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Social Protection and Disability in Zambia

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Social Protection and Disability in Zambia Social Protection and Disability in Zambia Stephen Kidd, Lorraine Wapling and Krystle Kabare Working Paper: October 2019 Development Pathways Limited 5 Kingfisher House Crayfields Business Park New Mill Road Orpington BR5 3QG United Kingdom Tel. +44 (0) 1689 874764 Email: [email protected] http://www.developmentpathways.co.uk Twitter: @DevPathways This material has been funded by UK aid from the UK government; however the views expressed do not necessarily reflect the UK government’s official policies. i Acknowledgements Acknowledgements This report comprises one component of the DFID-financed study “Leaving no-one behind: how social protection can help people with disabilities move out of extreme poverty.” This study incorporated a visit to Zambia between 31st October – 4th November 2016 by Stephen Kidd, Lorraine Wapling and Krystle Kabare during which they undertook a range of interviews and focus group discussions. It was complemented by a review of the literature and some limited analysis of administrative data. Daisy Sibun led on the design and finalisation of the report. The team would like to thank all those who gave their time to be interviewed and also helped in setting up meetings. We are particularly grateful for the support given by the Ministry of Community Development and Social Services and the local office of the International Labour Organisation. Since this report was written, Krystle tragically passed away and is greatly missed by everyone at Development Pathways. Stephen and Lorraine would like to record their debt to the great work that Krystle did on this project and her contributions to the report. It was a real pleasure to work with her in Zambia where her enthusiasm and commitment shone through. ii Table of Contents Table of Contents Acknowledgements ii List of Acronyms v 1 Introduction 1 2 Contextual Analysis 2 3 Description of the National Population of Persons with Disabilities 4 4 Challenges Faced by Persons with Disabilities 9 5 The Legislative and Policy Framework on Disability 12 6 Governance of Disability and Social Protection 13 7 Disability Classification 15 8 Overview of the National Social Security System 20 8.1 Civil Service Pension 20 8.2 Contributory schemes 20 8.2.1 NAPSA 20 8.2.2 Worker’s Compensation Fund 21 8.3 Social Cash Transfer Programme 21 9 Evolution of Zambia’s Social Cash Transfer Scheme 22 9.1 Inclusive 10 per cent model 22 9.2 Universal pension 22 9.3 Child Grant 23 9.4 Multiple Categorical Targeting Grant 23 9.5 Dependency ratio 24 9.6 Disability and old age benefits for households 26 9.7 The political economy of the evolution of the SCT 28 10 Access to the Social Cash Transfer Scheme 29 10.1 Exclusion by the disability assessment 29 10.2 Exclusion by the proxy means test 31 10.3 Exclusion as a result of the household benefit 34 iii Table of Contents 10.4 Exclusion during registration for the SCT 35 10.5 Exclusion from the double benefit for persons with disabilities 37 10.6 Payments 39 10.7 Complaints mechanism 39 10.8 Monitoring and evaluation 40 11 Conclusion 41 Annex 1 Disability Medical Assessment Form 43 Annex 2 Results of the Registration Process in Chongwe District 50 Bibliography 51 iv List of Acronyms List of Acronyms CWAC Community Welfare Assistance Committee DMIS Disability Management Information System DSW Department of Social Welfare DSWO District Social Welfare Officers GDP Gross Domestic Product ILO International Labour Organization MCDSW Ministry of Community Development and Social Welfare MCTG Multiple Categorical Targeting Grant MIS Management Information Systems NAPSA National Pension Scheme Authority OPM Oxford Policy Management PCA Principal Component Analysis PMT Proxy Means Test SCT Social Cash Transfer ZAPD Zambia Agency for Persons with Disabilities v 1 Introduction 1 Introduction This report comprises one component of the DFID-financed study “Leaving no-one behind: how social protection can help people with disabilities move out of extreme poverty.” It is one of seven country case studies to identify good practice in enabling the inclusion of persons with disabilities in social protection systems and programmes. The research aims to address the gaps in knowledge in the design and delivery of social protection for persons and find examples of good practice that can be used to improve policies and programmes so that social protection in developing countries can become more disability sensitive. The study is being undertaken by Development Pathways. The report presents findings from a short study in Zambia to examine its social protection system and programmes and identifies the challenges faced by persons with disabilities in accessing them. The study was undertaken by a visit to Zambia between 31st October – 4th November 2016 by Stephen Kidd, Lorraine Wapling and Krystle Kabare during which they undertook a range of interviews and focus group discussions. The study was supported by a review of the literature and some limited analysis of administrative data. The report begins by discussing the broader context of Zambia particularly around issues of education, health and consumption dynamics in Section 2. A detailed description of the national population of persons with disabilities is presented in Section 3, while Section 4 unpacks key challenges faced by persons with disabilities. The legislative and policy framework on disability in Zambia is discussed in Section 5 followed by Section 6 that looks at the governance of social protection and support for persons with disabilities. Section 7 details the disability classification system and an overview of the social protection system is presented in Section 8. Section 9 examines the evolution of the Social Cash Transfer while access to the scheme by persons with disabilities is considered in Section 10. Section 11 provides a conclusion and presents the recommendations of this report. The team would like to thank all those who gave their time to be interviewed and who supported the set-up of meetings and roundtable discussions. 1 2 Contextual Analysis 2 Contextual Analysis Zambia is a lower-middle income country with an estimated population of 15.5 million people: 58 per cent of the population reside in rural areas while 42per cent inhabit urban areas.1 Although progress has been made by the Government of Zambia to develop and implement measures to improve the overall quality of life for its citizens, the high prevalence of HIV/AIDS, the disease burden, the high levels of poverty and vulnerability and a poor macroeconomic situation remain a hindrance. Economic growth has recently slowed down: a GDP growth rate of 4.9 per cent in 2014 fell to 3.6 per cent in 2015.2. The national poverty rate is high, at 60 per cent in 2015.3 Poverty is highest in rural areas, where the poverty rate was 76.6 per cent, compared to 23.4 per cent in rural areas. Figure 1 shows the distribution of urban and rural households across wealth quintiles. However, the poverty line is only ZMW 6.10 per day (US$0.61), which is particularly low and, indeed, around 80 per cent of the population are subsisting on less than ZMW 10 (US$10) per day. In fact, only 3-4 per cent of the population has daily per capita consumption above ZMW 32.20 (US$3.24) per day. Taking into account that household incomes are likely to be highly dynamic – rising and falling as households take advantage of opportunities or experience shocks and crises – the vast majority of the population should be considered as living in poverty or insecurity (and, therefore, in need of social protection). Furthermore, inequality is very high, with a Gini Coefficient of 0.69.4 Figure 1: Minimum income per day across population Middle class ZMW 32.20 Insecurity Poverty Extreme poverty Source: OPM (2013). [Adapted using LCMS 2010 findings and World Bank consumption aggregates] 1 Central Statistics Office (2015). 2 World Bank (2016). 3 OPM (2013). 4 Central Statistics Office (2015a). 2 2 Contextual Analysis Indicators of wellbeing are problematic across a range of other areas. The rate of stunting among young children is high, with around 40 per cent affected, which is higher than many poorer countries. However, as Figure 2 indicates, there has been a significant reduction since 2001/02.5 The under-5 years mortality rate still stands at 75/1,000, but that is a reduction from 168/1,000 in 2001/02.6 The vast majority of the population has attended some form of education – around 16 per cent of females and 12.7 per cent of males have not accessed any form of education, but a high proportion of the population only has some level of primary education: 46.2 per cent of the national female population and 42.7 per cent of the male population. HIV prevalence rates among adults aged 15-49 years remain high but have slightly decreased over time from 15.3 per cent in 2001-02 to 13.4 per cent in 2013/14.7 Figure 2: Stunting and wasting trends 60 53 50 49 46 45 40 40 30 20 Percentage of children 10 6 5 6 5 6 0 1992 1996 2001/2 2007 2013/14 Stunting Wasting Source: OPM (2013). [Adapted using LCMS 2010 findings and World Bank consumption aggregates] Persons with disabilities live within this broader challenging and disabling environment and the national disabled population and the challenges they face are described in the following two sections. 5 OPM (2013). [Adapted using LCMS 2010 findings and World Bank consumption aggregates] 6 Ibid 7 Central Statistics Office (2015b). 3 3 Description of the National Population of Persons with Disabilities 3 Description of the National Population of Persons with Disabilities Zambia has been collecting disability data in its census since 1969 but the way it has been defined has varied considerably, making direct comparisons over time impossible.
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