Disability in Mongolia is still understood and approached through a predominantly medical – rather than social – lens.
Ludovico Carraro, Chris Rayment
Persons with Disabilities (PWD) face significant challenges in being able to enjoy an adequate standard of living and lead independent lives in Mongolia. Barriers that PWD face include, for example, the unavailability of appropriately tailored public services (including social care services and employment services) and a physical environment, including public transport system, which does not take into account mobility challenges and needs.
In partnership with the Population, Teaching and Research Centre, National University of Mongolia and Partnership for Every Child (CEE/CIS Consultancy group), we were contracted by the Asian Development Bank (ADB) to carry out the design of a major project. This project was designed to support the development and implementation of a comprehensive national disability strategy with the aim of shifting the focus from a medical to a biopsychosocial paradigm. The project supported overall strategic reform, with particular attention to a number of key areas:
- disability early diagnosis/assessment;
- social services for PWD including children and orphans;
- access to the physical environment; and
- improving work and employment prospects for PWD.
Despite a number of positive developments in recent years - including adoption of a general plan for the implementation of the United Nations Convention of the Rights of Persons with Disabilities 2013-2016, a new draft law on the rights of people with disabilities, and the development of a national programme on the rights of people with disabilities - a number of key priorities require further attention. These include the way in which disability is perceived, understood, and addressed.
From a conceptual point of view, a medical model of disability prevails in Mongolia. This results in a narrow perspective, often with a focus on the deficits of the individual, rather than on the need to adapt the environment in which the person lives. Furthermore, approaches and methodologies used in the classification and diagnosis of disability are not keeping pace with international research, evidence, and good practice, including the critical importance of early diagnosis and intervention. These and other challenges, including lack of access to public services such as public transport, contribute to serious and long-term implications for PWDs, their families, and caregivers who experience high levels of social exclusion. This includes their ability to participate in the labour market and earn a decent income, thereby perpetuating their dependency on the public purse.
Drawing upon extensive international, regional, and local expertise and experience in policy and public service delivery relevant to PWD, we carried out an intensive situational assessment and consultation process. This involved a wide range of Mongolian stakeholders, including national and local government, NGOs, national Disabled Peoples Organisations (DPOs), and PWD and their families. Given the multi-dimensional nature of the project, we have deployed a highly experienced team of international and Mongolian consultants with wide-ranging technical expertise.
A range of methods were used to achieve the expected outcomes, including primary and secondary qualitative and quantitative research and - reflecting the importance of the maxim at the heart of the international disability movement 'nothing about us without us' - meaningful consultation and engagement with PWD and DPOs. Our approach to research and analysis, and the conceptual framework underpinning project design, was influenced by the International Classification of Functioning (ICF) model of disability. This focuses on identifying environmental barriers to participation and inclusion in relation to a range of medical conditions and levels of functioning.
The key output of the project was a detailed and justified project plan - acting also as a reliable baseline - focusing on five key outcomes:
- strengthened and institutionalised early diagnosis of children with disabilities;
- improved service delivery for PWD;
- improved access to the physical environment;
- improved work and employment prospects; and
- strategic development in support of PWD.
As part of the strategic development, the project looked at:
- development of a communications and public awareness raising strategy, including the production of a short film;
- reforms of the social welfare system;
- ways to implement the use of the International Classification of Functioning; and
- adapting the statistical system to better monitor disability prevalence and the policy impact on PWD.
In light of the strong commitment shown by the government of Mongolia to improve the lives of PWD in the country, and a significant commitment to investment by the ADB, our work should positively impact upon the lives of adults and children with disabilities in a number of ways.
Contributing to the overarching goal of ensuring inclusiveness, and shifting from a medial to a social approach, implementation of the project based on our strategic design work is expected to lead to positive outcomes for PWD in integrated service delivery, physical access through infrastructure and transporation, and work and employment prospects.