The preconditions necessary to ensure

disability inclusion across policies,

services, and other interventions
Background
Reforms to improve social inclusion and access to services for persons with disabilities often fall short
because of the lack of the essential building blocks or preconditions that are necessary to ensure
disability inclusion. These preconditions are the foundational aspects that are indispensable in
addressing the requirements and views of persons with disabilities and should be considered in public
policy making and programming across all sectors. If the preconditions to disability inclusion are in
place, then persons with disabilities can access services across all sectors, such as education, health,
justice, etc. A multi-sectoral approach to establish and set up these preconditions, avoids duplication
and inconsistencies across sectors and encourages greater efficiency.

UNPRPD’s approach
UNPRPD joint programming is designed to respond to gaps in CRPD implementation by focusing on
these preconditions and translating them into concrete policies, programs, and services through a
cohesive, inter-sectoral approach. The preconditions should be structured according to the national
context and anchored in national priorities and will be the focus of situational analyses that informs
UNPRPD MPTF programming.

This focus on the preconditions marks a shift in UNPRPD MPTF’s programming to concentrate on
issues commonly affecting UN entity programming and provides a focal point for joint programming
across the diverse priorities of UN entities. It also lays the groundwork for successful governmental
reforms to implement the CRPD.

The preconditions
There are six cross-sectoral preconditions for the inclusion of persons with disabilities that are
essential to policies, systems, and services. These preconditions apply to all persons with disabilities,
but some preconditions may be of more importance to one group of persons with disabilities than
another. In addition, the preconditions are inter-related and require a joint approach tailored to the
context.

Preconditions for disability inclusion

Equality and non-discrimination

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 Service delivery
Accessibility
Participation of persons with disabilities
CRPD-compliant budgeting & financial management
Accountability & governance

Figure 1: Preconditions to disability inclusion

1. Equality and non-discrimination

Disability results from the interaction between persons with impairments and attitudinal and
environmental barriers that hinder their full and effective participation in society on an equal basis
with others1. These attitudinal barriers or stigma are grounded in stereotypes, misperceptions, and
assumptions about persons with disabilities, which often stem from a lack of exposure to or
understanding of the capabilities of persons with disabilities. The nature of disability-based stigma
and discrimination is often influenced by the type and severity of impairment a person has. In addition,
other aspects of a person’s background, such as gender, ethnicity, or socio-economic status, may
further contribute to exclusion. Therefore, measures to protect against stigma and discrimination
should include consideration of the most marginalized groups of persons with disabilities and
intersectional approaches2.

As a first step, there must be official recognition of persons with disabilities as a protected group at
national and sub-national levels. This involves recognition of each type of disability, which is a critical
step in ensuring that each sector is aware of the types of disabilities and their obligations to consider
the requirements of each group, thus ensuring that persons with disabilities can access services across
sectors. There must be protections in place to prevent and address disability-based stigma and
discrimination and to promote equality and non-discrimination, as well as measures to raise
awareness to foster respect for the rights and dignity of persons with disabilities. These protections
mush guarantee access to reasonable accommodations3. Understanding, capacity, and protection of
equality and non-discrimination are usually established through a mix of national legislation that
ensures recognition to each group of persons with disabilities, awareness raising and capacity building
policies and programs, policy guidance on reasonable accommodations, and administrative measures.

2. Service delivery
Service delivery must adopt a twin track approach with both mainstreamed and disability-specific
targeting of services to ensure inclusion of persons with disabilities. Persons with disabilities require

1 Convention on the Rights of Persons with Disabilities 2008, A/RES/61/106, preamble (e).
2 See generally, UNPRPD MPTF Strategic Operational Framework: Briefing on Cross-Cutting Approaches.
3 Reasonable accommodations are the necessary and appropriate modifications and adjustments that do not impose an

undue burden, where needed in a particular case, to ensure persons with disabilities enjoy their rights on an equal basis
with others.
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some services that are specifically designed for persons with disabilities, such as disability assessment
and referral services and disability support services, as well as disability mainstreamed services.

Disability assessment and referral services - Some disabilities are more difficult to detect than others,
particularly invisible or more complex disabilities. Even where a disability is readily identified, there
may be a lack of information on the condition, how to make adjustments, or where to go for support.
A disability assessment and referral system is intended to identify the kind and extent of disability a
person has, to receive information about their disability, and to ensure that they are referred to
appropriate supports and services in their communities. Disability assessment and referral systems
should be designed to empower persons with disabilities, including access to information, and should
be used for advancing the enjoyment of rights and access to services.

While disability assessment and referral systems often link to evaluation and determination of
benefits, services, or protections for individuals, they should not be used to impose unnecessary
restrictions based on formal assessment, such as requiring a formal assessment in order to request
reasonable accommodations or discrimination against certain groups of persons with disabilities (e.g.,
restricting protections to legal capacity for persons with intellectual or psychosocial disabilities). While
assessment and referral systems may help identify those individuals who require specific types of
support needs, such as access to community-based care services, they should not have a negative
impact on the personal independence or enjoyment of the rights of persons with disabilities 4 .
Furthermore, disability assessment and referral systems can also restrict access to necessary supports
in order to keep government spending down, which can lead to deprivations of rights. Therefore,
disability assessment and referral systems must be valid to avoid ‘false positives’ (i.e., people receiving
benefits who do not have a disability) and ‘false negatives’ (i.e., people who should receive benefits
but do not), reliable to ensure consistency in the quality of assessment, and transparent and
standardized so that the grounds for decision-making are publically known and indepently evaluated.5

In addition, early identification and intervention for children with disabilities is critical for ensuring
their development and should be included in plans for disability assessment and referral systems.
However, assessment and referral systems should be designed to ensure that persons of all ages,
including older persons, have access to assessment and referral, particularly since the incidence of
disability increases with age.

Disability assessment and referral systems are usually implemented through multi-sectoral programs
and administrative systems and may be based in national law and / or policy.

4 See generally, UN Committee on the Rights of Persons with Disabilities, Inquiry concerning the United Kingdom of Great
Britain and Northern Ireland carried out by the Committee under article 6 of the Optional Protocol to the Convention,
CRPD/C/15/4, 24 October 2017, paras. 70-81.
5 Bickenback, J. et al. Assessing Disability in Working Age Population: A Paradigm Shift from Impairment and Functional

Limitation to the Disability Approach, 18 June 2015, p. xi.

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Disability support services – Autonomy is a core principle of the CRPD, and for many persons with
disabilities, this can be achieved through disability support services. These support services are unique
to persons with disabilities and entail the provision of help or assistance necessary to carry out regular
activities and participate in society. These disability support services encompass a wide range of
formal and informal interventions, including personal assistance, mobility aids, assistive devices and
technologies, supportive decision-making, communication support (such as sign language or guide
interpreters), and community services. These disability support services are critical for accessing
general services, such as housing, health, education, justice, emergency services, and more6.

Disability support services are a precondition to living and fully participating in the community on an
equal basis with others, and without this support, persons with disabilities face exclusion from
accessing services, participating in society, institutionalization, and neglect7. The provision of support
services should seek to overcome or eliminate social and environmental barriers and should be
tailored to the individual. However, a portfolio of disability support services can be designed and
implemented to meet the needs of a wide range of support needs. Where public services do not exist,
allocation of funding to access disability support services may be necessary, e.g., financial support to
families that support persons with disabilities or the hiring of private sector support. Disability support
services are usually implemented through direct services, including access to assistive devices and
technology, live assistance, or community services, or money to pay for services, and legislative and
policy frameworks may also be necessary to enable and guide these services.

Mainstreamed services - Persons with disabilities require access to the same services as persons
without disabilities, such as education, vocational training, health, access to justice, emergency
services, social protection, recreational services, etc. These services need to mainstream disability
inclusion and identify structures, plans, and measures to ensure they are available, accessible,
adequate, and affordable for persons with disabilities. Persons with disabilities should have equal
access to services that are inclusive and not segregated. These mainstreamed services may also need
to link with disability support services to ensure full access to all persons with disabilities. For example,
access to Sign Language interpreters to appear in court, access to community-based support
mechanism to evacuate in an emergency, or access to an appropriate wheelchair and advice on how
to use the wheelchair in order to attend school.

3. Accessibility
Accessibility is necessary for persons with disabilities to live independently, to actively participate in
society, and to have unrestricted enjoyment of all rights on an equal basis with others. It refers to the
extent to which products, systems, services, environments, and facilities can be used by people with
diverse requirements, needs, characteristics, and capabilities to achieve their goals in certain contexts.

6 UN Special Rapporteur on the rights of persons with disabilities, Human Rights Council Report of the Special Rapporteur
on the rights of persons with disabilities, A/HRC/34/58, 20 December 2016, paras. 13-14.
7 Ibid., para. 15.

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The CRPD requires States to take appropriate measures to ensure to persons with disabilities access,
on an equal basis with others, to the physical environment, to transportation, to information and
communications, including information and communications technologies and systems, and to other
facilities and services open or provided to the public and to remove barriers and obstacles to
accessibility8. For example, this means that information must be provided in accessible formats, such
as Braille, large print, Sign Language, Easy Read, etc.

Accessibility is usually implemented through standards expressed in laws and policies and
implemented in programs or through operating or administrative procedures or public procurement.
In addition, awareness raising and technical know-how on accessibility as well as monitoring or
regulatory systems are required to ensure practical implementation9.

4. Participation of persons with disabilities

The active and informed participation of persons with disabilities in decisions that affect them is
consistent with a human rights-based approach and ensures good governance and accountability10
and the disability movement’s motto, ‘nothing about us without us’. It is a cross-cutting principle of
the CRPD11 and a precondition to inclusive policy making to overturn the common practice of decisions
being made on their behalf. Participation of persons with disabilities should be effective and
meaningful, ensuring a systematic, timely, and open approach. This also includes the provision of
relevant measures to ensure reasonable accommodations to consultative processes, free from stigma,
and recognizing every person’s legal capacity.12

Participation of persons with disabilities is usually through representative organizations of persons

with disabilities (OPDs), which are civil society organizations comprising a majority of persons with
disabilities – more than half of their membership – and governed, led, and directed by persons with
disabilities rooted in, committed to, and fully respectful of the CRPD. Participation may be facilitated
through both formal and informal mechanisms, ensuring that monitoring and accountability are
cornerstones of the participation13.

8 Convention on the Rights of Persons with Disabilities, Article 9.

9 See CRPD General Comment No. 2 (2014) on Article 9: Accessibility, CRPD/C/GC/2, 22 May 2014, para. 10.
10 Committee on the Rights of Persons with Disabilities, General comment No. 7 (2018) on the participation of persons with

disabilities through their representative organizations, in the implementation and monitoring of the Convention,
CRPD/C/GC/7, 9 November 2018, para. 2.
11 See CRPD, preamble and Articles 1, 3, 4, 7, 9, 19, 21, 24, 26, 29, and 32-35.
12 Committee on the Rights of Persons with Disabilities, General comment No. 7 (2018) on the participation of persons with

disabilities through their representative organizations, in the implementation and monitoring of the Convention,
CRPD/C/GC/7, 9 November 2018, paras. 21-22.
13 For more information, see generally, UNPRPD Strategic Operational Framework: Briefing on Cross-Cutting Approaches.

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 5. CRPD-compliant budgeting and financial management
A major stumbling block to the implementation of disability inclusive legislation, policies, programs,
and services is the allocation of resources to cover the costs of disability inclusion. Persons with
disabilities often incur high expenditure due to their disabilities in order to be independent and to
effectively participate in society. Since many persons with disabilities cannot afford these costs, they
are often excluded. The CRPD cannot be effectively implemented without CRPD-compliant financial
planning and regulation and support for the extra costs of disability.

Financial planning and monitoring - To ensure governments are fulfilling their CRPD obligations, the
overall public finance management and budgeting system must contribute efficiently, effectively, and
on an equitably to take steps to the maximum of their available resources to implement the CRPD.
This means that all available means (e.g., public procurement, tax expenditure, revenue generation,
grants, etc.) are utilized, central and local public spending (including development assistance) foster
accessibility and non-discrimination across sectors, public resources are used to ensure universal
access to services, budgeting decisions are made in close consultation with persons with disabilities,
and public resources (including policies, guidelines, or regulations) do not contradict CRPD standards,
such as segregated education services14. In addition, principles, such as transparency, participation
(including marginalized groups of persons with disabilities), and progressive realization should be
applied.

CRPD-compliant budgeting and financial management is usually implemented through budgeting

processes and include legislative and policy measures, administrative procedures, cross-sectoral
cooperation, and regulatory and oversight systems.

Regulation and support for the additional costs of disability - Persons with disabilities are diverse and
have different requirements, depending on their disability, the level of accessibility, and the
environment. Often, the cost of meeting these requirements is not affordable to persons with
disabilities. They incur direct costs or expenditure due to having a disability, such as the cost of
purchasing a wheelchair, accessing therapies, or hiring a Sign Language translator, and they incur
indirect costs, such as lower levels of income, limited access to education, or opportunity costs of
family members giving up work to provide support.15

These additional costs must be regulated and factored into policy, programs, and planning, so that
services are accessible to persons with disability, thus decreasing the need for persons with disabilities
to bear the burden or be excluded outright due to these additional costs. Strong accessibility
standards, the provision of reasonable accommodations, and access to disability support services can
help to ensure the additional costs of disability are reduced and the additional costs of disability should

14 Center for Inclusive Policy, Clarification needed: Inclusive, Disability responsive or CRPD compliant budgeting?, May
2019.
15
UNPRPD MPTF and Leonard Cheshire, Inclusive Social Protection for Empowerment of Persons with Disabilities:
Considering the Disability related Extra Costs in Social Protection, March 2020, p. 4.
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be considered when devising strategies for these other preconditions. The additional costs of disability
are often regulated and supported through a combination of social protection measures, provision of
publicly available disability services, accessibility standards, provision of reasonable accommodations,
as well as regulations and legal and policy frameworks.

6. Accountability and governance

Governments are obliged to ensure that they have the appropriate governance and accountability
systems in place to implement the CRPD. This includes systems to collect information, including
statistical and research data to inform policies16, national implementation and monitoring systems17,
and effective coordination across sectors.

Inclusive evidence and data gathering systems - There are significant gaps in reliable information on
persons with disabilities at international, national, and sub-national levels, including qualitative and
quantitative research and evidence on what works for disability inclusion and internationally
comparable data collection. This often results in inaccurate figures on the number of persons with
disabilities accessing services and a lack of consensus on the necessary interventions to implement
the CRPD, thus stifling inclusive policies. The multiplicity of approaches and models for disability
inclusion leads to a lack of cohesion in priorities or lack of collaboration between actors, including
government ministries.

Significant advances have been made in addressing the gaps in disability-disaggregated data in
national censuses and surveys by the Washington Group on Disability Statistics, including
internationally agreed methods through a Short Set of Questions, an Extended Set of Questions, and
a module on Child Functioning18. There is increasing pressure to collect better disability-disaggregated
data across a range of sectors as a result of the SDG indicator framework19. However, the adoption of
the Washington Group Questions by National Statistics Offices remains low.

Administrative data routinely collected by individual ministries as part of operating and managing
government programs can provide some data in persons with disabilities. However, there are
shortcomings, as administrative data can only provide information on those participating in the
programs, may not define disability in line with the CRPD (e.g., eligibility for disability benefits), and
may not be comparable with persons without disabilities. Programs that target the general
population, such as education or health through management information systems (MIS), should
improve collection of administrative data on persons with disabilities, so that mainstream services can
better accommodate persons with disabilities20.

16 Convention on the Rights of Persons with Disabilities 2008, A/RES/61/106, Article 31.
17 Ibid., Article 33.
18 See generally, the Washington Group on Disability Statistics, washingtongroup-disability.com.
19 There are 11 references to disability indicators in the global indicator framework.
20 Mont, Daniel. UCL Working Paper 32: The Use of Administrative Data in Disability Inclusive Policies.

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There are a number of international and national research institutes, universities, and civil society
organizations (including OPDs) conducting qualitative and quantitative data on disability inclusion.
However, research and evidence on disability inclusion remains low in comparison with research on
other international development issues and the majority derive from the disability sector where
disability mainstreaming was not the focus.21

Inclusive evidence and data gathering systems should use a targeted and mainstreaming approach to
inform inclusive policy making. This is usually achieved through policies and programs led by National
Statistics Offices (e.g., national censuses and household surveys) and statistical and administrative
data collected led by individual ministries and sub-national government bodies, as well as qualitative
and quantitative data and research conducted by of universities, think tanks, research institutes,
foundations, OPDs, and CSOs and commissioned by governments, civil society, and private sector.

National accountability mechanisms – UN Human Rights Monitoring Mechanisms, such as UN Treaty

Bodies (including the CRPD Committee), UN Special Procedures, and the Human Rights Council, as well
as the monitoring and reporting mechanism of the SDGs offer numerous international platforms for
monitoring and reporting in order to hold governments to account on human rights obligations and
SDG commitments. Some of these mechanisms, such as UN Treaty Bodies, also have complaints
mechanisms on rights violations 22 . In addition, some countries may be held to account through
regional bodies that also receive State reports and may have complaints mechanisms. These
international monitoring and reporting and complaints mechanisms are essential for advancing the
rights of persons with disabilities.

However, national accountability mechanisms for monitoring CRPD implementation and making
complaints on rights violations are equally important, and many countries do not have them or
maintain ineffective or inaccessible mechanisms. In addition, national independent monitoring
mechanisms for SDG implementation often do not include persons with disabilities, resulting in
exclusion of persons with disabilities in SDG planning processes.

States are obliged to designate one or more focal points within government for matters relating to
the implementation of the CRPD as well as an independent mechanism to promote, protect and
monitor the implementation of the CRPD. 23 National government and independent monitoring
mechanisms play a critical role in progressing and promoting the CRPD and may carry out a range of
responsibilities, such as coordination between disability actors, review of national laws and policies,
complaints mechanisms, monitoring and reporting on CRPD implementation, and more. Depending

21 International Center for Evidence in Disability, ICED Conference on Evidence in Disability Inclusive Development, 5-6
November 2019, London.
22 However, this function is limited, as claimants must exhaust all domestic remedies before making a complaint, and most

UN Treaty Bodies, such as the CRPD Committee, require States to sign up to the complaints mechanism through an
Optional Protocol.
23 Convention on the Rights of Persons with Disabilities 2008, A/RES/61/106, Articles 33.1 and 33.2.

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on their functions, national monitoring mechanisms are often arranged through separate ministries
or sub-ministry departments, national human rights institutions, national disability commissions, civil
society networks or partnerships, and sub-national human rights or disability commissions or councils.
There are also a number of national and sub-national government mechanisms, such as complaint
mechanisms at minitstry level, and independent mechanisms on a range of issues, such as women’s
rights, Indigenous rights, children’s rights, where disability mainstreaming and accessibility should be
considered. These mechanisms may be set up via legislation, regulation, policy, or through other
formal or informal processes.

Coordination across sectors - In order for the cross-sectoral preconditions for disability inclusion to be
a success, actors across sectors need to coordinate and cooperate. This involves building intensive,
long-term partnerships and coordination between government, civil society organizations (including
OPDs), private sector, academia, and international organizations, including UN entities, to plan,
coordinate, and implement policies, programs, and systems to support the preconditions. In addition,
it requires coordination across the various thematic or policy sectors, such as education, health, social
affairs, gender, employment, economy, finance, procurement, etc., to ensure that the cross-sectoral
preconditions work practically across sectors. Moreover, cross-sectoral coordination ensures shared
accountability for developing and maintaining the preconditions, making them an integral element
within each sector and bringing ingenuity and learning from each sector.

Coordination across sectors is often led by government and is usually implemented through programs,
administrative systems, formal bodies, and clearly defined processes and may be standardized
through law or policy.

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