LITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY IN ZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA LITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY IN ZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA 2024 INCLUSION DISABILITY FROM PEOPLE WITH DISABILITIES IN TANZANIA EXPERIENCES AND RECOMMENDATIONS SION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION I 2024 INCLUSION DISABILITY FROM PEOPLE WITH DISABILITIES IN TANZANIA EXPERIENCES AND RECOMMENDATIONS TABLE OF CONTENTS ABBREVIATIONS 6 ACKNOWLEDGEMENTS 8 © 2024 International Bank for Reconstruction and Development / The World Bank EXECUTIVE SUMMARY 11 1818 H Street NW Washington DC 20433 1. INTRODUCTION 20 Telephone: 202-473-1000 Internet: www.worldbank.org 2. METHODOLOGY 22 3. PREVALENCE DATA FOR DISABILITY IN TANZANIA 26 This work is a product of the staff of The World Bank with external contributions. The findings, 4. LAWS AND POLICIES RELATED TO DISABILITY 32 interpretations, and conclusions expressed in this work do not necessarily reflect the views of The 4.1 International and Regional Commitments 33 World Bank, its Board of Executive Directors, or the governments they represent. 4.2 National Legislative Framework 35 The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work and does not assume responsibility for any errors, omissions, or discrepancies in 4.3 Gaps in Implementation of the Legislative and Policy Framework 19 the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. The boundaries, colors, denominations, and other information 5. AN INTERSECTIONAL UNDERSTANDING OF DISABILITY IN TANZANIA 38 shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. 6. SECTOR WISE CONSTRAINTS 42 Nothing herein shall constitute or be construed or considered to be a limitation upon or waiver of the Inclusive Education 43 privileges and immunities of The World Bank, all of which are specifically reserved. Employment and Livelihoods 47 Social Protection 48 Health 50 Rights and Permissions Accessible Infrastructure and Transport 52 The material in this work is subject to copyright. Because The World Bank encourages dissemination Communications and Information and Communication Technology (ICT) 53 of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Politics and Public Life 54 Any queries on rights and licenses, including subsidiary rights, should be addressed to 7. INSTITUTIONAL LANDSCAPE 58 World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights@worldbank.org. 8. KEY RECOMMENDATIONS 62 Cover photo: ©Judith Matemba / World Bank. Further permission required for reuse. ANNEXES 68 Cover design: Anatol Ursu, https://www.behance.net/olywebart 6 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 7 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities NBS National Bureau of Statistics ABBREVIATIONS OPD Organization of Persons with Disabilities PD - MIS Disability Information Management System PHC Population and Household Census PMO-LYED Prime Minister’s Office Labour, Youth, Employment and Persons with Disability PORALG President’s Office Regional Administration and Local Government PSSN Productive Social Safety Net AIDS Acquired immunodeficiency Syndrome SHIJUWAZA Zanzibar Federation of Disabled People Organizations BRT Bus Rapid Transit System SHIVYAWATA Tanzania Federation of Disabled People's Organizations CCBRT Comprehensive Community Based Rehabilitation in Tanzania SIT Sense International Tanzania CCM Chama Cha Mapinduzi SLI Sign Language Interpretation CHAVITA Tanzania Association of the Deaf SSI Sight Savers International CHAWATA Tanzania Association of the Physically Handicapped STEM Science, Technology, Engineering and Mathematics COBET Complimentary Basic Education in Tanzania TAMH Tanzania Association for Mentally Handicapped CSO Civil Society Organization TASAF Tanzania Social Action Fund DDA Department of Disability Affairs TCRA Tanzania Communications Regulatory Authority DHS Demographic and Health Survey TEPDGHO The Empowerment for Persons with Disability and Gender Health Organization DS Disability Survey TLB Tanzania League of the Blind ESF Environmental and Social Framework TSL Tanzanian Sign Language ESRAC Education Support and Resource Assessment Centers TUSPO Tanzania Users and Survivors of Psychiatry Organization FCS Foundation for Civil Society UK United Kingdom FGD Focused Group Discussions UN United Nations GoT Government of Tanzania UNCRPD United Nations Convention on the Rights of Persons with Disabilities GBV Gender-Based Violence UNICEF United Nations Children's Fund HBS Household Budget Survey UNDP United Nations Development Programme HIV Human Immunodeficiency Virus URT United Republic of Tanzania ICT Information and Communication Technology VP1 First Vice President’s Office IDA International Development Association NPA-VAWC National Plan of Action to End Violence Against Women and Children KII Key Informant Interviews WASH Water, Sanitation and Hygiene INGO International Non-Governmental Organization WG-SS Washington Group Short Set of Questions IPOSA Integrated Programme for Out-of-School Adolescents WHO World Health Organization LFW Light for the World WB World Bank LGA Local Government Authorities ZANAB Zanzibar National Association of the Blind MoEST Ministry of Education, Science and Technology ZNCPD Zanzibar National Council for Persons with Disabilities NAC National Advisory Council ZSSF Zanzibar Social Security Fund 8 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 9 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities acknowledge Andrew Roberts, Senior Social Development Specialist, for offering ACKNOWLEDGEMENTS valuable inputs. The team also notes with deep gratitude the support provided from a vast network of Organizations of Persons with Disabilities, international Non-Governmental Organizations (INGOs) and development partners who gave generously of their time and expertise during stakeholder consultations. It was an honor to highlight their experiences and voices through this report. These groups spanned seven regions in mainland and Unguja and Pemba islands in The report was commissioned by the World Bank Tanzania Gender and Zanzibar. A full list of the organizations consulted is provided in Annex 7. Inclusion Platform under the Tanzania program of the World Bank. The team was led by Tanya D’Lima, Social Development Specialist, M.Yaa Oppong, Lead Social Development Specialist, and Naima Besta, Senior Social Development Specialist. The core team consisted of Makiko Watanabe, Program Leader, Sustainable Development, Dr. Inaam-Ul-Haq, former Program Leader for Human Development, East Africa at the World Bank, Rutachwamagyo Kaganzi, Disability Inclusion Consultant, Jonathan Grabinsky who contributed to report writing and data analysis, and Matilda Kivelege, who supported consultations and provided input to finalize the report. Judith Matemba and Diana Mwaipopo provided administrative support. Other contributors included consultants Kwame Gyamfi Boateng and Peter Binyaruka, and Jacob Obongo, Senior Social Development Specialist. Charlotte McClain Nhlapo, the Global Disability Advisor for the World Bank provided valuable guidance to the team. Matt Zoller and Anatol Ursu assisted in editing and layout. The cover photo was taken by Judith Matemba. The report was prepared in collaboration with the Prime Minister’s Office, Labour, Youth Employment and Persons with Disabilities (LYED) in Tanzania Mainland and the First Vice President’s Office in Zanzibar. The team is especially thankful to Ussy Khamis Debe, Executive Secretary, Zanzibar National Council for Persons with Disabilities. From Mainland, the team extends thanks to Rasheed H. Maftah, Director of Disability, Oliver Njogopa, and Wamburo Kizito, (Senior Social Welfare Officers) and Bruno Mwakibibi, Lin Jocktani,Ismale M. Salehe (Social Welfare Officers) and Suzana N. Mayengo. The team is immensely grateful for the dedication, guidance, and close collaboration with government counterparts. The work was overseen by Helene Carlson Rex, Practice Manager, Social Sustainability, and Inclusion, and Nathan M. Belete, Country Director for Tanzania, Malawi, Zambia, and Zimbabwe. In addition, the team would like to 10 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 11 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ES. EXECUTIVE SUMMARY This report presents the findings of a mixed methods assessment, drawing from stakeholder consultations and from nationally representative household surveys. It aims to provide a deeper contextual understanding of the barriers encountered by persons with disabilities in Tanzania. Persons with disabilities experience difficulties when accessing basic services such as healthcare, employment, education, transportation, and social welfare. It provides recommendations for promoting disability inclusion across sectors. The intended audience is a mix of policy makers, donors, and civil society. The assessment was commissioned by the World Bank (WB) in collaboration with the United Republic of Tanzania (URT), through the Prime Minister’s Office, Labour, Youth Employment and Persons with Disabilities (LYED) in Tanzania Mainland and the First Vice President’s Office in Zanzibar. Photo by Alex Radelich 12 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 13 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities KEY FINDINGS In 2022, 2.6 percent of the population in Tanzania are persons with Tanzania has made some progress on legal protection for persons with disabilities;1 this is in line with estimates from Sub-Saharan Africa (SSA), disabilities, but there are remaining gaps in existing legislation as well as although national prevalence estimates vary due to lack of harmonization in implementation. The URT has ratified and established several legislative in how disability is defined. Females make up 56 percent of persons with frameworks, including the United Nations Convention on the Rights of Persons disabilities.2 The national estimate of disability prevalence used in this report, with Disabilities (UNCRPD), the Persons with Disability Act of 2010 which aims which adopts the international standards espoused by the Washington Group to incorporate the rights set out in the UNCRPD into domestic law, and the 2022 Short Set of Questions (WG-SS), is in line with the 3.2 aggregate prevalence Zanzibar Persons with Disabilities Act No 8 and its regulations in 2023. The 2030 across several countries in SSA.2 The 2022 Tanzania Demographic and Health Agenda for Sustainable Development, adopted by the URT along with all other Survey (DHS) points to decreases in prevalence rates by levels of education. United Nations (UN) Member States in 2015, seeks to empower persons with Comparisons of estimates in the country over time are hindered by lack of disabilities to ensure they are fully and equally able to participate in all spheres harmonization in how estimates are measured. The 2008 Disability Survey (DS) of society. Laws and policies have not been effectively implemented due to estimates that 7.7 percent of the population in the country has a disability – lack of awareness and understanding of existing protections by persons with 7.8 percent on the mainland and 5.9 percent in Zanzibar. The 2012 Population disability and key stakeholders working on the disability agenda, by inadequate and Household Census (PHC) suggests a 9.3 percent disability prevalence in knowledge, among legal practitioners and administrators, of international the country – 9.2 in Mainland and 7.3 percent in Zanzibar. Likewise, the United laws and policies critical to safeguarding the rights of men and women with Nations Children’s Fund (UNICEF) 2021 analysis of the 2017/18 Mainland disabilities, and by ineffective implementation mechanisms. Key government Household Budget Survey (HBS) and 2019/20 Zanzibar HBS estimates national stakeholders often also lack inadequate resources to ensure disability initiatives disability prevalence for the mainland at 6.8 percent and 3.2 percent in Zanzibar. are being properly cascaded across all geographic levels (to the district, The challenges facing persons with disabilities are not unique to Tanzania, ward and village levels). The country has adopted several disability-inclusive instead, these are echoed all over the world. According to the 2018 UN Disability legislative commitments, including the 2010 Persons with Disabilities Act, and Development Report, worldwide, compared to those without disabilities, which enshrined their rights into law. In 2014, the government also formalized persons with disabilities experience higher levels of poverty, are more likely to Tanzania Sign Language (TSL) into the education system. Under the Third have poor overall health, and more likely to live in food insecure households.3 National Five-Year Development Plan 2021/22 – 2025/26, the government of It is only recently that the world has coalesced around the need to advance Tanzania committed to supporting persons with disabilities with technical and the opportunities available to men and women with disabilities. As recently as vocational educational programs, employment and skill building opportunities, 2010 the European Commission adopted its first European Disability Strategy4 and to boosting their overall economic empowerment. Legislation in Zanzibar and only in 2018 did the African Union (AU) adopt the Disability Protocol to the also mandates that one percent of all revenue raised by local government be African Charter on Human and People’s Right.5 allocated to persons with disabilities and that recipients of social protection programs receive additional financial support if their household includes family members with disabilities.6 1. Tanzania Demographic and Health Survey (DHS) 2022. 6. The Revolutionary Government of Zanzibar. Mid-Term Evaluation of the Zanzibar Social Protection Policy. 2020. 2. Ibid. 2. The study aggregates disability data from Botswana, Lesotho, Gabon, Namibia, Rwanda, Sierra Leone, Swaziland, and South Africa. Source: Montes, Swindle. 2021. 3. UN-DESA- Disability and Development Report. 2018. 4. European Commission. European Disability Strategy 2010 – 2020: A Renewed Commitment to a Barrier-Free Europe. 5. African Union. Protocol to the African Charter on Human and People’s Rights of Persons with Disabilities in Africa. 14 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 15 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Among persons with disabilities, gender, age, and location are factors that Persons with disabilities struggle to get adequate access to health services. increase levels of marginalization and vulnerability. This intersectional Negative attitudes of healthcare providers toward persons with disabilities relationship was emphasized in focus group discussions with persons with are often exhibited through discriminatory practices. Such practices are disabilities and organizations of persons with disabilities (OPDs). Women particularly prevalent in sexual and reproductive health services, where women with disabilities are more vulnerable to gender-based violence (GBV) and are with disabilities are often humiliated and discriminated against by healthcare disproportionately subjected to discrimination in the workplace. Culturally, workers. Pregnant women with disabilities are frequently subjected to mockery these women are also systematically excluded from marriage and from engaging and ridicule by medical personnel. Health facilities often lack accessible in consensual sexual relations due to stigma and discrimination. Children with infrastructure, like wheelchair-accessible ramps, adjustable hospital beds and disabilities struggle to gain access to inclusive education. There are possible qualified sign language interpretation for accessible communication. links between children with disabilities and inadequate levels of socialization, Physical and attitudinal barriers/social taboos remain obstacles to as parents often shelter these children to protect them from abuse and accessing employment. Limited educational opportunities, discrimination and discrimination. Persons with disabilities in rural and remote areas lack access stigma, and inaccessible work environments are the main barriers to accessing to services. gainful employment. These barriers lead to the denial of job opportunities, Educational enrollment rates of children with disabilities have increased, inappropriate job placements, a lack of reasonable accommodations for but challenges remain. In 2023, a high percentage of students with disabilities persons with disabilities, and non-inclusive human resource policies. Some were enrolled at different levels of the education pipeline: 6,892 students with women with disabilities experience sexual exploitation when they apply for jobs disabilities were enrolled in pre-primary education, 74,401 were enrolled and harassment in the workplace. in primary education, and 16,120 were enrolled in secondary education. National social protection schemes do recognize persons with disabilities as This represents an increase in overall enrollment from those children with a vulnerable category, though there are implementation challenges. These disabilities enrolled in 2022. The 2022 Zanzibar Persons with Disabilities Act schemes are reported to have gaps in coverage since they do not specifically No 8 also mandates the production of guidelines on usage and training of sign target persons with disabilities and lack adequate implementing mechanisms to languages and other languages used by persons with disabilities in schools.7 include persons with disabilities. There is also a perceived lack of transparency There has also been a growth in enrollment, among children with disabilities and fairness, an absence of accountability among leadership, and a lack of to the Complimentary Basic Education in Tanzania (COBET) and the Integrated involvement from persons with disabilities and their organizations at both the Programme for Out-of-School Adolescents (IPOSA). And yet, a large percentage design and disbursement stages. These challenges hinder some persons with of classrooms, especially those beyond the primary education level, are difficult disabilities from accessing funds and services including from the Tanzania to access due to inadequate infrastructure, that is not aligned with international Social Action Fund (TASAF). accessibility standards. In addition, having to travel long distances to school without adequate assistive devices and accessible transport exacerbates Buildings and transportation facilities are inadequate and public information the accessibility issue and represents a significant time burden on parents of and communications is often not in an accessible format. Challenges include children with disabilities. Teachers lack the requisite training to implement inaccessible vehicles and negative attitudes toward persons with disabilities inclusive education guidelines highlighted under the Tanzania National Strategy among commercial drivers and co-passengers. Users of public transportation for Inclusive Education, and social stigmas, taboos, and violence all hamper the with wheelchairs and other assistive devices are charged extra fees for educational achievement of children with disabilities. carrying mobility devices. There are limited boarding platforms and bells at traffic lights facilitating access to public transportation. Public information and 7. Zanzibar Government Assembly. 2022. “The Persons with Disabilities Act.” Act number 8. 16 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 17 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities communications are not available in accessible formats, such as sign language, inclusive policies, laws and programs services should thus be adequately easy-to-read and plain language, audio, and large print, which is particularly tailored to meet the diverse functional challenges facing persons with an issue for those with cognitive or sensory impairments. The poor quality of disabilities. The report has prioritized actionable recommendations and tried sign language interpretation (SLI) services and the lack of resources to maintain to categorize immediate “quick-wins” along with medium and longer terms braille equipment further contribute to inaccessibility. priorities, although the report recognizes all proposals are important. Participation in voting, politics, and in public life for persons is hindered by social taboos and inaccessible facilities. The lack of orientation on the use of tactile ballot papers, abrupt relocation of polling stations and inaccessible ACTION PRIORITY LEVEL polling booths for wheelchair users make it difficult for both men and women with disabilities to vote. The exclusion of candidates with disabilities, particularly Expand, uphold, and update legislation and policy women, from participation in political parties also inhibits them from assuming The Prime Minister’s Office on Labour, Youth, Employment and Persons with political leadership positions. Insufficient resources and the prevalence of Disabilities (PMO-LYED) (Mainland) to finalize and disseminate the new disability Immediate policies and acts for Mainland. The Zanzibar Department of Disability Affairs (DDA) attitudinal barriers prevent the participation of persons with disabilities in to disseminate 2022 Zanzibar Persons with Disabilities Act No 8. voting, politics, sports and competitive activities. The PMO-LYED and the Zanzibar DDA to harmonize domestic legislation and policies Medium term so they do not contradict or violate the UNCRPD. RECOMMENDATIONS PMO-LYED and Zanzibar DDA to set up reporting mechanism on the UNCRPD. The URT must invest in monitoring systems at the local level through disability focal Medium term Over the past decades, Tanzania has shown a steadfast commitment to pushing points or strategic engagement with OPDs on disability reporting. the needs and requirements of persons with disabilities forward. However, as this report outlines, persons with disabilities in the country continue to face GoT to enact laws and strengthen existing laws to effectively prosecute crimes against persons with albinism; consider enacting hate crime laws. Adopt a a myriad of challenges across a broad range of cross-cutting dimensions. comprehensive approach to mainstream and promote disability-inclusive language Long term The country’s existing institutional frameworks and policy programmes on in government policies, strategies and programs, with a focus on women and inclusion of people with disabilities lack access to financing and the key actors marginalized populations. lack implementation capacity. Given the long-standing discrimination faced Improve data collection by persons with disabilities in Tanzania, and the many challenges in financing Scale up the use of the piloted Persons with Disability Management Information that accompany the design of disability-inclusive policies, the government of System (PD-MIS) in mainland Tanzania and Jumuishi database in Zanzibar and Immediate Tanzania must adopt an incremental, cross-sectional approach that encourages allocate resources for their long-term sustainability. strengthening the government’s collaboration with Organizations of People Refer to the WG-SS for all future censuses and household surveys to harmonize the with Disabilities (OPDs), donors and the private sector. The expansion and definition of disability and ensure consistency in their analysis of gathered data; Long term implementation of disability-inclusive policies and programming should be conduct proper training for enumerators; include organizations of persons with spearheaded by the government, while also ensuring strong networks of disabilities in the data generation process. collaboration with OPDs, donors and the private sector. The challenges facing persons with disabilities are not all uniform and vary significantly based on the form of physical disability – seeing, hearing, communication, cognition, walking, or self-care – they experience. Disability- 18 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 19 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ACTION PRIORITY LEVEL For OPDs, Donors with support from the Private Sector: Enhance inclusive service delivery ACTION PRIORITY LEVEL Education: Expand availability of accessible learning materials and assistive Reduce stigma through scaled-up awareness raising. Raise awareness about devices. Train teachers in inclusive education practices. Ensure adequate financing the causes of disability, the importance of inclusion, and the need to respect the to support the implementation and operationalization of the National Inclusive rights of persons with disabilities. Provide psycho-social and mental health care Immediate Education Strategy. Use the National Continuous Professional Development Immediate interventions for persons with disabilities who have been bullied, traumatized, Framework to develop skills and awareness for all teachers on inclusive education. attacked, and discriminated against. Review and modify the time allocated for children with disabilities to qualify and complete their national examinations. Explore best practices across the world to see Enhance strategic funding, including with cross donor collaboration with a focus how the cost of learning materials and assistive devices can be reduced. on underserved regions and groups: Donors contribute to funding government, OPD and CSO initiatives. This can be done in more accelerated and enhanced way on Protection from violence: Ministry of Community Development, Gender, Women Immediate key strategic issues. Donors should consider strengthening disability in other cross- and Special Group and Ministry of Community Development, Gender, Elders and cutting areas such as gender, education, child protection, social protection and in Children to utilize the framework of the National Plans of Action to End Violence Immediate health systems strengthening. Against Women and Children to integrate protective services, counseling, and appropriate social services for people with disabilities. Establish safe spaces and Enhance coordination: Enhance cross-donor collaboration with a focus on provide inclusive prevention and response services to GBV. underserved regions and groups. OPDs should define key sectoral expertise and Medium term collaborate on knowledge, partnerships, and funding Health: Ministry of Health to train and provide healthcare providers in disability inclusive practices. Ensure young people and women with disabilities have access to Immediate Commit to hiring people with disabilities: Employers can commit to hiring qualified sexual and reproductive health. persons with disabilities and creating workplaces that accommodate people with Medium term different abilities. Private sector companies can consider providing internships, Livelihoods and Employment: Partner with the private sector to invest in inclusive apprenticeships for persons with disabilities to make them more employable. vocational training, skills development, and implementation of employment quotas in private sector. Mainstream disability inclusion in government job creation Immediate Enhance the participation of persons with disabilities in designing schemes programs. Continue offering loans and grants for entrepreneurs with disabilities – and programs: Persons with disabilities are asking to be actively consulted during Medium term but with enhanced transparency. project or program design phase as well as during implementation. Transport: Assess the transportation needs of persons with disabilities, particularly in rural areas and with public transport providers. Consider investing in training Medium term government contractors on universal access design standards. Infrastructure: Raise awareness and knowledge to ensure that all new buildings, schools, healthcare clinics designed by the government and the private sector Medium term guarantee proper access to persons with disabilities. Infrastructure: Ensure that all existing public and private infrastructure follows Immediate disability-inclusive access designs. Social Protection Programs: Address the implementation challenges, including lack of transparency and discrimination, that prevent persons with disabilities from Medium term accessing TASAF and other social protection programs. Hiring people with disabilities: Governments should commit to hiring qualified persons with disabilities and creating workplaces that accommodate people with Medium term different abilities. Also increase participation of persons with disabilities and OPDs in the design of government schemes and programs. 20 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 21 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Tanzania has a robust legislative framework to address the needs of persons with disabilities. The country ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in 2009 and enacted the Persons with Disabilities Act in 2010, with the aim of incorporating the rights set out in the UNCRPD into domestic law. In 2022, the Government of Zanzibar also ratified the Persons with Disabilities Act. As part of the Persons with Disabilities Act of 2010, the government enshrined into law the guarantee that persons with disabilities have access to health care, education, employment, adequate access to buildings, to free movement, to financial services, and to political and public life.11 The inclusion of persons with disabilities remains a cornerstone priority of the World Bank (WB), especially as it aims to boost human capital accumulation Photo by TrianglePod and jobs in the country. The WB safeguards the rights of men and women with disabilities through several avenues, including the Disability Inclusion and Accountability Framework,12 and the International Development Association 1. (IDA) 20 and the Environmental and Social Framework (ESF). The World Bank portfolio in Tanzania currently amounts to over 9 US$ billion, invested across several sectors, including transportation, education, urban resilience, energy, water and sanitation, and human protection. INTRODUCTION This report is a mixed-methods assessment which aims to provide a deeper contextual understanding of the barriers encountered by men and women with disabilities in Tanzania. It looks at overall disability prevalence in the country, Approximately 1.6 million people, or 2.6 percent of the population in the and at the country’s legislative framework and policies. It also examines inter- URT, currently live with a disability, and an estimated 56 percent of these are sectoral issues facing persons with disabilities seen through gender, age and women.8 This is comparable with the 3.2 percent aggregate prevalence estimate geographic location. The report identifies policy and programmatic entry points across several countries in SSA.9 In addition to those persons with disabilities, to engage with multiple stakeholders; the government, donors, OPDs and the an estimated 8.4 percent of the population faces some degree of difficulty in private sector. functioning along one of the six core domains: seeing, hearing, communication, cognition, walking, and self-care.10 Persons with disabilities are more likely to experience poorer education and health outcomes, lower and unequal levels of employment, barriers to full participation in leadership positions, and higher poverty rates. 8. DHS 2022. 11. Parliament of Tanzania. Persons with Disabilities Act, 2010. 9. In addition to Tanzania, the study included data from Botswana, Lesotho, Gabon, Namibia, Rwanda, Sierra Leone, Swaziland, 12. Mcclain-Nhlapo et. al 2022. and South Africa. Source: Montes, Swindle. 2021. 10. According to the WG-SS, a person with a disability is someone who expresses a lot of difficulty or inability to perform in one of the following six core domains: seeing, hearing, communication, cognition, walking, and self-care. The WG-SS recommends measuring national estimates of disability among segments of the population ages 5 years and older. See Appendix 9 for list of household questions recommended by the WG-SS. 22 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 23 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities National disability prevalence was estimated using the standards recommended by the WG-SS on Disability Statistics. According to the WG-SS, a person with a disability is someone who expresses “a lot of difficulty” or “cannot do at all” in one of these six core functional domains. The WG-SS is a useful, standardized measure to capture national estimates of disability over time and across different countries, which has been espoused by the WB as the standard definition for measuring prevalence.14 National and sub-national (regional) disability prevalence values were estimated from the 2022 Tanzania Demographic and Health Survey (DHS).15 Additional data points were retrieved from the 2008 Disability Survey (DS), and other household surveys, i.e, the 2018-19/2019-20 Household Budget Survey (HBS) for Mainland and Zanzibar, respectively.16 The quantitative data presented in this report is intended to offer a broad overview of disability prevalence in the country. Qualitative research was also carried out by consultants who engaged with various organizations representing persons with disabilities. A desk review assessed the state of existing legislation, policies, and programming. Photo by Freepik Consultations with government organizations, donors and civil society groups were undertaken in seven provinces in Mainland Tanzania and the two islands of Unguja and Pemba in Zanzibar. The analysis sought to establish the progress 2. made in the operationalization of relevant regulations sand guidelines under the Persons with Disability Act 2010 and 2022 Zanzibar Persons with Disabilities Act, and within the context of the UNCRPD. METHODOLOGY Focus Group Discussions: Nine focus group discussions (FGD) with organizations of persons with disabilities and their members were conducted in the cities of Dar Es Salaam, Arusha, Morogoro, Mtwara, Mara, Mbeya, Kigoma Zanzibar and Pemba, with a combined total of one hundred and seventy-one This report provides an overview of disability prevalence, together with men and women. The FGD’s provided greater understanding of key issues from Tanzania’s legal and policy framework. It is informed by a desk review, focus different perspectives. group and key informant feedback, and designed to present a rounded picture of the barriers persons with disabilities face in the country. For the purposes of this study, and in alignment with international standards, disability is examined through six functional domains (i.e., i) have difficulty seeing, ii) hearing, iii) walking, iv) remembering, v) self-caring, and vi) communicating).13 14. Tiberti,Marco; Costa,Valentina. 2020. 15. The 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022 TDHS-MIS) was implemented by the Tanzania National Bureau of Statistics (NBS) and the Office of the Chief Government Statistician (OCGS) in collaboration with the Ministry of Health, Tanzania Mainland and the Ministry of Health, Zanzibar. 13. See Appendix 9 for the expanded list of questions across each of the six core functional domains. 16. Ministry of Finance and Planning - Poverty Eradication Division (MoFP- PED) [Tanzania Mainland], National Bureau of Statistics (NBS) and the World Bank. 2020 Tanzania Mainland Household Budget Survey 2017/18. Final Report Dodoma, Tanzania MoFP-PED, NBS and Washington DC USA, and WB and the National Bureau of Statistics, Office of the Chief Government Statistician, Zanzibar and the Ministry of Health and Social Welfare. The 2008 Tanzania Disability Survey. 24 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 25 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Key Informant Interviews: Thirty-six purposively selected (25 home visits and 11 organizations) key informant interviews (KII) were conducted between June and September 2022. Persons living in Morogoro, Arusha, Mara, Mbeya, Mtwara and Kigoma regions were engaged. They shared their personal experiences of attitudinal and structural barriers to accessing education, health services, employment, information and communications, transportation, assistive devices and technology, and social protection. Feedback was also obtained from care givers. Weaknesses of the methodology: Methodological limitations include: 1) household surveys do not always include questions on disability, and there are sharp differences in how national disability prevalence rates are estimated. At the time of finalizing this report, 2022 census data was not available, so the assessment relied on the 2022 Demographic and Health Survey data for prevalence estimates; 2) an extensive amount of qualitative work was undertaken for this report, but the sampling was opportunistic and not representative. FGDs and other interviews offers rich qualitative evidence, which is backed up by consultations with both government and civil society groups who have ample experience, often spanning several decades, working on this agenda. 26 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 27 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities According to the 2022 DHS,17 the latest estimates available, persons with disabilities comprise 2.6 percent of the population in Tanzania. This prevalence rate is derived via the WG-SS definition of a person with a disability as someone, over the age of 5, who expresses “a lot of difficulty” or “cannot do at all” in one of the following six core domains: seeing, hearing, communication, cognition, walking, and self-care. The national estimate of persons with disability in Tanzania is in line with the 3.2 aggregate prevalence across several countries in Sub Saharan Africa (SSA).18 In addition to those persons with disabilities, an estimated 8.4 percent19 of the population faces a more moderate level of physical difficulty – “some degree of difficulty”, as opposed to “a lot of difficulty” or “cannot do at all” – along one of the six domains.20 Disability prevalence increases significantly with age, as 12 percent of respondents ages 60 and older stated that they experienced a lot of difficulty along one or more of the core domains, compared to only 1.0 percent among those ages 20-29. (Table A).21 Table A: Disability Prevalence by Age DEGREE OF DIFFICULTY REPORTED IN AT LEAST ONE DOMAIN NO SOME A LOT OF CANNOT DO AGE DIFFICULTY DIFFICULTY DIFFICULTY AT ALL 5-9 96.3 2.7 0.6 0.4 10-14 96.3 2.8 0.6 0.2 15-19 94.5 4.1 1.0 0.4 20-29 94.6 4.1 1.0 0.3 Photo by Wavebreak Media 30-39 91.9 6.1 1.4 0.5 40-49 84.9 12.6 2.0 0.5 50-59 75.2 20.7 3.7 0.3 PREVALENCE DATA 60 + 50.7 34.9 11.9 2.5 Source: DHS 2022 3. FOR DISABILITY IN TANZANIA 17. 18. 19. 20. Ministry of Health (MoH) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF. 2022. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022 Final Report. Dodoma, Tanzania, and Rockville, Maryland, USA: MoH, NBS, OCGS, and ICF. The study aggregates disability data from Botswana, Lesotho, Gabon, Namibia, Rwanda, Sierra Leone, Swaziland, and South Africa. Source: Montes, Swindle. 2021. Individuals who express “some degree of difficulty” are not considered as persons with disabilities because the international cutoff is around those who express “ a lot of difficulty” or “cannot do at all,”. See Appendix 9 for disability prevalence questions recommended by the WG-SS. 21. The prevalence of persons with disabilities may be under-reported, given that social stigmas and taboos may lead to certain segments of the population being concerned to self-report the difficulties they face. 28 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 29 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Although the country demonstrates significant regional variations in Table C: Disability by levels of education and household wealth disability prevalence, the urban-rural divide is not pronounced. An estimated 56 percent of persons with disabilities are female, and 44 percent are male.22 LOCATION MEN WOMEN A relatively higher percentage of the population with disabilities age 15 and Level of Education over lives in rural areas, 70 percent, compared to 30 percent in urban areas.23 No education 8.9 8.1 This reflects the country’s broader rural (71 percent) vs. urban (29 percent) Primary complete 2.5 2.6 population divide. Around 3 percent of men who lived in urban areas have a disability, compared to 4 percent who lived in rural areas (Table B). As shown Secondary + 1.3 1.4 in Annex 3, by region, the percentage of persons with disabilities for women Wealth Quintile over age 15 is highest in Njombe, where 7.5 percent of women are persons Lowest 4.6 3.4 with disabilities. For men, the highest percentage is in Tanga, where 7 percent Second 3.5 4.8 of men are persons with disabilities. Among men and women, the regions with the lowest percentage of persons with disabilities is Mjini Magharibi, where 1 Middle 2.8 3.4 percent of both men and women have a disability. Fourth 3.3 4.4 Highest 3.0 3.1 Note: Disability is defined as percent of respondents age 15 and over who experienced “a lot of difficulty” or “cannot do at all” in at least Table B: Disability by place of residence one of the six domains. Source: DHS 2022 RESIDENCE MEN WOMEN Urban 3.2 3.9 years or above.24 This suggests that, compared to previous generations, newer Rural 3.5 3.7 generations of persons with disabilities are more likely to complete school. A finding which is backed up by the increased levels of enrollment among children Note: Table shows percent of respondents, 15 years and older, who experienced “a lot of difficulty” or “cannot do at all” in at least one of the six domains. with disabilities detailed in Chapter 5. Source: DHS 2022 Disability prevalence among children is higher in poorer households. The estimates of children, ages 5-18, with a disability is at 1 percent, and 4 percent Persons with disability have lower levels of educational attainment. expressed at least some form of difficulty in at least one of the six core domains. An estimated 9 percent of men, and 8 percent of women age 15 and over Around 3 percent of children in the poorest wealth quintile are children with without education in the country are persons with disabilities, compared to disabilities, compared to 1 percent in the richest quintile. Disability prevalence an estimated 1.3 percent of men and 1.4 percent of women with a secondary among children does not vary based on the education level of the household education or above. However, estimates of prevalence of disability do not vary head: according to the DHS 2022, in homes where the head of the household did in a consistent manner according to levels of household wealth (Table C). The not have an education, around 1 percent of children had a disability, compared to association between levels of education of the household head and disability 1.3 of children in households where the household head had above a secondary prevalence is statistically significant for those household heads ages 20 years education.25 old, and the association is strongest among those household heads ages 60 22. DHS 2022. 24. Own analysis using DHS 2022 . 23. Ibid. 25. DHS 2022. DISABILITY INCLUSION IN TANZANIA 31 Experiences and Recommendations From People With Disabilities The URT has stressed that persons with The comparability of disability prevalence statistics in the country is disabilities must be included across hindered by lack of harmonization in how estimates are measured. For example, although the 2022 DHS, the 2008 DS and the 2012 Population nationally representative household surveys. and Household Census (PHC) all ask for the core dimensions of disability In Tanzania Mainland, OPDs representatives recommended by the WG-SS, the 2008 DS and 2012 census adopt different, less restrictive, definitions of disability than what is recommended. The 2008 DS have been selected to represent OPDs in and the 2012 PHC captures disability among those segments of the population testing the 2022 census instrument, with ages 7 and above, the 2012 PHC and the NBS also considered albinism as an additional core domain of disability. This comes at the expense of ensuring ease similar arrangements in other regions. In of comparability over time and with other countries. To help ensure adequate tracking of disability statistics in the country, as suggested by the WB,26 this Zanzibar, OPDs noted that persons with report recommends that future disability- related research and analytical work disabilities have been included in the District in Tanzania adheres to the definitions of prevalence adopted by the WG-SS. Census Committees, and trainings have The kind and form of physical functional difficulties facing persons with disabilities vary and should be considered when designing disability- been organized for these persons with OPDs inclusive policies. Not all persons with disabilities face the same type of functional difficulty. According to the 2022 DHS, an estimated one percent of invited to participate in the preparation of respondents in Tanzania experienced at least serious difficulties seeing, the new survey instruments. Some enumerators same amount experienced at least serious difficulty walking or climbing steps, and less than one percent had serious difficulty in remembering or concentrating lacked awareness and perceived disability and communicating or dressing. The challenges persons with disabilities face are not uniform. Disability-inclusive laws and programs services should be as an illness. In previous surveys, there also adequately tailored to meet the varying functional physical challenges facing used to be issues with the appropriateness persons with disabilities. of questions about household disability. In some regions, such questions were excluded altogether. Reflections from the process of data collection from the Population and Household Census 2022 26. Tiberti,Marco; Costa,Valentina. 2020. 32 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 33 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities 4.1. International and Regional Commitments Ratification of the UNCRPD is a notable step for Tanzania, but legal awareness, reporting and implementation can be improved.27 The country has signed and ratified several international treaties that advance the rights of men and women with disabilities, including the 1986 African Charter on Human and People’s Rights, the 1991 UN Convention on the Rights of the Child, the 1985 Convention on the Elimination of All Forms of Discrimination against Women, and the 1976 International Covenant on Economic, Social and Cultural Rights. In 2009, Tanzania ratified the UNCRPD and its Operational Protocol, the first international legally binding treaty that recognizes the rights of persons with disabilities globally. The UNCRPD provides a legal framework and a set of standards for ensuring that persons with disabilities enjoy the same rights than other citizens. The UNCRPD also creates mechanisms for persons with disabilities and their representative organizations to participate in decision making processes and monitor its implementation. Despite the UNCRPD’s ratification and domestication into policies and legislation over a decade ago, implementation has been weak.28 The URT has not submitted the State Report – to be submitted two years after signing of the UNCPRD ratification– to the UN special committee, even though a shadow report from OPDs was validated in 2023. A 2022 qualitative study29 in Tanzania with thirty-six participants with disabilities found that sixty-seven percent were not aware of the international and national laws meant to address economic equality among men and women with disabilities. Fifty four percent of people interviewed for the study were unaware of the existence of the UNCRPD. In Photo by Matilda James Kivelege the Mara Region of Mainland Tanzania, for example, only two out of twenty-two participants interviewed were aware of the UNCRPD. In the Kigoma and Mbeya regions, five out of sixteen, and six out of seventeen participants, respectively, had an awareness of the UNCRPD (see Annex 5 for additional information). LAWS AND The URT has established disability-designated focal points in the PMO-LYED 4. and the Zanzibar DDA. This includes the National Advisory Council (Mainland) POLICIES RELATED and Zanzibar National Disability Council, both of which are mandated to monitor and evaluate the implementation of the UNCRPD. TO DISABILITY 27. The complete list of Tanzania’a laws and policies and their respective objectives are listed in Annex 2. 28. Disability Inclusive Development. Tanzania Situational Analysis. June 2020 Update. https://opendocs.ids.ac.uk/opendocs/bitstream/ handle/20.500.12413/15509/DID%20Tanzania%20SITAN%20_%20June%202020.pdf?sequence=1. 29. Tambwe et. Al. 2022. 34 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 35 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Box 1 4.2. National Legislative Framework The URT’s 1977 constitution protects all citizens from discrimination and guarantees their basic rights and freedoms but it does not confer any special protections to persons with disabilities. While the 1977 Constitution Relevant National Strategies and Legislative Framework in Tanzania of Tanzania grants freedoms to citizens with disabilities, the protection of The United Republic of Tanzania Constitution, 1977 freedom is issued as a directive and therefore not enforceable in a court of law. The African Charter on Human and People’s Right, 1982 This makes the 1977 Constitution non-compliant with the UNCRPD. The 1977 The Disabled Persons Mainland (Employment) Act, 1982 Constitution mentions disability only once under Article 11. Under Article 5 of The National Policy on Disability, 2004 (under review) the Constitution, the Parliament of Tanzania may impose conditions restricting Zanzibar Persons with Disabilities (Rights and Privileges) Act, 2006 a citizen from exercising the right to vote if they are “mentally infirmed.” This Zanzibar Persons with Disabilities Act No 8. of 2022 provision may deprive persons with disabilities of the right to vote, and to hold The Persons with Disability Act, 2010 The Education and Training Policy Act of 2014 (version 2024) public office. The National Education Act, 1978 The Persons with Disability Act, 2010. This serves as the landmark legislation The School WASH Guideline, 2016 on disability for the Mainland. It builds on the 2004 National Policy on Disability30 The Financial Act, 2018 and is meant to ensure protection of the rights and welfare of persons with The Political Parties Act, 2018 disabilities. The Act established the National Advisory Council (NAC), whose The National Strategy for Inclusive Education, 2019 mandate is to advocate for the rights of these persons. The NAC provides The Third National Five-Year Development Plan III 2021/22 – 2025/26 The Education Sector Development Plan (EDSP) 2022-2026 direction for appropriate measures, including amending or abrogating existing laws, regulations, customs, and practices that constitute discrimination related to disability. Despite the NAC’s formation, low levels of awareness and capacity Additional policies relevant to social inclusion affect its ability to effectively implement, especially at lower administrative and disability inclusion are: levels. Additional challenges in implementation include overlapping roles between different government departments,31 inadequate representation of The Inheritance Act, 1963 members with disabilities in the NAC, and an absence of redress mechanisms The Law of Marriage Act, 1971 and civil remedies for individuals who suffer violations to their rights. The Zanzibar Education Act, 1982 The Employment and Labour Relations Act, 2004 Zanzibar Persons with Disabilities Act, 2022. This Act amends the Zanzibar The Employment Policy, 2008 Persons with Disabilities (Rights and Privileges) Act, 2006 and sets out the The National Plan of Action to end Violence Against Women and Children, fundamental rights and freedoms to which people with disabilities in Zanzibar 2017/18-2021/22 (Mainland) (under revision) are entitled and incorporates the UNCRPD into Zanzibar’s law. Unlike in The National Plan of Action to End Violence Against Women and Children, mainland, in Zanzibar, key informants and participants in FGDs had a higher 2017-2022 (Zanzibar) (under revision) The National Plan for Reproductive, Maternal, Newborn, Child and perception on the Government of Zanzibar’s capacity to promote the rights of Adolescent Health and Nutrition, 2016–2021/22–2025/26 persons with disabilities. The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Zanzibar, 2019-2023 30. The 2004 National Policy on Disability was developed to create a “conducive environment for persons with disabilities to engage in productive work for their development and utilization of available resources for improved service delivery.” The policy’s definition of disability, which is not in line with Article 1 of the UN CRPD, restricts abilities of persons with disabilities from participating in community life on an equal basis. Subsequent legislation such as the Persons with Disability Act in mainland Tanzania and the Zanzibar Persons with Disabilities Act of 2022 aim to rectify some of the shortcomings of this policy. 31. UNPRPD Situational Analysis on Persons with Disabilities in the United Republic of Tanzania, UNCT Tanzania. 2021. 36 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 37 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Additional policies and commitments made by the URT are outlined in Annex 2. Issue 4: There is a lack of enforcement of the implementation of disability They cover access to education, finance, justice, equal political participation and policies. The 2010 Persons with Disabilities Act mandates that, for those with employment and labor relations. The enshrinement of such a diverse legislative a workforce greater than 20 persons, at least 3 percent of employees must be framework is a promising step to mainstream opportunities for men and women persons with disabilities. However, implementation remains a challenge: a 2022 with disabilities across the policy spectrum. study surveyed 395 organizations in Tanzania and found that only 46 percent of them employed one or more persons with disabilities and only 38 percent of human resources departments in the organizations were aware of the policies. 4.3. Gaps in Implementation of the Legislative and While the 2019 amendment of the Local Government Financial Act mandates Policy Framework that all Local Government Authorities (LGAs) allocate 2 percent of interest- free loans to persons with disabilities, the fund faces several administrative Despite the development of legal and policy frameworks, these alone have challenges. These include: i) lack of outreach and information about the been insufficient in granting equal access to opportunities, and full inclusion loans, ii) lack of training about repayment terms, minimum accountability, and and participation in society for people with disability. This assessment identifies transparency, iii) eligibility criteria and iv), the absence of sufficient loan officers four main issues: on the ground. Issue 1: Poor reporting record on the rights of persons with disabilities. The URT has failed in its obligation to submit reports to the UN Special Committee which all signatory states are obligated to submit after the first two years of being a signatory of the UNCRPD and thereafter, every four years. The URT ratified the UNCRPD in 2009 but has yet to make a single submission, leaving a gap in accountability and transparency. Issue 2: There is a lack of awareness of policies and laws that support equality for persons with disability. Government authorities and civil society organizations working on disability lack knowledge of laws and policies critical to promoting the rights of persons with disabilities; this includes knowledge of the UNCRPD as well as awareness of national laws and policies regarding disability. Issue 3: The URT, as well as development partners, do not allocate adequate resources for the implementation of disability-inclusive policies. A 2022 study32 found that low budget allocation and financing to disability-inclusive policies and programs acted as a hindrance to the implementation of the UNCRPD, and the enforcement of domestic disability laws. The operationalization of disability-related instruments remains underfunded. 32. The Participation of Persons with Disabilities in Political and Democratic Processes in Tanzania. 2022. The Foundation for Civil Society. 38 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 39 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Prevalence of disability often interacts with several areas of inequality, including age, race, class, gender, ability, and creates interdependent systems of discrimination and disadvantage.33 Men and women with disabilities are not a homogenous category; certain sub-groups are more vulnerable, and experience additional layers of marginalization. Government programs must address the unique needs and requirements of these populations. This section examines how disability intersects with gender, age, and geographic location. GENDER: Women with disabilities face increased challenges in accessing education and healthcare.34 Around half of all women and girls with a disability have not completed any formal education, compared to only 21 percent of women nationwide.35 Around 36 percent of boys and men with a disability have not completed any formal education, compared to 16 percent nationwide. A qualitative study of access to sexual and reproductive health services among 136 adolescent females with disabilities in Tanzania found that they were often victims of maltreatment and abuse by staff at healthcare facilities.36 Another study looking at over 2,000 adolescents in the Southern Highlands region of Tanzania found that adolescents with disabilities were less likely to self-report having access to adequate health services.37 Women and girls with disabilities are vulnerable to sexual abuse, exploitation, and multiple forms of GBV. Women with disabilities remain vulnerable to rape and sexual exploitation. Young boys with disabilities are also subjected to sexual violence. Women and girls with albinism are sometimes Photo by Wavebreak Media victims of sexual violence because of the misconception that having sexual relations with them can heal human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).38 Many young women with disabilities are also forced by their families to marry or abort pregnancies which often leads AN INTERSECTIONAL to domestic violence. Pregnant women with disabilities are often subjected to inhumane practices and GBV, including forced sterilization, and abortions. The implementation of the National Plans of Action to End Violence Against Women UNDERSTANDING 5. 33. Collins, Patricia Hill. “Patricia Hill Collins: Intersecting Oppressions.” (2006). OF DISABILITY IN 34. Includovate 2021. UNPRPD Situational Analysis on Persons with Disabilities in the United Republic of Tanzania, UNCT Tanzania. 35. DHS 2022. 36. Mesiäislehto V, Katsui H, Sambaiga R. Disparities in Accessing Sexual and Reproductive Health Services at the Intersection of Disability and Female Adolescence in Tanzania. Int J Environ Res Public Health. 2021 Feb 9;18(4):1657. doi: 10.3390/ TANZANIA ijerph18041657. PMID: 33572337; PMCID: PMC7916121. 37. Quinones S, Palermo TM, Lukongo TM on behalf of the Tanzania Adolescent Cash Plus Evaluation Team, et al Disability status and multi-dimensional personal well-being among adolescents in the Southern Highlands Region of Tanzania: results of a cross- sectional study BMJ Open 2021;11: e044077. doi: 10.1136/bmjopen-2020-044077. 38. This finding is echoed in page 31 of: Includovate 2021. UNPRPD Situational Analysis on Persons with Disabilities in the United Republic of Tanzania, UNCT Tanzania. 40 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 41 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities and Children (NPA-VAWCs) had led to the creation of gender focal desks in both mainland Tanzania and Zanzibar, which have been helpful first points of contact A male teacher who came for block teaching impregnated girls with disabilities and to report abuse or seek services. escaped the penalties by giving pseudo names in order to avoid being traced thereafter. Case study conducted at the Buguruni Deaf School “Women with disabilities (especially women with intellectual disabilities) are easy prey for sexual violence” LOCATION: Persons with disabilities living in rural areas tend to face more A female participant with physical disabilities and a veteran high leader in OPDs-Zanzibar challenges than those in urban areas. As mentioned previously, a relatively higher percentage of the population with disabilities lives in rural areas, 70 percent, compared to 30 percent in urban areas.41 This reflects the country’s broader rural vs. urban distribution. Rural area residents with disabilities are CHILDREN AND YOUTH: One percent of boys and girls between 5 and 18 often isolated, impoverished, and excluded from the mainstream disability years have disabilities.39 Around 4 percent of children experience some policy agenda.42 Much of the work of OPDs, including advocacy, is focused in the level of difficulty in one of the six core physical domains. An estimated 1.3 urban areas. In rural areas, children with disabilities attend school at a lower percent of those ages 18–24 are people with disabilities, and 5.2 percent rate, 36 percent, compared to children without disabilities, 50 percent.43 Most experienced some level of difficulty in one of the six core domains. Some inclusive education schools, or special disability units, are located in the urban children with disabilities are subjected to violence and abuse; this is especially areas of mainland Tanzania. Additionally, girls with disabilities in rural areas are true for children with albinism.40 Existing laws designed to protect the rights of at a higher risk of being subjected to sexual violence.44 children with disabilities often have gaps in their implementation, and domestic laws do not fully align with the UNCRPD. Children with disabilities who require support or assistance lack access to assistive services and early intervention. Girls with disabilities are even less likely to receive healthcare and assistive devices compared to boys with disabilities. According to the 2022 DHS, the percentage of young men, ages 15-24, with disabilities who are employed, 50.6 percent, is lower than the overall 61.3 percent employment rate of young men in Tanzania. Inaccessible transportation and toilets are some of the challenges young persons with disabilities face when attempting to access education facilities. Children with disabilities are also more likely to experience discrimination and violence caused by socio-cultural norms. The spate of killings, abductions, and maiming of people with albinism in Tanzania in the mid-2000s continues to impact children and adults with albinism. 39. DHS 2022. 41. DHS 2022. 40. UNICEF 2021. 42. FGDs. 43. UNICEF 2021. 44. ibid. 42 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 43 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Inclusive Education Across the education pipeline, there has been an increase in enrolment levels of children with disabilities. In 2023, approximately 6,892 students with disabilities enrollment in pre-primary education, 74,401 enrolled in primary education, and 16,120 enrolled in secondary education. A significant increase from the 6,120 students with disabilities in pre-primary education, 74,401 in primary education and 16,210 enrolled in secondary education in 2022. There has also been an increase in the percentage of children with disabilities enrolled in complimentary education programs, such as COBET and IPOSA. Foundations for an inclusive education policy framework exist in Tanzania despite gaps in implementation. The right for every person to pursue education is enshrined into law in the 1997 Constitution, the Education Act, 2016, and the Education and Training Policy of 2014. The government also introduced the Inclusive Education Policy 2019 which involved developing Education Support and Resource Assessment Centers (ESRACs). The ESRAC’s seek to strengthen the early identification and assessment of children with special needs, provide care and support for children with albinism, as well as improve teaching provisions for visually and hearing-impaired children and learners with intellectual disabilities and/autism. The 2016 National Guidelines for water, sanitation, and hygiene (WASH) require that all the physical infrastructure of primary schools be universally accessible to persons with disabilities. In 2014, the government also formalized Tanzanian Sign Language (TSL) in the education system and created partnerships between schools, communities, and agencies, including social and health services, to identify school-aged children with disabilities.45 The inclusive school approach stipulates that all schools be constructed to be accessible to persons with disabilities, however, gaps remain in implementation Photo by Matteo Guedia at the local levels. The ESRAC have little geographic penetration. As of 2021, only the national ESRAC, headquartered in Dar es Salaam, exists.46 Additional gaps in the implementation of the disability-inclusive agenda include the 6. parallel existence of special “integration” and “inclusive” education practices SECTOR WISE that contradict the UNCRPD and the 2010 Disability Act. There has also been CONSTRAINTS 45. Embassy of Ireland, Tanzania.” Latest News - Tanzania’s Deaf Community Celebrates Significant Progress in Harmonizing Sign Language. - Department of Foreign Affairs, 27 Sept. 2019, www.dfa.ie/irish-embassy/tanzania/news-and-events/latestnews/ tanzanias-deaf-community-celebrates-significant-progress-in-harmonizing-sign-language-.html. 46. The United Republic of Tanzania: National Ministry of Education, Science and Technology. National Strategy for Inclusive Education, 2021/22-2026/26. 2021. 44 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 45 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities confusion on what implementation of education policies means in practice. The Inclusive education is also hindered by a shortage of specialized teaching, prevalent practice of implementing parallel education approaches for students learning materials, and lack of options within higher education. It is only given with disabilities is contrary to the Person with Disabilities Act 2010, which emphasis at the primary level and for very few secondary schools.49 Schools that specifies that “special schools shall be for a transitional period toward inclusive do enroll children with disabilities often do not have a curriculum that caters to education.” In addition, education policies, such as the 1978 Legislation No.25 their intellectual and cognitive needs. Many teachers at the secondary education and the 2014 Education and Training Policy, do not categorically mention or level are not properly trained in special needs education, and special schools endorse “inclusive education.” also often lack adequate human resources, including qualified administrators. Additionally, many parents who wish to send their children with disabilities to school often lack the financial support and resources to do so. Box 2 “Education for persons with disabilities is mainly limited to primary level; chances to receive education are slimmer at secondary and tertiary levels.” Additional Education Related Challenges and Opportunities Facing Children with Disabilities a male participant with a physical disability in Kigoma- Tanzania Mainland The groundwork for an inclusive education policy framework exists in Tanzania, which stipulates that all schools be constructed to consider the needs of persons with disabilities. Through several legislative and policy frameworks, the educational rights of children with disabilities have also been enshrined into law. The Education and Training Policy (2014, version 2024) mandates that There is an overall lack of resources, but especially for visual and hearing every child, including children with disabilities, complete ten years of education. Despite progress, impairments. Visually impaired learners and students with hearing disabilities several educational challenges remain. For instance, although the Ministry of Education, Science and Technology (MoEST) sets aside two percent of its education budget to address the needs lack access to textbooks in braille and properly trained sign language interpreters of children with disabilities, financing of the budget remains a challenge, and it is insufficient to (SLIs). Braille textbooks that do exist often provide inadequate information. address the needs and requirements of boys and girls with disabilities. In rural areas, levels of basic braille literacy among students with disabilities There are encouraging initiatives seeking to address the many educational challenges facing are low. Perkins Braillers, which are mechanical braille writers, are widely children with disabilities. In 2023, the MoEST launched a “home school” guideline to support unavailable, and there is a shortage of personnel to maintain braille resources.50 children with disabilities who are unable to travel safely to school.47 Since the ESRAC’s have little In Pemba, most teachers consider it futile to teach science to visually impaired geographic penetration, CSOs and the international development community have also developed early identification tools to use in schools to identify children with disabilities. Shule Bora,48 a learners given the lack of resources, which has resulted in Science, Technology, national primary education program funded by United Kingdom (UK) aid is pioneering the use of Engineering and Mathematics (STEM) competent learners from progressing such screening tools. with their education. There also remains a need to expand colleges specialized in providing training to address the needs and requirements of children with disabilities. The Patandi Teacher’s College of Special Needs and Inclusive Education in Arusha, Tanzania is one example that could be replicated nationwide. In- school assessments, exams and evaluations should also be better tailored and adapted to address “Special education is not readily available for everyone in need and the the particular needs and requirements of children with disabilities. inappropriateness of teaching/learning materials for blind and visually impaired people leads to either poor performance or dropping out altogether.” A male participant with a physical disability and a leader of the Federation’s Kigoma Regional Branch - Tanzania Mainland. 47. The United Republic of Tanzania: National Ministry of Education, Science and Technology. Home School Guide for Students with Special Needs, 2023. 48. Shule Bola; Quality Learning for All Children. Ministry of Education Science and Technology Child/Student Identification Form 49. UNICEF 2021. with Deafness Failure to See. 50. FGDs. 46 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 47 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities The physical infrastructure of most schools is often inaccessible. Schools do According to the 2018/19 HBS, in mainland Tanzania, about 34.6 percent of not appropriately consider sitting arrangements, examination times, and other children with disabilities currently in school were not attending on a regular basis. infrastructural concerns for persons with disabilities. Most schools only consider In the Zanzibar HBS 2019/20, this number is 27.9 percent. The HBS documents accessibility in terms of doorsteps, entrances, and toilets. Issues such as the multiple reasons for missing school, including being unable to afford school and unavailability of reliable water sources, the presence of slippery floor tiles, steep personal sickness. Students willing to continue their education past the primary “ramps,” narrow door and pathways, windows poorly located, and one-size fits level to the tertiary level are often unable to secure loans to guarantee access.51 all toilet facilities can endanger some students. Persons with disabilities are seldom involved in the process of designing school facilities or in helping modify Employment and Livelihoods existing arrangements to better meet their needs and requirements. Tanzania’s legal framework attempts to enable livelihood opportunities. The UNCRPD guarantees the right of persons with disabilities to pursue and obtain “A student with disabilities was repeatedly falling in the latrine basin (squatting type) work on an equal basis with others. This includes the right to gainful employment, because of her size. Ultimately the student decided to use a bucket instead. When the where they can earn a living through work that is chosen freely in a labor market improvisation measure was discovered by school authorities, the child was expelled and performed in an environment that is open, inclusive, and accessible. As from school for that action irrespective of reasons that drove her to do it.” mentioned previously, the Disabled Persons Employment Act of 1982, updated Mbeya FGDs -Tanzania Mainland in 2010, requires that at least 3 percent of employees in companies with a workforce of 20 or larger be persons with disabilities. In Zanzibar, the Zanzibar Social Security Fund (ZSSF) provides conditional and unconditional cash and in- kind transfers, social pensions, and school feeding systems. The 2022 Zanzibar Box 3 Disability Act reaffirms the rights of persons with disabilities to work and employment and mandates ministries and “institutions responsible for labour and employment to ensure the creation of enabling environment empowering persons with disabilities to be engaged in employment, self-employment or Transporting children with disabilities contributes participation in the national, regional and international labor market.”52 It also to parents’ time poverty establishes the Zanzibar Development Fund for persons with disabilities. Children with disabilities lack access to assistive devices and modes of transportation to travel Persons with disabilities are left out of the workforce, and exclusion is long distances to and from school (especially in the few schools that accommodate children with disabilities). The situation is more prevalent among families who live in rural areas. Parents and costly. The formal Sector Employment Survey Report 2015 indicated that in caregivers of school age children with disabilities (notably mothers under the poverty line) shoulder Tanzania mainland, out of 767,000 employees in the public sector, only 0.1 the responsibility of carrying children with severe levels of disabilities to and from school. As such, percent had some form of disability, rising to 0.6 percent in the private sector. many hours and days are spent on a single family member at the expense of the rest of the family. This often has a disproportionate effect on women more than men. In part, this might be explained by supply factors: exclusion in the education system (leading to low literacy rates and the lack of degrees) and limited access This is confirmed by the data. According to the 2018/19 HBS, 0.2 percent of people in Mainland to trade schools. According to a 2018 report53 of the Comprehensive Community Tanzania spent all their time looking after a person with disability and 0.2 percent of the sample population spent some time taking care of a person with disability. In Zanzibar, 6.4 percent of the Based Rehabilitation in Tanzania (CCBRT), the exclusion of employees with sample population spent all their time looking after a person with disability and 2.8 percent of the disabilities from the workplace, either through discrimination or inaccessible population in Zanzibar spent some time caring for a person with disability (Zanzibar HBS 2019/20). work environments, costs Tanzania $480 million every year. Only 3.1 percent 51. FGDs. 52. Zanzibar Government Assembly. 2022. “The Persons with Disabilities Act.” Act number 8. 53. Hope and Health in Tanzania - Kupona Foundation Annual Report 2019, kuponafoundation.org/wp-content/uploads/2021/01/Kupona-2019-Annual-Report-pdf. 48 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 49 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities receive income from paid employment resulting in households headed by Government (PORALG) are then tasked with verifying this information before persons with disabilities experiencing greater levels of poverty. extending this benefit to households. During the mass validation exercise carried out in 2020, TASAF collected data on those living with disabilities Women with disabilities noted that stigma and sexual exploitation is among all households enrolled in the program. As of January 2021, information commonplace in seeking work. They were commonly subject to exploitation on 178,000 households, including 202,000 people with disabilities, had been and abuse, including sexual harassment and abuse when they apply for jobs. updated in PSSN’s database. Lack of transparency in allocation of TASAF The experience of trauma adversely impacts their creativity, self-confidence, financing is perceived as the main challenge to accessing funds. “Some health and well-being – important skills for both entrepreneurs and job seekers. respondents noted that they see nepotism as a challenge to being selected as Women with disabilities are also vulnerable to abuse from spouses54 and beneficiary households of the program, since many who consider themselves desertion by male partners once they become pregnant. to be eligible were not selected or even considered. This points to limited understanding of the selection process and eligibility criteria of the program, and its objectives.” In Mbeya, when a visually impaired young lady applied for a job, she was asked for carnal knowledge (surprisingly by a boss who also had a disability) in order to help her secure the advertised job opportunity (“tupumzike kwanza kwa wiki moja ili nikusaidie kupata ajira”). “In Longido District, none of persons with disabilities qualified for TASAF support but a A blind female participant in the top leadership of ODPs in Mbeya Region-Tanzania Mainland. non-disabled person with a herd of 1000 cattle qualified by merely looking at his type of abode.” Cited in FGD-Arusha. Social Protection Through the Tanzania Social Action Fund (TASAF), the government of Tanzania has implemented a Productive Social Safety Net (PSSN) Program “I was deleted from the TASAF list of beneficiaries on grounds that I contested for a for the poor and vulnerable, including persons with disabilities. However, voluntary leadership position in an OPD.” challenges in accessing social protection programs remain owing in part Anecdote by a male participant with a physical disability and a leader of to the program’s limited coverage. Some of the features of PSSN include an OPD-Kigoma region-Tanzania Mainland. implementing community savings and investment programs, providing cash transfers, and increasing the productivity of vulnerable households, including those of persons with disabilities.55 The program, however, targets exclusively on the basis of poverty and not categorically, i.e. it does not specifically target persons with disabilities. PSSN includes a small additional benefit for beneficiary households with a person with a disability, and TASAF beneficiaries must self-report their disability status to the program administrators and LGAs. Social workers under the President´s Office Regional Administration and Local 54. For instance, in study participants stated that the male partners of married women who are deaf actively restrict their wives from seeking employment. This has resulted in high unemployment rates and financial dependance. In Mainland, women with disability noted it was common for male partners to advise women with disabilities to sell assets or properties and then leave home with the profits. 55. TASAF defines disability as per national legislation and is in line with the Persons with Disability Act from 2010. 50 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 51 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Health “My son with hydrocephalous changes pampers five time a day which is too costly for Through various legislative and policy frameworks, the Tanzanian govern- the family to afford.” ment has shown a commitment toward ensuring access to healthcare for A parent of a child with Spina Bifida and Hydrocephalous and persons with disabilities. In 2022, the URT pledged to include disability data a leader of the Federation’s OPD-Pemba-Zanzibar. in its Health Management Information System at all levels. They also pledged to increase the accessibility of health facilities and services for persons with disabilities. The Universal Health Coverage Bill of 2023 seeks to expand access Negative attitudes and misinformation from health care service providers to health insurance in the country and makes it compulsory for all citizens to are barriers. Misinformation and or guidance from medical professionals is have health insurance, with special mechanism in place to help finance care for common. Parents of children with spina bifida and hydrocephalus, for example, those citizens unable to pay.56 This will likely expand access to healthcare for are often told that they are unlikely to survive much beyond the diagnosis which men and women with disabilities, who are often in vulnerable situations and negatively impacts family confidence and their decision to seek treatment. unable to bear the costs of services. Some non-government actors57 have also Healthcare providers violate the privacy rights by refusing to provide private attempted to establish health facilities to ensure better access. rooms and SLI consultation services. About 66 percent of women with The cost of medical care is prohibitive and access to healthcare remains disabilities in the 2018 the TEPDGHO study reported different forms of verbal an issue for persons with disabilities. A 2018 study58 found that access abuse or discriminatory practices when seeking maternal care. There is also a challenges centered on affordability, distance to health facilities, inadequate lack of tailored sexual and reproductive health education programs for persons medicines or medical equipment in district hospitals, lack of specialized with disabilities, which perpetuates stigma and harmful myths, particularly care and rehabilitation services, poor maternal health services, stigma and addressed towards young people and women with disabilities. discrimination, and communication barriers. The district hospitals surveyed all had inaccessible infrastructure, unsanitary toilets, non-adjustable beds, and lack of elevators, amongst other issues. Although stipulations in the 2007 “Additionally, healthcare providers often dismiss the complaints of persons with National Health Policy require the Tanzanian government to provide quality, disabilities. In a situation where a patient with a physical disability was struck by a equitable, and accessible healthcare to citizens with disabilities, about 94 drunk motorcyclist, the medical personnel asked him why he got into an accident in percent of persons with disabilities interviewed in the 2018 The Empowerment the first place and dismissed him by simply prescribing paracetamol despite the severe injuries he sustained” for Persons with Disability and Gender Health Organization (TEPDGHO) study could not afford the cost of medical services. Direct medical care costs include A deaf male participant and a representative of an OPD in Kigoma Tanzania Mainland. expenditures for medical goods and services, routine and specialized services, consultation, counseling, and medication. Persons with disabilities considered that direct medical care cost of an operative to insert a shunt to support a child with spina bifida and hydrocephalus remains costly. When a woman with disability tried to access condoms. This was the response of a health professional: “You are disabled; what do you need a condom for?” 56. Tanzania enacts the Universal Health Insurance Bill. Partners for Health Social Protection Network. 7 December 2023. A parent of a child with Spina Bifida and Hydrocephalous and https://p4h.world/en/news/tanzania-enacts-the-universal-health-insurance-bill/#:~:text=On%20November%201%2C%20 a leader of the Federation’s OPD-Pemba-Zanzibar. 2023%2C%20the,a%20comprehensive%20health%20insurance%20system. 57. Examples include the Karagwe CBR Program (KCBRP), Comprehensive Community Rehabilitation in Tanzania (CCBRT) (Dar es Salaam and Moshi), Muhimbili National Hospital, Monduli Rehabilitation Centre, Kilimanjaro Christian Medical Centre (KCMC), Jakaya Kikwete Cardiac Medical, Lake Victoria Centre (LVDC), Bugando Referral Hospital, and Gabriella Children Rehabilitation Centre (Moshi). Private organizations, such as Marie Stopes, provide reproductive health education for persons with disabilities in three district councils in the Mbeya region. The Mbeya referral hospital is the only health facility in the region to employ a sign language interpreter. 58. Study conducted by the Empowerment for Persons with Disability and Gender Health Organization (TEPDGHO). 52 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 53 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Accessible Infrastructure and Transport “When advised on accessibility consideration, one estate owner rebutted ‘I did not Transportation: build for the disabled’” (“Sikuwajengea walemavu”) The United Nations Convention on the Rights of Persons with Disabilities requires A woman with physical disabilities and a veteran high leader in OPDs-Zanzibar. states to take appropriate measures to ensure men and women with disabilities have access to transportation, buildings, roads, and other infrastructure on an equal basis with others. The 2010 Persons with Disability Act mandates that the design, construction, and refurbishment of infrastructure considers the Communications and Information and Communication special needs of vulnerable groups and persons with disabilities. The 2019 Technology (ICT) Tanzania Public Bodies, Code of Practice, Standards & Guideline on Accessibility Requirements for Persons with Disabilities underlines that “accessibility” as a The Government, through various policies such as the Access to Information pillar in the process of implementing the UNCRPD and special attention is given Act, 2016, and the National ICT Policy, 2016, has put measures in place to to whether the needs of vulnerable road users. support better access to communication, information, and ICT, though it remains a challenge. Barriers include: A flagship example of disability-inclusive transportation is the Bus Rapid Transit (RBT) System in Dar es Salaam, where accessibility features include the use Inaccessible information and lack of adequately trained sign language of the universal symbol of accessibility, traffic lights with acoustic signals to interpreters. General information is typically not accessible to persons with assist those with sensory impairments, access ramps for passengers with sensory-related vision impairments. For example, printed literature, including mobility impairments, as well as marked pedestrian crossings. However, newspapers, is neither produced in braille nor in large fonts, and is also not despite exceptions like the RBT in Dar-es-Salaam, disability-inclusive public provided in plain text versions Both public and private media houses, as well transportation infrastructure in the country remains inadequate.59 Literature other sectors, rarely employ sign language interpreters and the Tanzania from SSA points to encouraging examples, such as Ghana, of countries Communications Regulatory Authority (TCRA) has no regulations on sign integrating comprehensive disability-inclusive transport policies and guidelines language interpretation and media houses. Persons with hearing impairments into their national transport policy frameworks.60 are further tasked with making out-of-pocket payments before they can access news or information that is readily available to the public for free. Where sign Public transportation vehicles in Tanzania are physically inaccessible language interpreters’ services are provided by media houses, they are limited particularly for individuals in wheelchairs and those with visual impairments. to news bulletins rather than information of public interest or emergencies. Even in big cities like Dar es Salaam and Arusha there are no boarding platforms and bells at traffic lights. Renovation of the historic Stone Town in Zanzibar continues to disregard the accessibility requirements of users with disabilities, and existing walkways are encroached by petty traders, which makes walking “Sign language interpretation services are not commonly practiced, e.g., where difficult for those with a physical disability. Shopping facilities are constructed practiced, portrayed (by TVs) sizes of an interpreters are too small to be visibly without dedicated parking lots, slippery and steep ramps (in cases where ramps comprehended; a case of deaf person who was slapped by a police officer by being mistaken as a naughty guy who ignored the blown horn to give way” were available), and open sewages and gutters. A deaf male participant and a member of the governing board-Federation of OPDs – Dar es Salaam - Tanzania Mainland. 59. UNPRPD. 2022. 60. Vandershuren, Nnene. 2021. Inclusive planning: African policy inventory and South African mobility case study on the exclusion of persons with disabilities. 54 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 55 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Politics and Public Life The prevalence of negative attitudes is a significant barrier to competing for political and public offices. Persons with disabilities experience constant Several international, regional, and local instruments, including the International ridicule, which erodes their self-confidence and thus prevents them from Bill on Human Rights, and the 2010 Persons with Disabilities Act as well as the running for political and public offices. These individuals also lack acceptance 2022 Persons with Disabilities Act from Zanzibar articulate the rights of citizens by community members who judge them to be unfit. Illegal disqualification or with disabilities to fully enjoy public and political life on an equal basis with withdrawing from political contests due to threats, bribery, promise of favors, others. These provisions include the right and opportunity for persons with and prohibitive costs are commonplace. disabilities to vote and to be elected, yet these rights are often not enforced. Provisions in the Constitution of Tanzania and the Persons with Disabilities Act of 2010 are discriminatory. The Constitution of Tanzania disqualifies persons with mental disabilities from candidatures, and it considers mental disability “I was disqualified from contesting for a political position on grounds that I was not born at that locality, had no house of my own, and had a disability” a basis for depriving a citizen of his or her right to vote, be voted for, and hold public office. This sentiment is also echoed by the 2010 Persons with A male participant with a physical disability and a leader of an Disabilities Acts where cognitive disability is equated with insanity, or unsound OPD- Morogoro Municipal Council-Tanzania Mainland. mind, and ground to remove political rights. Contrary to articles 6 and 7 of the UNCRPD,61 with the exception of the 2022 Zanzibar Persons with Disabilities Act, none of the disability-related Acts have provisions that aim to safeguard the rights to women and girls with disabilities. This affects the ability of women with disabilities to run for political office and leadership positions, which is also contrary to the Convention on the Elimination of all Forms of Discrimination Against Women. There are very few opportunities for women and girls to be in leadership positions. A focus on encouraging voting. The Tanzania mainland government has made a commitment to improve awareness and sensitization of voting rights for men and women with disabilities. General election evaluations carried out by CCBRT (in 2010) and by the Tanzania Federation of Disabled People’s Organizations (SHIVYAWATA) (in 2016) to assess the level of participation of men and women with disabilities in Tanzania’s general elections reveal poor participation. The absence of information in accessible formats, lack of orientation on the use of tactile ballot papers, abrupt relocation of polling stations, wheelchair inaccessible polling booths, and exclusion in electing candidates at the political party level all inhibit voting and running for leadership positions. 61. UNPRPD. 2021. Highlighting successful outliers Highlighting successful outliers in private and public decision-making structures: in private and public decision-making structures: “Though I have a physical “I see no problem because of disability, still I have been a support rendered by community member of “Serikali ya Mtaa” members. I have been a for 20 years and “ten houses member of “Water Committees cell leader” for 15 years and at village and Ward levels” was awarded Tshs 500,000= by the CCM Secretary General in FGD-Morogoro-Tanzania Mainland. recognition of my struggles“ A male participant with physical disability- Morogoro-Tanzania Mainland. 58 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 59 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Need for enhanced collaboration with the government and internally amongst OPDs: OPDs continue to work towards enhancing cooperation between themselves and social welfare officers at the ward and district levels. Their joint advocacy efforts, however, are stymied by silos, inter-agency disputes and internal conflicts, which harm their potential at collectively tackling several of these issues. OPDs need to invest in bettering their institutional governance, ensuring diversity among its leadership and memberships by considering issues such as type of disability, gender, age, geographic representation, and at improving the capacity of their staff. The siloed, grassroots activities could be improved if these organizations invested in bettering their coordination mechanisms. OPDs lack of funding at the grassroots levels remains a huge barrier: Key development partners62 support the disability agenda in several ways, including in providing financial and technical support. OPDs often have a strong focus on urban areas, leaving the rural poor population critically underserved. National-level programs rarely effectively cascade down. Organizations that do not fall under OPD umbrella but still do small scale and effective work in their communities struggle for visibility and access to donor funding. OPD’s encouraged the WB to continue to strengthen stakeholder engagements during the execution of projects. There are incidences of several projects where they were consulted on but advocated for more collaborations, especially at the design stage. They encouraged the establishment of disability focal points at the country office level to further deepen engagement between OPDs and the World Bank. There have been several successes from CSO and OPD engagement on the disability agenda, which have resulted in improved enrollment rates of school-age children with disabilities,63 enhanced training64 and access to vocational skills,65 and promoting sports for youth with disabilities and resettling youth that were abandoned because of their disabilities.66 Photo by SeventyFour Images 7. INSTITUTIONAL 62. For instance, Wellspring Advisors (via the Foundation for Civil Society (FCS)), The Foreign Commonwealth and Development Office (FCDO) (via FCS) and Action on Disability Development, Sense International, Sight Savers International, Leonard Cheshire, Finish Development Agency (via the Finnish Embassy to Tanzania, Abilis Foundation, UNFPA, UN Women), and Swedish Development Agency (via MyRight). UNICEF, United Nations Development Programme (UNDP), and ILO. LANDSCAPE 63. Child Support Tanzania, Jipemoyo, and Edukaid. 64. Sanaa Arusha and Lake Victoria Disability Center (LVDC). 65. Sibusiso Arusha, LVDC, Mehayo and Amani Rehabilitation and Vocational Training Centers. 66. Amani and Mehayo Rehabilitation Centers. 60 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 61 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities The implementation of the UNCRPD is an entry point for INGOs work, although greater collaboration among key stakeholders is needed. There is a need for better definition on the scope of their programming, monitoring, and training of local OPDs to follow global conventions and capacity building for better advocacy. This would also enable the voices of women with disabilities to be represented in policies and disability programs and would permit for a more frequent evaluation of the implementation status of the UNCRPD. Greater collaboration and coordination between various government agencies tasked with implementing disability-inclusive programs is required along with more streamlined programming. The lack of subsidies prevents persons with disabilities from accessing opportunities and essential care. Although government policies and other programmes are designed specifically for citizens with disabilities, high levels of poverty meant that even targeted beneficiaries could not bear additional costs. For example, the Prime Minister’s Office sponsored 50 youths with disabilities to undergo vocational training at Lake Victoria Disability Center but less than half of them could afford meal payments. Hence, attendance at the training was poor. Greater dedicated financial support for such initiatives is required. In Zanzibar, CSOs use their funds to subsidize healthcare costs for persons with disabilities but inaccessible and ill-equipped health services in hospitals were a hindrance. For example, there is only one dermatology expert (for people with albinism) at the Mnazimmoja Hospital, while no such expert was present in Pemba and no services to address hydrocephalous and spina bifida related problems. 62 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 63 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities Over the past decades, Tanzania has shown a strong commitment to advancing the rights and requirements of persons with disabilities. The country has adopted several disability-inclusive legislative commitments that have enshrined the rights of persons with disabilities into law. However,, significant challenges remain. This report has demonstrated the extreme complexity involved in advancing the needs of persons with disabilities in the country as well as the multiple barriers and challenges persons with disabilities face. As outlined throughout this report, certain kinds of disabilities and marginalized identities make some persons with disabilities more vulnerable than others. Disability prevalence among children is higher in poorer households and women and girls with disabilities are particularly vulnerable to sexual abuse, assault, exploitation, and multiple forms of GBV and deprivation of their rights to health, particularly sexual and reproductive health. Gaps in the implementation of the country’s legislative and policy framework include insufficient awareness and lack of enforcement of laws and the implementation of disability policies. In this overall context, a pragmatic, incremental approach, adopting a bottom- up people-centric approach, whilst not losing sight of necessary top-down policy and legislative changes, seems practical. Given the long-standing discrimination faced by persons with disabilities in Tanzania, and the many challenges in financing that accompany building disability-inclusive policies, moving forward, a gradual, cross-sectional, approach is required, that considers both mainstreaming strategies and affirmative action. The update of outdated and non-UNCRPD compliant disability policies and legislation as well as expansion and implementation of disability-inclusive policies and programming should be spearheaded by the government, while also ensuring wide-reaching networks of collaboration with OPDs, donors and the private sector. The challenges facing persons with disabilities are not uniform and vary Photo by Freepik significantly based on the form of physical disability – seeing, hearing, communication, cognition, walking, or self-care – they experience as well as by demographic and socioeconomic backgrounds. Disability-inclusive laws and 7. programs services should thus be adequately tailored to meet the diversity of KEY functional physical challenges and other intersecting dimensions facing persons with disabilities. An overarching sectoral audit on the accessibility challenges facing persons with disabilities in the country could also serve as a first step RECOMMENDATIONS to help identify the most pressing policy gaps. Literature from SSA points to 64 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 65 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities encouraging examples, such as Ghana, of countries integrating comprehensive ACTION PRIORITY LEVEL disability-inclusive transport policies and guidelines into their national transport policy frameworks.67 Improve data collection As mentioned in the Executive Summary, this section offers two sets of Scale up the use of the piloted Persons with Disability Management Information System (PD-MIS) in mainland Tanzania and Jumuishi database in Zanzibar and Immediate recommendations; one set specifically for the government and the second set allocate resources for their long-term sustainability. of recommendations is directed at OPDs, donors and the private sector. Both set of recommendations are organized by order of priority in what is considered Refer to the WG-SS for all future censuses and household surveys to harmonize the definition of disability and ensure consistency in their analysis of gathered data; low hanging fruit versus those areas which require more medium to long-term Long term conduct proper training for enumerators; include organizations of persons with investments in research, policy, and programmatic actions. In addition to the disabilities in the data generation process. recommendations included in this report, the hope is that this piece helps Enhance inclusive service delivery catapult country-level policy dialogue of the challenges facing persons with disabilities and support the GoT in their mobilization of resources. Scale up the use of the piloted Persons with Disability Management Information System (PD-MIS) in mainland Tanzania and Jumuishi database in Zanzibar and Immediate allocate resources for their long-term sustainability. Refer to the WG-SS for all future censuses and household surveys to harmonize the definition of disability and ensure consistency in their analysis of gathered data; For Government conduct proper training for enumerators; include organizations of persons with Long term disabilities in the data generation process. ACTION PRIORITY LEVEL Enhance inclusive service delivery Expand, uphold, and update legislation and policy Education: Expand availability of accessible learning materials and assistive devices. Train teachers in inclusive education practices. Ensure adequate financing The Prime Minister’s Office on Labour, Youth, Employment and Persons with to support the implementation and operationalization of the National Inclusive Disabilities (PMO-LYED) (Mainland) to finalize and disseminate the new disability Education Strategy. Use the National Continuous Professional Development Immediate Immediate policies and acts for Mainland. The Zanzibar Department of Disability Affairs (DDA) Framework to develop skills and awareness for all teachers on inclusive education. to disseminate 2022 Zanzibar Persons with Disabilities Act No 8. Review and modify the time allocated for children with disabilities to qualify and complete their national examinations. Explore best practices across the world to see The PMO-LYED and the Zanzibar DDA to harmonize domestic legislation and policies how the cost of learning materials and assistive devices can be reduced. Medium term so they do not contradict or violate the UNCRPD. Protection from violence: Ministry of Community Development, Gender, Women PMO-LYED and Zanzibar DDA to set up reporting mechanism on the UNCRPD. The and Special Group and Ministry of Community Development, Gender, Elders and URT must invest in monitoring systems at the local level through disability focal Medium term Children to utilize the framework of the National Plans of Action to End Violence Immediate points or strategic engagement with OPDs on disability reporting. Against Women and Children to integrate protective services, counseling, and appropriate social services for people with disabilities. Establish safe spaces and GoT to enact laws and strengthen existing laws to effectively prosecute crimes provide inclusive prevention and response services to GBV. against persons with albinism; consider enacting hate crime laws. Adopt a comprehensive approach to mainstream and promote disability-inclusive language Long term Health: Ministry of Health to train and provide healthcare providers in disability in government policies, strategies and programs, with a focus on women and inclusive practices. Ensure young people and women with disabilities have access to Immediate marginalized populations. sexual and reproductive health. Livelihoods and Employment: Partner with the private sector to invest in inclusive vocational training, skills development, and implementation of employment quotas in private sector. Mainstream disability inclusion in government job creation Immediate programs. Continue offering loans and grants for entrepreneurs with disabilities – but with enhanced transparency. 61. UNPRPD. 2021. 66 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 67 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ACTION PRIORITY LEVEL For OPDs, Donors with support from the Private Sector: Transport: Assess the transportation needs of persons with disabilities, particularly ACTION PRIORITY LEVEL in rural areas and with public transport providers. Consider investing in training Medium term government contractors on universal access design standards. Reduce stigma through scaled-up awareness raising. Raise awareness about the causes of disability, the importance of inclusion, and the need to respect the Infrastructure: Raise awareness and knowledge to ensure that all new buildings, rights of persons with disabilities. Provide psycho-social and mental health care Immediate schools, healthcare clinics designed by the government and the private sector Medium term interventions for persons with disabilities who have been bullied, traumatized, guarantee proper access to persons with disabilities. attacked, and discriminated against. Infrastructure: Ensure that all existing public and private infrastructure follows Enhance strategic funding, including with cross donor collaboration with a focus Immediate disability-inclusive access designs. on underserved regions and groups: Donors contribute to funding government, OPD and CSO initiatives. This can be done in more accelerated and enhanced way on Social Protection Programs: Address the implementation challenges, including Immediate key strategic issues. Donors should consider strengthening disability in other cross- lack of transparency and discrimination, that prevent persons with disabilities from Medium term cutting areas such as gender, education, child protection, social protection and in accessing TASAF and other social protection programs. health systems strengthening. Hiring people with disabilities: Governments should commit to hiring qualified Enhance coordination: Enhance cross-donor collaboration with a focus on persons with disabilities and creating workplaces that accommodate people with underserved regions and groups. OPDs should define key sectoral expertise and Medium term Medium term different abilities. Also increase participation of persons with disabilities and OPDs collaborate on knowledge, partnerships, and funding in the design of government schemes and programs. Commit to hiring people with disabilities: Employers can commit to hiring qualified persons with disabilities and creating workplaces that accommodate people with Medium term different abilities. Private sector companies can consider providing internships, apprenticeships for persons with disabilities to make them more employable. Enhance the participation of persons with disabilities in designing schemes and programs: Persons with disabilities are asking to be actively consulted during Medium term project or program design phase as well as during implementation. 68 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 69 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities documents.worldbank.org/curated/en/437451528442789278/Disability-inclusion-and-accountability-framework 17. 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European Disability Strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe. https://eurlex.europa.eu/LexUriServ/LexUriServ.do?uri=COM%3A2010%3A0636%3AFIN%3Aen%3APDF 30. The United Nations Partnership on the Rights of Persons with Disabilities (UNPRPD). 2021. “Situational Analysis On Persons With Disabilities: Country Report. 10. German Federal Ministry for Economic Cooperation and Development (BMZ). 2015. “Applied Research Concerning Inclusion of Persons with Disabilities in Systems of Social Protection: Social Protection Policy Analysis, Tanzania.” 31. The United Republic of Tanzania Ministry of Health, Community Development, Gender, Elderly and Children. 2021. https://www.unprpd.org/sites/default/files/library/2022-11/CR_Tanzania_2021.pdf?ref=disabilitydebrief.org “Health Sector Strategic Plan: July 2021 – June 2026 (HSSP V) Leaving No One Behind. 2021. 11. Human Rights Act. 2019. “Tanzania Should Move Ahead With An Albinism Protection Plan”. , https://www.hrw.org/ 32. The United Republic of Tanzania National Bureau of Statistics, Ministry of Finance and Planning. 2016. Disability news/2019/04/23/tanzania-should-move-ahead-albinism-protection-plan Monograph. 12. Human Rights Watch. 2019. ““It Felt Like A Punishment”: Growing Up With Albinism In Tanzania.” 33. The United Republic of Tanzania: National Ministry of Education, Science and Technology. National Strategy for Inclusive Education, 2021/22-2026/26. 2021. 13. Jose Montes & Rachel Swindle, 2021. “Who is Disabled in Sub-Saharan Africa?Who is Disabled in Sub-Saharan Africa?,” World Bank Publications - ReportsWorld Bank Publications - Reports 35536, The World Bank Group. 34. The United Republic of Tanzania. 2004. “The National Economic Empowerment Policy.” https://www.uwezeshaji.go.tz/ uploads/publications/sw1544002360-Policy.pdf 14. Mapunda, P.H., Omollo, A.D. & Bali, T.A.L. 2017. “Challenges in identifying and serving students with special needs in Dodoma, Tanzania”. ICEP 11, 10. 35. The United Republic of Tanzania. 2004. “Tanzania Employment and Labour Relations Act, 2004.” http://parliament. go.tz/polis/uploads/bills/acts/1453997277-ActNo-6-2004.pdf 15. Mbughuni, L. 1974. “The Cultural Policy Of The United Republic Of Tanzania”. UNESCO Press. 1974, 36. The United Republic of Tanzania. 2007. The Roads Act, 2007. https://www.tanroads.go.tz/common/uploads/acts/ 16. Mcclain-Nhlapo,Charlotte Vuyiswa; Koistinen,Mari Helena; Lord,Janet Elaine; Martin,Anna Hill; Rana,Trishna z68d4318ced1a27694a9adb01e13a892.pdf Rajyalaxmi.Disability inclusion and accountability framework (English). Washington, D.C. : World Bank Group. http:// 70 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 71 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities 37. The United Republic of Tanzania. 2009. “ Public Health Act, 2009 (Act No. 1/09).” http://parliament.go.tz/polis/ 57. Vanderschuren, M.J.W.A., Nnene, O.A. Inclusive planning: African policy inventory and South African mobility case uploads/bills/acts/1452146412-ActNo-1-2009.pdf study on the exclusion of persons with disabilities. Health Res Policy Sys 19, 124 (2021). https://doi.org/10.1186/ s12961-021-00775-1 38. The United Republic of Tanzania. 2015. “The Electronic Transactions Act Supplement to the Gazette of the United Republic of Tanzania No. 22 Vol 96 dated 22nd May 2015.” 58. World Health Organization (WHO) & Alliance for Health Policy and Systems Research. 2017. “Primary Health Care Systems (PRIMASYS): Comprehensive Case Study From The United Republic Of Tanzania.” https://apo.who.int/ 39. The United Republic of Tanzania. 2016. “The Public Procurement Acts, 2016. Bill Supplement to the Gazette of the publications/i/item/primasys-comprehensive-case-study-from-the-united-republic-of-tanzania United Republic of Tanzania No. 21 Vol 97 dated 10th June 2016.” 59. World Health Organization (WHO) Tanzania Investment Case For 2020-21.”, https://www.afro.who.int/publications/ 40. The United Republic of Tanzania. 2018. “The Electronic and Postal Communications (Radio and Television who-tanzania-investment-case-2020-21 Broadcasting Content).” 60. World Health Organization (WHO). 2017. “Rooting Out Female Genital Mutilation In Tanzania.” https://www.afro.who. 41. The United Republic of Tanzania. 2019. Chapter 251. “The Statistics Act.” int/news/rooting-out-female-genital-mutilation-tanzania 42. The Uniter Republic of Tanzania. 2015. “The Cybercrimes Act, 2015, Act Supplement to the Gazette of the United 61. World Health Organization. 2020. “Progress Report for the Implementation of the COVID 19 Response Plan WHO Republic of Tanzania No. 22 Vol 96 dated 22nd May 2015.” Tanzania Country Office.” 43. The Uniter Republic of Tanzania. 2010. “The Architects and Quantity Surveyors (Registration) Act, in the Gazette of the 62. Zanzibar Government Assembly. 2022. “The Persons with Disabilities Act.” Act number 8. Uniter Republic of Tanzania, No 13.” 44. The United Republic of Tanzania: National Ministry of Education, Science and Technology. Home School Guide for Students with Special Needs, 2023. 45. The Washington Group on Disability Statistics. 2022. “The Washington Group Extended Set on Functioning (WG-ES).” The Washington Group on Disability Statistics. 46. The World Health Organizations (WHO). 2018. “The Zanzibar Policy Guidelines For Occupational Health, Safety And Wellbeing Of Workers In The Health System.” https://www.afro.who.int/publications/zanzibar-policy-guidelines- occupational-health-safety-and-wellbeing-workers-health 47. Tiberti,Marco; Costa,Valentina.Disability Measurement in Household Surveys : A Guidebook for Designing Household Survey Questionnaires (English). LSMS Guidebook Washington, D.C. : World Bank Group. http://documents.worldbank. org/curated/en/456131578985058020/Disability-Measurement-in-Household-Surveys-A-Guidebook-for-Designing- Household-Survey-Questionnaires 48. Tungaraza F. 2012. Who Sinned? Parents’ Knowledge Of The Causes Of Disability In Tanzania. International Journal of Special Education Vol 27, No: 2 49. United Nations Children’s Act (UNICEF). 2017. “Education fact sheet: Progress, challenges and what we want to achieve.” 50. United Nations Children’s Act (UNICEF). 2021. “Children and Young Persons with Disabilities in Tanzania. “ 51. United Nations Children’s Act (UNICEF).2021. “Living With HIV And In School.” 52. United Nations Children´s Fund (UNICEF). 2021. “Situational Analysis of Children and Young Persons with disabilities in Mainland Tanzania and Zanzibar.” 53. United Nations Children´s Fund (UNICEF). 2021. “The State of the World´s Children.” https://www.unicef.org/reports/ state-worlds-children-2021 54. United Nations Department of Economic and Social Affairs. (UN-DESA). “Disability and Development Report 2018; Realizing the Sustainable Development Goals by, for and with Persons with Disabilities.” 55. United Nations Educational Scientific and Cultural Organization (UNESCO). 2017. “Inclusive Education and Accountability Mechanism.” 56. United Republic of Tanzania Ministry of Infrastructure Development Safety and Environment Unit. 2019. “A Guide to Traffic Signing.” 72 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 73 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 2: LEGISLATIVE AND POLICY FRAMEWORK BY SECTOR I. Overall The Microfinance Act, 2018 provides conditions where banks in Tanzania are gradually liberalizing their credits conditions to be more inclusive of persons with disabilities. At the Global Disability Summit 2022, the URT made several commitments in line with its legal obligations under international instruments such as the UNCRPD, the ILO Conventions 159 on Vocational Rehabilitation and The Disabled Persons (Employment) Act, 1982 in Tanzania Mainland establishes a quota scheme mandating Employment of people with disabilities, the Violence and Harassment Convention No. 190 of 2019, as well as employers to hire persons with disabilities. However, persons with disabilities continue to be excluded from the African Protocol on the rights of persons with disabilities and the National Employment and Social Protection participating in the economic life of the country due to ineffectual implementation policies. Policy. “Chama cha Mapinduzi” (CCM) has factored disability in its 2020-2025 manifesto in various aspects. II. Education IV. Access to Justice The Inclusive Education Policy 2019 underscores early identification and interventions in schools. The Judicature and Application of Laws Act provides access to legal justice for persons with disabilities in The School WASH Guideline 2016 requires all constructed primary schools to ensure WASH facilities are Tanzania Mainland. It also offers sign language interpretation services, designation of desk officers to handle accessible to people with disabilities. matters such as printing materials (copies of the judgment, ruling, decree, order and proceeding) in Braille format for the visually impaired at no cost and provides legal aid in accordance with the Legal Aid Act. III. Labor and Employment V. Politics National Policy on Disability 2004 aims at providing a conducive environment for persons with disabilities to engage in productive work. Political Parties Act 2018 obliges political parties to set aside a section of preferential seats for eligible female members with disabilities. The Third National Five-Year Development Plan III 2021/22 – 2025/26 (FYDP III): seeks to promote employable skills for youth, women, and persons with disabilities. It mentions persons with disabilities in relation Global Disability Summit Commitment make improvements in ensuring increased participation of persons with to increased resource allocation (mainly loans), promoting human capital development, and completion of basic disabilities at all levels of leadership and decision making by 2024. education. It also outlines the government’s dedication to inclusive development through policies that focus on addressing gender barriers in promoting employable skills for persons with disabilities. Even though the plan is disability-inclusive, the text could go farther in guaranteeing the rights of people with disabilities.. While “gender mainstreaming” appears in the specific interventions that highlight the major areas of the plan’s priorities, Zanzibar Legislation “disability” does not. Persons with Disabilities (Rights and Privileges) Act of 2006 (PDA) in Zanzibar seeks to protect persons with disabilities from employment discrimination, protect their right to education, and provide medical care. It also The 2010 Persons with Disabilities Act obliges public and private sectors to employ qualified people with introduced tax incentives for the private sector to employ persons with disabilities. disabilities, ensure that they retain employment, prohibits discriminations in all stages of employment and labor relations, encourages persons with disabilities to apply for jobs, and calls for conducive and friendly working environments for people with disabilities. It also requires employers with a workforce of 20 or more to hire at least 3 percent of suitable employees with disabilities. The Financial Act protects the employment rights of persons with disabilities. It prohibits discrimination on disability basis and safeguards the right to employment in public and private entities. The Financial Act 2018 also includes persons with disabilities among those targeted by the 10 percent interest free loan package raised by LGAs to promote self-employment through entrepreneurship. The FYDP III plans to provide low-interest loans for persons with disabilities (72 billion by 2025/026) and acknowledges the fact that this group can benefit from human capital development initiatives e.g., inclusive promotion of skills, knowledge, and technological transfer. The Local Government Finance Act 2018 requires all local government authorities to set aside 10 % of their revenue collection for purposes of funding in terms of free interest loans to registered groups of women, youth, and persons with disabilities. The Employment and Labor Relations Act (ELRA) prohibits discrimination based on disability. Public Procurement Regulatory Authority (PPRA) Amended Regulations (2016) of Tanzania Mainland reserves 30% of procured services exclusively for women and persons with disabilities to register for tendering and/or providing service providers. 74 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 75 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 3: ANNEX 4: DISABILITY PREVALENCE BY REGION AWARENESS AND ACCESS TO KEY INSTRUMENTS I.E., UNCRPD AND DISABILITY LAWS AT THE GRASS ROOTS LEVEL IN TANZANIA MAINLAND AND ZANZIBAR. REGION MEN WOMEN REGION MEN WOMEN Among those who participated in the FGDs, very few were aware of the UNCRPD: Mara (10 percent); Kigoma (31 percent); Pemba (none); Mtwara (none); Morogoro (none); Mbeya (38 percent); and Arusha (none). Only 18 % of participants in Kigoma Dodoma 3.4 2.2 Shinyanga 2.7 4.8 had a copy of the UNCRPD. Arusha 3.1 4.3 Kagera 4.2 2.8 AWARE HAD A COPY OF THE UNCRPD REGION (AMONG FGD PARTICIPANTS) (AMONG FGD PARTICIPANTS) Kilimanjaro 5.8 7.9 Mwanza 3.4 4.4 Mara 2/22 (10%) 0 Tanga 6.7 6.6 Mara 2.8 2.0 Kigoma 5/16 (31%) 3/16 (19%) Morogoro 2.1 2.2 Manyara 2.8 2.9 Mbeya 6/17 (38%) Pwani 2.9 5.3 Njombe 2.4 7.5 Pemba 0 0 Dar es Salaam 3.5 4.4 Katavi 3.2 4.6 Mtwara 0 0 Lindi 4.5 3.1 Simiyo 2.7 3.3 Morogoro 0 0 Mtwara 4.2 4.9 Geita 1.9 1.7 Arusha 0 0 Ruvuma 2.6 4.6 Songwe 2.4 2.6 Iringa 1.7 4.5 Kaskazini Unguja 3.1 2.5 Mbeya 4.2 3.3 Kusini Unguja 3.1 3.1 Singida 2.6 2.2 Kurisini Unguja 2.2 3.1 Tabora 3.1 3.0 Mijni Magharibi 1.3 0.8 Rukwa 5.5 5.9 Kaskazini Pemba 3.6 2.2 Kigoma 3.4 2.8 Kusini Pemba 1.7 2.2 Note: Table shows percent of respondents, 15 years and older, who experienced “a lot of difficulty” or “cannot do at all” in at least one of the six domains. Source: DHS 2022 76 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 77 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 5: ANNEX 6: CAPACITY OF OPDs TO ACCOMPLISH THEIR MANDATE LIST OF OPDS’ WEAKNESSES The table below is an assessment of OPDs “capacities” to accomplish their missions in Tanzania Mainland and Zanzibar. The table below is an assessment of OPDs perceived weaknesses to accomplish their missions in Tanzania Mainland and Zanzibar. OPD FINANCIAL ADMINISTRATIVELY/ HUMAN RESOURCE GENERAL SPECIFIC TYPE OF BENEFITS ISSUES STRUCTURE PROBLEMS ISSUES Mobilization of members to Health services, assistive devices (sunscreen lotion, spectacles, take advantage of the 2% TAS and wide breamed huts especially for students) No reliable income (even Failure to employ personnel loans window and other Public education on albinism membership dues and contributions OPDs hardly have physical offices (formal to occupy constitutional/ openings that emerge not collected) (except for CHAVITA) operating bases) legal structures (Disability (census included persons Extends peer support. Committees) with disabilities in various Advocates for physical accessibility of public offices e.g., banks ways including training CHAWATA and other commercial facilities Distribution of assistive devices. Failure to satisfy members’ basic and Abuse of power among numerators) The URT abandoned the practice of Public education on disability related international instruments. social needs which is a demoralizing leaders of OPDs- providing subsidies to OPDs. Capacity building of member factor. organizations Public education on rights of people with intellectual disabilities. Supported a student who was exceptionally intelligent to attain Except for CHAVITA, OPDs’ fail to Soliciting health insurance TAMH take advantage of basic sources of Some OPDs do not provide their members education at the tertiary level. support for members income i.e., membership annual with copies of the constitution of the Counselling families to accept irreversible realities. Coordination of external dues, sales of membership cards organization or membership cards. partnerships Supports two girls to access medical services. and voluntary contributions. Cooperates with mental health department. Adequate Exchange of TUSPO Conducts home visits/counselling and care. Members don´t have the financial Lack of unobstructed communication information Advocates for health services at primary facilities. resources to contribute. channels (vertically and horizontally). Running clinics for members Promotes literacy and Sign Language. Inadequate professionalism CHAVITA Addresses communication barriers in various sectors especially Leadership overstaying their stipulated Commemoration of in resource mobilization (e.g., health services. terms in power. international days on appealing strategic plans). different types of disabilities Holds meetings according to constitutional requirements. Over dependence on external Duplication of functions between their Conducting public TLB Promotes access to education. sources. different members. education (TCRA/economic Reduces number of beggars on the streets. empowering groups) No dependable and sustainable ASBHAT Offers vocational skills training sources of funding, including lack Identification of school age ZAPDD Offers vocational skills training of membership annual fees and children with disabilities. contributions, and no penalties Using OPDs to amplify the Promotes accessibility considerations. against defaulters. voices and concerns of UWZ Fights GBV people with disabilities. Offers Inclusive education (CBID) Inability to troubleshoot and resolve conflicts within and among OPDs Fighting for the rights of ZACDID Vocational skills training people with disabilities No membership cards or copies for Promotes Sign language. CHAVIZA respective organizations Offers peer support and Offers Counselling services networking Running organization on voluntary Promotes sports especially for students with intellectual SOZ basis that leads some personalities to Serves as a mouthpiece for disabilities the constituency at decision institutionalize themselves making forums. HSBCO Supports hygiene paraphernalia (pampers) JMZ Promotes participation of people with albinism in community life 78 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 79 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 7: INGOs and UN AGENCIES Table 2: Types of Disabilities Focused and Thematic Areas Focused by INGOs As part of the assessment, the WB team conducted an exercise to seek an understanding of the work INGOs undertake in TYPE OF THEMATIC Tanzania. Their responses are below: INGO DISABILITY FOCUSED AREAS FOCUSED Social Inclusion (disability needs, inclusive education, health and neglected tropical Table 1: INGOs Geographic Coverage Sight Savers Sight and other disabilities diseases) International (SSI) Advocacy for policy change OPERATING AREA ONLY Early identification and interventions (visual INGO TANZANIA ONLY BOTH SIDES GEOGRAPHIC REGIONS and audio) MAINLAND ZANZIBAR OF THE URT REACHED Inclusive Education (deaf blindness) Unguja & Pemba, Lindi, Livelihood and vocational support including Ruvuma, Morogoro Deaf blindness and multisensory Sight Savers Sense International access to the 2% loan window X Singida, Manyara, Dodoma even other disabilities in some International (SSI) Tanzania (SIT) (in selected Districts or cases OPDs strengthening (Tanzania Association institutions) of Deafblind and Chama cha Wazazi wa Kilimanjaro, Ruvuma, Manyara, Watoto wenye Ulemavu Tanzania)) Dar es Salaam, Advocacy for policy change Sense International Kagera, Iringa, Shinyanga, X Technical support Tanzania (SIT) Mwanza, Singida, Njombe (in livelihood, everyone with BD is traced wherever s/he is) Policy and influence Pwani, Kilimanjaro, Iringa, Gender Unguja Magharibi (B), Youth in leadership (coaching, internship, Action on Disability Action on Disability Dodoma, Kigoma, Katavi, etc.) and Development (ADD X X and Development (ADD Cross disabilities Rukwa, Simiyu, Singida, Mara, International) International) Inclusive education Shinyanga, Mwanza and Tanga Livelihood Dar es Salaam, Morogoro, OPDs strengthening Dodoma, Ruvuma, Mwanza, Light for the World (LfW) X occasionally Shinyanga (in some thematic Economic empowerment issues, operations go beyond this list) Inclusive education especially for visually Light for the World (LfW) Visual impairment impaired students Mainstreaming disability in public sectors Enlightenment 80 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 81 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 7: ANNEX 8: INGOS INSIGHTS OF THE ADVANTAGES AND DISADVANTAGES INGOS INSIGHTS ON THE ADVANTAGES AND DISADVANTAGES OF OF PARTNERING WITH OPDs IN TANZANIA MAINLAND AND/OR PARTNERING WITH THE GOVERNMENT IN THE COURSE OF INGOS ZANZIBAR OPERATIONS IN TANZANIA MAINLAND AND/OR ZANZIBAR ADVANTAGES DISADVANTAGES PROS CONS A learning opportunity OPDs driven by money and not change e.g., misuse of opportunity when they met Some government Operational level of government and that of CSOs do not match (bureaucracy) to know the insides the President. officers are cooperative of different types of Poor accountability and coordination at the inter-ministerial levels (PMO, disabilities and for Community Development and Special Groups, LGA). experimenting with concepts. Bureaucratic/complicated processes of finalizing MoUs Possibilities to sustain Lack of visionary leaders to plan. attained results. Abrupt transfers of government operational staff after being trained at the expense of INGOs Role modelling and Self-centeredness. coordination. A driving force and Poor institutional governance (recurrence of conflicts, poor skills on resource sense of ownership. mobilization by optimally tapping emerging opportunities, lack of safeguards and other essential internal policies, lack of succession plans, and the perception that INGOs funds belong to them) Being overly urban centered. Limited application of the “collaborative’ strategy in advocacy. Implementation of pre-defined projects without flexibility The legal requirement of NGOs to re-register after every ten years affects funding prospects especially in the last three years. 82 DISABILITY INCLUSION IN TANZANIA DISABILITY INCLUSION IN TANZANIA 83 Experiences and Recommendations From People With Disabilities Experiences and Recommendations From People With Disabilities ANNEX 9: WG SHORT SET ON FUNCTIONING QUESTIONS CORE FUNCTIONAL QUESTION DOMAIN VISION [Do/Does] [you/he/she] have difficulty seeing, even if wearing glasses? Would you say… [Read response categories] 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all HEARING [Do/Does] [you/he/she] have difficulty hearing, even if using a hearing aid(s)? Would you say… [Read response categories] 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all MOBILITY [Do/Does] [you/he/she] have difficulty walking or climbing steps? Would you say… [Read response categories] 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all COGNITION [Do/does] [you/he/she] have difficulty remembering or concentrating? Would you (REMEMBERING) say… [Read response categories] 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all SELF-CARE [Do/does] [you/he/she] have difficulty with self-care, such as washing all over or dressing? Would you say… [Read response categories] 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all Using [your/his/her] usual language, [do/does] [you/he/she] have difficulty communicating, for example understanding or being understood? Would you say… [Read response categories] COMMUNICATION 1. No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all 84DISABILITY INCLUSION IN TANZANIA Experiences and Recommendations From People With Disabilities LITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY IN ZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA LITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY IN ZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA | DISABILITY INCLUSION IN TANZANIA