Inclusive education for children with disabilities in third world countries (intersectionality between disability, gender and poverty)

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This publication was produced for review by the United States Agency for International Development (USAID). It was

prepared by EnCompass LLC with contributions from Amy Mulcahy-Dunn, Anna Martin, Daniel Mont, Emma Venetis,

Sarah Rotich, and Thomaz Alvares de Azevedo for the Data and Evidence for Education Programs (DEEP) activity,

Contract No. GS-10F-0245M. The views expressed in this publication do not necessarily reflect the views of USAID or

the United States Government.

ARE WE FULFILLING OUR PROMISES?

INCLUSIVE EDUCATION IN SUB-

SAHARAN AFRICA DATA AND EVIDENCE FOR EDUCATION PROGRAMS

(DEEP) PROJECT

September 2020

PHOTO | WORLD BANK/DEEPTI SAMANT RAJA

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CONTENTS LIST OF EXHIBITS .................................................................................................................................. I

ACKNOWLEDGMENTS...................................................................................................................... II

ACRONYMS AND ABBREVIATIONS ............................................................................................. III

INTRODUCTION ................................................................................................................................. 1

SECTION 1: INCLUSIVE VERSUS SEGREGATED VERSUS INTEGRATED EDUCATION 3

SECTION 2: GOVERNMENT PRIORITY ......................................................................................... 5 2.1: Inclusive Education Policies .......................................................................................................................... 5

2.2: Financing Inclusive Education ..................................................................................................................... 10

SECTION 3: SCHOOL ACCESS ..................................................................................................... 12 3.1: Participation in School ................................................................................................................................. 13

3.2: Barriers to Enrollment ................................................................................................................................. 16

3.3: School Completion ....................................................................................................................................... 17

3.4: Barriers to Retention ................................................................................................................................... 18

SECTION 4: SCHOOL EXPERIENCE ............................................................................................ 19 4.1: Accessibility of Facilities .............................................................................................................................. 19

4.2: Bullying and Violence ................................................................................................................................... 21

4.3: Instructional Accommodation and Teacher Training ........................................................................... 21

SECTION 5: USAID INITIATIVES TO SUPPORT DISABILITY PROGRAMMING IN SUB-

SAHARAN AFRICA ............................................................................................................................ 23

CONCLUSIONS ................................................................................................................................. 27

REFERENCES ........................................................................................................................................ 28

LIST OF EXHIBITS Exhibit 1: Country approaches to education for learners with disabilities............................................... 3

Exhibit 2: Educational provisions seen around the world for learners with disabilities ........................ 4

Exhibit 3: Inclusive education policies in Sub-Saharan Africa ....................................................................... 9

Exhibit 4: Proportion of 15- to 29-year-olds who have ever attended school, by disability status

and sex .................................................................................................................................................................... 14

Exhibit 5: Out-of-school rate for primary and lower secondary school-age children, by disability

status (%) ................................................................................................................................................................ 15

Exhibit 6: School completion rate for primary school-age children, by disability status and sex ...... 18

Exhibit 7: USAID programs with inclusive education initiatives ................................................................ 24

Exhibit 8: USAID support of inclusive education initiatives in Sub-Saharan Africa ............................... 26

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ACKNOWLEDGMENTS USAID would like to acknowledge and thank the contributions of all who made this report possible:

• Mitch Loeb for his review and contributions to this report.

• Joshua Josa and Kathy Guernsey (USAID), Charlotte Vuyiswa McClain-Nhlao, Ruchi Khulbir,

Singh, and Deepti Samant Raja (World Bank), Thomas Sabella (Inclusive Education and ECCE),

Aliou Tall (USAID/Liberia), Iris L. Young and Mohamed Traore (USAID/Mali), Ezra Simon

(USAID/Senegal), Melissa Chipili (USAID/Uganda), Andrea Barbosa (USAID/Zambia), for their

review of this report

• Kakali Banik for making this study possible and for all her guidance and support throughout this

process

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ACRONYMS AND ABBREVIATIONS CRPD Convention on the Rights of Persons with Disabilities

DEEP Data and Evidence for Education Programs

DHS Demographic and Health Surveys

DRC Democratic Republic of Congo

EMIS Education Management Information System

IDA International Disability Alliance

LSMS Living Standards Measurement Study

MICS Multiple Indicator Cluster Survey

SDG Sustainable Development Goal

UNCRC United Nations Convention on the Rights of the Child

UNESCO United Nations Educational, Scientific and Cultural Organization

UNICEF United Nations Children’s Fund

USAID United States Agency for International Development

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INTRODUCTION Sustainable Development Goal (SDG) 4 calls for ensuring inclusive and equitable quality

education and promoting lifelong learning opportunities—a key element in achieving

the Agenda for Sustainable Development 2030 and the United States Agency for

International Development (USAID) Journey to Self-Reliance. SDG 4.1 goes on to call

for all girls and boys to complete free, equitable, and quality primary and secondary

education that leads to relevant and effective learning outcomes by 2030. Two targets

explicitly mention disability:

• Target 4.5 aims to ensure access to all levels of education and vocational training

• Target 4.a calls for building and upgrading all education facilities that are sensitive

to persons with disabilities and providing inclusive learning environments for all

children (United Nations 2018)

Education, a fundamental human right, is essential to individual development and

effective participation in society. Therefore, education must be accessible to every

single child. Numerous conventions and frameworks declare that everyone has a right

to education and that education is an integral part of universal human rights: the

Universal Declaration of Human Rights (1948), the UNESCO Convention Against

Discrimination in Education (1960), the United Nations Convention on the Rights of

the Child (UNCRC 1989), the Salamanca Statement and Framework for Action on

Special Needs Education (1994), the Convention on the Rights of Persons with

Disabilities (CRPD 2006), and the Incheon Declaration adopted at the World

Education Forum (2015) (United Nations 2018). The Protocol to the African Charter on Human and

Peoples’ Rights on the Rights of Persons with Disabilities in Africa (The African Union Commission

2018), in particular Article 16, gives children with disabilities and their families an important regional

legal tool to ensure their right to inclusive education against states which fail to fulfill the obligation of

this right (Dubin 2019). The SDGs use the momentum generated by these and many other documents

to ensure measures are taken to achieve the full inclusion of all children, including children with

disabilities, in schools across the world.

In this report, disability is defined as a functional difficulty (i.e., difficulty doing basic activities linked to an

impairment or health condition) that, due to environmental barriers, may exclude someone from full

participation in society.

According to the United Nations’ Flagship Report on Disability and Development, Realization of the

Sustainable Development Goals by, for and with Persons with Disabilities, there is an urgent need to improve

access to education for persons with disabilities so they can acquire the skills and knowledge required

for full inclusion in society and active participation in the labor market. Otherwise, existing educational

disadvantages are likely to lead to even higher exposure to social exclusion and poverty. Among adults

with disabilities, each additional year of schooling they completed reduces the probability that they will

be in the poorest two quintiles by 2–5 percent (UNESCO 2015). It is evident that increasing access to

high-quality, equitable education based on principles of universal design for learning is a key element in

ending this cycle (United Nations 2018).

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Although 42 percent of countries in sub-Saharan Africa are considered to be pursuing inclusive

education policies,1,2 children with disabilities still face significant barriers to access and complete

education—barriers that differ for each child depending on their disability (UNESCO, 2020). For

example, building ramps can help many learners physically enter the school but does nothing to improve

access for learners who are blind or deaf, or have intellectual disabilities.

Evidence shows that children with disabilities are less likely to attend school. Even when they are able to

enroll in school, other challenges in the design of the education system create barriers for learners with

disabilities and make it less likely for them, on average, to complete levels of education comparable to

their peers without disabilities (UNESCO 2018a). Barriers to the successful completion of school

include lack of government prioritization of inclusive education in strategies and policies; lack of

knowledge/resources for parents/caregivers to support their children in schooling; the prejudices,

discrimination, and attitudes that many still hold against children and adults with disabilities; a lack of

qualified teachers, principals, and pedagogic supervisors, to accommodate the needs of learners with

disabilities;3 poor accessibility of school infrastructure; the low supply of accessible teaching and learning

materials; and the low number of teachers with disabilities who better understand and show empathy

towards learners with disabilities, provide mentorship to learners with and without disabilities, provide

guidance and expertise on the inclusion process, lead to a positive change in attitude, advise colleagues

on being more aware of learners’ difficulties, and create a more inclusive environment for teachers and

students with disabilities (IDA 2020; UNESCO 2014; UNESCO 2020; GPE 2018).

There is a global systemic dearth of data on inclusive education programs that are needed to ensure the

achievement of the SDGs by 2030 (Mont 2007). Through the collection of data disaggregated by

disability, resources can be allocated equitably, budgets can be managed more efficiently, inclusive

education programs and policies can be implemented and monitored more closely, and efforts to

enhance education services can be strengthened (GPE Stocktake 2018). It is especially critical to

disaggregate data not only by disability, in general, but by types of disabilities. We can then begin to

understand the specific barriers faced by children who are deaf or with reduced hearing, by those who

are blind or with low vision, or those faced by children with intellectual or physical disabilities. It will

also be possible to examine barriers faced by children with any combination of difficulties, for example,

those who are deaf-blind.

The educational experience for all learners, and specifically learners with disabilities, must be both

accessible and inclusive so they can stay enrolled until completion. It must also provide qualified teachers

and adapted learning materials to meet each learner’s unique needs. Schools must ensure that learners

are safe from harm (e.g., bullying, violence, undeserved discipline) so each learner (regardless of their

disability status) and their caregivers feel that being in school does not come at a cost beyond the

financial one.

In the sections that follow, we discuss the state of inclusive education across Sub-Saharan Africa. While

many of the broader observations apply to much of the world, we have provided examples that are

1 The focus of inclusive education differs by country. In high-income countries, inclusive education often refers to

efforts to educate children with disabilities, whereas in low-income countries, where more children are excluded

from school, the term is used more broadly to refer to the education of girls and the poorest children, in addition

to children with disabilities (EDT and UNICEF 2016). 2Countries that have Inclusive Education Policies include: Angola, Botswana, Ghana, Lesotho, Liberia, Mauritius,

Namibia, Nigeria, Rwanda, Seychelles, South Sudan, Tanzania, Zambia, and Zimbabwe. 3 The CRPD defines disability as long-term physical, mental, intellectual, or sensory impairments that, in interaction

with various barriers, may hinder their full and effective participation in society on an equal basis with others.

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specific to sub-Saharan Africa throughout this report. ln Section 1, we begin with a description of

inclusive, integrated, and segregated schooling for children with disabilities. In Section 2, Government

Priority, we review declarations, laws, policies, and funding allocations through which Sub-Saharan

African countries prioritize or recognize inclusive education. In Section 3, School Access, we review

data on inclusive education, including the school attendance and school completion of learners with

disabilities, as well as the barriers to enrollment and retention. In Section 4, School Experience, we

review the practical experience of learners with disabilities in school, including how accessibility of

facilities, bullying and violence, and instructional accommodations affects this experience. The report

concludes in Section 5 with a review of USAID’s initiatives to support inclusive education in Sub-Saharan

Africa

SECTION 1: INCLUSIVE VERSUS

SEGREGATED VERSUS INTEGRATED

EDUCATION There are different approaches to the provision of education for children with disabilities. These

different approaches reflect different constructs of disability, namely the social versus the medical model

of disability4 which can affect whether there are efforts at systemic change or only various levels of

individual accommodation. Given these fundamental differences, we begin our discussion by describing

these different approaches. According to the World Bank’s Every Learner Matters report (2019), most

countries make explicit reference to persons with disabilities’ right to education in their constitutions,

laws, and policies. However, definitions are rarely included, they vary widely, and their implementation

(if it exists) often aligns more with segregated learning and special schooling than true inclusion. Even

when countries claim they are following inclusion, they may only be placing children with disabilities in

regular classrooms, and not creating a learning environment that addresses their needs. Of the 51

countries included in the GPE Stocktake of Education Sector Plans (ESPs), 41 countries have segregated

schools, 3 are piloting integrated schools and 23 have implemented them at a large scale, 17 have both

special and integrated learning, and only 17 are piloting inclusive education (Exhibit 1) (2018).

Exhibit 1: Country approaches to education for learners with disabilities

Learners with disabilities are frequently placed in special schools or classrooms because of the belief that

they will benefit more from learning in such settings. Separating learners in their own classrooms and

4 Please see USAID’s Mapping of Tools for Disaggregation by Disability Status for a description of the social and

medical models of disability.

https://www.edu-links.org/resources/mapping-tools-disaggregation-disability-status

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schools isolates learners with disabilities and bolsters existing negative stereotypes. Although it will take

time to reach full inclusion, taking steps toward inclusive schools and away from segregated and

integrated learning is critical to meeting SDG 4.

Inclusive education means having one inclusive system of education that is responsive to the needs of all

learners, at all levels (early childhood, primary, secondary, and post-secondary) and provides supports to

meet the needs of learners with disabilities. It advocates access to schools through the principles of

Universal Design for Learning and having resources for specific needs available to teachers and learners.

It supports the participation of all learners in a safe and friendly environment, using the mother tongue

or sign language for primary learning and technology to further support communication. It also

promotes achievement that comes with qualified teachers trained in Universal Design for Learning,

adaptable curriculum, and resources available to meet the needs of each child.

This differs from segregated education, where learners with disabilities are in special schools. It is also

not the same as integrated schooling, which has learners with disabilities on the same campus or

compound as learners without disabilities, but without the necessary supports or considerations for

their needs. Integration is often confused with inclusion, but without support or inclusive pedagogy for

learners with disabilities, this does not equate to inclusion. Other approaches to education for learners

with disabilities are via pilot programs, in-hospital schools or classrooms, and in-home teaching (World

Bank 2019).

Exhibit 2: Educational provisions seen around the world for learners with disabilities

According to a qualitative study by Okyere and colleagues (2019), learners with intellectual and

developmental disabilities in inclusive schools in Accra, Ghana, received support from many of their

peers, but also faced challenges such as corporal punishment, low family and teacher support for their

learning, and victimization from other peers. Learners expressed concern over the lack of teachers’

support, saying, “If teacher helps me, I can be able to understand and write” and “I want someone to

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always help me to learn.” Learners with disabilities often had to complete the assignments in the same

amount of time as their peers and without any modifications to the lessons (instructions and

assignments), even when those changes would have proved helpful. Often, when they were unable to

complete an assignment in the time allotted, learners with disabilities were punished by not being

allowed to go out and enjoy recess or, even more seriously, a lunch break.

Education for learners with disabilities in inclusive settings provides an opportunity for learners with and

without disabilities to work together on assignments and even interact outside the classroom during

their commutes home, which improves not only their academic skills but also their social interactional

skills (Okyere et al. 2019). Inclusive education benefits all learners because they are able to access the

material through alternative methods and Universal Design for Learning that will only bolster their

understanding of the material. According to UNICEF (2017), inclusive education promotes

understanding, reduces prejudice, and strengthens social integration among all learners, with ripple

effects into the community.

SECTION 2: GOVERNMENT PRIORITY Government support and prioritization of inclusive education influence the availability and allocation of

resources and school-level policies that reinforce inclusive education (UNICEF 2009). Across Sub-

Saharan Africa, governments recognize inclusive education through various declarations, disability and

education acts and laws, national policies, constitutional provisions, and funding allocations.

2.1: INCLUSIVE EDUCATION POLICIES

A number of international treaties spearheaded by the United Nations have been signed, ratified, or

adopted by the majority of Sub-Saharan African countries. The UNCRC, a human rights treaty signed in

1989, sets out the rights of children around the world and specifically seeks to ensure these rights apply

to all children, irrespective of disability status. All United Nations Member States except the United

States have ratified the UNCRC (United Nations Treaty Collection 2020a).5

The education of children with disabilities is not a particularly new initiative in Sub-Saharan Africa.

Formal education of children with disabilities has occurred in special schools since the colonial era

(Mpofu, Oakland, and Chimedza 2007). Additionally, some countries in Africa were among the first to

sign and ratify the UNCRC (EDT and UNICEF 2016). A shift of policy and practice toward inclusive

education is happening with commitment and enthusiasm (Charema 2010).

The CRPD is an international treaty adopted in 2006 that identifies the rights of persons with disabilities

and obliges states to promote, protect, and ensure those rights. It does not set out new requirements,

but clarifies existing rights of persons with disabilities already existing in international treaties. Most Sub-

Saharan African countries in this review have signed and ratified the CRPD which guarantees the right to

inclusive education. More specifically, Article 24 recognizes the right of persons with disabilities to

inclusive education without discrimination and on an equal basis with others, and requires parties to

ensure persons with disabilities can access inclusive education. General Comment No. 4 on Article 24

further defines and conceptualizes inclusive education and provides a framework and guidance for states.

It makes it clear that persons with disabilities experience persistent discrimination that denies them their

5 Somalia and South Sudan are the most recent members to do so in 2015.

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right to an education. The CRPD articulates the concept of inclusive education for the first time in

international law. Fewer, but still the majority of countries, have ratified the CRPD’s Optional Protocol,

which gives the Committee on the Rights of Persons with Disabilities the right to receive complaints and

investigate serious violations of the Convention, essentially holding ratifying countries accountable for

following through with guaranteeing the rights outlined in the CRPD (CRPD 2006; IDA 2020; United

Nations Treaty Collection 2020c).

The United Nations’ 2030 Agenda for Sustainable Development, adopted in 2015, includes SDG 4.5,

which commits countries to ensure equal access to all levels of educational and vocational training for

persons with disabilities. The 2030 Agenda sets out specific intergovernmental global goals for countries

to, build and upgrade educational facilities to be disability sensitive and in compliance with the CRPD

(Sustainable Development Goals Knowledge Platform n.d.; IDA 2020). All United Nations Member

States have adopted the 2030 Agenda. These high-profile declarations signal growing interest in inclusive

education in Sub-Saharan Africa and around the world (UNESCO 2018a).

National policies and strategies on inclusive education) are in various stages in many countries. It should

be noted that often the term “special needs education” is still used6, although that term has historically

also been used for segregated education. These policies and strategies include specific sections on

education as part of disability legislation, and some include sections on disability within education

legislation. These acts vary in specificity by country, and many call for the availability of special schools

for children whose disabilities are too severe for or cannot be accommodated by ordinary schools (see

the Inclusive Versus Segregated Versus Integrated Education section for a discussion on separate

schools). What qualifies a learner for admission to a special school and who decides on those

qualifications differs by country. A review of national policies and strategies completed for this literature

review finds that many of these policies and strategies specifically call for:

• Physically accessible educational facilities (e.g., Ghana, Kenya, Madagascar, Nigeria, South Africa, and

Uganda)

• Communication accommodations such as Braille, sign language, and audio libraries (e.g., Ghana,

Kenya, Nigeria, and Senegal)

• Teacher training on special needs education (e.g., Madagascar, Nigeria, Rwanda, Tanzania, and

Uganda)

• Adapting the curriculum to meet the needs of learners with disabilities (e.g., Kenya, Senegal, and

Uganda)

• Financial assistance or tuition reduction for learners with disabilities (e.g., Malawi and Senegal)

Not all countries mandate inclusive education as it is outlined in legislation; some laws simply state that

the government will “encourage” such actions. Certain countries have documented their prioritization

of inclusive education in their constitutions. Many Sub-Saharan African countries have constitutional

provisions that protect persons with disabilities from discrimination, such as South Africa, Malawi,

Zimbabwe, Eritrea, Kenya, Ghana, Namibia and Gambia, and some also have provisions that ensure the

right to education for children with disabilities, like South Africa, Kenya and Burundi (ACPF 2014).

Government prioritization of inclusive education is essential for children with disabilities to have access

to education. It should be noted, however, that while essential, establishment of education policies alone

6 Examples of its use were found in the policies in Senegal, South Africa, and Uganda.

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is not sufficient to guarantee inclusion. There frequently is a gap between political intent and the actual

provision of inclusive education in schools in all 21 eastern and southern African countries included in a

study on the fulfilment of the right to education of children with disabilities (EDT and UNICEF 2016).7

For example, a case study of the Comoros established that despite political intent, enrollment in school

was particularly challenging for children with disabilities due to barriers to parents bringing their child to

school and parents being unwilling to admit their child has a disability as a result of cultural attitudes.

Another report determined that policy in low- and middle-income countries was often not clearly stated

or understood. The same report found that some schools were not even aware of their country’s

inclusive education policies and received no training on how to implement them (Graham 2014). Many

countries with government support of inclusive education have seen progress, but further advancement

requires appropriate funding, awareness, and specific strategies for achieving educational provisions for

learners with disabilities, such as teacher training (EDT and UNICEF 2016).

7 Angola, Botswana, Burundi, the Comoros, Eritrea, Ethiopia, Kenya, Lesotho, Madagascar, Malawi, Mozambique,

Namibia, Rwanda, Somalia, South Africa, South Sudan, Swaziland, Uganda, United Republic of Tanzania, Zambia, and

Zimbabwe.

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Examples of National Inclusive Education Policy

Kenya – Persons with Disabilities Act

18. Education

(1) No person or learning institution shall deny admission to a person with a disability to any course of study by reason only of such disability, if the person has the ability to acquire substantial learning in that course.

(2) Learning institutions shall take into account the special needs of persons with disabilities with respect to the entry requirements, pass marks, curriculum, examinations, auxiliary services, use of school facilities, class schedules, physical education requirements and other similar considerations.

(3) Special schools and institutions, especially for the deaf, the blind and the mentally retarded, shall be established to cater for formal education, skills development and self-reliance.

19. Special and non-formal education

The Council shall work in consultation with the relevant agencies of Government to make provisions in all districts for an integrated system of special and non-formal education for persons with all forms of disabilities and the establishment where possible of Braille and recorded libraries for persons with visual disabilities.

Nigeria – Discrimination Against Persons with Disabilities (Prohibition) Act, 2018

17. (1) A person with disability shall have an unfettered right to education without discrimination or segregation in any form.

(2) A person with disability is entitled to free education to secondary school level.

(3) The Commission shall provide educational assistive devices.

18. (1) All public schools, whether primary, secondary or tertiary shall be run to be inclusive of and accessible to persons with disabilities, accordingly every school shall have-

(a) at least a trained personnel to cater for the educational development of persons with disabilities; and (b) special facilities for the effective education of persons with disabilities.

(2) Braille, sign language and other skills for communicating with persons with disabilities shall form part of the curricula of primary, secondary and tertiary institutions.

19. The education of special education personnel shall be highly subsidized.

20. Government shall ensure that the education of persons with disabilities, particularly children, who are blind, deaf or with multiple disabilities, is delivered in the most appropriate language, mode and means of communication for the individual, and in environments which maximise academic and social development.

Rwanda – Law N⁰ 01/2007 of 20/01/2007 Relating to Protection of Disabled Persons in General

Chapter 2. Rights of a Disabled Person in Matters Related to Education

Article 11: A disabled person has the right to appropriate education in respect of the nature of his or her disability. The Government or centres which cater for disabled persons who are not able to study with others, shall provide with them modalities to study in a specialised school and shall have qualified and trained teachers and appropriate equipment. The Minister in charge of Education shall, basing on basic categories of disability determined by the Minister in charge of Health, determine modalities of facilitating the needy disabled persons in ordinary schools and in specialised schools in case of failure to study with others.

Article 12: A pupil or a student with disabilities that do not enable him or her to sit exams with fellow schoolmates or in the same manner as others is entitled to the right of sitting for exams in a special manner.

Article 13: The Minister in charge of education shall determine modalities of facilitating the needy disabled persons in pursuing education.

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Exhibit 3: Inclusive education policies in Sub-Saharan Africa

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2.2: FINANCING INCLUSIVE EDUCATION

Despite policy commitment to inclusive education by the majority of countries in Sub-Saharan Africa,

significant barriers, in the form of “inadequate facilities, poorly trained teachers, and a lack of accessible

learning materials,” remain the operational reality (IDDC and IETG 2017). A lack of adequate funding for

inclusive education represents a significant barrier to effective implementation. Funding should ideally

enable “education systems to take learners’ educational needs into account and to support parents in

meeting the direct and indirect costs of education” (Ebersold and Meijer 2016).

Increases in funding alone, however, do not necessarily guarantee effective implementation of inclusive

education commitments. Factors such as political will, an understanding of the types of investments

needed to support inclusive education, and funding allocation approaches have an impact on the

effectiveness and sustainability of inclusive education investments. As Ebersold and Meijer (2016) state,

“The implementation of inclusive education is correlated with the way funds are allocated and to whom

the funds are addressed.” Funding allocations have the potential to facilitate or inhibit inclusion in

education.

The 2017 IDDC and IETG report on costing inclusive education calls for sufficient domestic and donor

funding to support a two-track investment model needed for the effective adoption of inclusive

education. The first track focuses on systemic change and requires investing in new policies as well as

shifts in “practice and attitudes” to help “remove barriers and create enabling conditions to enhance the

quality and access to education for all children” (IDDC and IETG 2017). This first track benefits all

learners in the system. The second track requires investments specifically designed to increase access to

education and accommodation in instruction for learners with disabilities.

In many countries, ministries of education tend to

have systems supporting separate special schools

rather than supporting inclusive education in

mainstream schools. This often stems from a limited

understanding of inclusive education and its scope,

as well as the interchangeable use of the

terminology in many countries. In addition to

further segregating learners with disabilities, such

special schools are less cost-effective than inclusive

mainstream schools (IDDC and IETG 2017). In low-resource environments, segregated schools are

economically unsustainable, are generally unable to accommodate all learners with special needs, and

perpetuate the perception that provision of education for learners with special needs is extremely

expensive. Conversely, there are increasing examples from successful models of inclusive education in

low-resource settings (Stubbs 2008). For example, strategic partnerships between government, NGOs,

donors and civil society have been successful in supporting inclusive education combined with early

screening and intervention programs for students with low vision (IDDC and IETG 2017).8 A UNICEF

study found that “If good quality education, featuring well-trained teachers and strong peer support

were in place, as many as 80 to 90 percent of learners with disabilities could be educated in mainstream

schools with only minor additional support” (IDDC and IETG 2017).

An important exception is around schools for the deaf, which some organizations, such as the World

Federation of the Deaf and the International Federation of Hard of Hearing, have noted are critical for

8 Please see the following for examples of successful inclusive education strategies in low resource settings.

“If good quality education, featuring well-trained

teachers and strong peer support were in place,

as many as 80 percent to 90 percent of learners

with disabilities could be educated in

mainstream schools with only minor additional

support” (IDDC and IETG 2017, p. 18)

https://www.google.com/search?q=Miles%2C+S+(2000)+Overcoming+Resource+Barriers%3A+The+challenge+of+implementing+inclusive+education+in+rural+areas%2C&rlz=1C1EJFC_enUS813US814&oq=Miles%2C+S+(2000)+Overcoming+Resource+Barriers%3A+The+challenge+of+implementing+inclusive+education+in+rural+areas%2C&aqs=chrome..69i57.1264j0j7&sourceid=chrome&ie=UTF-8

https://scholar.google.com/scholar?q=Miles,+S+(2000)+Overcoming+Resource+Barriers:+The+challenge+of+implementing+inclusive+education+in+rural+areas,&hl=en&as_sdt=0&as_vis=1&oi=scholart

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providing deaf children with the opportunity to learn and socialize in sign language in a setting with peers

with the same disability. Placing deaf learners in mainstream schools that do not provide them with

adequate access to and direct instruction in sign language does not support inclusion for all deaf

learners. Bilingual education for deaf learners is a form of inclusive education for deaf learners. Taking

this into account, the International Disability Alliance (IDA) proposes the supported transition of

schools for the deaf and inclusive, bilingual sign language schools that meet the needs of deaf learners

but still create an inclusive setting (IDA 2019).

A range of funding allocation approaches has been applied to support inclusive education. The

effectiveness of these different approaches varies depending on the country’s existing systems. The

following are the main approaches:

• Conditional cash transfers are designed to increase access to school via individual cash

transfers, in which families living in poverty receive cash conditionally depending on factors such as

school attendance and obtaining preventive medical care. The transfers are designed to create an

incentive for school attendance by helping compensate for direct and indirect costs associated with

attendance. Transfer programs such as these have proven successful in increasing girls’ attendance

and reducing poverty among adults with disabilities, but there is little disaggregated data about their

impact on the school attendance of children with disabilities (Krishnaratne, White, and Carpenter

2013; Mont 2006). Additionally, without systemic reforms needed to make classroom instruction

more accommodating, conditional cash transfers alone do not ensure that once in school, learners

receive the accommodation needed to help them engage successfully, learn, and remain in school

(Stubbs 2008).

• CCT programs can disadvantage families in which children with disabilities face barriers to

education because the inability to attend school puts those transfers at risk. One strategy for

working around this issue is to exempt children with disabilities from this conditionality; however,

while this provides the family with an economic safety net, it undermines the goal of promoting

education for the child with a disability (See Mont D, “Social Protection and Disability,” Chapter in

Poverty and Disability 2010).

• Ministries of education frequently rely on Education Management Information System (EMIS)

enrollment data to determine per capita funding allocations to regions, sub-regions, and/or

schools. EMIS data on student disability status frequently are incomplete, inaccurate, or are

available with a lag of a year or more9. Some ministries build on this existing funding allocation

system by supplementing the per capita allocations for learners who have been identified as having

disabilities. Under Kenya’s Free Primary Education program, for example, the government allocates

1,420 Kenyan shillings per learner. This capitation funding is supplemented with an additional 2,300

Kenyan shillings for learners with disabilities (Ministry of Education 2018). Per capita funding has

the potential to provide a transparent, formula-based way to allocate targeted inclusive education

funds where needed. However, this approach requires accurate disability prevalence data, which

are frequently not available at the subnational or school level. In addition, if data on the number of

learners with disabilities are drawn from schools’ EMIS data, this has the potential to create an

incentive for schools to over-identify learners with special needs (IDDC and IETG 2017). The per

capita funding approach also runs the risk of reinforcing the idea that accommodations for an

individual child are enough, rather than the design of an inclusive system.

9 See USAID’s Tracking Inclusion: Data Sources on Inclusive Education in Sub-Saharan Africa report, section 2.3.

12 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

• Needs-based systems and school-level investments are less dependent on school and

student-level data requirements. System and school-level investments needed to support greater

mainstreaming of inclusive education may be more cost-effective (IDDC and IETG 2017). Examples

of investments include curriculum reform, development of adaptive materials and instructional

approaches, allocation of specialized teachers, teacher training, community outreach programs and

construction of accessible infrastructure (e.g., ramps, sidewalks, and accessible toilets).

• Even in countries that have implemented universal primary education, household contributions

to education continue to represent a significant portion of domestic spending. In some cases, they

contribute more to education than governments make (IDDC and IETG 2017). Students with

disabilities who are enrolled in segregated classes or schools are often required to pay additional

fees and levies, on top of those paid by other students (Ministry of Education and VSO Jitolee

2016). These costs can exacerbate educational exclusion. However, to the extent that they are

already being collected, these funds can be used to support inclusive education. School

administrators or school-level Boards of Management typically decide how this money is spent.

Interventions sensitizing them to the importance of inclusion have been effective in increasing the

admission of children with disabilities to schools, improving access to buildings and infrastructure,

and promoting staff training and student support (Mariga, McConkey, and Myezwa 2014).

SECTION 3: SCHOOL ACCESS To further highlight the differences between policy and practice, the report explores school access,

focusing first on disability prevalence rates to highlight the magnitude of this issue.

Globally, the World Health Survey estimates that 15.6 percent of the population 15 years and older

have some form of disability. Among children under 15, prevalence is estimated to be around 5.1

percent for moderate to severe disabilities and 0.7 percent for those with severe disabilities10 (WHO

2011). Sub-Saharan Africa has the highest regional prevalence rate, with 6.4 percent of children under

age 15 having a moderate to severe disability and 1.2 percent having a severe disability (EDT and

10 There are seven disability classes. Within those, “severe” disability includes classes VI and VII (e.g., blindness,

Down syndrome, quadriplegia, severe depression, or active psychosis) and “moderate and severe” disability

includes classes III and higher, such as angina, arthritis, low vision, or alcohol dependence (WHO 2011).

Countries in East Africa have established and have been investing in dedicated resource

centers to provide a decentralized and flexible way for governments to fund education for children

with disabilities. In some cases, special schools have been converted into these centers. Known by

different names in different countries—for example, Educational Assessment and Resource Centers in

Kenya, Educational Assessment and Resource Services in Uganda, and Inclusive Education

Resource Centers in Ethiopia—they can provide a number of different services: assessing students,

recommending school placements, training teachers, loaning specialized materials to schools,

supporting curriculum development, and/or providing referrals to healthcare providers (UN Committee

on the Rights of Persons with Disabilities 2014; 2015b; 2015a). However, in many cases, these

centers have limited funding, support, and staffing, and there is little data showing what type of

spending and interventions have the greatest impact on student enrollment and achievement.

13 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

UNICEF 2016). New data from the latest round of the MICS shows high rates of childhood disability in

SSA that can vary quite a bit by country.

COUNTRY

YEAR SOURCE % OF CHILDREN AGE 5-17 YEARS WITH A DISABILITY

TOTAL MALE FEMALE RURAL URBAN

DRC 2018 MICS 19.5 19.8 19.2 20.9 17.7

Ghana 2018 MICS 20.7 20.5 20.9 21.5 19.5

Madagascar 2018 MICS 14.2 14.3 14.0 14.1 14.6

Source: UNICEF n.d

Malnutrition, poor medical care, lack of access to clean water and basic sanitation, dangerous living and

working conditions, conflicts, and natural disasters all contribute to increases in disability (UNICEF

2013). Disability prevalence rates are sometimes estimated to be higher in lower-income countries but

are frequently underreported in official data sources. The prevalence rates are often specific to

impairments, which are not adequate proxy for disability information. Health conditions are sometimes

conflated with disability (WHO 2011). Estimates of overall disability prevalence tend to lack reliability

and comparability and tend to underreport the scale of disabilities (UNESCO 2018b).

Underreporting of children’s disability status often comes because parents are unaware of that status. In

other cases, parents know of their child’s disability but decline to answer survey or census questions

about disability (ACPF 2014). A UNESCO working paper indicates, “In most developing countries the

number of children with disabilities is grossly underestimated. Children with severe and moderate

disabilities may be acknowledged, but children with mild or hidden disabilities are ignored” (Graham

2014). Many are not identified and then go undetected in EMIS data, either because data on disability is

not collected or it is not done appropriately. However, that is changing as efforts to improve disability

data in EMISs are growing (Mont and Sprunt 2019; UNESCO 2019). The significance of under-counting

disability prevalence rates has clear implications for potential inaccuracy in estimating enrollment, out-of-

school, and completion rates among children with disabilities.

3.1: PARTICIPATION IN SCHOOL

Participation in school among learners with disabilities lags significantly behind that of their peers

without disabilities.

The introduction of Universal Compulsory Education has brought about an increase in enrollment of

children in primary school throughout Sub-Saharan Africa. However, increases in enrollment among

children with disabilities have not kept pace with increased enrollment of children without disabilities,

resulting in growing gaps in enrollment rates. Based on national census data from 11 countries in the

region11, a World Bank study found that the chance a 12-year-old child with disabilities has ever

attended school is 10 percentage points lower than a child without disabilities (Wodon, Male,

Montenegro, and Nayihouba 2018).

Exhibit 4 lists the percent of individuals aged 15–29 who have ever attended school, disaggregated by

disability status. Among children with disabilities, the percent who reported ever attending school

ranged from 35.8 percent in South Sudan to a surprisingly high rate of 98.2 percent in Zambia, and in 37

of the countries analyzed in a UNESCO Institute for Statistics study, children with disabilities were less

11 Burkina Faso, Ethiopia, Ghana, Kenya, Liberia, Mali, Malawi, Mozambique, South Africa, South Sudan, and Zambia.

14 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

likely than their peers to have attended school (UNESCO 2018a). The estimated gap in the rates

between children with and without disabilities ranges from a low of 1.5 percentage points in Mali to 26.2

percentage points in Nigeria (see Exhibit 4). The range in these rates, as well as the gap between the

rates, may in part reflect inconsistencies in how disability is defined, how data are collected, and how the

sample is designed.

The probability of never having attended school varies with the type of disability. Multiple Indicator

Cluster Survey (MICS) data from 2006 indicate that the probability of never having attended school is

much higher among those with a risk of mental disabilities than those with a risk of hearing

impairment.12 Wodon and colleague’s review of census data from Sub-Saharan Africa similarly finds that

the impact of disability on having ever attended school is greatest among children with intellectual or

psychosocial disabilities and those with multiple disabilities (2018).

Exhibit 4: Proportion of 15- to 29-year-olds who have ever attended school, by disability status and sex

% OF PERSONS AGED 15–29 WHO EVER ATTENDED

SCHOOL

COUNTRY YEAR SOURCE WITHOUT DISABILITY WITH A DISABILITY

MF M F MF M F

DRC 2015 SWTS 97.8 98.7 96.9 95.0 95.3 94.6

Ethiopia* 2007 IPUMS 49.4 58.7 40.5 38.8 46.2 30.2

Ghana* 2010 IPUMS 83.2 86.7 79.9 74.8 77.7 72.1

Kenya* 2009 IPUMS 90.0 90.6 89.4 82.7 83.1 82.3

Liberia 2008 IPUMS 66.5 74.3 59.1 57.0 63.2 51.0

Liberia 2012 SWTS 90.4 95.3 86.1 (59.8) . .

Madagascar 2013 SWTS 85.3 87.4 83.5 81.6 (76.3) 85.9

Madagascar 2015 SWTS 85.9 88.2 83.9 83.7 84.1 83.5

Malawi* 2008 IPUMS 85.3 88.8 82.2 78.5 81.1 75.8

Malawi 2012 SWTS 95.6 97.2 94.2 90.0 (93.7) (85.6)

Malawi 2014 SWTS 93.0 94.1 92.0 (96.0) . .

Mali* 2009 IPUMS 37.7 45.6 30.7 36.2 41.2 31.3

Mali† 2018 DHS 53.8 62.7 47.0 41.9 46.5

Mozambique 2007 IPUMS 70.2 81.1 61.0 56.2 66.4 45.5

Nigeria† 2018 DHS 75.3 80.7 70.6 57.3 63.2 51.2

Nigeria† 2018 LSMS 81.4 85.4 77.1 55.2 . .

South Africa† 2016 DHS 99.0 99.0 99.1 91.2 87.6 95.6

South Sudan 2008 IPUMS 34.3 43.2 26.1 35.8 44.9 27.4

Uganda 2013 SWTS 96.1 97.1 95.2 89.4 (92.8) (85.3)

Uganda 2015 SWTS 94.1 96.0 92.5 84.5 (83.8) (85.1)

Uganda 2016 DHS 95.4 96.4 94.4 85.3 87.4 83.2

12 This example comes from the 2006 MICS in Iraq, which showed that 10 percent of 6–9-year-old-children

without a disability had never been to school and 19 percent of children with hearing impairment had never been

to school, while 51 percent of those with mental disabilities had never been to school (Graham 2014).

15 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

% OF PERSONS AGED 15–29 WHO EVER ATTENDED

SCHOOL

COUNTRY YEAR SOURCE WITHOUT DISABILITY WITH A DISABILITY

MF M F MF M F

Zambia 2010 IPUMS 88.9 91.4 86.7 72.4 75.4 68.9

Zambia 2012 SWTS 97.1 98.0 96.3 98.2 (97.7) (98.6)

Source: ICF 2004-2017; World Bank 2020; UNICEF n.d.; Ruggles et al. 2020; UNESCO 2018a.

All indicators are calculated by UNESCO, using source as listed unless otherwise indicated.

† Indicators calculated by authors using source as listed.

Notes: (1) An asterisk (*) identified surveys that did not use the Washington Group questions; (2) A period (.) indicates that values were

not reported because they were based on a sub-sample with fewer than 25 unweighted observations; (3) Numbers in parentheses are

based on 25–49 unweighted observations; (4) Averages are unweighted and were calculated from the most recent data for each country.

(5) Abbreviations used in the table are as follows: Male (M); Female (F); Male and Female (MF); School-to-Work Transition Survey

(SWTS); Demographic and Health Surveys (DHS); Living Standards Measurement Study (LSMS).

Having ever attended school should not be conflated with regular

enrollment in school. Comparing out-of-school rates of school-aged

children provides another and more current measure of differences in

school access among children with disabilities than the previous

indicator, which collects data from adults about their previous school

experience. UNESCO’s 2020 GEMR estimates that 59 million primary-

aged children are out of school. More than half (32 million or 54

percent) of these children live in Sub-Saharan Africa (UNESCO 2020).

Globally, one-third of all out-of-school children have some form of disability (GPE 2018). The differences

in out-of-school rates among children living with and without disabilities in Sub-Saharan Africa are

highlighted in Exhibit 5. In Ethiopia and Uganda, the out-of-school rate is almost twice as high among

children with disabilities. In South Africa, where enrollment rates tend to be higher in general, the out-

of-school rate is more than 10 times greater among children with disabilities.

Exhibit 5: Out-of-school rate for primary and lower secondary school-age children, by disability status (%)

Source: ICF 2004-2017; World Bank 2020; UNICEF n.d.

Enrollment levels in other reports mirror these data on out-of-school rates. In 2006, the Global

Education Monitoring Report stated that only 10 percent of deaf children ages 7–12 were enrolled in

Burkina Faso. In Malawi and Tanzania, half as many children with disabilities attended school when

37%

16%

46%

33% 36%

2% 16%

71%

19%

67%

48%

64%

19%

32%

Ethiopia 2015

Madagascar 2018

Mali 2018

Nigeria 2018a

Nigeria 2018b

South Africa 2016

Uganda 2016

without a disability with a disability

In Malawi and Tanzania,

half as many children with

disabilities attended school

when compared with

children without disabilities

(UNESCO, 2010).

16 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

compared with children without disabilities (UNESCO 2010). There is a critical issue when it comes to

the enrollment of children with disabilities. In the following section, the report highlights some of the

barriers to enrollment.

3.2: BARRIERS TO ENROLLMENT

Countries report multiple barriers that limit enrollment among children with disabilities. Physical

barriers take the form of a lack of accessible infrastructure and transport. Financial barriers to

enrollment (e.g., school fees; transport costs; and the cost of school materials such as books, notebooks,

uniforms, and toiletries for boarding schools) common among many children in Sub-Saharan Africa are

more pronounced among children with disabilities, given the correlation between poverty and disability

prevalence (ACPF 2014). Social barriers influence parents’ willingness to send children to school, as well

as schools’ and communities’ acceptance of children with disabilities in school.

According to a UNICEF report, Every Child’s Birth Right: Inequities and trends in birth registration, some of

the lowest levels of birth registrations are found in Sub-Saharan Africa. It is estimated that 44 percent13

of babies are registered before age 5 (UNICEF 2013). Among children with disabilities, these rates are

disproportionately lower. For example, due to parents’ reluctance to register their children given the

stigmatization associated with disabilities, only 48.7 percent of babies with disabilities in Uganda are

registered at birth, compared to 62 percent of babies without disabilities. Children with multiple

disabilities are even less likely than children with one disability to be registered at birth (ACPF 2011a).

From the beginning of life, children with disabilities experience stigma and discrimination. Without a

birth certificate, it is difficult for children to access the rights they are entitled to, such as access to

school (ACPF 2014).

A 2018 qualitative study from Zambia on barriers

to and facilitators of lifelong learning provides

several interesting observations for reasons

children are not being enrolled in schools. These

findings could provide insights relevant to other

Sub-Saharan African countries. Delayed

enrollment is common among children with

disabilities. Parents frequently delay enrolling their

children because they do not know their child can

enroll in neighborhood schools, they are unsure of

whether the schools are equipped to handle their

child’s specific needs, or they wish to protect their

child from a negative experience. Parents and

caregivers might also be suspicious of the

qualifications of teachers of learners with

disabilities and are thus less likely to send their

child to school to be taught by someone they deem less qualified or unable to meet their child’s

educational needs. Many local schools discriminate against learners with disabilities and give them very

little priority or even mistreat them, and parents are rightly concerned that their children will not get

the attention they need or that the attention they do receive will be negative. In some cases, delayed

6 According to the same report, the rate is even lower when looking specifically at East and Southern Africa,

where 38 percent of all children registered before age 5.

17 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

enrollment comes from parents’ hiding their children as a result of a cultural belief that a child with

disabilities is a curse or punishment for something the parents have done in their past. Often, children

with disabilities are deemed incapable or their potential is not recognized; as a result, they are not

considered worth the educational investment. Extremely poor households might be forced to choose

which of their children receive an education, and children with disabilities are not often prioritized in

these situations. (Malungo et al. 2018; GPE 2018).

Removing barriers to education access for children with disabilities is critical to achieving SDG 4, but we

also know that the experience children with disabilities have once in school is important to both

learning and retention. Even for those children with disabilities able to access schools, dropout rates

tend to be higher and completion rates lower when compared to their peers without disabilities.

3.3: SCHOOL COMPLETION

Dropout rates tend to be higher among learners with disabilities and are likely higher than reported

because learners with “hidden” disabilities—those with mental or intellectual disabilities or those with

unidentified disabilities—are excluded from these calculations (Graham 2014). As with ever having

attended school, the dropout rate among learners with disabilities varies by disability type. In Uganda,

dropout rates are lower for visually impaired and physically disabled children than those with learning

difficulties, who are often hidden and/or misidentified as having behavioral challenges. In one area of

Kenya, a dropout rate of 33.3 percent was recorded among learners with learning disabilities (Ogadho

and Ajowi 2013).

Barriers to both entrance and retention in school contribute to lower completion rates among learners

with disabilities. Average primary school completion rates in Sub-Saharan Africa are 10.1 percentage

points lower for girls with disabilities than girls without disabilities and 12.8 percentage points lower for

Communities working to increase access and completion in Mali and Rwanda

Communities in Mali have created school committees that involve varied stakeholders to ensure

learners with disabilities receive the proper services and promote awareness among members of both

the school community and the larger community on the importance of inclusive education. They select

one person to focus on girls and learners with disabilities to make sure their access to education is

prioritized. In Rwanda, it has been observed that where the community takes ownership of education,

there is better attendance and the rates of completion are higher. Where the community is involved

and works alongside the governments and implementing agencies, the uptake of inclusion is more

probable. (Stubbs 2008)

The World Bank’s Malawi Inclusive Education for Disabled Children project tested innovative ways to

increase enrollment among children with disabilities who were not in mainstream schools. Parents of

children with disabilities carried out sensitization and community mobilization campaigns in 150

schools; stakeholder consultations were held; and guidelines on identification of disabilities,

enrollment, and supporting the educational needs of children with disabilities were developed by the

national umbrella DPO (Nannyonjo 2016).

18 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

boys with disabilities than those without14 (Wodon et al. 2018). Recent household survey data reflect

similar gaps in primary completion rates (Exhibit 6).

Exhibit 6: School completion rate for primary school-age children, by disability status and sex

COMPLETION RATE, CHILDREN

COUNTRY YEAR SOURCE

WITHOUT A DISABILITY

(%)

WITH A DISABILITY (%)

MF M F MF M F

Madagascar† 2018 MICS 64.6 59.9 69.1 61.8 61.2 62.5

South Africa† 2016 DHS 97.0 95.4 98.6 80.9 . .

Uganda 2011 DHS 39.5 36.0 43.1 34.2 (23.2) (47.7)

Uganda† 2016 DHS 44.3 42.7 46.0 22.7

Source: ICF 2004-2017; World Bank 2020; UNICEF n.d.; UNESCO 2018a.

All indicators are calculated by UNESCO, using source as listed unless otherwise indicated.

† Indicators calculated by authors using source as listed.

Notes: (1) A period (.) indicates that values were not reported because they were based on a subsample with fewer than 25 unweighted

observations; (2) Averages are unweighted and were calculated from the most recent data for each country. (3) Abbreviations used in the

table are as follows: Male (M); Female (F); Male and Female (MF); Demographic and Health Surveys (DHS); Multiple Indicator Cluster

Surveys (MICS).

Although less pronounced, differences in completion rates exist at the secondary level as well. Among

girls, the secondary-level completion rate gap was 7.0 percentage points, while among boys it was 11.1

percentage points. Completion rates at primary and secondary levels have continued to increase over

the past 20 years, but the increase among learners with disabilities has been slower—continuing to

widen the completion rate gaps as a result (Wodon et al. 2018).

3.4: BARRIERS TO RETENTION

The reasons for higher dropout rates and resulting lower completion rates among learners with

disabilities include many of the same ones that keep them from enrolling in the first place: lack of

accessible infrastructure throughout the school, costs associated with attendance, and health and

nutritional status. There are even lower completion rates for secondary school than for primary school,

and these rates are lower for girls with disabilities than boys due to school-related gender-based

violence, child marriage, and early childbearing (Wodon et al. 2018). Social factors also lead to their

dropping out, such as the attitudes of teachers and learners toward learners with disabilities, feelings of

isolation due to delayed entry into school, and bullying and violence that tend to disproportionately

target learners with disabilities. From a pedagogic perspective, learners experience a lack of adaptive or

inclusive teaching practices as well as low availability of adapted teaching materials.

These diverse factors all undermine the quality of experience and learning opportunities in school and

increase the probability of dropouts among learners with disabilities. In addition to these in-school

factors, girls with disabilities are especially at risk of dropping out due to early marriages and pregnancy

(Wodon et al. 2018). In the following section, we discuss three principal factors affecting learners’

experience in school: school accessibility, adaptive teaching, and bullying and violence.

14 Based on national census data from 11 Sub-Saharan countries (Burkina Faso, Ethiopia, Ghana, Kenya, Liberia,

Mali, Malawi, Mozambique, South Africa, South Sudan, and Zambia).

19 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

SECTION 4: SCHOOL EXPERIENCE

4.1: ACCESSIBILITY OF FACILITIES

According to the Africa Report on Children with Disabilities, most educational buildings lack ramps,

handrails, and especially lifts to make facilities accessible to all children (ACPF 2014). The Global

Partnership for Education’s report, Disability and Inclusive Education: A Stocktake of Education Sector Plans

and GPE-Funded Grants, notes that 21 of 51 developing-country partners included in this stocktaking15

noted including “building new schools” or “renovating existing schools to make them more accessible to

children with disabilities” as a strategic priority, with considerations for accessible buildings, classrooms,

toilets, covered drains, and proper lighting in the classrooms (GPE 2018). Ackah-Jnr and Danso (2018)

find that carefully planning an inclusive physical environment affects the “feeling” of the school and the

“extent of social connectedness and respect for differences,” thereby setting the tone for more inclusive

attitudes and a safer space for learners with disabilities. However, few schools are actually adapting and

modifying the physical environments to meet the needs of learners with disabilities. According to the

Ghana Ministry of Education’s Education Sector Analysis (2018), for example, only 8 percent of schools

were equipped with ramps and hardly any had handrails. Even among special schools, only 32 percent

had ramps and just 23 percent had handrails.

Schools often have stairs, narrow doorways, and seating that does not accommodate those with special

needs, such as wheelchair users. When there are ramps in schools, it is common for them to be so

steep that it is dangerous or impossible for wheelchair users to navigate them. Although there might be

standards for the gradient of ramps, they are often disregarded. Many schools have a single ramp that

makes limited areas of the school accessible, leaving the remaining space inaccessible to learners who

require ramps or other accessible infrastructure to access buildings, upper levels, bathroom facilities, or

spaces for eating or recreation (ACPF 2014).

15 Afghanistan, Bangladesh, Benin, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad,

Comoros, Congo, Democratic Republic of Congo, Côte d’Ivoire, Djibouti, Eritrea, Ethiopia, The Gambia, Ghana,

Guinea, Guinea-Bissau, Guyana, Haiti, Kenya, Kyrgyz Republic, Lao, PDR, Liberia, Madagascar, Mali, Mauritania,

Mozambique, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Papua New Guinea, Rwanda, São Tomé and Príncipe,

Senegal, Sierra Leone, Somalia, South Sudan, Sudan, Tajikistan, Tanzania, Togo, Uganda, Uzbekistan, Vietnam,

Yemen, Zambia, and Zimbabwe.

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Bathrooms are often inaccessible for learners who use wheelchairs or mobility devices or need support

in standing or sitting comfortably. Bathrooms are often extremely unsanitary, which can make it

especially challenging for learners who require assistance to avoid unhygienic conditions. This can be

particularly problematic for girls with disabilities during their monthly menstrual cycle. Many girls with

disabilities simply do not go to school during their monthly periods, or at all, to avoid situations where

their privacy is violated or equipment is inadequate to allow them to take care of themselves

independently (ACPF 2014).

For learners with sensory disabilities, low lighting can often be a barrier. It inhibits learners who are deaf

and hard of hearing and/or who might rely on sign language or lip reading to communicate. For learners

with poor vision, low lighting can further decrease their ability to see and concentrate.

Seating in the classroom can have an impact on a learner’s ability to engage in learning. Learners with

low vision, for example, might be better able to follow instruction if they are seated at the front of the

class. Learners who are hard of hearing could benefit from front-row seating so they can focus on the

sign language interpreter or hear with their residual hearing. Additionally, a front-row seat may increase

the learner’s ability and confidence to ask for more explanation or additional support. Unfortunately,

teachers are frequently unaware of learners’ sensory disabilities or are unaware of the benefits of front-

row seating for learners with sensory disabilities, and learners may be relegated to the back row.

Learners with disabilities often use assistive devices to mitigate barriers to learning, such as wheelchairs,

spectacles, and hearing aids. However, if they are not used appropriately, they do not provide the

potential benefits they could offer.

Accessibility of Facilities in Rwanda

The total percent of primary schools in Rwanda with adequate infrastructure for disabilities increased

from 18 percent to 24 percent between 2017 and 2018, reaching Rwanda’s Education Sector Strategic

Plan target of 21 percent. Similarly, the total percent of secondary schools in Rwanda with adequate

infrastructure for disabilities increased from 23.5 percent to 28.6 percent between 2017 and 2018,

reaching the target of 26 percent. This is important progress, especially considering that 36.9 percent

of learners with disabilities in Rwandan public primary schools and 46 percent of learners with

disabilities in Rwandan public secondary schools have physical disabilities. The Ministry of Education

states that especially because physical disabilities are the most common disabilities among enrolled

students, it is important to have adequate infrastructure that allows these learners to be comfortable at

school and pursue their studies. (Republic of Rwanda Ministry of Education 2018)

Use of Assistive Devices in Botswana

A School Vision Screen Pilot conducted in Botswana found that after 3 or 4 months, only 60.1 percent

of learners who participated in the follow-up wore their spectacles. Girls were more compliant than

boys, and learners in primary and lower secondary school were more compliant than those in upper

secondary school. It was concluded that improved compliance with the use of the assistive device

would increase the overall effectiveness of the program. This finding can be assumed for other types

of assistive devices as well. (McCormick et al. 2018)

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4.2: BULLYING AND VIOLENCE

Learners with disabilities in Sub-Saharan Africa often have difficulties engaging at their schools for

reasons beyond the lack of adaptive instruction and physical accessibility of the facilities. Bullying and

violence are directed at children with disabilities at higher rates than for those without disabilities,

especially girls, creating an unsafe school environment. According to Stubbs (2008), if a learner is bullied

or struggles in any way, it is viewed as the learner’s problem rather than that of the teacher or the

environment, so little support is given to mitigate the problem. Very few schools have reporting

mechanisms in place for learners to alert the school of this type of behavior, and many learners have

communication barriers that would prevent them from saying something even if a system were in place.

In a study ACPF conducted, 100 percent of the 956 children with disabilities interviewed in Cameroon,

Ethiopia, Senegal, Uganda, and Zambia had suffered at least one act of emotional or sexual violence, and

81.5 percent had suffered at least one instance of physical abuse (ACPF 2011). Given the stigma

surrounding disability in Sub-Saharan Africa, children with disabilities are often more likely to be victims

of abuse. In the ACPF study, boys with disabilities were more vulnerable to physical and emotional

violence, whereas girls with disabilities were more vulnerable to sexual violence. Sexual violence ranged

from 1.9 counts per child in Senegal to 3.9 counts per child in Cameroon, where 52 percent of the

sample had been raped, 30 percent forced into prostitution, and 43 percent touched inappropriately

(ACPF 2011).

These patterns of abuse are similarly observed in school settings where learners with disabilities report

higher incidences of abuse. Okyere and colleagues (2019) report peer bullying and victimization to be

especially high among learners with intellectual and developmental disabilities in Ghana. When reports

were made concerning this type of violence, teachers often dismissed them, illustrating that these

learners are viewed with skepticism. The authors point to the importance of developing strategies that

will increase peer support to harness the overall positive peer interaction observed in mainstream

schools, as well as the need to sensitize teachers to respond appropriately to violence and bullying.

According to a study by Devries and colleagues (2014), the incidence of violence against learners with

disabilities is three to four times higher than against learners without disabilities. Girls with disabilities

are even more likely to endure physical violence and twice as likely to endure sexual violence than girls

without disabilities; 23.6 percent of girls with disabilities experienced sexual violence, compared with

12.3 percent of their female peers without disabilities. Boys with disabilities in Uganda saw four times as

much sexual violence compared to their peers without disabilities.

4.3: INSTRUCTIONAL ACCOMMODATION AND

TEACHER TRAINING

Learners with disabilities face an array of barriers that limit their ability to participate actively and

achieve learning outcomes. If a child can overcome the physical and social barriers that keep them out of

the classroom, they often encounter additional barriers in the classroom. A lack of local sign language

can exclude a child who is deaf from communicating and learning. The lack of an adapted learning plan

(with additional time to explain lessons and complete tasks, or modified lessons) can prevent a child

with an intellectual disability from learning. To address these barriers, it is imperative that teachers

receive adequate training to help create a classroom environment that can address a learner’s needs and

provide the opportunity for learning achievement. Although inclusive education policies exist in many

22 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

parts of the region, they frequently fail to provide teachers with guidance on how to address learners

with special needs and carry out inclusive education (Mwangi 2013).

Most teachers are not equipped with the skills necessary to provide an environment where every

learner can thrive. Teachers are introduced to “inclusive education” without guidelines, follow-up,

support, or training (Malungo et al. 2018). A World Bank note suggests, based on a review of 11

countries, that only 1 in 10 teachers receive in-service training to promote inclusive education (Wodon

et al. 2018). According to Mwangi (2013), teachers lack the repertoire of learning and teaching strategies

appropriate for addressing the barriers to learning and providing individual supports; she notes that

teachers have called for additional training to help them develop the strategies to respond appropriately

to the identified learning difficulties.

Kenya’s Education Cabinet Secretary has increased funding for special needs education, with an emphasis

on training teachers to work with learners with special needs, recognizing the grave need to equip

teachers with the right skills to work with all learners (Nyaundi 2019). According to Ogadho and Ajowi

(2013), 38.3 percent of teachers who work with learners with learning difficulties had participated in

special needs education training, while 59.9 percent had not had any sort of formal training on how to

work with learners with disabilities. When training programs are applied, adaptive teaching approaches

and attitudes toward inclusive education improve, as demonstrated via observations of trained teachers

in Kenya (Mwangi 2013).

The importance of adequately preparing teachers for inclusive education is emphasized in another study

by Ogahdo and Ajowi (2013) in Kenya that examines the high drop-out rates among children with

learning difficulties. This study found that very little adaptation of the curriculum took place (only 13.5

percent of respondents reported adapting the curriculum), presumably because teachers were not

equipped with the skills to do so. Teachers acknowledge the importance of adaptation; 97.7 percent said

they believe that when curriculum is not adapted, learners with disabilities are at increased risk of

dropping out. The dropout rate in this study was shown to be inversely related to the number of

teachers trained specifically in special education. Where there was a higher percentage of special needs

educators, there was an associated lower dropout rate (Ogahdo and Ajowi 2013).

In addition to the need for all teachers to receive training in inclusive education and adaptive practices,

there is a need for specialist support, such as itinerant (or “visiting”) teachers—qualified teachers or

specialists who travel from school to school to provide educational supports to multiple schools

potentially across several communities. Not every inclusive school has a blind student, for example, so

an itinerant teacher would rotate among schools with blind learners and provide services such as

supporting Braille literacy, transcribing materials into Braille, and advising teachers on how to support

each learner’s educational needs. If a school has a deaf student, an itinerant teacher could support sign

language and literacy acquisition and help adapt curriculum (Hayes et al. 2018). In Uganda, itinerant

teachers find children who are not yet in school and determine ways to ensure they can be included

appropriately in school, prepare them for entering school, and support inclusion in the mainstream

schools by, for example, providing individual classroom support and advice to regular teachers on how

to include these learners (Lynch et al. 2011). Greater percentages of special needs educators, who are

skilled and prepared to support their teachers in creating an environment that fully supports learners

with disabilities, is associated with lower dropout rates (Ogahdo and Ajowi 2013).

Another barrier that teachers often face is simply not knowing that a child has a learning difficulty or a

disability. Learners are not often properly identified, screened, or assessed early on. As a result, a

teacher might assume a behavioral issue when, in fact, the learner might be facing a difficulty that could

23 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

require particular support. Ensuring that proper screening and assessments take place in schools is

essential to making every child’s learning experience better. Mwangi (2013) also recommends using

individual education plans to influence and maintain high expectations for the learners.

Due to a lack of teacher training and appropriate

student screening, discipline is often misdirected

toward learners with disabilities. Children with learning

difficulties or intellectual disabilities are often

incorrectly identified as misbehaving and, therefore,

wrongly disciplined, frequently without any explanation

or understanding of what they are being disciplined for.

Discipline often comes in the form of corporal

punishment (Devries et al. 2014).

The lack of teacher training, student identification, and

adaptive learning has an impact on engagement, and

ultimately learning, among learners with disabilities. Of

those who graduate from primary school, half leave

unable to read or write, and only 25 percent go on to complete secondary school (Wodon and

Alasuutari 2018). Recent census data from Sub-Saharan Africa indicate 11.9 and 13 percentage point

gaps in literacy for girls and boys, respectively, living with disabilities (Wodon et al. 2018). Access to the

high-quality, equitable inclusive education the SDGs call for is achieved not when seats are filled, but

when each learner completes the educational experience equipped with the skills to successfully enter

and thrive in the job market and contribute to society in a meaningful way.

SECTION 5: USAID INITIATIVES TO

SUPPORT DISABILITY PROGRAMMING IN

SUB-SAHARAN AFRICA Of the 20 Sub-Saharan African countries considered in this report, at least eight have current USAID

initiatives that support inclusive education for learners with disabilities (

24 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

Exhibit 7). The programs in these countries—Kenya, Liberia, Malawi, Mali, Rwanda, Senegal, Uganda, and

Zambia—implement a diverse range of initiatives, from teacher training to physical accessibility and

more (Exhibit 8). Notably, most of these programs focus on learners who have vision or hearing

impairment. Other disabilities (e.g., physical, intellectual) are addressed less frequently.

25 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

Exhibit 7: USAID programs with inclusive education initiatives

COUNTRY USAID PROGRAMS WITH INCLUSIVE EDUCATION INITIATIVES

Kenya Tusome

Liberia Accelerated Quality Education (AQE)

Malawi Malawi Early Grade Reading Improvement Activity (MERIT)

Reading for All Malawi (REFAM)

Partnership with Ministry of Education, Science, and Technology*

Mali Inclusive Education for Visually Impaired School Children

Inclusion of Deaf and Blind Children into Mainstream Schools

Mali Mission’s Civic Engagement Project*

Rwanda Soma Umenye

Senegal Lecture Pour Tous

Our Children Read

Uganda General work to expand voice/political participation of persons with disabilities*

Zambia Let’s Read Project

Partnership with Ministry of General Education*

*Not a program, but a partnership or individual initiative

26 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

Adapt/Develop Inclusive Learning Materials: Most USAID inclusive education programs in

Sub-Saharan Africa entail the development and distribution of inclusive learning materials. This

includes the adaption of textbooks and classroom materials into Braille and large print to cater to

visually impaired learners, as in the Malawi Early Grade Reading Improvement Activity and Senegal’s

Lecture Pour Tous program. In a unique case, Rwanda’s Soma Umenye program plans to digitize reading

materials to make them more accessible to learners with disabilities.

Adapt/Develop Inclusive Teaching Materials: Many programs develop and distribute

inclusive materials for teachers. As a part of Mali’s Inclusive Education for Visually Impaired

Primary School Children program, the early grade reading assessment was adapted to be used with

learners with visual impairment. Other programs more generally note that they distribute “specialized

teaching materials for learners with special needs.”

Advocacy/Raising Awareness: As a part of USAID/Mali’s Civic Engagement Project, a

subgrantee organized a meeting to raise awareness among civil society associations and

grassroots community organizations about including persons with disabilities into all sectors of

community life, including education. In Uganda, due to USAID’s work to expand the voice of persons

with disabilities, persons with disabilities developed 33 advocacy position papers that were presented to

local government and resulted in increased budgets for inclusive education.

Disability Identification: Some programs create tools to help teachers identify disabilities in

their learners. The Lecture Pour Tous program in Senegal produced student tracking data sheets to

help teachers identify learning impairments, while the Let’s Read Project in Zambia provides e-learning

audiology packages that help teachers identify learners who may be hearing impaired.

Distribute Assistive Devices: The Inclusive Education for Visually Impaired Primary School

Children in Mali distributes spectacles to children with visual impairment enrolled in schools.

Enrollment in School: The Inclusive Education for Visually Impaired Primary School Children

and the Inclusion of Deaf and Blind Children into Mainstream Schools programs in Mali enroll

children with disabilities in school.

Parent/Family Training: Programs in Malawi and Mali help train parents to support their

children with disabilities at home, especially with reading and writing. The Inclusion of Deaf and

Blind Children into Mainstream Schools program in Mali also trained parents in Braille and sign language.

Physically Accessibility: Two programs, including the Accelerated Quality Education program

in Liberia, prioritize making schools physically accessible to learners with disabilities.

Special Activities: The Malawi Early Grade Reading Improvement Activity held reading

competitions for vision- and hearing-impaired learners. In 2019, the reading competition for

vision-impaired learners included 46 learners from 16 schools, while the pilot reading competition for

hearing-impaired learners involved 18 learners from three schools.

Teacher Training: Several USAID inclusive education initiatives involve teacher training. For

example, Senegal’s Our Children Read program developed a training module to encourage

including learners with disabilities in the classroom. Mali’s Inclusion of Deaf and Blind Children in

Mainstream Schools program trained teachers, principals, and pedagogical advisors in pedagogy and the

use of course preparation sheets that facilitate inclusive teaching.

27 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

Exhibit 8: USAID support of inclusive education initiatives in Sub-Saharan Africa

This information comes from the 2019 USAID Performance Plan and Report (PPR) data. This chart represents the inclusive education

initiatives referenced in the PPR narrative submissions.

28 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

CONCLUSIONS Policies: Access to quality education is a fundamental human right, one that is essential to individual

development and effective participation in society. Lack of access to quality education limits the ability

for persons with disabilities to acquire the skills and knowledge needed to fully participate in society and

in the labor market, leading to social exclusion and poverty. This right is reflected in the UN’s

Sustainable Development Goals and has been enshrined in international and regional conventions and

frameworks. Many countries in Sub-Saharan Africa include policies that guarantee the right to inclusive

education for children with disabilities.

Finance: A lack of adequate funding for inclusive education represents a significant barrier to effective implementation. Increases in funding alone, however, do not necessarily guarantee effective

implementation of inclusive education commitments. Many countries’ funding systems support

segregated education, which is costly and not sustainable. Models exist that can support inclusive

education in low resource settings, though more systemic research is needed to identify the most

effective approaches.

Barriers: Despite inclusive education policies, evidence shows that children with disabilities are less

likely to attend school and are less likely to complete school if they are able to enroll. Children who are

able to enroll face increased probability of experiencing bullying, violence, and undeserved discipline

(UNESCO 2018a). Children with disabilities face additional barriers to the successful completion of

school, such as lack of government prioritization of inclusive education in strategies and policies; lack of

knowledge/resources for parents/caregivers to support their children in schooling, the prejudices and

discrimination that many still hold against children and adults with disabilities; a lack of qualified teachers,

principals and pedagogic supervisors to accommodate the needs of learners with disabilities; poor

accessibility of school infrastructure; the low supply of accessible teaching and learning materials; and the

low number of teachers with disabilities, who are better able to understand and show empathy toward

learners with disabilities (IDA 2020; UNESCO 2014; UNESCO 2020; GPE 2018).

Data: Through the collection of data on students disaggregated by disability and on the barriers and

facilitators of access, resources can be allocated equitably, budgets can be managed more efficiently,

inclusive education programs and policies can be implemented and monitored more closely, and efforts

to enhance education services can be strengthened (GPE Stocktake 2018). Though there are many

international efforts to systematize the collection of comparable, quality education data, the data needed

to ensure the achievement of the SDGs by 2030 remains severely limited (Washington Group 2016).

Local, country and subnational level data needed for advocacy, decision-making, and funding allocations

is particularly wanting.16

Donor Support: USAID and other donors are working with local ministries to raise awareness around

inclusive education and to pilot projects to increase accessibility to quality education for all learners.

Continued efforts to address systemic barriers, increase access, and improve the educational experience

for children with disabilities is essential if we are to achieve SDG4 by 2030.

16 DFID disability data portal. https://www.disabilitydataportal.com/about-the-portal/indicators/

https://www.disabilitydataportal.com/about-the-portal/indicators/

29 | INCLUSIVE EDUCATION IN SUB-SAHARAN AFRICA USAID.GOV

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