially constructed norms, behaviors, and roles of male, female, and nonbinary and their Disabilities relationships with each other. Gender is hierarchical and produces inequalities that intersect with other social and economic Who are Women and inequalities (WHO 2022). Girls with Disabilities? According to the United Nations Who are persons with Convention on the Rights of Persons disabilities? with Disabilities (CRPD), women Persons with disabilities include and girls with disabilities are not a those who have long-term homogenous group. physical, mental, intellectual, They include women, girls, and adolescents or sensory impairments that in with all types of impairments that may or may interaction with various barriers not come with functional limitations, multiple may hinder their full and effective disabilities, and varying levels of supports. They participation in society on an equal can be Indigenous women; refugee, migrant, basis with others (CRPD, Art. 1). asylum-seeker, and internally displaced women; women in detention and women living in poverty; What is intersectionality? and women of different ethnicity, religion, race, class, sexual orientation, and gender identity and “Intersectionality is a lens through expression (CRPD Committee 2016). which you can see where power comes and collides, where Under the social model of disability, disability it interlocks and intersects” is construed as the interaction between a (Crenshaw 2017). person’s impairment or impairments and environmental, social, and attitudinal barriers. This model challenges the medical model of disability, in which disability is regarded as an individual condition that requires treatment and medicalized solutions. Instead, the social Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 10 model emphasizes systemic barriers that effectively exclude persons with impairments from society. It recognizes that barriers can be physical, legal, or social and may include technological, communication, programmatic, policy, and transportation barriers. Barriers can also be discriminatory attitudes and social settings. The social model focuses on minimizing and removing these barriers to enable all persons with disabilities equal access to and participation in society. Disability and human functioning are assessed against a person’s individual capacities and level of participation, as affected by environmental barriers, whereas the medical model adopts a clinical approach instead. Ableism is a prevalent system of thought that supports these systemic barriers. Like many other isms, such as racism and sexism, ableism is based on beliefs that pathologize nondominant characteristics. Ableism views persons with disabilities as inferior. The CRPD was informed by the social model and a human rights-based approach that acknowledges that disability, like other dimensions of identity, is part of human diversity and as such must not be used as a basis for denial or restriction of fundamental rights (figure 1.1). This is perhaps best articulated in article 12 of the CRPD, which underscores that all persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life, and that the existence of a disability is not a rationale for removal of legal personhood. Figure 1.1. The Medical and Social Models of Disability Medical Model One or several impairments A person Disability (for example, loss of vision) Social Model One or several Environmental impairments and other barriers Disability (for example, (for example, lack of loss of vision) translations in braille) Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 11 Source: Shutterstock. New data collected by the World Bank’s Women, Business and the Law project show that about half of the world’s economies that have a disability rights law (74 out of 157) use the social model of disability, as articulated by the CRPD1 . Of the 52 economies where the disability law specifically protects and promotes the rights of women with disabilities, 39 use the social model (figure 1.2). Figure 1.2. Use of the Social Model of Disability in Line with International Standards Across the Laws in 190 Economies Economies where the disability law specifically protects and promotes 13 39 the rights of women with disabilities (52) Economies with a law on persons with 83 74 disabilities (157) 0 20 40 60 80 100 120 140 160 180 200 Number of Economies Laws using the medical model Laws using the social model Source: Women, Business and the Law database. 1 Data are from the Women, Business and the Law dataset on the rights of women with disabilities, World Bank Group, Washington, DC (accessed December 16, 2022), https://wbl.worldbank.org/en/disability. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 12 The Relationship between Disability and Gender Prevalence rates of disability are higher among women than among men. A 2021 study on disability incidence rates in 23 countries showed that gender inequality is significantly associated with the probability of disability onset for women (Lee et al. 2021). This prevalence gap varies greatly across countries—a 2021 study conducted by the World Bank Group in Latin America and the Caribbean showed that the gap varied between 1.7 percent to 8.7 percent (Mora, Schwartz Orellana, and Freire 2021). Rates are also higher among women in lower-income countries: 22.1 percent of women in lower-income countries have a disability, compared with 14.4 percent in higher-income countries (WHO 2002–2004). This prevalence gap is largely due to gender-based discrimination. For example: ● Households with limited financial resources may choose to invest in boys’ earning potential and prioritize their education and health care needs, leaving girls’ needs poorly attended or not at all. For these girls, any potential difficulty in seeing or hearing, for example, can eventually lead to disability, if not properly treated or cared for. ● Difficult access to maternal health care in developing economies can lead to disability and death during and after pregnancy. ● Gender-based violence is a contributing factor to disabilities among women, and intimate partner violence has been linked to disability status (Montes and Swindle 2021). A History of Invisible Multiple and Intersectional Discrimination The intersection of disability and gender has mainly been ignored. Yet policies that focus on either gender or disability fail to account for the experience of women with disabilities. “International and national laws and policies on disability have historically neglected aspects related to women and girls with disabilities. In turn, laws and policies addressing women have traditionally ignored disability. This invisibility has perpetuated the situation of multiple and intersecting forms of discrimination against women and girls with disabilities” (CRPD Committee 2016, para. 3). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 13 As a result of intersectional and multiple Source: World Bank. discrimination, data show that employment rates of women with disabilities are lowest compared with men with disabilities and nondisabled men and women. 2 Additionally, women with disabilities face higher rates of gender-based violence and harassment, including at the hands of their caregivers, according to a World Bank brief which looks into the causes, types, and consequences of violence and the context-specific violence across age groups; provides recommendations for inclusive interventions and a situational analysis; and examines key areas to respond to this issue in international development (World Bank 2019a). The limited data available suggest that women with disabilities are up to 10 times more likely to experience violence For example, a policy on access to sexual and than nondisabled women (Chirwa et al. reproductive health services for women that 2020; Dunkle et al. 2018; Ozemela, Ortiz, and does not address women with disabilities Urban 2019). Studies on attitudes show that a fails to abolish environmental barriers, such higher percentage of women with functional as inadequate height of examination tables, difficulties—a measurement of disability under wheelchair-inaccessible bathrooms, and the standards elaborated by the Washington the lack of sign language interpreters and Group on Disability Statistics Short Set on assistants during medical checkups and Functioning—thinks that a husband is justified procedures (Salian 2022). The aggregation of in hitting his wife (Mitra and Yap 2022). policies focusing only on disability or only on gender neglects the ways in which disability Specific focus on the intersection of gender and gender interact and produce unique and disability is needed to effectively combat situations and experiences for women with these negative effects of the intersectional disabilities. Studies show how gender sets and multiple discrimination that women with the experiences of women with disabilities disabilities face. The interaction of gender apart from those of men with disabilities and and disability creates unique barriers for from nondisabled women. In Bangladesh, women with disabilities, barriers that cannot for example, multiple and complex barriers be completely understood by the aggregation deprive women with disabilities of access to of gender-focused and disability-focused education, employment, health, and family analyses. life (Quinn et al. 2016). Negative bias and misconceptions about the capability of women with disabilities exacerbate their exclusion. 2 Data are from the International Labour Organization ILOSTAT data catalogue, International Labour Organization, Geneva (accessed December 16, 2022), https://ilostat.ilo.org/data. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 14 Environmental and social factors lead ● Reliance on others for long-term care and to multiple discrimination against girls daily support services may increase the and women with disabilities. Some exposure of women with disabilities to examples include the following: sexual violence and other forms of violence. ● Scarcity of data on women with disabilities ● Negative bias against and misconception of and measures for their inclusion often the capacities and abilities of women with results in their exclusion from development disabilities exist worldwide. efforts, including from efforts focused on ● Perception of women with disabilities gender equality. as unable to make choices limits their ● Lack of support to access equal independent living and can lead to opportunities in education and employment institutionalization, forced sterilization, and exacerbates gender gaps in socioeconomic other invasive and overprotective measures outcomes that also exist between (box 1.1). nondisabled women and men. Source: Mari Koistinen, World Bank. BOX 1.1 A Focus on Agency to Empower Women with Disabilities The inclusion of women with disabilities in World Bank projects should go beyond considering them as beneficiaries. The focus should also be on empowering women with disabilities to express their voice and agency. Agency is the ability to make decisions about one’s own life and act on them to achieve desired outcomes (World Bank 2016b). The World Bank Group Gender Strategy notes progress in lifting restrictions on women’s agency, such as enacting laws against intimate partner violence and child marriage. But agency includes an external aspect (the absence of unsurpassable exogenous constraints) and an internal aspect (the motivation to make a choice and act upon one’s desires; Perova and Vakis 2013). Expanding individual agency is a powerful catalyst for improving welfare and cost-effectiveness. To enhance the agency of women with disabilities, interventions should aim to eliminate environmental barriers and equally ensure access to opportunities and empowerment. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 15 absence of care, and injuries that may cause disability (Lankinen et al. 1994). Disability may also increase the risk of poverty through exclusion from the workforce; inadequate education; lower wages; and the cost of care, technologies, and devices needed to reduce environmental barriers to access (Banks, Kuper, and Polack 2017; Turmusani 2019). One in five households living in extreme poverty in the Latin America and the Caribbean Region has a member with a disability. This suggests that the WBG must actively seek to target Source: World Bank. greater inclusion for persons with disabilities if it is to achieve ending extreme poverty (Mora, Orellana, and Freire 2021). How Does Inclusion of Focusing on the socioeconomic inclusion Women with Disabilities of disadvantaged groups is part of the Relate to the World Bank World Bank’s GRID approach, which recognizes that rising inequality and the Group’s Work? exclusion of social groups from services, markets, and opportunities impedes their The World Bank Group’s (WBG) twin participation in society and the economy goals will not be met without involving and may foment discord (World Bank Group persons with disabilities. 2021). Thus, promoting economic growth must be inclusive and consistent with The development process needs to include environmental and social sustainability. The all people in order to be sustainable and GRID approach also includes climate change ensure that societies can truly thrive. Working aspects, recognizing that poverty, inequality, toward social cohesion, resilient communities, and climate change are interrelated, and that and the inclusion of all persons regardless those who are poorest (often women and of their gender, race, religion, ethnicity, age, girls with disabilities) need specific attention sexual orientation, or disability, while ensuring to adaptation and resilience. Climate change process legitimacy, lies at the heart of the affects women disproportionately because of Social Sustainability and Inclusion (SSI) their higher dependence on natural resources global practice. Advancing the socioeconomic to fulfill disproportionate responsibilities of inclusion of women with disabilities is also securing food, water, and fuel (UN Women part of the Green, Resilient, and Inclusive 2022). Because climate change multiplies Development (GRID) approach. threats, women have more vulnerability Poverty and disability work in a cycle. in climate disasters and are less likely to Poverty may increase the risk of disability survive or access support. Without deliberate, through limited access to health care, inclusive policies, preexisting inequities may education, safe employment, nutrition, and cause women to benefit less from the growth sanitation. This limited access exposes those in green jobs as economies decarbonize living in poverty to illnesses, malnutrition, (World Bank 2022a). Women’s empowerment Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 16 and leadership are central to effective climate and Polack 2017; Houtenville and Kalargyrou action because greater gender diversity 2012; Muntz and Meier 2013). Estimates is associated with better environmental calculated based on 10 economies found performance of firms (Altunbas et al. 2021). losses of 3 percent to 7 percent of 2006 The GRID approach also recognizes that or 2007 national gross domestic product discrimination and disadvantages are higher (Buckup 2010), and in Spain, 4 percent of where identities such as gender, race, and 2020 gross domestic product (Cámara, sexual orientation intersect. Martínez, and Santero-Sánchez 2020). Thus, fostering the socioeconomic inclusion of Social sustainability and inclusion of persons with disabilities is a vital element of women with disabilities are central to poverty reduction, and sustainable growth achieving the World Bank’s twin goals of can be achieved only with their meaningful reduced poverty and shared prosperity. participation in the development process. Poverty reduction measures alone are insufficient to achieve sustainable growth when they are not accompanied by a focus on groups that are vulnerable to exclusion based Source: Shutterstock. on their identity, among other factors (Cuesta, López-Noval, and Niño-Zarazúa 2022). Fostering inclusive and resilient societies in which citizens have a voice and governments respond requires supporting people in overcoming obstacles that prevent their full and equal socioeconomic participation— regardless of their gender, race, religion, ethnicity, age, sexual orientation, or disability. As the world is becoming more divided and unequal, exclusion and vulnerability are compounded by persistent shocks, including the COVID-19 pandemic, conflict, and climate change, which is expected to push millions of people into poverty. These threats need to be “Social sustainability is when countered with socially sustainable responses. all people feel part of the Empirical analysis confirms that social development process and believe sustainability is positively associated with that they and their descendants will benefit from it. Socially per capita income and negatively associated sustainable communities and with poverty and income inequality (Cuesta, societies are willing and able Madrigal, and Pecorari 2022). Studies also to work together to overcome show that societies that exclude persons challenges, deliver public goods, with disabilities lose substantial individual and allocate scarce resources and household earnings and suffer from in ways that are perceived as increased government spending on social legitimate and fair by all so that protection programs, lost tax revenues, and all people may thrive over time” lost productivity for businesses (Banks, Kuper, (Barron et al. 2023 forthcoming). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 17 not explicitly mention women and girls with International disabilities. However, in 1991, the Committee Treaties and Goals on the Elimination of Discrimination against Women adopted General Recommendation The United Nations Convention No. 18, which asks state parties to report on on the Rights of Persons with measures taken for the greater inclusion of Disabilities (CRPD), which entered women and girls with disabilities. into force in 2008 and has been The Convention on the Rights of the Child ratified by 185 countries, recognizes (CRC), which entered into force in 1990 and in Article 6 the experience of multiple has been ratified by 190 countries, calls for discrimination among women and girls respecting the rights of all children, regardless with disabilities and requires states to of their gender and disability (Article 2, among take the appropriate measures to ensure others). Article 23 explicitly addresses state women’s and girls’ full enjoyment of obligations to ensure “the fullest possible social integration and individual development” human rights and freedoms. of children with disabilities and their families. The CRPD also mentions gender in its Some regional treaties also address the rights preamble and in articles referring to general of women and girls with disabilities. The principles; awareness raising; freedom from African Charter on Human and Peoples’ exploitation, violence, and abuse; health; Rights, in its Protocol on the Rights of and adequate standard of living and social Persons with Disabilities in Africa, has a protection. In 2016, the CRPD Committee specific article on women and girls with adopted General Comment No. 3 on women disabilities (Article 27). and girls with disabilities. Five of the Sustainable Development The Convention on the Elimination of All Goals—on education, employment, reducing Forms of Discrimination against Women inequality, inclusive cities, and data as a (CEDAW), which entered into force in 1981 means of implementation—explicitly mention and has been ratified by 189 countries, does persons with disabilities. Source: Disability Rights Fund / Disability Rights Advocacy Fund (DRF/DRAF). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 18 2 What are the World Bank Group Commitments to Women with Disabilities? The lack of attention to the intersection of gender and disability in the international policy dialogue has resulted in the exclusion of women with disabilities from development efforts. Statistics show that women with disabilities are at least one in every five women, the majority of whom live in the Global South. Thus, including this population in development is critical to reaching goals that are important to the WBG. In recent years, the WBG has recognized both the imperative of a gender inclusive and a disability-inclusive approach and has made commitments setting out goals at every level of the institution. WBG frameworks ensure that operations avoid discrimination and enhance development opportunities for “disadvantaged and vulnerable groups.” The World Bank Environmental and Social Framework (ESF), which became operational in October 2018, sets out standards to protect people and the environment in WBG investment project financing. It lays the groundwork for required social assessments to ensure that projects emphasize inclusion through promotion of equality and nondiscrimination and pay attention to barriers, risks, and impacts that could disproportionately affect “disadvantaged and vulnerable” groups or exclude them from development benefits (World Bank 2017). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 19 Good Practice Notes on Nondiscrimination and Disability (2018) and on Gender (2019) explain how to use ESF standards in relation to these disadvantaged and vulnerable groups. Among other things, engagement of stakeholders – including women with disabilities – in all project efforts is recognized as crucial. ESF Guidance Note for Borrowers 10 on Stakeholder Engagement and Information Disclosure outlines these principles, such as accessibility of documentation. The Disability Inclusion and Accountability Framework (updated in 2022, following the framework of 2018) elaborates a set of guiding principles to support implementation of the ESF and other efforts toward disability inclusion. Gender is included as a cross-cutting theme. The World Bank Group Gender Strategy for 2016–23 (currently undergoing review to be updated for fiscal year 2024), guides commitments on gender equality and aligns them with the 2030 Agenda for Sustainable Development. Intersectionality in WBG Frameworks Several of these WBG frameworks outline intersections of identity that make it more likely for women with disabilities to face discrimination or greater barriers in accessing benefits from client projects supported by the WBG. ✚ The Bank Directive on Addressing ✚ The ESF Good Practice Note on Risks and Impacts on Disadvantaged or Nondiscrimination and Disability Vulnerable Individuals or Groups defines underscores that “the relationship of “disadvantaged or vulnerable” as “those disability with other and multiple factors individuals or groups who, by virtue of, for that can increase vulnerability, such example, their age, gender, race, ethnicity, as poverty, gender, age, and disability religion, physical, mental or other disability, (intersectionality), should also be addressed social, civic or health status, sexual to the extent possible.” orientation, gender identity, economic ✚ The Good Practice Note on Gender notes, disadvantages or indigenous status, and/or “Males and females are not homogeneous dependence on unique natural resources, groups, but are stratified by race, ethnicity, may be more likely to be adversely affected and disability, which together with income by the project impacts and/or more limited level, geographic location, and migratory than others in their ability to take advantage status, can lead to multiple overlapping of a project’s benefits.” layers of vulnerability and discrimination.” Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 20 WBG 10 Commitments on Disability Inclusion The first Global Disability Summit, held in London in 2018, was a game-changing event that brought together world leaders, government officials, civil society, the private sector, the donor community, and Organizations of Persons with Disabilities (OPDs) to share experiences and aspirations for development and humanitarian work to be more disability inclusive. People with disabilities were at the center of the design and delivery of the Summit. On this occasion, the WBG, alongside other participating donor organizations, made 10 commitments on disability inclusion to better address risks and increase benefits for persons with disabilities. The ten commitments intend to accelerate global action for disability-inclusive development in critical areas, like education, digital development, data collection, gender, post-disaster reconstruction, transport, private sector investments, and social protection. Under Commitment No. 4, the WBG pledged to explore opportunities for the economic empowerment of women and girls with disabilities. The 10 commitments have also influenced the 19th Replenishment of the International Development Association (IDA19) and the 20th Replenishment of the International Development Association (IDA20) with policy commitments on gender and disability. Commitment No. 4 Women and Girls with Disabilities “The Women Entrepreneurs Finance Initiative (We-Fi), housed at the World Bank, creates a unique opportunity to comprehensively tackle the full range of barriers facing women entrepreneurs across developing countries. Future rounds of We-Fi funding provide opportunities to focus more deliberately on the economic empowerment of women and girls with disabilities by addressing the policy and regulatory frameworks; designing projects, for example, in the transport and information and communication technology sectors, with a gender disability lens; and developing and rolling out new products, for example, disability insurance. The next round of the Women, Business and Law survey, feeding into a data set on the laws and regulations that restrict women’s economic opportunities, will include questions on legislation and protections for women with disabilities” (World Bank Group 2018). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 21 IDA19 Introduces Disability as a Cross-Cutting Issue Concrete actions for women and persons with disabilities are expressed in the IDA19 Replenishment policy commitments and results measurement system, with guidance by sector to advance implementation (figure 1.3). Figure 1.3. Commitments to Gender and Disability Inclusion in IDA19 Policy Commitment 7: “Fifty percent of entrepreneurship and micro, small, and medium enterprise projects will incorporate digital financial services and/or digital JOBS AND ECONOMIC entrepreneurship elements and... address particular constraints facing women and TRANSFORMATION people with disabilities” (IDA 2020, vii, para. ii.7). Policy Commitment 8: “IDA [will] support at least 15 IDA countries, including at least 12...with lowest Human Capital Index, with programs or policies to improve skills and employability…considering the differential constraints facing young women and men, and people with disabilities” (IDA 2020, vii, para. ii.8). Policy Commitment 12: “IDA [will] conduct 20 pilots in ‘economic transformation IDA projects’ to estimate indirect and/or induced jobs. ...Where feasible, jobs reporting will be disaggregated by the poorest quintile, gender, FCS [fragile and conflict-affected situation], disability, and youth” (IDA 2020, vii, para. ii.12). Policy Commitment 3: “At least 20 IDA FCS country portfolios [will] support improvements in social sector service delivery...with a focus on addressing the FRAGILITY, CONFLICT differential constraints faced by men and women, boys and girls, and by people with AND VIOLENCE disabilities” (IDA 2020, ix, para. v.1). Policy Commitment 6: “IDA [will] support at least 12 IDA countries to adopt universally accessible GovTech solutions” (IDA 2020, x, para. vi.6). GOVERNANCE AND INSTITUTIONS Policy Commitment 10: “IDA [will] support at least 50 percent of IDA countries to establish and strengthen platforms for engaging with multiple stakeholders, including women as well as vulnerable groups, in policy making and implementation to enhance public participation, accountability, and responsiveness” (IDA 2020, xi, para. vi.10). Policy Commitment 12: “IDA [will] support 30 IDA countries, including those with ongoing statistical operations, to support institutions and build capacity to reduce gaps in the availability of core data for evidence-based policy making, including disaggregation by sex and disability ” (IDA 2020, xi, para. vi.12). “... progress and results... will be reported by a new indicator in Tier 3 of the RMS that will track the share of IDA [investment project financing] IPF operations that have IDA ORGANIZATIONAL applied the concept of universal access at design [percent of approved IDA IPF in fiscal AND OPERATIONAL year]” (IDA 2020, 26, para. 59). EFFECTIVENESS Source: IDA 2020. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 22 IDA20 Focuses on Inclusion Based on IDA19 progress and COVID-19 realities, the IDA20 Replenishment maintains key themes of climate change; fragility, conflict, and violence; gender; and jobs and economic transformation and introduces a human capital theme covering vaccines, health and nutrition, education, and safety nets, with a focus on disability inclusion. “Participants supported IDA20’s focus on inclusion, and its efforts to tailor support to the most vulnerable, including persons with disabilities and those discriminated based on their sexual orientation and gender identity. Within the overall goals of universal access to core human capital services, this focus on inclusion means that IDA20 will pay heightened attention to the barriers that prevent the poor, persons with disabilities, refugees, internally displaced populations, and other marginalized individuals, including those discriminated based on their sexual orientation and gender identity, from achieving their full potential” (IDA 2022). Concrete actions for persons with disabilities in IDA20 commitments are spelled out under the Human Capital and Jobs and Economic Transformation themes as well as in a specific Results Measurement System (RMS) indicator (figure 1.4). Figure 1.4. Commitments to Gender and Disability Inclusion in IDA20 Policy Commitment 6: “Expanding access to core services for persons with disabilities: To promote inclusive societies, support at least 18 IDA countries to HUMAN CAPITAL meet the needs of persons with disabilities by implementing the principles of non- discrimination, inclusion, and universal access as per the Environmental and Social Framework, through projects in education, health, social protection, water, urban, digital development and/or transport” (IDA 2022, 48, para. 93). Policy Commitment 8: “Boosting institutional capacity to improve data for policy decision-making: Support 34 IDA countries including those with ongoing statistical JOBS AND ECONOMIC operations (i) to strengthen institutions and build capacity to reduce gaps in the TRANSFORMATION availability of core data for evidence-based policy making, including disaggregation SPECIAL THEME by sex and disability where appropriate; and (ii) to increase resilience of statistical systems, including through investments in digital technology and high-frequency monitoring capabilities” (IDA 2022, 71, para. 134). “On disability inclusion, IDA20 will track the share of operations using the concept of universal access and the number of countries collecting disability data with IDA RESULTS support. IDA remains committed to use the question sets from the Washington Group MEASUREMENT SYSTEM on Disability Statistics [Countries collecting disability data with IDA support (number)]” INDICATOR (IDA 2022, 97, para. 12). Source: IDA 2022. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 23 Chapter 1: References Altunbas, Yener, Leonardo Gambacorta, Alessio Chirwa, Esnat, Rachel Jewkes, Ingrid Van Der Reghezza, and Giulio Velliscig. 2021. “Does Gender Heijden, and Kristin Dunkle. 2020. “Intimate Diversity in the Workplace Mitigate Climate Partner Violence among Women with and without Change?” BIS Working Papers 977, Bank for Disabilities: A Pooled Analysis of Baseline Data International Settlements, Basel, Switzerland. from Seven Violence-Prevention Programmes.” BMJ Global Health 5 (11): e002156. Banks Lena Morgon, Hannah Kuper, and Sarah Polack. 2017. “Poverty and Disability in Low- and Committee on the Rights of Persons with Middle-Income Countries: A Systematic Review.” Disabilities (CRPD Committee). 2016. Convention PLOS ONE 13 (9): e0204881. on the Rights of Persons with Disabilities: General Comment No. 3 (2016) on Women and Girls with Disabilities. New York: United Nations. Barron, Patrick, Louise Cord, José Cuesta, Sabina A. Espinoza, Greg Larson, Michael Woolcock. 2023 (forthcoming). Social Sustainability in Development: Committee on the Rights of Persons with Meeting the Challenges of the 21st Century. Disabilities (CRPD Committee). 2018. General Washington DC: World Bank. Comment No. 7 (2018) on the Participation of Persons with Disabilities, Including Children with Disabilities, through Their Representative Braunmiller, Julia C., and Marie Dry. 2022a. “The Organizations, in the Implementation and Importance of Designing Gender and Disability- Monitoring of the Convention. New York: United Inclusive Laws: A Survey of Legislation in 190 Nations. Economies.” Global Indicators Briefs 11, World Bank, Washington, DC. Cuesta, Jose, Lucia Madrigal, and Natalia Pecorari. 2022. “Social Sustainability, Poverty, and Income: Braunmiller, Julia C., and Marie Dry. 2022b. An Empirical Exploration.” Policy Research Working “Safeguarding the Rights of Women with Paper 10085, World Bank, Washington DC. Disabilities to Family Life, Work, and Protection from Gender-Based Violence.” Global Indicators Briefs 14, World Bank, Washington, DC. Cuesta, Jose, Borja López-Noval, and Miguel Niño-Zarazúa. 2022. “Social Exclusion: Concepts, Measurement, and a Global Estimate.” Policy Buckup, Sebastian. 2010. “The Price of Excluding Research Working Paper 10097, World Bank, People with Disabilities from the Workplace.” Washington DC. International Labor Organization, December 1, 2010. Dunkle, Kirstin, Ingrid van der Heijden, Erin Stern, Cámara, Angeles, Isabel Martínez, and Rosa and Esnat Chirwa. 2018. “Disability and Violence Santero-Sánchez. 2020. “Macroeconomic Cost against Women and Girls: Emerging Evidence of Excluding Persons with Disabilities from the from the What Works to Prevent Violence against Workforce in Spain.” IZA Journal of Labor Policy 10 Women and Girls Global Programme.” What Works (15). to Prevent Violence, United Kingdom Department for International Development, London. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 24 García Mora, María Elena, Steven Schwartz Montes, Jose, and Rachel Swindle. 2021. “Who Orellana, and Germán Freire. 2021. Disability is Disabled in Sub-Saharan Africa?” Poverty and Inclusion in Latin America and the Caribbean: A Equity Notes 40 (April), World Bank, Washington, Path to Sustainable Development. Washington, DC: DC. World Bank. Muntz, Harlan R., and Jeremy D. Meier. 2013. “The Houtenville, Andrew, and Valentini Kalargyrou. Financial Impact of Unrepaired Cleft Lip and Palate 2012. “People with Disabilities: Employers’ in the Philippines.” International Journal of Pediatric Perspectives on Recruitment Practices, Strategies, Otorhinolaryngology 77 (12): 1925–28. and Challenges in Leisure and Hospitality.” Cornell Hospitality Quarterly 53 (1): 40–52 Ozemela, Luana Marques Garcia, Diana Ortiz, and Anne-Marie Urban. 2019. “Violence against International Development Association (IDA). Women and Girls with Disabilities: Latin America 2020. Additions to IDA Resources: Nineteeth and the Caribbean.” Policy Brief IDB-PB-302, Inter- Replenishment; IDA19: Ten Years to 2030: Growth, American Development Bank, Washington, DC. People, Resilience. Washington, DC: IDA. Perova, Elizaveta, and Renos Vakis. 2013. Improving International Development Association (IDA). 2021. Gender and Development Outcomes through Cross-Cutting Issues in IDA20. Washington, DC: IDA. Agency: Policy Lessons from Three Peruvian Experiences. Washington, DC: World Bank. International Development Association (IDA). 2022. Additions to IDA Resources: Twentieth Quinn, Marlee Elizabeth, Cynthia L. Hunter, Replenishment; Building Back Better from the Sumanta Ray, Mohammad Morshedul Quadir Crisis: Toward a Green, Resilient, and Inclusive Rimon, Krishno Sen, and Robert Cumming. 2016. Future. Washington, DC: IDA. “The Double Burden: Barriers and Facilitators to Socioeconomic Inclusion for Women with Disability in Bangladesh.” Disability, CBR, and Lankinen, Kari S., Staffan Bergstrom, P. Helena Inclusive Development 27 (2): 128–49. Makela, and Miikka Peltomaa, eds. 1994. Health and Disease in Developing Countries. London and Basingstoke: The Macmillan Press. Salian, Priti. 2022. “I Am Disabled, It Doesn’t Mean I Have No Dignity.” The Lancet 399 (10322): 349–50. Lee, Jinkook, Erik Meijer, Drystan Phillips, and Peifeng Hu. 2021. “Disability Incidence Rates for Men and Women in 23 Countries: Evidence on Turmusani, Majid. 2019. Disabled People and Health Effects of Gender Inequality.” Journals of Economic Needs in the Developing World: A Gerontology Series A: Biological Sciences and Political Perspective from Jordan. Milton Park, Medical Sciences 76 (2): 328–38. Abingdon, Oxon: Routledge. Mitra, Sophie, and Jaclyn Yap. 2022. The Disability UN Women. 2022. “Explainer: How Data Report 2022. New York: Disability Data Initiative, Gender Inequality and Climate Change are Fordham Research Consortium on Disability. Interconnected.” UN Women, February 28, 2022. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 25 World Bank. 2016a. “Addressing Risks and Impacts World Bank. 2022a. “Delivering for People and on Disadvantaged or Vulnerable Individuals or the Planet: Human Capital, Gender and Climate Groups.” Bank Directive EXC5.07-DIR.117, World Change.” Climate and Development Brief, World Bank, Washington, DC. Bank, Washington, DC. World Bank. 2016b. World Bank Group: Gender World Bank. 2022b. Disability Inclusion and Equality, Poverty Reduction, and Inclusive Growth: Accountability Framework. Washington, DC: World Strategy 2016–2023. Washington, DC: World Bank. Bank. World Bank. 2017. The World Bank Environmental World Bank Group. 2021. Green, Resilient, and and Social Framework. Washington, DC: World Inclusive Development . Washington, DC: World Bank. Bank. World Bank. 2018a. “Environment and Social World Bank Group. 2022. “IDA20 - Building Back Framework for IPF Operations: Nondiscrimination Better from the Crisis: Toward a Green, Resilient and Disability.” Good Practice Note, World Bank, and Inclusive Future.” Washington, D.C.: World Washington, DC. Bank Group. World Bank. 2018b. “ESS10: Stakeholder World Health Organization (WHO). 2022. “Gender Engagement and Information Disclosure.” and Health: Overview” (accessed December 19, Guidance Note for Borrowers, World Bank, 2022). Washington, DC. World Health Organization (WHO) and World Bank World Bank Group. 2018. “Commitments on Group (WBG). 2011. World Report on Disability. Disability-Inclusive Development.” Brief, July 24, Geneva: World Health Organization. 2018, World Bank Group, Washington, DC. World Bank. 2019a. “Brief on Violence against Women and Girls with Disabilities.” Washington, DC: World Bank. World Bank. 2019b. “Environment and Social Framework for IPF Operations: Gender.” Good Practice Note, World Bank, Washington, DC. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 26 CHAPTER 02 Taking the Next Steps to Achieve Socioeconomic Inclusion of Women and Girls with Disabilities A Checklist for Task Team Leaders Source: DRF/DRAF and RULIP (Rwandan Union of Little People) Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 27 Every stage in the lifecycle of a World Bank Group (WBG) project presents an opportunity to consider inclusion of women and girls with disabilities (figure 2.1). This checklist is informed by the Technical Note on Accessibility, Part 2: Project Cycle Guidance. It can be used (together with the sector-specific sections that follow in chapter 3) as a support for task teams to promote project alignment with the World Bank’s operational policies and guidelines. The aim is to help ensure that both the World Bank and the borrower are intentionally considering and addressing barriers to inclusion. Similarly, project teams can consult the four criteria listed in the World Bank’s Disability-Inclusive Investment Project Financing in Education Guidance Note (stakeholder engagement, analysis, inclusive project design, and monitoring and reporting) as they can guide teams beyond the Education global practice on making projects disability-inclusive and preparing the relevant information for Investment Project Financing (IPF) documentation. Figure 2.1. The Inclusion of Women with Disabilities Throughout the World Bank Project Cycle I Preliminary Phases SCD (Svstematic Country Diagnostic) CPF (Country Partnership Framework) V II Evaluation Identification ICR (Implementation Completion Women with PCN disabilities (Project Concept Note) and Results Report) IV III Implementation Preparation ISR PAD (Implementation Status (Project Appraisal and Results Report) Document) Source: World Bank 2022. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 28 Stakeholder engagement (also emphasized in the Environmental and Social Framework (ESF) and ESS10 Guidance Note on Stakeholder Engagement and Information Disclosure) is the most important step. This checklist starts each project stage with the question, “Who is at the table?” Inclusive project design that takes accessibility and reasonable accommodation into account is a baseline requirement, so that persons with disabilities can participate. Data analysis is equally critical in guiding project design and evaluation and safeguarding against risk.  his checklist ensures that task teams analyze relevant data and other information, T including lived experience of women with disabilities. Monitoring and reporting are necessary to ensure accountability to women with disabilities and transparency about lessons learned, so that teams can scale up and repeat successes. 1 Preliminary Phases (Systematic Country Diagnostic and Country Partnership Framework) a. Who is at the table? ● WBG staff with gender or social inclusion skills or both; for example, a social development or gender/GBV specialist from the Social Sustainability and Inclusion (SSI) Global Practice (box 2.1) ● Government officials tasked with implementing international treaty obligations to women and persons with disabilities, such as reporting under the Convention on the Elimination of All Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 29 Forms of Discrimination Against Women (CEDAW), Convention on the Rights of Persons with Disabilities (CRPD), Convention on the Rights of the Child (CRC); for example, representatives from the National Council on Disability, the Ministry of Gender, or the Ministry of Social Affairs; Equal Opportunities Commission; or National Human Rights Institution ● Representatives from organizations of persons with disabilities, especially organizations of women with disabilities b. What data are being reviewed? ● Gender and disability disaggregated data from national household surveys and international programs, such as the Demographic and Health Survey (DHS), Multiple Indicator Cluster Surveys (MICS), or censuses or ministry-specific surveys; WBG Living Standards Measurement Survey (LSMS), data available in the Disability Data Initiative ● If available, any information derived from WBG country disability assessment, country gender assessment, SSI Disability-Inclusive Country Briefs (box 2.2), and Women, Business and the Law data set on the rights of women with disabilities By including perspectives and data on women and girls with disabilities, a significant population of people who are often left behind in development efforts can be considered key actors and beneficiaries in the next phase of project design. Box 2.1 Using World Bank Analytics to Bring Women with Disabilities to the Forefront Too often, and without specific analysis, the situation of women and girls with disabilities is invisible because of stigma and a culture of shame. World Bank staff with long experience in disability inclusion report that superstition and lack of understanding of causal factors about disability and fears about violence and exploitation make parents keep children with disabilities behind closed doors, especially girls with disabilities. This is particularly acute in the case of women and girls with intellectual and psychosocial disabilities. Poverty analyses may miss these populations if they review only material position rather than vulnerabilities. When a disability lens is applied, it can help open conversations about what disability is and how systemic barriers interact with negative bias to marginalize women and girls with disabilities. World Bank task teams have used data, for example, on the disproportionally low numbers of women and girls with disabilities in communities and from gender-based violence assessments to advance the inclusion of women with disabilities. In Tanzania, for example, task team leaders recently initiated a disability assessment based on knowledge gained from previous gender and gender-based violence assessments that uncovered Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 30 the high incidence of violence against women and girls with disabilities and highlighted the importance of intersectional issues. Analyses showed that women and girls with a disability have a significantly higher risk of being sexually assaulted or harassed (including in public places such as hospitals and schools), which prevents them from integrating into society, leading fulfilling lives, and having access to basic services. This was echoed in focus group discussions with people with disabilities and advocacy groups in different parts of the country. With support from the Country Management Unit, the gender platform was expanded into a joint disability and gender platform. The team then partnered with Tanzanian organizations of persons with disabilities to draft a disability assessment. Learnings from this assessment will support World Bank Group projects to better address the intersections between gender and disability. A portfolio review of more than 20 active projects found that the majority of them missed opportunities to address the inclusion of people with disabilities. Good practices are identified when the project (i) makes a concerted effort to identify people with disabilities as a distinct target group, (ii) addresses the inclusion of people with disabilities and their unique needs through concrete actions outlined in project documents; and (iii) strongly endorses a disability inclusion lens through project components. The review also highlights gaps and opportunities for a more disability-inclusive lens during project implementation and lessons that can be applied in future operations. These include the importance of the Environmental and Social Framework as an entry point to address people with disabilities and engage with them, and a holistic understanding of accessibility (focusing on those with learning disabilities and with physical disabilities, with limited or lack of sight or hearing). The World Bank in Tanzania has also engaged with various civil society groups run by and working with people with disabilities. Project teams are encouraged to connect with the Tanzania Gender and Disability-Inclusion Platform and the Tanzania Citizen Engagement Platform to facilitate stronger engagement with organizations of people with disabilities. Box 2.2 SSI Country Profiles on Disability Inclusion The Social Sustainability and Inclusion (SSI) Global Practice’s Country Profiles on Disability Inclusion provide important information on the rights of persons with disabilities and on the development gaps at the country level. The briefs include information on national data, key international and national human rights norms, policies, ministries in charge of disability issues, basic actors in the field, and ongoing projects supported by the World Bank. The information is collected from organizations of persons with disabilities, governments, other international organizations, and the Convention on the Rights of Persons with Disabilities’ concluding observations and General Comments. Briefs can be used in the preparation of Systematic Country Diagnostics and Country Partnership Frameworks and generally support project development and the implementation of the World Bank Group commitments on disability inclusion. The briefs can be downloaded from the WBG Disability-Inclusive Development internal website. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 31 2 Identification Phase (Project Concept Note) Are data relevant to girls and women with disabilities a.  part of project scoping and analysis? ● National laws and/or policies implementing the CRPD, such as national disability laws and their regulations and policies (for example, national action plans), especially clauses aimed at implementing Article 6 of the CRPD on women with disabilities and Article of the 7 CRPD on children with disabilities; national laws and/or policies implementing CEDAW, such as gender policies or gender-based violence (GBV) laws ● If available, information from WBG Country Gender Assessments to learn how countries are doing in terms of gender equality; note that gaps are likely to be even more pronounced for women with disabilities (see World Bank Gender Data Portal, Women, Business and the Law data, and specifically the data set on the rights of women with disabilities) ● Education acts and regulations and inclusive education policies ● Employment and labor laws that may refer to persons with disabilities and women, or information on the rights of persons with disabilities regarding nondiscrimination, education, and employment (see data available at the UCLA World Policy Analysis Center) ● National building control acts and regulations that may refer to accessibility standards; see WBG Technical Note on Accessibility to consider accessibility gaps at every stage of the project cycle ● Health acts and regulations, especially regarding access to sexual and reproductive health rights, maternal care and services, and violence prevention ● Social protection policies and their target groups; for an overview of country social protection systems and budgets, with data disaggregated by gender and disability, see the International Labour Organization World Social Protection Data Dashboards ● National (or local) budgets for inclusion of girls and women with disabilities, such as: • Financial implications analysis from the Ministry of Finance about enactment of a national disability law • Inclusive education budget disaggregated by gender • Health budget, which may specifically address girls and women with disabilities in areas such as rehabilitation, inclusive sexual and reproductive health and maternity services, inclusive GBV services, and mental health services Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 32 • Employment budget, which may specifically address women with disabilities in areas such as occupational services, skills training, reasonable accommodation, or employment quota and other incentives • Social protection budget disaggregated by disability and gender Are relevant World Bank commitments b.  and other standards being considered? ● Is the project considering the potential risks and benefits for women with disabilities under the ESF review (box 2.3)? • Use the ESF Good Practice Notes on Nondiscrimination and Disability and on Gender, the ESS10 Guidance Note on Stakeholder Engagement and Information Disclosure, and the Disability Inclusion and Accountability Framework as guidelines • Raise questions on disability inclusion when working with country gender programs and task teams and during the gender tagging process (box 2.4) • Contact the Global Disability Inclusion Team, headed by the World Bank’s Global Disability Advisor, for expertise and referrals ● Does the Project Concept Note discuss the risks and benefits for women with disabilities across different project phases (assessment, implementation, and evaluation), including in targets, results, and indicators (see indicator suggestions in chapter 3 of this toolkit)? ● Does the Project Concept Note outline the details of stakeholder engagement by describing how women with disabilities will be included in as many roles as relevant (implementers, vendors, beneficiaries, evaluators, and more)? Box 2.3 The Environmental and Social Framework (ESF) as Entry Point for Disability Inclusion in WBG Operations The ESF applies to all investment project financing (IPF) operations initiated on or after October 1, 2018. It strengthens the World Bank’s commitment to identify vulnerable or disadvantaged individuals and groups, including persons with disabilities, and assessing and preventing potential risks and negative impacts that could affect them disproportionately and present barriers to accessing project benefits. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 33 All the ESF standards apply to persons with disabilities and contain the principle of nondiscrimination, but there are three fundamental entry points: ● Environmental and Social Standard (ESS) 2: Labor and Working Conditions. Under ESS 2, the borrower is obliged to provide appropriate measures of protection and assistance to address vulnerabilities of project workers, including women and people with disabilities. This includes providing reasonable accommodation in the workplace. ● ESS 4: Community Health and Safety. Under ESS 4, the borrower must apply the concept of universal access to the design and construction of new buildings and structures and the provision of services to communities. ● ESS 10: Stakeholder Engagement and Information Disclosure. ESS 10 requires inclusion of persons with disabilities in stakeholder engagement and that project information be disclosed in an accessible format. The ESS10 Guidance Note on Stakeholder Engagement and Information Disclosure sets out some entry points for inclusive engagement. Task team leaders can implement this requirement in the following ways: • Consider whether women and girls with disabilities are project-affected and analyze any vulnerabilities or disadvantages they may face as a result of the project, or to equitably access project benefits. • Consult with women and girls with disabilities in a disability-inclusive and culturally appropriate manner (separately, if necessary). • Ensure that any barriers to communication and participation or engagement are mitigated, such as accessibility or safety of venue or meeting time or information. • Work with independent third parties, such as the larger disability community and OPDs (especially OPDs focusing on women and girls with disabilities), to reach women and girls with disabilities. • Develop and implement a stakeholder engagement plan that clarifies how women and girls with disabilities will be included throughout the project cycle. “An inclusive engagement process should empower all relevant stakeholders to participate. This participation includes systematic engagement with, for example, women, children, youth, the elderly, people with disabilities, and other vulnerable or disadvantaged groups. […] Documentation should also be accessible for stakeholders with sensory disabilities, for instance, through providing documents in Braille or engaging a sign language interpreter at a consultation meeting, as appropriate.” (ESS10 Guidance Note on Stakeholder Engagement and Information Disclosure) Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 34 Box 2.4 persons with disabilities, and refugees. Economic growth in Djibouti has not Leveraging the World Bank Gender succeeded in reducing inequalities in labor Tag to Achieve Greater Inclusion of force participation, especially for women. Women with Disabilities The project establishes targets for women, particularly those who are refugees or have a The gender tag, introduced through the disability, as part of the technical vocational WBG Gender Strategy 2016–23, is an internal training programs. Activities include learning tool that helps task teams identify strategic modules and tools for online entrepreneurship opportunities to narrow gender gaps within to increase employability and employment the scope of their projects. It applies only outcomes in both the informal and formal to International Bank for Reconstruction sectors. The project’s key results indicators and Development (IBRD) and International track the share of persons enrolled in the Development Association (IDA) lending technical and vocational trainings and operations. The tag identifies operations their employment after completion, all that (i) address one or more of the gender disaggregated by gender, disability, and strategy’s four pillars; and (ii) have a Project refugee status. Appraisal Document that articulates a logical chain from analysis, to actions, to indicators The Tuvalu Second Resilience Development in the results framework. The gender tag Policy Operation with a Catastrophe-Deferred encourages projects to consider specific Drawdown Option aims to increase access actions to improve development outcomes for to inclusive quality education for Tuvaluan women and men in ways that are sustainable children living with disabilities. The project beyond the project. Addressing gender gaps identified the prevalence of GBV and violence can also relate to a gap among men or boys, against children as significantly higher than for example, by considering the needs of the global average. Evidence from Tuvalu and at-risk boys in areas with high dropout rates the Pacific indicates that girls and women from school or promoting positive gender with disabilities are particularly at risk of norms in areas with high incidence of gang harassment and violence. At the same time, violence fueled by rigid notions of masculinity. the majority of the country’s survivors of GBV The gender tag also recognizes that women and violence against children do not seek help, are not a homogeneous group and notes the and children with disabilities have extremely importance of considering intersectionality limited opportunities to do so. The education of gender norms with other factors such as system is often the first point of contact for climate change, conflict, disability, ethnic and child survivors of violence, but no systemic religious identity, and so on. training on GBV and violence against children exists. The project supports the approval Task team leaders can leverage the gender of the Disability-Inclusive Education Policy tag to promote the inclusion of women with and Action Plan, which will train teachers on disabilities. The following project examples GBV, violence against children, and referral explain how gender-tagged operations mechanisms, among others. The project address the nexus between gender and results framework includes the percentage disability in Djibouti and Tuvalu. of teachers who attend the training and demonstrate improved understanding of The objective of the Djibouti Skills inclusive education, GBV, violence against Development for Employment Project is children, and referral mechanisms. It also to improve employability and employment requires the Ministry of Education to collect outcomes of technical and vocational training regular data on students with disabilities, programs graduates, focusing on women, disaggregated by sex. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 35 3 Preparation Phase (Project Appraisal Document) a. Who is at the table? ● Do mainstream stakeholder engagement consultations include OPD representatives (box 2.5)? ● Is the national council or commission on disability or any national umbrella OPD included? See for example: • UN Partnership on the Rights of Persons with Disabilities for OPDs working with UN country teams • International Disability Alliance member organizations for national OPDs ● Is there room for specific consultation with organizations of women with disabilities? See for example: • Disability Rights Fund’s grants directory by country and CRPD Article 6 • Women Enabled International’s Global Map of Advocates Does the project consider relevant b.  World Bank commitments and other standards? ● Do evaluation metrics include indicators that will show the project’s impact on women with disabilities? (See the sector-specific sections in chapter 3 of this toolkit for suggested indicators.) ● Do private companies involved have leadership commitments to disability inclusion and gender equality? See, for example, the Valuable 500 and ILO Global Business and Disability Network ● Does the project apply WBG procurement standards for diversity, including in hiring, regarding project management with any vendors? Is the conversation accessible to persons with disabilities? Are reasonable accommodations provided to enable meaningful participation? The Australian Human Rights Commission provides a Guide for Hosting accessible and inclusive in-person meetings and events. WBG procurement policies aim to increase diversity and provide opportunities for businesses owned by women and persons with disabilities (World Bank Group 2022a). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 36 Box 2.5 of women with disabilities, the proposal to include a specific article triggered heated The Importance of debates among delegations on whether Meaningful Participation of to adopt a mainstreaming or twin-track Women with Disabilities approach. The mainstreaming approach called for addressing the needs of men and women simultaneously, and the twin-track The global disability movement’s motto, approach called for including a specific article “Nothing about us without us,” amplifies the on the rights of women with disabilities and importance of full and effective participation, specific mention of women in additional and the participation of persons with articles. Proponents of the mainstreaming disabilities in decision-making is at the heart approach emphasized the likelihood of of the CRPD. Meaningful participation must missing other vulnerable groups; proponents also be viewed with a gender lens. Like of the twin-track approach argued that only many other spaces in society, the disability a specific article would enable countries to movement reflects patriarchal norms and actively address the issues that women with lacks the leadership of women and women’s disabilities face. Representatives of OPDs organizations. To ensure meaningful supported the twin-track approach, which participation of women with disabilities, ultimately prevailed in the form of Article 6 gender power relations must be considered. (Kim 2013; UNDESA 2005). For effective protection of the rights of The first UN Special Rapporteur on the persons with disabilities, it is crucial for rights of persons with disabilities affirmed persons with disabilities to participate in that states should prioritize the participation developing, negotiating, and drafting policies. of organizations led by persons with The elaboration of the Convention on the disabilities and support their establishment Rights of Persons with Disabilities is a and functioning (UN 2016). She also raised good example of how to include persons concerns about the precarious situation of with disabilities, including women with women and girls with disabilities, pointing out disabilities, in law-making processes. A that it is still unsafe in many places for them range of persons with disabilities from around to take part in open consultations, but their the world participated in the negotiating active and informed participation is a requisite and drafting of the Convention, and thus the of a human rights-based approach. Enabling Convention is an innovative human rights meaningful consultation and participation instrument that underscores the dignity and of women with disabilities requires an fundamental rights of persons with disabilities intersectional approach to the barriers that (CRPD Committee 2018). Furthermore, the prevent them from participating. Leadership Convention dedicated Article 6 to women structures in the disability movement often with disabilities, which recognizes the multiple reflect hierarchical and patriarchal norms that discrimination to which they are subjected. are present across many social strata and During the CRPD negotiations, the delegation present similar gender gaps in representation. of the Republic of Korea had proposed a separate article to recognize the rights of Some good practices to circumvent these women with disabilities in the Convention. barriers include creating safe spaces for Although every government recognized women with disabilities, allowing flexible times the importance of safeguarding the rights for meetings, and having women facilitators. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 37 4 Implementation Phase (Implementation Status and Results Report) Who are the actors involved in the project, and what are they doing? a.  ● Has the project included women with disabilities and/or their representative organizations in as many relevant roles and phases of the project as possible (and not just as beneficiaries) (box 2.6)? ● Has the project evaluated the role of any private company vendor in relation to provision of opportunities to women with disabilities, with measurable indicators? WBG procurement policies aim to increase diversity and provide opportunities for businesses owned by women and persons with disabilities (World Bank Group 2022a). If private company vendors need support with inclusion, they can become members of communities of practice, such as the Valuable 500 (a global business collective innovating for disability inclusion) and International Labour Organization Global Business and Disability Network, to learn from and share best practices. ● Has the project reviewed any government stakeholder regarding their obligations to women with disabilities? Review engagement in government and civil society reports to UN treaty bodies, including reports to the CRPD Committee, the CEDAW Committee, and the UN Universal Periodic Review. Search Voluntary National Reviews submitted to the High-Level Political Forum on Sustainable Development for disability-related information. Does the project enhance data analysis on women with disabilities? b.  ● Is the project using the Washington Group Short Set Questions on Functioning (WG-SS) to understand disability prevalence and its interaction with gender among beneficiaries? ● Are there any intersectional data at the national level? ● Are there any lessons learned from this process to share during evaluation? WBG Vendors Code of Conduct: “Vendors will provide opportunities for access and growth of entities owned and controlled by minorities, women, LGBTQ individuals, and disabled persons with an emphasis on measurable results and continuous improvement” (World Bank Group 2022b, 4, para. 6). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 38 Source: Shutterstock. Box 2.6 Intersectional Perspectives in Action: Vietnam’s Country Gender Program A task team member of the Vietnam Country Gender Program (led by the Social Sustainability and Inclusion (SSI) Global Practice) explained their view of intersectional risks and potential project benefits for women and girls with disabilities. The Vietnam Quality Improvement of Primary Education for Deaf Children Project (QIPEDC) developed special learning materials that have been used in more than 180 special and inclusive schools for nearly 2,000 deaf children (including those from ethnic minorities and poor populations) across 20 provinces. The team’s research uncovered data reported in the state media about the large number of girls with disabilities who had been victims of sexual harassment and violence over several years. They used this critical information to encourage the client to address gender gaps in the proposed project. “Once the Ministry of Education and Training understood the data on sexual violence against girls with disabilities, they were supportive about including measures in the project to address it,” a social development specialist explained. Major outputs included developing, with the deaf community, new signs in Vietnamese Sign Language to talk about sexual violence in the education curriculum. The project also produced an age-appropriate sign language video to help deaf children recognize and report sexual harassment and abuse, which was then integrated into the Ministry of Education and Training’s curriculum and shared with nearly 5,000 people, including teachers, teaching assistants, deaf mentors, leaders in the deaf community, parents, and children. The team noted that the SSI-led country gender program, provides a unique opportunity for social staff to streamline gender targets with the social assessment, coordinate community consultations, and look into intersectionality. The country gender program helped the task team to increase their understanding of the intersectional barriers that women with disabilities face and how people with disabilities can enhance and benefit from projects once barriers are addressed. In addition to addressing sexual harassment for girls with disabilities under the QIPEDC project, the SSI team is working with the General Statistics Office (GSO) to integrate a disability-focused module in the Labor Force Survey. The team is collaborating with the National Committee for Disability on the survey design and future dissemination of the findings, in the hope to inform upcoming revisions of the Law on Disabilities and the Law on Employment. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 39 Source: Shutterstock. 5 Evaluation Phase (Implementation Completion and Results Report) On whom does the project monitoring, a.  reporting, and assessment focus? ● Are outcomes, challenges, and lessons learned reported in terms of including and reaching women with disabilities in different project stakeholder roles? ● Are women with disabilities and their organizations and the broader OPD community benefiting from project learnings? How is the project sharing any data collected b.  and lessons learned about the intersection of gender and disability? ● Are project lessons learned and key stories shared with other WBG task teams focused on social inclusion, gender, and disability? ● Is the project collecting any data in accordance with the WG-SS and gender indicators? ● Is the project sharing data and lessons learned with sectoral or government actors who could use it in other work or to broaden the project work? Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 40 Chapter 2: References Australian Human Rights Commission (AHRC) United Nations (UN). 2016. Report of the Special and IncludeAbility. 2021. “Hosting Accessible and Rapporteur on the Rights of Persons with Inclusive In-Person Meetings and Events.” AHRC, Disabilities. New York: UN. Sydney. World Bank. 2017. The World Bank Environmental Committee on the Rights of Persons with and Social Framework. Washington, DC: World Disabilities (CRPD Committee). 2018. General Bank. Comment No. 7 (2018) on the Participation of Persons with Disabilties, Including Children World Bank. 2018. “ESS10: Stakeholder with Disabilities, through Their Representative Engagement and Information Disclosure.” Organizations, in the Implementation and Guidance Note for Borrowers, World Bank, Monitoring of the Convention. New York: United Washington, DC. Nations. World Bank. 2021. Criteria for the World Bank’s Kim, Mi Yeon. 2013. “Women with Disabilities: Disability-Inclusive Investment Project Financing The Convention through the Prism of Gender.” In (IPF) in Education. Washington, DC: World Bank. Human Rights and Disability Advocacy, edited by Maya Sabatello and Marianne Schulze, 113–45. Philadelphia: University of Pennsylvania Press. World Bank. 2022. Technical Note on Accessibility, Part 2: The Project Cycle Guidance. Washington, DC: World Bank. Raja, Deepti Samant. 2016. “Bridging the Disability Divide through Digital Technologies.” Background Paper, World Bank, Washington, DC. World Bank Group. 2022a. Corporate Procurement Policy Summary: For Vendors Doing Business with the World Bank Group. Washington, DC: World United Nations Department of Social and Bank. Economic Affairs (UNDESA). 2005. “UN Convention on the Human Rights of People with Disabilities Ad Hoc Committee - Daily summary of World Bank Group. 2022b. “Vendors Code of discussion at the sixth session 02 August 2005.” Conduct.” World Bank, Washington, DC. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 41 Source: Inclusive Education Initiative, World Bank. CHAPTER 03 What are the Key Barriers for Women and Girls with Disabilities, and How is the World Bank Group Addressing Them? Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 42 1 Key Barriers and Solutions across World Bank Group Sectors Numerous World Bank Group (WBG) projects focus on the socioeconomic inclusion of women or persons with disabilities. However, only a few address the intersection of gender and disability by targeting women and girls with disabilities. Worldwide, women and girls with disabilities encounter multiple barriers to their full and equal socioeconomic participation. Some affect all persons with disabilities, and others affect all women. Women and girls with disabilities are often affected disproportionately because their intersecting identities put them in a disadvantageous position. Frequently, more than one barrier is present at the same time. The lack of reliable data makes it difficult to assess the exact scope and impact of each barrier. And legal and policy frameworks that promote the rights of women with disabilities are often missing, making it hard to address barriers when they are identified. Figure 3.1 shows some of the most common barriers that women and girls with disabilities face. Figure 3.2. lists these barriers as seven key issues for World Bank task to examined through the lens of both disability and gender when designing and implementing projects. Examples from the WBG illustrate throughout this chapter how intersectionality can be incorporated into operations across different sectors and provide practical ideas how women and girls with disabilities can be empowered. Figure 3.1. Primary Barriers for Women and Girls with Disabilities Legal Safety Physical Access Lack of data Digital Attitudinal Access Financial Information / Knowledge Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 43 Barriers can be overcome through is important to collaborate across sectors targeted interventions that incorporate and share knowledge. Increasing disability inclusion in one sector, such as transportation, both disability- and gender-inclusive can have implications for other sectors, such actions and standards (figure 3.2). as education or health, or require certain The WBG projects referenced in this toolkit prerequisites that can be achieved only by have applied an intersectional approach to working together. When more girls with support a wide range of innovative solutions, disabilities are able to travel safely, parents such as constructing gender- and disability- may increase their school enrollment, and inclusive toilet facilities in schools, digitalizing more girls and women with disabilities may be identity documents and government able to access health services. Conversely, if services in an accessible manner, supporting disability inclusion is considered too narrowly, employment through vocational training and for example, only in education, lack of public awareness activities, constructing disability- and gender-inclusive transportation accessible and safe bus terminals, and or lack of access to health care may mean that enabling women with disabilities to assume few girls with disabilities will actually attend. leadership roles in an emergency by Women and girls with disabilities are a diverse constructing disability- and gender-inclusive group, and the type of interventions needed command centers. In order to achieve impact to promote their socioeconomic inclusion also that is socially inclusive and sustainable, it depends greatly on country context. Figure 3.2. Seven Key Issues for WBG Task Teams to Examine through the Lens of Gender and Disability Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 44 Table 3.1. Sample Solutions to Overcome Key Structural Barriers for Women with Disabilities Key Barriers Explanation Solutions Lack of Data National or sectoral data may not Support National Statistics Offices and sectoral be disaggregated by gender and/ data experts to use the Washington Group Short or disability or show intersectional Set on Functioning (WG-SS) questions on disability data for gender and disability. and to ensure that data are disaggregated by gender and disability. Enabling laws National laws and policies may Amend any legal or policy restrictions based on and policies discriminate against or even gender and/or disability identity. exclude women and girls with disabilities, especially those Support the development of harmonized national with intellectual or psychosocial technical standards, such as accessibility disabilities who may have standards, inclusive gender policies, and disability restricted legal capacity. policies focused on gender equality. National laws may fail to protect Explicitly guarantee the rights of all girls and women from violence and harmful women with disabilities in national law, especially and exploitative practices. for essential services (education, health care, justice, social protection, transportation, and Employment strategies may not be banking). inclusive of girls and women with disabilities. Include protections of the labor rights of women and girls with disabilities in formal and informal employment, including the right to reasonable accommodation. Depending on context, affirmative action may be needed to close the gap for girls and women with disabilities. Ensure that girls and women with disabilities who are affected by violence or harmful practices are entitled to tailored and accessible support measures. Physical Buildings (including schools; Adapt infrastructure to consider both disability (for accessibility health facilities; workplaces; justice example, ramps, signs) and gender (for example, systems; shelters; and water personal safety). (buildings, supply, sanitation, and hygiene transportation facilities) may not be appropriately Apply universal design principles for infrastructure, facilities, equipped for girls and women with schools, and transportation systems, and support equipment) disabilities. girls and women with disabilities with assistive technologies. Transportation systems may not consider the unique needs of girls Ensure that girls and women with disabilities and women with disabilities, which have accessible and safe water supply, sanitation, can prevent them from accessing and hygiene facilities; shelters; and means of services and community life. transportation. Give technical and financial support to officials in both the public and private sectors for provision of reasonable accommodations. Consider providing coverage for disability-related costs in social protection programs, including assistive technology. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 45 Key Barriers Explanation Solutions Digital Girls and women with disabilities Integrate digital skills into education curricula, accessibility run a high risk of digital illiteracy particularly for girls with disabilities. and of falling behind because (assistive of lack of digital skills and Ensure that public services and data are digitalized technology, inaccessible digital programs and as much as possible and accessible to all persons digital technology. with disabilities (for example, access to digital services) devices and assistive technologies). Awareness Curricula and other public service Equitably allocate funds to support accessibility information may not be available in of information for women with disabilities. For (information, disability-friendly formats (braille, example: knowledge) large print, or multimedia). • Adapt material, including online educational Materials may be underresponsive material, for girls and women with diverse to gender needs or overresponsive impairments, and make it widely accessible. to stereotypes about gender and disability. They may not depict • Develop inclusive and gender-sensitive curricula or mention girls and women with and information materials, ensuring that girls disabilities. and women with disabilities are depicted in an empowered manner. Affordability Social protection systems may not Ensure that social protection systems are gender- be accessible, reach women, or and disability-sensitive, and target recipients (costs, address the extra costs of assistive directly (rather than households) to empower financial or other services needed for women with disabilities. support, inclusion. banking Make eligibility gender and disability sensitive, services) Eligibility criteria may be too strict aligned with the social model of disability. or narrow, such as: Develop holistic social protection programs, • Requiring “severe disability” as combining cash and in-kind support, considering assessed under the medical both disability and gender dimensions, and model and excluding other forms covering especially: of disability • Disability-specific expenses (for example, • Imposing conditions that assistive technologies, adaptive devices, mobility women with disabilities have aids, house adaptation, personal assistance, and difficulty fulfilling (for example, service animals). prior employment or minimum contribution periods) • General support measures to promote deinstitutionalization and independent living (for Banking and finance services may example, tax reliefs, wage subsidies, care credits, be inaccessible for women with maternity and childcare services, income support disabilities. for those both in and out of work, and subsidized or free access to public transportation). Acceptability Social and cultural norms about Conduct awareness-raising activities to emphasize gender roles and disability the skills and potential of girls and women with (social norms, stereotypes can interfere with disabilities, and target all relevant stakeholders: perceptions) the rights of girls and women family, teachers, peers, policy makers, employers, with disabilities, particularly their justice officials, and service providers. sexual and reproductive health (for example, belief that women and girls with disabilities are asexual or “cursed”). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 46 Key Barriers Explanation Solutions Safety Girls and women with disabilities Equip enforcement mechanisms and support have a high risk of being subjected accessible services to respond to the needs of (violence, to bullying; sexual, physical, and women and girls with disabilities, especially: abuse, verbal abuse; and other forms exploitation) - Shelters of violence both at home and in the community. The risk is even - Complaint mechanisms higher for girls and women with - Reproductive health care services. intellectual and psychosocial disabilities and those in Educate women and girls with disabilities on the institutionalized settings. various forms of exploitation and abuse and the services available to them. Women and girls with disabilities may lack the necessary knowledge Train social and health care service providers and or information to escape an legal and law enforcement professionals about the abusive situation. specific needs of women and girls with disabilities and how to assist them. Source: Shutterstock. 2 The Importance of Disaggregated Data to Inform Policies and Projects Women and girls with disabilities are largely absent from official statistics and surveys. Data on persons with disabilities are often not disaggregated by gender, and data on gender may not be disaggregated by disability. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 47 Even when disability data are being The collection of timely, reliable, and high- collected, there can be significant quality data disaggregated by disability (among other characteristics) is one of differences and inconsistencies in the main targets of the 2030 Sustainable measurements and indicators, making Development Goals (Goal 17, Target 17.18). comparability difficult because of the However, as noted in the UN’s Sustainable following: Development Goal Report 2022, the COVID-19 pandemic has delayed the development and ✚ The definition of disability for different implementation of new national statistics purposes—such as to collect population plans in line with this objective. “Out of 10 SDG data; or identify who can benefit from social [Sustainable Development Goal] indicators protection, educational, or health services that require disaggregation by disability status, or employment accommodations—can vary data are available for only 2 of them” (UN 2022, significantly among agencies and between 4). Such data are vital for the development countries. of evidence-based policies to improve the ✚ The social stigma attached to disability socioeconomic inclusion and empowerment of and fears about safety can deter people women and girls with disabilities. with disabilities from self-reporting and registering, especially women with disabilities and their families. ✚ Data collection procedures are often Collecting disability inaccessible, complex, or bureaucratic, disaggregated data is with inadequately digitalized records, poor a WBG commitment information, and lack of trained human resources. Most important, improving disability data The United Nations Children’s Fund’s collection is one of the World Bank Group’s Multiple Indicator Cluster Survey (MICS) 10 commitments on disability-inclusive is one exception. It now incorporates a development. Policy commitments to Child Functioning Module (developed in strengthen the collection and use of consultation with organizations of persons disaggregated data are also part of both with disabilities) and has led to the first cross- the 19th and 20th Replenishments of IDA nationally comparable data on children with (IDA19 and IDA20). IDA20 requires using disabilities. As of November 2021, data are and promoting the question sets from the available from about 50 countries, and data Washington Group Short Set on Functioning from an additional 20 will be available in the (WG-SS). near future. The Washington Group on Disability Statistics Short Set on Functioning (WG-SS) is the international standard for collecting data on disability. Intended for use in censuses and household surveys, the questions obtain information on functional difficulties any person may have in undertaking basic activities, including seeing, hearing, walking or climbing stairs, remembering or concentrating, self-care, and communication. Each question is answered on a spectrum from no difficulty to cannot do at all. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 48 In June 2022, the World Bank announced a populations, geographies, and development partnership with Microsoft and the Disability indicators” (McClain-Nhlapo and Lay-Flurrie Data Initiative (DDI) at Fordham University to 2022). expand access to and use of demographics The Disability Data Initiative’s 2022 report and statistics data on disability, particularly reviews disability questions in national in low- and middle-income countries. “The censuses and household surveys and goal of this effort is to develop a public- disaggregates well-being indicators between facing, online ‘disability data hub’ to offer women with and without functional difficulties information on persons with disabilities across in 35 countries. Source: Inclusive Education Initiative, World Bank. “Gender, ethnoracial identity How is the WBG Using and living in rural settings can the Washington Group further intensify the exclusionary Short Set on Functioning effects of a disability and can also increase the probability of to Identify Persons with developing an impairment in the Disabilities? first place. Being indigenous or Afro-descendant has a dramatic The World Bank report Who is Disabled in impact on education outcomes Sub-Saharan Africa is a good example of and magnifies wage disparities. disaggregating data based on the WG-SS These imbalances multiply out of questions, but gender is not included in gender disparities” (Garcia Mora, the report’s charts. The World Bank Global Orellana, and Freire 2021, xiv). Database of Shared Prosperity demography survey also uses the Washington Group questions. The World Bank publication Disability Inclusion in Latin America and the Caribbean gathers data on both disability and gender, in addition to other identities.  ake the WBG online course Collecting Data on Disability Inclusion to T understand why collecting disability data is important and learn to identify persons with disabilities by using survey data. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 49 Source: World Bank. Dos and Don’ts of Data Collection Include women with a range of disabilities  in the design of data collection efforts and their implementation (for example, sensory, physical, intellectual, and psychosocial disabilities). Source: Shutterstock. Use international standardized questions  (for example, the Washington Group Short Set on Functioning). Accounting for the Consider requirements for the WBG  Diversity of Women gender tag when addressing persons with with Disabilities disabilities. Persons with disabilities are not a Make all data collection efforts accessible  homogenous group. They share significant for a diversity of women with different barriers and restrictions to socioeconomic impairments, educational levels, and inclusion, but they have different skills, languages. (For example, provide different needs, different backgrounds, and accommodations and flexibility when divergent views and perspectives. Surveys administering questionnaires where and data collection systems that treat persons relevant, and provide materials in an with disabilities as a homogenous group, for accessible format and in easy-to read or example, by limiting choices for self-reporting plain language.) (such as one check box on disability requiring Obtain feedback on project  a yes or no answer) risk leaving out persons implementation from women with whose experiences may differ significantly, disabilities. including women with disabilities. Reliable data collection requires acknowledging the Do No Harm by guaranteeing the safety  diversity of disability and the intersection and security of women with disabilities of disability with other identities. Data on and ensuring confidentiality during data disability should be informed by the subjective collection and anonymity of sensitive experience of disability and its socioeconomic data. dimensions. Don’t allow for elite capture, but reach out  Stakeholder engagement is one important to the broader disability community, both way to include women with disabilities in urban and rural. conversations during the project cycle and Don’t forget the diversity of disability. decide how to approach data collection for or in a specific project. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 50 Source: World Bank. 3 National laws are more likely to meet principles stipulated under international law, when they recognize the fundamental rights of The Critical Role women with disabilities. of Disability- Inclusive Laws  ownload the data set on the D and Policies rights of women with disabilities The Women, Business Laws and policies can act and the Law Data Set on as legal barriers or aids the Rights of Women with to the socioeconomic Disabilities inclusion of women with disabilities. The Women, Business and the Law project, under one of the 10 WBG commitments on Laws and policies can exclude women with disability-inclusive development, has collected disabilities from opportunities by restricting and analyzed data related to the rights of access and exacerbating discriminatory women with disabilities. The research covers practices. For example, a 2016 global study 11 data points based on laws, regulations, and of disability and labor legislation illustrated policies across 190 economies and includes how national labor laws can pose structural lessons learned regarding the four areas barriers to the participation of persons with studied: nondiscrimination, parental rights mental disabilities in competitive employment. and responsibilities, labor market inclusion, This includes direct and indirect discrimination and protection from GBV (box 3.1). Two policy in recruitment procedures and the absence briefs accompany the data set: of provisions related to equal remuneration, equal opportunities for career advancements, ✚ The Importance of Designing Gender protection from harassment, and access to and Disability Inclusive Laws: A Survey of reasonable accommodation (Nardodkar et Legislation in 190 Economies al. 2016). Laws and policies can also foster ✚ Safeguarding the Rights of Women inclusion by shaping access to basic services with Disabilities: Family Life, Work, and and enabling participation in decision-making. Protection from Gender-Based Violence Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 51 Source: Shutterstock. Box 3.1 Women, Business and the Law 2022 Research Questions on the Rights of Women with Disabilities 1. Is there a gender equality or nondiscrimination law that specifically recognizes and protects the rights of women with disabilities? 2. Is there a law on persons with disabilities that specifically protects and promotes the rights of women with disabilities? 3. Does the disability rights law follow the social model? 4. Does the law provide support to women with disabilities in the exercise of their parental rights and responsibilities (for example, extension of maternity leave, financial aid, legal protection to keep custody for children, and others)? 5. Is there a law or policy that mandates reasonable accommodation for workers with disabilities? 6. If the answer is “Yes,” does the reasonable accommodation law or policy mention women with disabilities? 7. Are there incentives in law or policy for businesses to employ persons with disabilities (for example, quotas, tax breaks, wage replacement)? 8. If the answer is “Yes,” does the employment incentive law or policy mention women with disabilities? 9. Does the domestic violence law explicitly address women with disabilities? 10. Does the domestic violence law establish accessibility to services for women with disabilities survivors of violence? 11. Is there legislation on sexual harassment against women with disabilities? Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 52 The Rights of Women with Disabilities 1.  to Equality and Nondiscrimination Laws and policies worldwide largely fail to account for both gender and disability. Only one-quarter of economies worldwide explicitly recognize the rights of women with disabilities (figure 3.3): 86 economies have a gender equality or nondiscrimination law. Only 30 of them explicitly  mention women with disabilities. This is only 16 percent of the 190 examined economies. 157 economies have a disability rights law. Only 52 of them, or 27 percent of all economies,  mention women with disabilities. Only 10 economies mention women with disabilities in both their gender equality or  nondiscrimination law and their disability rights law. Figure 3.3. Economies that Recognize Multiple Discrimination of Women with Disabilities in Their Gender and Disability Rights Laws Disability 52 105 33 rights law Gender equality or 30 56 104 nondiscri- mination law 0 20 40 60 80 100 120 140 160 180 200 Number of Economies Mentions women No mention of No law with disabilities women with disabilities Source: Women, Business and the Law database. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 53 2. Parental Rights and Responsibilities of Women with Disabilities Laws around the world overwhelmingly do not provide support to women with disabilities in the exercise of their parental rights and responsibilities (for example, financial aid or personal assistance, legal protection to keep custody of children, specific attention to maternal health care, or extended maternity benefits). Of 190 economies studied, only 27 legally stipulate support to parents with disabilities (table 3.2). Table 3.2. Examples of Laws Protecting the Parental Rights of Women with Disabilities Measure Example Financial aid or France has widened access to disability compensation benefits for parents with personal assistance disabilities, recognizing the need for human assistance (Decree No. 2020- 1826 of December 31, 2020). The Republic of Korea provides a woman with a natal care” (Act disability “with a helper who is to visit her home for pre­and post­ on Welfare of Persons with Disabilities, box 3.2). In Cameroon, the law provides that the state will contribute to school expenses and professional development of children whose parents have disabilities (Law No. 2010/002 of April 13, 2010). Nondiscrimination In Benin, the law states that “no child shall be separated from his or her parents clause for without just cause because of his or her disability or the disability of his or her custody rights parents” (Law No. 2017-06 Protecting and Promoting the Rights of Persons with Disabilities in the Republic of Benin). In Fiji, the law protects the right of persons with disabilities to be free from discrimination in all matters relating to parenthood (Fiji, Rights of Persons with Disabilities Act of 2018). Specific attention In Togo, the law provides that the personnel of health structures will pay to maternal special attention to a woman with a disability during pregnancy and shortly health care after childbirth (Law of April 23, 2004, on the social protection of persons with disabilities). Extended In Kuwait, mothers with disabilities employed in the public sector are granted maternity benefits special fully paid leave (Law No. 8 of 2010 Concerning the Rights of People with Disabilities). In Spain, the birth allowance is paid for an additional 14 days (General Social Security Law as amended in 2015). Source: Women, Business and the Law database. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 54 Source: Shutterstock. Box 3.2 Laws in the Republic of Korea Offer Support to Mothers with Disabilities In the Republic of Korea, 89 percent of women with disabilities who gave birth to children in the past three years received support for childbirth expenses under the 1989 Act on Welfare of Persons with Disabilities, which stipulates specific attention in maternal health care. Disability rights advocates explain that the best support practices for mothers with disabilities are financial assistance for birth related costs and provision of homecare services for childcare. Article 14 of the 2015 Act on Guarantee of Right to Health and Access to Medical Services for Persons with Disabilities states that local governments can provide a helper service for women with disabilities. In Seoul, the Home Helper Service for Women with Disabilities has been available since 2003, through which eligible women with disabilities may receive care services related to pregnancy management, postpartum care, child rearing, and household chores for up to 70 hours per month. The service was first established upon advocacy of a staff member of the Seoul Northern Welfare Center for the Disabled – herself a working mother with a disability when she recognized that there was no specialized social welfare service for mothers with disabilities in Korea. Many women have benefited from the service. For example, Park, a 36-year-old woman with a visual impairment, is a beneficiary of this program. She has two children: the oldest goes to a daycare center while the youngest stays at home with her. She wants to participate in educational and social activities for her children but faces environmental barriers to doing so. After learning about the Home Helper Service, she applied for the program. With the support provided, she has started attending a local welfare center to receive braille training, which has helped alleviate some of the barriers she faces as a parent. However, OPDs raise concerns that care support for raising children is insufficient. For example, parents with disabilities have difficulties accessing the National Child Care Project and there is no gender component in the 2011 Personal Assistant Law for Persons with Disabilities. A draft law on support for women with disabilities is currently under discussion in the national assembly with the goal of establishing a single, systematic, and integrated framework for the rights of women with disabilities. Source: National Assembly Legislative Research Service 2020; Seoul Metropolitan Government 2018; Women, Business and the Law database. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 55 3. Labor Inclusion for Women with Disabilities Across 190 economies studied, very few laws related to the inclusion of persons with disabilities in the labor force consider the effect of gender: 111 economies have reasonable accommodation mandates in their law or policy. Only 6  explicitly mention women with disabilities (box. 3.3).  120 economies have employment incentives in law or policy such as quotas, tax breaks, wage replacement, and others. Only 5 mention women with disabilities. Box 3.3 Inclusion of Women with Disabilities Under Ethiopia’s Labor Law In Ethiopia, only 53.5 percent of persons with disabilities participated in the labor market in 2013, while the general labor force participation rate was 80.7 percent. Women with disabilities were even less likely than men with disabilities to be employed (43.7 per cent compared to 63 per cent), being predominantly involved in unpaid family work. The Right to Employment of Persons with Disability Proclamation No. 568/2008 aims to better include women with disabilities in the labor market and is unique in recognizing intersectional discrimination. Article 6(1)(b) states that it is the responsibility of employers to “take all reasonable accommodations and measures of affirmative action for women with disability taking into account their multiple burden that arise from their sex and disability.” Overall, the law significantly advances the rights of persons with disabilities by placing the burden of proof on the employer, meaning that a person with a disability who takes their case to court does not need to provide all the evidence to support their case. The passage of this law was the result of long-term lobbying by organizations of persons with disabilities (OPDs), including the National Association of the Blind and the Ethiopian Women with Disabilities National Association, demanding an implementing regulation to the previous law, Proclamation No. 101 of 1994. The Civil Service Commission had originally drafted the law, under the leadership of the legal director, who was a blind person. A committee formed by the Ministry of Labor and Social Affairs that included representatives of the Civil Service Commission and OPDs eventually concluded that a comprehensive instrument needed to replace the 1994 law and adopted Proclamation No. 568/2008. However, OPDs have criticized the enforcement mechanisms of the new law – including a fine of only 2,000 to 5,000 birr (the equivalent of US$40 to US$100) – as insufficient to effectively increase the hiring of persons with disabilities. The recently adopted Labour Proclamation No. 1156/2019 further advances women’s economic empowerment by prohibiting sexual harassment in employment for the first time. While the law protects women with disabilities from nondiscrimination, the sexual harassment provisions do not explicitly protect persons with disabilities. Source: Central Statistics Agency-Ethiopia 2013; Women, Business and the Law database. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 56 4. Protection against GBV for Women with Disabilities Women, Business and the Law’s analysis of 190 economies found the following: Only 51 of 160 economies globally with a law prohibiting domestic violence explicitly protect  women with disabilities. Only 17 establish accessibility to services for women with disabilities survivors (table 3.3). A total of 144 economies legally prohibit sexual harassment in employment. Only 30 explicitly  mention women with disabilities. Table 3.3. Good Practice Examples in Law to Prevent and Reduce Violence against Women with Disabilities Economy Legislation Provision Peru Law No. 30364 to Prevent, The law states that disability sets individuals in Punish, and Eradicate positions of vulnerability to violence and mandates Violence against Women and that measures related to domestic violence Family Members should take on an intersectional approach, considering identities such as marital status, sexual orientation, HIV-positive status, immigrant or refugee status, age, or disability, to name a few. Mozambique Law No. 29/2009 on Domestic The law provides that the disability status of a Violence Perpetrated against survivor of domestic violence is considered an Women aggravating circumstance, which increases the sentences ordered by courts. Republic of Act on Special Cases The act stipulates that centers and shelters may Korea Concerning the Punishment, specialize in welcoming a target group, such etc. of Crimes of Domestic as persons with disabilities, and if a shelter Violence (Act No. 17499) operates for persons with disabilities, it must provide appropriate assistance that considers Act on Special Cases all disabilities to ensure full accessibility to the Concerning the Punishment of services. Sexual Crimes (2012) Provides communication assistance to persons with disabilities during the investigative processes and legal proceedings. Oman Penal Code Provides for aggravated penalties for sexual harassment committed against a person with a disability. Source: Women, Business and the Law database. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 57 4 Sector-Specific Barriers and Solutions a. Education Access to education is a universal right, and education contributes to building human capital and reducing poverty. Globally, about 240 million children have a disability. Children with disabilities are more likely to never attend school because of multiple barriers, including stigma, lack of trained teachers, inadequate learning materials and inaccessible facilities (UNICEF 2021b). Those who are in school are less likely to complete education at any level, compared with children without disabilities. Girls with disabilities are among the most excluded from education. “Nine out of ten children with disabilities in developing countries are excluded from formal education, and the majority of them are girls” (UNGEI 2021). They run a high risk of being left out of school because of prevailing social norms that prioritize the education of their nondisabled peers and in some instances, boys with disabilities. Initiatives to address these barriers and the relevant considerations for World Bank operations are described in the guidance note on criteria for disability-inclusive investment project financing (IPF) in education (box 3.4). Emerging Practices in Education  Digital education: Digital learning can greatly benefit students with disabilities, especially because e-learning and remote education are becoming increasingly important in global crises. Digital skills are also vital to all other aspects of socioeconomic empowerment, such as access to employment and basic services. Compared with their peers, girls with disabilities are less likely to possess digital literacy (Tyers-Chowdhury and Binder 2021).  Inclusive education: Education systems should be inclusive, meaning that all children are taught together in the same classroom and not in segregated or special schools. Inclusive schools lay an early foundation for lifelong inclusion in society. Disability and gender are two main causes of segregation in education. Girls with disabilities are at the highest risk of being segregated because of their intersecting identities (World Bank 2022e). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 58 Source: Masaru Goto, World Bank. Box 3.4 WBG Initiatives Promoting Disability-Inclusive Education in Sub-Saharan Africa The WBG’s aim is to make all its education programs and projects disability inclusive by 2025. Among other initiatives, the World Bank has set up the Disability-Inclusive Education in Africa Program, with the United States Agency for International Development, a $3 million trust fund to increase access for children to primary school and to design and implement inclusive education programs across Africa. The program provides advisory and analytical support, strengthening the evidence base on the economic, social, and system-level structures that impact inclusion for children with disabilities and showing “what works” to overcome these barriers. The recent study, “Understanding Multidimensional Determinants of Disability-Inclusive Education: Lessons from Rwanda, Sierra Leone, and Zambia,” finds that the most significant barriers are not familial but societal and institutional and need government intervention and investment. Recommendations include the development of assistive technology service delivery systems and rehabilitation services, provision of accessible public transportation and barrier-free environments, improving access to learning-related accommodations and personal care assistance, assessment and coverage of out-of-pocket costs of families through social protection, and delivery of awareness- raising programs. The Inclusive Education Initiative (IEI), is a multi-donor trust fund overseen by the World Bank, supported by the British and Norwegian governments. The paper Pivoting to Inclusion: Leveraging Lessons from the COVID-19 Crisis for Learners with Disabilities examines how the COVID-19 pandemic furthered the risk of marginalization for children with disabilities and reiterates the importance of accessible information for every child in multiple languages and multiple formats and the training and sensibilization of teachers. An important resource document is the World Bank’s Criteria for Disability-Inclusive IPF in Education Guidance Note. It supports task team leaders in applying four main criteria to projects under implementation and includes a project worksheet for easy application: stakeholder engagement, analysis, inclusive project design, and monitoring and reporting. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 59 Addressing Discrimination Based on school, especially once menstruation starts Gender and Disability in Tanzania (World Bank 2017). In a primary school in rural by Promoting Changes in Education Tanzania, 16 student toilets were constructed Policies and Providing Accessible, in the framework of the World Bank–financed Safe Toilets Tanzania Sustainable Rural Water Supply and Sanitation Program (SRWSSP). The In Tanzania, girls who became pregnant were toilets were split evenly among girls and banned from school (CEDAW Committee 2016; boys. One accessible toilet was included on CRC Committee 2015). Girls with disabilities, each side. According to the headmaster, the who experience high exposure to sexual impact of the new toilet facilities on student violence, ran an increased risk of having to attendance was “phenomenal.” Accessible drop out of school because of pregnancy, and gender-sensitive toilets in schools are although precise data were not available. beneficial not only for girls with disabilities, A new educational circular has lifted this but also for female teachers or administrators barrier and recognizes that pregnant girls and with disabilities. To date, the program has adolescent mothers can remain at or return provided 637 public primary schools in the to school (World Bank 2021b). The World 17 regions with lowest water, sanitation, and Bank’s Tanzania Secondary Education Quality hygiene services with access to adequate and Improvement Project aims to support girls, improved facilities. They meet the required including girls with disabilities, to complete criteria of providing an adequate number of secondary education by developing safe toilets and handwashing facilities for girls learning environments, accessible schools, and boys, including one accessible toilet for and alternative education pathways for both boys and girls, and access to menstrual pregnant students and adolescent mothers. hygiene rooms and disposal incinerators. The The project is committed to supporting the program has also helped to ensure that the implementation of the new education policy. design and construction of school sanitation and hygiene facilities is standardized country- Inaccessible and unsafe toilets are a major wide through the Ministry of Education reason why girls with disabilities drop out of Science and Technology. Three Key Questions to Ask on Education and Women with Disabilities during the Project Cycle 1. Data: Does the country collect educational data disaggregated by gender and disability, and what are the gaps in educational attainment for girls and women with disabilities? 2. Frameworks: What policy measures have schools taken to accommodate girls with disabilities, especially in relation to gender-based violence and bullying? 3. Program: Does the curriculum in all levels of education respond to the gender and disability- specific needs of girls and women with disabilities? Are measures in place to raise awareness and promote the education of girls and women with disabilities across relevant stakeholders (family, peers, teachers, policy makers, and the community)? Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 60 Sample Project Indicators to Measure Inclusion of Women with Disabilities in Education ⊕ National laws or policies enacted that recognize the right to inclusive education for girls and women with disabilities ⊕ Educational data disaggregated by both gender and disability, using the Washington Group Short Set on Functioning ⊕ Percentage of girls enrolled in segregated versus mainstream schools and/or out of education ⊕ Percentage of girls and women with disabilities who have completed primary, secondary, and higher education ⊕ Percentage of schools that are accessible and inclusive of girls with disabilities ⊕ Number of teachers trained under inclusive education curriculum ⊕ Percentage of girls with disabilities benefiting from assistive technology or other accessible communication, such as sign language or braille, in education ⊕ Number of reported incidents of bullying and school violence against girls with disabilities ⊕ Number and reach of government-led, awareness-raising campaigns addressing the right to education of girls and women with disabilities without disabilities (ILO and OECD 2018). In b. Employment and countries where gender-disaggregated data Entrepreneurship are available, the labor force participation rate for women with disabilities is significantly Most of the world’s 1 billion people lower than that of other groups. In 60 with disabilities are of working age, countries with available data, the inactivity yet their labor force participation is rate of women with disabilities was higher particularly low. than that of women without disabilities and higher than the rates of men with and without According to the International Labour disabilities (ILOSTAT 2022). Organization, seven of 10 persons with disabilities are not active in the labor force, In northern Africa and western Asia, women compared with four of 10 persons without with disabilities are five times less likely to disabilities (ILOSTAT 2022). Women with be employed as men without disabilities, and disabilities worldwide are employed at lower in Europe, two times less (UNDESA 2018). rates than men with disabilities and women Even when employed, women with disabilities commonly earn less than women without Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 61 disabilities and men with disabilities, and they The Care Economy is are more likely to be employed in the informal Predominantly Female sector, where they experience limited labor The gendered responsibility for care work protection and work instability (WHO and weighs heavy on women with disabilities WBG 2011). Young women with disabilities are who often perform care and other home in a particularly disadvantageous position— duties. Having a person with disability in the they are the least likely to be in employment, household also affects employment of other training, or education, compared with their household members, particularly women. In peers (ILOSTAT 2022). the Latin America and the Caribbean Region, for example, between five and seven out of Lack of Assets and Credit ten female household heads in families with Impedes Female Entrepreneurship disabilities are unemployed (Garcia Mora, Because of barriers to formal employment, Orellana, and Freire 2021). Women report many people with disabilities work in being unavailable to work because of unpaid the informal labor market, including as domestic obligations nine times more often entrepreneurs. But starting a business than men (43 percent versus 5.2 percent), requires assets or the ability to get a loan. including providing care to persons with Globally, there are significant gender gaps disabilities. This exacerbates gender gaps in in entrepreneurship and financial inclusion. employment, including an overrepresentation According to recent data by the World Bank’s of women working in informal and care work. Women Entrepreneurs Finance Initiative In Latin America and the Caribbean, for (WeFi) Entrepreneurship Database, women example, women perform 80 percent of all represent only one-quarter of new business domestic tasks, which includes caretaking owners and directors. According to the 2021 for family members with disabilities. In Chile, Global Findex Database, 74 percent of men 80 percent of all adults with disabilities in developing countries have a bank account, who receive personal assistance get it from compared with only 68 percent of women. a household member; 74 percent of the Lack of credit is one of the most significant caretakers are daughters, wives, or partners; hurdles for women to become successful and 94 percent of the care work is unpaid entrepreneurs. Data show that women are left (Garcia Mora, Orellana, and Freire 2021). This with an estimated $1.7 trillion of unmet credit situation can shift if more attention is given to demand (IFC 2017). Because of patriarchal the economic benefits of supporting human gender norms and legal barriers, women are capabilities and recognizing the value of care less likely to own property that might generate work (Folbre 2006). This includes the notion credit, including land. A study across 10 that people are the real worth of nations, countries in Africa found that only 12 percent and that public investment in care can pay of women reported owning land individually, off by increasing productivity not only for compared with 31 percent of men (World Bank persons with disabilities but also for other 2022b). It is assumed that these gaps are family members. Because women are often greater for women with disabilities, despite the the caretakers and those being cared for, it is lack of data. critical to use both a gender and disability lens when thinking through policies and financing of care. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 62 Emerging Practices in ● Reasonable accommodations: Employment and Entrepreneurship Appropriate accommodations that support people with disabilities to work, such as ● Effective affirmative action to adjustable desks and accessible toilets in promote employment: This can include the workplace, when also considered from entrepreneurship support programs; a gender perspective can contribute to inclusive or targeted public procurement employment sustainability among women measures; financial incentives for employers with disabilities (UN Women 2021). (for example, wage subsidies, reduction in social charges); quotas; and supported ● Digital technologies to ensure that social employment (CRPD Committee 2021; ILO protection and labor market systems and OECD 2018). However, these measures are accessible: These should include should not lead to isolation of workers measures to increase digital skill building with disabilities (box 3.5). In addition, among women with disabilities, especially information gathered from quota systems in developing countries, because women across 18 countries in Latin America and with disabilities are less likely to be digitally the Caribbean showed that to be effective, literate and are less likely to be employable quotas need to be paired with human without these skills (Tyers-Chowdhury and capital strengthening such as inclusive Binder 2021). education, skills matching, and awareness campaigns to dispel negative stereotypes (Garcia Mora, Orellana, and Freire 2021). Box 3.5 Isolation of Workers with Disabilities through Sheltered Workshops The merits of employment incentives to include persons with disabilities in the workforce are heavily debated. Arguments in favor of sheltered workshops, where persons with disabilities work in separated environments outside the “regular” labor force, stress their ability to provide work adapted to different types of disability and levels of severity. However, these workshops can leave workers with disabilities isolated and at risk of financial exploitation, and they do not foster the ability to transition to formal employment. A study that surveyed more than 200 workers with intellectual disabilities showed that a majority would prefer working outside of sheltered workshops and would feel comfortable doing so with adequate assistance. Efforts should thus be made to significantly improve the number of persons with disabilities who participate in the mainstream labor market. Sources: Braunmiller and Dry 2022b; Hoffman 2013; Migliore et al. 2007; UNDESA 2018. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 63 World Bank Operations in St. Lucia: Integrating Women with Disabilities into the Labor Market Children with disabilities are often enrolled in special schools, which do not provide them with skills that would help them enter the workforce. The Saint Lucia: Human Capital Resilience Project seeks to improve the labor market relevance of skills of vulnerable groups by strengthening vocational education (rationalizing existing courses, adding new offerings, providing financial assistance to low-income students, and supporting internships and job placements). It also aims to create an enabling environment, especially for women and persons with disabilities, through training instructors and wider awareness-raising activities to increase inclusion and counteract gender and disability stereotypes. Three Key Questions to Ask on Employment and Entrepreneurship of Women with Disabilities during the Project Cycle 1. Data: Are labor force data disaggregated by both gender and disability? 2. Frameworks: Do labor laws and policies expressly promote the inclusion of women with disabilities, and if so, how (quota system, wage subsidies, financial incentives)? Do national laws ban discrimination in the workplace based on both gender and disability? Are female employees with disabilities entitled to reasonable accommodations in both the private and public sectors? Do women with disabilities have access to finance and banking services? 3. Program: To what kinds of training and vocational programs do women with disabilities have access? Are there programs specifically for digital skills training? Source: Tim Mossholder, Unsplash. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 64 Sample Project Indicators to Measure the Inclusion of Women with Disabilities in Employment and Entrepreneurship ⊕ National laws or policies adopted to promote nondiscrimination and access to work based on disability and gender ⊕ Percentage of women with disabilities active in the formal and informal labor force ⊕ Labor force characteristics for women with disabilities, including age and distribution across public and private sectors, occupational sectors, and leadership roles ⊕ Percentage of women with disabilities attending and completing training and vocational programs ⊕ Share of women with disabilities benefiting from employment promotion programs (quota, wage subsidies) ⊕ Average earnings of (different impairment groups of) women with disabilities compared with other women and with men with disabilities ⊕ Share of women with disabilities benefiting from accessibility and/or reasonable accommodation measures in the workplace ⊕ Share of women with disabilities with access to finance and banking services but disability benefits may not be enough to c. Social Protection guarantee income security if the increased costs of living associated with a disability Poverty is higher among are not taken into account (UNDESA 2018b). persons with disabilities than Furthermore, many programs are based on persons without disabilities. contributions and thus do not reach persons with disabilities in the informal sector or Persons with disabilities are more likely outside the labor market. Because many to encounter greater daily living costs, social protection programs rely on public including health-related expenses and awareness campaigns (which may not be expenses for assistive devices, interpreters accessible) and medical assessments (which and personal assistants, service animals, are often available only in centralized places), or transportation. Yet only 33.5 percent of the majority of people with disabilities have persons with severe disabilities worldwide little access, especially those who are more receive disability benefits, and in low-income marginalized, such as women. For example, a countries, coverage can be as low as 8.6 study carried out in rural areas in India in late percent (ILO 2021). Almost all countries offer 2005 revealed that 94 percent of households disability-specific social protection programs, Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 65 with persons with disabilities had not heard may disadvantage women with disabilities of the Persons with Disabilities Act of 1995 beyond their impairment (UNDESA 2018b; and its associated entitlements, and that 60 ILO and International Disability Alliance percent of persons with disabilities in rural 2019). areas had not heard of the country’s disability ● Digitalized systems: These have the pension (UNDESA 2018b). potential of ensuring better access to social The risk of poverty is even higher for women protection and coverage if accompanied with disabilities because they are more likely with measures to ensure digital inclusion to be out of the labor force, or when employed, of women with disabilities, especially in they tend to be in informal or part-time developing countries. employment. Additionally, they tend to receive lower wages because of gender and disability- related barriers in education and employment Increasing Access to Social (Special Rapporteur on the rights of persons Protection for Women with with disabilities 2015; ILO 2015). Designing and Disabilities through Universal ID implementing social protection programs in Coverage and Unconditional Cash an inclusive manner can ensure that women Transfers with disabilities are able to cover basic needs critical for their inclusion in society and the A study in Nigeria by the Identification for workforce. Development initiative revealed that women and other marginalized groups were often deprived of national ID cards and access Emerging Practices to government services and were more in Inclusive Social Protection vulnerable to poverty and exclusion (World Bank 2021a). The risk was particularly high for ● Independent living and women with disabilities. The Nigeria Digital deinstitutionalization: Social protection Identification for Development Project seeks systems should empower all women with to increase the number of persons holding a disabilities to live independently and be national ID card to facilitate access to health included in the community. This should and social protection services, especially include choice of their place of residence among women. Both gender and disability and access to community services and dimensions were considered in creating facilities and to individualized personal an inclusive and accessible ID system—for assistance and assistive technologies. example, ensuring universal coverage through Institutionalization in all forms should be an enabling legal and regulatory framework, avoided (CRPD Committee 2016). using mobile equipment to reach populations instead of requiring beneficiaries to travel to ● Universal social protection coverage: enrollment centers, and developing flexible Social protection should specifically exception handling mechanisms for those include women with disabilities to ensure unable to produce birth certificates and effective access and outreach and improve biometrics. coverage, considering social factors that Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 66 The Tanzania Productive Social Safety Net ● The project identifies persons with Project II aims to improve access to income- disabilities as potentially subjected earning opportunities and socioeconomic to discrimination. It carried out an services for targeted poor households while assessment to determine whether persons enhancing and protecting the human capital with disabilities had been subjected to of their children. Three factors make it a good discrimination, highlighting this population practice example on disability and gender as vulnerable from the beginning of project inclusion: preparations. ● Persons with disabilities are included ● Persons with disabilities are highlighted in in the project components, notably the the policies and procedures of the project’s provision of unconditional cash transfers to labor management procedures report. households with persons with disabilities. Gender is mainstreamed throughout the project. It focuses on women as the main recipient and includes an action plan for addressing gender issues. Three Key Questions to Ask on Sample Project Indicators to Social Protection and Women with Measure Inclusion of Women with Disabilities during the Project Cycle Disabilities in Social Protection 1. Data: Are social protection data available ⊕ Inclusion of women with disabilities as and disaggregated by both gender and target population for social protection measures disability? ⊕ Number of women with disabilities 2. Frameworks: Do social protection policies receiving social security payments or cash contain specific measures to support transfers independent living and income security, such as coverage of extra costs related to ⊕ Percentage of women with disabilities disability, and access to employment for receiving disability benefits and other types women with disabilities? of social assistance ⊕ Percentage of extra costs for women with 3. Program: Are social protection services disabilities covered by social protection physically, informationally, and digitally measures accessible to women with disabilities? How flexible and user-friendly are the ⊕ Social protection buildings and services, procedures? including digital services, that are accessible to women with all types of disabilities ⊕ Social protection providers trained on gender and disability inclusion Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 67 Source: Tim Mossholder, Unsplash. d. Gender-Based Violence Girls and women with disabilities are at heightened risk of sexual abuse, exploitation, and violence that goes undetected (World Bank 2019a). The risk is even higher for girls with intellectual or psychosocial disabilities. Often, their dependence on financial and personal support—coupled with social isolation or limited physical mobility or means of communication—places them in a particularly vulnerable position. Poverty, conflict, and social stigma are additional aggravating factors (World Bank 2019a). Sexual violence, abuse, and exploitation can take various forms and include intimate and nonintimate partner violence, and online and in-person exploitation and abuse. Global data on GBV against women and disabilities is limited, which indicates a largely invisible crisis (UNFPA 2018). The limited data available suggest that women with disabilities are up to 10 times more likely to experience violence than nondisabled women (ACPF 2010; Dunkle et al. 2018; Ozemela, Ortiz, and Urban 2019). Between 40 percent and 68 percent of young women with disabilities experience sexual violence before age 18 (OHCHR 2020). Another study based on evidence from Sub-Saharan Africa and South Asia showed that women with disabilities are nearly twice as likely to have experienced domestic violence in the past year compared with women without disabilities, and that the likelihood of recent domestic violence increases with the severity of the disability (Chirwa et al. 2020). Stigma and attitudes exacerbate the issue. Data across 35 countries show that although 30.7 percent of women with no functional difficulties think that a husband is justified in hitting his wife, this figure increases to 38.3 percent for women with “at least a lot of difficulty” (Mitra and Yap 2022). Yet women and girls with disabilities, especially those with intellectual or psychosocial disabilities, often lack access to GBV support services and legal mechanisms. The COVID-19 pandemic has exacerbated GBV worldwide and has further limited or disrupted access to support services for the survivors (UN Women 2021). In addition, in many places around the world, the families of girls and women with disabilities force these women and girls into marriages because they cannot care for them or are trying to ensure their long-term security. In some countries, marriage is thought to remove the stigma of a disability or “cure” it (World Bank 2019a). GBV causes trauma and injury but also has long-term consequences on the survivors’ physical and mental health. It can negatively affect their ability to sustain employment or attend school and can lead to personal, social, and economic isolation and poverty. GBV also has enormous costs on society and reduces economic growth. Ensuring that women and girls with disabilities have a life free of violence and empowering survivors to overcome trauma and stigma requires a holistic and multisectoral approach. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 68 Emerging Inclusive Assessing GBV-Related Risks as Practices to Address GBV Part of a Development Response to Displacement Impacts in Uganda ● Network-oriented interventions, which recognize the need to build connections Uganda currently hosts the third largest between survivors with disabilities refugee population in the world (approximately and other survivors and activists, 1.2 million), the majority of whom are women practitioners, and organizations working and children. The World Bank scaled up on GBV prevention, are an effective way activities under the Development Response to integrate women with disabilities into to Displacement Impacts Project in the Horn efforts to address GBV. This can be done, of Africa, supporting access to basic social for example, by including women with services in refugee-hosting communities. In disabilities in gender- and age-appropriate this context, an assessment was conducted in focus groups assessing GBV approaches Uganda’s refugee-hosting districts to identify (World Bank 2019a). key risk factors for GBV, map services, and provide recommendations (Government of ● Multisectoral strategies, which aim to Uganda and World Bank 2020). The report coordinate the actions and programs recognized that GBV against women and of various institutions (police, justice girls (especially intimate partner violence) system, and health and social services) was prevalent in both refugee and host and develop a common approach based communities, with disability (and childhood) on interinstitutional partnership and an aggravating factor, and that existing cooperation, can improve the quality of services were uncoordinated and inaccessible services offered to GBV survivors and in situations of intersecting GBV. increase their safety (UNFPA EECARO 2015). Three Key Questions to Ask on GBV and Women with Disabilities during the Project Cycle 1. Data: Are data on gender-based violence disaggregated by gender and disability? 2. Frameworks: Do national laws prohibit gender-based violence, especially against women and girls with disabilities? 3. Program: Do women and girls with disabilities have effective access to information and complaint mechanisms? Are support services addressing violence accessible (such as shelters, health services, social protection)? Are GBV stakeholders adequately trained to address women and girls with disabilities? Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 69 Sample Project Indicators to Measure Inclusion of Women with Disabilities in GBV Programs ⊕ Data on gender-based violence disaggregated by gender and disability ⊕ Percentage of women and girls with disabilities who are survivors of domestic violence, rape, or sex trafficking, including online sexual exploitation ⊕ Number of sexual exploitation, abuse, and harassment cases brought to authorities and/or workplace complaints logged with employers by women and girls with disabilities ⊕ Percentage of women with disabilities among persons who contacted GBV help lines and benefited from GBV support services ⊕ Percentage of women and girls with disabilities benefiting from GBV-program activities ⊕ Percentage of shelters and/or GBV-response information accessible to women and girls with disabilities ⊕ Number of women and girls with disabilities who have received training on GBV, including online sexual exploitation e. Health Persons with disabilities need general physical and mental health services like everyone else and specialized services related to their disability (for example, surgery, specific medication, or assistive devices). Some are more susceptible to injury and infection and are more likely to develop secondary conditions because of their disability (OHCHR 2020). Yet persons with disabilities have poorer access to health services, compared with persons without disabilities. Globally, persons with disabilities are less likely to be able to afford health care and more at risk of suffering catastrophic health expenditure (WHO and World Bank 2011). The risk of exclusion from health care is even higher for women and girls with disabilities (WHO and World Bank 2011). Compared with men with disabilities, women with disabilities are three times more likely to have unmet health care needs than men without disabilities (UNDESA 2018a). Access to sexual and reproductive health services is particularly challenging (Special Rapporteur on the Rights of Persons with Disabilities 2017). Limited evidence from a few developing countries shows that 29 percent of births by women with disabilities are not attended by a skilled health care worker, gaps compared with nondisabled women being particularly high in rural areas. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 70 Source: Tim Mossholder, Unsplash. Additionally, an average of 22 percent of disabilities have access to health services, women with disabilities have unmet family medicine, and vaccines without suffering planning needs (UNDESA 2018a). Coerced financial hardship. and forced sterilization against persons with ● Participatory practices: Health care disabilities is a harmful, discriminatory practice models, which empower patients to actively that continues today (National Women’s Law participate in decision-making about their Center 2022). Evidence shows that women treatment, can improve health outcomes with intellectual and psychosocial disabilities and patient satisfaction and reduce costs are particularly at risk of being coerced or (WHO 2016). This requires providing forced to be sterilized (Servais et al. 2004; women and girls with disabilities, especially WHO 2014). those with intellectual disabilities, with Access to health care is often denied for adequate information in accessible format women with disabilities. A study conducted and in easy-to read or plain language, so in India, for example, found that medical that they can make meaningful choices. professionals held stigmatizing views of Health-related policies should be developed disability as a problem to be fixed, and it and implemented with the participation exposed other barriers in accessing medical of persons with disabilities across the full facilities and devices, such as inadequate range of disability (UNDESA 2016). height of examination tables, inaccessible ● Community-based rehabilitation and bathrooms, and the lack of sign language health care: Community-based health interpreters and assistants during medical services delivered outside the clinic (for checkups and procedures (Salian 2022). example, through mobile health units, Developing inclusive health care systems is home care, or outpatient visits) are more vitally important because the number of people effective than institutional care. They ensure with disabilities is increasing worldwide, better access to services, especially for particularly women with disabilities. rurally based women with disabilities, and can promote independent living within the community. In one longitudinal study Emerging Practices of a community-based rehabilitation in Inclusive Health program in Afghanistan, results indicated improvements in overall well-being of ● Universal health coverage: All women persons with disabilities, even in a conflict with disabilities should have access to context (Trani, Vasquez-Escallon, and health services. Universal health coverage Bakhshi 2021). can help ensure that women with Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 71 Expanding Availability of Inclusive Health Services through World Bank Operations in Tuvalu The World Bank’s Health System Strengthening Project in Tuvalu aims to boost the delivery of health services, incorporating both disability and gender considerations. No specific strategies are currently in place for addressing gender inequalities in health care. In addition, unmanaged onset of diseases is a top risk factor for disability, especially among women. Planned activities include upgrading sanitation facilities in health clinics so that they are accessible for women and persons with disabilities; strengthening clinical capacities (for example, diagnostic services, surgery) and general screening programs for all the adult population, coupled with awareness-raising and outreach activities to reduce the risk of acquired disabilities; investing in inpatient mental health services and rehabilitation (patients with mental health problems are often held in local jails) and social service counseling for GBV survivors; purchase of field vehicles for specimen collection and outreach and communication technology equipment for remote consultation; digitalizing patient records; and organizing short, frequent, and online practical trainings for human resources, with a special focus on GBV-detection. Three Key Questions for Task Team Leaders to Ask on Inclusive Health Access during the Project Cycle 1. Data: Are data on health disaggregated by both gender and disability? 2. Frameworks: Does the health law ensure that health facilities and information are accessible to and affordable for women and girls with disabilities? 3. Program: Are disability-specific health services and assistive technologies widely available? Are health care workers trained on how to manage the health needs of women and girls with disabilities? Sample Project Indicators to Measure Inclusive Health Care ⊕ Percentage of girls with disabilities who have received full immunizations ⊕ Percentage of women and girls with disabilities who have access to general health services, reproductive health services, and health care information ⊕ Number of women and girls with disabilities who have been subjected to (forced) sterilization ⊕ Percentage of health care facilities that provide disability-specific services ⊕ Percentage of health care facilities equipped to receive women and girls with disabilities ⊕ Number of health personnel trained on gender and disability inclusion Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 72 Source: Unsplash. f. Digital Development Rapid digital transformation has created new jobs and expanded access to the labor market. Globally, more than 90 percent of jobs have a digital component (Tyers-Chowdhury and Binder 2021). Online platforms have provided girls and women with disabilities with new pathways to communicate, interact, and receive information. Digital assistive technologies and adaptive devices are increasingly important in promoting independent living and enabling access to education, transportation, health, social protection, finance, e-government, and other services in a cost-effective manner (Raja 2016). Women and girls with disabilities are at high risk of being deprived of digital technology’s benefits. Although the role of gender and disability in mobile use varies by country, women with disabilities have among the lowest rates of mobile and smartphone ownership, and barriers include lack of perception of benefits, literacy, digital skills, and safety concerns (GSMA 2020). Promoting the Inclusion of Women with Disabilities through Artificial Intelligence Bridging the digital divide has become critically important to the socioeconomic inclusion of women and girls in an increasingly digitalized world. Artificial intelligence offers enormous opportunities for persons with disabilities. Smart software, particularly in assistive technology, can promote independent living for persons with different types of impairments and improve access to services and benefits through automated data processing. However, it also entails significant risks that need to be regulated with the active consultation of persons with disabilities, including women with disabilities (Special Rapporteur on the Rights of Persons with Disabilities 2021). Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 73 Addressing Barriers to Digital Skills for Girls and Women with Disabilities in Uganda The Uganda Digital Acceleration Project aims to support digital economy transformation by expanding access to high-speed internet, digitizing government services, and creating an enabling environment, among others, for women and persons with disabilities. Activities under this project include expanding internet access to places where women and other marginalized groups can safely use it, designing and implementing government e-services considering both gender and disability, supporting digital skills training for persons with disabilities and women (especially women-owned small and medium enterprises), and addressing the needs of persons with disabilities for connectivity by providing assistive technologies. Three Key Questions to Ask on Digital Skills and Women with Disabilities during the Project Cycle 1. Data: Are data on digital access and inclusion available and disaggregated by both gender and disability? 2. Frameworks: Are any measures in place to protect girls and women with disabilities against online bullying, abuse, and exploitation? 3. Program: Are any programs in place to help women and girls with disabilities access education and training on digital skills and digital safety and to afford digital technologies? Sample Project Indicators on Digital Access and Inclusion ⊕ Percentage of women and girls with disabilities who own and use technological devices (for example, mobiles phones, smartphones, laptop, tablets) and benefit from digital assistive technology and adaptive devices ⊕ Social protection coverage for digital technologies, especially for health, education, and employment purposes ⊕ Training programs on digital skills and digital safety for girls and women with disabilities ⊕ Number of reported incidents of cyberbullying, sexual abuse, and financial exploitation against women and girls with disabilities Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 74 As global pressure on water resources g. Water increases (also because of climate change), it is vitally important that the needs of women Access to water is a fundamental and girls with disabilities are not excluded. human right and a vital underpinning Natural disasters disproportionately affect of good health and socioeconomic both women and persons with disabilities. inclusion. For example, a WBG study on inclusion and mobility in Kumasi, Ghana, showed that when Contaminated or inadequate drinking water flooding occurs, people with disabilities are and poor sanitation and hygiene can cause more likely than other groups not to travel diseases and dehydration, affect physical and because of the impact of the floods on mobility mental health, and even lead to death. About and safety (Arroyo and Dominguez Gonzalez 2 billion people worldwide do not have access 2023, forthcoming). to safely managed drinking water, 3.6 billion people do not use safely managed sanitation services such as private toilets and latrines, Emerging Practices and 2.3 billion lack basic handwashing in Access to Water facilities (WHO and UNICEF 2021). Evidence suggests that the risk of exclusion is even ● Innovative technologies: Innovative higher for persons with disabilities because technologies are increasingly important to they face specific attitudinal, infrastructural, improving access to clean and safe water and environmental barriers in accessing water and sanitation, especially for persons with resources and sanitation facilities (World disabilities, while conserving and protecting Bank 2017a). Dependency on others for water resources and improving water accessing water resources such as drinking, resilience worldwide. sanitation, hygiene, and irrigation can result in adverse and unsafe personal consequences, ● Participation: Inclusive water policies particularly for women with disabilities, for and programs should ensure that persons example, an increased risk of sexual and with disabilities, particularly women, financial exploitation (World Bank 2017a). participate in decision-making processes Women and girls with disabilities face great and procedures regarding water planning, challenges in managing their personal hygiene management, and delivery. in a dignified and healthy way because of ● Universal design: Accessible, safe, and inaccessible or insufficient infrastructure and inclusive water supply, sanitation, and the double stigma attached to disability and hygiene facilities based on universal menstruation (UNICEF 2021a). They are often design benefit everyone in the community, unable to use water supply, sanitation, and including elderly persons, families with hygiene facilities whenever they need, even young children, pregnant women, and within their own home. persons with injuries or ill health. Source: Tim Mossholder, Unsplash. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 75 Inclusive Responses to Water and Sanitation Challenges in Indonesia A World Bank project in Indonesia focused on inclusive water development and access through community participation. The Water Supply and Sanitation for Low Income Communities Project (PAMSIMAS) supported the government in providing universal access to water for its population by supporting sustainable water supplies for underserved rural and peri-urban populations (World Bank 2020b). The program has promoted the active participation of marginalized groups, including women and persons with disabilities, at all stages of the process, for example, by holding community meetings in accessible venues, checking the facilities to assure accessibility, and developing inclusive water facility specifications technical standards. In constructing disability- inclusive school water supply, sanitation, and hygiene facilities, the incremental costs for items such as ramps and rails were found to be marginal or nonexistent relative to the much larger costs of pipes and pumps of the water supply and sanitation system. Thus, disability inclusion is a modest amount if incorporated at the beginning of the activities. Retrofitting, however, would be substantially more expensive. Three Key Questions on Inclusive Water Access to Ask during the Project Cycle 1. Data: Are data on access to safe drinking water and safe sanitation and hygiene facilities disaggregated by both gender and disability? 2. Frameworks: Are any measures in place to prevent and combat violence against girls and women with disabilities in the water supply, sanitation, and hygiene sector, especially when using communal facilities? 3. Program: Do schools, health care facilities, transportation systems, government buildings, workplaces, and other key institutions have water supply, sanitation, and hygiene facilities accessible and safe to use for women and girls with disabilities? Source: Tim Mossholder, Unsplash. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 76 Sample Project Indicators on Inclusive Water Supply, Sanitation, and Hygiene Projects ⊕ Percentage of women and girls with disabilities who have access to safe drinking water ⊕ Percentage of public services (schools, health care facilities, transportation systems) with safe and accessible sanitation facilities for girls and women with disabilities ⊕ Percentage of households where women with disabilities have access to an adequate sanitation facility ⊕ Availability of financial support for water-related costs in health and social protection systems for women with disabilities ⊕ Percentage of girls and women with disabilities trained in personal hygiene and safety measures in water supply, sanitation, and hygiene about transportation scheduling (World h. Transport Bank 2022c). For example, women have and Urban Planning different trip patterns than men because of their social and economic roles, including Transport plays an essential role in household and caretaking duties, which socioeconomic stability and has been can influence the transportation modes shown to be the largest challenge they use and the distance and frequency to participation in the labor force in of travel (Borker 2022a; Borker 2022b; developing countries (ILO 2017). Sustainable Mobility for All 2017). Women and girls also face different constraints from Mobility constraints are a major factor in the men, especially relating to safety, which marginalization of persons with disabilities can influence their travel choices. Because and such constraints exacerbate personal, women and girls with disabilities rely on social, and economic isolation (World Bank transit as an essential means of integration 2015). Inclusive transportation systems enable and are perceived as vulnerable, they are persons with disabilities to access education, hardest hit by the violence and crime that employment opportunities, health care, can exist in environments related to public and any other service and place intended transportation, such as overcrowding, time for public use. Ensuring that women and spent waiting, low-lit areas, and lack of girls with disabilities can effectively access monitoring. Actual or perceived danger can transportation requires more than providing cause them to take circuitous routes or seek physical access to vehicles or to information to change employment schedules, affecting Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 77 Source: Mari Koistinen, World Bank their economic standing (Iudici, Bertoli, ● Smart technologies: New assistive Faccio 2017). In addition, women and girls technologies, especially artificial with disabilities may forego using even free intelligence-enabled systems (for example, services, such as health care or education, navigability tools, virtual maps, accessible if they must pay for transportation, including routes tracking), can significantly improve for someone supporting them such as a mobility and transportation services for family member or personal assistant (World persons with disabilities (UN Special Bank 2022c). Including women and girls with Rapporteur on the Rights of Persons with disabilities in transportation requires a holistic Disabilities 2021). approach that incorporates both a gender and disability dimension to help address a multitude of barriers, including accessibility Universal Design issues, safety concerns, harmful social norms, and Gender Considerations and lack of funds. The principle of universal design ensures that spaces, structures, and objects are designed Emerging Practices considering all people regardless of age, size, in Transportation or disability. However, attention also needs to be paid to the intersection of these areas with ● Trip chaining: Making means of gender. This requires considering elements transportation accessible is not enough. It such as cost, safety, and violence prevention is essential that all steps along the route are when deciding on location, lighting, and other accessible. Inclusive transportation system factors. Systematically including women with design should consider every link in the trip disabilities as stakeholders in project design, chain (for example, accessible pedestrian implementation, and evaluation is one way streets, accessible ticketing services) to to ensure that both gender and disability are improve usage. considered. Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 78 Construction of an Accessible and Safe Bus Terminal in Sri Lanka In Sri Lanka, the Kandy Multimodal Transport Terminal Development Project seeks to enhance accessibility, efficiency, and safety for public transportation users of a central bus terminal. The project proposes to incorporate both disability- and gender-inclusion standards. For example, the terminal is expected to be built based on universal design principles and will include women-only waiting areas, breastfeeding rooms, and well-lit sanitation facilities. Safe and disability-friendly walkways will be developed to ensure easy access to the station, and special focus will be placed on safety from sexual harassment—for example, inclusion of a kiosk and hotline to report sexual harassment incidents, signage, and messaging to reduce sexual harassment of female commuters; training drivers and conductors; and developing protocols for bystander intervention. Three Key Questions to Ask during the Transport Project Cycle 4. Data: Are data on access, use, safety, and demand for transportation services disaggregated by both gender and disability? 5. Frameworks: Do social assistance programs offer women and girls with disabilities compensation or other forms of financial support for transportation costs? 6. Program: Are safe and accessible transportation routes to schools, health centers, markets, and other important public service settings available? Sample Indicators for Gender and Disability-Inclusive Transport Projects ⊕ Policies adopted that establish universal design principles and reasonable accommodation measures in both public and private transportation systems ⊕ Percentage of people using public transportation who are women and girls with disabilities ⊕ Percentage of women and girls with disabilities experiencing difficulties in accessing education, employment, and health care because of the lack of accessible or safe transportation ⊕ Share of women and girls with disabilities benefiting from financial assistance for transportation purposes ⊕ Reported incidents of violence against women and girls with disabilities during transportation Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 79 are critically important. Understanding the i. Fragility, Conflict, and range of barriers, (including disability-related Violence and Disaster Risk barriers, gender inequality, and higher risk of Management violence) experienced by diverse women and girls with disabilities is the first step in sound Conflict, violence, disaster, and planning (Erman et al. 2021; Balikisu, Escobar humanitarian emergencies Saenz and Trohanis 2022). Stakeholder engagement—bringing women with disabilities affect persons with disabilities into the conversation—is vital to building this disproportionately. understanding and recognizing women with In addition, conflict, disaster, and humanitarian disabilities as significant agents of change disasters often result in an increase in the and not just victims (as outlined in the Sendai number of persons who acquire disabilities Framework for Disaster Risk Reduction 2015– (CRPD Committee 2015). Persons with 2030). Building resilience in advance through disabilities are particularly exposed to negative social protection programs and involving socioeconomic impacts both during and in the women with disabilities in reconstruction post aftermath of a disaster. They are more likely to disaster are some ways to build back better be left behind during evacuation, to be injured, (World Bank 2022a). and unable to reach humanitarian assistance. The death rate for persons with disabilities during times of conflict and disaster is Emerging Practices: Gender–and estimated to be at least twice as high as that Disability–Sensitive Disaster of other affected populations (HI, CBM, and Management International Disability Alliance 2020). Women and girls with disabilities are in an even worse ● New technologies: Digital technologies situation because they must also overcome can improve the capacity of persons with gender-specific barriers and inequalities disabilities and their families and response (CEDAW Committee 2018). Women are personnel, community workers, and disaster exposed to higher levels of violence, morbidity, management authorities to prepare better, and mortality than men. For example, during respond quickly, and access disaster relief the 2004 Indian Ocean tsunami, between 70 services more easily (Raja 2016). and 80 percent of the victims were reported ● Inclusive leadership: Including women to be women (ESCAP 2022). Women and girls with disabilities in disaster management with disabilities are among the first groups to processes and allocating positions of lose access to essential goods and services leadership and responsibility to them such as water, food, shelter, basic nonfood can better ensure that their needs are items (including menstrual hygiene products), addressed but also help change stereotypes and health services. They are also more and foster positive social perceptions. likely to be pushed further into poverty in the aftermath of a disaster (ESCAP 2022; CBM, HI, ● Cost efficiency: Integrating disability and International Disability Alliance 2020). inclusion into social protection systems to build resilience and into management As the frequency of natural and constructed preparedness and recovery at the outset disasters is anticipated to worsen, inclusive benefits all affected populations and helps disaster management and recovery systems lower the cost versus retrofitting later on that can guarantee access to protection and (Uzair, Balog-Way, and Koistinen 2021). safety for girls and women with disabilities Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 80 Adaptation of Public Buildings Critical to Disaster Response in Romania WBG Task Teams are increasingly focusing on disability- and gender-inclusive measures to prevent and respond to disasters. For example, in Romania, the Strengthening Disaster Risk Management Project seeks to improve the seismic safety and structural resilience of public buildings that have a critical function in disaster and emergency response, such as fire stations. All new constructions, upgrades, and retrofitting are based on gender- and disability-inclusive design, for example, gender-sensitive dormitories, safe bathrooms and sanitary facilities, and universal access principles. Female professional and volunteer staff using the buildings are direct beneficiaries of the project. Three Key Questions to Ask during the Project Cycle 1. Data: Are data on populations affected by disaster management and recovery disaggregated by both gender and disability? 2. Frameworks: Have national procedures for evacuation, humanitarian assistance, recovery, and reconstruction been informed by women and girls with disabilities? What budget has been allocated to address their needs? 3. Program: Do women and girls with disabilities have access to accessible evacuation and to shelters? Is safety from GBV a consideration for women and girls with disabilities during disasters and in recovery? Sample Project Indicators ⊕ Fatality rates during disasters among women and girls with disabilities ⊕ Share of women and girls with disabilities who have access to evacuation ⊕ Number of shelters adjusted to accommodate women and girls with disabilities ⊕ Share of women and girls with disabilities receiving humanitarian assistance (water, food, clothes, hygiene kits) ⊕ Number of reported incidents of gender-based violence against women and girls with disabilities during disaster ⊕ Number of women and girls with disabilities participating in disaster management planning Including Women and Girls with Disabilities in World Bank Operations / Toolkit / 81 Chapter 3: References African Child Policy Forum (ACPF). 2010. 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