ľ¹ÏÓ°Ôº

Skip to Main Navigation
BRIEFJune 28, 2023

Disability Inclusive Social Protection Across Europe and Central Asia

A group of individuals with disabilities pose for a photo

An estimated 15% of the world¡¯s population experience some form of disability. Across Europe and Central Asia, persons with disabilities represent one of the largest segments of the population that are vulnerable and often socially excluded. In the region, individuals aged 16 and above report enduring limitations in their day-to-day activities due to health-related issues¡ª, while at least 3% regionally experiencing severe constraints. With most countries across Europe and Central Asia experiencing a rapidly aging population, this percentage is anticipated to rise as older individuals are more prone to developing disability.

Drawing from a wide array of projects and analytical work, a team of disability inclusion experts from across the World Bank aims to highlight instances where governments in Europe and Central Asia have provided support to persons with disabilities through social protection. By outlining technical and operational experiences from several countries including North Macedonia, Romania, and Uzbekistan, the team can provide valuable lessons learned for other governments in better designing and developing social protection systems to meet the needs of persons with disabilities and ensure more inclusive, resilient economic growth.

The team¡¯s focus falls across five areas:

Modernizing Disability Assessment Systems

Establishing a system for assessing disability is crucial for accurately identifying an individual¡¯s specific impairments and functional limitations as well as identifying the support and resources required for ensuring that the individual can lead an independent life within the community.

Defining Disability and the Role of ICF and CRPD

While some countries across Europe and Central Asia continue to rely on a solely medical assessment of disability¡ªwhere disability is primarily viewed as a medical issue requiring medical or rehabilitative interventions¡ªinternational approaches have shifted to a functioning model of disability assessment. Such a model recognizes the impact of environmental barriers on individuals and emphasizes the need for social inclusion.

The (ICF) and the provide modern frameworks for disability assessment. The ICF focuses on a person¡¯s functioning, considering body functions, activities and participation, and environmental factors. The CRPD defines disability as the interaction between impairment and environmental barriers offers a more comprehensive perspective. It promotes accessibility, non-discrimination, and equal opportunity for persons with disabilities, supporting the use of the ICF framework in assessments. Aligning assessment with the principles of the CRPD promotes inclusion and empowers persons with disabilities to lead independent lives. 

Why is it Important to Modernize Disability Assessment??

Modernizing disability assessment is crucial as it serves as the gateway to accessing social benefits and services. By ensuring assessment procedures accurately capture an individual's functioning and limitations, tailored support packages can be provided to address their specific needs. Modernization also shifts the focus from the traditional medical model of disability to a functioning model, which recognizes the impact of environmental barriers and emphasizes social inclusion.?Adopting such a framework is key for identifying the needs of persons with disabilities more accurately, which better ensures the well-being of the individual and other members of the household, who often dedicate time to care for loved ones with disabilities. 

Many governments in the region are undergoing reforms to align their assessment systems with the CRPD, offering lessons learned on the adequacy of existing disability assessment systems as well as the steps involved in transitioning from a medical model of disability to one based on ICF.

Modernizing disability assessment systems involves three aspects:

(1) Disability Assessment System Analysis

A comprehensive analysis of the disability assessment system, based on the ICF, aims to improve policies and services for individuals with disabilities. The analysis explores various components of the system, including legislation, assessment processes, human resources, information systems, benefits and services, individual experiences, and institutional arrangements. By considering factors such as budget, time frame, national context, and available data, the analysis seeks to identify areas for improvement and generate recommendations for a more inclusive and efficient disability assessment system. The ultimate goal is to enhance the functioning of the disability system, promote inclusivity, and cater better to the needs of persons with disabilities. Key documents from , , , and provide valuable insights into their respective disability policies and assessment systems.

(2) Disability Assessment

By adopting a holistic approach that aligns with the ICF and CRPD, the goal is to accurately assess the impact of health conditions on individuals¡¯ daily lives. The integration of the functioning model recognizes the importance of considering impairments and environmental factors, leading to a more comprehensive understanding of disability. The tool serves as a reliable means of evaluating functioning and has been implemented in various countries, including France, Italy, Canada, Cyprus, Argentina, Brazil, and Taiwan. Countries like Albania, Azerbaijan, , , , North Macedonia, and Romania have sought technical support from the World Bank to improve their disability assessment systems and ensure fair and accurate assessments.

(3) Needs Assessment

While many countries require a certified disability status for accessing benefits and services, there is a growing recognition of the need for a more comprehensive needs assessment beyond determining disability status. Disability status assessment serves the function of categorizing individuals, while needs assessment quantifies individual needs and matches them with appropriate services. Needs assessment encompasses various aspects of an individual¡¯s life affected by disability and involves a detailed and individualized process. The assessment instruments and tools used collect comprehensive information to address individuals¡¯ specific needs and circumstances. A synchronized approach between disability status assessment and needs assessment is crucial to ensure coherence and consistency in the evaluation process. Key documents from Romania and highlight the focus on needs assessment and the piloting of disability assessment and needs assessment to strengthen the disability system.

World Bank Reports