PROGRAM BRIEF 1 Allowances for the Financially Insolvent Disabled A significant share of people are affected by disabilities in Bangladesh – some studies find that People with Disabilities (PWDs) constitute 7 percent of the population of Bangladesh,i or almost a third of households have one member or more with disabilities.ii Disability and poverty constitute a vicious cycle, each fueling the other through generations. The country’s cost of disability is estimated at about 1.74 percent of its GDP.iii Most PWDs live in rural areas and a majority are women who suffer from additional disadvantages of poor access to suitable services and facilities. Allowances for the Financially Insolvent Disabled aim to provide poor PWDs with cash transfers to improve their socio-economic wellbeing. 1 The Program Brief series discusses major safety net programs that the Government of Bangladesh implements. The series includes notes on the Old Age Allowance; Allowances for the Widow, Deserted and Destitute Women; and Allowances for the Financially Insolvent Disabled by the Ministry of Social Welfare; Employment Generation Program for the Poorest; Food for Work; Work for Money; Test Relief; and Vulnerable Group Feeding by the Ministry of Disaster Management and Relief; and the Child Benefit Scheme. Many of these programs are supported by the World Bank. 1 Allowances for the Financially Insolvent Disabled PROGRAM BRIEF BACKGROUND Disability is an important dimension of Bangladesh’s poverty. A Bangladesh. The approach has increasingly integrated medical significant share of people is affected by disabilities in Bangladesh and occupational rehabilitation services. For instance, the and many of them live in poverty with limited means of living. In Ministry of Social Welfare (MoSW) operates 103 physiotherapy addition to economic disadvantages, people with disabilities facilities which are operated by the Jatiyo Protibondhi Unnayan (PWDs) also suffer from social stigma and exclusion. Studies Foundation (JPUF) and provide physical, occupational, speech suggest that many people in Bangladesh tend to believe that therapy; hearing and vision tests; and devices and mobility aids for disability is a curse or punishment for wrongdoings and therefore free. Out of these, 50 facilities were supported by the World Bank a cause of embarrassment to the family.iv Stigmatization continues (Disability & Children at Risk Project). In addition, the National to prevail and affect PWDs’ rights and access to education, health Forum of Organizations Working with the Disabled (NFOWD) care and other basic services and facilities. Disability in young was also formed to promote PWD’s rights and provide guidance children are often unreported and those of adults are regarded to organizations working with PWDs. Some Government and as social burden, having a devastating psychological impact on NGO initiatives also exist on building vocational skills of PWDs PWDs. including children affected by disabilities, to help them become contributing members of society. Women are significantly more disadvantaged. A woman with the same level of disability as a man may be considered more Despite numerous Government and NGO initiatives, and disabled, and her access to education, health care and chance supportive policies, the quality of services varies, and coverage of marriage are much lower. Women and girls with intellectual is very limited. Due to poor accessibility and low awareness, disabilities are particularly more vulnerable to sexual abusev some rehabilitation and health care resort to traditional healers and child marriage.vi Children with disabilities are neglected by especially in rural areas.x While all matters related to disability is families, get less food and clothing than others of the same age, the responsibility of MoSW (as per the Rules of Business of the and their education and health needs may be ignored. Government of Bangladesh), involvement of other ministries including the Ministries of Primary & Mass Education, Education, In recognition of such daunting challenges, the Government Health and family Welfare is crucial for better services for PWDs. and Non-Governmental Organizations (NGOs) have been This requires more efforts for policy coordination. implementing some health and education servicesvii as well as rehabilitation servicesviii for PWDs. There are advocacy efforts In addition to the provision of services described above, the related to co-education among students with and without Government of Bangladesh also provides the Allowances for the disabilities, and to develop skilled teachers and disability- Financially Insolvent Disabled (Disability Allowances [DA]). The appropriate materials (e.g. syllabi, braille content). A number of Department of Social Services (DSS) under MoSW implements institutions also work on identifying training and rehabilitation this program alongside other cash transfers – including the Old needs as well as developing human resources for working with Age Allowance and Allowances for Widow, Destitute and Deserted the disabled.ix At the same time, the Government provides Women (Widow Allowance) – which target particularly vulnerable financial support to students with disabilities, through a Disabled and marginalized groups. The objective of the program is to Students’ Stipends scheme. provide basic income support to PWDs living in poverty. A large number of Government, NGOs and private organizations work in the Community-Based Rehabilitation (CBR) approach in 2 PROGRAM BRIEF KEY FEATURES OF THE ALLOWANCES FOR THE FINANCIALLY INSOLVENT DISABLED The DA began in Bangladesh in FY06 with around 100,000 beneficiaries at a monthly allowance of BDT 200 (US$ 2.9 as of FY06 FY19 FY06). As of FY19, the number of beneficiaries is 1 million and the monthly allowance BDT 700 (US$ 8.5). Table 1: Key features of the Disability Allowance (DA) 100,000 1 million beneficiaries at a beneficiaries at a monthly allowance of monthly allowance of Number of beneficiaries 1 million BDT 200 BDT 700 Amount of monthly BDT 700/ US$ 8.5 (US$ 2.9) (US$ 8.5) allowance Eligibility Means-tested and disability- based targeting Agency Department of Social Services, Ministry of Social Welfare Since the beginning of the program in FY06, the number of beneficiaries has multiplied almost eight times and the amount of benefit per beneficiary has increased almost four times cash transfers for vulnerable populations such as the Old Age (figure 1). The pace of increase is much faster than that of other Allowance (OAA) and Widow Allowance (WA) under the DSS. Expenditure on the DA has rapidly increased (figure 2), and currently constitutes 1.3 percent of the country’s social Beneficiary Allowance (BDT) protection budget and 0.03 percent of the GDP. 1.20 800 700 1.00 600 1.00 Monthly Allowance 600 DA Beneficiaries 10 0.80 500 0.83 (million) 8.40 Budget in BDT billion 8 0.60 0.65 400 250 300 6.93 220 6 0.40 200 0.40 5.40 0.31 200 4 0.20 0.29 3.60 0.20 0.26 0.00 0.10 0.17 0 2 0.60 1.03 2.40 1.32 0 0.94 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19* Figure 1: Growth of beneficiaries and benefits under DA Source: DSS, MSW http://www.dss.gov.bd/site/page/a8c37128-200f-4cfe-9836- Figure 2: Annual Expenditure for DA, FY09 – 19 (*budgeted) 1d1ac7737e91/Am”Qj-cÖwZeÜx-fvZv Source: Budget Archive, Financial Division, Ministry of Finance 3 Allowances for the Financially Insolvent Disabled PROGRAM BRIEF PROGRAM DETAILS The objectives of the DA specified in the Government’s policies • Administrative – DSS has one staff, the Union Social Worker and rules include: (USW) at the union level, tasked with administering all programs of DSS in that union. Carrying out meaningful awareness • To comply with constitutional and legal commitments; campaigns therefore becomes difficult. • To promote socioeconomic development; In reality, communities gather information on the needs of safety • To ensure the inclusion of insolvent PWDs under social nets from informal channels, including Ward Members (who are protection; locally elected representatives) and villagers acquainted with • To provide monthly allowances to beneficiaries selected in Government officials. It is noted by evaluations of similar other compliance with implementation guidelines by responsible programs implemented by DSS that greater awareness activities authorities; and would help improve targeting and reduce scope for leakage. • To mainstream affairs related to PWDs in the national workplan. 2) Eligibility Criteria and Intake As stated in the implementation guidelines of the DA, beneficiaries 1) Outreach are selected based on the following eligibility criteria: According to the implementation guidelines of the Program, • Registered PWDs: in accordance to the definition of disability widespread awareness campaigns should be carried out to invite stipulated in the Persons with Disabilities Welfare and Protection applications for the DA, and to gather community members and Act 2013, and registered as a PWD in the area of residence; conduct community vetting to finalize the list of beneficiaries. The Upazila Executive Officer (UNO), Assistant Commissioner • Residency: Permanent resident of the area; (Land), Officer-in-charge (OC) of the local police station, local • Minimum age in years: At least 6; and NGOs and mass media are expected to be present as observers • Annual income: less than BDT 36,000 (US$ 439). at the community gathering. The guidelines are not clear about the frequency of such campaigns. In reality, however, awareness Eligible applicants shall be prioritized if they are: campaigns are limited to announcements through local mosques • among the oldest of applicants; and some ‘mic-ing’, if at all, especially ahead of a payment cycle. • affected by multiple disabilities; Awareness campaigns to invite applications are rare, mostly due • children with intellectual disability or autism; to the following reasons: • women; • Limiting expectations – The DA continues to be a means- • landless (own less than 0.5 acre) and/or destitute; and tested, targeted program with budget limitations. Widespread • extreme poverty stricken or live in remote areas. awareness about the Program may invite a large number of applications, every year, beyond the ability of the DA to enroll An applicant shall be considered ineligible if he or she is and provide for. The DA has a list of beneficiaries that continues employed in a Government or private organization; receives to be used on a rolling basis year after year until a beneficiary’s Government pension or regular safety net benefits or grants death is reported or the Government announces an increase in from the Government, NGOs or any other source. Participation the number of beneficiaries through annual budget increments. of multiple members of the same household is not specifically • Financial – Dedicated budget allocations for awareness limited in the implementation guidelines, and, considering the generating activities are largely absent at the union level. nature of vulnerability, a multiple-benefit-per-household practice is in place. THE WORLD BANK 4 PROGRAM BRIEF The implementation guidelines of the DA delineate the process of According to the guidelines, the program can set aside up to 10 inviting applications and selecting beneficiaries as follows (figure 3): percent ‘quota’ for areas affected by natural disasters, extremely poor, hard-to-reach or ‘backward’ regions and any other emergency. Step 1 Registration A few challenges affect appropriate targeting of DA. The Deputy Director (DD) or Upazila Social Service Officers (USSOs) (rural) and District Social Service Officers (DSSOs) • Registration of PWDs: Following the ratification of the Person (urban) shall register all PWDs living in that district and with Disabilities Rights and Protection Act, 2013 and the maintain a registration book. Neurodevelopmental Disability Protection Trust Act 2013, the The DD, as the Member Secretary of the District Committee MoSW identified and registered more than 1.5 million persons will provide ID cards to the registered persons. with disabilities primarily through the Disability Detection Survey conducted by DSS and subsequently through self- reporting by potential applicants for the DA. Based on the Step 2 Application information so far from the Disability Information System,xi the following chart (figure 4) presents the types of disabilities. Applications submitted to USSO and DSSO, using the Physical disability affects almost half of those registered. designated form. Though it is encouraging to note that there are initiatives to identify PWDs, it should be noted that the number of registered Step 3 Initial listing of Applicants PWDs represents a very small proportion of the estimated number of PWDsi in the country. Therefore, there is a risk of huge exclusion errors where those who are significantly USSOs and DSSOs prepare ward wise lists of potential disabled, poorest with limited accessibility, and unable to beneficiaries and present them to the Union Committee report themselves, may remain unregistered. and Municipality/City Committee for rural and urban wards respectively. 13 oth Union (rural) and Ward/Municipal % Step 4 ers (urban) Committees’ approvals Union Committee (rural) and Municipal Committee (urban) 12% select potential beneficiaries and send a primary list of multip le eligible beneficiaries from the lists prepared by USSOs and DSSOs to the Upazila Committee. 46% physical Step 5 Upazila Committee’s (rural)/City Corporation Committee’s (urban) approval 8%l tua intellec The Upazila Committee (rural) and the District Committee (urban) finalize the list of potential rural beneficiaries, and 7% ee ch waitlist of potential beneficiaries and seek approval of sp the local Member of Parliament. The committee shall also 14% vision finalize a waitlist. Figure 4: Types of disabilities of DSS registered PWDs in Bangladesh Figure 3: Process of beneficiary selection of DA Source: Disability Information System, DSS, April 2018 Allowances for the Financially Insolvent Disabled 5 Allowances for the Financially Insolvent Disabled PROGRAM BRIEF The second big challenge in terms of identification is the ones from the waiting list. However, beneficiaries can only be registration of women with disabilities. While the National Social replaced in case of any of the following scenarios that make Security Strategy (NSSS) 2015 suggests that a greater proportion them ineligible for the DA: of women are disabled than men, and numerous studies referenced earlier conclude that women’s vulnerability is greater, - Improvement in financial status; over 60 percent of PWDs registered are men. This may indicate - Improvement in disability status; that women have limited accessibility to registration and therefore - Drawing benefits from other Government or NGO programs; are deprived of the allowance and other disability related support - Migration from the area; based on the statistics of the Disability Information System. - Drawing DA from more than one location; and - Death – replacements will be subject to the approval of the Cabinet Committee on Safety Nets. The above conditions for replacement, except death, are in most cases very difficult to verify unless self-reported or 11.2 million PWDs in Bangladesh confirmed by local leaders. These are also often subjective and can be misused as influential people wrongly report change in circumstances of existing beneficiaries to make space for new entrants they want to favor. Compared to OAA and WA, fewer assessments for DA have been conducted and detailed insights on how well targeting, enrolment 1.5 million and payment functions perform are not documented. However, PWDs registered given that the OAA, WA and DA are similar programs implemented by the same agency in the same context, the DA mostly likely faces similar challenges as discussed further below. 3) Enrolment Poverty eligibility Within seven days of the approval of the final list of beneficiaries, and budget the USSOs and DSSOs are expected to issue a ‘passbook’ to each beneficiary, with the beneficiary’s photo attested by a Government official and beneficiary ID number, and arrange to open the beneficiary’s account with a bank designated to provide payments for DA – currently, Sonali, Janata, Agrani, Bangladesh Krishi Unnayan and Rajshahi Krishi Unnayan Banks. The beneficiary account number shall be labelled ‘Disabled’ for ease of identification. At the same time, the USSO/DSSO shall 0.825 million also maintain a register of the list of beneficiaries of DA and it PWDs receive DA should be updated every quarter. 4) Payment The beneficiary payment process under DA has two parts • Replacement – While the program continues with the same like other cash transfer programs: cash-in (from treasury to list, there is however some annual change due to increase in individual’s bank account) and cash-out (cash withdrawal from budgetary allocations and the demise of existing beneficiaries. individuals’ bank account). The cash-in process starts with the According to DSS, about 10-15 percent of beneficiaries are new release of funds from MoSW followed by Treasury allocation to due to replacements or additions. The program guidelines (State-owned) Sonali Bank for the amount of benefit payments have provision for the replacement of beneficiaries with new budgeted for a quarter. Sonali Bank then transfers the funds to THE WORLD BANK 6 PROGRAM BRIEF four other state-owned banks and each of these five banks then transfer funds to their upazila or district branches based on advice from DSS. At the local branches, the funds are MoSW approves fund deposited in an account, jointly administered by UNO and release USSO for rural areas; Deputy Director (DD), Social Services and DSSO for urban areas. Based on the list of beneficiaries received from the USSO and DSSO, the local bank branch then transfers benefits to individual beneficiary accounts. With these layers of processes, the entire cash-in process DSS issues bill to Chief (figure 5) often takes months every quarter. Accounts Officer (CAO) The cash-out process involves the physical presence of beneficiaries arriving at the bank branch with their passbooks. In case a beneficiary is unable to come due to sickness, disability or reasons associated with social norms, CAO issues check for each program a nominee can collect the payment, authorized by a locally elected representative for every payment cycle. Following the death of a beneficiary, the nominee can also collect payments for three months (including the month of death) to facilitate funeral expenses. Treasury allocates check amounts to Even though beneficiaries can draw benefits any day in Sonali Bank theory, the practice is not encouraged by local banks to manage transaction schedules and plan workload. They designate specific days to issue payments to beneficiaries, each quarter. The withdrawal date is announced through Sonali Bank divides the words of mouth from USSOs, USWs and others involved. amount and transfers to However, with a large number of beneficiaries per union the head offices of each (approximately 500 on average), not all beneficiaries queuing payee bank up for payment may be served on the same day and many of them have to return the next day, inflicting additional financial costs and physical exertion. Long queues also mean that beneficiaries have to wait several hours with little or no Each payee bank transfers food, and no place to rest, which may be a significant burden funds to upazila branches, in to elderly PWD beneficiaries. the acocunt jointly administered by the USSO/UNO or DSSO/DD. Such capacity constraints and manual processes also hamper banks’ ability to verify beneficiary details while issuing payments, sometimes resulting in erroneous payments. The timely update of payment records is also The local branch transfers lacking, which makes it difficult for beneficiaries to collect funds to individual allowances for payment cycles they have missed to appear beneficiary accounts based for. Moreover, reconciliation hardly takes place and DSS is on list from USSO from the joint account not refunded the leftover amount due to banks’ inability to account for how many beneficiaries have actually collected payments. Such constraints could create systemic loopholes for leakage and scope for rent seeking by those involved in the payment process. Figure 5: Payment (cash-in) process of DA Allowances for the Financially Insolvent Disabled 7 Allowances for the Financially Insolvent Disabled PROGRAM BRIEF 5) Grievance increasing the number of payment access points, closer to Complaints – typically regarding eligibility criteria and payment where beneficiaries live; and also to be a more accountable and accuracy and timing -- can be filed with the Union Committee. secure system including a more trustworthy and convenient However, this indicates a serious conflict of interest given that nomination process. In case of digitized payment systems, these committees are the ones that undertake the primary biometric authentication may be a challenge if the specific selection of beneficiaries. If the Committee fails to come up with disability has implications on authentication (e.g., finger print a mitigation measure, the grievance shall escalate sequentially authentication of a beneficiary who has no hands), and thus upto the central level; though the implementation guidelines customized provisions must be worked out. do not define specific procedures. Anecdotal evidence suggests • The grievance process can be strengthened to be more that complaints are few and those filed are usually lodged with accountable and provide reassurance to potential complainants Ward Members or Union Chairmen with little evidence of their about timely resolution and minimal chances of backlash. resolution. According to the NSSS, the Government’s schemes for PWDs, including the DA, a scheme for injured Freedom Fighters and PROGRAM OUTCOMES some special schemes for autistic children and disabled girls, cover only a small number of eligible people. While disability It is expected that similar to OAA and WA, the DA would help poor affects a very large number of working age population, the households improve consumption of food and health care, as existing schemes are not sufficient. well as social esteem. Anecdotal evidence suggests that access to DA also leads to other types of disabilities support including the The NSSS envisages that the MoSW will consolidate existing use of disability centers. However, the investigation of the impact programs in the near future for improved support to PWDs and of DA on beneficiaries’ wellbeing remains as an important area of better alignment with the life cycle approach, and recommends future research. the following: • A Child Disability Benefit for all children with disabilities, up to 18 years of age – where approximately 350,000 children with CHALLENGES AND WAY FORWARD disabilities will be supported and the cash will be provided to The DA has been an important initiative towards supporting the female care giver of each child. A holistic support system insolvent PWDs and has most likely yielded some outcomes including helping street children with disabilities will be despite the low level of benefit. Nevertheless, certain challenges developed around this scheme. continue to affect program’s outcomes as summarized below: • A Disability Benefit for all adults with severe disabilities, aged • The identification of PWDs depends on self-reporting by PWDs 19-59 years – where approximately 1.15 million PWDs will be which may eliminate many due to poor access of the most supported. A significant expansion of the current scheme i.e. vulnerable ones, including women and the severely disabled DA, is envisaged under this, but the scheme will be directed and old, to the Social Services Offices. At the same time, children to those with severe disabilities only. The scheme will also with disabilities aged under six years fail to benefit from the work towards improved access of PWDs to the labor market program. including access to vocational skills, jobs and finance to invest in small business. • The insolvency eligibility assessment has scope to be more objective and pro-poor. • Transition to the OAA once a PWD benefiting from an existing disability scheme reaches the eligible age for the OAA. • The payment process has scope for more efficiency and transparency, to enhance the convenience of the PWDs, by 8 PROGRAM BRIEF WORLD BANK SUPPORT The World Bank supported the Disability and Children-At-Risk The World Bank continues to support MoSW, in recognition of Project up until June 2016. The Project provided assistance the need to strengthen the administrative aspects of DA. In this to the Government of Bangladesh to establish and operate 50 regard, the Cash Transfer Modernization Project was approved by Disability Service Centers (DSCs), as well as equip additional 53 the Bank’s Board of Executive Directors in January 2018. DSCs. These facilities provided access to counseling, diagnostic, The Project aims to improve the transparency and efficiency and treatment services to 150,000 PWDs, among whom about 40 of DA and other major cash transfer programs for vulnerable percent were female. Upon the closure of the Project, DSCs and populations by modernizing service delivery. The Project mobile van therapy services were mainstreamed under the MoSW provides technical assistance to DSS and financial support for the alongside services financed by the revenue budget. OAA. i Household Income Expenditure Survey (HIES), 2016 ii National Social Security Strategy, 2015 iii Ali, Zulfiqar, Bangladesh Development Studies, Vol. XXXVII, December 2014, No. 4, Economic Costs of Disability in Bangladesh iv Haque, Shahidul, and Shahnaz, Begum. Feelings on Disability Issues in Bangladesh. Dhaka: SARPV. 1997; Unicef, 2014, Situation Analysis on Children with Disabilities in Bangladesh v Danish Bilharziasis Laboratory, for the World Bank, May 2004, Disability in Bangladesh: A Situation Analysis National Grassroots and Disabilities Organization (NGDO), National Council for Women with Disabilities (NCDW) & Bangladesh Legal Aid and Services Trust (BLAST), 2015, Current status of Rights of vi Persons with Disabilities in Bangladesh: Legal and Grassroots Perspectives 7 schools for the hearing impaired, 5 for the visually impaired, 1 for the intellectually impaired run by the Government; National Center for Special Education (NCSE), Society for the Welfare of the vii Intellectually Disabled, Bangladesh viii Impact Foundation Bangladesh, BNSB, CRP, ABC, BDF, Pangu Shishu Niketan (Disabled Children’s Home), Bangladesh Protibandhi Kallyan Somity (BPKS), AWDP, HICARE, DRRA, CDD and VHSS ix National Center for Special Education (NCSE), Centre for Disability in Development (CDD) x Japan International Cooperation Agency, March 2002, Planning and Evaluation Department, Country Profile on Disability xi https://www.dis.gov.bd/en/ For more information: Overview on Bangladesh’s safety net program: This Program Brief has been prepared World Bank. 2016. Bangladesh Social Protection by Rubaba Anwar, Yoonyoung Cho https://bit.ly/2RM7hXi and Ashiq Aziz, Social Protection & https://bit.ly/2stPrtU and Labor Review: Towards Smart Social Protection Jobs Global Practice, World Bank, with and Jobs for the Poor. Bangladesh Development the kind support of the Korea-World Series,no. 33;. World Bank, Dhaka, Bangladesh. Bank Partnership Facility (KWPF). © World Bank. https://bit.ly/2TWVVx9 World Bank Office Dhaka Plot- E-32, Agargaon, Sher-e-Bangla Nagar Dhaka-1207, Bangladesh Tel: 880-2-5566-7777, Fax: 880-2-5566-7778 www.worldbank.org/bangladesh 9