Chapter 5. USAID Disability Policy


The National Council on Disability made several recommendations to USAID in 2003 to promote access to and inclusion of people with disabilities in USAID programs. These recommendations included (1) establishing a “Fund for Inclusion”; (2) creating an office on disability in development; and (3) requiring specific action plans to include people with disabilities in strategic planning efforts in all USAID sectors. This chapter reexamines USAID’s Disability Policy, its implementation, and significant developments since 2003 both within USAID and within inclusive development. Further coverage is provided of USAID’s Disability Fund and the provision of disability-inclusive development training. The chapter concludes with research findings concerning the implementation of the Disability Policy, including the identification of areas requiring improvement.

Overview of USAID Disability Policy

The United States Agency for International Development (USAID) is the central U.S. Government agency working to provide assistance to countries recovering from disaster, trying to escape poverty, and engaging in democratic reform.[1] USAID is an independent Federal Government agency that receives foreign policy guidance from the Secretary of State.[2] Its work in five regions supports long-term and equitable economic growth and U.S. foreign policy objectives through programming in agriculture, economic growth and trade, education, health, democracy and governance, and humanitarian assistance.[3]

In 1991, the Government Accountability Office (GAO) undertook an investigation into U.S. foreign assistance programming in developing countries to determine how inclusive they were of people with disabilities.[4] The GAO found, among other things, that while such programs were directly relevant to people with disabilities, disability inclusion remained “sporadic” and concluded that USAID “does not generally attempt to target the people with disabilities in its regular bilateral assistance programs….”[5] Thereafter, in 1996, NCD issued a report entitled Foreign Policy and Disability, which reviewed the activities of the U.S. Department of State, USAID, and the U.S. Information Agency and concluded that “the United States does not have a comprehensive foreign policy on disability” and “neither the spirit nor the letter of U.S. disability rights laws is incorporated into the activities of the principal foreign policy agencies.”[6]

In 1997, USAID, noting the NCD report and recommendations, issued USAID Disability Policy Paper, a nonbinding guidance note.[7] The policy articulated in the 1997 document was grounded in the principle of nondiscrimination, as reflected in U.S. federal disability rights laws, with the objective “[t]o avoid discrimination against people with disabilities in programs which USAID funds and to stimulate an engagement of host country counterparts, governments, implementing organizations and other donors in promoting a climate of nondiscrimination against and equal opportunity for people with disabilities.”[8] An additional aim was “to promote the inclusion of people with disabilities both within USAID programs and in host countries where USAID has programs.”[9]

The 1996 NCD report was followed by a subsequent NCD review in 2003, Foreign Policy and Disability: Legislative Strategies and Civil Rights Protections to Ensure Inclusion of People with Disabilities.[10] In subsequent years, several key developments occurred, particularly within the context of USAID programming. In November 2004, USAID made the 1997 disability guidelines part of USAID policy.[11] The specific objectives of the USAID Disability Policy are as follows:

  1. Advance U.S. foreign assistance program goals by promoting the participation and equalization of opportunities of people with disabilities in USAID policy, country and sector strategies, activity designs and implementation;
  2. Increase awareness of disability issues within USAID programs and in host countries;
  3. Engage other U.S. Government agencies, host-country counterparts, governments, implementing organizations, and other donors in fostering a climate of nondiscrimination against people with disabilities; and
  4. Support international advocacy for people with disabilities.[12]

In an effort to deepen its institutional commitment to inclusive development, USAID established two Acquisition and Assistance Policy Directives (AAPDs) in support of implementing the Disability Policy.[13] AAPDs provide information and guidelines for agency personnel and partners involved in the acquisition and assistance process, and these two AAPDs provide agency personnel with information directly applicable to solicitations.[14] AAPD 04-17, Supporting USAID’s Disability Policy in Contracts, Grants, and Cooperative Agreements,[15] requires USAID contracting officers (COs) and agreement officers (AOs) to include a standard provision in all solicitations and in the resulting awards for contracts, grants, and cooperative agreements. For acquisitions (contracts), COs are required to include the provision “USAID Disability Policy-Acquisition” in Section H of all Requests for Proposals (RFPs).[16] For assistance awards (grants and cooperative agreements), AOs must include the provision “USAID Disability Policy-Assistance” in RFAs and must ensure it is included as a special provision in the award.[17]

The second relevant policy directive issued by USAID, AAPD 05-07, Supporting USAID’s Standards for Accessibility for the Disabled in Contracts, Grants, and Cooperative Agreements,[18] requires COs and AOs to include a provision that supports USAID’s Disability Policy in solicitations by outlining standards for accessibility in all new construction, as well as in renovations of structures, facilities, or buildings. According to this AAPD, the provisions that must be included in all solicitations “set out the agency’s objectives regarding disability policy in terms of construction; require compliance with accessibility standards; how to comply in new construction and in alterations to existing structures; and construction related activities that are exempt from the requirements for compliance.”[19] For acquisitions, COs must include the provision “Standards for Accessibility for the Disabled in USAID Construction Contracts (September 2004)” in Section H of all RFPs and subsequent contracts.[20] For assistance awards, AOs must include the provision “Standards for Accessibility for the Disabled in USAID Assistance Awards Involving Construction (September 2004)” and must ensure it is included as a special provision in the award.[21]

Although the two policy directives require USAID to include the Disability Policy in all RFAs and RFPs, there are serious limitations that call into question the utility of these provisions and their actual impact on disability inclusion in program implementation. Chief among these concerns are—

  1. Examples of solicitations that fail to incorporate the required Disability Policy provision;[22]
  2. Placement of the provision at the end of solicitations embedded on a page that offerors and applicants may not closely review;
  3. Absence of any requirement that points be allocated for inclusion of people with disabilities in the application-grading process;
  4. Lack of any requirement for “statements of work” or “program descriptions” to reference people with disabilities as program participants and beneficiaries; and
  5. Absence of any requirement or guidance on budgeting for reasonable accommodations within programming, and thus many programs do not provide reasonable accommodations for people with disabilities to access program materials and activities.[23]

In addition, the second policy directive, Supporting USAID’s Standards for Accessibility for the Disabled in Contracts, Grants, and Cooperative Agreements, allows USAID to authorize waivers “where compliance with accessibility standards is technically infeasible or presents an undue burden.” COs and AOs are required to obtain waivers in accordance with the USAID Policy on Standards for Accessibility for the Disabled in USAID-Financed Construction[24] prior to issuing approval. The policy states that “[its] guidance extends the principles of the ADA and the ABA to USAID-financed assistance.”[25] Waiver requests “must identify the specific requirements and procedures of the guidelines from which a waiver is sought and provide a detailed explanation, including appropriate information or documentation, as to why a waiver should be granted.”[26] In addition to waivers, the policy directive also provides for certain exceptions in construction-related activities.[27] The emergency construction exception applies to structures “intended to be temporary in nature” and, under this exception, emergency construction efforts include providing tents or plastic sheeting, minor repairs, or upgrades to existing structures; rebuilding certain parts of existing structures; or constructing temporary structures.[28] The waivers and exceptions are problematic as they may lead to new construction efforts that are inaccessible and USAID should only authorize such waivers and exceptions in narrowly defined and limited circumstances.

In 2009, the two USAID policy directives were codified in USAID’s Automated Directive System (ADS).[29] ADS is USAID’s directive management system and thus is crucial to the process of creating binding policy within USAID. USAID policy directives, required procedures, and other guidelines and optional materials are drafted, cleared, and issued through the ADS. The ADS functions as a database of relevant, useful, and valid information that USAID employees need to reference to correctly follow agency directives and guidelines. As AAPDs provide information and guidelines for agency personnel and partners involved in the acquisition and assistance process,[30] AAPD 04-17 and AAPD 05-07 had to be issued through the ADS. As such, this process codified the two AAPDs, thereby making them binding on all USAID employees.

USAID Reports on the Implementation of the Disability Policy

USAID has issued five reports on the implementation of the USAID Disability Policy, the most recent of which was issued in December 2008.[31] In its Fifth Report on the Implementation of USAID Disability Policy (Fifth Report), USAID set forth the following recommendations to further advance the implementation of its Disability Policy:

  1. Increase outreach to and consultation of DPOs and disability leaders by USAID missions, offices, and bureaus;
  2. Systematize the inclusion of disability into USAID program selection criteria;
  3. Increase formal and nonformal training opportunities and raise awareness of inclusive practices for staff, implementing partners, and DPOs; and
  4. Increase the number of missions with disability plans.[32]

The Fifth Report illustrates that USAID’s commitment to disability inclusion and the uniform implementation of its Disability Policy across all missions is leading to an increase in policies and programs that raise awareness of disability issues and are addressing the needs of people with disabilities. In total, 78 country missions, 8 regional offices, and 13 bureaus and offices voluntarily submitted reports.[33] Missions were more willing to participate in the voluntary disability inclusion reporting process, with 75 percent of missions submitting versus 43 percent for the previous report issued in 2005.[34] The number of missions with disability inclusion plans reached 20 percent, as opposed to “a handful” for the previous report, and 75 percent of respondents reported undertaking programs and activities that benefited people with disabilities.[35] A quarter of the reporting missions indicated an increase in the capacity of local DPOs.[36] The report indicates that the uniform implementation of the USAID Disability Policy has increased the profile of disability inclusion at the mission level. According to the report, it is now standard practice to include the Disability Policy provision in the solicitation process; there is an increasing presence of disability-related programming and program components; missions are disseminating USAID policy information to implementing partners; and missions are seeking greater coordination from experts in the disability field.[37]

Although the Fifth Report points to important progress, it does not necessarily follow that the increased percentage of reporting missions resulted from greater implementation of the USAID Disability Policy. This seems especially true considering the percentage of reporting missions (75 percent) compared to reporting missions with disability inclusion plans (20 percent).[38] Missions are not required to have disability-inclusion plans, but it should be noted that missions with inclusion plans are actively advancing the Disability Policy. Furthermore, while all missions were in compliance with equal employment opportunity standards, few missions reported having people with disabilities on staff and fewer still reported making any concerted effort to increase the number of people with disabilities employed by the mission.[39] Additionally, only 10 percent of missions reported collecting any input from people with disabilities.[40] The findings and recommendations provide an important lens through which to review USAID’s progress in promoting the Disability Policy agency-wide.

The Disability Fund and Inclusive Development Trainings

In 2005, Congress, under the sponsorship of Sen. Tom Harkin (D-IA), appropriated funds to USAID for “programs and activities to address and protect the rights of people with disabilities in developing countries” through the Consolidated Appropriations Act.[41] The act made funding available for such programs, but also required that USAID establish the Disability Program Fund (hereafter Disability Fund or the Fund), an initiative that supports programs intended to benefit people with disabilities and foster disability inclusion in the development programs supported by USAID.[42] The appropriation was originally $2.5 million,[43] and has grown to approximately $4 million per year and has supported small-scale programs in more than 48 developing countries.[44] The Fund not only supports programs that benefit people with disabilities, but also includes DPOs in project design, implementation, and monitoring and evaluation. The emphasis on partnership with DPOs builds the institutional capacity of DPOs to participate in future USAID and other donor-funded development programs.[45]

In another positive step toward implementation of the USAID Disability Policy, USAID developed an e-training course entitled “Inclusive Development” for staff to learn more about the inclusion of people with disabilities in USAID programs.[46] The e-training course is a learner-controlled course that focuses on ways to include people with disabilities in USAID programs and missions. The course features five online modules: (1) foundations of inclusion; (2) barriers to inclusion; (3) the inclusive development program; (4) leading examples of inclusive development; and (5) inclusive human resources management.[47] The e-training course also consists of self-paced exams to test the learner’s knowledge and extensive reference documents for learners to review.[48] At present, the e-training course is voluntary and does not reach as many USAID personnel as it could under a mandatory training directive. While a new incentive has been created according to which mission eligibility to host programs under the Disability Fund requires that at least one mission member must have completed the course, mandatory training would clearly have greater impact. In addition to the voluntary e-training course, USAID has added a disability training component to its new staff training and orientation in Washington, DC.[49] The disability training component was developed in an effort to “[i]Integrate disability inclusion concepts in other trainings given to new staff” and “to stimulate thinking on the topic and provide specific contact information within the Agency.”[50] This marks an important step in the right direction for training USAID personnel, but has a limited impact as it fails to reach existing USAID employees. A disability training component should be integrated into trainings for all staff members at all levels within USAID. Active learning approaches combined with specific technical tools to help personnel understand how to address disability inclusion within the framework of their specific jobs would deepen knowledge and promote fuller implementation of the USAID Disability Policy.

Appointment of Coordinator on Disability and Inclusive Development

Perhaps one of the more significant developments in USAID’s efforts to advance disability-inclusive development in its operations is the appointment in 2010 of a Coordinator on Disability and Inclusive Development. It is premature to provide any assessment of the impact of this appointment on the advancement of USAID’s Disability Policy and furtherance of disability-inclusive development. It is clear, however, that the placement of the Coordinator within the Bureau for Policy, Planning and Learning, together with the various initiatives underway to strengthen USAID and the commitment in the QDDR to ensure inclusion in USAID’s work, represent unique opportunities to press for much-needed reforms. In order for the Coordinator on Disability and Inclusive Development to realize a much-needed and ambitious agenda, appropriate resources must be allocated for this purpose.

Research Findings on the Implementation of the USAID Disability Policy

The next section reviews the findings from interviews, focus group discussions, and desk-based research on the implementation of the Disability Policy by USAID and provides examples of where the policy is not being adequately implemented, as well as examples that highlight progress toward full implementation of the policy.

Lack of Knowledge Regarding Disability Issues and the USAID Disability Policy

One of the main findings was the serious lack of knowledge that USAID employees have about disability issues and, specifically, how to include people with disabilities in development work.[51] Many of the personnel interviewed indicated that they had given little or no thought to the issue of including people with disabilities in USAID programs. Interview participants drew a sharp distinction between programs that include disability components and programs that include gender components and made it clear that gender is far more of a focus of discussion during program design. Further, interviewees indicated that little training is offered on disability issues and even when training sessions are available, few people attend.[52] Few mission personnel who were interviewed knew of any local DPOs in their country or nongovernmental organizations (NGOs) working on disability issues. For those mission employees who indicated they did not know of any DPOs, when asked to describe a DPO, they discussed organizations that provide services to people with disabilities but rarely pointed to organizations composed of people with disabilities.[53] According to the local advocate from Nepal, “their understanding about disability issues is just limited to the health issues, which is one of the major problems among many donor agencies.”[54]

USAID personnel interviewed disclosed little awareness of the USAID Disability Policy, or, if they were aware of it, they were unable to articulate its purpose and how it applies to their work.[55] For example, when asked to describe any USAID policy relating to disability of which they were aware, one Program Officer stated, “[t]here is a rule that anything funded with our money must be accessible. So that pertains basically to ramps or removal of barriers. I cannot really recall the exact name of the policy, but it does exist.”[56] The officers interviewed in Bangladesh reported there is no disability policy as such “aside from preliminary discussions surrounding an inclusion plan.”[57] This is problematic, as the policy cannot effectively impact development programming if it is little known or understood by mission personnel.

A further problem is that some solicitations fail to comply with USAID’s solicitation directive, which requires inclusion of the Disability Policy provision in all solicitations. In a review of 66 full solicitations that were issued on the website from February to July 2010, only 33 of the solicitations included the standard disability provision language outlined in USAID’s policy directives.[58] The solicitations issued on were from missions from around the world as well as from USAID DC.

In reviewing USAID solicitations, there is, however, some evidence of good practice, which should serve as a guide in the effort to see the Disability Policy more uniformly applied throughout the Agency. For example, the West Bank USAID Mission included the required disability provision for new construction efforts in solicitations they released on during the reviewed period.[59] In addition, the USAID Zambia Mission not only included the Disability Policy provision in its solicitations, but also meaningfully included people with disabilities in statements of work during the reviewed period.[60] This is noteworthy, as Zambia’s mission received training on disability-inclusive development funded by USAID.

Disability-Specific Funding Sometimes Reflects Outmoded Approaches

In procurements that fund disability-specific programming, the desk review and interviews disclosed some serious problems in relation to compliance with the letter and spirit of the USAID Disability Policy. Most notably, the U.S. Government’s funding of institutions, orphanages, and other segregated settings for people with disabilities—with no apparent attention paid to community-based alternatives or even transition plans—is troubling insofar as these living arrangements do not reflect American or international standards that underscore the importance of living in the community with appropriate supports.[61] To provide one illustration, in a recent RFA from the Republic of Georgia, the mission calls for rebuilding orphanages and specifically mentions children with disabilities as beneficiaries.[62] The proposed project to rebuild Georgia’s orphanages is problematic.

American disability law recognizes that living arrangements for people with disabilities must be provided in the least restrictive setting possible and that community living arrangements are preferable to institutional ones.[63] It is often assumed that orphanages offer an acceptable and even desirable place for children with disabilities to live and grow up, whereas it is understood that orphanages tend to segregate children with disabilities from their peers and confine them to an institution, where they are often locked away for the rest of their life. Disability rights organizations have documented the egregious abuses that so often accompany congregate custodial arrangements, including orphanages, and have pointed to the near impossibility of ever providing for the full enjoyment of civil and political rights within institutions, irrespective of the conditions.[64] Investigations into orphanages throughout the world have found that children with disabilities in orphanages do not receive proper education, food, or care, and many are in “deplorable conditions.”[65] According to Disability Rights International (DRI), “[o]ne of the main drivers of institutionalization—particularly in developing countries—is the use of misdirected foreign assistance funding to build new institutions or rebuild old crumbling facilities, instead of providing assistance and access to services for families who want to keep their children at home…governments and international donors spend millions worldwide building and rebuilding these torture chambers for children with disabilities instead of supporting families, substitute families when necessary, and community services and education.”[66] A staff attorney from DRI interviewed mission personnel in Georgia and discussed the horrific conditions that children with disabilities are often exposed in orphanages in an effort to dissuade the mission from funding the reconstruction. Mission personnel did not change their position on the program and stated that they were funding a program that the local government identified as important and required.[67] This response echoed many of the responses from other mission personnel who claimed they were implementing programs that the local government in the country requested, and yet disability programming should reflect the values and principles of the USAID Disability Policy. The local advocate in Serbia expressed concern over this issue: “Even though USAID is funding projects in Serbia that are recognized by local communities as important and needed, their passivity in reliance on partners which are not critical of the reform and do not possess adequate knowledge, makes them an actor that is de facto contributing to exclusion of persons with mental health/intellectual disabilities in Serbia.”[68] The local advocate in Nepal expressed similar concerns and noted that mission personnel “did not know about CRPD and explained in plain language they would always focus on what the government of Nepal requests them to do.”[69] A core component of any dialogue on disability programming should include principles of nondiscrimination, independence, inputs from people with disabilities, and participation with the local government. Unfortunately, lack of knowledge on the part of USAID mission personnel will constrain such dialogue and limit learning opportunities. The result may well be the funding of inappropriate programming that undermines the USAID Disability Policy, U.S. federal disability law, and the CRPD. This is of considerable concern given that the vast majority of countries around the world possess little to no domestic disability law and policy and those that do, particularly in developing countries, tend to fall well short of the standards applied in either U.S. federal disability law or international disability rights law.[70]

Disability-Specific Programming Favored over Inclusion in General Development Programming

USAID uses a twin-track approach to inclusion by funding small-scale disability-specific programs in addition to promoting its Disability Policy in general development programs. Unfortunately, the disability-specific programs appear to be more effective than the large-scale, general development programs, which disclose very limited disability inclusive development strategies. For example, USAID/Bangladesh has a $90 million-per-year budget, with a single $300,000 grant program for capacity building of DPOs run by Handicap International (HI).[71] When asked about programs that include people with disabilities, the mission personnel stated they did not have any programs that included people with disabilities, but when asked a more specific question they mentioned the disability-specific HI program.[72] This response was similar in interviews at other missions and reveals that missions are not proactively advancing the inclusion of people with disabilities in all programs.[73] USAID’s twin-track approach to disability inclusion should systemically build on the successes and lessons learned in disability-specific programs and use such examples as the point of departure for facilitating full inclusion in all USAID programs. When USAID missions implement disability-specific projects, personnel should be trained on how to successfully align those projects with general development programs being implemented at the same time. At issue here is what tools, training, and other strategies could help USAID transition from the twin-track approach to a more comprehensive and holistic approach that fully includes people with disabilities and accords accessibility for all beneficiaries in general development programming.

In the programming reviewed, there were very few general development programs that meaningfully included people with disabilities. Most general development programs had no provisions to include people with disabilities or to provide reasonable accommodations or modifications to facilitate access.[74] USAID personnel in various missions reasoned that there was no need to make accommodations in general development programs, as people with disabilities were not program participants or beneficiaries.[75] The USAID personnel in Egypt reported that only disability-specific programs provide accommodations or modifications for people with disabilities. Further, the USAID personnel interviewed in Armenia stated that “there are no special accommodations made” for people with disabilities to participate in general programming.[76] The interview responses drew a clear line between USAID programs that specifically target people with disabilities versus all other programs, referred to as “general” programs.

Many general programs do not specify disability inclusion at any stage—whether design, implementation, or monitoring and evaluation. On the other hand, programs that are specific to people with disabilities receive a tiny fraction of funding in comparison to general development programs and often only benefit people with specific disabilities, such as programs targeting people who are blind, deaf, or mobility impaired. These programs do not reflect the diversity of disability, and in many cases people with mental health disabilities, intellectual disabilities, or developmental disabilities are completely excluded from such programs. The foregoing suggests that greater attention should be paid to fostering the diversity of disability in USAID programming and to include disability in the broad spectrum of general programming undertaken by USAID. This cannot be accomplished absent specific expertise in disability inclusion across the various sectors of USAID programming.

Monitoring and Evaluation Efforts Fail to Apply a Disability Lens

Evaluation is the systemic collection and analysis of information about the characteristics and outcomes of programs and projects as a basis for judgments, to improve effectiveness, and/or inform decisions about current or future programming—USAID Evaluation Policy (2011).[77]

The interviews, focus-group discussions, and desk-based research undertaken in the course of the study revealed that very few monitoring and evaluation efforts incorporate a disability lens in development programming. This is problematic as the fundamental purposes of evaluation are “accountability to stakeholders and learning to improve effectiveness.” USAID cannot determine whether and how a project effectively included people with disabilities without incorporating a disability lens in monitoring and evaluation efforts. Additionally, monitoring and evaluation efforts that do not include a disability lens have negative implications on budgeting for disability inclusion. The USAID Forward website on “Strengthening Monitoring, Evaluation and Transparency” outlines USAID’s new approach to monitoring and evaluation as follows:

Recognizing that the way in which development programs are monitored and evaluated is inadequate, we will change the Agency’s policies, structures and processes that seek to establish USAID as ‘best in class’ with respect to accountability and learning. To accomplish this goal, we will: 1) Introduce a much-enhanced monitoring and evaluation process and 2) Link those efforts to our program design, budgeting and strategy work.[78]

Accordingly, it is essential that monitoring and evaluation efforts integrate a disability lens into the monitoring and evaluation framework to ensure that project implementers effectively budget for disability inclusion during project design and report on their use of funds for disability-related project components.

The USAID evaluation policy released in January 2011 fails to mention disability, but the section on gender provides a useful example for how USAID should draft language on disability in evaluations. Gender is listed as one of the basic features that must be included in all evaluations: “gender-sensitive indicators and sex-disaggregated data.”[79] The basic feature section of the evaluation policy should use similar language, such as “disability-sensitive indicators.”

Many interview and focus-group participants reported that disability is not easy to include in monitoring and evaluation efforts for various reasons. One of the primary issues mentioned focuses on the difficulty of tracking the number of people with disabilities who participate in a project, because not everyone has a visible disability and many people with hidden disabilities may not feel comfortable self-reporting. Although this is important information to consider, this is not at all a sound basis for continuing to exclude disability data in monitoring and evaluation and, in fact, runs counter to international standards, including the CRPD.[80] It is essential that USAID initiate the development of innovative indicators and outputs that have a disability lens but do not require people to self-report on their disability or require USAID and implementing partners to try to determine if someone has a disability. Such an initiative would bring USAID into alignment with international standards on disability data and statistics.

Some good practices warrant mention and can serve as a foundation for further progress in this context. The mission in Vietnam, for example, has proactively included people with disabilities in programs since 1989 and has established useful disability indicators. The personnel interviewed reported that disability-specific indicators and targets had been established and that “the number of persons with disabilities and family members receiving assistance from USAID-funded program is tracked through quarterly and annually performance reports.”[81] Likewise, the mission in Ecuador also noted progress in tracking people with disabilities reached in USAID programs.

The monitoring and evaluation efforts that were most effective combined a quantitative and qualitative approach to capturing disability inclusion in projects. The following indicators serve as useful examples for future USAID programming:

  • Number of trainings for DPOs
  • Number of trainings on disability rights for community members
  • Number of DPOs who have participated in program trainings and events
  • Number of DPOs with a fund-raising strategic plan
  • Number of DPOs that play an important role in awareness-raising activities
  • Number of civil society initiatives that include a disability component
  • Number of organizations receiving small grants to implement a disability component
  • Number of new laws, regulations, or guidelines that are developed

USAID should also promote qualitative methods in monitoring and evaluation efforts that include: detailed document review, case studies, focus groups, project site visits and direct observations, and semistructured key informant interviews.

Disability Rights International’s final evaluation from a USAID-funded project in Kosovo provides a useful model for USAID, applicants, and offerors to review in developing monitoring and evaluation efforts during the project design stage that have a disability lens:

MDRI will survey and monitor participants in all programs to document levels of inclusion and participation by people with mental disabilities before, during, and after the establishment of the program. The survey will document the subjective experiences of program participants, and a monitoring instrument will document the objective outcomes of the project. MDRI will summarize these evaluations and produce a report of lessons learned from this project. The report will include detailed recommendations to civil society and development programs as to how to ensure the effective inclusion of people with mental disabilities in existing programs.[82]

USAID Afghanistan recently issued an RFP that provides a useful example of language for USAID to consider in efforts to promote a disability lens in all monitoring and evaluation efforts. The “Representations and Instructions” section of the Stability in Key Areas (SIKA)-West states, “As part of the submission the offerors shall provide a proposed Project Monitoring Plan (PMP) that will include, at a minimum, the following elements and be capable of generating the following data and reports: Reporting on disadvantaged groups (Women, Youth, Disabled, etc) with both PMP indicators and budget/project data.”[83]

Finally, the QDDR places significant emphasis on strengthening USAID’s monitoring and evaluation system by establishing new requirements for performance evaluations, designing rigorous impact evaluations, linking evaluations to future funding decisions, and promoting the unbiased appraisal of programs and the full disclosure of findings.[84] This undertaking, combined with the commitment in the QDDR to disability inclusion in DOS and USAID programs, provides a clear mandate for improving the capture of disability-specific data through the reformed monitoring and evaluation scheme. To this end, USAID should ensure monitoring and evaluation efforts are conducted with a disability lens. The recently appointed Coordinator of Disability and Inclusive Development within the Bureau for Policy, Planning and Learning, where other efforts to improve data collection are already underway, can spearhead this process. This effort should be directed at ensuring disability inclusion in future project design and implementation and the development of best practices.


The findings relating to USAID and the implementation of its Disability Policy disclose some positive practices and also support a review of the Policy, the terms of which were drafted in 1997. A review and revision of the Policy is timely given the commitment to disability inclusion set forth in the QDDR and will help facilitate a redoubling of efforts to ensure inclusion in all programming and to provide specific, concrete, and achievable guidance to USAID personnel and implementing partners. An emphasis on training that reaches USAID personnel in Washington, as well as in the missions around the world, is clearly needed based on the findings. The development of disability indicators to enrich the monitoring and evaluation of USAID’s programs is likewise timely and warranted. Finally, and presenting a new and unique challenge, with rapid CRPD ratification occurring across the world, it becomes ever more important to take disability inclusion into careful account when designing development assistance programming consonant with local law and prevailing international standards. Ultimately, taking specific steps to ensure the inclusion of people with disabilities in all foreign assistance programming avoids future human harm and reduces redevelopment costs.


[1] The origins of USAID may be traced to the Marshall Plan reconstruction of Europe after World War II and the Truman Administration’s Point Four Program. In 1961, the Foreign Assistance Act was signed into law and USAID was created by executive order. See USAID, “About USAID,”

[2] The 2010 National Security Strategy articulates the objective of development as follows:

“Through an aggressive and affirmative development agenda and commensurate resources, we can strengthen the regional partners we need to help us stop conflict and counter global criminal networks; build a stable, inclusive global economy with new sources of prosperity; advance democracy and human rights; and ultimately position ourselves to better address key global challenges by growing the ranks of prosperous, capable and democratic states that can be our partners in the decades ahead.”

The White House, National Security Strategy, (May 2010),

[3] See “About USAID,” supra note 156. Note that while USAID is the lead agency for international development assistance, there are a number of other agencies that implement foreign assistance programming, including the U.S. Departments of State, Defense, Agriculture, Commerce, Justice, Labor, and Treasury, among others. The proliferation of the international programs of federal departments or agencies across the government presents a major challenge for disability inclusion, as it also does for the coherence and coordination of U.S. foreign assistance generally. For a useful critique of U.S. foreign policy and development policy, see Gerald F. Hyman, Foreign Policy and Development: Structure, Process, Policy and the Drip-by-Drip Erosion of USAID, The Center for Strategic and International Studies (September 27, 2010),

[4] U.S. General Accounting Office, GAO/ NSIAD-91-82, “Foreign Assistance: Assistance to Disabled Persons in Developing Countries” (February 15, 1991),

[5] Id. at 2. For a review of efforts to ensure inclusion in foreign assistance programming, see NCD, Foreign Policy and Disability, supra note 50.

[6] NCD, Foreign Policy and Disability (1996), 1996/08011996. There, NCD recommended (1) creating a comprehensive foreign policy on disability to advocate for people with disabilities through activities on international levels; (2) extending U.S. disability law by legislation or executive order to unambiguously include the international operations of the U.S. Government; (3) employing domestic standards of nondiscrimination in U.S.-sponsored international activities; (4) training U.S. foreign affairs agencies and their contractors to plan for programmatic accessibility; and (5) establishing the principle that no U.S. international activity should have a lower standard of inclusion than its domestic correlate.

[7] USAID, Policy Guidance, USAID Disability Policy Paper (September 12, 1997),

[8] Id.

[9] Notably, the 1997 Policy Paper takes the position that “While the ADA applies to U.S. citizens (including USAID employees) overseas, it does not apply to non-U.S. citizens, who are the primary beneficiaries of USAID programs. The USAID Disability Policy is thus in part an effort to extend the spirit of the ADA in areas beyond the jurisdiction of U.S. law.” Id. at 2.

[10] NCD, Foreign Policy and Disability, supra note 50.

[11] See USAID, “Disability Policy,”

[12] Id.

[13] USAID, AAPD 04-17 USAID Acquisition and Assistance Disability Policy Directive, Supporting USAID’s Disability Policy in Contracts, Grants, and Cooperative Agreements [hereafter AAPD 04-17] (December 17, 2004), business_opportunities/cib/pdf/aapd04_17.pdf; USAID, “AAPD 05-07 USAID Acquisition and Assistance Disability Policy Directive, Supporting USAID’s Standards for Accessibility for the Disabled in Contracts, Grants, and Cooperative Agreements [hereafter AAPD 05-07] (June 16, 2005), business_opportunities/cib/pdf/aapd05_07.pdf.

[14] According to the Directive, such information includes, among other things, advance notification of changes in acquisition or assistance regulations; reminders; procedures; and general information. Also, AAPDs may be used to implement new requirements on short notice, pending formal amendment of acquisition or assistance regulations. AAPD 04-17, supra note 174.

[15] Id.

[16] This language reads as follows:

“USAID Disability Policy - Acquisition (December 2004)

(a) The objectives of the USAID Disability Policy are (1) to enhance the attainment of United States foreign assistance program goals by promoting the participation and equalization of opportunities of individuals with disabilities in USAID policy, country and sector strategies, activity designs and implementation; (2) to increase awareness of issues of people with disabilities both within USAID programs and in host countries; (3) to engage other U.S. Government agencies, host country counterparts, governments, implementing organizations and other donors in fostering a climate of nondiscrimination against people with disabilities; and (4) to support international advocacy for people with disabilities. The full text of the policy paper can be found at the following website:

“(b) USAID therefore requires that the contractor not discriminate against people with disabilities in the implementation of USAID programs and that it make every effort to comply with the objectives of the USAID Disability Policy in performing this contract. To that end and within the scope of the contract, the contractor’s actions must demonstrate a comprehensive and consistent approach for including men, women and children with disabilities.” Id. at 2–3.

[17] Note that the required provision is substantially the same for RFPs and RFAs, but there are terminology differences between acquisitions and agreements that are applied in the required provisions.

[18] See USAID, USAID Acquisition and Assistance Policy Directive (Disability Policy on New Construction) (2005),

[19] Id.

[20] Id.

[21] Id. Note that the required provision is substantially the same for RFPs and RFAs, but there are terminology differences between acquisitions and agreements that are applied in the required provisions.

[22] In a review of 55 RFAs released between February and July 2010, 23 of the RFAs did not include the required disability provision. See USAID Brazil, Mozambique RFA-512-10-000004, Trilateral Cooperation—Food Security (July 7, 2010); USAID RFA-111-10-000004, Support to Armenia-Turkey Rapprochement (July 2, 2010). Further, the disability provision was included in only one of the 10 annual program statements (APSs) reviewed in the same time period.

[23] See USAID Southern Africa RFA 674-10-0051, Support for Integrated Service Delivery (July 7, 2010) (includes Disability Policy provision, but makes no mention of people with disabilities in any other section of the RFA).

[24] “The Agency recognizes that it does not have specific expertise in universal/accessible design. Therefore, the U.S. Access Board, an independent Federal agency devoted to accessibility for people with disabilities, is USAID’s consultative partner in developing and maintaining accessibility requirements and providing technical assistance and training on guidelines and standards. The Access Board and the list of resources included in this document provide additional technical information.” USAID, USAID Policy on Standards for Accessibility for the Disabled in USAID-Financed Construction,

[25] Id.

[26] AAPD 05-07, supra note 181.

[27] Id. at 1(f).

[28] Id. at 1(f)(2).

[29] USAID, ADS Series 300, 302: Acquisition and Assistance, 302.5.14 Supporting USAID’s Disability Policy in Contracts,

[30] See supra note 174.

[31] These reports are available on the USAID website at

[32] USAID, Fifth Report on the Implementation of USAID Disability Policy [hereafter Fifth Report] (December 2008),

[33] Id.

[34] Id. USAID, Fourth Report on the Implementation of USAID Disability Policy (November 2005),

[35] Fifth Report, supra note 187.

[36] d.

[37] Id.

[38] Id.

[39] Id. Note that missions were not specifically asked to report on employment of people with disabilities. The missions that did report decided to include hiring in their self-reporting.

[40] Id.

[41] Consolidated Appropriations Act of 2005, § 579 (a), Pub. L. No. 106-447.

[42] Id.

[43] Id.

[44] “Disability Program Fund,” USAID,

[45] Id.

[46] USAID’s Involvement in Promoting Disability Inclusion, March 8, 2011.

[47] Id.

[48] Id.

[49] Id.

[50] Id.

[51] “We found the understanding of disability issues and its inclusiveness in USAID programs is very low. They have one program focused on medical rehabilitation like providing different artificial and assistive devices to the persons with physical disabilities.” Local advocate interview with USAID personnel, USAID, Nepal.

[52] Personnel from various missions indicated that they had never attended trainings on disability when they were offered. The officers interviewed in Armenia stated that the mission never offered any disability trainings, but they would like to attend such trainings if offered in the future. Further, there was a disability session at the democracy and governance officers training held in June 2010. Only a few people showed up at the session, as the majority of attendees elected to attend a session on “Legislative Web Portals” that was taking place at the same time.

[53] “Their partnership with DPOs for the strengthening and organizational development is almost nonexistent.” USAID interview, Nepal, supra note 206.

[54] Id. Final Write-Up after Interviews.

[55] The officers interviewed in seven missions were not aware of the USAID Disability Policy.

[56] Local advocate interview with USAID personnel, USAID, Serbia.

[57] Local advocate interview with USAID personnel, USAID, Bangladesh.

[58] Review information on file.

[59] USAID West Bank/Gaza, RFA 294-2010-116, Enhancing Palestine Independent Media (Issued May 7, 2010).

[60] USAID Zambia, RFP 611 2011-02, Institutional Support Program; RFP 611 2011-04, Improved Student Effectiveness Program.

[61] Credible documentation of human rights abuses in congregate institutions, including orphanages, psychiatric hospitals, and other facilities, is now ubiquitous and was a major reason that the CRPD reflects the trend against such living arrangements in favor of community-based alternatives.

[62] USAID Caucasus, RFA 114-10-000001, Social Infrastructure Project (February 12, 2010).

[63] Olmstead v. L.C., 527 U.S. 581 (1999).

[64] See generally DRI, Not on the Agenda: Human Rights of People with Disabilities in Kosovo (2002); Human Rights & Mental Health: Mexico (2000); Children in Russia’s Institutions: Human Rights and Opportunities for Reform (1999); Human Rights and Mental Health: Hungary (1997); Human Rights and Mental Health: Uruguay (1995). These reports are available at For a detailed report outlining specific abuses against people labeled with psychiatric disorders, see National Council on Disability, From Privileges to Rights: People with Psychiatric Disabilities Speak Out for Themselves (January 20, 2002) available at

[65] DRI, Hidden Suffering: Romania’s Segregation and Abuse of Infants and Children with Disabilities, romania-May-9-final_with-photos.pdf.

[67] Id.

[68] USAID interview (1), Serbia, supra note 211.

[69] USAID interview, Nepal, supra note 206.

[70] See Lord and Stein, supra note 89.

[71] USAID interview, Bangladesh, supra note 212.

[72] Id.

[73] After meeting with USAID personnel in various missions, many local advocates reported that people with disabilities are not being included in all programs.

[74] Local advocate interviews at USAID in Serbia and Egypt revealed that only disability-specific programs provide accommodations or modifications for people with disabilities. USAID interview, Serbia, supra note 211; local advocate interview with USAID personnel, USAID, Egypt.

[75] USAID interview (2), Serbia, supra note 211. “We did not make such accommodations for the mere fact that there were no handicap people within the beneficiary group of our programs so far. For example, in programs dealing with Serbian media there were no journalists that were handicapped. Also, there wasn’t anyone handicapped, or should I say disabled, in the Ministry of Justice we worked with, at least to our knowledge. So, there was no need to make that type of accommodations or changes.” Id.

[76] Local advocate interview with USAID personnel, USAID, Armenia.

[77] USAID, USAID Evaluation Policy, January 2011, USAIDEvaluationPolicy.pdf “The evaluation policy sets out an ambitious recommitment to learn as we ‘do,’ updating our standards and practices to address contemporary needs. In an increasingly complex operating environment, the discipline of development demands a strong practice and use of evaluation as a crucial tool to inform our global development efforts, and to enable us to make hard choices based on the best available evidence.” Id. at 5.

[78] “Strengthening Monitoring, Evaluation and Transparency,” USAID Forward,

[79] Id. at 5.

[80] CRPD, supra note 9, at art. 31.

[81] Local advocate interview with USAID personnel, USAID, Vietnam.

[82] James W. Conroy, Report of the Independent Evaluator on the Outcomes of the USAID Grant Entitled “Initiative for Inclusion: A Civil Society Support Program for Citizens with Mental Disabilities and Their Families in Kosovo (July 2007) (citing DRI’s original proposal to USAID).

[83] USAID Afghanistan, RFP 306-10-0034.

[84] QDDR, supra note 14, at 104.

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