Is ‘legal empowerment of the poor’ relevant to people with disabilities in developing countries? An empirical and normative review

Figures & data

Fig. 1 Process of selecting articles.

Table 1 Results of database searches

Database	Records
CINAHL	37
HeinOnline	7
PubMed	339
SocIndex	32
Web of Science	893

Table 2 Representation of economies and regions

World Bank economies and regions	No. of articles
Low income	10
Lower middle-income	9
Upper middle-income	3
East Asia and Pacific	3
Europe and Central Asia	1
Latin America and Caribbean	2
Middle East and North Africa	1
South Asia	10
Sub-Saharan Africa	8

Table 3 Overview of included articles

First author, year, and reference	Objective	Study design, instrument, and setting	Sample	Main findings
Alade 2004 (43)	To describe a community-based vocational rehabilitation (CBVR) program and its outcomes.	Case study. Nigeria.	A CBVR program with a total of 155 participants with various disabilities over 8 years	More than 90% of the participants were gainfully employed. About 10% of the trainees had benefited from a revolving loan scheme.
Borg 2012 (45)	To explore the relation between assistive technology use and enjoyment of human rights.	Quantitative cross-sectional. Questionnaire based on ICF. Bangladesh.	Hearing impairment: 136 people using hearing aids, 149 not using hearing aids. Ambulatory impairment: 149 people using wheelchairs, 149 people not using wheelchair.	Hearing aid use was positively associated with access to medical care, physical, and mental health, literacy, education, participation in school, participation in work, participation in using public transportation, and ambulatory performance. Working status did not differ statistically significantly between users and non-users of hearing aids. Wheelchair use was statistically significantly associated with better ambulatory performance and lower likelihood of working. Physical accessibility to working places and duration of wheelchair use was statistically significantly associated with higher participation in work and positive work status, respectively.
Dhungana 2006 (36)	To explore and discuss the lives of women with disabilities and analyze how external factors put these women at the lowest level of existence.	Qualitative cross-sectional (interview). Nepal.	30 women with physical disabilities.	Women had no or little education, were discriminated against when it comes to jobs and were excluded from employment. Women got less advantage of vocational training programs for people with disabilities. Men got training on skills in high demand. The built environment is not accessible. Inaccessible buildings, including toilets, make it impossible to keep a job or to look for training and jobs. Public transportation services were inaccessible. (Women are denied equal inheritance of property.)
Drew 2011 (34)	To review the evidence for the types of human rights violations experienced by people with mental and social disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights.	Qualitative cross-sectional (questionnaire, literature review). Questionnaire partly based on WHO Quality Rights Assessment Tool. Belize, Bosnia and Herzegovina, Egypt, Georgia, Ghana, Indonesia, Jordan, Kenya, Lithuania, Mexico, Nepal,, Paraguay, Peru, South Africa, Sri Lanka, Tajikistan, West Bank and Gaza, Zambia.	51 people with mental and psychosocial disabilities. Literature in English (UN publications, non-governmental organization reports, press reports, academic literature)	Stigma and discrimination lead to violations of human rights, including civil, cultural, economic, political, and social rights. Denial of people's rights to exercise legal capacity and discrimination in employment are central issues.
Fritz 2009 (35)	To examine the inclusive dimension of poverty-reduction strategy (PRS) processes, to review the relationship between poverty and disability in three projects, to describe the three projects and to analyze their successes and challenges.	Case studies. Cambodia, Tanzania, Vietnam.	3 PRS projects	The PRS process provides a framework for capacity development of disabled peoples’ organizations and for raising awareness on disabilities among government and civil society. The public and authorities perceived people with disabilities differently and acknowledged their rights and needs. In Cambodia, community bodies signalled that they plan to include disability aspects in their development plans and people with disabilities were called to participate in vocational training programs. It is important to create sustainable structures of empowerment.
Hosain 2002 (39)	To examine the impact of disability on the quality of life of people with disabilities.	Quantitative cross-sectional. ICF, SF-36. Bangladesh.	162 people with disabilities	More than 70% of 57 respondents aged 5–30 years had been unable to attend or compelled to leave school due to disability. About four out of five men aged above 12 responded that disability had negative consequence on their employment, including lower salary than non-disabled, forced to change employment or being unemployed.
Kiani 2009 (37)	To analyze the gap in current and desired life situations of women with disabilities.	Qualitative cross-sectional (focus groups, interviews and participant observation). Cameroon.	Focus groups: 24 (15 + 9) Interviews: 12	Difficulty in obtaining employment due to discrimination by employers or lack of education. Difficult to move around and reach markets, workplaces, etc. No public or accessible transportation system. Negative attitudes when attempting to use taxi or using the road. Desire to learn income-generating skills and entrepreneurships. Need for capital to run and maintain businesses.
Mitra 2008 (38)	To explain employment differences between males with and without disabilities.	Quantitative cross-sectional. World Bank Village Disability Survey. India.	262 men with disabilities, 980 men without disabilities	The employment rate for men without disabilities was higher than for men with disabilities. The gap was not explained by differences in human capital and productivity. It may result from differential returns to characteristics and from discrimination.
Mitra 2013 (40)	To draw an economic profile of persons with disabilities.	Quantitative cross-sectional. World Health Survey. Bangladesh, Brazil, Burkina Faso, Dominican Republic, Ghana, Kenya, Lao PDR, Malawi, Mauritius, Mexico, Pakistan, Paraguay, Philippines, Zambia, Zimbabwe.	All countries together: 7,443 persons with disabilities, 84,381 persons without disabilities	In 14 countries, people with disabilities had completed primary school to a statistically significantly less degree than people without disabilities. In 9 countries, people with disabilities were employed to a statistically significantly less degree than people without disabilities.
Rischewski 2008 (42)	To assess the association between poverty and musculoskeletal impairment (MSI).	Quantitative cross-sectional. Questionnaire based on World Bank's Living Standards Measurement Study. Rwanda.	345 persons with MSI, 532 controls	Adults with MSI were more likely to have no employment. Children with MSI were less likely to attend school.
Savill 2003 (46)	To identify barriers experienced by people with disabilities when using public transport services in urban areas of the developing world.	Qualitative cross-sectional (interview, focus groups). India, Malawi, Mozambique, South Africa.	Up to 150 people with disabilities in each country.	Three types of barriers to accessibility were identified: structural, social, and psychological.
Trani 2012 (28)	To compare data collected from household surveys and to explore the potential link between multidimensional poverty and disability.	Quantitative cross-sectional. Questionnaire partly based on ICF. Afghanistan, Zambia.	Afghanistan: 641 persons with disabilities, 903 controls. Zambia: 1,845 persons with disabilities, 1,643 controls.	People with disabilities have lower access to education and labor market. To some extent they also have less access to healthcare services. Women with disabilities had a very low likelihood to have had access to school. Persons with cognitive, mental or multiple disabilities were the least likely to work.
Uppal 2007 (41)	To explore the relationship between the health status of the elderly and their labor market participation.	Quantitative cross-sectional. 1995/96 National Sample Survey. India.	32,338 aged 60 years and above, nationally representative	Disabilities and chronic illnesses have a negative association with the probability of working, the effect being stronger in rural areas.
Werner 2009 (44)	To present corporate social responsibility (CSR) projects that are designed to reduce social exclusion among marginalized populations and to explore whether CSR initiatives can increase economic and social capabilities to reduce exclusion.	Case studies (interviews, literature). Bangladesh.	Purposive selection of CSR examples, including one targeting, among others, women with disabilities.	One example of the CSR initiatives increases job skills and employment opportunities for women with disabilities. More than 80 out of 1,800 women have a disability.

Table 4 What legal empowerment measures of the CLEP pillars are addressed by which CRPD articles and reviewed articles.

	CRPD articles addressing the measure^1
Legal empowerment measures	Fully	Partly	Reviewed articles addressing the measure
Domain: access to justice and the rule of law (7, pp. 5–6)
1. Ensure that every person with disability has the right to legal identity and is registered at birth.	12(1–2); 18(2)		(34)^2
2. Repeal or modify laws and regulations that are biased against the rights, interests, and livelihoods of people with disabilities.	4(1.a–c,e)		(34, 35)
3. Facilitate the creation of state and civil society organizations and coalitions, including paralegals who work in the interest of people with disabilities.		4(3);33(1,3)	(35)
4. Establish a legitimate state monopoly on the means of coercion, through, for example, effective and impartial policing.		14(1.b,2); 15(2);16(4)
5. Recognize and integrate customary and informal legal procedures with which people with disabilities are already familiar (regarding the formal judicial system, land administration systems and relevant public institutions).
6. Encourage courts to give due consideration to the interests of people with disabilities.	13
7. Support mechanisms for alternative dispute resolution.
8. Foster and institutionalize access to legal services so that people with disabilities will know about laws and be able to take advantage of them.	12(3); 13; 16(2)
9. Support concrete measures for the legal empowerment of women, minorities, refugees, internally displaced persons and indigenous people with disabilities.		6(2)
Domain: property rights (7, p. 7)
10. Promote efficient governance of individual and collective property in order to integrate the extralegal economy into the formal economy and ensure it remains easily accessible to people with disabilities.
11. Ensure that all property recognized in each nation is legally enforceable by law and that all owners with disabilities have access to the same rights and standards.			(36)^2
12. Create a functioning market for the exchange of assets that is accessible, transparent, and accountable.
13. Broaden the availability of property rights, including tenure security, through social and other public policies, such as access to housing, low interest loans and the distribution of state land.			(36)^2
14. Promote an inclusive property rights system that will automatically recognize real and immoveable property bought by men as the co-property of their wives or common-law partners.			(36)^2
Domain: labor rights (7, pp. 7–8)
15. Respect, promote, and realize freedom of association so that the identity, voice, and representation of the working people with disabilities can be strengthened in the social and political dialog about reform and its design.	27(1.c); 29(b)
16. Improve the quality of labor regulation and the functioning of labor market institutions, thereby creating synergy between the protection and productivity of people with disabilities.	27
17. Ensure effective enforcement of a minimum package of labor rights for workers with disabilities and enterprises in the informal economy that upholds and goes beyond the Declaration of Fundamental Principles and Rights at Work.		27^3
18. Increase access to employment opportunities for people with disabilities in the growing and more inclusive market economy.		27	(28, 34–45)
19. Expand social protection for workers with disabilities in the event of economic shocks and structural changes.		27(1.e); 28(2)
20. Promote measures that guarantee access to medical care, health insurance and pensions for people with disabilities.	25; 26; 28(2.e)		(28, 45)
21. Ensure that legal empowerment drives gender equality among people with disabilities.	6(2)
Domain: business rights (7, pp. 8–9, 31)
22. Guarantee basic business rights for people with disabilities; including the right to vend, to have a workspace, and to have access to necessary infrastructure and services (shelter, electricity, water, sanitation).		26(1.b); 27(f)
23. Strengthen effective economic governance that makes it easy and affordable for people with disabilities to set up and operate a business, to access markets and to exit a business if necessary.		19(b); 26(1.b); 27(f)
24. Expand the definition of ‘legal person’ to include legal liability companies that allow owners to separate their business and personal assets, thus enabling prudent risk taking.
25. Promote inclusive financial services that offer entrepreneurs with disabilities savings, credit, insurance, pensions and other tools for risk management.		19(c); 27(1.f)	(37, 43)
26. Expand access to new business opportunities through specialized programs to familiarize entrepreneurs with disabilities with new markets and help them comply with regulations and requirements, and that support backward and forward linkages between larger and smaller firms.			(43)
27. Ensure freedom of association of people with disabilities.		27(1.c); 29(b)
28. Ensure freedom of movement of people with disabilities.	18(1); 20		(36, 37, 45, 46)
29. Ensure freedom of people with disabilities to develop one's owns talents.	30(2)		(28, 35–37, 39, 40, 42, 44, 45)
30. Ensure freedom of people with disabilities to exchange legitimately acquired goods and services.

¹Numbers in brackets refer to specific sections of the mentioned CRPD article.

²The reviewed article addresses the measure to a limited extent.

³CRPD does address labor rights for workers with disabilities but not explicitly for enterprises in the informal economy.

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