Over the last two decades, developing countries particularly those in sub-Saharan Africa have demonstrated a key interest in the design and implementation of social protection schemes as a mechanism for poverty reduction (Handa & Park, 2012).
Social protection is defined as “having security in the face of vulnerabilities and contingencies, it is having access to healthcare and working in safety” (International Labour Organisation, 2010).
Moreover, social protection has been increasingly recognised as a means to reducing not only poverty but also social exclusion (Chapman, 2006).
Social grants or cash transfers are widely regarded as one of the primary tools for implementing social protection programmes (Abbey, Odonkor & Boateng, 2014).
Cash-based social transfers are regular non-contributory money provided by government or donor agencies to individuals or households, aimed at reducing chronic poverty, addressing social risks and economic vulnerability.
Following the success of cash transfer schemes in countries such as Brazil, South Africa and Turkey, Ghana adopted social cash transfer schemes as a means of addressing extreme poverty and reducing inequality.
A key cash transfer scheme in Ghana is the current Livelihood Empowerment Against Poverty (LEAP) programme.
In demonstrating commitment to eradicating extreme poverty and inequality, and protecting the vulnerable and marginalised in society, the government of Ghana in 2008 introduced the LEAP programme as a fundamental component of the country’s National Social Protection Strategy (Ministry of Gender Children and Social Protection, 2016).
The target beneficiaries of the LEAP programme are extremely poor households.
The Ghana Statistical Service defines extreme poverty as those whose standard of living is insufficient to meet their basic nutritional requirements even if they significantly devoted their entire consumption budget to food (Ghana Statistical Service, 2014).
This definition is in line with the United Nation’s view of extreme poverty as a condition constituted by severe deprivation of basic human needs such as food, healthcare, education, information, safe drinking water, and sanitation facilities (United Nations, 1995).
According to Handa and Park (2012), beneficiary households of LEAP are often poorer than the national rural poverty average, with 51% of beneficiaries falling below the national (upper) poverty line.
The specific eligibility criteria of the LEAP programme include households with members in at least one of the following demographic groups: orphans/ vulnerable children, pregnant women and children from 0 to 1 year old, persons who are 65 years or older without support, and persons with severe disabilities without productive capacity (LMS, 2020).
Needy households are selected based on consideration of poverty status and presence of any one of the above categories of vulnerable groups (Gbedemah, Jones & Pereznieto, 2010).
Selection of beneficiary communities is done by a national LEAP implementation committee which has been put in place which selects communities within a district using district poverty maps as eligible beneficiary communities.
At the community level, a Community LEAP Implementation Committee (CLIC) is tasked with carrying out a selection of households that meet the LEAP membership eligibility criteria, with potential beneficiaries later verified with a proxy means test before registration or certification as LEAP beneficiaries.
According to Owusu-Addo (2016), the LEAP programme has achieved tremendous impact such as improved child nutrition, education, access to healthcare, improved emotional and social well-being.
In another study, Handa et al (2014) found that the LEAP programme has contributed to an increase in access to secondary schooling as well as improving the quality of access to education at all levels.
Studies also show that strong impacts on enrolment to the National Health Insurance Scheme (NHIS) have also been recorded among LEAP beneficiary households (Handa et al., 2016a).
However, there remain challenges related to the inclusiveness of the LEAP programme, specifically regarding the inclusion of persons with disabilities. This reform proposal explores ways of making targeting mechanisms related to the LEAP programme disability inclusive.
It establishes a rationale for proposed reform, a description and justification of proposed changes. It concludes with an action plan that highlights financial, human and technical resources required for the proposed reform to the current LEAP targeting mechanism.
Rationale for proposed reform
Persons with disabilities currently constitute an estimated 14% of LEAP beneficiaries (Ministry of Gender Children and Social Protection, 2016), despite being 3% of the total population of Ghana (Ghana Statistical Service, 2014).
Anecdotal evidence suggests that the current LEAP targeting mechanism as limited as it does not widely cover persons with disabilities. The LEAP beneficiary targeting mechanism specifically targets persons that are considered ‘having severe disabilities and lacking productive capacity’.
This eligibility criteria specific to persons with disabilities raises pertinent questions. For instance, who or what categories of persons with disabilities are considered as having severe disabilities? How is severe disabilities determined? In the absence of clarity by the LEAP Management Secretariat, the concept of ‘severe disabilities’ as the basis of eligibility, is up for debate.
Moreover, it can be deduced that the current LEAP beneficiary targeting mechanism does not provide any definition of disability, neither does it indicate disability assessment as the requirement for eligibility and enrolment onto the programme.
The current identified shortfalls in the LEAP beneficiary targeting process particularly related to persons with disabilities contravenes Article 28 of the Convention on the Rights of Persons with Disabilities (CRPD).
Article 28 of the CRPD requires state parties to recognise the right of persons with disabilities to social protection and the enjoyment of such right without discrimination on the basis of disability (MacKay, 2006).
To this extent, it could be argued that the limited scope of the current LEAP beneficiary targeting mechanism is discriminatory as it does not cover all persons with disabilities but rather those with severe disabilities.
Besides, beneficiaries of the LEAP programme including persons with severe disabilities are selected on the basis of a means proxy test, rather than a standard disability assessment to define eligibility (Ministry of Gender Children and Social Protection, 2016).
As a result, it could be argued that using household or individual characteristics to correlate with welfare levels may not necessarily reflect the situation of persons with disabilities in Ghana.
This reform proposal therefore seeks to address the shortfalls in the current LEAP beneficiary targeting mechanism by suggesting key changes targeted at ensuring disability-inclusion in cash-transfer schemes, specifically the LEAP programme in Ghana.
It is envisaged that the proposed changes or reforms will improve the current beneficiary targeting mechanism, and possibly be useful to other countries in sub-Saharan Africa that have implemented similar cash-transfer schemes.
Description and justification of proposed key reforms
The proposed reforms to the current LEAP beneficiary targeting mechanism are summarised as follows: conduct disability needs assessment; determination of disability status/disability assessment; and inclusive and community-led LEAP beneficiary targeting.
With regards to the conduct of disability needs assessment, although the present LEAP programme conducts a needs assessment as part of the beneficiary targeting and selection process, it is rather a generalised one and not specific to persons with disabilities.
It is therefore proposed that as part of the LEAP beneficiary targeting, there should be a needs assessment specific to persons with disabilities to assess the disability situation and experiences of persons with disabilities at the community level.
Moreover, a disability-specific needs assessment will be crucial towards establishing the poverty situation of persons with disabilities, their productive capacity, as well as economic opportunities that cash transfers from the LEAP programme could be channeled into.
In addition, it is proposed that eligibility of persons with disabilities as potential LEAP beneficiaries should be defined on the basis of disability status using the Washington Group Short Set of Questions, rather than by virtue of ‘severe disability’ or by proxy means test questionnaire.
Significantly, the Washington Group Short Set of Questions is designed to identify persons with disabilities and comprises questions on six core functional domains: seeing, hearing, walking, cognition, self-care, and communication.
On this basis, it is proposed that all persons with disabilities that qualify or are identified using the Washington Group Short Set of Questions should be eligible for cash transfers through the LEAP programme.
Finally, it is proposed that the LEAP beneficiary targeting process or mechanism should be a community-led process, rather than the current arrangement where Community LEAP Implementation Committees (CLICs) are tasked with carrying out a selection of households that meet the LEAP membership eligibility criteria.
In the proposed change, the LEAP Management Secretariat, District LEAP Implementation Committees (DLICs), and CLICs, in consultation with village authorities, will convene a public community meeting where targeting criteria will be agreed upon. Persons with disabilities will be invited and encouraged to participate in the community meeting.
The writer is the National Co-ordinator of Inclusion Ghana and a graduate student at the Faculty of Law, University of Pretoria.