1. The World Bank DISABILITY REVIEW IN THE MIDDLE EAST AND NORTH AFRICA Akiko Maeda and Nedim Jaganjac Health, Nutrition & Population Sector Human Development Department Middle East & North Africa Region The World Bank Washington DC Presented June, 2009

2. The World Bank and Disabilities Disability, as a development theme, cuts across key mission and corporate goals of the World Bank, including poverty reduction, economic growth, and reaching the Millennium Development Goals.

3. Disability Prevalence Function of Benefits? Within established economies, the prevalence rate varies from 8% to over 20%. This variance is a function of what types of disabilities are included – both in kind and degree. Many developing countries report very low rates of disability – often 1% or 2%. These low prevalence rates usually result from methodological deficiencies in data collection and definition. International classification (ICF)

4. Disabled People are Greatly Invisible 1-3% of population (country surveys) 7% of population (WHO) 0 1 2 3 4 5 6 7 Albania Benin Cameroon Cambodia Kyrgyzstan Pakistan % of Total Population Invisible Disabled People Identified in Poverty Surveys

5. Main Causes of Disabilities in the Region: Birth related disabilities and consanguinity; communicable and chronic diseases; weak access to and availability of health services; poor nutrition; accidents and violence; Among the highest rates of traffic accidents in the world, Job related injuries and diseases are on the rise. Poverty, political instability and conflicts are taking a toll on the physical as well as the mental health of the population, with reported increases in incidences of depression.

6. Road Traffic Accidents The mortality rate per 100,000 population caused by road traffic injury in MENA is among the highest in the world. About 130,000 people died in road accidents in MENA in 2002. More than half of the people killed in traffic accidents are individuals aged between 15 and 44 years – often the breadwinners in a family. Cost of traffic accidents in low income and middle- income countries is between 1 percent and 2 percent of their Gross National Product.

8. Work Related Injuries ILO estimates 6,000 workers die everyday around the world as a result of accidents or illness in the workplace which translates to an estimated 2.2 million deaths every year from work-related accidents and diseases worldwide. Non-fatal incidents cause about 270 million workers to be absent from their jobs for at least three days. ILO claims that occupational safety is a "worldwide concern “ and marginalized groups like migrant workers are more at risk to workplace-related hazards

9. How Persons with Disability are More Likely to Become Poor E. Andrews

10. How the Poor Are More Likely to Risk Becoming Disabled E. Andrews

11. Key argument: Excluding persons with disabilities from development process will adversely impact the further progress in poverty reduction and economic development.

12. Prevention - - - - - - - - - Education Safety devices Work protection Physical Accessibility Medical interventions - - - - - - - - - Reconstructive Surgery Rehabilitation Integration - - - - - - - Education Vocational Training Job Opportunity Benefits Physical Accessibility

13. Moving Forward: Strengthen evidence and knowledge dissemination Promote evidence based regional dialogue Help develop National Disability Strategies Build institutional capacity to implement the strategy Identify policies and programs to mainstream disability

14. Web Resources World Bank Web Site: www.worldbank.org Disability Web Site: www.worldbank.org/disabilitywww.worldbank.org/disability NGO/Civil Society Web Site: http://wbln0018.worldbank.org/essd/essd.nsf/NGOs/home Social Funds Web Site: www.worldbank.org/sp/socialfundswww.worldbank.org/sp/socialfunds Junior Professionals Program http://lnweb28.worldbank.org/hrs/careers.nsf/key/jpa Young Professionals Program http://lnweb28.worldbank.org/hrs/careers.nsf/key/ypp