Disability Inclusion in Nigeria A Rapid Assessment B Disability Inclusion in Nigeria A Rapid Assessment © 2020 International Bank for Reconstruction and Development/World Bank 1818 H Street NW, Washington, DC 20433 202-473-1000 | www.worldbank.org Some rights reserved. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of the World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of the World Bank, all of which are specifically reserved. Rights and Permissions The material in this work is subject to copyright. Because the World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. 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Photo credits: CBM International except p. 90: Arne Hoel / World Bank ii Contents Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii 1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Objective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Research Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 Statement of the Problem and Justification for the Study . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Study Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Sampling and Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Ethical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 4 Review of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Disability Data in Nigeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Cultural Beliefs, Stigma, and Discrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Impacts of Intersectionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Barriers to Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 State Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 5 Conclusions and Key Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Capacity Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Establishment of National and State Platforms for Disability Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Medium- or Large-Scale Local Manufacturing of Assistive Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Stigma Reduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Disability Data Generation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 iii Figures 1 Prevalence of Functional Difficulties in Nigeria in at Least One Domain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii 4.1 Prevalence of Functional Difficulties in Nigeria in at Least One Domain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 4.2 Level of Difficulty in at Least One Domain Among People with Functional Difficulty in Nigeria . . . . . . . . . . . . . . 12 4.3 Prevalence of “Some Difficulty” by Functional Domain and Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4.4 Prevalence of More Severe Difficulties by Functional Domain and Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4.5 Educational Attainment by Functional Difficulty Among Women and Girls Ages 6 to 30 . . . . . . . . . . . . . . . . . . . . . 13 4.6 Wealth Outcomes by Functional Difficulty Among Men and Women Ages 18 to 40 . . . . . . . . . . . . . . . . . . . . . . . . . . 13 4.7 Ownership of Assets by Functional Difficulty Among Women Ages 15 to 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4.8 Employment by Functional Difficulty Among Women Ages 15 to 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4.9 Unpaid Employment by Functional Difficulty Among Women Ages 15 to 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Tables 1 Key Findings Matrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii 4.1 Key Findings Matrix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 iv Acknowledgments This report was commissioned by a team compris- Development Specialist; Deepti Samant Raja, Disabil- ing Varalakshmi Vemuru, Lead Social Development ity Consultant; Idowu Oguntuashe, former Permanent Specialist; Rosa Maria Martinez, Social Development Secretary in the Ekiti State Public Service; Theophilus Specialist; Michael Ilesanmi, Senior Social Development Odaudu, Program Officer for Nigeria Disability Rights Specialist; and Sabina Anne Espinoza, Social Inclusion Advocacy Fund; Dr. Irene Patrick-Ogbogu, Disability Consultant, Social Development Global Practice, World Rights Advocacy Centre; and Shola Omotosho, Social Bank. The report was prepared by Toyin Janet Ader- Development Adviser, Department for International emiIge, Social Development Consultant. Laura Johnson Development (DFID); as well as guidance from edited and designed the report, and Tesfahiwot Dill- Charlotte Vuyiswa McClain-Nhlapo, Disability Advisor, nessa provided administrative support. and Senait Assefa, Practice Manager, Social Develop- ment Global Practice. The team is grateful for the useful comments and suggestions of Mari Helena Koistinen, Senior Social v Abbreviations BMZ Federal Ministry for Economic INEC Independent National Electoral Cooperation and Development Commission (Germany) JONAPWD Joint National Association of Persons CBR community-based rehabilitation with Disabilities COCIN Church of Christ in Nations LASODA Lagos State Office for Disability Affairs COPE Care of the People MDA ministries, departments, and agencies CSO civil society organization NAPID National Association of Persons with Intellectual Disabilities DFID Department for International Development (United Kingdom) NDHS Nigeria Demographic and Health Survey ECWA Evangelical Church Winning All NGO nongovernmental organization ESSPIN Education Sector Support Programme in Nigeria OHCSF Office of the Head of Civil Service of the Federation FMWASD Federal Ministry of Women Affairs and Social Development OSHE occupational safety, health, and environment FMPWH Federal Ministry of Power, Works and Housing PEPUDA Promotion of Equality and Prevention of Unfair Discrimination Act GHS General Household Survey PERL Partnership to Engage, Reform and Learn HANDS Health and Development Support Programme UK United Kingdom IDEA International Association for Integration, UNICEF United Nations Children’s Fund Dignity and Economic Advancement USAID United States Agency for International Development Currency N = Nigeria Naira vi Executive Summary Background and face higher rates of multidimensional poverty than the general population. They encounter attitudinal and According to the World Health Organization, in 2018, environmental barriers that hinder their full, equal, about 29 million of the 195 million people who com- and effective participation in society. Their lower rates prise Nigeria’s national population were living with a of economic and labor market participation impose a disability. Data from the 2018 Nigeria Demographic greater welfare burden on governments and highlights and Health Survey reveal that an estimated 7 percent the costs of exclusion, which range from about 3 to of household members above the age of five (as well as 7 percent of gross domestic product (Buckup 2009). 9 percent of those 60 or older) have some level of diffi- culty in at least one functional domain—seeing, hear- Disability-inclusive development directly responds to the ing, communication, cognition, walking, or self-care; World Bank’s twin goals of ending extreme poverty and and 1 percent either have a lot of difficulty or cannot promoting shared prosperity; it is also directly linked to function at all in at least one domain (see figure 1). the Human Capital Agenda.1 The global development These estimated rates, while significant, are probably and poverty reduction agenda will not be effective even higher because currently available data likely unless it addresses the socioeconomic inequality of underestimate the prevalence. persons with disabilities and ensures their participation in all stages of development programs. The prevalence rate of disabilities is expected to 1. Human capital consists of the knowledge, skills, and health that people accumulate increase due to the impact of aging, war, conflict, nat- throughout their lives, enabling them to realize their potential as productive members of soci- ety. Investing in people through nutrition, health care, quality education, jobs and skills helps ural disasters, and forced displacement, among other develop human capital, and this is key to ending extreme poverty and creating more inclusive societies. The Human Capital Agenda pursued by the Bank is helping to create the political factors. As a group, persons with disabilities are more space for national leaders to prioritize transformational investments in health, education, and social protection through country and regional engagements, for example in South Saharan likely to experience adverse socioeconomic outcomes Africa. vii Figure 1. Prevalence of Functional Difficulties The Nigerian government has expressed a strong in Nigeria in at Least interest in working with the World Bank to strengthen One Domain programs and services for persons with disabilities. The Bank’s Social Development Global Practice, in Cannot do at all collaboration with the Nigeria Country Team, under- <1% A lot of took a rapid social assessment to better understand di culty 1% the challenges around disability inclusion across the Some various types of disabilities and to identify drivers and di culty 7% opportunities for inclusion that could be leveraged in a development context. Methodology No di culty This study included a desk review of published and grey 92% literature, a mapping of services, and an online ques- tionnaire-based assessment to document the barriers Source: NPC and ICF 2019: 458 based on Demographic and Health Survey data: faced by persons with disabilities; the prevalence of Nigeria DHS-VII (NDHS) 2018. Note: Functional domains are seeing, hearing, communication, cognition, walking, disabilities; available disability-related services, pro- and self-care. grams, and funding; existing legal frameworks and pol- icies; and the capacity of actors for disability inclusion. Nigeria recently signed the national-level Discrimi- Findings from the literature review also guided the May nation of Persons with Disabilities (Prohibition) Act 2019 collection of qualitative data from government 2018—a major disability inclusion milestone indicative officials, organizations of persons with disabilities, of the Nigerian government’s increasing prioritization disability-focused organizations, and individuals with of disability mainstreaming. Prior to the signing, a few disabilities, using key informant interviews and focus Nigerian states had enacted similar laws, which are group discussions. Persons with disabilities shared currently being implemented to varying degrees. There their experiences of attitudinal and structural barriers is no existing documentation of progress made to date to accessing education, health services, employment, or of lessons learned from the implementation of these information and communications, transportation, laws, which could otherwise be drawn on for the imple- assistive devices and technology, and social protection. mentation of the national law. Doing nothing to address the challenges faced by per- sons with disabilities in Nigeria will have consequences Findings for individuals as well as for the country as a whole, Summarized below are the study’s findings regarding which bears the greatest burden. Given the vicious the prevalence of disabilities, stigma and discrimina- cycle of disability and poverty, excluding persons with tion, education, health, community-based rehabilita- disabilities from accessing basic services would impact tion, assistive devices and technology, employment the country’s economy enormously. and social protection, public information and viii communications, electoral and political processes, In 2018, for the first time, the Nigeria Demographic and public transportation, legal frameworks, and the insti- Health Survey included questions in its disability mod- tutional landscape. ule that were based on the Washington Group’s Short Set. The survey’s estimated disability prevalence rate Availability of Data of around 8 percent is still significantly lower than the Disability-related data are sparse in Nigeria. Data World Health Organization’s 2011 estimate of around collection challenges include the government’s low 15 percent of the global population (WHO and World prioritization of collecting disability-disaggregated Bank 2011). data and the lack of expertise in the collection process. Utilizing a disability/impairment approach known to Stigma and Discrimination yield low results (NPC 2009), the 2006 Nigerian popula- Persons with disabilities in Nigeria face stigma and tion census reported a disability prevalence rate of 2.3 discrimination in the form of negative attitudes among percent. In 2011, a national baseline survey conducted family and community members, name-calling, and by the Federal Ministry of Women Affairs and Social wrong beliefs about the causes of disabilities, which Development2 documented a similar rate: 3.2 percent results in low self-esteem, depression, and isolation. (FMWASD 2011). Cultural beliefs around gender roles that favor males Nigeria’s General Household Survey Panel 2010–11 magnify the challenges of women and girls with also documents a 2 percent disability prevalence rate disabilities, who may not meet the norms in terms of (Leonard Cheshire 2018). The panel used the Washing- beauty or of being a wife and mother, compounded by ton Group on Disability Statistics “Short Set,”3 a set of the myth that women with disabilities will give birth to questions based on the framework of the World Health children who also have disabilities. Organization’s International Classification of Function- ing, Disability, and Health and commonly referred to as Education the Washington Questions. The low rates may be con- Education is inaccessible to persons with disabilities nected to unreported alterations to survey instruments, due to the lack of adapted learning materials, inade- such as screener or introductory statements, cultural quately trained teachers, school shortages, a physically barriers around mentioning functional difficulties, and inaccessible school environment, and inaccessible com- differences in the training of interviewers (Leonard munication. Inclusive education is typically thought Cheshire 2018). The 2012–13 edition of the same survey to aid social inclusion, but participants expressed has not yet been analyzed with a disability lens, and the reservations about learning outcomes and the full survey’s third wave (2015–16) only collected data on participation of children with disabilities when school vision difficulties. environments, teaching staff, and supports cannot adequately meet the needs of students with diverse dis- abilities, such as by ensuring sign language immersion. 2. In August 2019, the Federal Ministry of Women Affairs and Social Development was split to Federal Ministry of Women Affairs and Social Development was moved to a newly created Hearing impaired participants were particularly con- Federal Ministry of Humanitarian Affairs, Disaster Management and Social Development. 3. The Washington Group “Short Set” includes questions that are designed to identify persons cerned about the development of sign language as their with disabilities in a census or survey format, for example, if they have difficulty performing basic universal activities such as walking, seeing, hearing, cognition, self-care, and communi- mother tongue, and participants with visual disabilities cation. See http://www.washingtongroup-disability.com/washington-group-question-sets/ short-set-of-disability-questions/. ix expressed concerns over the availability and use of lacks the expertise needed for the local manufacturing braille documents, particularly at the primary level. of quality assistive devices and technology. Current attempts are small in scale, obsolete, and often inappro- Health priate for the intended users. There is dearth of research into the accessibility of health facilities across the country. One study reported Employment and Social Protection that 71 percent of respondents with disabilities in the Attitudinal and physical barriers are among the major states of Kogi and Niger were unable to access needed challenges that prevent persons with disabilities in health services (Smith 2011). Study participants with Nigeria from obtaining gainful employment. These bar- disabilities reported inadequate access to health riers result in the denial of job opportunities, inappro- services characterized by negative attitudes among priate job placement, lower expectations at work, a lack health workers toward persons with disabilities, igno- of reasonable accommodations, noninclusive human rance of health workers regarding disability issues, the resource policies, inaccessible workplaces, and denial of prohibitive cost of care, inaccessible information and leadership roles. Women with disabilities may be even communications, and inaccessible environments and more marginalized due to “beauty” standards required equipment. by some employers and because they have fewer opportunities to pursue an education or develop skills. Community-based Rehabilitation These factors may partly explain Leonard Cheshire’s Community-based rehabilitation (CBR) projects are (2018) finding that there were no Nigerian women with currently limited in Nigeria. Participants were only disabilities in managerial positions compared with 0.9 aware of a few such projects in the states of Zaria percent of women without disabilities. and Kaduna. However, previous studies documented Despite the disproportionate impact of poverty on successfully implemented CBR projects in Nigeria. The persons with disabilities in Nigeria, social protection adoption of CBR principles and community develop- schemes do not adequately include them, and there ment projects can stimulate improvements in living are no tailored interventions to reduce the impact of conditions, self-esteem levels, and community accep- poverty. The internal bureaucracies of the organizations tance of people affected by leprosy. Key to a robust CBR of persons with disabilities and a lack of accountabil- program are staff training in the principles, adoption ity among their leadership further negatively impacts of rights-based approach, program ownership, effec- access to social protection. tive collaboration with government, and multisectoral partnerships. However, efforts will not be sustainable if Public Information and Communications persons with disabilities remain economically depen- Public information and communications—especially on dent on the program and if partnerships remain weak. websites of public organizations and the various min- istries, departments, and agencies—are seldom acces- Assistive Devices and Technology sible to persons with disabilities in Nigeria, particularly Study participants claimed that assistive devices and those with cognitive or sensory impairments, including technology are not readily available, and if available, people with albinism. Findings indicate that public are unaffordable because they are imported. Nigeria x information and communications are not available in Legal Frameworks accessible formats, such as in sign language, easy-to- The study documents existing legal frameworks and read and plain language, audio, and large print. High policies that specifically target or at least include per- levels of illiteracy among persons with disabilities and sons with disabilities. Eleven states—Plateau, Lagos, the poor quality of sign language interpretation services Ondo, Jigawa, Anambra, Nasarawa, Ogun, Kano, Bau- further contribute to the inaccessibility problem, along chi, Kogi and Kwara—have enacted disability laws, each with other factors. at a different implementation stage. Multiple factors are cited as having facilitated the implementation of the Electoral and Political Processes recently passed national-level Discrimination against Nigeria’s electoral and political processes are charac- Persons with Disabilities (Prohibition) Act 2018 (FRN terized by inadequate knowledge regarding disability 2019), including political will, the creation of an imple- inclusion among Independent National Electoral Com- mentation committee and framework, the establish- mission (INEC) staff; inaccessible election procedures ment of an independent commission, pressure from and facilities, and a dearth of opportunities for persons civil society, the active participation of persons with with disabilities to participate in politics or to serve in disabilities, and a strong disability movement. leadership roles. In addition, the implementation of the INEC’s Framework on Access for Persons with Disabili- Institutional Landscape ties in the Electoral Process is inadequate. Nigeria’s civil society is weak with regard to disability inclusion. Disability inclusion is also not a priority for Public Transportation government ministries, departments, and agencies Study participants cited multiple barriers to transpor- in their policies, budget allocations, basic services tation, including inaccessible vehicles and negative provision, programs, and infrastructure. The newly attitudes toward persons with disabilities among established Federal Ministry of Humanitarian Affairs, commercial drivers and co-passengers. Regarding the Disaster Management and Social Development, which aviation sector, participants reported discriminatory now has the mandate for disability inclusion, has an attitudes among airline and airport staff, driven by an immense opportunity to enhance technical capacity on approach that views passengers with disabilities as ill disability know-how/expertise in the ministry to spear- and incapable of caring for themselves while onboard. head this agenda. There is a shortage of disability-re- Participants also reported examples of being denied lated service providers, and the few available services accessible parking, damaged assistive devices, and fees are provided by private individuals and organizations, for assistance services. which are often unaffordable and concentrated in large cities. Assistive devices and technology are expensive and not readily available. Capacity development and local production are key to increasing such availability. xi Table 1. Key Findings Matrix Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Education Inadequate oppor- Mostly special edu- Few (mostly private) inclusive Inadequately trained Primary schools that tunities for partici- cation programs schools available teachers adopt the inclusive pation in schools Inclusive education Few nongovernmental orga- Lack of early detec- education model and Inadequate learning is an emerging nizations working on inclusive tion and intervention well trained staff (e.g., aids concept education Dearth of learning primary school in Jos, Few teachers Inadequately im- Special education focal points materials and assis- Plateau State) trained in sign plemented national in federal and state ministries, tive technologies Discrimination language or spe- policies on special departments, and agencies Lack of educational against Persons cialized staff and needs education, Unavailable tertiary training in support in tertiary ed- with Disabilities personnel trained in inclusive education, inclusive education ucation for students (Prohibition) Act strategies and skills and albinism Limited funding of inclusive with disabilities to ensure adequate education through USAID, learning for persons International Agency for the with disabilities Prevention of Blindness, DFID, Limited career and Disability Rights Advocacy opportunities in Fund areas and sectors Few programs on inclusive that are not con- education by Sightsavers sidered “disability International for those with adequate” visual impairment; Independent Negative attitudes Living Programme for Persons among teachers with Disabilities (advoca- and peers cy-related), and Daughters of Charity (for hearing impaired persons); and Brien Holden Vision Institute Production of braille books by Niger Wives Association Health Negative attitudes Inclusive health Health care delivery inaccessi- Unavailable early Comprehensive among health policies are ble to persons with disabilities intervention services Community Mental workers unavailable No disability focal point in the Lack of disability Health Programme in Health workers’ Health care costs Federal Ministry of Health training for health Benue State ignorance of related to disability Small-scale inclusive health workers Discrimination disability Health services are “out programs by a few nongov- Inadequate budget against Persons workers ignorance of pocket.” ernmental organizations: CBM allocation with Disabilities of disability (causes New national pol- International, Sightsavers Lack of inclusive (Prohibition) Act and treatment) icy on sexual and International, Disability health policies Good practices among Prohibitive cost of reproductive health Rights Advocacy Center, health workers in care for persons with Deaf Women Association of Akwa Ibom State Inaccessible disabilities Nigeria/Ipas, Daughters of Policy on the sexual environment, equip- Charity, HANDS, The Leprosy and reproductive ment, information, Mission, German Leprosy health of women and and communication and Tuberculosis Relief girls with disabilities Association, and Brien Holden Vision Institute Mental health by Gede Foundation and Comprehensive Community Mental Health Programme Donors include BMZ, International Agency for the Prevention of Blindness, CBM International, Australian Aid, Disability Rights Advocacy Fund, and Liliane Foundation (continued) xii Table 1. Continued Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Employment Employers’ negative No clear provision Livelihood programs seldom Lack of inclusive Plateau State employ- attitudes for inclusive em- target persons with disabilities human resource ment provision in its Disabling work ployment until the Few actors in inclusive policies disability law environment recently passed livelihood or employment: Lack of advocacy for Discrimination Lack of affirmative national disability Sightsavers International, inclusive employment against Persons action law CBM International, Failure to implement with Disabilities Inappropriate Theseabilities Foundation, inclusive employment (Prohibition) Act employment The Leprosy Mission, pronouncement Special quota of 1 Denial of leadership Comprehensive Community percent for persons roles Mental Health Programme, with disabilities of any Discriminatory and Propcom organization that has language in job Donors funding inclusive live- up to 100 persons advertisements lihoods: DFID, BMZ, European in the Lagos State Union, and TY Danjuma Special People’s Law Foundation 2011 Office of the Head of Civil Service of the Federation has a disability desk but the Ministry of Labour and Employment does not Social protection Lack of access The National Social Actors with inclusive social Eligibility re- Lagos State disability to social security Protection Policy protection programs: The quirements are grants schemes makes provisions Leprosy Mission, CBM discriminatory Social security Office of the Head for disability International, Comprehensive Recognition level schemes implemented of Civil Service inclusion Community Mental Health of the relationship through the Plateau of the Federation Programme, and Save the between poverty and State Disability Rights bureaucracy Children International disability is low. Discrimination Unaccountable Donors in this sector: DFID, Disability is not a against Persons leaders European Union, and BMZ cross-cutting factor with Disabilities Lack of coordination between in the National Social (Prohibition) Act departments in FMWASD Protection Policy Failure to implement the policy Low level of imple- mentation monitoring of the of schemes Community- Unaffordable as- The previous Assistive devices in short Inadequate expertise Vocational rehabilita- based services, sistive devices and rehabilitation supply and manufactur- tion program in Oyo assistive technology policy was vague Mostly run by private compa- ing centers for State devices, and Dearth of available and poorly nies and charities assistive devices and Community-based technology quality assistive implemented Few community-based reha- technology rehabilitation and devices National policy on bilitation programs Low knowledge levels vocational training Inadequate disability is at the FMWASD is in charge but not on the principles experiences in Kaduna, therapists and draft stage doing enough and practice of Zaria State community-based Not a focus of key donors community-based Assistive devices rehabilitation rehabilitation and support provided services Lack of sustainability by organizations plan for the design of such as the Leprosy community-based re- Mission International, habilitation programs German Leprosy Relief Low level of govern- Agency, and Damien ment commitment Foundation (continued) xiii Table 1. Continued Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Electoral Low knowledge of INEC’s Framework INEC has a disability desk Low capacity of INEC Framework on Access and political disability inclusion on Access for Actors in inclusive gov- for inclusive electoral for Persons with processes among staff at Persons with ernance and electoral process Disabilities in the the Independent Disabilities in the participation: Inclusive Lack of political will Electoral Process National Electoral Electoral Process Friends Association, Centre to facilitate active developed by INEC Commission (INEC) for Citizens with Disabilities, participation and A paper ballot de- Inaccessible elec- The Albino Foundation, and leadership of persons signed in braille for the toral procedures ActionAid International with disabilities in 2019 elections and facilities Donors: DFID, USAID, politics Lack of opportu- European Union, Ford Poor implementa- nities for political Foundation, and the tion of the INEC’s and leadership Netherlands Embassy Framework on participation Access for Persons Physical inacces- with Disabilities in the sibility of voting Electoral Process environment Situations of more vulnerability in case of electoral violence Public Inaccessible Lack of inclusive No disability desk in the Low awareness level Lagos Metropolitan transportation vehicles transportation Ministry of Transport of transportation Area Transport Negative attitudes policy Dearth of programs targeted rights and needs of Authority (LAMATA) among drivers and Recently passed at addressing inclusive persons with disabil- has put in place the passengers disability law transportation ities among relevant following disability Discriminatory includes provisions stakeholders inclusive measures for attitudes among for inclusive public Lack of facilities for its bus rapid transport: staff of airlines and transportation safe, convenient, and priority queue; priority airports dignifying boarding ticket purchase; prior- Risky and inap- ity seating; wheelchair propriate boarding space; accessible procedures buses; level boarding; and accessible infra- structure, e.g., ramps and disabled-friendly crossings Public Inaccessible public No policy on No disability desk in the Lack of available Sign language information and information and accessible Ministry of Information assistive technolo- interpreters at public communications communications information and Organizations and the media gies for accessible events and to ensure High level of illiter- communications do not prioritize accessi- information adequate dissemina- acy among persons There are ble public information and Accessible in- tion of key information with disabilities provisions on ac- communications formation and about government-re- Poor quality sign cessibility of public Awareness programs are usu- communications lated issues. language interpre- information and ally not provided in accessible are low priorities of tation services communications in formats stakeholders the new national Lack of capacity for disability law providing accessible information and communications Lack of regulation of sign language inter- pretation services BMZ = Federal Ministry for Economic Cooperation and Development; DFID = Department for International Development; FMWASD = Federal Ministry of Women Affairs and Social Development; HANDS = Health and Development Support Programme; INEC = Independent National Electoral Commission; USAID = United States Agency for International Development. xiv Conclusions providers, development and humanitarian actors, This rapid social assessment was undertaken to docu- persons with disabilities, parents and caregivers, and ment the current socioeconomic status of persons with organizations of persons with disabilities. disabilities in Nigeria. Findings indicate that persons Support the generation of disability-related data, with disabilities lack access to basic services and that which is urgently needed to inform the planning and attitudinal barriers represent a major impediment funding of disability-inclusive programs and services to their socioeconomic inclusion. Inclusive policies in Nigeria. are either nonexistent, weak, or inadequately imple- mented. There is an urgent need to improve the current All levels of government as well as development socioeconomic situation of persons with disabilities in partners should allocate adequate budgets or Nigeria. increase budget allocations to disability-inclusive policies, programs, and services. They should man- Recommendations date that their implementation partners and key Target households; communities, including religious, stakeholders in private and organized sectors do the traditional, and opinion leaders; schools; the media; same. and the general population with measures to reduce Establish national and state platforms to coordinate the stigma associated with disabilities and persons a disability-inclusive response, which is critical to with disabilities, which is based on misconceptions creating a synergy among stakeholders, including and negative attitudes. persons with disabilities. Tailor needed capacity development to improve the Invest in the local manufacturing of assistive devices current disability inclusion principles and practices and other technology and the development of the in various sectors of the economy to relevant stake- needed expertise to produce and use such resources. holders, such as government officials at the policy- and decision-making levels (duty bearers), service xv xvi 1. Background About 29 million Nigerians have a disability, represent- the Human Capital Agenda. The global development ing 15 percent of the estimated national population and poverty reduction agenda will not be effective of 195 million in 2018.1 This number is expected to unless it addresses the socioeconomic inequality of increase as the prevalence of disabilities is affected persons with disabilities and ensures their participation by aging, war and conflict, natural disasters, and in all stages of development programs. forced displacement, among other factors. Persons The disability-inclusive 2030 Agenda for Sustainable with disabilities are more likely to experience adverse Development highlights the need to empower persons socioeconomic outcomes and face higher rates of with disabilities. The Habitat III New Urban Agenda multidimensional poverty than the general population. and the Sendai Framework for Disaster Risk Reduction They encounter attitudinal and environmental barriers for 2015–30 also explicitly include disability concerns. that hinder their full, equal, and effective participation The right of a person with a disability to fully and effec- in society. Their lower rates of economic and labor tively participate and be equally included in society is market participation impose a higher welfare burden laid out in the United Nations Convention on the Rights on governments, highlighting the costs of exclusion, of Persons with Disabilities,2 which is close to universal which range from about 3 to 7 percent of gross domes- ratification and which Nigeria ratified in 2010. tic product (Buckup 2009). The World Bank recently launched the Disability Inclu- Disability-inclusive development directly responds to the sion and Accountability Framework3 on disability-in- World Bank’s twin goals of ending extreme poverty and promoting shared prosperity, and it is directly linked to 2. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons- with-disabilities.html. 1. Author’s calculations based on 2011 World Health Organization disability data: https:// 3. http://documents.worldbank.org/curated/en/437451528442789278/ www.who.int/disabilities/world_report/2011/report/en/. Disability-inclusion-and-accountability-framework. 1 clusive development, which showcases the institution’s Objective strong commitment to leaving no one behind. The main objective of the framework is to mainstream The objective of the study is to conduct a rapid social disability issues in World Bank activities. In addition, assessment of the status of persons with disabilities, as on July 24, 2018, the World Bank’s chief executive officer well as the barriers and facilitators to their socioeco- announced 10 commitments—many with specific nomic inclusion in Nigeria. target dates—to accelerate global action toward disability-inclusive development in key areas such as Research Questions education, digital development, data collection, gender, postdisaster reconstruction, transportation, private The following research questions guided the collection sector investments, and social protection.4 Many of the of data: commitments have a specific target date. What legal frameworks, policies, strategies, plans, The Nigerian government has expressed a strong and data are in place to promote or uphold disability interest in working with the World Bank to strengthen inclusion in Nigeria? programs and services for persons with disabilities. The What kinds of barriers do persons with disabilities Bank’s Social Development Global Practice, in collab- encounter when trying to access basic services, such oration with the Nigeria Country Management Unit, as education, health, livelihoods, employment, and undertook a rapid social assessment to better under- transportation? stand the challenges around disability inclusion across the various disability clusters and to identify drivers What facilitating factors exist or could be put in and opportunities for inclusion that can be leveraged in place to improve the lived experiences of persons the development context. The results of this study will with disabilities in Nigeria? form the basis of a series of consultations and shape the What and where are the available disability-related design of potential development interventions. services in the country? 4. See https://www.worldbank.org/en/topic/socialdevelopment/brief/ world-bank-group-commitments-on-disability-inclusion-development. 2 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT 2. Statement of the Problem and Justification for the Study Stigma and discrimination against persons with disabil- Doing nothing to address the challenges faced by Nige- ities are rife in Nigeria, and evidence suggests that basic ria’s community of persons with disabilities will not services continue to be inaccessible to persons with only affect individuals with disabilities as well as their disabilities. However, the magnitude of such problems households but will also have consequences for the has not been comprehensively documented, especially larger society and for country as a whole, which bears from the perspective of a person with a disability. Little the burden of disability. Given the vicious cycle of dis- is understood of the structural and institutional factors ability and poverty, excluding persons with disabilities influencing the socioeconomic status of persons with from accessing basic services will have a huge impact disabilities in the country. on the country’s economy. Nigeria recently signed the national-level Discrimi- This study therefore aims to provide deeper contextual nation of Persons with Disabilities (Prohibition) Act understanding of the barriers that persons with dis- 2018—a major disability inclusion milestone indicative abilities in Nigeria encounter. It analyses the state of of the Nigerian government’s increasing prioritization the various institutions that are relevant to disability of disability mainstreaming. Prior to the signing, a few inclusion and to the implementation of legal frame- Nigerian states had enacted similar laws, which are works as well as policies to protect and promote the currently being implemented to varying degrees. No rights of persons with disabilities. Such assessments are documentation currently exists of progress made to not currently available in Nigeria. date or of lessons learned through the implementation of these laws, which could otherwise be drawn on for the implementation of the national law. 3 3. Methodology This section presents the methodology utilized toward Sampling and Data Collection achieving the study’s main objectives. The study includes one-on-one interviews with key informants in the cities of Oyo, Ibadan, Lagos, Jos, and Study Design Abuja. Participants living outside of these cities were This is a mixed-method study that uses both quanti- interviewed by telephone. Focus group discussions tative and qualitative data collection methods. The were held in Lagos and Jos. The key informant inter- quantitative component includes an online question- views and focus group discussions were held May 6–24, naire-based rapid assessment of disability-inclusive 2019. The data collection tools and procedures utilized programming among civil society in addition to a for the study are detailed below. mapping of disability-related services. The qualitative component comprises a desk review, key informant Desk Review interviews, and focus group discussions with govern- This study reviews the available literature to document ment officials, leaders of organizations of persons the prevalence of, societal attitudes toward, and stigma with disabilities, disability-focused organizations, regarding disabilities in Nigeria. It identifies barriers academics, and persons with disabilities. In all, about encountered by persons with disabilities when access- 60 people participated in key informant interviews and ing basic services, particularly education, health, skills focus group discussions, including 45 persons with development, vocational training, labor market, digital disabilities or their caretakers. The study also included technology, and social protection. It reviews existing five individual consultations with persons with legislation and policies that include persons with dis- disabilities. abilities and that specifically target them. The findings 4 of the literature review guided the development of the Guides for Key Informant Interviews research tools to better understand the considered The study developed guides for the collection of data topics. from federal- and state-level government officials, orga- nizations of persons with disabilities, disability-focused Mapping of Disability-related Services organizations, and academics during the key informant The study reviewed the available literature—published interviews. They are described in turn below. and unpublished—and canvassed individuals to map public, private, and nongovernmental organization Federal-level Government Officials (NGO) sector entities that offer specific services to per- The guide for the interviews with federal-level govern- sons with disabilities, including rehabilitation services, ment officials was developed to explore the govern- clinical or surgical interventions, and the provision of ment’s provisions, plans, and strategies to protect and assistive devices and technologies. promote the welfare of persons with disabilities, includ- ing their access to basic services. The following minis- Rapid Assessment Survey tries, departments, and agents (MDAs) were targeted: This study utilized an online rapid assessment survey Federal Ministry of Education (Special Education to collect data from development partners and the civil Branch); society to explore the degree to which their program- ming, products, and services are addressing the needs Federal Ministry of Health (Hospital Services of persons with disabilities, as well as to identify the Department); disability-inclusion- related challenges, opportunities, Federal Ministry of Women Affairs and Social Devel- and support needed. opment (Rehabilitation Department); The survey was shared with potential study partici- Federal Ministry of Labour and Employment; pants through existing networks, such as the Nigeria International NGO platform; by email; and through Federal Ministry of Power, Works and Housing social media (Facebook), also encouraging potential (Urban Housing Development Department); and participants to share the link to the online survey with Federal Ministry of Science and Technology. their own networks. Each ministry received a letter inviting its participation The survey, which takes about 20 minutes to complete, in the study. The letter included information about the was available for four weeks between April 29 and May study and a consent form to participate in it. Other 24, 2019. About 50 responses were submitted, including than the Federal Ministry of Labour and Employment, seven duplicates, which were deleted, for a total of 43 whose minister was out of the office when the letter responses. arrived, all of the ministries agreed to participate and supplied contact information for interview partici- pants, along with relevant dates, times, and venues. In lieu of the Federal Ministry of Labour and Employment, 3. METHODOLOGY 5 the study engaged the Office of the Head of Civil Ser- Nigerian National Association of the Deaf; vices of the Federation due to their availability for the National Association of the Blind; interview and the office’s relevance to employment issues. The study conducted a total of six key informant National Association of the Persons with Physical interviews with federal government officials ( four men Disability; and two women). International Association for Integration, Dignity and Economic Advancement (IDEA), Nigeria; State-level Government Officials Another key informant guide was developed to cover National Association of Persons with Intellectual state-level government officials in Plateau and Lagos. Disabilities (NAPID); The two states were selected because they have an Spinal Cord Injury Association of Nigeria; and office or commission that is specifically set up for persons with disabilities, socially vulnerable groups, The Albino Foundation (albinism is not yet an and ongoing government social protection programs. officially recognized national-level cluster, but most The study targeted relevant officials in the Plateau states do recognize it, including Plateau and Lagos). State Disability Rights Commission and the Lagos State No member organization currently officially represents Office for Disability Affairs. The executive chairman of the interest of persons with mental health conditions the former granted an interview, but the latter declined. in Nigeria, although a community-based program in Benue State has been operating the Mental Health Organizations of Persons with Disabilities Advocacy Initiative for over five years, which comprises The Joint National Association of Persons with Dis- mental health service providers and other advocates. abilities (JONAPWD) is the umbrella organization of The key informant interview guide for the cluster organizations of persons with disabilities in Nigeria. organizations was also utilized to collect data from a Separate key informant interview guides were devel- member of the initiative who is also a mental health oped to collect data from key management officials at service user. JONAPWD and cluster representatives to explore their members’ experiences when accessing basic services, The study conducted eight key informant interviews, prevailing barriers, facilitating factors, opportunities, each targeting a different type of impairment, as well as and suggestions on how to improve the situation. one key informant interview with JONAPWD. The par- ticipants comprised leaders from the seven disability Associations under JONAPWD represent different cluster organizations, including The Albino Foundation, impairments: visual, physical, and intellectual intellec- a leader from the Mental Health Advocacy Initiative in tual disabilities; persons with spinal cord injury; and Benue State, and a representative of JONAPWD’s board persons affected by leprosy. JONAPWD is currently of trustees. Participants were recruited into the study composed of the following associations: based on information provided by members of cluster organizations and other individuals in the disability community. 6 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Disability-focused Organizations with local organizations of persons with disabilities Another key informant interview guide was developed from both states to reflect the key cluster groups, except to explore the barriers to inclusion that persons with mental health conditions. Separate discussions were disabilities face, the facilitators of disability inclusion, held for male and female participants in both states. policies and legal frameworks, and recommendations. All of the key informant interviews and focus group Two disability-focused organizations were selected discussions were recorded with the permission of for the key informant interviews based on their active the participants. A notetaker also took notes during participation in disability-inclusive programming and every session, each of which was one to three hours in leadership roles in the enactment of the Discrimination length. The quotations in this report are taken verbatim against Persons with Disabilities (Prohibition) Act 2018. from the focus group discussions and key informant interviews. Academics A separate guide was created for the key informant A telephone conversation conducted with a leader of interviews of three academics (two men and one Jigawa State’s disability community served to document woman) to explore their views on the inclusion of the implementation of the disability law there—no persons with disabilities, including perceived facilita- commission or dedicated office for the implementation tors of inclusion, lessons and good practices, their role of the law exists there. A disability activist in Ondo in improving the availability of disability data, assistive State—which has a disability law with an established devices, and technology. The participants were from office—the Agency for the Welfare of Persons with Dis- Federal College of Education (Special), Oyo; Univer- abilities—was also interviewed. However, the agency’s sity of Ibadan, Ibadan; and University of Jos, Jos. The executive secretary was not keen to grant an interview. two male academics are in the special education field; The study did conduct a personal interview with a the female academic works in public health but has a visually impaired male teacher at the Federal College of background in special education. There is a dearth of Education (Special), Oyo, after following his Facebook academics working on disability issues in Nigeria. The posts regarding the plight of visually impaired students sampling was purposive in nature, based on existing trying to write their examinations in Nigeria’s tertiary networks. institutions; and with and a woman with a disability in Abuja regarding her encounter with the staff of a Focus Group Discussions Guide domestic airline. A focus group discussion guide was developed to Skype sessions were held with two men from South explore the lived experiences of men and women with Africa: an academic with a disability from the Univer- disabilities, including stigma and discrimination, access sity of Cape Town and a leader of the QuadPara Associ- to livelihoods and other basic services, and availability ation of South Africa. The focus of the discussions was of disability-related services and programs. Seven to to hear their views regarding the implementation of the 11 men and women with disabilities, including caregiv- White Paper on the Rights of Persons with Disabilities ers, participated in focus group discussions in Plateau and other sectoral and general laws that have disability- and Lagos. Participants were selected in collaboration inclusion provisions. 3. METHODOLOGY 7 Ethical Considerations Data Analysis All of the participants for this study were adults (age 18 Quantitative Data and older) at the time of the research. Due to ethical The assessment of the data collected through the considerations, study participants did not include online rapid assessment entailed the generation of people with intellectual impairments, but some parents descriptive statistics using the Google Forms feature and caregivers participated in the four focus group for the response summary. Forty-three of the 50 sur- discussions in Lagos and Jos. vey responses were included in the assessment. Seven duplicate responses were deleted. Information about the study and a consent agreement was presented on the first page of the online survey. For the service mapping, detailed information was Respondents had to affirm that they understood the collected on the types of disability-related services information and that they gave their consent to partic- and programs in Nigeria, their scope, and contact ipate in the study before they were able to proceed to information. the actual survey questions. Qualitative Data Before every key informant interview, participants The qualitative data comprised 26 key informant read information about the study and signed a written interviews and focus group discussion scripts/files in consent agreement to take part. Permission was also Microsoft Word documents. The qualitative data analy- sought to record the sessions. For telephone interviews, sis for this research entailed a verbatim transcription of participants gave verbal consent prior to the interviews each recorded interview and discussion. The recorded after reading and acknowledging their understanding of interview script allows a participant to be identified by the study information and consent agreement. gender and disability (if relevant). Before every focus group discussion, the study infor- The data analysis utilized NVIVO 12 software. Each mation and consent agreement document were read interview file was imported into the program and aloud to participants in English; it was also interpreted read for content analysis; selected texts were coded as into Hausa for those with a limited understanding of nodes. The nodes were later grouped into overarching English, and sign language for the hearing-impaired. themes based on the study’s objectives. The themes are: Each participant signed a separate sheet of paper stigma and discrimination, key intersections with dis- attached to the study information and consent agree- ability, disability data in Nigeria, barriers to inclusion, ment document signifying their understanding of the institutional landscape, policies and programming, and information and giving their consent to participate. state case studies. Subthemes under each were used to Focus group discussion participants also gave their explain the findings. permission to have the sessions recorded. 8 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT 4. Review of Findings This section presents the study’s findings, which are Availability of Disability-related Data based on the quantitative and qualitative primary data Disability-related data in Nigeria are sparse. The collec- collected, analysis of Nigeria Demographic and Health tion of disability-disaggregated data to inform planning Survey (NDHS) 2018 data, as well as the literature for persons with disabilities in the development context review. The findings are further explored under the lens does not appear to be a priority in the country. There of the overarching themes. are a few unreliable statistics on the prevalence of disabilities—the only type of data that most consider. There are also some disability-specific data, particularly Disability Data in Nigeria regarding access to basic services and vulnerability to Disability data are crucial to social inclusion and devel- certain social issues among persons with disabilities. opment of persons with disabilities. Data allow for an Usually, these kinds of data are not properly dissemi- objective diagnosis of disparities in outcomes between nated to the general population and are restricted to a people with and without functional difficulties. They specific audience. Data in national surveys are seldom are indispensable for the monitoring of progress (or disaggregated by disability. For national planning, regress) and the impact evaluation of policies and such data are more relevant than standalone or dis- interventions over time. The study explored and doc- ability-specific data, which are rarely of interest to the umented the situation of disability data in Nigeria the various stakeholders, including policy makers. following sections describe. 9 The 2006 Nigeria population census (NPC 2009) indi- partial paralysis. There were no data for Zamfara State cated a disability prevalence of 2.3 percent. This figure or Federal Capital Territory. has been challenged as it is significantly below the A cross-sectional study of 1,824 elderly persons from global average. The definition of disability in the 2006 three local government areas of Borno State, Abdulra- census— “disability is the inability of the respondent to heem, Oladipo, and Amodu (2011) reported a disability perform up to normal natural expectation”—was some- prevalence of 28.3, 15.7 , and 12.1 percent using 10, what general and vague. The census also identified six 6, and 5 basic activities of daily living methodology, categories—seeing, hearing, speaking, mobility, mental, respectively. The functional limitation of the respon- and other—with definitions better suited for capturing dents was 22.5 percent. Disability prevalence and func- severe impairments. The prevalence rate therefore falls tional limitations were higher in elderly women than within the limit of severe disability documented by the elderly men. This study defines disability as a “restric- World Report on Disability (WHO and World Bank tion in the ability to perform normal activities of daily 2011). Mont (2007) noted that this method of measur- living.” According to the authors, disability prevalence ing disability prevalence usually yields rates between 1 in the elderly with functional limitations is important and 3 percent, even when surveys of the same popula- for policy development of the formal and informal care tion using a more functional approach generate esti- of the elderly. In a recent analysis of the data from the mates of 10 to 20 percent. Contributing factors include first wave (2010–11) of Nigeria’s General Household the stigma attached to disability, particularly mental Survey Panel 2010–11, which involves 3,586 respon- and psychological disabilities; that the word disability dents age 50 and older, there is a higher prevalence of implies a very significant or severe condition; and that mobility disability among women than men (Balogun disability interpretation—how disability is understood and Guntupalli 2016). These findings also lend credence or perceived—varies by cultures, age group, and income to the importance of collecting data disaggregated by group (Mont 2007). age, gender, and disability in national surveys/surveil- A national baseline survey by the Federal Ministry of lance for the development of public policies that are Women Affairs and Social Development (FMWASD inclusive of men, women, and children with disabilities. 2011) documented a disability prevalence of 3.2 per- Disability prevalence varies with the method of mea- cent, which was higher than that of the 2006 population surement. Mont (2007) observes that the tendency census but lower than expected. is for developing countries to record the lowest dis- There are patchy reports regarding the prevalence of ability prevalence. Disability prevalence varies with disabilities that focus on certain disciplines or areas the method of measurement, definition of disability of interest. For example, a survey report by the Federal employed and how the prevalence questions are Ministry of Youth Development documented a dis- structured. Surveys that use questions around levels of ability prevalence of 0.26 percent (167,549) among the functional difficulties such as the Washington Group total youth population of 64,038,008 who were surveyed short set on disabilities tend to report higher rates of (FMYD 2012). The definition of disability used for that prevalence than those that employ narrow categorical survey is not clear, but the categories of disability in the questions, often found in developing country cen- report include visual impairment, poliomyelitis, and suses. However, the census is often the only alternative 10 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT available to developing countries, and hence they are Figure 4.1. Prevalence of Functional Difficulties usually adopted for the purpose of international com- in Nigeria in at Least One Domain parison (Mont 2007). Cannot Most national surveys and surveillance data are not do at all <1% disaggregated by disability in Nigeria. In light of the A lot of di culty above, the Washington Group questions5 have been 1% recommended for reliable and comparable disability Some di culty data in censuses (Mont 2007). The questions focus on 7% six basic core activities designed to capture most adults with disabilities, except individuals with mental disabil- ities (Mont 2007). To the knowledge of the authors, the only two available surveys in Nigeria that have used the Washington Group questions in Nigeria are the General No di culty 92% Household Survey Panel 2010–11 and, more recently, the 2018 Nigeria Demographic and Health Survey Source: NPC and ICF 2019: 458 based on Demographic and Health Survey data: Nigeria (NDHS). The General Household Survey Panel 2010–11 DHS-VII (NDHS) 2018. estimates a disability prevalence of 2 percent (Leonard Note: Functional domains are seeing, hearing, communication, cognition, walking, and self-care. Cheshire 2018). The 2012–13 edition of the same survey has yet to be analyzed with a disability lens, while the third wave of the survey (2015–16) only collected data on the visually impaired. estimated 7 percent of household members age 5 and older (and 9 percent of those age 60 and older) The popular Demographic and Health Survey is widely have some level of difficulty in at least one functional utilized for national planning and is useful for interna- domain; and 1 percent either have a lot of difficulty tional comparisons. In 2018, the Nigeria Demographic or cannot function at all in at least one domain (see and Health Survey (NDHS) included for the first time figure 4.1; also NPC and ICF 2019: 458). a disability module that is based on the Washington Group on Disability Statistics questions, which are The 2018 NDHS data suggest that disability rates are themselves based on the framework of the World significantly higher for those over the age of 60; one- Health Organization’s International Classification of third of this population reportedly has some difficulty Functioning, Disability, and Health. The questions in at least one functional domain. While only 1 percent address six core functional domains: seeing, hearing, of household members under the age of 40 have a lot communication, cognition, walking, and self-care. of difficulty or cannot function at all in at least one According to the 2018 survey data for Nigeria, an domain, 9 percent of those age 60 and above have a lot of difficulty or cannot function at all in at least one 5. The Washington Group Short Set are questions designed to identify people with a domain (figure 4.2). The data also reveal that 30 percent disability (in a census or survey format). People are asked if they have difficulty performing basic universal activities: walking, seeing, hearing, cognition, self-care, and communi- of widowed women and 37 percent of widowed men cation. http://www.washingtongroup-disability.com/washington-group-question-sets/ short-set-of-disability-questions/. have difficulty seeing, and that 31 percent of widowed 4. REVIEW OF FINDINGS 11 Figure 4.2. Level of Difficulty in at Least Figure 4.3. Prevalence of “Some Difficulty” One Domain Among People with Functional by Functional Domain and Age Difficulty in Nigeria Respondents were asked if they experienced "some di culty" with six functional domains: seeing, hearing, communication, 10 cognition, walking, and self-care 9 Women 40 Men Seeing 35 Hearing Percent of respondents 30 Communication 1 1 25 Cognition 1 <1 Walking 20 Self-care Some di culty A lot of di culty Cannot do at all 15 Percent distribution of women and men 10 age 15 and above 5 Source: NPC and ICF 2019: 458 based on Demographic and Health Survey data: 0 Nigeria DHS-VII (NDHS) 2018. 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 Age Note: Functional domains are seeing, hearing, communication, cognition, walking, and self-care. Source: Author’s calculations, based on Demographic and Health Survey data: Nigeria DHS-VII (NDHS) 2018. women and 35 percent of widowed men have some dif- ficulty in at least one domain (NPC and ICF 2019: 458). Figure 4.4. Prevalence of More Severe Difficulties by Functional Domain and Age Types of disabilities. The most common functional Respondents were asked if they experienced "a lot of di culty" or difficulty experienced by Nigerians, according to 2018 "cannot do at all" with six functional domains: seeing, hearing, communication, cognition, walking, and self-care NDHS data, is difficulty seeing, followed by difficulty 14 walking, and difficulty carrying out self-care (dressing Seeing 12 Hearing and washing entire body). Figures 4.3 and 4.4 illustrate Percent of respondents Communication 10 that all types of functional difficulties increase with age. Cognition 8 Walking Difficulty seeing is by far the most common mild diffi- Self-care 6 culty (described by respondents as “some” difficulty) for 4 younger age groups. For more severe functional difficul- 2 ties (described by respondents as “a lot of difficulty” or 0 “cannot do at all”), the variation between different types 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 Age of functional difficulties is less pronounced, and seeing, Source: Author’s calculations, based on Demographic and Health Survey data: walking, and self-care are the most commonly experi- Nigeria DHS-VII (NDHS) 2018. enced difficulties. Educational attainment. According to the 2018 also less likely to have a partial or complete secondary survey, women and girls who report having “a lot of or higher education. Women and girls who report that difficulty” in at least one of the six functional domains they are not able to “do at all” with regard to one of (figure 4.5) are more likely to have an incomplete pri- the domains are much more likely to have received no mary education or only a primary education; they are education. 12 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Figure 4.5. Educational Attainment by Functional Difficulty Among Women and Girls Ages 6 to 30 Respondents were asked about di culties in six functional domains: seeing, hearing, communication, cognition, walking, and self-care. 70 No education Incomplete primary 60 Complete primary Incomplete secondary Complete secondary 50 Higher 40 30 20 10 0 No di culty Some di culty A lot of di culty Cannot do at all Source: Author’s calculations, based on Demographic and Health Survey data: Nigeria DHS-VII (NDHS) 2018. Note: In the NDHS, the sample is designed to represent the national population ages 15 to 49. For this figure, only people ages 6 to 30 were included in the sample to exclude those who may have acquired functional difficulties later in life and which therefore may not have impacted their educational attainment. NDHS data do not allow for the calculation of educational attainment by functional difficulty among boys and men. Wealth outcomes. People ages 18 to 40 reporting “a to those with “no” or only “some” functional difficulty lot of difficulty” engaging in at least one of the func- (figure 4.6). Persons who report that they “cannot do tional domains are more likely to live in a household at all” at least one of functions are more than twice as that belongs to the two poorest wealth quintiles than likely to live in a household belonging to the bottom Figure 4.6. Wealth Outcomes by Functional Difficulty Among Men and Women Ages 18 to 40 Respondents were asked about di culties in six functional domains: seeing, hearing, communication, cognition, walking, and self-care. 70 Poorest Poorer 60 Middle Richer 50 Richest wealth quintile 40 30 20 10 0 No di culty Some di culty A lot of di culty Cannot do at all Source: Author’s calculations, based on Demographic and Health Survey data: Nigeria DHS-VII (NDHS) 2018. 4. REVIEW OF FINDINGS 13 Figure 4.7. Ownership of Assets by Functional Difficulty Among Women Ages 15 to 40 Respondents were asked about di culties in six functional domains: seeing, hearing, communication, cognition, walking, and self-care. 15 Women owning land alone or jointly Women owning house alone or jointly 10 5 0 No di culty Some di culty A lot of di culty Cannot do at all Source: Author’s calculations, based on Demographic and Health Survey data: Nigeria DHS-VII (NDHS) 2018. Note: In the NDHS, the sample is designed to represent the national population ages 15 to 49. For this figure, only people ages 18 to 40, who are expected to be in their “breadwinning” years, were included. wealth quintile than those with no functional difficulty, Data are crucial to development—its planning, at rates of 41 and 18 percent, respectively. People with implementation, monitoring, and evaluation. The “a lot of difficulty” or “cannot do at all” at least one of lack of available disability data makes it difficult to the functions are also less likely to live in a household develop policies and interventions for Nigeria’s devel- belonging to the two richest wealth quintiles than those opment agenda that address the needs and concerns with no or some difficulty. of persons with disabilities. It is therefore important that data from future censuses conducted in Nigeria Ownership of assets. Overall, men in Nigeria are more than three times as likely to own a house or land as are women (NPC and ICF 2019: 382). Women who have “a Figure 4.8. Employment by Functional lot of difficulty” or “cannot do at all” any of functions Difficulty Among Women Ages 15 to 49 are significantly less likely to own land or a house alone Respondents were asked about di culties in six functional domains: or jointly figure 4.7). seeing, hearing, communication, cognition, walking, and self-care. 80 Employment. Women who “cannot do at all” at least 70 one of the functions are less likely to be employed, 60 50 although 43 percent still work (figure 4.8). At the same 40 time, women with “a lot of ” difficulty with one of the 30 six functions, particularly those categorized as “cannot 20 10 do at all” are much more likely not to be paid for their 0 work: 21 percent of women with “a lot of ” difficulty and No Some A lot of Cannot di culty di culty di culty do at all 37 percent of those who “cannot do at all” one of the functions receive no payment for employment com- Source: Author’s calculations, based on Demographic and Health Survey data: Nigeria DHS-VII (NDHS) 2018. pared with 18 percent of those with no difficulty and Note: NDHS data do not allow for the calculation of employment by functional 14 percent of those with “some difficulty” (figure 4.9). difficulty among men. 14 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Figure 4.9. Unpaid Employment by Functional Challenges Related to the Collection Difficulty Among Women Ages 15 to 49 of Disability-related Data Respondents were asked about di culties in six functional domains: The problems associated with collecting disability- seeing, hearing, communication, cognition, walking, and self-care. related data stem from a lack of understanding of 40 disabilities as a cross-cutting development issue that 35 30 requires attention. Some stakeholders view and portray 25 disabilities as a complex issue, which may discourage 20 the collection of data. The collection of disability- 15 10 disaggregated data is a low priority among stakeholders 5 in the major sectors of the economy, such as education, 0 No Some A lot of Cannot health, and transportation. di culty di culty di culty do at all “The major challenge is [a lack of] political will or Source: Author’s calculations, based on Demographic and Health Survey data: interest in generating data on people with disabilities.” Nigeria DHS-VII (NDHS) 2018. Note: Data do not allow for the calculation of educational attainment by functional – a male double amputee, Lagos difficulty among men; see NDHS sample. The capacity for conducting disability-related research in Nigeria is limited. There is a lack of expertise for col- be disaggregated by disability. National surveys and lecting disability data, which also makes it very difficult surveillance data should also collect disability-disag- to gather reliable data. In addition, persons with dis- gregated data to ensure that the on-the-ground reality abilities and their organizations are seldom consulted regarding disability is reflected. by researchers. The United Nations Children’s Fund (UNICEF) has “I’ll say people don’t understand disability. We don’t collaborated with the Washington Group to develop focus enough on disability. People don’t feel that it is another set of questions for identifying children something to collect data on. Also, we don’t have the with disabilities: the UNICEF–Washington Group expertise. We don’t have people who are good disability Child Functioning Module.6 These questions, used as enumerators, who can define disability data and know designed and with the technical support of the Wash- how to collect it.” – a wheelchair-user, Abuja ington Group show that prevalence rates tend to fall It is imperative to raise awareness around and develop within 6–12 percent (Leonard Cheshire 2018). There the capacity of relevant stakeholders in Nigeria to adopt is reason to believe that that the very low prevalence the Washington Group questions in their censuses and rates reported by some countries could be due to surveys. Doing so would allow access to internationally “unreported alterations such as screener/introductory comparable data, which would also provide a baseline statements, cultural barriers around mentioning func- for the implementation of the Sustainable Develop- tional difficulties, or differences in interviewer training” ment Goals and the United Nations Convention on the (Leonard Cheshire 2018). Rights of Persons with Disabilities (Leonard Cheshire 6. The UNICEF-Washington Group Child Functioning Module. https://data.unicef.org/topic/ 2018). It would also provide a solid foundation for the child-disability/module-on-child-functioning/. 4. REVIEW OF FINDINGS 15 development of inclusive public policies in Nigeria. Negative Attitudes Toward Persons One key advantage of the Washington Group ques- with Disabilities tions is that they are not stigmatizing because they Attitudes toward persons with disabilities vary but are do not mention disabilities, something with which most often negative. Such mindsets emanate from inac- some households and individuals may not want to be curate beliefs about disabilities and people with them identified. and from the sense that persons with disabilities seem and/or behave differently than the “norm.” Recommendations for Improving Data Collection “I don’t have hands. […] So, people don’t like the way I Raise awareness among stakeholders, including look because I look odd. I look, you know, shapeless that’s how people see me. So people discriminate against me, decision makers and policy makers, and advocate people avoid me, people stigmatize me.” – a male double for disability to be viewed as a development issue amputee, Lagos that should be mainstreamed into all sectors of the economy. Persons with disabilities experience the negative Ensure the active participation of persons with attitudes others have toward them in various ways, including rejection, neglect, loss of respect, reducing disabilities and their organizations in the design of visibility to/of children with disabilities, being consid- data collection instruments, capacity building, data ered useless, and being thought unworthy of being alive. collection, monitoring, and leveraging the Washing- ton Group methodology. “I offered my hand to somebody, [but] he said no, Develop the capacity of relevant stakeholders I don’t shake hands with an albino.” – a man with albinism, Abuja for disability data collection and disaggregation, including defining the term disability for research “I was about a month old and still didn’t have a name purposes. because they believed I was a spirit.” – a man with Analyze the dataset from the first and second waves albinism, Jos of Nigeria’s General Household Survey through a “There was a woman I asked for money. She said she disability lens. didn’t have any and later she sent someone to come and tell me not to waste my money on that girl, that I should just let her die.” – father of a child with cerebral palsy, Jos Cultural Beliefs, Stigma, and Discrimination A common experience reported by persons with albi- nism in particular is being called derogatory names Prejudice, social isolation, and discrimination are the that connote difference and rejection. This manifes- greatest global barriers to disability inclusion reported tation of negative attitudes cuts across all parts of the by experts and persons with disabilities (Ashi, Olayi, country. and Ikwen 2015; Groce 1999). These factors are at the root of all of the other barriers that persons with dis- abilities encounter in their daily lives. 16 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT “There are many other names like ‘anyare’- I can’t even positive attitudes can actually infantilize them. This spell that - in the Onitsha area. There are all kinds of model is therefore not empowering, and often turns out names, you go to the Yorubas, [they say] ‘Afin,’ afin oriran to be negative over the long term. Harmful attitudes osan (afin does not see in daylight). I can’t even spell that, include overprotection and the belief that disabilities but it is derogatory, you know. You go to the north, they are the will of God and that a person with a disability call us ‘baturen tuda,’ which is ‘fake white man’. Then, you should just accept their fate and beg for a living. go to Benin, they call us ebo, ebo, ebo. All those names “They said that if there is fracas or fighting they [people are not complimentary, they are very derogatory, and we with disabilities] will be hurt or injured, that there is have to live with that” – man with albinism, Abuja no need for them to come out and participate in the The consequences of these negative attitudes include elections” – a male double amputee, Lagos low self-esteem, isolation, depression, and suicide. “One widespread idea is that we are beggars, that we Therefore, some persons with disabilities see them- are all beggars, that we should be recipients of charity. selves as inferior to people who do not have disabilities […] It prevents people from seeing us as humans who and as unacceptable to others. They may withdraw have rights.” – a female wheelchair-user, Abuja from society due to such attitudinal barriers. “Even when you go to Jos, children gather and start Family and Society singing. One of them even called me Santa Claus. You In Nigeria, persons with disabilities are discriminated know, you are a human being, someone calling you Santa against by their families and by society; many are Clausis very dehumanizing.” – a man with albinism, Jos therefore kept indoors, hidden away from neighbors and visitors, and mostly neglected (Mohammed 2017; “I started thinking of suicide, I became Okafor 2003). They are rendered invisible to avoid being depressed because my friends all deserted me.” an embarrassment to their families (Okafor 2003). – a hearing impaired woman, Lagos Sometimes, persons with disabilities are not allowed to “That is why we use the name Integration, Dignity, participate in family decisions or are betrayed by family and Economic Advancement (IDEA) intentionally, members. Many families have very low expectations for because some of us who suffer from leprosy see their family members with disabilities. And some fami- themselves as inferior. The self-esteem is no longer lies are extremely overprotective of their family mem- there.” – a man affected by leprosy, Benin bers with disabilities, preventing them from discovering their potential. The Charity Model Masking as Positive Attitudes “They often hide the person (with a disability) so that Study respondents did identify some attitudes that he won’t stain their image. They will hide you, keep could be considered positive, often informed by a you away from society and social organizations, and charity model. However, this model can drive persons make you feel lost and lonely. They go to soothsayers, to with disabilities into a state of perpetual dependence spiritual healers, to traditional healers for solutions.” and can prevent them from exercising their rights. For – a man with mental illness, Makurdi persons with intellectual disabilities, such seemingly 4. REVIEW OF FINDINGS 17 “Even the family, [when they sit down] and discuss sickness that befalls a person as punishment for their something, they will say, let us discuss it, we will let her sins. Some believe it is a curse or bewitchment. know later.” – a hearing impaired woman, Jos “Some people say the reason why I am visually However, the family-level experience is not always impaired is because I committed a sin.” – a visually negative. There are many families that take good care of impaired woman, Jos their family member with a disability—most usually try Some study participants expressed the belief that their best in a “hostile” environment and without any impairments can be acquired through close contact support. persons with disabilities and that women with disabil- “I used to say that my father played a major role in ities always give birth to children with disabilities— my [upbringing] because he really trained me to be which may be why some women with disabilities find it independent.” – a woman with spina bifida, Lagos difficult to get married. Participants with disabilities decried their lack of par- “When hearing impaired people have children, they ticipation in decision making and social activities in the tell them that if their children stay with them, they will community. Naturally, persons with disabilities want to inherit deafness.” – a hearing impaired woman, Lagos take part in community life. However, they are seldom People with albinism are believed to be spirits or gods invited to participate, and if they do so, are often rejected with supernatural powers who can disappear at any and ridiculed, which makes them tend to withdraw. time and that this is why they do not have long lives. Some lose the right to their inheritance due to their disability. Religious gatherings are no better. Persons with “So, there are entrenched superstitious beliefs, you disabilities are usually neglected at these gatherings, know, for instance, in certain areas—Igbo, Yoruba, reflecting the attitudes of the larger community. Hausa—believe that we are gods. Others belief that we disappear; others feel that we don’t have longevity.” “We are battling with cultural barriers. We are completely – a man with albinism, Abuja relegated out of the community. They will not even allow you to be part of any decision making, they will The literature supports the finding that many Nigeri- not allow you to get involved in a town hall meeting, they ans believe the false notion that disabilities result from will completely keep you out of the main community.” supernatural causes, including being cursed by the gods – a woman affected by leprosy, Jos and witchcraft (Abang 1988; Abasiubong 2010; Abosi and Ozoji 1985; Okafor 2003). Okafor (2003) notes that “some Beliefs Around Causes of Disability local ancient mythology has it that persons with disabil- Study participants with disabilities shared some com- ities are social outcasts serving retribution for offences mon beliefs around the causes of disabilities. These of their forefathers.” Anyatunwa (1977) reveals the Igbo’s include the inaccurate belief that disabilities are a belief that persons with disabilities, including those punishment for the past sins of the individuals, their with albinism, must have sinned in their former lives. parents, or their families. This belief is also being rein- According to Adeoke (1977), the Yoruba culture believes forced by some religious practitioners across multiple that epilepsy is caused by the presence of a lizard-like faiths, who consider disability to be an affliction or creature in the stomach that is contagious. A recent 18 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT study of Yoruba women with epilepsy reveals the belief promote acceptance of persons living with disabilities. that epilepsy is identified with witchcraft and evil spirits Worshippers of the Yoruba deity Obatala, for example, (Komolafe et al. 2011). According to Abang (1988), a who is said to be in charge of creation, see persons with common misperception is that persons with disabilities disabilities as being very precious because it is said that are inferior to others and that they can be exploited for Obatala creates persons with disabilities after he gets social and economic gain, such as with money rituals,7 drunk, which accounts for their differences. because they are seen as less than fully human. Etieyibo and Omiegbe (2016), however, highlight dis- Yaksat and Hill (1997) acknowledge that the general criminatory practices against persons with disabilities attitude toward persons with disabilities in Nigeria is in Nigeria on the basis of religion and culture such as: negative, although due to its cultural diversity, there Trafficking and killing of persons with mental is no homogenous “Nigerian attitude” toward any- illness and raping of women with mental illness. thing—every tribe has its unique culture. Some Nigerian Such practices result from a belief that the victims cultures are favorably disposed to their members with must have violated a community tradition or are disabilities. In some cultures of North West Nigeria, involved in witchcraft. Homeless women with men- fathers tend to show more favorable attitudes toward tal illness are sometimes raped by men who believe their children with disabilities than do mothers who that doing so will make them wealthy (Eze 2005). might be disappointed at not having the desired “ideal child” or because mothers do the bulk of the childcare Trafficking and killing of people with oculocu- (Mohammed 2017). According to Abang (1988), some taneous albinism and angular kyphosis. Such people in the north accept disabilities as the will of God; practices are fueled by the belief that the body parts and according to the folklore of the Tiv8 ethnic group, it of persons with albinism and angular kyphosis can is the wish of the first chief of the land that all children be used for rituals for wealth and long life (Anumihe with disabilities should be born in his village, where they 2008; Oji 2010; Omiegbe 2001). can be adequately cared for. This study postulates that Use of children with disabilities in alms-begging. many people in the northern part of the country believe Some parents send their children with disabilities to disabilities are the will of God, and a person with a dis- the streets to beg for alms; the children obey for fear ability just has to accept it and move on. of being punished (Omiegbe 1995). These parents “When there is a person with a disability in the family, use their children to evoke a sense of empathy from it is believed it is “divine” and you just have to accept it.” members of society, especially those who consider – a visually impaired man from Gombe alms-giving to be an obligation. Nicholls (1993) notes that indigenous African beliefs The use of proverbs for the transfer of knowledge, val- around disability are not always negative, such as ues, morals, and learning is prevalent in Nigeria, with witchcraft, sin, and retribution. In some cases, a spir- the capacity to influence attitudes (Kisanji 1995). There- itual perception of disabilities and their causes can fore, McKenzie and Ohajunwa (2017) suggest explor- ing the representations of persons with disabilities 7. Money rituals are practices among people who believe they can create wealth for individuals with spells, charms, and sacrifices, which sometimes involve the use animal or human body in proverbs as a means of understanding the cultural parts. 8. The Tiv is an ethnolinguistic group; mostly found in Benue State, Nigeria, and in Cameroon. 4. REVIEW OF FINDINGS 19 connotations around disability among the major ethnic JSS 3. [He] said “What is the use of paying? It is a waste groups in Nigeria. of resources”, since one day I would disappear because I am a spirit.” – a man with albinism, Jos Implications for Access to “If you talk about education, you will see that persons Basic Services affected by leprosy are far behind all other groups When persons with disabilities experience negative because of the stigmatization they suffer as a child in attitudes toward them, it reduces their access to basic school.” – a man affected by leprosy, Benin services, such as education and employment. Nega- tive attitudes can also contribute to institutional and Recommendations environmental barriers that shut out persons with Raise awareness about the causes of disabilities to disabilities from receiving basic services. Children with demystify the topic and to promote acceptance of disabilities may drop out of school or may not be given persons with disabilities. the opportunity to attend school at all due to negative attitudes toward them at home, at school, and in the Raise and support champions who identify with community. Adults with disabilities report that some persons with disabilities. community members will not patronize their busi- Raise families’ knowledge and awareness of support nesses because of their disability. All of these factors services and programs for persons with disabili- can negatively impact the socioeconomic status of ties; increase services and information available to persons with disabilities. families. “When I started my business, people refused to patronize it because I have disability. Only few people buy from me. Others will say ‘buying kunu9 from a Impacts of Intersectionality hearing impaired person, no’.” – a hearing impaired Study participants, as well as the literature, describe woman from a rural area, Jos the intersections of disabilities with multiple factors, particularly gender, age, displacement, religion, and “When the attitudes of policy makers are negative, it geopolitical zone. Findings related to each intersection affects the institutions and the environment. Institutions are summarized below. are manned by individuals and individual attitudes shape the environment and institutions. So, when the attitudes of a community are negative towards a particular, Gender A variety of beliefs exist around the sexuality of persons vulnerable group, they will struggle much more to realize with disabilities, particularly women. Common miscon- their potential” – a male amputee, Lagos ceptions in Africa are that persons with disabilities are “When my sister was born, the second child who was asexual (Groce 2004) and that people with intellectual also albino, my father stopped paying my school fees in disabilities are hypersexual (Aderemi 2014). Yousafzai et al. (2004) documents that women with disabilities 9. Kunu is a drink consumed throughout Nigeria, usually made from a grain such as millet or in southern Africa experience sexual abuse due to the sorghum 20 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT false and dangerous idea that having sex with a virgin “There are many situations where a woman with can cure HIV, coupled with the misconception that disability will get pregnant, and the man will just women with disabilities are asexual and therefore collect the child and send the woman away. And most likely virgins. While there are more available data oftentimes, they want to experience what it is like to on the overall prevalence of gender based violence in have sex with a girl with disability, and that is why rape Nigeria (DHS, 2018), there is scant information and is increasing even here on the Plateau. It has happened data on the prevalence of GBV against women living many times, and many have been reported and others with disabilities. This is an issue that should be further left just like that.” – a female with albinism, Jos looked into as anecdotal information suggests that the Men who are not hearing impaired might not even prevalence is high. consider marrying a woman who is hearing impaired or This study’s findings indicate that it is more difficult for hearing impaired due to communication-related chal- women with disabilities to be involved in romantic rela- lenges, which might also explain the high rates of hear- tionships or to marry than for their male counterparts. ing impaired women and men marrying one another. Cultural beliefs around gender roles generally favor men “There are some guys that are so called “able”, over women, and this is magnified for women and girls approaching them, but sometimes the families reject with disabilities who might not meet a culture’s norms them and say “how will they communicate with them”?” in terms of beauty or be able to take on the expected – a hearing impaired woman from rural area, Jos role of wife and mother. There is also the common mis- conception that women with disabilities will give birth People affected by leprosy often marry one another due to children with disabilities or that they are asexual. to their stigmatized status in society. A woman that acquires a disability after marriage is more likely to be “[A]ny able-bodied man will believe that when you divorced or neglected by her spouse than would a man want to get married, a disabled woman cannot in the same circumstance. play her role very well as a homemaker, in terms of cooking, taking care of the children, and the house” “If a woman develops leprosy after getting married, – a visually impaired woman from rural area, Jos the man will find a way to divorce her. […] For example, in Jigawa State, there are two couples who got married As a result, women and girls with disabilities are and none of them were suffering from leprosy. But more likely to suffer from low self-esteem and, in their the woman later developed leprosy and the man ran desperation, sometimes settle for the first man that away from her. But in the same State, a man happened will have them. This could partly explain the reported to contract leprosy and the wife did not leave him.” experience of exploitation and violence in romantic and – a man affected by leprosy, Benin marital relationships among women with disabilities participating in this study. When a man without dis- Furthermore, female family members of persons with abilities sexually exploits or marries a woman (or girl) disabilities, particularly mothers, may experience more with a disability, he often later abandons her and denies marginalization than the rest of the family. These moth- her the right to raise their children. ers are at risk of losing their marriages and raising their children alone and in isolation. 4. REVIEW OF FINDINGS 21 “After everybody spoke and it was my mother’s turn to Develop the capacity of gender-based violence and speak last, she said “this is my child and he has all the women’s rights actors to address disability-related features of a human being, nobody will take my child issues in their work related to sexual and reproduc- away from me.” Then the battle lines were drawn because tive health and rights. she was left with the choice of either leaving her marriage Address the current programming gap between gen- or surrender her child to the chief priest, so she made a der and women’s rights actors on the one hand and decision to run away with me to a distant aunt for one disability rights actors on the other to strengthen year, three months” – a man with albinism, Jos interventions that target the intersection of gender Study participants opined that women and girls with and disability. disabilities have fewer opportunities than their male Support the active participation of girls and women counterparts to participate in socioeconomic activ- with disabilities and the organizations that repre- ities such as employment, education, and attending sent them in national platforms on sexual and repro- social events. Contributing factors to this inequity may ductive health and gender-based violence. include the inaccessibility of water, sanitation, and hygiene facilities; attitudinal barriers; and limited eco- Develop and implement inclusive policies regarding nomic opportunities. sexual and reproductive health and rights and gen- der-based violence. “When is comes to using toilets, rest rooms, monthly flow there are more complications. I wonder how they Age live. When somebody is perceived to be unkempt […], Study participants shared their views on the influ- even the women will not like to associate with her. […] In ence that age plays in the experiences of persons with fact, it hinders them from even attending education.” – a disabilities. Low knowledge levels among children with male double amputee, Lagos disabilities regarding the nature of their particular dis- Finally, experts on disability inclusion in Nigeria also ability exposes them to greater risk of harm than adults point out the lack of opportunities for women living with disabilities. It is therefore crucial to educate these with disabilities to exercise leadership roles, reinforc- children about the nature of their disabilities and to ing the fact that the barriers and needs of women with provide guidance on how they can manage them. disabilities continue to be invisible and, thus, are not “the [albino] child may see his friends playing under being addressed. the sun and will want to join, not knowing that the sun is dangerous to his skin.” – a woman with albinism, Jos Recommendations Raise awareness of girls, boys, women, and men with “I tell mothers and parents to allow children to be disabilities with regard to their sexual and reproduc- aware of the disabilities they have. When they know tive health and rights and develop their capacity to what they have, they will know how to manage.” advocate for their rights in this regard. – a woman with spina bifida, Lagos Advocate for inclusive sex education for girls, boys, However, early intervention services in Nigeria women, and men with disabilities. are poorly developed. Therapists are scarce, are 22 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT concentrated in major cities, and lack the necessary milestones and skills development and impacts their equipment; and their services are often unaffordable to futures. Children and youths with disabilities have the average family. much to contribute to society, and society should take advantage of this by making basic services more acces- “I went here and there, probably until he was 15, sible to them. when I learned that there was a psychiatric hospital I could take him to where he can be given speech Society must recognize them [people with disabilities] and occupational therapy. By then, his hand had and give them opportunity to contribute. Like in the coagulated, he could barely turn his hand to do case of my brother, he works with the radio station. But anything. But he talks, walks, he is very active.” it is more difficult for an elderly person who has […] – mother of an adult with Down syndrome lived a “normal” life until he becomes disabled.” – a visually impaired man from rural area, Jos Some participants shared their belief that individuals who acquire impairments as adults carry a greater On the other hand, a person who becomes impaired burden than children with disabilities. The adult has in his or her adulthood who has already accomplished already experienced life without a disability, whereas a a great deal and is well recognized by society tends to child may not yet fully understand the implications of face less discrimination than a person who becomes his or her disability. However, adults and children with impaired at a young age. In a study that included three disabilities alike are hurt by maltreatment and stigma- ethnic groups from Nigeria: the Igede from North Cen- tization. Among other things, children with disabilities tral, the Yoruba from South West, and the Igbo from the have limited access to education and recreation, which South East, Nicholls (1993) notes that the Igede distin- are crucial to their development, including their mental guish between impairments resulting from accidents capacity. or the aging process (objective causation) and those resulting from birth defects, which cannot be explained. “For the elderly, their own [stigma] is worse than The former group receives more favorable treatment, that of children. Once you were using your hands, legs, that is, they are less likely to experience discrimination and eyes, but over time you can no longer do all those and isolation; the latter are subject to more negative things. Their own stigma is much worse than that of attitudes. children.” – a visually impaired woman, Jos “Some people may lose their sight with age, but they “There are many differences when it comes to a child may have the advantage of being rich and people in the [with disability] because there are no recreation activities community will respect them because of their wealth. for development, and the mental capacity as a child is There is a former Commissioner of Plateau State who not there. As adults, some can struggle to make their way is now visually impaired, but people do not despise him and survive.” – a visually impaired man, Gombe and accord him due respect because of his status.” Further, children likely have many more years to live – a visually impaired man, Jos with their disabilities than adults do. The degree of access they have to early intervention services is a significant determinant of meeting development 4. REVIEW OF FINDINGS 23 Recommendations for them, or will call them to his house and provide food Make early intervention services more available for free.” – a man affected by leprosy, Jos by promoting skills development in related fields, “We are Muslims and we have taken medication from such as speech therapy and pediatric neurology, and Christians and lived with Christians without problems. through the provision of relevant equipment. But since they have left, we don’t have a place to collect Offer counseling to and educate parents about their drugs or even treat ourselves. Missionaries were helpful child’s disability so they can teach their children to us, my leg was amputated in Mangu for free, but now how to care for themselves so as to safeguard their we have to pay 120,000 and also go with a patient relative health and prevent secondary conditions. in Bayera in Bauchi state before they can attend to you.” – a man affected by leprosy, Jos Deliver disability management services, including care-taking, access to education, and health services However, many persons with disabilities have a through the formation of and networking with sup- different experience in terms of inclusion in religious port groups. activities and leadership under the current dispensa- tion. Despite biblical teachings against stigmatizing Ensure that adults who have recently acquired persons with disabilities, religious leaders and follow- impairments have access to rehabilitation services, ers still reflect the larger society, which does stigmatize including mental health, psychosocial, and reinte- them. Many view persons with disabilities as miracu- gration support. lous rather than allowing them to actively participate Provide inclusive basic services to children and in religious activities. The Islamic faith practiced in young persons with disabilities, including recre- Nigeria is less discriminatory in terms of the participa- ational activities, transportation, and education. tion and leadership of persons with disabilities in the religious sphere. Foster disability inclusion among children and youth through awareness-raising and role modeling activi- Recommendations ties that demystifies disability. Raise awareness among religious and traditional lead- ers about disabilities and persons with disabilities. Religion and Geopolitical Zones In Nigeria, religion informs many of the beliefs and atti- Advocate for the inclusion of persons with disabil- tudes toward persons with disabilities in the northern ities in places of worship by, for example, making and southern parts of Nigeria. The predominant reli- churches and mosques accessible. gion in the north is Islam; in the south, it is Christianity. Promote the active participation and leadership of The Islamic religion teaches that disability is the will of persons with disabilities in religious settings. Allah and should therefore be accepted. Promote the idea that persons with disabilities can “The Islamic religion holds that people with disabilities be religious leaders. should seek help from others who are well-to-do in the society. Like during Ramadan, when people go to the Encourage religious leaders to publicly champion mosque in the evening, rich men will cook and bring food disability inclusion. 24 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Displacement Develop the capacity of humanitarian actors to The Boko Haram insurgency in North East Nigeria mainstream disability into their work. and attacks by herdsmen in the north and south have Raise awareness of the existing international frame- displaced many, including persons with disabilities. works and resources on inclusion of persons with Further, conflict and humanitarian contexts are known disabilities in humanitarian actions among relevant to result in impairments. actors. A recent review of disability inclusion in the humani- Provide technical support and resources to relevant tarian response in North East (CBM International and actors to implement frameworks on the inclusion of JONAPWD 2019) reveals that the efforts reported by persons with disabilities in humanitarian actions. four selected actors toward disability inclusion were inadequately systematic to have a positive impact on Establish and support a national platform on dis- beneficiaries with disabilities. Disability data were not ability-inclusive humanitarian actions. available, services and programs were not accessible to Advocate for active participation of persons with persons with disabilities, and beneficiaries with disabil- disabilities. ities did not actively participate in making decisions that affect their lives in the camps. Identified reasons for this include a disability-inclusion capacity gap Barriers to Inclusion among humanitarian actors, the absence of an avail- Access to basic services is critical to the socioeconomic able coordination platform for disability inclusion, the development of individuals. Persons with disabilities low prioritization of disability inclusion in the face of a regularly face a variety of obstacles related to educa- complex humanitarian environment, the adoption of a tion; employment and livelihoods; public information charity approach, and the lack of a budget allocation for and communications; health; community-based reha- disability inclusion. bilitation, assistive devices, and technology; transporta- Study participants reported that environmental barri- tion; social protection; electoral and political processes; ers, which lead to dependence, represented their main institutional landscape; and legal frameworks and challenge. Internally displaced persons with disabilities programming. They are each discussed in turn below. are cut off from the environment to which they had already adapted and where they had already mastered Education their livelihoods. Moving into a new environment poses According to Ojile (2000), the first attempts at meeting great barriers to their freedom and independence. the educational needs of persons with disabilities in Many are traumatized by being separated from their Nigeria was initiated by missionaries. According to this families and friends. research, a school for the visually impaired was estab- lished in Faliya, Bauchi State, in 1935, and the Gindiri Recommendations School for the Blind was established in Plateau State in Address disability as a cross-cutting issue in emer- 1953 by the US and UK branches, of the Sudan United gency, relief, and recovery interventions by humani- Mission, respectively. The Pacelli School for the Blind tarian actors. and the Wesley School for the Deaf were both founded 4. REVIEW OF FINDINGS 25 in 1962 by Roman Catholic and Protestant church mis- Inadequate opportunities to participate in quality sionaries, respectively. education. The education sector is segregated, chil- dren with disabilities have difficulty getting admitted Nigeria currently operates a special school system, par- into schools, most schools lack adequate facilities ticularly at the primary level, including a few attempts and resources, and parents lack the financial capacity at an integrated approach focused on specific disabili- needed. ties at the secondary level. There are very few inclusive public schools in the states of Katsina and Kaduna. “First there is the educational barrier, many of them As awareness of inclusive education for children with [people with disabilities] don’t have access to quality disabilities has increased, a few private inclusive schools education. Many parents cannot even afford getting have been springing up, particularly in Lagos and Abuja. admitted [to the school] and then as to continuing Tertiary institutions of learning are mostly inaccessi- education, the system itself is not inclusive enough to ble to students with disabilities. However, no official cater to their needs.” – a man with albinism, Abuja documentation exists regarding the degree of accessibil- Inadequate learning aids. Learning materials, includ- ity of these various tertiary schools, other than limited ing assistive devices and technology, are not available information from a few universities (Ahmed, Awad, and in adequate quantities for effective learning. Adam 2014; Ajuwon and Chitiyo 2016). “They are not really available, you take your recorder In 2008, 29.6 percent of children with disabilities who to class, then you have to get your own scanner to were of primary school age were reportedly out of scan. If you cannot afford to have your own scanner school (FRN 2012a). A study by Smith (2011) in the then you have to go to shops to get online materials. states of Kogi and Niger indicated that half of the sam- Your source for all these things is yourself.” ple had no education, while 19 percent had a primary – a visually impaired woman, Jos education (of which two-third were male and one-third female), and 18 percent had an Islamic education. Dearth of resource persons. There are too few resource specialists, even at special schools. Sometimes Multiple studies identify the following impediments specialists are posted to the wrong schools, impeding to the education of learners with disabilities in learning and participation in the classroom and eventu- Nigeria: a lack of facilities and learning aids, including ally having a negative impact on performance. assistive technologies due to their high cost; inade- quate and unskilled human resources; an absence of “I may be specialized in vision impairment, another legislation that guarantees inclusive education; inade- person in hearing impairment. I witnessed a situation quate funding to meet learning and teaching needs for where a visually impaired person who studied children with disability; inadequate implementation of education for the visually impaired was posted to existing education policies; discriminatory attitudes; Wesley school for the hearing impaired to teach.” and a dearth of early identification and intervention – a visually impaired man, Lagos programs (Akogun, Njobdi, and Adebayo 2018; Eleweke, Inaccessible environment. The physical environment Agboola, and Guteng 2015; Nkechi 2013; Obiakor and in schools is often inaccessible to students with physi- Eleweke 2014; Oladele, Ogunwale, and Dafwat 2016). cal and vision disabilities. The overall state of buildings Participants of this study also cited these barriers, as dedicated to impart educational services to children well as others outlined below. 26 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT living with disabilities could also be improved. This available to teach particular subjects, such as mathe- poses a challenge to their participation in education at matics to visually impaired students. A common mind- all levels and puts the health of the students at risk. set among those in the education sector is that persons with disabilities should not pursue careers other those “Let’s talk about visual impaired people in the related to their disability. school environment. Especially in Unijos, the school environment is not adapted to the visually impaired “They feel that there are courses a visually impaired at all. I fell into the gutter several times and injured person should not do […]. Like the one I studied, myself, even now I still have a wound on my leg.” psychology, it wasn’t expected for a visually impaired – a visually impaired woman, Jos person to study psychology. So, a lot of discrimination, lecturers will tell you to your face you don’t have “I’ve been to schools where there is no ramp and the any business coming to this department.” floor is so rocky that the wheelchair cannot easily move.” – a visually impaired woman, Lagos – a woman with physical disability, Lagos “Some people believe that all hearing impaired Inaccessible communication. Hearing impaired people should go into special education as a teacher.” students in schools face communication barriers. Some – a hearing impaired man, Lagos teachers are not proficient in sign language, even in special schools. Students with albinism are cut off from Many students with disabilities are systematically classroom communication due to their eyesight, partic- excluded from science-oriented careers because of their ularly if a teacher refuses to acknowledge the issue and disabilities. Studying the sciences is associated with does not let them sit at the front of the classroom. better paying jobs, so excluding persons with disabil- ities contributes to the high poverty rates among the “Many teachers in schools for the hearing impaired population, particularly women and girls. Participation nowadays cannot sign. Employment of the hearing rates among women and girls in the sciences is low impaired teachers has become something else. They across the globe; some governments are responding just receive notes from politicians and take them with affirmative actions. However, women and children to schools for the hearing impaired for immediate with disabilities are not included in any affirmative employment, even though they are not trained in sign action programs in Nigeria, despite their vulnerability. language. In my state, Kwara State, many teachers of the hearing impaired cannot sign. They will just write on the “Even in our school, there is no one that can board and they leave. The same in Osun State andLagos teach visually impaired persons maths or English, State.” – a hearing impaired teacher, Oyo and these subjects are the gateway to university.” – a visually impaired man, Jos “Some of us [people with albinism] are short sighted and this affects our education. Teachers ask you to sit at the “I think the ministry needs to develop specific policies back of the class, knowing full well that you cannot see.” to encourage children living with disability to study – a woman with albinism, Lagos sciences.” – federal ministry official Limited career opportunities. Persons with disabil- Negative attitudes among teachers and peers. ities are often limited in their choice of careers due Negative attitudes toward children with disabilities are to stigma and to the dearth of skilled professionals widespread among teachers and peers, particularly 4. REVIEW OF FINDINGS 27 impacting children with albinism, children affected by Inclusive Education for Hearing Impaired leprosy, and children with epilepsy. Name-calling, bul- Learners lying, and teasing are common at school. This relates to The hearing impaired participants of this study strongly the issue of child protection and the fact that children oppose the idea of inclusive education in Nigeria. living with disabilities experience higher vulnerabilities Similarly, most of the hearing impaired participants in a compared with other students. This issue should be study by Nkechi (2013) preferred segregated to inclu- further explored and researched to inform educational sive education. From the perspective of many hearing programming in Nigeria. impaired people, inclusive education does not suit their learning, particularly at the primary level. There is a “So you understand, it starts at home and continues current dearth of teachers who know sign language, at school. In school, […] we go through all kinds of even in special education settings. Fellow students who teasing, name calling, all sorts of humiliation. The are not necessarily proficient in sign language them- teachers do not help, the teachers will call you names, selves are sometimes asked to be interpreters. Commu- “you, this blind man”, you know. All of that brings its own nication barriers result in hearing impaired students untold pressure that many of us, at a certain point,drop receiving less benefit in an inclusive setting. out of school and never want to go back to school.” – a man with albinism, Abuja “We might have some other students sign for us during class but those students might not be very good at it.” Inclusive Education for Children – a hearing impaired woman, Jos with Disabilities “If you look at the schools for the hearing impaired in Inclusive education is still lacking in Nigeria. Nkechi Nigeria, most teachers cannot communicate in sign (2013) opines that special education should be made language. Most of those who studied special education available to all learners with disabilities, while inclusive in universities are posted to schools for the hearing education is the ultimate goal. impaired because they cannot find jobs. They don’t even Some study participants expressed the view that study education of the hearing impaired. They keep educating children with and without disabilities in posting teachers to schools for the hearing impaired and the same classroom improves attitudes toward chil- the teachers are not trained in sign language, how will dren with disabilities as well as the social interactions they communicate?” – a hearing impaired man, Jos among all students. Inclusive education can also accel- Structure and language development are vital to the erate speech-related improvements among children education of hearing impaired children. Educators with developmental disabilities. believe that inclusive education at the primary level “Inclusion is best for children with intellectual negatively impacts hearing impaired students because disabilities because it helps in their speech therapy.” their opportunities for sign language development, – mother of a son with Down syndrome, Lagos which is the mother tongue of the hearing impaired, is reduced. They advocate for direct student-teacher “When I was in university, one of my lecturers would interaction using sign language—not through make disabled and “normal” persons sit together to break interpreters. the barrier of discrimination. SInclusive education is very important.” – a visually impaired woman, Jos 28 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Study participants emphasized that hearing impaired “For people who lose their sight later in life, culture and values are also better absorbed when hear- maybe when they are about to write West African ing impaired learners can interact with one another Examination Council (WAEC)10 or they are in the and with hearing impaired adults. Inclusive education university, need rehabilitation—how to read and write, does not promote hearing impaired culture because mobility and all that. Visually impaired children who hearing impaired children have fewer opportunities to are going to school for the first time have the same interact with hearing impaired peers and adults. needs. So, those kind of special schools will be there to cater for that kind of students. To now advocate for Inclusive Education for Visually Impaired inclusive school like that, to me, it’s not going to work Learners for now, particularly at the primary education level. Similarly, visually impaired participants of this study do Inclusive is good but let’s have functional special schools.” not support inclusive education for visually impaired – a visually impaired man, Lagos children at the primary level. Visually impaired chil- Challenges experienced by visually impaired students dren feel left out in an inclusive classroom, sometimes attending regular schools in South East Nigeria, accord- because the teacher excludes them, even if uninten- ing to a descriptive study by Esere et al. (2016), include tionally. Visually impaired learners in an inclusive negative cultural and traditional beliefs, such as lowered setting also experience inadequate access to learning expectations among teachers and school staff; inad- materials in accessible formats. equate availability of adaptive and assistive devices; “The teacher will write on the board and continue and architectural barriers. A study of visually impaired teaching, forgetting that there are visually impaired students in Lagos State similarly finds a lack of instruc- children in the class and we get lost. Sometimes in the tional support and discriminatory attitudes (Brydges course of teaching, they point to the board and say ‘this’ and Mkandawire 2016). Coping mechanisms include but we don’t know what the ‘this’ is, so they don’t take us getting to know another visually impaired student who along.” – a visually impaired woman, Jos performs well academically and relating with nondis- abled peers without disabilities who are open to such “[…] What is the point of being in the same class relationships (Esere et al. 2016). Role models, champions, preparing for the same examination and the handout and advocates are crucial to raising awareness about the is in print and not braille? We are not prepared for education of persons with disabilities. Esere et al. (2016) inclusive education.” – a visually impaired man, Jos further posits that the low rates of school enrollment The visually impaired participants of this study believe rates among girls may be due to the parents’ fear that that special education is extremely relevant at the their children will suffer abuse and discrimination at the primary level to develop the ability of visually impaired schools and that the removal of subjects such as braille children to read and write and to rehabilitate those education, typing, daily living skills, mobility, and orienta- who become visually impaired. Mobility and orienta- tion from the secondary school curriculum has discour- tion are also more effectively taught in a special educa- aged people with vision impairments to pursue further tion setting. education in Nigeria. 10. The West African Senior School Certificate Examination (WASSCE) is a type of standard- ized test in West Africa administered by West African Examinations Council (WAEC). The examination is informally known as WAEC. 4. REVIEW OF FINDINGS 29 According to Iroegbu (2007), segregated education Management Information System data from states sup- focuses on individuals’ disabilities, isolates them ported by the Education Sector Support Programme in from their homes and communities, and provides Nigeria (ESSPIN) (Humphreys and Crawfurd 2015). The them with less exposure to experiences in the society report identifies disability as one of the cultural barriers (Dada 2006), but it also affords learners with disabil- to education and acknowledges the lack of education ities the opportunity for individualized educational provided to learners with disabilities in Nigeria’s basic programs. Segregated special education can also aid education system. Enrollment rates among children the effective implementation of inclusive education as with disabilities in mainstream schools has been the latter draws from the experience, expertise, and increasing in states that have been implementing the resources of the former, making it more effective at recent ESSPIN interventions, such as Jigawa, Lagos, and accommodating learners with disabilities in inclusive Kaduna, but the retention rate, their needs, and their settings (Iroegbu 2007). experiences at school are not known (ESSPIN 2013). Special education and integrated approaches are Vocational Education and Technical Training currently ineffective at providing education to learners Vocational education involves skill-based programs with disabilities in Nigeria; they force learners to leave that help students acquire the skills they will need their communities, and there are not enough specially to enter a defined vocation or workplace. Technical trained teachers to meet the need (Iroegbu 2007). Mul- training offers general technical knowledge not specific tiple experts affirm that inclusive education is a better to a particular vocation (Okoye and Arimonu 2016). approach (Adetoro 2014; Fareo 2012; Iroegbu 2007; Furthermore, “technical education prepares people for Lang and Upah 2008). In addition, inclusive education entry into recognized occupation at a higher level but practices already exist in the country as general educa- usually lower than the first degree” (Okoye and Ari- tion teachers manage learners of varying cognitive abil- monu 2016). Both technical and vocational education ities, with only those at either extreme being classified offer people the opportunity to become more proficient as special needs learners (Iroegbu 2007). in their current or future occupation. Both take place in Iroegbu (2007) therefore recommends that all preser- formal and nonformal settings in Nigeria, and they are vice teachers be trained in the principles and practice usually offered as combined technical and vocational of inclusive education so that every teacher has the education that merges basic technical and scientific basic skills and knowledge to accommodate all learners knowledge with skill-based learning, particularly in in the same classroom. Other experts express similar formal settings (Okoye and Arimonu 2016). opinions (Adetoro 2014; Eleweke, Agboola, and Guteng There is dearth of published information on the expe- 2015). Teachers already trained in inclusive educa- riences of persons with disabilities in technical and tion can benefit from in-service training to improve vocational education in Nigeria. The government has their skills, assisted by specially trained teachers and established six rehabilitation and vocational centers resources, as needed. The National Policy of Special (one in each geopolitical zone) to provide training to Needs Education 2015 adopts such an approach. persons with disabilities, but most are in deplorable Currently, information on the number of children with condition as a result of neglect by the authorities. Anec- disabilities in Nigerian schools is limited to Education dotal reports indicate that most vocational training 30 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT offered at these centers is outdated, nonfunctional, and “Some of the challenges that visually impaired irrelevant to the young generation. Inclusive technical children face are that some of them want to learn and vocational training is rare in Nigeria, although it carpentry, but the equipment for learning is very sharp, can be found in some other African countries, includ- or that some want to learn how to make liquid soap, ing Uganda and Kenya. The inclusive technical and but there are some chemicals that are very harmful.” vocational training that development partners and – a visually impaired woman, Jos civil society organizations are implementing could be Regular vocational centers and programs are not inclu- studied to guide a similar effort in Nigeria (Light for the sive. Persons with disabilities also encounter stigma World 2017). and communication barriers when they try to learn at It is very common for vocational training to be con- regular vocational centers or programs. ducted in nonformal settings in Nigeria, which allows “Sometimes we go and there is no interpreter, so we just participants to learn in the local community, but little sit and look because there is no interpreter. We have a lot to no evidence exists regarding the accessibility of for- of hearing impaired women who are willing to take on mal and nonformal vocational training to persons with skill acquisition, but there is no interpreter. and nobody disabilities, nor of the related barriers and facilitators. is willing to help them.” – a hearing impaired woman, Jos According to participants of this study, vocational and rehabilitation centers specifically for persons with Adult Literacy disabilities exist around the country, but their number An adult literacy rate is the percentage of a population is inadequate. Many are dilapidated, lack programs for age 15 years or older who can both read and write with relevant vocations, and only have obsolete equipment. understanding a short, simple statement regarding everyday life. Literacy also encompasses numeracy— “We have a vocational center in Zawan, but it is the ability to make simple arithmetic calculations dilapidated, and we want the government to help (UNESCO 2019). because some of our equipment [ for people with disabilities] is obsolete and some not even there.” Groce and Bakhshi (2011) note the global lack of – a visually impaired woman, Jos available publications, statistics, reports, policies, or practices on adult literacy programs and adults with “I think there are about five or six federal disabilities. A recent review of literature on this topic government-established rehabilitation centers in Nigeria reveals that notable adult literacy programs, in the whole of Nigeria we are talking of about such as the UNIVA Functional Literacy Programme 36 states and then the federal capital territory.” and use of radio for nomadic educational programs and – a man with physical disability, Ibadan mother and child educational programs, do not target Furthermore, protective items needed to make it or include adults with disabilities, and that the program possible for students with disabilities to learn certain activities are not available in accessible formats (Akin- vocations—such as carpentry and soap making—are tolu, Nzima, and Kapueja 2018). Given the barriers they not available at the vocational centers, limiting their face in accessing education, persons with disabilities choices. could benefit from inclusive adult literacy. 4. REVIEW OF FINDINGS 31 An analysis of the data (Leonard Cheshire 2018) on the Gaps in Programming inclusion of persons with disabilities in education from Unprepared and inadequately trained stakeholders Nigeria’s General Household Survey Panel 2012–13, and teachers reveals the following: Relevant stakeholders in the inclusive education of stu- dents with disabilities are not yet adequately prepared Primary school completion rates among persons to embrace the concept and take up the challenge. with disabilities is 100 percent compared with Similarly, teachers do not have a solid understanding of 78 percent of people without disabilities; inclusive education practices. Secondary school completion rates of persons with “Inclusive education is very good but the situation disabilities is lower (40 percent) than that of people is that the teachers, special teachers, are not well without disabilities (56 percent); trained.” – a visually impaired woman, Lagos The participation rate in organized learning (a year Lack of early detection and intervention before the official primary entry age) is higher for Most students with disabilities have better outcomes people without disabilities (57 percent) than for if they receive appropriate interventions very early, but persons with disabilities (12 percent); early detection and intervention is not practiced in The rate of participation in formal and nonfor- Nigeria. mal education and in training over the previous “Those students who will benefit from that type of 12 months is lower among youth with disabilities education have been evaluated, and provided with (25 percent) than for youth without disabilities hearing aids for them to follow with their peers. (55 percent); We know that many of the students we have in Adults with disabilities participated less in formal special schools would be in regular classrooms outside and nonformal education and training during the Nigeria because they would have been identified early. previous 12 months (0.5 percent) than had adults For instance, they would have had cochlea implants as without disabilities (4.5 percent); a baby and would have developed speech like every other child. We don’t have this opportunity, and so Nondisabled persons in the age cohort of 25–54 years early detection is not there. And even if it is detected or 55 years and older are more likely to complete early, for how many of them do we intervene?” a university education (9.1 and 9 percent, respec- – a female academic in Public Health, Ibadan tively) than persons with disabilities in the same age groups (4.5 and 5 percent, respectively); and Dearth of learning materials and assistive technologies Among the age cohorts of 15 and older, under 25, Most of the printed materials are not available in and 25 and older, persons with disabilities are less formats accessible to visually impaired students, likely to have functional literacy skills (37, 36, and which are expensive to produce. Assistive technology 35 percent, respectively) than people without dis- is not always available, and when it is available, it is abilities (68, 64, and 61 percent, respectively). unaffordable. 32 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT “As a visually impaired student—at all levels—you don’t sheets of paper plus a carbon sheet between them, have access to most of these materials […] in braille which is manually set. format […] Also those materials seem to be very, very A lack of skills in terms of using assistive technology expensive, the gadgets, accessibility to printers, the devices among teachers is another factor. In fact, a few computer.” – a visually impaired man, Gombe institutions have limited access to assistive technologies, In a survey of 165 special educators from five Nigerian but their students do not due to the inability of unskilled states, Ajuwon and Chitiyo (2016) show that the largest teachers to transfer the necessary skills to the students. users of assistive technologies are learners with a hear- ing or learning disability (53 and 40 percent, respec- Good Practices tively). The study also indicates that the professionals An inclusive private primary school in Jos, Plateau are not trained in the use of assistive technologies, State, enrolls children with various disabilities as well assistive devices and services are not available in class- as those without disabilities, teaching them in the rooms, and the electricity supply is erratic. Respondents same classroom. The teachers are adequately trained from a different study also reported that they have little to educate children with disabilities, and parents of access to assistive devices out of ignorance and due to hearing impaired children are required to have one the high cost (Smith 2011). other family member take lessons in sign language lessons at the school so that the child can communi- No information or publications exist regarding the cate at home. It is compulsory for all students to learn availability and contents of policies, strategies, stan- sign language, regardless of their disability status. The dards, programs, services, resources, and facilities for school’s educational standards are high, which attracts the inclusion of students with disabilities in tertiary many students. institutions in Nigeria. The efforts of information tech- nology stakeholders to make public information more Recommendations accessible to persons with various types of disabilities Ensure that the government puts in place the educa- is also not understood. tional support necessary for inclusive education to work in Nigeria. Lack of educational support to students with disabilities in tertiary education Advocate for inclusive education that targets key Students in higher education do not receive any sup- stakeholders, such as the hearing impaired commu- port to help them study. Other countries have dis- nity and special needs educators and administra- ability support units to cater to the needs of students tors, to get their buy-in, commitment, and support. with disabilities, including the provision of reasonable Develop mainstream teachers in the principles and accommodations in classes and during examinations. practices of inclusive education. Visually impaired students in all Nigerian tertiary insti- tutions use typewriters to answer examination ques- Investigate and learn from the experiences of the tions. According to one visually impaired informant, an private schools that are currently practicing inclu- invigilator reads the questions to the visually impaired sive education for children with disabilities. students, who then respond on a typewriter using two 4. REVIEW OF FINDINGS 33 Integrate the learned experiences of other African with 0.9 percent of women without disabilities. Partic- countries where inclusive education is working. ipants for this study cited several barriers to employ- ment, outlined below. Explore the perspectives of teachers in mainstream schools regarding inclusive education, how prepared Negative Attitudes Among Employers they are to include learners with disabilities in the Persons with disabilities are rarely hired due to the regular classroom, and what would motivate them mindset among employers that sees the disability to accommodate learners with disabilities in an rather than what the person might offer on the job. inclusive setting. Employers in some sectors think persons with disabil- Strengthen early detection and early intervention ities will negatively impact their brand, and in some efforts for children with disabilities by developing cases, job advertisements explicitly discourage persons relevant expertise, providing equipment, and devel- with disabilities from responding. And in a context of oping referral pathways. high unemployment in the general population, persons with disabilities end up relegated to the back of the Establish disability support centers to provide edu- employment line. cational support services to learners with disabilities in tertiary institutions. “There are many people that have graduated and have all the degrees but they don’t have a job. Employment and Livelihoods In fact, they will say ‘we the non-disabled persons Employment is crucial to poverty alleviation and don’t have jobs let alone the disabled persons.’” independent living. However, attitudinal and physical – a male academic in special education, Jos barriers have been cited as some of the challenges “There is a shop where I was working for a preventing gainful employment of persons with dis- woman, and some people came and asked her why abilities in Nigeria, including denial of job opportuni- she allowed me to work in her shop, people would ties; inappropriate job placement; lower expectations not come and buy anything. The woman answered at work; and a lack of reasonable accommodations, and said to them ‘a human being is a human being including assistive devices and technology (Eleweke and I don’t discriminate against people.’” and Ebenso 2016). This may also take a gender dimen- – a woman with albinism from rural area, Jos sion for women with disabilities, who may not meet the standard of beauty required by some firms for employ- Disabling Work Environment ing women; and women with disabilities may be less Persons with disabilities who do get hired can prove educated than women without disabilities and men unproductive due to a lack of inclusive human with disabilities (Eleweke and Ebenso 2016). Leader- resources workplace policies. They may find themselves ship positions may not be given to women with dis- in a work environment that is disabling, including an abilities for a variety of reasons, including the fact that inaccessible physical environment, a lack of assistive they have few opportunities to receive an education devices and technologies, and negative attitudes among or skills development. This may partly explain Leon- colleagues. This results in a lack of job security because ard Cheshire’s (2018) finding of 0 percent women with disabilities in managerial positions in Nigeria compared 34 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT persons with disabilities are likely among the first to be “They don’t employ us because of our short stature. laid off if a redundancy is declared. The only place they accept us is in movies, or in entertainment like dancing. They use people of short “I know that at one point the federal civil service stature as statues by coloring our bodies so people can will improve the employment drive. But if we want laugh. It’s for money that people play such roles.” to look at employment, is it really just about putting – a woman with short stature, Lagos somebody on your payroll and paying them for doing nothing? Part of being employed is to be productive, Denial of Leadership Roles you understand. […] When looking at employment, Persons with disabilities employed in government agen- we shouldn’t just be looking at your name getting on cies tend to be denied leadership roles because of their the payroll but making sure that your environment disabilities. Study respondents cited multiple cases that isconducive, there are disability policies in place at the they believe were intentional. workplace, and all of that. So, looking at it that way we might not find that the quota is being implemented.” “I have never seen a director who is an albino.” – a female wheelchair user, Abuja – a man with albinism, Jos Additionally, most employers of labor today demand Lack of Inclusive Affirmative Action in more skills than previously. However, persons with Employment disabilities may have fewer opportunities to develop In line with the provision of the Disability Act, all their skills due to the many barriers they face—attitudi- public organizations are to reserve at least 5 percent of nal, physical, institutional, and communication-related. employment opportunities for persons with disabilities. Skills development opportunities must be opened up However, it is technically a federal law until domesti- to men and women with disabilities to increase their cated by states, the provision is not being enforced, and participation in the labor market. is mostly subject to the individual discretion of hiring personnel.11 Data from Nigeria’s General Household Survey Panel 2012–13 reveal unemployment rates among persons “With regard to access to employment, we also know with disabilities of 77 and 63 percent for ages 15–24 and that the government has announced that for any 25–64, respectively, compared with people without dis- government established, a certain percent of employee abilities in the same age cohorts at 49 and 21 percent, should be reserve for persons with disabilities. How have respectively (Leonard Cheshire 2018). The data also we implemented this thing?” – a male academic, Oyo show that 61 percent of youth with disabilities (ages 15–24) are not in education, employment, or training Inappropriate Employment compared with 23 percent of persons without disabil- Persons with disabilities sometimes accept jobs in ities in the same category. Additionally, 12 percent of undesirable industries because it is their only available adults with disabilities and 16 percent of people with- opportunity. For example, the portrayal of persons with out disabilities (ages 15 and older) have an account at a disabilities in the entertainment industry can indirectly bank, at another financial institution, or with a mobile reinforce negative images of disability. money service provider. 11. https://www.premiumtimesng.com/news/headlines/307494-ten-things-to-know-about- nigerias-new-disability-law.html. 4. REVIEW OF FINDINGS 35 Gaps in Programming those with cognitive impairments (Eleweke and Ebenso The implementation of inclusive employment poli- 2016). In addition, information meant for the general cies and pronouncements is inadequate. population is not available in language simple enough for people with intellectual disabilities to access. The absence of an inclusive human resources policy puts employees with disabilities at a disadvanta- In tertiary institutions in Nigeria, studies indicate geous situation at work. insufficient access to assistive technologies for making information accessible to students with disabilities There is a lack of advocacy for inclusive employment. (Ezeani et al. 2017). Reported challenges include the lack of available assistive technologies for people with Good Practice sensory impairments, out-of-use assistive technologies, The Plateau State government is implementing the negative attitudes among relevant staff and peers, and employment provision in its disability law. physically inaccessible information and communica- Lagos State Special People’s Law 2011 has an employ- tions technology facilities and resources. This study ment quota for any organization with 100 or fewer reveals similar findings, as described below. people in their workforce of 1 percent for people with disabilities. Inaccessible Public Information and Communications Recommendations Public information and communications are not acces- Increase advocacy efforts for inclusive employment sible to people with sensory impairments, including that target all private and public sectors. individuals with albinism. Information is not available in accessible formats, such as sign language, audio, sim- Develop and fund inclusive employment and liveli- ple language, and large typeface. When provided, sign hood interventions by development partners. language interpretation on television is ineffective. Promote the active participation of men and women “We have sign language interpreters on TV, but in a very with disabilities in skills development programs and small corner and we might have to call our children to in leadership roles. come and interpret for us. But the children sometimes run away or fall asleep when it is time for news because they Public Information and Communications are tired of interpreting.” – a hearing impaired woman, Jos Study participants identified the lack of access to public information and communications as a major constraint Illiteracy to the social development of persons with disabilities, The high rate of Illiteracy among persons with dis- particularly individuals with sensory and cognitive abilities makes it difficult for many to access public impairments. Elsewise and Ebenso (2016) document information in English. Sometimes, information is not the absence of adequately trained sign interpreters as a available in the local languages. challenge for the hearing impaired population in Nigeria in accessing public information and communications. “The information on the radio is in English and this Similarly, public information is seldom available in for- language is not understood by a majority of our members mats that are accessible visually impaired persons or to at the grassroots level.” – a visually impaired man, Gombe 36 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Poor Quality Sign Language Interpretation Review, document, and provide assistive technol- The quality of sign language interpretation in the coun- ogies and apps for persons with different types of try is poor. Interpreters do not receive any organized disabilities, such as for a mathematics student with training to qualify, hindering effective communication weak hands. with hearing impaired people and ultimately negatively Develop expertise to foster the local production of impacting their socioeconomic development. assistive technologies. “We don’t have any institution in Nigeria that trains interpreters. Those who we call “interpreters” are just Health signers. They are o nly trained to use sign language. They In Nigeria, as elsewhere in the developing world, health use speech language to sign; we can’t classify them as services are seldom accessible to individuals with phys- interpreters. There should be something like a registered ical, sensory, intellectual, or mental disabilities. Barriers certificate for interpreters.” – a hearing impaired man to accessing health services include physically inacces- (hearing impaired educator), Oyo sible environments, negative attitudes among health workers, low knowledge of disability issues by health Gaps in Programming care workers, inaccessible equipment, and lack of avail- Assistive technologies are lacking to make public able health-related information in accessible formats. information accessible in alternative formats. There is dearth of research into the general accessibility Making information and communications accessible of health services in Nigeria. Smith (2011) reports that to persons with disabilities is a low priority for the 71 percent of the respondents of a survey of persons government. with disabilities in the states of Kogi and Niger were unable to access disability-specific health services. Some Capacity is lacking to provide accessible information studies focused on sexual and reproductive health, and communications. including HIV, document the experiences of persons Good Practice with a variety of disabilities while they try to access Ability Plus, a television program on Nigeria television health care services. They demonstrate that informa- that highlights the needs and the potential of persons tion, educational resources, and services for sexual and with a variety of disabilities, is anchored by a hear- reproductive health, including HIV, are inaccessible to ing impaired woman and presented in sign language. persons with disabilities despite the reportedly high Experts have pointed that the studios where the pro- rates of risky sexual behavior among this group (Ader- gram is recorded should be improved to allow access of emi, Pillay, and Esterhuizen 2013; Groce, Yousafzai, and persons of disabilities into the building. van der Maas 2007; Olaleye et al. 2007). Most available studies focus on the hearing impaired community (Aru- Recommendations logun et al. 2012, 2013; Groce, Yousafzai, and van der Develop and implement inclusive information and Maas 2007; Osowole 1998). communications policies. Research shows that persons with disabilities, like Provide assistive technologies to make public infor- other vulnerable groups, are at a high risk of acquiring mation accessible to persons with disabilities. conditions related to sexual and reproductive health, 4. REVIEW OF FINDINGS 37 and that they need equal access to relevant services Ignorance of Disability Among (Aderemi 2014; Aderemi, Pillay, and Esterhuizen 2013; Health Workers Arulogun et al. 2012, 2013; ENR 2015). However, persons People affected by leprosy complain that health with disabilities are seldom able to access sexual and workers stigmatize them as being contagious long after reproductive health services—or any other health care they have ceased being so, although they live with the services for that matter. The findings of a recent audit of resultant impairments caused by the infection. Such health, social, and criminal justice facilities reveal that an attitude is indicative of the ignorance level among 93 percent of health care facilities do not have disabili- health workers on topics with which they should be ty-friendly policies, and only two of the 14 audited facili- familiar—they should be educating the general popula- ties are physically accessible (DRAC 2018). tion to reduce stigma. There are a few studies documenting the low level of “I am a leper, when I go to the hospital, they treat knowledge among health care personnel regarding dis- me very well the first day. And, if I pass the night at ability matters. For example, Bakare et al. (2009) finds the hospital, the next day they chase me out saying that health care workers have little knowledge of some other patients won’t want to come because I am there.” of the symptoms of childhood autism. Similarly, only a – a woman affected by leprosy, Jos few respondents were aware of risk factors for hearing loss in infants, such as low birthweight and mater- Prohibitive Cost of Care nal exposure to noise during pregnancy (Olusanya The cost of medical treatment is often beyond the and Roberts 2006). This study’s findings corroborate means of the average person with a disability. Most the existing literature, as illustrated by the following persons with disabilities have no access to health descriptions of their experiences. insurance, except the few who work for the federal government. Negative Attitudes Among Health Workers “It is not really affordable because by the time you Health workers exhibit negative attitudes toward per- check the consultation fee and other fees, not everybody sons with disabilities, particularly in the area of sexual can afford it. Particularly the mentally ill, who have and reproductive health. They generally frown upon the been neglected, and nobody is taking care of them.” idea of a woman with a disability being sexual, and if the – a man with mental illness, Benue woman is pregnant, health workers will probably ridicule and blame her for it. The health workers’ attitudes reflect Inaccessible Information and those of the larger society that discriminates against Communications women and girls with disabilities. In some instances, this Health-related information and educational materials has reportedly led to the sudden death of the woman. are not available formats accessible to persons with “There are instances where midwifes help a woman disabilities in Nigeria. Hospitals lack sign language to give birth, see a person with albinism, and are in interpreters, so hearing impaired patients must depend shock. “What have you given birth to?”. And some on their family members and friends to communi- women will just go into depression and die.” cate, representing a breach of confidentiality. Visually – a man with albinism, Abuja impaired patients are unable to independently read 38 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT their medication instructions, and must also sacrifice Gaps in Programming their right to confidentiality in some instances. Dearth of early intervention services Early medical interventions, such as rehabilitation and “Our major challenge is communication, I had high BP, the speech therapy, are scarce in Nigeria. The lack of exper- doctor didn’t tell me my diagnosis. Health is not accessible tise in these areas constitutes a major challenge to early to us as persons with disability. It’s a big challenge, so intervention, particularly for children with develop- we rarely use hospitals but rely on self-medications or mental disabilities. The experts who are available are pharmacies.” – a hearing impaired woman, Lagos very expensive. “For most government programs that have to do with Lack of training and skills in disability inclusion health, whether it is reproductive health or else, most Health workers lack disability-inclusion training, rep- information is not in accessible format for visually resenting an enormous gap in addressing the needs of impaired people.” – a visually impaired man, Gombe persons with disabilities in the health sector. “Sometimes, when you go to the hospital, you are Lack of budget allocation given different types of prescription. To find the drug A lack of relevant budget allocation is an impediment you need to rely on somebody else, there is no inscription to the implementation of health policies for addressing on the [medication] to identify which one you need to issues impacting persons with disabilities. take in the morning, which one you take in the afternoon, which one is which.” – a visually impaired man, Gombe Lack of inclusive health policies Health-related policies do not address the needs of Inaccessible Environment and Equipment persons with disabilities. The only disability-specific The physical environment at most health facilities in national-level policy on sexual and reproductive Nigeria is inaccessible to persons with mobility and health for persons with disabilities has not yet been visual impairments. Also, hospital beds and equip- implemented. ment may not be accessible to persons with mobility impairments. Good Practices Health workers in Akwa Ibom State do not discrim- “Health is not accessible, starting from the accessi- inate against persons affected by leprosy—a result bility into the facility, to their beds. This caused me of the work of The Leprosy Mission and the German to lose my child 10 years ago when I was pregnant and Leprosy and Tuberculosis Relief Association to sen- enrolled for an antenatal clinic. Unfortunately sitize and raise awareness of relevant stakeholders the antenatal clinic was upstairs, the rest rooms and in the health sector. The health workers are now well bathrooms were not accessible. If the hospitals had versed in the treatment and prognosis of leprosy. been accessible, I would have been on bed rest for them to manage my condition; I do not have a child till now.” The Comprehensive Community Mental Health – a female wheelchair-user, Lagos Programme in Benue State provides mental health services at the community level using low-cadre health workers trained specifically for the purpose. The health workers are government workers, which 4. REVIEW OF FINDINGS 39 promotes the sustainability of the program. The sectors that can make up a CBR strategy include:12 (1) health workers are supervised by a tertiary hospital education; (2) employment; (3) health; (4) livelihoods; in the catchment area. The program includes the and (5) social services. A CBR program does not have to establishment of the Mental Health Advocacy Initia- implement activities in all of the components; rather, it tive, which includes mental health service users and should consult with persons with disabilities to identify community members. It raises awareness around and prioritize the services they need, and the establish mental health at the community level and provides collaborative relationships with other programs in its support to service users. service provision catchment area. The Minister of Health recently launched a policy on Empirical studies documenting the practice of CBR in the sexual and reproductive health of women and Nigeria, the experiences of persons with disabilities, girls with disabilities, developed in collaboration with lessons learned, and good practices during the imple- the national-level nongovernmental organization mentation of CBR programs are sparse. A pilot project (NGO) Disability Rights Advocacy Center in Abuja. aimed at facilitating the reintegration of persons with disabilities into their communities after they completed Recommendations a vocational rehabilitation program was implemented Provide health information, education, and commu- in Oyo State (Alade 2004). Reportedly, the project has nication in accessible formats. successfully trained 155 persons with disabilities since its inception, has witnessed an increase in vocational Train health workers to provide inclusive health training programs from 7 to 24, has provided revolving services and to understand the rights that men and loans to trainees, and has been introduced in six other women with disabilities have to health care services. Nigerian states. Major implementation challenges Collect and disaggregate disability-related data from include inadequate funding due to low repayment rate patient records. of loans and lack of expertise among local artisans to train people with vision impairments. Findings from Raise awareness among persons with disabilities of another descriptive survey of the beneficiaries of a their right to health services, including sexual and CBR program in Akwa Ibom State indicate a significant reproductive health care. association between CBR and livelihood enhancement Make health insurance accessible to persons with dis- among persons with disabilities (Effiong and Otu 2017). abilities to reduce exorbitant out-of-pocket expenses. Ebenso et al. (2010) presents the findings of a 13-year historical review of the transformation of the socio- Community-based Rehabilitation, economic rehabilitation project in northern Nigeria Assistive Devices, and Technology into a coordinated CBR program for people affected by Community-based rehabilitation (CBR) is a communi- leprosy, including formulating new program policies ty-level effort and multisectorial approach to rehabil- and guidelines and training staff in CBR principles itate persons with disabilities, equalize opportunities, and practices. The review’s findings point to the fact and socially include all children and adults with dis- that the adoption of CBR principles and community abilities (Samuel 2015). The CBS matrix, which gives an overall visual representation of CBR and the different 12. See: World Health Organization https://www.who.int/disabilities/cbr/matrix/en/ 40 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT development projects can stimulate improvements in Reorient CBR actors and their capacity develop- living conditions, self-esteem, and acceptance of people ment efforts to enshrine CBR principles into project affected by leprosy into the community. However, peo- implementation plans; ple in the program who are affected by leprosy remain Maintain the change processes initiated by com- economically dependent on the program, and the munity-level CBR programs (e.g., by ensuring the mobilization of other funding and partnerships for the continuity of an effective idea or scheme); program is weak, making the program unsustainable. Ensure the participation of persons with disabilities, In 2015, CBM International’s Nigeria country office, their organizations, and the community in decisions one of the main funders of CBR programs in the regarding the evaluation and ownership of CBR country, evaluated its 10 CBR projects, most of which programs; and had already been supported for about 10 years each (Enablement 2015). The evaluation found multiple Mobilize multisectoral partnerships and networks factors crucial to effective CBR programming: the (Ebenso et al. 2010; Enablement 2015). establishment of a multisectoral partnership network, Participants of this study claimed that assistive devices including a strong collaborative relationship with and technology are not readily available in Nigeria, and the government; the empowerment of persons with because they are imported, they are very expensive if disabilities; a clear understanding and practice of CBR available. principles; community-targeted activities; CBR program ownership; and the adoption of a rights-based rather Local expertise regarding the manufacturing of assis- than a charity-based approach. A community-based tive devices is lacking, and when is available, there is approach is also more effective than a CBR program little funding and incentives from development finance operating within an institution, such as a hospital. institutions, which reduces the opportunities for scaling up the production of these devices easily and quickly. According to the findings of the present study, CBR is There is only small-scale production, with most of the currently quite uncommon in Nigeria, with only a few locally fabricated assistive devices being either obsolete such programs in existence, such as blindness rehabil- or inappropriate for the intended users. itation in Zaria and a program for other disabilities in Kaduna. “The types they produce in Nigeria are not comfortable. We just put the person in the wheelchair, not minding if “Okay, we have a few that do provide basic rehabilitation they are comfortable.” – a hearing impaired man, Jos services. We have one in northern Nigeria, we call it Hope for the Blind, Zaria.” – a visually impaired man, Gombe “Ordinarily, assistive technology is not readily available in markets in Nigeria, because they are The revival of CBR programming in Nigeria is vital to not commonly demanded due to their high cost. promoting the inclusion of persons with disabilities at But if you demand it, they can import it for you.” the community level and for advancing disability-inclu- – a visually impaired man, Lagos sive development in the country. The following steps are essential to sustain their sustainability: 4. REVIEW OF FINDINGS 41 “One barrier is the availability of knowledge. offers a diploma program in community-based rehabil- Do they even know it’s available? And that starts itation. The program helps to generate interest in the from the educational system.” field and raise experts. However, it is only offered as a – a female academic in public health, Ibadan diploma course. Similarly, therapists are very few, based in large cities, A few international NGOs focused on leprosy provide and usually with privately-owned practices; it is also assistive devices to persons affected by leprosy in the very expensive to engage their services. These factors states where they work, including The Leprosy Mis- have significant implications for early intervention and sion International, German Leprosy Relief Agency, and rehabilitation, particularly in rural settings. Damien Foundation. “The speech therapists are too expensive to access. Recommendations The speech therapist, occupational therapist, Assess and strengthen existing CBR initiatives physiotherapist. My God! There are some people who say through capacity development on CBR principles “There are NGOs that have this equipment”, but you will and practices. pay through the nose to access the therapy for the child and they keep telling you they are doing you a favor.” Mainstream CBR issues into existing and future – mother of an adult with Down syndrome community-based interventions to address the needs of persons with disabilities. Gaps in Programming Develop manpower and establish facilities to locally Inadequate expertise and centers for manufacturing produce assistive devices and technology. of modern assistive devices. Low knowledge level of the principles and practice Transportation of community-based rehabilitation. Accessibility is both a principle and an Article of the United Nations Convention on the Rights of Persons Lack of sustainability plan or design of community- with Disabilities (UN 2006). Accessibility should be based rehabilitation programs. comprehensive, including the provision of accessible Little government commitment to community- information and communications. Access to transpor- based rehabilitation and the local production of tation goes beyond services to include the personnel assistive devices. and physical environment utilized in the delivery of such services. Therefore, the inclusion of persons Good Practices with disabilities should be prioritized across all com- There are a few local government areas in Kaduna ponents of the travel chain, including the pedestrian that have community-based rehabilitation programs, environment, access to terminal buildings, information including the local government areas of Kajiru and provision, public transportation, and operators and Suba. These communities run workshops supported by managers (Babinard et al. 2012). The government and the local government authority. They train persons with its partners have an obligation to understand, identify, disabilities within the community in vocations such as and remove every barrier to the transportation of per- welding, bricklaying, and tailoring. The University of Jos sons with disabilities. 42 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Accessible transportation is important to increasing Negative Attitudes Among the participation of persons with disabilities in the Commercial Drivers mainstream of life—social, economic and political— Some commercial drivers think that it is a waste of and in reducing poverty (Babinard et al. 2012; Odufuwa their time to help a passenger load a wheelchair into 2007). When transportation is accessible, other groups their vehicle or assist a visually impaired person by also benefit, including the elderly, children, and preg- dropping them at an appropriate bus stop. nant women (Babinard et al. 2012). However, inclusion “So, when we stop a vehicle, the driver will say, ‘ is rarely a priority in transportation planning, design, If I pick up this person, she doesn’t even know where construction, or implementation in Nigeria. she is going, she will waste my time and that of other A few available studies indicate the road environment, passengers.’ If I don’t go out with my guide, I might end vehicle design, and travel information as the main up in the wrong place.” – a visually impaired woman, Jos mobility challenges faced by persons with disabilities in Nigeria (Ipingbemi 2015; Odufuwa 2007). Poverty is Negative Attitudes Among Co-passengers also a negative consequence of the exclusion of persons Additionally, other passengers may shift away from with disabilities from transportation in the country persons with severe disabilities or alight from a vehicle, (Odufuwa 2007). The transportation barriers reported suggesting a discriminatory attitude toward persons by persons with disabilities for this study are summa- with disabilities. Due to these attitudes, persons with rized below. disabilities are often forced to hire taxis to their desti- nations rather than boarding buses or public taxis. This Inaccessible Vehicles means additional expenses for people who are already Public transportation in Nigeria is physically inaccessi- economically disadvantaged in many ways. ble to persons with various types of disabilities. Com- “When you stop a vehicle to enter and they see mercial drivers often have negative attitudes toward you’re disabled, the people in the vehicle will not even them; some refuse to drive people who have been allow you to enter. Some drivers believe that if they take affected by leprosy; some charge more to transport you, other passengers might not get on or alight from the assistive devices such as wheelchairs; and some will not public bus.” – a woman affected by leprosy, Jos even accept a wheelchair-using passenger. It is crucial to raise awareness to these challenges And most cars are not constructed to take care of among relevant stakeholders—policy makers, develop- persons with disability. We struggle to get into the car, ment partners, and personnel—and to jointly explore we struggle to see how we can get on the bus.” sustainable solutions. It is also critically important to – a male disability activist, Akure consult with persons with disabilities and their organi- “He has his wheelchair and the loads. Each time zations during the planning, design, construction, he wanted to enter, they would tell him he had and implementation phases of transportation programs to pay for all the seats where he would sit.” in Nigeria. – a male academic in Special Education, Jos Anecdotal reports suggest that the Nigerian avia- tion sector is grossly inaccessible to persons with 4. REVIEW OF FINDINGS 43 disabilities, although there is an unfortunate lack of personal socioeconomic and political roles. Domes- published research on the subject. Disability inclusion tic and international airports in Nigeria should make in this sector is primarily informed by the medical provisions to allow access for persons with disabilities, model of disability, which does not recognize the rights including those using wheelchairs. Airport staff, includ- of persons with disabilities to accessible air travel. ing that of the Federal Airport Authority of Nigeria, do not receive adequate training on the principles and This study finds evidence of discriminatory attitudes practices of inclusive air travel for persons with disabil- among airline and airport staff, who often associate ities. They usually demonstrate inappropriate and risky disabilities with illness and think that passengers with boarding procedures and handling, such as demanding disabilities are incapable of caring for themselves while a passenger with mobility difficulties pay for the use onboard. Sometimes, persons with disabilities are told of a wheelchair for boarding, as this study documents. they must travel with a companion, even though many Sometimes, airport staff damage assistive devices, such can and do travel unaccompanied, especially given as wheelchairs, and then refuse to replace them. the expense of traveling with an assistant. In some instances, unaccompanied passengers with disabilities “The airline insisted I pay for wheelchair services have been prevented from boarding planes or have despite the provisions of the Disability Act and been forced to deplane. the Air Passenger Bill of Rights.” – a female with mobility impairment, Abuja “As a visually impaired person, you cannot get on board [an airplane] without a guide. […] A visually impaired Furthermore, the wheelchair-accessible parking at woman reported to us; she finished school and tried the Nnamdi Azikiwe International Airport, Abuja, is to come back to Abuja from Lagos, from a kind of not available to air travelers with disabilities. The parking rehabilitation center in Lagos. Suddenly, when she went has been converted to “VIP” (very important person) to the airport in Lagos, they told her she could not board use and requires the purchase of a sticker that costs unless she had somebody [to take care of her]. After a lot N100,000 annually. Indeed, there is a great need for inter- of dragging, the woman had to pay a certain amount ventions in the aviation sector to improve the situation. of money for her to be taken care of on board before she was allowed to board. This is a serious. It is not all Gaps in Programming There is little awareness among commercial drivers, the airlines [that do this], but we receive these types of airline staff, and airport staff of the transporta- cases.” – a visually impaired man, Gombe tion-related rights and needs of persons with disabil- Many think this sector is a lower priority than public ities, including the handling of assistive devices. road transportation under the incorrect assumption There is a lack of facilities for safe, convenient, and that only a few persons with disabilities travel by plane. dignified boarding. This category of men and women with disabilities, who have the resources to undertake air travel, are key to Inclusive transportation is a low priority to relevant disability inclusion advocacy in Nigeria and globally if stakeholders. they are able to travel without constraints. They depend on air travel to fulfill this important role as well as other 44 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Recommendations community-based health insurance scheme. Govern- Raise awareness among commercial drivers as well ment ministries, departments, and agencies (MDAs) as among the staff and management of airlines and have implemented other ad hoc social assistance airports about disabilities, persons with disabilities, programs, such as child savings accounts, disability and their rights. grants, health waivers, education support, and nutrition support. Other donor-led programs include conditional Train airline and airport staff on how to appropri- cash transfers for girls’ education in three states, child ately handle assistive devices. development grants in two states, and programs that Ensure that the government provides accessible include social protection components. transportation for passengers with disabilities. In 2016, the Nigerian government organized all of its Develop and implement an inclusive transportation social welfare initiatives under a single umbrella called policy. “social investment,” with no deliberate effort to ensure the inclusion of persons with disabilities. The social Social Protection investment umbrella includes five program compo- Social protection (or social security) is a human right, nents: (1) N-Power—job provision to youth, particularly defined as a set of policies and programs designed to young graduates: (2) homegrown school feeding; (3) the reduce and prevent poverty and vulnerability through- national cash transfer program; (4) an enterprise and out the life cycle (ILO 2017). According to the Interna- empowerment program; and (5) the STEM (science, tional Labour Organization (2017), social protection technology, engineering, and mathematics) bursary includes benefits for children and families, maternity, program (Ukpong and Ikoh 2017). The National Social unemployment, employment injury, sickness, old age, Protection Policy was finally approved in 2017, but disability, survivors of crisis and conflict, and health these five program components persist as the govern- protection. Social protection systems address these ment has not yet rolled out the full implementation areas with a mix of contributory and noncontributory plan for it (Ukpong and Ikoh 2017). schemes (ILO 2017). Disability, gender, ethnicity, geographical location, and HIV status are social dimensions of vulnerability Poverty and inequality are rife in Nigeria. A social pro- that influence people’s exposure to risk as well as their tection policy has been on the agenda since 2004 but resilience (UNICEF 2015). Social protection programs remained at the draft stage due to inadequate political can therefore improve people’s living standards and traction (Hagen-Zanker and Holmes 2012) until it was households’ access to services, which can then lead to finally approved in 2017. The lack of a national-level inclusive development outcomes (UNICEF 2015). social protection policy had been an impediment to the implementation of a social protection policy at the Disability and poverty interact in a vicious cycle such state level. There are currently three small-scale pro- that persons with disabilities are among the poorest grams led by the federal government: Care of the People of the poor, with limited access to education, employ- (COPE), a conditional cash transfer program; subsi- ment, or livelihoods. Coupled with adequate access to dized maternal and child health care provision; and the basic services, social protection can provide livelihood 4. REVIEW OF FINDINGS 45 security of and alleviate poverty among persons with internal bureaucracies of organizations of persons with disabilities (Palmer 2013; UNICEF 2015). disabilities, and corruption of the leadership of organi- zations of persons with disabilities. These are discussed Despite the vulnerability of persons with disabilities, in turn below. there is no evidence of concrete provisions for including them in all of the existing social protection programs in Lack of Access to Social Security Schemes Nigeria, although the National Social Protection Policy Persons with disabilities experience high levels of included such provisions. In fact, some of the eligibility poverty, but they do not have access to loans or grants conditions may not favor most persons with disabilities. to start businesses, to access education and health, or For example, COPE’s conditional cash transfer program to augment their incomes. Life is more expensive for a targets households with children of school-going age person living with a disability, who might need assistive that are headed by a woman or that include a member devices, aides, personal assistance, home accommo- who is elderly, has a disability, has fistula, or is HIV-pos- dations, accessible transport, rehabilitation services, itive. A woman with a disability in Nigeria may not have or medical treatments to improve functioning. Access children or a head a household and so therefore may not requires financial resources that the average person be eligible to be a primary beneficiary. Similarly, women with a disability or a typical household that includes a with disabilities are less likely to benefit from the mater- member with disability may not have. nal and child health care program. Only the Jigawa State government provides disability grants to its citizens “My elder sister gave me a plot of land now and said without clear eligibility criteria. Eligibility requirements “Since you have learned about poultry, “Start a poultry for social protection schemes should be reviewed to [ farm] and take care of yourself.” But without money better include persons with disabilities. to invest in the poultry business, how was I supposed to do that?” – a woman with physical disability, Jos Studies on the coverage of persons with disabilities by the conditional cash transfers in Nigeria are sparse. A “It is very expensive, especially with cerebral palsy review of cash transfer programs for persons with dis- children. I tried taking my daughter to [an NGO], the abilities in developing countries generally indicate pos- condition there is that you have to bring a nanny. itive socioeconomic and service access outcomes, but If the child cannot sit you have to get a special chair, coverage and benefit levels remain low (Palmer 2013). called the CP Chair, and the last time I checked it cost Leonard Cheshire (2018) reported a social protection about 200,000. As a person who is not working, you get coverage of 1.4 percent for persons with disabilities in [the chair] and you will be able to move the child to Nigeria compared with 2.4 percent for persons without school, but you still have to settle the school fees.” disabilities. This report was based on data on people – father of a child with cerebral palsy, Jos that contributed to the national insurance scheme, which also highlights the exclusion of persons with Internal Bureaucracies of Organizations disabilities from employment. of Persons with Disabilities Occasionally, when social security is available, persons The experiences of persons with disabilities participat- with disabilities who are not affiliated with an orga- ing in this study related to social protection are char- nization do not benefit, possibly because they did not acterized by a lack of access to social security schemes, 46 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT receive the relevant information or because they did Recommendations not meet certain requirements, such as being a regis- Investigate the level of access to the current social tered member of a relevant organization. Provisions are protection schemes that persons with disabilities not usually made to facilitate the access of persons with have, including barriers and facilitating factors. disabilities to schemes aimed at the general population. Address disability as a cross-cutting issue in the “Between 2013 to 2015, the government established current National Social Protection Policy. a program and we were given money to start a small Develop an implementation plan for the National business. But to enjoy this program, you had to belong to Social Protection Policy, including monitoring and a certain association.” – a visually impaired woman, Jos evaluation with disability-specific indicators and “Like for the cash transfer, we are not aware and disaggregation of data by disability. nobody is going to tell us. So it would be better if Develop eligibility criteria that do not exclude per- the government could send us text messages.” sons with disabilities. – a visually impaired woman, Jos Ensure the active participation of persons with Gaps in Programming disabilities, their organizations, and/or disabili- Provisions of the National Social Protection Policy ty-focused actors in the development of the imple- that address the needs of persons with disabilities mentation, monitoring, and evaluation plan for the are not being implemented. National Social Protection Policy. The National Social Protection Policy does not include disability as a cross-cutting issue; only a few Electoral and Political Processes provisions mention disability inclusion. Low Knowledge Levels Among Staff Independent National Electoral Commission (INEC) staff Monitoring and accountability strategies to ensure lack adequate knowledge about disabilities. They did not the proper implementation of the existing social receive any disability-related training for the 2019 elec- security schemes are Inadequate. tion, which made it difficult for them to define or identify persons with disabilities during the election cycle. Good Practices The Lagos State government is implementing a “We deployed observers to seven states and Abuja disability grant to alleviate poverty among persons and the report was the same. […] So even the INEC with disabilities through the Lagos State Office for [Independent National Electoral Commission] ad hoc Disability Affairs. The entrepreneurship loans aimed staff does not know who is a person with a disability, at the general population are also inclusive of per- they don’t even recognize it. So, when the INEC does not sons with disabilities. make a concerted effort to build the capacity of their staff to cater for people with disabilities, it becomes a The Plateau State government, through the Plateau problem.” – a male amputee, Lagos State Disability Rights Commission, is implement- ing social security schemes specifically targeted at persons with disabilities. 4. REVIEW OF FINDINGS 47 Inaccessible Election Procedures “Recently the Albino Foundation launched what and Facilities we call a “disability inclusion campaign.” And Although INEC made attempts in some places, overall, this disability inclusion campaign is not only to the electoral procedure and facilities were not accessi- get persons with disability into the electoral process ble to all persons with disabilities. For example, persons but to get persons with disability into every sphere, with disabilities who do not have fingers were unable to every sphere of governance you know. Now we vote. Similarly, some polling units were not physically are putting pressure on the state house to appoint a accessible to persons with mobility difficulties. person with a disability as one of the cabinet ministers.” – a man with albinism, Abuja “During the INEC registration, we registered but we were not given Permanent Voters Card. We Gaps in Programming have visited the INEC office several times, but they Political will is lacking to facilitate the active partic- keep directing us to different places, and we cannot ipation and leadership of persons with disabilities in cast votes. And it was announced on the news that electoral process and governance. even people with disabilities have the right to vote.” – a man affected by leprosy, Jos The capacity of electoral workforce to ensure disabil- ity-inclusive elections is weak. “That is why even in the last election so many of us could not thumbprint. Many of us are disenfranchised The implementation of the INEC framework on and I even complained to the INEC chairman. He said access and participation of persons with disabilities he was going to look into the matter but nothing is in electoral processes is haphazard. being done.” – a man affected by leprosy, Benin Good Practices Lack of Opportunities for Political INEC developed the Framework on Access for Per- Participation and Leadership sons with Disabilities in the Electoral Process. Persons with disabilities are systematically excluded A paper ballot was designed in braille for the 2019 from political participation and leadership. They are elections. often marginalized into political appointments that are disability-specific, even when they have areas of Recommendations expertise or interest where they could better perform. Adequately implement the INEC framework for the Currently, persons with disabilities are not represented access and participation of persons with disabilities among Nigeria’s cabinet ministers. If they can partic- to the electoral process, guided by an implementa- ipate, they are more vulnerable to cases of political tion plan. violence, for example. Develop the capacity of INEC officials to oversee an “[…] The best that they can do is to create a disability inclusive electoral process. office for you. Even if you are the best doctor or the best communicator in a wheelchair, they won’t consider you Foster the active participation of persons with disabil- for Commissioner of Health or Education. At most, they ities and their organizations, and develop the capacity will give you “Disability affairs, Special Adviser.” These of INEC officials to implement the framework. things are demoralizing.” – a visually impaired man, Lagos 48 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Institutional Landscape with disabilities. It used to have a vague rehabilitation This section presents the findings and discussions policy that was inadequately implemented. However, related to the situation of the various institutions that the ministry recently developed a national-level disabil- are relevant to disability inclusion and the socioeco- ity policy. nomic development of persons with disabilities in About 20 of FMWASD’s current staff members are per- Nigeria. sons with disabilities, 40 percent of whom are female. Government Ministries, Departments, “I don’t have the actual number, but we should be and Agencies about 20 or less than. I think they are more than us, on Core mandates average let’s say 40 percent.” – FMWASD official While its area of discipline informs the core mandate of There is no coordination between the other depart- an MDA, all share broad responsibilities including: ments of the ministry and the rehabilitation depart- Regulation of its areas of specialization, includ- ment that handles disability issues. The ministry ing the setting of standards and guidelines and includes departments that handle gender, children, monitoring; and the elderly, but their programs and policies are not disability-inclusive despite the known intersections Provision of relevant services; between the issues of these other departments with Formulation, review, and implementation of policies disability. Similarly, disability issues are isolated in and programs; the ministry’s rehabilitation department, with other ministries believing that FMWASD should manage all Personnel welfare and management; and disability-related concerns, an approach that further Coordination and/or collaboration with states to marginalizes persons with disabilities. Overall, however, ensure uniformity and standardization in its spe- the study and the opinion of experts consulted for it cialty area. point to an overall gap in institutional coordination in the government to address disability inclusion. The rehabilitation department of FMWASD is respon- sible for disability matters in Nigeria. The ministry still FMWASD may also be unintentionally encroaching relies heavily on the charity approach to deliver its into the mandates of other ministries due to a lack of mandates. effective collaboration and coordination. Budget allocations are insufficient to run programs for Disability-inclusive policies and practices persons with disabilities. Some past programs are no Only three of the MDAs who participated in this study longer feasible due to lack of funds. claim to have any disability-inclusive or disability-spe- cific policies or practices, and even these are only being “Now we can’t even provide the subsidies we used to give partly implemented—if at all—usually due to lack of to organizations for persons with disability in the past.” funding. The Federal Ministry of Education is subject – FMWASD official to the following policies, none of which have been fully The ministry is not currently implementing any implemented: National Policy on Special Needs Educa- policies to address the needs and concerns of persons tion in Nigeria and Implementation Guidelines, 2015; 4. REVIEW OF FINDINGS 49 National Policy on Inclusive Education in Nigeria, 2017; public service delivery. OHCSF interfaces with other and National Policy on Albinism in Nigeria, 2012. MDAs on issues regarding civil service regulation, including the welfare of employees. The Federal Ministry of Power, Works and Housing (FMPWH) is subject to the National Urban Develop- In 2003, OHCSF became the first government organ in ment Policy, National Housing Policy, and National Nigeria to establish a disability desk. It is located in the Building Code. The National Building Code enforces the Occupational Health, Safety and Environment Division country’s building standards. It addresses everyone’s under the Employee Relations and Welfare Department. needs, including persons with disabilities. It sets stan- The division’s main function is to provide guidelines on dards to ensure that private and public buildings are health, safety, and the environment. The disability desk usable by persons with disabilities. was established to implement disability-inclusive prac- tices in OHCSF with the main objective of coordinating “The National Building Code [… is] a set of guidelines the affairs of all federal civil servants with disabilities and that addresses the needs of everybody with regard to to improve their working conditions. building developments, but there are special sections that address issues of disability.” – FMPWH official “First and foremost, my department passed their own mandate and one of the mandates is that there should be “It talks about providing capacity for people who disability inclusion. And the second is the establishment are limited in their capacity that they will have ability of the disability desk of the head of service, of which one to use either private or public buildings effectively. of the main objectives is to coordinate the affairs of all That’s the general, but in doing that, there are details federal civil servants with disabilities and also to improve about entrances have facilities that people with their working conditions.” – OHCSF official wheelchair would be able to go in and also move in different ways.” – FMPWH official “They were the first to establish the disability desk in 2003. […]” – OHCSF official The National Building Code has yet to be signed into law; it was under review at the time of this study’s data The disability desk collates data of civil service with collection. disabilities; ensures that the office environment in all the MDAs are safe for and accessible to persons with The Minister for Health recently launched the National disabilities; receives and addresses complaints about Policy on Sexual and Reproductive Health of Persons disability inclusion in government policies that are with Disabilities, with an emphasis on women and girls, staff-related, and attends to issues around reasonable developed by the Federal Ministry of Health through accommodations for civil servants with disabilities. processes led by the NGO Disability Rights Advocacy Center. The ministry will develop the implementation “First and foremost, we collate data on persons with guidelines and kick-start its implementation. disabilities nationwide. The main aim of the occupational safety health and environment (OSHE) is that we make The Office of the Head of the Civil Service of the Fed- sure that the office environment is as friendly as we can. eration (OHCSF) has the unique mandate of providing Of course, the structures have been there for years and leadership, management, and capacity development to we understand that some of these MDAs have no lifts.” all civil servants for effective, efficient, and accountable – OHCSF official 50 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Apart from OHCSF, the finance, national human rights Organizations Representing Persons commission, justice, and other ministries have disabil- with Disabilities ity focal points. The findings and discussions presented here relate to the mandates and activities of organizations of persons However, these focal points seem to be works-in-prog- with disabilities in Nigeria. ress as many of the federal ministries are still physically inaccessible, with very steep ramps and no lifts. Reports Joint National Association of Persons by staff members with disabilities in some MDAs also with Disabilities indicate that the provision of reasonable accommoda- The Joint National Association of Persons with Dis- tions to staff is inadequate. abilities (JONAPWD) is the umbrella organization for persons with disabilities in Nigeria. Established in 1992, “Personally, I don’t have interpreters. No sign language it operates under FMWASD’s supervision. interpreters. I remember not long ago, we had a program for my level […].” – a hearing impaired FMWASD official Core mandates The aim of JONAPWD is to promote the rights and Programming gaps development of Nigerians with disabilities. It represents The formulation and implementation of disability- their interests at the local and international level by: inclusive policies is inadequate. Promoting the human rights of Nigerians with Knowledge and skill levels regarding disability- disabilities; inclusive policies, programming, and service delivery is inadequate. Advancing the economic and social integration of persons with disabilities; Disability focal points are unavailable in most MDAs; those that do exist should look into disability Delivering technical support to grassroots organiza- inclusion across all other mandates of the MDAs, tions of persons with disabilities; including the provision of accessible services and Providing a national platform for disability dis- products, as well as the formulation and review of course; and policies with a disability lens. Serving as a national clearinghouse on disability and Collaboration and coordination on disability issues development. within and between departments and MDAs is lacking. Structure JONAPWD members include an appointed board of Good practice trustees, national officers, zonal coordinators, advisers, Other MDAs should adopt having a disability desk like and heads of disability clusters. JONAPWD’s head- the one at OHCSF. quarters is in Abuja, with branches operating in all of Nigeria’s 36 states as well as in the Federal Capital Territory. A few local government areas also have their own JONAPWD branches. 4. REVIEW OF FINDINGS 51 Governance and Leadership project (2018–20) is funded by the Disability Rights JONAPWD’s constitution needs to clearly spell out the Advocacy Funds. responsibilities of its board of trustees and its executives JONAPWD has also been involved in advocacy regard- for more effective functioning. In addition, JONAPWD ing the electoral process and governance during the needs to have a clear strategy for coordinating with country’s recently concluded elections. other actors, including disability-focused organizations and the disability community as a whole to promote Programming gaps disability inclusion in Nigeria. In the opinion of the Coordination and collaboration with other actors to experts consulted for this study, there is also a need to promote disability inclusion, including the MDAs, is enhance the level of representation and accountability weak. of JONAPWD, which is manifest in internal disagree- Capacity is low in terms of good governance, leader- ments among JONAPWD leadership and members. ship, and accountability. “We make sure that whatever committee the govern- There is no strategic plan. ment sets up, as long as they have a representative of forwomen, for youth, there must representatives of The constitution is controversial, which slows down people with disabilities. There is no way we can be out the organization’s progress. of anything they are doing, either in agriculture, either in Good practice education either in economy there’s nothing nobody.” JONAPWD has initiated and implemented develop- – JONAPWD Board of Trustees member ment programs such as inclusive education and disabil- Programs and partnerships ity rights projects. JONAPWD has recently engaged in multiple programs Disability clusters and partnerships, including: There are six official disability cluster members under Advocating for inclusive basic education for JONAPWD: (1) Nigerian National Association of the children with disabilities in Nigeria. Funded by Deaf; (2) National Association of the Blind; (3) National the United States Agency for International Develop- Association of Persons with Physical Disabilities; (4) ment (USAID) through its Strengthening Advocacy National Association of Persons with Intellectual Dis- and Civic Engagement project, this inclusive educa- abilities (NAPID); International Association for Inte- tion initiative, implemented from 2014 to 2018 in the gration, Dignity and Economic Advancement, Nigeria Nigerian states of Akwa Ibom, and Kwara and in the (IDEA); and (6) Spinal Cord Association of Nigeria. The Federal Capital Territory included support to rebuild Albino Foundation may soon join as an official cluster JONAPWD’s institutional and management systems. member as well. Fulfilling the duty of the Nigerian government “But I was told in the last meeting that they had passed to protect and uphold the human rights and the resolution to include it in the constitution and dignity of persons with disabilities by passing therefore we have unofficially become a cluster group.” the disability rights bill into law. This two-year – chief executive officer, The Albino Foundation 52 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT NAPID is currently being led by a person with physical Partnerships disability, which seems fitting given that the associ- Disability cluster organizations partner with ation’s long-term mission has been to influence and JONAPWD, their parent organization. They also partner encourage the parents of children with intellectual dis- with national and international NGOs, particularly abilities. Awareness levels have improved, with parents those with related mandates, diplomatic missions, and caregivers of people with intellectual disabilities United Nations agencies, donors, and MDAs. now encouraging their wards and forming stronger The nature of the partnerships varies depending on the coalitions with other parents and caregivers of children capacity of the cluster members forging the partner- with intellectual disabilities. ship, including consultations, funding support, provi- “Well, the association seeks to influence parents sion of assistive devices, capacity development, policy of persons with intellectual disability to have hope, formulation, and implementation. to know that such children are children that should Programming gaps not be discarded outright, just kept somewhere. The Capacity is inadequate, particularly in terms of association also seeks to encourage persons with accountability, governance, leadership, and project intellectual disabilities to do what we know that they management. are capable of doing, but which they or their parents don’t know …” – NAPID chairman Partnership and funding opportunities are scant, stemming from weak organizational and program- Persons with mental health conditions are not repre- matic capacity. sented in JONAPWD, which could be connected to the level of stigma associated with them. But such orga- There are no strategic plans. nizations are springing up in other African countries. Good practices There is also the Mental Health Advocacy Initiative on a The Albino Foundation has strong networks and community mental health project in Benue State. collaborates well with MDAs. All of the cluster organizations were established over IDEA and international NGOs working on leprosy a decade ago, except NAPID, which was established 9 are engaged in effective collaboration. years ago. Most have branches in each of the 36 states and the Federal Capital Territory. The Albino Founda- A strategic plan guides the operations of The Albino tion has 54 branches, with more than one branch in Foundation. some states for better coordination across some states. Disability-related services and actors Core mandates A wide array of disability-related services and actors The core mandates of all of the cluster members gen- operate in Nigeria. Findings from the online assessment erally revolve around the promotion of the rights and of 43 organizations working on disability-related issues welfare of their members through advocacy, training, (international and national NGOs) have relevant orga- provision of assistive devices, and empowerment of nizational strategies. However, this does not greatly their members. influence their programs—many have insufficient or nonexistent budget allocations for disability inclusion. 4. REVIEW OF FINDINGS 53 Only a few of the organizations disaggregate data by either specifically working on disability inclusion or disability using the Washington Group questions, which that are providing disability-specific services, such as leaves in doubt their level of effectiveness at addressing the production and distribution of assistive devices or the needs of persons with disabilities in their programs. inclusive education. Other actors address issues of per- Such gaps in programming may partly contribute to the sons with disabilities within the mainstream, but most current dearth of disability data for the country. of these are few, primarily concentrated in major cities, and their services are expensive. The most relevant A mapping of actors working on disability issues in actors are outlined below. Nigeria involved documenting organizations that are Disability-focused organizations Key national, international, and private organizations with a core mandate that involves disability and that implement programs and provide services to persons with disabilities Organization Description of Services or Programs Angel Wings global freedom foundation Builds capacity of people living with disabilities, especially young girls; raises awareness among parents and guardians of children living with disabilities. Anglo-Nigerian Welfare Association for Provides braille books and printed materials for visually impaired learners; provides training in braille, mobility, the Blind and typing for newly visually impaired adults. CBM International Delivers disability-inclusive programming that addresses neglected tropical diseases, eye health, mental health, community-based rehabilitation, and humanitarian response (health, livelihoods, and education). Centre for Citizens with Disabilities Involved with disability advocacy and rights, governance and electoral processes, and inclusive public infrastructure. Comprehensive Community Mental Supports community mental health and livelihoods. Health Programme Daughters of Charity Provides community-based rehabilitation, health, and education services to persons with disabilities, including those affected by leprosy. Deaf Women Association of Nigeria Promotes the rights of hearing impaired women; advocates for the sexual and reproductive health of hearing impaired women. Disability Rights Advocacy Center Involved in disability advocacy and rights, gender-based violence, sexual and reproductive health, and capacity development. German Leprosy and Tuberculosis Provides community-based rehabilitation for people affected by leprosy. Relief Association Hope for the Blind Foundation Provides support to visually impaired people, including services and training. Inclusive Friends Association Promotes inclusive electoral processes, addressing gender-based violence, disability rights, and advocacy. Independent Living Programme for Promotes rehabilitation, integration, and support to persons with disabilities and vulnerable people to live Persons with Disabilities independently through research, interventions, monitoring and evaluation, inclusive education, and advocacy. International School of Disability Conducts research and training in disabilities, including but not limited to intellectual and developmental Studies disabilities and mental illness in Nigeria. Nigerwives Association Produces and distributes braille books to visually impaired children. Sightsavers International Promotes eye health, inclusive education, livelihood, neglected tropical diseases, and support to visually impaired persons (e.g., facilitation of Marrakeshi International Treaty for Nigerians that are visually impaired to have access to reading materials in accessible formats). The Albino Foundation Provides educational support and empowerment for people living with albinism. The Leprosy Mission Nigeria Engages in community-based rehabilitation, advocacy, and medical treatment for persons affected by leprosy; provides livelihood support. TheseAbilities Foundation Advocates for social inclusion of persons with disabilities in everyday life and inclusive employment. 54 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Disability-inclusive organizations Mainstream national and international organizations that address the needs of persons with disabilities in their programs and through service delivery Organization Description of Services or Programs ActionAid International Supports social justice, gender equality, and poverty eradication; partners with organizations of persons with disabilities on inclusive governance programs. Balm in Gilead Foundation for Supports initiatives that include persons with disabilities in gender-based violence programs Sustainable Development Brien Holden Vision Institute Promotes eye health, including “low vision” and inclusive education. British Council—The Rule of Law and Seeks to reform the criminal justice system; ensure that women, children, and people with disabilities have Anti-Corruption Programme access to justice; improve the performance of and coordination between anticorruption agencies; and enhance the voice of Nigerians in curbing corruption. Dorothy Njemanze Foundation Feminist organization using entertainment media to blur divisive lines that promote trends of abuse toward children, youths, women, people with disabilities, and members of a sexual minority group Gede Foundation Research and services in mental health and HIV Health and Development Support Diagnoses and treats “low vision” and neglected tropical diseases; promotes eye health. Programme (HANDS) Ipas Promotes sexual and reproductive health and rights for women and girls; partnered with the Deaf Women Association of Nigeria to make sexual and reproductive health services accessible to hearing impaired women in the Federal Capital Territory. Journalists Against AIDS Engages in research, community and media mobilization, policy advocacy and response, monitoring and training to address issues related to HIV/AIDS and tuberculosis, and is interested in partnerships with organizations of persons with disabilities to make HIV services accessible to persons with disabilities. Partnership to Engage, Reform and Promotes the improved delivery of public services in Nigeria, including the rights of the marginalized to access Learn (PERL) quality public goods and services; supports activities to develop and enact disability laws at the state level; and facilitates processes for implementation of disability laws at the state and national levels Population Council Engages in evidence-based sexual and reproductive health care and rights, HIV services, and empowerment of girls. Project Alert Violence against Women Promotes the rights of women, girls, and persons with disabilities against violence; provides shelter for survivors of domestic violence. Propcom Mai-Karfi—A program An innovative, market-driven program aimed at reducing poverty in Nigeria by making rural markets work for managed by the Palladium the poor in northern Nigeria; it seeks to mainstream disability into the program, including data collection, using the Washington Group questions. Save the Children International Saves children’s “lives and fights for their rights” has a focus on health and nutrition, education, hunger and livelihoods, child rights governance, and child protection; and seeks to evaluate child development grants with a disability lens and to mainstream disability in the project. 4. REVIEW OF FINDINGS 55 Developmental disabilities support services Public and private organizations and facilities that provide services to people with developmental disabilities Organization Description of Services or Programs Autism Association Provides autism-related care and support. Benola Foundation Promotes an inclusive Africa where people living with cerebral palsy receive proper recognition and have an equal opportunity to realize their potential. Blazing Heart Autism Center Provides autism-related care and support. Centre for Autism and Provides comprehensive care and translational medicine to individuals with autism or related neurodevelopmental Developmental Disabilities disorders. Centre for Children with Special Evaluates, diagnoses, and treats children, adolescents, and adults with complex developmental disabilities. Needs Cerebral Palsy Center Provides support, services, and therapeutic modalities for children with cerebral palsy. Comprehensive Autism and related Provides one-on-one educational interventions, behavioral therapy, speech and occupational therapy, and Disabilities Education and Training physiotherapy for children with developmental disabilities; does not operate a school but conducts educational (C.A.D.E.T.) Academy/Dew Drops assessments for school placement. Community Centre for Special Needs Down Syndrome Foundation Provides information and support to people with Down syndrome, their families, and professionals. Ire Pearl Centre of Hope Provides educational and therapeutic services to children with autism, developmental delays, or learning disabilities; parent training services; family therapy; psychological services for adults with mental health conditions; and professional consultations on inclusive teaching strategies, classroom management, and staff training. Let Cerebral Palsy Kids Learn Provides school readiness assessments, counseling, referrals to medical professionals, inclusive educational Foundation support to schools, and capacity development to teachers and educators. MO-Rainbow Foundation Provides support for Down syndrome-related concerns. Modupe Cole Memorial Child Care Caters to people with Down syndrome, cerebral palsy, and autism, among other concerns. and Treatment Home National Society for Autism Nigeria Provides autism-related support services. Nwatu Autism Foundation Provides support for autism-related concerns. Open Door Special Educational Provides quality special education, vocational training, speech and language therapy, and physiotherapy for Centre children with learning disabilities. OLG Autism Nigeria Provides autism-related care and support. Patrick Speech and Language Creates awareness around autism and other related developmental disabilities. Centre, Lagos Super Parents Support Foundation Offers a support group for parents of children with developmental disabilities and adults with disabilities. The Zamarr institute LEA Nursery Promotes excellency in education and training for exceptional children. and Primary School 56 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Occupational therapy services Public and private organizations and facilities that provide occupational therapy services Organization Description of Services or Programs Echo Occupational Therapy Services Provides occupational therapy services. Enability Occupational Therapy Centre Provides occupational therapy services. Kabworld Physiotherapy and Co. Provides excellent quality occupational and physiotherapy services based on consultations and medical conditions. Talktotherapist Inc. Provides neurodevelopmental therapy for cerebral palsy and Down syndrome and sensory integration therapy for autism and attention-deficit hyperactivity disorders. Teaching Hospitals and Federal Medical Centres Delivers health care services, including occupational therapy. Speech therapy services Public and private organizations and facilities that provide speech therapy services Organization Description of Services or Programs Asokoro General Hospital, Abuja Delivers health care services. Bingham University Teaching Hospital, Abuja Delivers health care services. BSA Hearing and Speech Centre Hearing and speech pathology consulting firm providing quality and reliable hearing diagnosis for children and adults as well as the supply and maintenance of hearing aids. Comprehensive Autism and related Disabilities Education and Provides educational interventions; behavioral, speech, and occupational therapy; Training (C.A.D.E.T.) Academy/Dew Drops Community Centre and physiotherapy for children with developmental disabilities; conducts educational for Special Needs, Abuja assessments for school placement. Federal Medical Centre Abeokuta Delivers health care services. Federal Neuropsychiatry Hospital, Kakuri, Kaduna Delivers health care services. Federal Specialist Hospital Gwagwalada, Abuja Delivers health care services. Federal Staff Clinic, Federal Secretariat, Central Areas, Abuja Delivers health care services. Glory Speech Centre Offers diagnostic and other services for children and adults with a speech defect. J and J Calvary Hearing and Speech Centre Provides development services to children with disabilities, disability management, and environmental assessments. Lagos State Psychiatric Hospital Delivers health care services. Maitama General Hospital Aguiyi Ironsi Street, Maitama, Abuja Delivers health care services. Nigerbell Speech and Hearing Centre Limited Promotes the prevention, identification, assessment, treatment, and rehabilitation of hearing difficulties in children and adults. Open Door Special Educational Centre, Jos Provides quality special education, vocational training, speech and language therapy, and physiotherapy for children and youth with learning disabilities. Patrick Speech and Language Centre Offers educational resources and promotes awareness of autism. State Hospital Abeokuta, Abeokuta Delivers health care services. The Pearl Centre of Hope, Lagos Delivers speech and language therapy sensory integration, behavioral therapy for children with autism, Down syndrome, or learning disabilities. University College Hospital, Ibadan, Oyo State Delivers health care services. Wellpath Physiotherapy and Wellness Limited Provides body therapy, hearing therapy, and support for learning disability. Wuse General Hospital, Abuja Delivers health care services. Zankli Medical Centre Shehu Yaradua Way, Abuja Delivers health care services. 4. REVIEW OF FINDINGS 57 Physical rehabilitation and orthopedic surgeries Public and private organizations and facilities that provide physical rehabilitation services and orthopedic surgeries Organization Description of Services or Programs Ageless physiotherapy Delivers highly specialized physical rehabilitation for diseases and illnesses such as stroke, spinal cord injury, and Parkinson’s disease. Children’s Developmental Centre Supports children and young adults with learning difficulties and provides services for the intellectually disabled; ensures the development of the skills they need in the future. Comprehensive Autism and related Disabilities Provides educational interventions; behavioral, speech, and occupational therapy; physiotherapy for Education and Training (C.A.D.E.T.) Academy/ children with developmental disabilities, and educational assessment for school placement. Dew Drops Community Centre for Special Needs Down Syndrome Foundation, Lagos Provides children with Down syndrome with the necessary encouragement and enabling environment they need to develop. Iblawy Investment Company Provides health care and rehabilitation services. Lagos Disability Support Home Provides rehabilitation and residential accommodations to adults and children with disabilities. Modupe Cole Memorials, Lagos Provides skills and empowerment to improve performance through enhanced learning capacities. National Orthopaedic Hospital Enugu, Nigeria Offers ambulance services, a diagnostic center, and dietician services. National Orthopaedic Hospital, Igbobi Lagos Provides corrective surgery, calipers, prostheses, and physiotherapy. Open Doors Special Education Centre Offers quality special education, vocational training, speech and language therapy, and physiotherapy for children and youth with learning disabilities. Physiofit Physiotherapy Clinic Offers physiotherapy and physical rehabilitation services. Ralphasal Global Limited Provides physical and psychological rehabilitation services. Teaching hospitals, federal medical centers and Delivers health care services. general hospitals 58 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Prosthetics and orthotics Public and private organizations and facilities that provide and/or produce prosthetics and orthotics Organization Description of Services or Programs Arm of Hope Foundation Provides prosthetic limbs, skill acquisition training, and financial support. Bimma Hospital Sabon Bariki Delivers health care services. Bingham University Teaching Hospital Delivers health care services. Cedar Crest Hospital Delivers health care services. Chidex Surgical Suppliers Limited Supplies hospital equipment. Daisy Land Orthopaedic and Trauma Hospital Delivers health care services. Doctor Bone Heritage Orthopaedic Centre Delivers health care services. Federal College of Orthopaedic Technology Lagos Delivers health care services. Feet of Grace Foundation Provides free prosthetic limbs, wheelchairs, and accessible vehicles. George Orthopaedic Services Delivers health care services. Goldville Prosthetics and Orthotics Services Provide prosthetics (artificial arms, hands, and legs) and orthotics. Ifean Health Nigeria LTD Prosthetics and Orthotics Provides professional artificial limb fitting services, repair, and maintenance. Naraguta Leather Works, Jos Locally produces artificial limbs. National Orthopaedic Hospital Delivers health care services. National Orthopaedic Hospital, Dala, Kano Reduces morbidity and mortality due to trauma. National Orthopaedic Hospital Enugu Delivers health care services. National Orthopaedic Hospital, Igbobi Lagos Offers corrective surgery, calipers, prostheses, and physiotherapy. Orthoex Nigeria Provider of medical and prosthetics devices. Orthofits Orthopaedics Limited Delivers health care services. Our Lady of Apostles Zaria Road, Jos Delivers health care services. Purple Prosthesis Designs quality prosthesis and orthotics for Nigerian amputees. Raphadon Global Health Care Limited, Abuja The use of latest bionic technology in prosthetic and orthotic, orthopedic support. Roca Prosthetics Ortho Care Enterprises Fabricates prosthetic devices. The 3D Team, Yola Humanitarian Innovation Hub Conducts research in 3D-printed prosthetic limbs with robotics to improve functionality. The IREDE Foundation Provides free prosthetic limbs to children and promotes awareness of amputation-related issues. Tolaram Charity Foundation, Lagos Provides artificial legs, cosmetic artificial hands, and polio calipers for free to any Nigerian in need. 4. REVIEW OF FINDINGS 59 Standard wheelchairs, cerebral palsy wheelchairs, and tricycles Public and private organizations and facilities that produce and/or donate standard wheelchairs Organization Description of Services or Programs A. Martins Stores Supplies standard wheelchairs, crutches, and walking frames and accessories. Ameri-care Medicals Central Distributes standard medical equipment. Business District Abuja Beautiful Gate Handicapped People Manufactures and freely distributes tricycles, crutches, and prosthetic limbs; distributes free crutches, folding Centre, Jos white canes, and recording devices to people with visual impairments; trains apprentices with disabilities and supports their education. Benola Cerebral Palsy Initiative Supports and advocates for people with cerebral palsy. Bingham University Teaching Delivers health care services. Hospital Cerebral Palsy Centre Promotes the full integration individuals with cerebral palsy into society. Chidex Surgical Suppliers Limited Supplies hospital equipment. Coscharis Medical and Food Limited Provides professional health care services. Ikeja Daughters of Charity Nigeria Limited Provides health, agricultural, and social development services. FinLab Nigeria LTD Ikorodu, Lagos Supplies hospital and laboratory equipment. Focus on Disability Foundation Provides educational materials and disability aids to persons with disabilities; empowers persons with disabilities. Fraham Enterprises Nigeria Ltd. Supplies hospital and laboratory equipment. Latter Day Saints Charities Faith-based charitable organization working on disability issues. Melvit, Lagos Meets hospitalization needs. Mobility Aid and Appliances Empowers persons with disabilities by providing innovative and affordable mobility aid appliances, including Research Development Centre motorized wheelchairs and vision- and hearing-related devices. National Cerebral Palsy Family Provides wheelchairs, vision- and hearing-related devices for people with cerebral palsy. Funds National Orthopaedic Hospital, Delivers health care services. Kofarua Dala, Kano State Obafemi Martins Foundation Provides humanitarian services. Super Parents Support Foundation Offers a support group for parents of children with developmental disabilities and adults with disabilities. Toyin Medical Supply Ltd. Supplies hospital and laboratory equipment, medical consumables and dressings, standard wheelchairs, crutches, and walking frames. 60 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Hearing aids and accessories Public and private organizations that provide or supply hearing aids and accessories Organization Description of Services or Programs BSA Hearing and Speech Centre Hearing and speech pathology consulting firm that provides quality and reliable hearing diagnoses for children and adults. International Centre for the Prevention of Provides ear, nose, and throat consultation services; ear mold manufacturing; and audiological Deafness and Rehabilitation of Hearing consultation services. Impaired Persons, Abuja International Hearing Centre Provides patients with quality audiological services, including evaluation, hearing, and filling. Victoria Memorial Hospital Jos Delivers medical services. Braille machines, accessories, and services Public and private organizations and facilities that provide braille services, machines, and accessories Organization Description of Services or Programs COCIN Hospital and Rehabilitation Provides general medical care, surgical care, laboratory services, eye care, and physiotherapy services. Centre Federal Nigeria Society for the Blind Provides psychological, emotional, and social rehabilitation, including mobility training for everyday living. Gindiri Material Centre For the Blind Provides brailing of printed materials and books. National Charity Project Provides educational services to visually impaired people, enabling them to achieve their optimum education and (Nigerwives) earn independent livelihoods. COCIN = Church of Christ in Nations. Low vision devices and services Public and private organizations and facilities that provide low vision devices and services Organization Description of Services or Programs Bingham University Teaching Delivers health care services. Hospital Brien Holden Vision Institute Targets governments and nonprofit organizations to provide low vision services; sets up low vision service units; provides training for skills and work tools; raises awareness and advocates to governments on the magnitude of the need for spaces to set up service units; monitors and assesses posttraining skills; sets up supply units and work tools. ECWA Eye Hospital Delivers health care services. Global Sales and Distribution Blindness and low vision products, including technological devices that make information accessible to visually Company Ltd./Accessible impaired persons. Technology Centre HANDS, Jos Assesses low vision assessment; sells low vision assistive devices to individuals, associations, and corporate organizations; promotes eye health; treats neglected tropical diseases. Jordan Eye Hospital Delivers health care services. Jos University Teaching Hospital Provides treatment and health care services. Our Lady of Apostles Zaria Road Provides quality preventive and rehabilitative health care. Jos Teaching Hospitals Delivers health care services. ECWA = Evangelical Church Winning All; HANDS = Health and Development Support Programme. 4. REVIEW OF FINDINGS 61 Assistive technology Private organizations that supply assistive technologies Organization Description of Services or Programs COCIN Hospital and Rehabilitation Centre Delivers health care services. Global Sales and Distribution Company Ltd./ Blindness and low vision products including technological devices that makes information accessible Accessible Technology Centre to visually impaired persons. Guide canes for blind and partially sighted persons Nigeria Association of the Blind Provides a platform to review the activities of associations and recognizes government interventions. Obafemi Martins Foundation Provides humanitarian services. COCIN = Church of Christ in Nations. Crutches and accessories Public and private organizations and facilities that supply crutches and accessories Organization Description of Services or Programs A. Martins Stores, Ibadan Supplies standard wheelchairs, crutches, and walking frames and accessories. Ameri-care Medicals Central Distributes quality medical equipment. Business District Abuja Chidex Surgical Suppliers Limited Supplies hospital equipment. Mobility Aid and Appliances Empowers persons with disabilities by providing innovative and affordable mobility aid appliances as well as Research Development Center, specialized items, including motorized wheelchairs and vision- and hearing-related devices. Lagos National Orthopaedic Hospital, Dala, Delivers health care services. Kano Toyin Medical Supply Ltd., Ibadan Supplies hospital and laboratory equipment and medical disposables and dressings, including standard wheelchairs, crutches, and walking frames. Calipers Public and private organizations and facilities that produce or supply calipers. Organization Description of Services or Programs Mon Scientific Serves as an online shopping destination for laboratory and scientific products. National Orthopaedic Hospital, Dala, Delivers health care services. Kano National Orthopaedic Hospital, Delivers health care services. Lagos 62 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Fully inclusive schools Private schools that provide fully inclusive education to children with disabilities Name Address Contact Details American Christian Academy 2, 4, 6 Shell Close, Onireke Ibadan https://www.acaonefamily.com; + 234 809-634-4878; 809-981-4312; acaonefamily@gmail.com Brooke House Learning Center 31 Kusenla Road, Ikate-Elegushi, Lekki https://www.brookehouseedu.com; + 234 908-568-9038; 909-079-1065; info@ brookehouseedu.com Casa Dei Bambini 10b Onikepo Akande Street, Lekki Phase 1 Lagos Casadeibimbinilekki@yahoo.com Children’s International School, Lekki Plot 8 Funke Zainab Usman Street, Lekki Phase 1 Lagos www.cislagos.com Cita International School Rumuogba Housing Estate, Port Harcourt info@citainternationalschool.org Fitrah Children’s School Oko Oba, Abule Egba + 234 0 802-345-3402; fitrahchildrensschool@yahoo.com Grange Schools 6 Harold Sodipo Crescent, Ikeja GRA Lagos info@grangeschool.com; + 234 1-295-7630 Great Expectations Private School 19 Raji Oladimeji Street, Magodo Phase 2 Lagos + 234 0 813-842-7404 Greater Scholars International School Road 41 Abraham Adesanya Estate Ajah Lagos admissions@greatscholars.com; + 234 0 802-966-0967 Green Wood House School 1 Green Wood House Road, off Layi Ajayi Street, Parkview greenwoodhous1995@gmail.com; Estate Ikoyi info@greenwoodhouseschool.org Greensprings Schools Anthony and Lekki Campuses www.greenspringsschools.com Hill Crest High School Lemna Road Ikot Effanga Mkpa, Calabar www.hillcrestschools.net Howbury School 3 Alegebe Close, Mende Maryland and Ota campus http://howburyschool.com; + 234 0 704-621-0181; 0 818-092-0687; 0 802-330-4870; info@howburyschool.com Inspired Christian Learning Center Abraham Afolabi Street, Ahmadiya Abule Egba, Lagos TBD Lagos Preparatory School 11/12 Bayo Kuku Street, Ikoyi Lagos www.lagosprepikoy.com.ng Meadow Hall School Alma Beach Estate, Meadow Hall Way, Lekki Peninsula II, info@meadowhalleducation.org Lekki Oakwood Montessori 33 Adedamola Ojomo Close, off Bode Thomas Street, https://oakwoodmontessorischool.org; Surulere + 234 0 909-144-2680; 0 704-633-1844; info@oakwoodmontessorischool.org Otana Integrated School By Living Faith Church, British-American Junction, Jos otanajos@yahoo.com Posh Babies and Kids 25 Sir Tony Eromosele Street, Parkview Estate, Ikoyi, Lagos https://poshbabiesandkids.com; +234 0 812-552-8442; 0 810-285-4056; 0 706-235-3379; pbk_office@yahoo.com Premier International School 26 N’djemena Crescent, Wuse 2, Abuja Info@premierinternationalschool.org Professor Abdullahi Mahdi Academy Off Jauro Abare Road, Gombe https://pama.com.ng/ +234 806-844-0084; info@pama.com.ng RA International School Bonny Island, Rivers State TBD Salem Montessori Centre 1 Aihie Close, off Ijeboh Street, off Airport Road, GRA, Benin + 234 0 806-645-7648 Supreme Education Foundation Schools 23 Emmanuel Keshi Street, Magodo Lagos www.supremeeducation.com Sure Start School 28 Queen Street, Alagomeji, Yaba + 234 0 802-312-1111 Temple Prep 213 Ikorodu Road, ilupeju Lagos www.templeprepschool.com Treasure House Schools 63a Coker Road, Ilupeju Lagos www.treasurehouseschools.com 4. REVIEW OF FINDINGS 63 Donors Donor organizations that fund disability-inclusive and disability-specific projects Commitment to Disability Inclusion Organization Funding Focus for Disability Inclusion Implementing global DFID/UK Aid Nigeria Mainstreams of disability into political and electoral processes, humanitarian action, organizational economic development, and accountability. disability policy USAID Nigeria Increases the governance capacity for civic advocacy, monitoring, and engagement with a focus on marginalized groups, including persons with disabilities; provides inclusive education for children with disabilities. BMZ Provides disability-inclusive humanitarian relief with a focus on health, livelihoods, and education. Australian Aid Promotes treatment for mental health and neglected tropical diseases, including the management of resulting disabilities; the treatment of obstetric fistula; and the sexual and reproductive health of women with disabilities. European Union Promotes access to social services among persons with albinism, access to justice for women with disabilities, and the participation of persons with disabilities in the electoral process. The Netherlands Embassy/ Promotes disability-inclusive governance and political participation. Government Disability-focused International Agency for the Promotes children’s eye health and inclusive education for children with disabilities. or disability-related Prevention of Blindness mandate CBM International Promotes eye health and community-based rehabilitation. Liliane Foundation Supports children with disabilities through Daughters of Charity. Disability Rights Advocacy Funds Promotes the rights of women with disabilities to health and justice, the right to inclusive (Disability Rights Advocacy Funds) education, and the disability rights law. Interest in social Ford Foundation West Africa Promotes political participation, including among persons with disabilities. inclusion/social Open Society Initiative for Western Promotes the rule of law, electoral processes, and the rights of women and other vulnerable justice Africa groups. TY Danjuma Foundation Supports women with disabilities, persons affected by leprosy, and visually impaired persons through the production of braille materials. Programming gaps Good practice Suppliers of assistive devices and rehabilitative ser- Established in 1999, Beautiful Gates Handicapped Peo- vices do not meet the needs of the target population ple’s Centre, Jos, is a small-scale producer of tricycles, and are concentrated in large cities. crutches, and artificial limbs. It distributes tricycles free of charge, with about 70 percent going to the northern Locally manufactured assistive devices are scarce. region. Its founder employs young persons with dis- The few that are available use outdated technology abilities and orphans as staff and apprentices; he pays and are produced on a small scale. them about N4,000 per month, with half set aside to The organizational and programmatic capacity of the help pay for their tuition. The center, which has report- few available national disability-focused NGOs is low. edly produced 13,000 tricycles over an 18-year period, has received donations from Rotary International and Systems and structures to drive disability-inclusive Sileka Foundation. development are lacking. There is emerging competition for disability funding associated with a lack of standards and principles regarding inclusive project management. 64 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Legal Frameworks and Programming Violence Against Persons (Prohibition) Act 2015 Attitudes toward persons with disabilities may be influ- seeks to eliminate violence in private and public enced by environmental factors, such as the availability life. It prohibits all forms of violence against per- of a disability law and the existence of a pool of persons sons, provides maximum protection and effective with disabilities who are able to advocate for their remedies for victims and punishment of offend- rights (Akhidenor 2007). This is evident in Akhidenor’s ers. The law applies to all people, including those (2007) study, which reveals that the majority of Nigeri- with disabilities, although they are not specifically ans living in the Sacramento area of California had posi- mentioned. The Disability Rights Advocacy Center tive attitudes toward persons with disabilities, while the organized a workshop in 2018 to familiarize disabili- attitudes of those age 46 and older and those who had ty-inclusive development actors with the provisions resided in the United States for one to four years were of the law. The law is applicable in the Federal Capi- more negative than among those who were younger tal Territory, but only a few other states have begun and among those who had resided in the United States to adapt it for their use (FRN 2015b). for longer than four years. Eleven states—Lagos, Plateau, Jigawa, Bauchi, Ondo, The following provides an overview of the existing legis- Ogun, Nasarawa, Anambra, Kano, Kogi, and Kwara— lation, policies, and strategies in Nigeria that include or currently have disability laws to safeguard the rights specifically focus on persons with disabilities. of persons with disabilities. However, the rate of implementation for these laws is very low, with General only Lagos and Plateau having structures in place The Constitution of the Federal Republic of Nigeria for their implementation, the extent and quality of (FRN 1999) prohibits discrimination against any which has not been adequately assessed. Nigerian on any grounds. Education Sector The Discrimination against Persons with Disabilities National Policy on Inclusive Education in Nigeria. (Prohibition) Act 2018 (FRN 2019), enacted January This policy seeks to provide unhindered access to qual- 23, 2019, is a comprehensive piece of legislation that ity education and engage the active participation of all guarantees the full integration of persons with disabil- learners in the same safe school environment. It aims to ities into society and establishes a national commis- achieve these objectives with the following strategies: sion responsible for ensuring their education, health care, social, economic, and civil rights. The law draws High-level sensitization and advocacy to enhance on and seeks to domesticate the provisions of the political will, acceptance, and buy-in on inclusive Convention on the Rights of Persons with Disabilities education by all; (2006), which Nigeria has signed and ratified. Imple- Effective stakeholder engagement and community mentation, which has not yet begun, will involve a mobilization at the local, state, national, and inter- rigorous process of developing and costing the plan, national levels; including the establishment of a national commission to monitor the process. Additionally, 11 states already Regular capacity building for all stakeholders; have disability laws in place. 4. REVIEW OF FINDINGS 65 Creation of access and safety in all schools and asserts that the education of children with disabilities learning centers; shall be free at all levels and makes provisions for all needed educational support, training, and retraining Improvement of institutional support for inclusive of teachers, learning materials, and assistive devices teaching; and technologies. However, the policy is weak in terms Adaptation of curriculum and resource materials; of early detection and identification mechanisms, the monitoring and evaluation system, the implementation Rehabilitation and upgrading of special schools to structure, funding, and data collection. And it is only serve as resource centers; and being partially implemented as is (Asiwe and Omiegbe Adequate resource mobilization, allocation, and 2014; Eleweke, Agboola, and Guteng 2015). Much needs utilization. to be done to ensure the full implementation of the pol- icy, including drafting a plan that has disability-specific It is a comprehensive policy, developed with support indicators for monitoring (FRN 2004b). and based on lessons learned from ESSPIN projects in Nigeria, which includes provisions for its implementa- National Policy on Albinism in Nigeria 2012. tion plan and monitoring and evaluation framework. This policy, whose review was completed in 2019 It clearly states how the educational needs of children (FRN 2012c), aims to guarantee the welfare and rights with disabilities should be mainstreamed. However, of persons with albinism through awareness and implementation seems to have stalled since 2016, and sensitization efforts, the protection and promotion it is not clear whether or not the plan has been costed. of their rights, the fostering of their participation and A coordination mechanism may be needed to revisit empowerment, the facilitation of the passage of a law the process. Strong political will coupled with funding to establish the National Agency for Albinism and support will be crucial to its proper implementation Hypo-pigmentation in Nigeria, and the promotion of (FRN 2016). relevant research and data collection. Universal Basic Education Act. This law provides for National Policy on Special Needs Education in compulsory and free universal basic education for all Nigeria 2015. This policy seeks to provide complete children of primary and junior secondary school age in service delivery that encompasses physical, mental, and Nigeria. It draws on the provisions of international legal emotional disabilities in Nigerian children at school, at instruments, such as the Convention on the Rights of home, and the hospital; to provide adequate qualitative the Child, to promote universal access to basic edu- education to all persons with disabilities in all aspects cation and equity. It therefore applies to all children, of national development; and to ensure that all persons including those with disabilities (FRN 2004a). with disabilities develop at a pace commensurate with their abilities so they can contribute to the nation’s National Policy on Education. This national-level pol- socioeconomic and technological development (FRN icy emphasizes inclusive education as a way of ensur- 2015a). ing equity in education as enshrined in the Universal Basic Education Act 2004 (Asiwe and Omiegbe 2014). It 66 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Social Protection Sector toward disability inclusion in any of the remaining six Economic Recovery and Growth Plan, 2017. This sectors. Disability inclusion should be considered as a medium-term plan builds on the 2016 strategic imple- cross-cutting issue in the policy, given the strong rela- mentation plan. Aimed at restoring economic growth tionship between poverty and disability (Ukpong and while leveraging the ingenuity and resilience of Nige- Ikoh 2017). rians, it envisions sustained inclusive growth through structural economic transformation focused on Housing and Urban Development Sector improving both public and private sector efficiency and National Building Codes, 2012. These legal codes provides a foundational blueprint for future generations support the 2012 National Housing Policy. They provide while building the capacity of Nigerian youth to carry standards and guidelines for the accessibility of private the country forward. The plan utilizes 60 strategies to and public buildings to persons with different types of attain its objectives, two of which are directly related to disabilities. However, they were neither approved nor social inclusion and another two to job creation. One implemented and are now being reviewed (FRN 2012b). of the strategies specifically targets the elderly and per- National Urban Development Policy in Nigeria, 2012. sons with disabilities; another—regarding social safety The aim of the policy is to promote a dynamic system nets—refers to the vulnerable in general terms. The of clearly defined, planned, and well-managed urban two job creation strategies do not make any mention of settlements that foster sustainable economic growth, disabilities, which has implications for addressing the promote efficient and balanced urban and regional needs of persons with disabilities. The disability move- development, and ensure an improved standard of ment and inclusion experts should actively participate healthy living and the well-being of all Nigerians. The in the development and review of any such documents policy was approved in June 2012 but has not been in the future. As a standard, disability inclusion should implemented (FRN 2012c). be treated as a cross-cutting issue, in addition to its role in targeted strategies. (FRN 2017). Health Sector National Social Protection Policy, 2017. The National National Policy on Sexual and Reproductive Health Social Protection Policy is an umbrella policy frame- and Rights of Persons with Disabilities, especially work with provisions covering all conventional core Women and Girls. This policy seeks to ensure that all sectors and emerging issues that the social protection sexual and reproductive health programs reach and programs and projects in the country are currently serve persons with disabilities, to expand access to implementing. It also encompasses emergency and cri- such services, and to increase understanding about the sis contexts of social protection. It comprises 16 policy sexual and reproductive health issues among women measures to be implemented in eight sectors. Persons and girls with disabilities. The policy, which also serves with disabilities are targeted specifically in three of its as an advocacy and resource mobilization tool for five education and health services sector programs as relevant stakeholders, seeks to achieve its objectives well as in one of its four livelihood enhancement and through the implementation of policy actions and stra- employment sectors. There are no other specific efforts tegic activities under five thematic areas: 4. REVIEW OF FINDINGS 67 1. Increasing knowledge, raising awareness, generating National Gender Policy, 2006. This policy brings a popular support, and mainstreaming the issue; gender perspective into all aspects of planning, policy, legislation, and transformation activities in Nigeria. 2. Improving access to sexual and reproductive health It is meant to address the systematic inequalities for women with disabilities, including access to between women and men in society without ignoring related education, services, transportation, informa- the fundamental differences between them. The policy tion, and communications; acknowledges disability as a form of social vulnerability, 3. Improving the inclusion of women with disabilities dedicating a section to it. Given the strong intersec- in governance by mainstreaming them into in all tionality between gender and disability, the minimum government programs, including them in policies standard should be to treat disability as a cross-cutting and laws, and allocating budgets for persons with issue in this policy. The country is already feeling the disabilities; effect of this omission because the gap in programming between women’s rights and disability rights is still 4. Building bridges for partnership and collaboration present. Recent efforts to close this gap by the disability and building the capacity of stakeholders; and rights movement, particularly women with disabilities, 5. Promoting research, monitoring, and evaluation for is increasing awareness about this intersectionality issues, activities, and programs involving women among relevant actors. Such efforts should receive with disabilities. more support so that the women’s rights movement includes a disability perspective in their work and the Adequate implementation will require the collabora- disability rights movement includes a gender perspec- tion of multisectoral stakeholders to develop an effec- tive in theirs. In addition, the monitoring system for the tive implementation plan that includes monitoring, National Gender Policy should disaggregate indicators evaluation, and costing (FRN 2018b). by disability and develop disability-specific indicators (FRN 2006). Social Development Sector National Rehabilitation Policy. Nigeria has a vague Electoral/Political Participation Sector and outdated policy for the rehabilitation of persons The Independent National Electoral Commission with disabilities. Relevant stakeholders have recently Framework on Access and Participation of Persons made unsuccessful efforts to develop a more functional with Disabilities in the Electoral Process (FRN policy. A comprehensive policy that meets the rehabili- 2018a). This framework enshrines the inclusion of per- tation needs of men, women, and children with disabili- sons with disabilities in all aspects of the electoral pro- ties is urgently needed. FMWASD, in collaboration with cess, including eliminating the barriers they encounter other stakeholders in the disability community, is cur- as voters, aspirants, candidates, party officials, and rently developing a national disability policy to replace staff of the INEC. The framework has an accompanying the National Rehabilitation Policy (FRN n.d.). internal operational plan to deliver on its objectives. 68 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Humanitarian Settings 6. Opportunity for employment and participation in National Policy on Internally Displaced Persons in politics and public life; Nigeria (FRN 2012d). This policy asserts the principles 7. Establishment of the National Commission for Per- that guide humanitarian assistance and implemen- sons with Disabilities; and tation of durable solutions in situations of internal displacement in Nigeria. It is a comprehensive policy 8. Appointment and duties of the executive secretary that addresses all of the causes of internal displacement and other staff. and all of the groups of internally displaced persons, The law came into being following years of relentless including those with disabilities. It is applicable to all of advocacy and struggles by the disability movement and the assistance and protection needs during every phase civil society in Nigeria. On January 23, 2019, President of displacement—preparedness, relief, and recovery— Buhari signed the act into law. Prior to its enactment, and at every level of government. there had never been a statute to protect the rights of persons with disabilities in Nigeria. The right to free- Discrimination against Persons with dom from discrimination is a human right enshrined in Disabilities (Prohibition) Act 2018 Nigeria’s 1999 constitution (FRN 1999), but it is limited The Discrimination against Persons with Disabilities to Nigerian citizens and does not make specific provi- (Prohibition) Act 2018 (FRN 2019) is a law of the Fed- sions for the privileges, opportunities, and services that eral Republic of Nigeria to provide for the full integra- may be occasioned by a significant human difference, tion of persons with disabilities into society; establish such as a disability. the National Commission for Persons with Disabilities; and vest in the commission the responsibilities for their The law criminalizes discrimination by imposing education, health care, social, economic and civil rights, sanctions on the offenders, including fines and prison and for related matters. sentences. It also stipulates a five-year transitional period for modifying public buildings, structures, and The law provides for the following socioeconomic automobiles to make them accessible. Employers of spheres of life among persons with disabilities in labor must ensure that 5 percent of their workforce Nigeria: comprises persons with disabilities. A person with a 1. Prohibition of discrimination and awareness disability who is discriminated against can instigate a program; civil action against the offender without prejudice to acquittal or conviction under this law. 2. Accessibility of physical structures; Furthermore, the law establishes a National Commis- 3. Road transportation; sion for Persons with Disabilities, which will ensure 4. Seaports, railways, and airport facilities; that stakeholders adequately implement its provisions, including by liaising with the public and private sector 5. Liberty; rights to education, health, and first con- and with the government to ensure that all policies, pro- sideration in queues; and accommodations in grams, and activities address the needs of persons with emergencies; disabilities. The commission has the power to receive complaints from persons with disabilities regarding any 4. REVIEW OF FINDINGS 69 violation of their rights and to provide support to such The law also implies that organizations of persons with complainants to seek redress through the courts. disabilities will need to raise awareness and mobi- lize their members to access basic services. They will The opinions expressed by this study’s respondents also play a role in monitoring the implementation regarding the Discrimination against Persons with Dis- and/or enforcement of the law by holding offenders abilities (Prohibition) Act are discussed below. accountable. Implications of the law “For organizations of people with disabilities it One important expected impact of the law, according also means that they create awareness to ensure to study participants, is that persons with disabilities that people with disability are not deprived of will have improved access to the physical environment education, health care services. And ensuring that and to basic services, such as education, health, and they hold a discriminatory office accountable […].” livelihoods, which will help alleviate poverty among – a male double amputee, Lagos persons with disabilities. Similarly, civil society is expected to become gradu- In addition, it is expected that society will begin to treat ally more inclusive by ensuring the application of the persons with disabilities as rights-holders rather than principles of equity, participation, and accessibility as objects of charity or as those whose needs should be in their programs and services. The law also calls for addressed only after all others. the expanded engagement of development partners “The law also provides criminalizes begging in the in disability inclusion through increasing funding of street and sets aside 5 percent of employment disability-inclusive interventions, particularly capacity opportunities for persons with disabilities in Nigerian development of organizations of persons with disabil- institutions. So, for the private sector, for businesses, ities to improve their participation and leadership in it is about the employment of people with disabilities, disability-inclusive development. ensuring that their facilities are accessible to persons “For civil society groups, it is ensuring that people with with disabilities, including their products.” disability are not discriminated in the delivery of their – a male double amputee, Lagos services.” – a male double amputee, Lagos “We just pray that the implementation will be “Development partners, too, should bring more prompt and not be difficult. Because this idea of money and actually support the objectives of ‘we see that you have a disability and we are trying to organizations of persons with disabilities. This is the help you’ has gained much ground. Most people, even time to grow organizations by persons with disabilities; the government, feel that they are just trying to help help them, support them build their systems, let them when they do things for persons with disabilities in be at the forefront. We are not saying that other people our society, […] They feel that you are an unfortunate cannot get involved but persons with disability should fellow, you are suffering and they have come to alleviate lead the way.” – a female wheelchair-user, Abuja your suffering. And you have got say ‘thank you’ even if they are not giving you what you deserve or what you have worked around the clock to qualify for.” – a man with physical disability, Ibadan 70 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Implementation potential at the national help anyone. We need to have sincere agencies that and state levels check on these types of things.” – a male academic in The law is being introduced at a time when disability Special Education, Jos inclusion is receiving global attention; and as a “And unfortunately, we do not have the capacity. subject of the Sustainable Development Goals, has We need the capacity to be strengthened in that area, made disability inclusion a high priority among many it’s just a few of us. And those who have the capacity stakeholders. The Nigerian government is facing might not have the reach or the resources to be able to pressure to commit to this global shift in priorities. do more.” – a female wheelchair-user, Abuja Disability is a key consideration of most of the key development partners supporting the Nigerian govern- “Disability discrimination or exclusion seems to be ment in its efforts to reduce poverty, uphold the rule moving into another phase now where everybody of law, and improve governance and accountability, wants to be an actor on disability. […] And then they do including the UK’s Department for International Devel- activities and don’t consult people with disabilities. opment (DFID) and USAID. We’ve noticed it, in three different organizations where they held meetings about the Disability Act and “It is to make sure that the development partners they didn’t consult a single person with a disability.” work in collaboration with government agencies – a female wheelchair-user, Abuja and disabled people organization make sure that the law is implemented properly.” – a man with Also challenging the law’s implementation is a dearth physical disability, Kaduna of disability-inclusive policies, and where disability- related provisions exist, whether in inclusive or Awareness of disability issues is increasing among disability-specific policies, implementation is deficient. civil society in Nigeria. Many civil society organiza- Further, the development and review phases for tions are becoming increasingly interested in making Nigerian policies lack the active participation of their programs and services inclusive of persons with persons with disabilities. disabilities, and Nigeria’s disability movement has greatly expanded its actors, which together represent a Actions to ensure the implementation of the law potentially formidable pressure group to facilitate the at the national and state levels implementation of the law. Study respondents asserted the need for several actions to adequately implement the law at the national and “I think the civil society as it is now if they are state levels. They are outlined below. adequately informed and then mobilized to take up the fight for disabilities inclusion I think it Awareness-raising and advocacy. The law must be could be, is one of the big opportunities we have.” popularized among the general population and key – a female wheelchair-user, Abuja stakeholders through awareness-raising activities and by advocating for its implementation. Beginning with “We have NGOs that do very well and bring up promoting awareness among the disability community, fantastic programs for persons with disabilities and the provisions of the law should be disseminated to all help to improve their lives. Equally, there are those that Nigerians in local languages and in formats accessible are just shambles. They virtually do nothing and do not to people with multiple types of disabilities. 4. REVIEW OF FINDINGS 71 “Persons with disabilities should not relax and think Establishment of a commission. The law provides for “we now have a law, everything you need will fall into the establishment of a commission to oversee its imple- place.” No, we must continue to work, to advocate for mentation. The study participants believe that the gov- implementation. We are already doing that, raising ernment should ensure the immediate establishment awareness. The first thing is to simplify the Disability of the commission. Appointments of people to serve on Act. We also have plans of putting it into local languages. the commission should be based on their capacity to And then, there is a need for a lot of advocacy at the state achieve its set objectives. The disability community has level.” – a female wheelchair-user, Abuja a role to play in this. “We also need to translate these laws into the three Budget allocations. Funding is critical to the imple- major languages in Nigeria. And the law can be mentation of the law, without which nothing tangible in braille so that nobody is excluded in Nigeria.” can be achieved. Budget allocations for disability issues – a man with physical disability, Ibadan has always been a problem, even for existing policies that address the needs of persons with disabilities. Creation of an implementation workforce. The Study participants affirmed that adequate budget allo- starting point is to create an implementation commit- cation is key to implementation. tee or a task force that will oversee the implementation of the law. This should allow for the active participation “There must be budget allocation. We’re not in this of persons with various types of disabilities as well as year’s budget, but that is not to say they cannot get professionals. Thereafter, a strategic framework should money from supplementary funds […]. Whatever it is, be developed to implement the law at the national level by the next budget we will be included in the budget.” with immediate effect. The same should be done at the – a female wheelchair-user, Abuja state levels, after each state has domesticated the law Collaborations and partnerships. To ensure proper or reviewed existing laws based on the national law. implementation, respondents emphasized the impor- “I’m still waiting for government to say “We want to tance of collaboration and partnerships among several constitute a committee to look at what has been signed stakeholders, including government, development part- and implemented.” The next step is for them to constitute ners, the disability community, and civil society. the committee to propose strategic implementation. “I think we too, who are involved, we need to A presidential task force to look at the law, and how it come together; all development partners and can be implemented.” – a man with albinism, Abuja institutions and all NGOs, we need to come “There has to be a national strategy framework together and chart a course, with government.” team. In the first 5 years, what do we want to see done – a male academic in Special Education, Oyo at the state level, at the local government level? Monitoring. Monitoring at various levels of imple- What will be the roles of different bodies, disability mentation is critical. Stakeholders should be careful bodies and all of that? That should be the next to report any discriminatory acts but also hold the thing and that should be done before it gets cold.” commission accountable for delivering their man- – a female academic in public health, Ibadan dates. JONAPWD, among other stakeholders, must be well-positioned to perform this role. 72 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT “Monitor compliance, you know. Continue to be a Table 4.1 presents the key findings on disability inclu- watchdog. If we see where discrimination is happening sion across various sectors. and call it out, hold individuals or organizations accountable for any form of disability discrimination.” – a female wheelchair-user, Abuja State Case Studies Capacity development. Capacity and skills devel- This section presents case studies of some of the opment is crucial for organizations of persons with Nigerian states that have passed disability laws. The disabilities, service providers, government, and devel- elements of the laws, implementation progress, and opment actors to properly implement the law. contributing factors toward success are examined. Lessons learned and the recommendations for the way Participation and leadership. Persons with disabil- forward are highlighted. ities should be given opportunities to actively partic- ipate and assume leadership roles in the affairs of the The assessed states are at different stages of imple- commission—this is crucial to the successful imple- menting their laws. Collected data are based on key mentation of the law and is linked to developing the informant interviews and focus group discussions. The capacity of persons with disabilities to assume leader- study conducted an interview with the Executive Chair- ship positions in every sector of the economy. person of the Plateau State Disability Rights Commis- sion and a disability activist in Ondo State; and a phone “We must make sure that in anything the government interview with a leader of the disability community in does, persons with disability are included, whatever Jigawa State. The information presented for Lagos State program, whatever policy […]. That is how we can move was extracted from the two focus group discussions forward.” – a man with spinal injury, Lagos conducted in Lagos, a key informant interview with a Recommendations representative of a disability-focused NGO in Lagos, Optimize the provisions of the legal frameworks and information on the website of the Lagos State and policies related to disability inclusion through Office for Disability Affairs (LASODA). adequate implementation, which will require the support of multisectoral stakeholders. Plateau State Strengthen the monitoring and evaluation of The Disability Rights Commission Law 2005 available policies and frameworks, including by The Disability Rights Commission Law 2005 (Plateau developing disability-specific indicators and by dis- State of Nigeria 2005) was passed in Plateau State aggregating data by disability. on December 22, 2005, by Governor Joshua Dariye. It establishes the Plateau State Indigenes with Disabilities Review the current instruments to better address Rights Commission and for other Matters Ancillary the needs and concerns of persons with disabilities thereto. in Nigeria. The commission’s objective is to coordinate and Conduct a thorough and/or expert audit of every implement activities that ensure the full inclusion of future framework to influence disability advocacy in persons with disabilities into the mainstream of society, the relevant sectors. particularly in education, employment, rehabilitation, 4. REVIEW OF FINDINGS 73 and civil rights. The law vests power in the commission The Plateau State Indigenes with Disabilities to mobilize resources, to collaborate with relevant Rights Commission actors within and outside Nigeria in pursuit of its aims, The Plateau State Indigenes with Disabilities Rights to demand and obtain relevant information and data, Commission was created in 2013, eight years after the and to report on relevant matters. The commission can law calling for its establishment was passed. The man- engage in multisectoral and multidisciplinary collabo- agement team was appointed in 2015. The commission rations, network with civil society organizations to the is a standalone entity with a direct link to the gover- benefit of persons with disabilities, and formulate and nor’s office. implement policies aimed at their full inclusion. The commission’s management includes an executive The commission is authorized to collaborate with a team, consisting of an executive chairman and four wide variety of stakeholders, including organizations other members, including a secretary. A management of persons with disabilities, MDAs, and international team oversees eight departments: rehabilitation ser- organizations, to engage in program activities, research vices; planning, research, and statistics; empowerment, and advocacy, community-based interventions, and civil rights, and legal issues; education and disability; technical assistance. It can set criteria for social ser- administration; finance; supplies; and accessibility. vices schemes, implement awareness and rehabilita- Of the five members managing the commission, three tion activities, and register and monitor the activities are women and two are men. Three of the members of NGOs that receive funds from the state and federal are persons with disabilities, and two of the three are government for the benefit of persons with disabilities. women with disabilities. There were 24 staff members Under this law, the government must ensure that at the commission at the time of the interview 13 of persons with disabilities have comprehensive access whom (54 percent) were persons with disabilities. The to public information and communications, public remaining staff members had at least one member with buildings, public transportation, and all sectors of the disabilities in their immediate families. economy—but particularly education, health, social Implementation progress security, and employment. The commission receives The commission collaborates and partners with wide an annual budget allocation from the government. range of actors, including international and national It may also raise funds through private and public NGOs, the German and Australian embassies, CBM donations, including NGOs and other organized private International, SightSavers International, the Leprosy sector actors; investments and property; or services Mission, Motivation UK, Disability Rights Advocacy rendered. The law repeals the Plateau State Rehabili- Center, Inclusive Friends Association, Health and tation Board Law (1999); and all of its property rights, Development Support Programme (HANDS), Emmaus assets, and liabilities were transferred to the commis- Christian Centre, and International Federation of sion. However, this law neither prohibits nor criminal- Women Lawyers Nigeria. The commission also col- izes any form of discrimination against persons with laborates with MDAs at both the federal and state disabilities in the state. levels. The partnerships are based on funding, technical support, the provision of assistive devices, and capacity development. 74 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Table 4.1. Key Findings Matrix Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Education Inadequate oppor- Mostly special edu- Few (mostly private) inclusive Inadequately trained Primary schools that tunities for partici- cation programs schools available teachers adopt the inclusive pation in schools Inclusive education Few nongovernmental orga- Lack of early detec- education model and Inadequate learning is an emerging nizations working on inclusive tion and intervention well trained staff (e.g., aids concept education Dearth of learning primary school in Jos, Few teachers Inadequately im- Special education focal points materials and assis- Plateau State) trained in sign plemented national in federal and state ministries, tive technologies Discrimination language or spe- policies on special departments, and agencies Lack of educational against Persons cialized staff and needs education, Unavailable tertiary training in support in tertiary ed- with Disabilities personnel trained in inclusive education, inclusive education ucation for students (Prohibition) Act strategies and skills and albinism Limited funding of inclusive with disabilities to ensure adequate education through USAID, learning for persons International Agency for the with disabilities Prevention of Blindness, DFID, Limited career and Disability Rights Advocacy opportunities in Fund areas and sectors Few programs on inclusive that are not con- education by Sightsavers sidered “disability International for those with adequate” visual impairment; Independent Negative attitudes Living Programme for Persons among teachers with Disabilities (advoca- and peers cy-related), and Daughters of Charity (for hearing impaired persons); and Brien Holden Vision Institute Production of braille books by Niger Wives Association Health Negative attitudes Inclusive health Health care delivery inaccessi- Unavailable early Comprehensive among health policies are ble to persons with disabilities intervention services Community Mental workers unavailable No disability focal point in the Lack of disability Health Programme in Health workers’ Health care costs Federal Ministry of Health training for health Benue State ignorance of related to disability Small-scale inclusive health workers Discrimination disability Health services are “out programs by a few nongov- Inadequate budget against Persons workers ignorance of pocket.” ernmental organizations: CBM allocation with Disabilities of disability (causes New national pol- International, Sightsavers Lack of inclusive (Prohibition) Act and treatment) icy on sexual and International, Disability health policies Good practices among Prohibitive cost of reproductive health Rights Advocacy Center, health workers in care for persons with Deaf Women Association of Akwa Ibom State Inaccessible disabilities Nigeria/Ipas, Daughters of Policy on the sexual environment, equip- Charity, HANDS, The Leprosy and reproductive ment, information, Mission, German Leprosy health of women and and communication and Tuberculosis Relief girls with disabilities Association, and Brien Holden Vision Institute Mental health by Gede Foundation and Comprehensive Community Mental Health Programme Donors include BMZ, International Agency for the Prevention of Blindness, CBM International, Australian Aid, Disability Rights Advocacy Fund, and Liliane Foundation (continued) 4. REVIEW OF FINDINGS 75 Table 4.1. Continued Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Employment Employers’ negative No clear provision Livelihood programs seldom Lack of inclusive Plateau State employ- attitudes for inclusive em- target persons with disabilities human resource ment provision in its Disabling work ployment until the Few actors in inclusive policies disability law environment recently passed livelihood or employment: Lack of advocacy for Discrimination Lack of affirmative national disability Sightsavers International, inclusive employment against Persons action law CBM International, Failure to implement with Disabilities Inappropriate Theseabilities Foundation, inclusive employment (Prohibition) Act employment The Leprosy Mission, pronouncement Special quota of 1 Denial of leadership Comprehensive Community percent for persons roles Mental Health Programme, with disabilities of any Discriminatory and Propcom organization that has language in job Donors funding inclusive live- up to 100 persons advertisements lihoods: DFID, BMZ, European in the Lagos State Union, and TY Danjuma Special People’s Law Foundation 2011 Office of the Head of Civil Service of the Federation has a disability desk but the Ministry of Labour and Employment does not Social protection Lack of access The National Social Actors with inclusive social Eligibility re- Lagos State disability to social security Protection Policy protection programs: The quirements are grants schemes makes provisions Leprosy Mission, CBM discriminatory Social security Office of the Head for disability International, Comprehensive Recognition level schemes implemented of Civil Service inclusion Community Mental Health of the relationship through the Plateau of the Federation Programme, and Save the between poverty and State Disability Rights bureaucracy Children International disability is low. Discrimination Unaccountable Donors in this sector: DFID, Disability is not a against Persons leaders European Union, and BMZ cross-cutting factor with Disabilities Lack of coordination between in the National Social (Prohibition) Act departments in FMWASD Protection Policy Failure to implement the policy Low level of imple- mentation monitoring of the of schemes Community- Unaffordable as- The previous Assistive devices in short Inadequate expertise Vocational rehabilita- based services, sistive devices and rehabilitation supply and manufactur- tion program in Oyo assistive technology policy was vague Mostly run by private compa- ing centers for State devices, and Dearth of available and poorly nies and charities assistive devices and Community-based technology quality assistive implemented Few community-based reha- technology rehabilitation and devices National policy on bilitation programs Low knowledge levels vocational training Inadequate disability is at the FMWASD is in charge but not on the principles experiences in Kaduna, therapists and draft stage doing enough and practice of Zaria State community-based Not a focus of key donors community-based Assistive devices rehabilitation rehabilitation and support provided services Lack of sustainability by organizations plan for the design of such as the Leprosy community-based re- Mission International, habilitation programs German Leprosy Relief Low level of govern- Agency, and Damien ment commitment Foundation (continued) 76 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Table 4.1. Continued Current Main Issues and Programming, Current Institutional Sector Barriers to Services Laws, and Policies Landscape Gaps in Programming Good Practices Electoral Low knowledge of INEC’s Framework INEC has a disability desk Low capacity of INEC Framework on Access and political disability inclusion on Access for Actors in inclusive gov- for inclusive electoral for Persons with processes among staff at Persons with ernance and electoral process Disabilities in the the Independent Disabilities in the participation: Inclusive Lack of political will Electoral Process National Electoral Electoral Process Friends Association, Centre to facilitate active developed by INEC Commission (INEC) for Citizens with Disabilities, participation and A paper ballot de- Inaccessible elec- The Albino Foundation, and leadership of persons signed in braille for the toral procedures ActionAid International with disabilities in 2019 elections and facilities Donors: DFID, USAID, politics Lack of opportu- European Union, Ford Poor implementa- nities for political Foundation, and the tion of the INEC’s and leadership Netherlands Embassy Framework on participation Access for Persons Physical inacces- with Disabilities in the sibility of voting Electoral Process environment Situations of more vulnerability in case of electoral violence Public Inaccessible Lack of inclusive No disability desk in the Low awareness level Lagos Metropolitan transportation vehicles transportation Ministry of Transport of transportation Area Transport Negative attitudes policy Dearth of programs targeted rights and needs of Authority (LAMATA) among drivers and Recently passed at addressing inclusive persons with disabil- has put in place the passengers disability law transportation ities among relevant following disability Discriminatory includes provisions stakeholders inclusive measures for attitudes among for inclusive public Lack of facilities for its bus rapid transport: staff of airlines and transportation safe, convenient, and priority queue; priority airports dignifying boarding ticket purchase; prior- Risky and inap- ity seating; wheelchair propriate boarding space; accessible procedures buses; level boarding; and accessible infra- structure, e.g., ramps and disabled-friendly crossings Public Inaccessible public No policy on No disability desk in the Lack of available Sign language information and information and accessible Ministry of Information assistive technolo- interpreters at public communications communications information and Organizations and the media gies for accessible events and to ensure High level of illiter- communications do not prioritize accessi- information adequate dissemina- acy among persons There are ble public information and Accessible in- tion of key information with disabilities provisions on ac- communications formation and about government-re- Poor quality sign cessibility of public Awareness programs are usu- communications lated issues. language interpre- information and ally not provided in accessible are low priorities of tation services communications in formats stakeholders the new national Lack of capacity for disability law providing accessible information and communications Lack of regulation of sign language inter- pretation services BMZ = Federal Ministry for Economic Cooperation and Development; DFID = Department for International Development; FMWASD = Federal Ministry of Women Affairs and Social Development; HANDS = Health and Development Support Programme; INEC = Independent National Electoral Commission; USAID = United States Agency for International Development. 4. REVIEW OF FINDINGS 77 Ongoing programs of the commission include: Participation and leadership. Persons with dis- abilities actively participate in and lead the affairs of An entrepreneurial project conducted in collabo- the commission, which has greatly motivated their ration with the state government and with funding commitment. from the African Development Bank that involves 107 persons with disabilities in potato farming; Autonomy. The commission is autonomous—it does not operate under any ministry or agency. It is The Church of Jesus Christ of Latter-day Saints, directly linked to the governor’s office, with func- United States, that donated 1,000 wheelchairs, tional autonomy. which were distributed by the commission; Annual budgetary allocation. Dedicated annual Technical support and advocacy training targeted at budget for disability inclusion with budgetary traditional leaders and other opinion leaders at the allocations deposited in the commission’s bank community level with funding from the Australian account, allowing for planning and implementation embassy; of disability-inclusive activities. Provision of educational assistance to persons with Gaps and challenges disabilities in collaboration with the state’s Universal None of the provisions in the health sector are being Basic Education Board; implemented. Social security grants such as scholarships and Only about 5 percent of the target has been met for entrepreneurial grants to persons with disabilities; assistive devices due to lack of funding. Automatic employment of qualified persons with Community-based rehabilitation services have yet to disabilities; and be planned and implemented. There are also funding Distribution of 1,500 devices, including crutches, constraints, including capacity development of staff guide canes to persons with disabilities, in collabo- to implement the services in a sustainable manner. ration with the State Ministry of Health. Funding is inadequate, with a large part of the bud- Contributing factors to implementation progress get dedicated to recurrent expenditures. Political will. The state governor is highly commit- Support is needed in terms of funding; technical ted to disability inclusion. assistance; and capacity development of duty bear- Supportive staff. Staff members are committed; ers, service providers, and persons with disabilities. they view their service at the commission as a way to also help themselves. Lagos State Community involvement. The community has Lagos State Special Peoples Law 2010 been sensitized to and is interested in disability The Lagos State Special Peoples Law 2010 (Lagos inclusion, even in rural areas, as illustrated by the State of Nigeria 2011), which came into force in 2011, training of traditional rulers on disability inclusion, established the Office for Disability Affairs to safeguard which targeted 18 participants but which eventually persons with disabilities against all forms of discrimi- had 37 people interested in attending. nation and to equalize their opportunities in all aspect 78 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT of living in society. The office issues guidelines regard- The law criminalizes—with fines and imprisonment— ing the education, social development, and welfare of treating persons with disabilities cruelly or inhumanely, persons with disabilities, and collaborates with relevant including medical and scientific experiments, torture, ministries, parastatals, and corporate bodies with the and degrading treatment; using them for alms begging; authority to issue building or design codes to facili- or subjecting them to slavery, forced labor, or any form tate the accessibility and use of buildings for persons of exploitation. with disabilities. It is authorized to receive complaints regarding violations of the rights of persons with dis- Lagos State Office for Disability Affairs abilities and to support the investigation, prosecution, Executive Governor of Lagos State Babatunde Raji and sanctioning of reported cases. Fashola (Senior Advocate in Nigeria-SAN) inaugurated the governing board for the Lagos State Office for Additionally, the office registers and coordinates Disability Affairs (LASODA) on July 9, 2012. LASODA, organizations of persons with disabilities, reorients and which operates under the supervision of the Ministry of educates the public to reduce stigma around disabil- Youth, Sports and Social Development, is charged with ities, and collects and collates data on persons with implementing the Lagos State Special People’s Law disabilities for planning purposes. It liaises with other 2011. It has nine principal officers, including a general ministries and government agencies to ensure that the manager and a secretary. Three of the principal officers needs and concerns of persons with disabilities are are women and three are men with disabilities. Of its addressed in government policies, programs, and activ- approximately 25–30 staff members, seven have disabil- ities. It maintains and updates a database of persons ities, including women. with disabilities, designs and issues customized insig- nias for use in parking lots, and sensitizes the public on Implementation progress how to interact with persons with disabilities. Lagos State Disability Fund was launched by the immediate past Governor of Lagos State Akinwumi Moreover, the law makes provisions for the social Ambode on May 29, 2016 with a seed fund of N protection of persons with disabilities; accessible public 500 million intended for the education and social transportation, including no extra charges for assis- advancement of persons with disabilities in Lagos tive devices; reserved parking spaces; and accessible State. The funds are being disbursed to persons public buildings with a transitory period within which with disabilities and disability cluster organization all roads, pedestrian crossings, and other structures registered with and recognized by LASODA. Persons should be modified for accessibility. with disabilities are recommended to receive the N The law also recognizes the rights of children with 100,000 per person funds by their respective organi- disabilities to their identity and to protection against zations. No clear eligibility criteria exist. neglect, exploitation, and violence; it also recognizes About 1,000 civil servants have received training the right of persons with disabilities to basic services, in sign language in Lagos State over the past three including health, education, and employment. Under years. this law, persons with disabilities have the right to free- dom; to drive; to inclusion in communal life; and to par- Persons with disabilities have been employed in the ticipate in cultural life, recreation, leisure, and sports. Lagos State civil service. 4. REVIEW OF FINDINGS 79 LASODA has initiated the Disability Entrepreneur- The office lacks the autonomy to directly interact ship and Empowerment Programme which is a loan with the governor’s office. service for eligible persons with disabilities. Bor- Funding levels are insufficient. rowers must have a viable business or be involved in entrepreneurial activities; loan amounts vary and The law does not provide a government budget must be paid back within one year. allocation to LASODA, except through the establish- ment of Lagos State Persons Living with Disability Assistive devices have been distributed. Fund with seed funds of N500 million. Bus Road Transport have allocated seats for persons with disabilities although the buses are not physi- Ondo State cally accessible. Ondo State Agency for the Welfare of There are some new accessible pedestrian bridges. Persons with Disabilities and Other Provisions Law 2011 Contributing factors to implementation progress Dr. Olusegun Mimiko, the then governor of Ondo State, Past state governors have demonstrated a commit- passed the Ondo State Agency for the Welfare of Per- ment to LASODA through, for example, the provi- sons with Disabilities and other Provisions Law 2011 sion of the seed funds for the Lagos State Persons (Ondo State of Nigeria 2012) on March 29, 2012. The Living with Disability Fund. objectives of the Ondo State Agency for the Welfare of The presence of a board provided oversight over the Persons with Disabilities are to: affairs of the office. Facilitate the protection of the rights of persons with Gaps and challenges disabilities in the state as well as the eradication of Study participants believe that there is a lack of all forms of discrimination against them; capacity to implement the Lagos State Special Peo- Mobilize persons with disabilities to be self-reliant, ple’s Law 2011. They believe that many of its provi- to contribute to economic development, and to sions are being inadequately implemented—if at all. foster public awareness on disability inclusion; They highlight that the employment of persons with disabilities in Lagos is lagging, as are health issues, Provide an avenue for programs that would enhance priority on queues, and designated parking spaces. interactions between persons with disabilities and their peers without disabilities within and outside There are indications that the general population is the state; and not yet aware of the law or its provisions. Promote, protect, and represent the interest of per- “When people are in a queue, you get there as a sons with disabilities in all spheres of life. person with disabilities and tell them that the law says I should be attended to first, they will not To achieve its objectives, the agency will formulate listen to you. They will even quarrel with you over policies and programs to enhance the welfare of per- that. That awareness […] is not there yet. sons with disabilities in the state; source funds from – a visually impaired participant, Lagos other tiers of the government, the organized private 80 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT sector, and international donor agencies; and make pro- of Women Affairs and Social Development. On July visions to enhance the employment of and empower 17, 2019, eight years after the agency was established, persons with disabilities. It expects to ensure adequate Governor Oluwarotimi Akeredolu inaugurated its board, health care for persons with disabilities in the state and which comprises five persons with disabilities (includ- advocate for accessible public buildings and recre- ing one woman and the chairman) who represent the ational facilities. It also seeks to prevent persons with state’s key disability cluster organizations. Additional disabilities from socially unacceptable behaviors such board members were drawn from the Ministry of as street begging. Women Affairs and Social Development; the Ministry of Health; the Ministry of Education; and the Ministry The law provides for the physical accessibility of public of Employment, Labour and Productivity. The agency’s buildings and roads. It demands that the development secretary also serves as secretary of the board. The prin- and remodeling of public transportation and public cipal officers of the agency include the secretary, who is communication conform to national standards and responsible for the administration of the agency under guidelines regarding access to persons with disabilities. the supervision of the chairman (who has not yet been The law makes it mandatory for the media industry appointed). The secretary will advise the board on the that operates in the state to raise awareness on the formulation and implementation of its policies and will rights, respect, and dignity of persons with disabilities, convene board meetings. The agency will determine the and to showcase their capabilities, achievements, and number of staff necessary to deliver its mandates, and contributions to society—with the involvement of per- then have them posted from the civil service. sons with disabilities. None of the agency’s current principal officers is a The law has provisions regarding the boarding of vehi- person with a disability. There were no persons with cles by persons with disabilities and for the preferential disabilities in the agency’s workforce until recently, treatment of persons with disabilities in boarding pro- when one person with a disability was recruited. The cess, but it does not specifically recognize the rights of agency’s primary source of funding is the state govern- persons with disabilities to access basic services, such ment’s subvention and budgetary allocation, coupled as education, health, and employment. It also makes no by funds from the federal and local governments, donor specific provisions for the rights of children or women agencies, gifts, money earned on property, and assets with disabilities. It does prohibit any form of discrimi- accrued to the agency from any other source. nation against or harmful treatment of a person with a disability, with criminal penalties that include fines and Implementation progress imprisonment. The implementation of the law is highly inconsistent. The agency occasionally implements empowerment pro- The Ondo State Agency for the Welfare of Persons with grams, but they are not sustainable. It is also working on Disabilities initially had two departments: (1) finance presenting the issue of employment to the government. and (2) administration, and rehabilitation, and health services—but the law allows for the creation of addi- “So, you see, you buy a sewing machine to empower tional departments with board approval. The agency somebody but there is no shop. So the empowerment operates under the supervision of the State Ministry opportunities they are giving are not comprehensive 4. REVIEW OF FINDINGS 81 enough to me. By the time you come back in six months disabilities, including the employment, use, or involve- to assess the people you claimed you have empowered, ment of persons with disabilities in alms begging, as they would have sold off the items because your well as discrimination in employment. empowerment talk is not comprehensive enough.” Furthermore, the law proposes adequate standard of – an activist, Akure living and social protection, the accessibility of public Gaps and challenges buildings and facilities, and supporting person with The board has only recently been inaugurated, disabilities in situations of risk and humanitarian allowing it to begin its work, which was a major emergencies. It specifies a transition period of five setback to the law’s implementation. years during which modifications should be made to all public buildings, roads, pedestrian crossings, and other Persons with disabilities did not actively participate relevant infrastructure to make them accessible to and in implementation because there was no board in usable by persons with disabilities. place. Further, the agency’s office is not physically accessible, and there are no sign language interpret- The law recognizes the rights of children with disabil- ers. Persons with disabilities are treated more as ities to protection from all forms of violence, free and beneficiaries and/or recipients of charity. compulsory education up to the secondary level, and recreational activities. Under the law, the government Awareness of the law is scant. Most of general pop- provides early intervention services and support to ulation and key stakeholders, including the media, children with disabilities and their families. does not know that the law exists. The law affirms the rights of persons with disabilities to Funds for implementing the law are lacking. free or affordable health care services of the same qual- ity available to their peers without disabilities, includ- Jigawa State ing any needed communication support; it guarantees Jigawa State Persons with Disabilities access to education absent any form of discrimination; Law 2016 and it promotes inclusive education. It recognizes the The Jigawa State Persons with Disabilities Law 2016 rights of persons with disabilities to gain employment (Jigawa State of Nigeria 2017) was signed on January in a chosen labor market and work environment. The 19, 2017, by Governor Muhammad Badaru Abubakar. law makes it compulsory for any employer with up The law is meant to safeguard persons with disabili- to 100 employees to reserve at least 5 percent of its ties from all forms of discrimination, to promote their workforce for qualified persons with disabilities. It access, and to advance their opportunities to engage also recognizes the right of persons with disabilities to in all aspects of society. It prohibits discrimination participate in politics and government policy; to access against and the harmful, cruel, or inhuman treatment transportation; to take part in communal life; and to of persons with disabilities. It recognizes the rights of engage in cultural life, recreational activities, leisure, women and adolescents with disabilities to all of the and sports. law’s provisions. However, it selectively criminalizes The Jigawa State Rehabilitation Board is mandated with only cruelty and inhuman treatment of persons with the responsibility of implementing the law’s provisions. 82 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT It has the responsibility to protect, promote, and support provision for the automatic employment of five persons the social and economic development of persons with with disabilities for each of the 27 local government disabilities in the state. The law does not establish a sep- areas and for empowerment in terms of vocational arate office or commission to oversee its implementa- training. In addition, there is a policy to ensure the tion. The law also does not provide a government budget participation of persons with disabilities in political life, allocation for implementation. Instead, it establishes the including a provision of a special adviser on disability Jigawa State Persons with Disabilities Fund to advance issues for each local government area who must be a the cause of persons with disabilities in the state. person with a disability. This policy produced 27 special advisers with disabilities as well as a member of the Implementation progress state house of assembly representing Dutse Constitu- The government set up and inaugurated a committee ency, who is a man with a disability. To ensure sustain- for the Jigawa State Disability Fund immediately after ability, a lawmaker with a disability in the Jigawa house the law was passed to raise funds for its implemen- of assembly during Governor Lamido’s tenure in office tation, but it has not been functioning. In response, sponsored the state disability bill for the first time. The the Partnership to Engage, Reform and Learn (PERL), bill sought to harmonize all of the ongoing social secu- in collaboration with the Jigawa State Rehabilita- rity schemes into one law and to include other relevant tion Board and a civil society initiative, established provisions for the well-being of persons with disabilities and inaugurated a disability law implementation in the state. committee and has developed an action plan for the implementation of the disability law and is raising Contributing factors to implementation progress public awareness on the importance of the law. The PERL, in collaboration with relevant stakeholders, implementation committee consists of government provided support to facilitate the process. officials from the relevant MDAs, such as the Ministry There were already existing social protection of Women Affairs, Ministry of Education, Ministry of schemes, which had been instituted due to the polit- Finance and Economic Planning, Jigawa State Due ical will of a past governor. Process and Project Monitoring Bureau, other organi- zations, and persons with disabilities. It has a chairman Gaps and challenges and is under the supervision of the Jigawa State Reha- There is no separate office or commission to manage bilitation Board. the implementation of the law. In 2007, prior to the passage of the law, Governor Sule Political will is insufficient. Lamido, rolled out a social security allowance of N7,000 Implementation funding is lacking. per month for 150 persons with disabilities in each local government area in the state. The state has also been There is a dearth of leadership among persons with implementing policies that provide free education to disabilities. everyone, including persons with disabilities from the primary to secondary level as well as scholarships to students at the tertiary level, provided that the edu- cation is at a state-owned institution. There is also a 4. REVIEW OF FINDINGS 83 Anambra State Moreover, the law makes it mandatory to ensure equity in employment for persons with disabilities. All employ- Anambra State Disabilities Rights Law 2018 ers of labor with at least 100 employees, as well as all The Anambra State Disabilities Rights Law 2018 state and local government public institutions, must (Anambra State of Nigeria 2018) came into force on reserve 1 percent of their workforce across different September 13, 2018. It provides for the full integration cadres for qualified persons with disabilities. It makes of persons with disabilities into society and prohibits all provisions for the fair treatment of employees who forms of discrimination and harmful practices against acquire permanent impairments whether in the course persons with disabilities, including the imposition of of duty or otherwise. fines and/or imprisonment. Under this law, a person with a disability who experiences discrimination can The Anambra State Disabilities Rights Commission, as instigate a civil action against the perpetrator and is established by the law, will implement it and monitor entitled to unconditional free legal aid provided by the compliance. The principal officers of the commission, government, as needed. who will work in part-time positions, will be selected from a variety of stakeholders, including organiza- The law mandates the prioritization of persons with tions of persons with disabilities, the civil society, and disabilities in welfare, social development, poverty relevant government ministries. The law mandates that reduction, and related programs, as well as the provi- half of the commission’s staff members be persons with sion of social security to persons with disabilities age 60 disabilities. and older. It affirms the rights of persons with disabil- ities to access public buildings and places; and man- Anambra State Office of the Governor on dates that roads, sidewalks, and pedestrian crossings Disability Matters be accessible to persons with disabilities. During a five- The Anambra State Office of the Governor on Disability year transition period, public buildings and facilities Matters was established in December 2016, following must be made accessible. the appointment of Senior Special Assistant to the The law protects the rights of persons with disabilities Governor on Disability Matters Barr. Chuks Bertrand to public information and communications in acces- Ezewuzie by the Executive Governor of Anambra State, sible formats, including the free use of assistive tech- His Excellency Dr. Willie M. Obiano. The office was nologies to facilitate same. It provides for accessible established to: transportation facilities, including free transport for Ensure employment opportunities for qualified per- assistive devices and the right of persons with disabil- sons with disabilities in the state; ities to drive and to reserved parking spaces. The law upholds the right of persons with disabilities to educa- Prevent all forms of discrimination against persons tion through special education and inclusive education with disabilities in society; and provides for scholarships; learning support; and Formulate and implement disability-inclusive poli- a curriculum that is inclusive of braille, sign language, cies in Anambra State; and augmentative and alternative communication. Promote self-reliance and entrepreneurship among persons with disabilities; and 84 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Provide support to NGOs and motivate public-pri- Free transportation for persons with disabilities in vate partnerships to benefit persons with disabilities state-owned vehicles; and living in the state. Harmonization of the activities of the disability clus- The Anambra State Office of the Governor on Disability ter organizations, NGOs, and the government. Matters has six principal officers—the senior special Contributing factors to implementation progress assistant to the governor on disability matters; the The state governor had the political will to special assistant to the governor on sign language and strengthen disability inclusion. communication; the executive assistant to the governor on disability services; the program coordinator; the An experienced senior special assistant to the gov- administrative and accounts officer; and the program ernor on disability matters was appointed who is and service coordinator. Seventeen staff members work able to establish platforms for coordinating disabil- in this office. Nine (53 percent) are persons with disabil- ity inclusion activities among the various disability ities, four of whom (44 percent) are women. stakeholders in the state. Implementation progress Persons with disabilities participate in and provide The implementation of the Anambra State Disabili- leadership for governance. ties Rights law has not begun because a commission The principal government officials collaborate with has not yet been established. However, the state has the Ministry of Social Welfare, Children and Women been embarking on some disability inclusion activities Affairs. through the Anambra State Office of the Governor on Disability Matters in coordination with the Ministry of Challenges Social Welfare, Children and Women Affairs, which is Funds to implement projects activities and tailored currently responsible for disability-related issues in the services are lacking. state. Key achievements include: The implementation of the Anambra State Disabili- The enactment of the Anambra State Disabilities ties Rights Law is delayed. Rights Law; The employment of about 100 persons with Ekiti State disabilities; Ekiti State Rights of Persons with Disability Bill 2013 The appointment of five persons with disabilities in The passage of the Ekiti State Rights of Persons with the governor’s cabinet; Disability Bill 2013 would ensure the inclusion of per- The provision of tailored services for persons with sons with disabilities into mainstream society and pro- disabilities, such as the establishment of a disability hibit all forms of discrimination against persons with law center and access to a computer technology disabilities in Ekiti State. The bill was drafted during Dr. center, and the recruitment of disability-related John Kayode Fayemi’s first tenure as the state governor. specialists, such as sign language interpreters and The state executive council ratified and forwarded it to braille instructors; the house of assembly for its passage into law. 4. REVIEW OF FINDINGS 85 It seeks to criminalize discrimination against persons disabilities. Within one year of the enforcement of the with disabilities, including an optional fine for anyone law, employers in the private sector with 20 or more or any organization violating its provisions. It provides employees will receive incentives to ensure that at least for an accessible physical environment, transportation, 5 percent of their workforce comprises persons with information, communication, and technology. During a disabilities. five-year transition period beginning at the date of noti- The bill provides for capacity development for the ade- fication of relevant standards and regulations, existing quate implementation and monitoring of its provisions, public buildings must be made accessible. including mandatory training in disability rights for the If the Ekiti State Rights of Persons with Disability Bill members of the house of assembly, the police, judges, becomes law, it would provide an approach to the lawyers, and legal officers; a disability component in the inclusion and prohibition of discrimination against per- training of professionals and community workers; tai- sons with disabilities that is more comprehensive than lored capacity building programs for persons with dis- similar laws. The bill provides for legal capacity and abilities, families, caregivers, and community members; guardianship of persons with disabilities, which means and the promotion of disability studies and research in it addresses the concerns of persons with intellectual tertiary institutions. disabilities better than the country’s existing disability laws. It includes affirmative actions related to agricul- The bill also provides for the constitution of a commit- tural land and housing, poverty alleviation, and the tee for persons with disabilities comprising a chair- allotment of land. It criminalizes all forms of violence person and six members. The committee would be and abuse of persons with disabilities, including jail responsible for monitoring the implementation of the terms for offenders. provisions of the law, if passed. It will have to liaise with the Ekiti State Citizens’ Rights Centre to discharge its The bill is very clear on the role of state and local educa- functions. tional institutions and governments in providing inclu- sive education to learners with disabilities. It further Ekiti State Office for Disability Affairs provides for the inclusion of persons with disabilities The administration of Dr. John Kayode Fayemi estab- in adult education, vocational training, and self-em- lished the Ekiti State Office for Disability Affairs on ployment programs. Government institutions of higher December 24, 2018. The office is primarily responsible education and higher educational institutions receiving for providing essential services and psychosocial inter- aid from state governments must reserve 5 percent of ventions to persons with disabilities. The functions of the seats in every class for students with disabilities, the office are to: and students with disabilities must then be allowed to compete for the remaining nonreserved seats. Promote the rights of persons with disabilities; Each state government Ministries, Departments and Motivate persons with disabilities to be self-reliant; Agencies (MDAs) must reserve at least 5 percent Facilitate the acquisition of working tools and of available vacancies for persons with disabilities, with allocations distributed across the major types of mobility aids; and 86 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT Encourage persons with disabilities to maximize Disability Legislation and Policies in their potential. South Africa—A Case Study The Ekiti State Office of Disability Affairs has four During the apartheid regime, South Africa adopted principal officers: an executive secretary, a director of the charity and medical models of disability, whereby disability affairs, a director of administration and sup- persons with disabilities only accessed rehabilitation plies, and a director of finance and accounts. It has a and habilitation services and social grants (Republic total of 27 staff members, six of whom (22 percent) are of South Africa 2016). Services such as education and persons with disabilities, and 3 of whom (50 percent) employment were segregated for children and adults are women with disabilities. The office is under the with disabilities. supervision of the State Ministry of Women Affairs and Today, South Africa lacks a comprehensive national Social Development. disability law but does have some national laws and Achievements policies that promote and protect the rights of persons The Ekiti State Office of Disability Affairs: with disabilities. For example, the Constitution of the Republic of South Africa, 1996, states that “everyone is Facilitated efforts to domesticate the Discrimination equal before the law and has the right to equal pro- against Persons with Disabilities (Prohibition) Act tection and benefit of the law.” It prohibits discrimina- 2018 in collaboration with the Ministry of Justice; tion on a number of grounds, including disability. The Monitored and supervised disability cluster organi- constitution also recognizes South African Sign Lan- zations operating in the state; guage as the first language of hearing impaired South Africans. Collaborated with NGOs working on disability inclusion; The Promotion of Equality and Prevention of Unfair Discrimination Act (PEPUDA) 2000 (Republic of South Employed 55 persons with disabilities in the state Africa 2003) is a law to give effect to section 9 of the government. South African constitution. The law prohibits unfair Maintained inmates at the state rehabilitation cen- discrimination and harassment, promotes equality, ter; and eliminates unfair discrimination, and prevents and pro- hibits hate speech. It mandates the removal of barriers Rescued and repatriated beggars, the destitute, and and acts to ensure that persons with disabilities can persons with mental impairments to their states of fully participate in society. origin. Similarly, the National Development Plan 2012 (National Challenges Planning Commission 2012) envisages a country that There is a shortage of resources and amenities. has eliminated poverty and reduced inequality by 2030. There are an inadequate number of professional The plan affirms the need for the integration of disability social workers. inclusion into all facets of planning by adopting a tailored approach. Sector-specific legislation and policies that cut across sectors such as education, health, employment, 4. REVIEW OF FINDINGS 87 and social protection address the needs of persons with development of new sectoral policies, programs, budgets, disabilities as part of the mainstream or as a group. and reporting systems to fulfill South Africa’s constitu- tional and international treaty obligations. It lays out A contributing factor to disability inclusion is the active benchmarks for the removal of barriers to access. participation of all previously marginalized and vulner- able groups, including persons with disabilities repre- The white paper holds to account multiple stakehold- sented by organizations of persons with disabilities in ers, including duty bearers and right-holders (persons the transformation agenda of democratic governance with disabilities and their families) for ensuring equal in South Africa. This effort was operationalized through opportunity for persons with disabilities at all levels the establishment of the first disability program in of government. It commits duty bearers to ensuring the Office of the Reconstruction and Development implementation of existing legislation and policies; Programme, leading to the formal establishment of upholding the rights of persons with disabilities; facili- the Office on the Status of Disabled Persons in the tating access and participation in planning, budgeting, Presidency, which is responsible for monitoring the and service delivery; recognizing the right to self-repre- implementation of the White Paper on an Integrated sentation; acknowledging the differences occasioned by National Disability Strategy (1997) in all government the intersection of disability with gender, age, sexuality, departments and facilitating disability mainstreaming religion, culture, and geographic location; and embed- across the public sector and civil society. ding the obligations in the United Nations Convention on the Rights of Persons with Disabilities in legislation, The Disability Rights Charter of South Africa 1992, policy, and service delivery. developed by Disabled People South Africa, has been the benchmark for all future legislation, programs, To achieve its purpose, the white paper builds on and projects on disability in South Africa, including nine strategic pillars that span accessibility and par- the White Paper on an Integrated National Disability ticipation; protection of rights of persons at risk of Strategy and the White Paper on the Rights of Persons compounded marginalization; support to sustainable with Disabilities. integrated community life; empowerment of children, women, and youths with disabilities; reduction of eco- The White Paper on the Rights of Persons nomic vulnerability; strengthening the voice of persons with Disabilities with disabilities; building a disability-equitable state The White Paper on the Rights of Persons with Disabil- machinery; promoting international cooperation; and ities (Republic of South Africa 2016) is a comprehensive providing monitoring and evaluation. document that brings together provisions to promote and protect the rights of persons with disabilities from The monitoring and evaluation pillar entails the elab- existing legislation and policies to fulfill the obligations oration of an implementation plan for each strategic of the United Nations Convention on the Rights of pillar, including outcome indicators to measure imple- Persons with Disabilities. It endorses mainstreaming as mentation impact on the lives of persons with disabili- the primary approach to realizing the inclusion rights of ties and their families. An implementation matrix lays persons with disabilities while providing guidelines for out targets to achieve by 2030, including the enactment disability mainstreaming and a review of existing and the of national disability-specific legislation. Every five 88 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT years, the South African Human Rights Commission Strong disability movement. South Africa’s disabil- is to publish an annual progress report of the white ity movement is robust, united, and committed. The paper’s implementation and to conduct an in-depth movement has assumed a leadership role in terms review of its impact. of lobbying and advocacy to ensure the implementa- tion of disability provisions in the available policies Disability-related issues used to be under the supervi- and legal instruments. sion of the social development department, which is responsible for social welfare, suggesting that disability Implementation matrix. The White Paper on used to be considered a welfare-related issue. How- the Rights of Persons with Disabilities includes ever, responsibilities for disability-related matters were an implementation matrix to monitor and evalu- recently moved back to the president’s office, a widely ate its progress, thereby holding the government supported move among the disability community. accountable. The White Paper on the Rights of Persons with Disabili- Accountability to global and regional disability ties has no legal authority, but the disability community bodies. South Africa complies with the submission in South Africa has been drawing on its and PEPUDA’s requirements of reports to global and regional plat- provisions for years to uphold the rights of persons forms on disability, such as the Committee on the with disabilities. While the white paper is relatively Rights of Persons with Disabilities and the African comprehensive as described above, PEPUDA is a legal Union, which has helped track the progress made instrument with a disability component. Anecdotal and implementing the legal frameworks such as the published indications suggest that the implementation United Nations Convention on the Rights of Persons for both is slow (HRW 2015, 2019; CRPD 2018), but with Disabilities as domesticated through the White implementation efforts of existing provisions offer the Paper on the Rights of Persons with Disabilities. following lessons: Direct link to the presidency. Disability issues Political will. The government of South Africa’s are better prioritized and treated as human rights post-Apartheid transformation agenda has focused issues by having direct contact to the office of the on race, gender, and disability; and in some ways, presidency rather than being under the social devel- this commitment has helped drive the country’s opment department, which suggests a charity- or disability agenda. welfare-based approach. Political participation. A major impetus for imple- menting disability policies and legal frameworks is the participation of persons with disabilities as par- liament members and their engagement in political issues of national interest, including those that focus on disabilities. 4. REVIEW OF FINDINGS 89 5. Conclusions and Key Recommendations The findings of this rapid social assessment of the Capacity Development socioeconomic status of persons with disabilities in Nigeria indicate that their access to basic services is Capacity development is crucial to improving on the wholly inadequate and that deeply ingrained and wide- current disability inclusion principles and practices in spread attitudinal barriers across the country signifi- various sectors of the economy. Capacity development cantly contribute to their exclusion from all sectors of efforts should target various stakeholders who will be the economy. Policies and legal frameworks to promote responsible for addressing the needs of persons with and protect the rights of persons with disabilities are disabilities, including: either nonexistent or poorly implemented. The current Duty bearers. Duty bearers are government offi- institutional landscape is poorly adapted to disabil- cials, policy makers, and decision makers at the ity-inclusive development. To advance the status of helm of state affairs. Gaining their buy-in for the pri- persons with disabilities in the country, substantial oritization of disability inclusion will require raising improvements are needed in the areas of disability awareness of the disability concept; the importance advocacy, disability data, capacity development, pro- of disability as a development issue, including the vision of assistive devices and technology, and stigma link to development instruments like the Sustain- reduction. Key recommendations based on the study’s able Development Goals; Nigeria’s commitment to findings are summarized below. disability inclusion; the practical implications of the Discrimination against Persons with Disabilities (Prohibition) Act 2018; the relevance of inclusive policies; the importance of data disaggregation by disability; and the costs of exclusion. 90 Service providers. These stakeholders need terms of disability inclusion. Specifically, they can expanded awareness of the concerns of persons with receive training to become trainers for disability disabilities, the various types of impairment, the awareness, rights, and inclusion, ensuring a pool of definition of disability, data collection, the use of the knowledgeable trainers who can collaborate with Washington Group questions, and legal frameworks other stakeholders, such as the duty bearers, service on disability inclusion. Their capacity to provide providers, and development actors. They may also disability-inclusive services tailored to their specific need capacity development in disability advocacy, spheres is also essential. Negative attitudes among community mobilization, and economic empow- service providers must be addressed in the context erment. Organizations of persons with disabilities of awareness-raising and disability advocacy. and disability-focused organizations may also need capacity development in governance, leadership, Development and humanitarian actors. Much of and accountability, which would help them attract the development and humanitarian aid that comes disability funding that they can use to implement into Nigeria is in the form of programs implemented relevant projects. Currently, most are probably not by development actors, including disability-fo- strong enough to receive funds for meaningful proj- cused organizations. This study’s findings suggest ect implementation. that there are gaps in such programming related to disability inclusion. It would therefore be valuable to develop the skills of the development actors regard- Establishment of National ing the principles and practice of disability-inclusive and State Platforms for project management. They also need more skills Disability Inclusion to collect disability-disaggregated data using the Washington Group questions. Advocacy efforts will There is currently a gap in the coordination of disability vital to gaining the commitment of top manage- inclusion in Nigeria. JONAPWD is in the best position to ment regarding disability inclusion and to promote lead a coordinated effort but seems to lack the neces- organizational practices that will serve as a basis for sary capacity at present. A coordinated platform could sustainable and inclusive programming, help organize pressure groups to push for a disabili- ty-inclusion agenda through partnerships; collabora- Persons with disabilities and their organiza- tions; networking; resource mobilization; technical tions. With the current drive for disability-inclusive support; advocacy; and capacity development, including programming, occasioned by Nigeria’s increasing knowledge sharing and transfer. Intersections between commitment to disability inclusion, there will likely disability and other marginalizing issues could be more to be a surge in the demand for expertise in dis- deeply explored and addressed through such platforms, ability-inclusive works. There is currently a dearth which could be established in a variety of sectors. The of such expertise in the country. It will therefore states should establish their own platforms as well, with be crucial to develop the capacity of individuals each comprising mainstream organizations, organi- with disabilities, their parents and caregivers, zations of persons with disabilities, disability-focused and organizations of persons with disabilities in organizations, and other relevant interest groups. These 5. CONCLUSIONS AND KEY RECOMMENDATIONS 91 mechanisms would help organize and track disabili- Role modeling and showcasing of persons with ty-inclusive initiatives, resources, donors, and actors in disabilities; the various sectors, and ensure the efficient and effec- Awareness-raising and public education on the tive use of available resources. They could also influence causes of impairments, with a focus on different the formulation and implementation of policy and the types of impairments, particularly albinism, leprosy, implementation of the disability law. mental illness, and developmental impairments; Affirmative actions by religious, traditional, and Medium- or Large-Scale opinion leaders; Local Manufacturing of Public enlightenment and sensitization on disability Assistive Devices inclusion through the media; Assistive devices are expensive because they are usu- Disability mainstreaming into community develop- ally imported into Nigeria. A few local manufacturers ment committees and formation of disability-inclu- produce devices on a small scale, often using outdated sive community development committees where technology and designs that may not suit the users. there are none; Therefore, to address the lack of available, affordable, and appropriate assistive devices, medium or large-scale Promotion of participation and leadership of per- local manufacturing of assistive devices should be estab- sons with disabilities in community activities and lished, beginning in a few places. This could address the decision making; country’s gross unmet needs for assistive devices. The Positive representations of persons with disabilities training of some people to manage the production may in the media; and also be necessary as expertise is also lacking. Formation of community level support and advo- cacy groups. Stigma Reduction Stigma is a major attitudinal barrier that precludes persons with disabilities from accessing basic services Disability Data Generation and from participating in mainstream society. Mea- Disability data generation is the bedrock of planning sures are needed to reduce the stigma associated with and design for disability inclusion. The dearth of misconceptions and negative attitudes around disabil- disability data in Nigeria is worrisome. Advocacy for ities and persons with disabilities in Nigeria. Interven- collection of disability-disaggregated data that targets tions around this should target households; community relevant stakeholders, such as the Nigeria Bureau of members, including religious, traditional, and opinion Statistics and National Population Commission, should leaders; school staff; members of the media; and the be intensified. Capacity development for disability data members of the general population. Adopting the fol- collection using the Washington Group questions is lowing strategies might benefit interventions: crucial and should be prioritized. Advocacy is needed 92 DISABILITY INCLUSION IN NIGERIA: A RAPID ASSESSMENT to encourage the collection of disability-disaggregated Funding data in the Health Management Information System and Education Management Information System and in Funding of disability inclusion activities must be prior- all national surveys and surveillance operations. itized through dedicated budgetary allocations for the ministries, departments, and agencies; for the proposed Strategic frameworks and implementation guidelines Disability Rights Commission; and for all government for policies should also include a mix of disability-inclu- planning, implementation, and monitoring and eval- sive indicators and disability-specific indicators. Devel- uation efforts. 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