Technical Note on Accessibility The Narrative 1 Inside front cover Technical Note on Accessibility Part 1: The Narrative © 2022 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. 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 the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. 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Washington, DC: World Bank.” Cover photo: [© VTT Studio, Shutterstock. ] The sections that comprise the Technical Note on Accessibility are: The Narrative (Part 1); The Project Cycle Guidance (Part 2); The Five Thematic Fact Sheets (Part 3); and The Technical References (Part 4). Table of Contents Acknowledgements 8 1. Purpose and Structure of this Technical Note 10 2. Introduction to Disability and Accessibility 15 3. Why Accessibility Matters 23 Social Benefits 25 Economic Benefits 29 4. Accessibility in the World Bank Project Cycle 35 5. Accessibility in Operations 37 5.A. What to Promote: A Holistic Approach for Accessibility 41 5.A.1. Institutional Commitment 42 5.A.2. Operationalization 43 5.A.3. Enablement 44 5.A.4. Enactment 47 5.A.5. Durability 47 5.B. How To Do It: Strategies for Enhancing Accessibility 49 5.B.1. Prepare or Comply with International and Regional 50 Frameworks for Accessibility 5.B.2. Prepare or Comply with National and Local Frameworks 55 for Accessibility 5.B.3. Ensure Meaningful Participation 56 5.B.4. Assess Accessibility 58 5.B.5. Advocate and Raise Awareness 61 5.B.6. Strengthen Capacities 63 5.B.7. Collect and Manage Accessibility Data 69 5.B.8. Ensure Capitalization and Knowledge Management 72 5.B.9. Budget for Accessibility and Related Human Resources 74 5.B.10. Enhance Implementation Mechanisms 78 5.B.11. Plan and Implement Accessibility 81 5.B.12. Apply Accessibility Norms and Standards 87 5.B.13. Promote Accessibility-Sound Procurement 92 5.B.14. Involve the Private Sector 98 6. Conclusion 100 Appendix A. Glossary 103 List of Acronyms 105 Appendix B. The World Bank and Accessibility 108 Appendix C. Accessibility and the World Bank Sectors 114 of Operation Sectoral Focus 1: Accessible Agriculture 115 Sectoral Focus 2: Accessibility in Social Protection Programs 119 Sectoral Focus 3: Accessibility in Disasters and Fragile, 125 Conflict, and Violent (FCV) Settings Sectoral Focus 4: Inclusive Education and Accessible Schools 130 Sectoral Focus 5: Accessible Health Care and Services 135 Appendix D. Minimum Accessibility Requirements 140 Appendix E. Additional Reading and Resources 141  | Acknowledgements Acknowledgements The document was conceptualized and developed by a team led by Charlotte McClain- Nhlapo (Global Disability Advisor and Lead Social Development Specialist, World Bank) and Mari Koistinen (Senior Social Development Specialist, World Bank). Humanity and Inclusion partnered with the World Bank to author the document. The report was written by Erika Trabucco (Consultant, Humanity and Inclusion) with key contributions from Mari Koistinen and Sara Rotenberg (Consultant). The team is immensely grateful for the continuous engagement and valuable contributions from the Technical Note Advisory Group members Fatima Arroyo Arroyo (Senior Urban Transport Specialist • IAWT4), Oualid Bachiri (Digital Development Analyst • IDDDR), Simone Balog-Way (Disaster Risk Management Analyst • GFDRR), Narae Choi (Senior Urban Development Specialist • SURGP), Claudia Sofia Concha (Consultant • SSIGL), Kamila Galeza (Social Development Specialist • SWAGL), Jonathan Todo Hasoloan (Consultant • SURGP), Karen Peffley (Operations Analyst • HSPGE), Tigran Shmis (Senior Education Specialist • HECED), Kelly Widelska (Manager • CEGGB) and John Roland Williams (Senior Procurement Specialist • OPSPR). The team acknowledges and thanks our peer reviewers: Arturo Ardila-Gomez (Global Lead Urban Mobility & Lead Transport Economist • ITRGK), Gina Cosentino (Senior Social Development Specialist • SAWS4), Ian White (Partnership Officer • OPSEF), Sarah Keener (Senior Social Development Specialist • SWAGL), Maitreyi B. Das (Practice Manager • SURGP), Professor Maria Soledad Cisternas Reyes (Special Envoy of the UN Secretary- General on Disability and Accessibility), and Doctor Victor Santiago Pineda (President, Pineda Foundation / World Enabled, Director, Inclusive Cities Lab at IURD, University of California Berkeley, Co-chair, Disability Inclusive and Accessible Urban Development Network). The team is also grateful for the guidance of Louise J. Cord (Global Director • SSIDR) and Maninder S. Gill (Director, OPSES) as well as for valuable inputs and written contributions from several colleagues: Colin S. Scott (Consultant • OPSEF), Elizabeth Temple Smith (Consultant • OPSEF) and Christopher Mark Browne (Lead Procurement Specialist • OPSPR). Elizabeth Acul (Program Assistant • SSIGL) provided administrative support, Cheryl Toksoz and Global Corporate Solutions copyedited the Note, and Elias Constantopedos was responsible for the graphic design. 8 | Technical Note on Accessibility | Part 1: The Narrative Acknowledgements |  This Note was funded by the Human Rights, Inclusion and Empowerment Umbrella (HRIE) in the Social Sustainability Inclusion Global Practice of the World Bank. HRIE is a multidonor trust fund that aims to increase and strengthen the understanding and application of human rights principles across the work of the World Bank Group. Part 1: The Narrative | Technical Note on Accessibility | 9  | Purpose and Structure of this Technical Note 1 Purpose and Structure of this Technical Note 10 | Technical Note on Accessibility | Part 1: The Narrative Purpose and Structure of this Technical Note |  Photo: © Ya Krukov, Pexels This Technical Note focuses on various dimensions of accessibility. To learn more about the World Bank’s general commitments in the area of disability inclusion please refer to other available Bank documents on the topic, in particular, tthe Disability Inclusion and Accountability Framework. This Note describes various accessibility barriers, recommendations, methodologies, and strategies, with a particular focus on persons with disabilities. However, as highlighted throughout the entire document, it is stressed that accessibility is a universal issue that concerns a much larger population and intersects with other identities, including those of children, older persons, persons who have terminal or transient illnesses/diseases, women and girls, Indigenous Peoples, youth, sexual and gender minorities, people with temporary injuries, and mothers/fathers/caregivers using strollers and other supportive devices to carry their children. The Technical Note on Accessibility is primarily meant for World Bank Task Team Leaders (TTLs), Project Implementing Units (PIUs) and Environmental & Social (E&S) specialists. However, it can also serve as a reference for other internal teams that are working on accessibility issues with the private sector (for example with the International Finance Corporation, IFC), and the procurement sector, as well as for the Bank’s development partners, borrowing countries, nongovernmental organizations (NGOs), and organizations of persons with disabilities (OPDs). This Note focuses primarily on Investment Project Financing (IPF). Part 1: The Narrative | Technical Note on Accessibility | 11  | Purpose and Structure of this Technical Note How is the Note Structured? This narrative is one of four sets of documents that together constitute the Technical Note on Accessibility. The four sets are organized as follows: Part 1: This Narrative Content: Insights on what is meant by accessibility, why it is important for the World Bank and for borrowers, what essential conditions should be assessed and addressed in order to improve accessibility at the national level, and what strategic activities should be proposed, negotiated, and supported by the Bank. Main Audience: Task team leaders (TTLs), E&S specialists. When to Read it: When designing and implementing a Figure 1: Visual appearance project. of the Narrative Part 2: Project Cycle Guidance Content: Key steps of the project cycle in which accessibility issues should be included. Main Audience: TTLs, E&S specialists, and other managers. When to Read it: When designing, implementing, and evaluating a project. Figure 2: Visual appearance of the Project Cycle Guidance 12 | Technical Note on Accessibility | Part 1: The Narrative Purpose and Structure of this Technical Note |  Part 3: Thematic Fact Sheets Content: Practical applications and examples from various World Bank operational sectors (Urban Development, Infrastructure, Information and Communication Technology (ICT), Transportation, and Water). Main Audience: TTLs, Project Implementation Units (PIU), E&S specialists, and other managers. When to Read it: When designing and implementing a sectoral project. Figure 3: Visual appearance of the Thematic Fact Sheets Part 4: Technical References Content: A walk-through of the main accessibility recommendations in the infrastructure domain. Main Audience: PIUs, TTLs, E&S specialists. When to Read it: When implementing and following up a project that involves an infrastructure component. Figure 4: Visual appearance of the Technical References Additional resources and accessibility tools have been listed in Appendix E. Part 1: The Narrative | Technical Note on Accessibility | 13  | Purpose and Structure of this Technical Note What is the Founding Principle of this Note? Following the motto “nothing about us without us,”1 this Note stresses that regular and meaningful consultations with persons with disabilities and their representative organizations (OPDs or DPOs2) should be at the core of every intervention aiming to improve accessibility and disability inclusion. OPDs have an important role to play, in terms of both effecting sustainable change and representing the views of their community, and their contribution is essential in order to ensure the appropriateness and technical quality of the proposed solutions. What is the Scope of this Note? This Note addresses the accessibility of infrastructure, mobility, communication and ICT mainly from an urban perspective. It is estimated by the UN Department of Economic and Social Affairs (UNDESA) that by 2050 68 percent of the world’s population will be living in urban areas,3 and according to the World Health Organization (WHO) statistics 15 percent of them will be persons with disabilities4. Therefore, accessibility is a particular concern in cities and urban areas, where the majority of persons with disabilities are likely to be living in the coming decades. However, rural areas are concerned by accessibility barriers as well; therefore this document includes some references to water and sanitation facilities in rural areas; to information sharing with a rural population; and to agriculture-related activities. 1 International Day of Disabled Persons 2004 | United Nations Enable. 2 Organizations of Persons with Disabilities, sometimes referred to as DPOs (Disabled People’s Organizations). 3 United Nations. Department of Economic and Social Affairs. 2018. 2018 Revision of World Urbanization Prospects. 4 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. 14 | Technical Note on Accessibility | Part 1: The Narrative Introduction to Disability and Accessibility |  2 Introduction to Disability and Accessibility Part 1: The Narrative | Technical Note on Accessibility | 15  | Introduction to Disability and Accessibility Photo: © Ravi_Sunlight, Shutterstock It is estimated that more than 1 billion persons globally - about 15 percent of the world’s population - have a disability5. Many of them live in low- and middle-income countries (LMIC). This number is expected to increase, because the prevalence of disability is affected by a range of factors, including aging, war and conflict, natural disasters, pandemics, climate change, and forced displacement. Persons with disabilities encounter attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others. Disability-inclusive development is a universal objective to which States are bound (according to treaties they have ratified and international agreements they have adopted6); it is also a clear commitment for the World Bank, since it is directly responsive to the Bank’s twin goals of ending extreme poverty and promoting shared prosperity. The agenda of global development and poverty reduction will not be effective unless it addresses the socioeconomic inequality of persons with disabilities and ensures their participation in all stages of development programs. The 2030 Agenda for Sustainable Development is disability-inclusive and highlights the need to empower persons with disabilities. The obligation to improve accessibility in a country is based on treaties and agreements. 5 Ibid. 6 For a detailed overview of such international frameworks, please refer to chapters 5.B.1 and 5.B.2 of this note. 16 | Technical Note on Accessibility | Part 1: The Narrative Introduction to Disability and Accessibility |  The highest international framework that defines the principles around disability and accessibility is the UN’s Convention on the Rights of Persons with Disabilities (CRPD), which makes accessibility an important legal mandate for the 184 countries7 around the world that have ratified it. The CRPD defines persons with disabilities as individuals “who have long-term physical, mental, intellectual, or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”8 This seminal document has made accessibility a legally enforceable, cross-cutting issue, relevant to all sectors in all countries. Please refer to Chapter 5.B.1 and 5.B.2 for additional information on international and national frameworks. The World Bank has an important role to play in meeting the global commitment to leave no one behind in achieving the Sustainable Development Goals (SDGs). The Bank, specifically through its Environmental and Social Framework (ESF), considers persons with disabilities as those who may be vulnerable or disadvantaged either in relation to the impacts of 7 As of February 2022. 8 Convention on the Rights of Persons with Disabilities (CRPD), Article 1. Part 1: The Narrative | Technical Note on Accessibility | 17 Photo: © Ellinnur Bakarudin, Shutterstock  | Introduction to Disability and Accessibility a project, or in their ability to benefit from a project. Under the ESF, their needs and protections should be assessed and supported by both the Bank and the borrower. Several of the ESF’s Environmental and Social Standards (ESS), which establish the standards the borrowers and the project will meet, offer entry points for assessing and mitigating the risks associated with disability and lack of access. The associated Directive: Addressing Risks and Impacts on Disadvantaged or Vulnerable Individuals or Groups,9 which applies to Investment Project Financing (IPF) operations under the ESF, establishes directions for Bank staff regarding their due diligence obligations concerning any form of discrimination in relation to disadvantaged or vulnerable groups. The Directive defines disadvantaged or vulnerable individuals as “those individuals who, by virtue of, for example, their age, gender, ethnicity, religion, physical, mental or other disability, social, civic or health status, sexual orientation, gender identity, economic disadvantages or indigenous status, and/or dependence on unique natural resources, may be more likely to be adversely affected by the project impacts and/or more limited than others in their ability to take advantage of a project’s benefits.” See Appendix B for more information on disability inclusion and accessibility requirements in World Bank policies and supporting documents. Along with participation and non-discrimination, accessibility is a prerequisite for fostering social inclusion. Without access to buildings, transportation, communication, and information, a person’s participation and full inclusion cannot be ensured, and persons with disabilities will remain unable to fully benefit from the World Bank’s development investments. In addition, recent examples of global crisis, such as the COVID-19 pandemic, remind us that much remains to be done to address persistent and emerging accessibility barriers that sustain inequalities and exclude persons with disabilities as well as other vulnerable groups. NOTE: In some situations, persons with disabilities might need to receive an equitable support, rather than an equal support: for example, they may need additional communication, opportunities, and resources in order to be able to access benefits and manage risks. This means that more resources may need to be dedicated to disadvantaged or vulnerable groups than to other stakeholders. 9 World Bank. 2021. Addressing Risks and Impacts on Disadvantaged or Vulnerable Individuals or Groups. Bank Directive. Washington, DC. 18 | Technical Note on Accessibility | Part 1: The Narrative Introduction to Disability and Accessibility |  For additional details on the benefits of accessibility, please refer to Chapter 3 of this Note (“Why Accessibility Matters.”) Accessibility is not just applicable to the built environment; it also applies to mobility solutions, communication and consultation strategies and tools, and digital technologies. Accessibility can refer to:  Private and public buildings, urban areas and rural settlements, refugee camps, squares, natural spaces, open facilities like stadiums and markets, playgrounds, riverbanks, and Water, Sanitation and Hygiene (WASH) facilities, among other things.  Land, air, sea, river, and lake means of transportation, both private and public, formal and informal (buses, trains, taxis, tuk-tuks, rickshaws, paratransit, ferries, planes); the related infrastructure (stations, airports, bus stops, etc.); and the connective system that allows them to circulate (road network, bridges and underpasses, sidewalks).  Written communication (books, newspapers, leaflets); graphic communication (banners, posters, wayfinding panels in buildings); verbal and mixed communication (meetings, conferences, workshops, radio, TV); and adapted communication techniques (sign language interpretation, easy-to-read documents, braille printing).  Websites, mobile applications, files and software, information technology (IT) equipment, audiovisuals, telecommunication, specific digital aids (screen readers, captions and subtitles, adapted keyboards and mouses). Universal Design (UD) The ideal goal of achieving full accessibility relies (among other things) on application of the seven principles of universal design in reference to both new infrastructure, products, and services, and to existing ones (while taking into consideration the local context). Universal design means “the design of products, environments, programs, and services to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.”10 The seven principles of universal design are as follows:11  Principle 1: Equitable Use  Principle 2: Flexibility in Use 10 Lidwell, W., K. Holden and J. Butler. 1997. Universal Principles of Design, revised and Updated - 2nd Edition. Raleigh, NC: The Center for Universal Design, NC State University. 11 Centre for Excellence in Universal Design: The 7 Principles. Part 1: The Narrative | Technical Note on Accessibility | 19  | Introduction to Disability and Accessibility  Principle 3: Simple and Intuitive Use  Principle 4: Perceptible Information  Principle 5: Tolerance for Error  Principle 6: Low Physical Effort  Principle 7: Size and Space for Approach and Use Reasonable Accommodation While it may not always be possible to fully apply the principles of universal design, it is always possible to identify and reasonably accommodate a person who requires some specific adaptations. The CRPD defines reasonable accommodation as “necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis with others of all human rights and fundamental freedoms.”12 On the one hand, denying reasonable accommodation to persons who need it is a discrimination, as pointed out in Article 2 of the CRPD. On the other hand, reasonable accommodation should not be seen as an alternative to ensuring full accessibility in a service; the latter should always be the ultimate goal. However, sometimes in the short-term reasonable accommodations need to be adopted as a temporary, partial solution. 12 CRPD, Article 2. 20 | Technical Note on Accessibility | Part 1: The Narrative Photo: © Bill45, Shutterstock Introduction to Disability and Accessibility |  Barriers should be removed in a continuous and systematic way, gradually yet steadily13. Barriers that prevent access to existing objects, facilities, goods, and services aimed at or open to the public shall be removed gradually in a systematic and, more importantly, in a continuously monitored manner, with the aim of achieving full accessibility14 Reasonable accommodation generally does not require a significant economic cost or complicated construction activities. Some examples might be:  Moving the most essential services that are open to the public to the ground floor of a building;  Setting up a disability focal point in the reception area to help deal with operations that otherwise would require access to spaces that are not fully accessible;  Giving priority to persons with disabilities;  Providing employees with adapted IT equipment (such as screen readers or braille printers);  Providing outreach services to persons who cannot leave their homes;  Allowing more time for a student during an exam.  Providing alternative arrangements for exam taking (for example, oral exams) to help address different learning needs. When designing an accessible building, public space, product, or digital service, the needs of persons with different types of disabilities should be considered: visible and invisible, mobility-related, sensory, cognitive, and psychosocial. In addition, an unbroken chain of movement should be ensured, so that persons with disabilities may perform every single action required to achieve a certain goal, not only some of them. This can be helped by referring to the steps that make up a chain of movement (RECU):  Reach buildings, public spaces, communications, forms of transportation, and other services they may wish to use; 13 Committee on the Rights of Persons with Disabilities, General comment n°2, Article 27. 14 Committee on the Rights of Persons with Disabilities, General comment n°2, Article 14. Part 1: The Narrative | Technical Note on Accessibility | 21  | Introduction to Disability and Accessibility  Enter buildings and other spaces, and have access to written materials and broadcast messages;  Circulate inside buildings and around other public places;  Use all of the services provided, and all of the communication materials.15 Comprehensive accessibility requires a continuous commitment to engaging with persons with disabilities, and understanding ways to mitigate and remove barriers. It is important that these efforts do not exclusively focus on the physical environment, but also extend to things like providing sign-language interpretation; speech-to-text captioning for meetings and events; multiple formats of documents, to accommodate screen readers; and/or keyboard access for Web-based communications. However, where these services are not available, the focal points for accessibility should be assessing projects, events, and meetings, and incorporating accessibility mitigation and enhancement measures to allow meaningful participation for all. 15 Age and Disability Consortium. 2018. Humanitarian Inclusion Standards for Older People and Persons with Disabilities. 22 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  3 Why Accessibility Matters Part 1: The Narrative | Technical Note on Accessibility | 23  | Why Accessibility Matters Photo: © Exposure Visuals, Shutterstock The World Bank is committed to inclusion and accessibility, and has expressed this commitment through various frameworks, such as the Environmental and Social Framework (ESF); International Development Association (IDA) 19 and IDA 20; and its Ten Commitments to Disability Inclusion.16 In addition, most of the World Bank client countries are legally mandating accessibility at the national and local levels, making it critical that the work of the World Bank supports accessibility, and mainstreams it across all sectors. Countries are accountable for accessibility in regard to the international community as well as to national stakeholders, including OPDs. Many Bank clients strive to comply with international frameworks concerning accessibility (for example, CRPD, Agenda 2030 for Sustainable Development, the New Urban Agenda, the Humanitarian Charter, and the Sendai Framework); and with regional or national frameworks (for example, explicit non- discrimination and accessibility requirements in their constitutions; national disability laws; ICT accessibility standards and regulations; and/or national education policies). The Bank should ensure that its supported projects are a driving force for promoting, fostering, and implementing accessibility at various levels, and in the operations of different sectors, so that borrowing countries are incentivized to increase their compliance with their legal obligations. Therefore, understanding the main benefits of accessibility (both social and economic) is crucial for Bank teams. 16 Please see Appendix B for additional details. 24 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  Social Benefits Accessibility improves Accessibility is a the quality of life for lifesaving necessity in everyone. emergencies. Accessibility is a right Accessibility can and a legal obligation enhance protection. for states. Accessibility can break Accessibility is a a vicious cycle of condition for inclusion. exclusion. Accessibility is Accessibility can a condition for mitigate the effects sustainability. of climate change on persons with disabilities. 1. Accessibility improves the quality of life for everyone. An accessible environment is not only essential for persons with disabilities, but Part 1: The Narrative | Technical Note on Accessibility | 25  | Why Accessibility Matters also a matter of safety and usability for all users.17 According to the Organisation for Economic Co-operation and Development (OECD) “the size of the group with necessity of an accessible environment varies from 20 up to 40 percent of the society. This includes, amongst others, people with temporary or age-related mobility restrictions, pregnant women, and people with strollers or dogs. Temporary restrictions occur for example, because of lots of luggage or accident-related injuries. From age-related restrictions, especially small children and elderly people are affected.”18 2. Accessibility is a right and a legal obligation for states. States that have ratified the CRPD19 are legally required to implement accessibility in all domains (infrastructure, communication, transportation, and ICT); and its implementation is monitored at the international level through various mechanisms, including through reports to the CRPD. Among other things, accessibility is recognized as essential to ensure fundamental rights like freedom of movement and freedom of opinion and expression, as well as for the right to life/survival, the right to health, the right to quality education, and the right to the highest attainable standards of physical and mental well-being. 3. Accessibility is a condition for inclusion. Accessibility (together with non-discrimination and participation) is a condition for inclusion. More accessible environments put persons with disabilities in a better position to fully reach their potential as human beings in the domain of their choice, and to live their lives on an equal basis with others. Accessibility boosts dignity and self-esteem because it allows persons with disabilities to live their lives in a more autonomous way, with the freedom to make their own decisions, live independently, and be included in the community. Accessibility also contributes to reducing the level of inequality that may exist in a country. For example, with universal accessibility, persons with disabilities will be able to exercise their right to education, work, and political participation, thus reducing social gaps. 17 Rebstock, M., 2017. Economic Benefits of Improved Accessibility to Transport Systems and the Role of Transport in Fostering Tourism for All. Discussion Paper No. 2017-04. Prepared for the Roundtable on The Economic Benefits of Improved Accessibility to Transport Systems (3-4 March 2016, Paris). International Transport Forum. OECD. 18 Ibid. 19 OHCHR. n.d. CRPD status of ratification interactive dashboard. 26 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  4. Accessibility is a condition for sustainability. The effort to move toward more sustainable development, embodied in Agenda 2030 and in the SDGs, will not be successful unless inclusion and accessibility are systematically considered in every strategy and intervention. Accessible environments, both physical and digital, are essential for truly inclusive education systems (SDG 4) and health care programs (SDG 3) to exist. Accessibility is crucial to ensuring equal employment opportunities to all (SDG 8) and, ultimately, to reducing poverty (SDG 1) and inequalities (SDG 10) as well. It is essential to ensure that water infrastructure and hygiene promotion activities are available to all (SDG 6), and that persons with disabilities can benefit from the essential freedoms available within cities, infrastructure, and mobility solutions (SDG 11). Finally, introducing accessibility-related approaches in the design, production, and procurement of works, services, and goods will promote innovation for all (SDG 9). 5. Accessibility is a lifesaving necessity in emergencies. Accessible early-warning mechanisms, temporary shelters, and evacuation processes and the like are life-saving components of emergency preparedness and response, and are needed in order to keep persons with disabilities safe in the event of natural disaster or conflict. It is also of paramount importance for persons with disabilities to have access to equitable20 care and support in cases of forced displacement (refugee camps, temporary shelters, water, sanitation, and hygiene (WASH) infrastructure, or collective centers). In global emergencies like the COVID-19 pandemic, the availability of accessible information strategies and tools (such as multiple accessible formats, or accessible handwashing stations) is vital to ensure that persons with disabilities are aware of essential health-related information and instructions, and can protect themselves and their caregivers. 6. Accessibility can enhance protection. Accessible ICT and digital services can play an important role in the protection of persons with disabilities who are the victims of violence, or in need of support for other reasons. In some cases, digital appliances are an easier way for vulnerable persons in need of support, for example in relation to gender-based violence (GBV), 20 In emergencies, persons who are vulnerable are not equal—they need equitable enhanced support, communication, and resources to maintain the same level of safety as others. Part 1: The Narrative | Technical Note on Accessibility | 27  | Why Accessibility Matters to deal with. Therefore, these services must be accessible to every persons at risk, including persons with disabilities. 7. Accessibility can break a vicious cycle of exclusion. Sometimes the fact that very few, or even no, persons with disabilities use a certain service (a school, a clinic, an employment center, an office) is used to explain why accessibility is not implemented or needed. However, the lack of accessibility is often the main cause behind the limited participation of persons with disabilities to a certain service. In other words, they do not use the service not because they do not need it, but because it is not accessible to them; or it cannot be reached due to transportation constraints or an inaccessible urban environment, or even because they have not been informed through accessible communication strategies that the service is available to them. 8. Accessibility can mitigate the effects of climate change on persons with disabilities. Climate change is causing increasing hardship for persons with disabilities as well as other vulnerable groups. Accessibility of WASH and infrastructure can contribute to the mitigation of the negative effects of changing environments on persons with disabilities in relation to, for example: decreasing access to WASH; increasing emergencies due to extreme weather events, which reduces access to infrastructure, shelter, and basic services; increasing displacement/migration, or necessary migration not being possible due to disability; increasing human security and protection issues, including issues due to conflicts resulting from climate change.21 21 Lewis, D., and K. Ballard. Disability and Climate Change. Understanding vulnerability and building resilience in a changing world. Christian Blind Mission (CBM). 28 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  Economic Benefits Accessibility allows more persons with disabilities to work, and therefore to contribute to the development and increase of a country’s gross domestic product (GDP). Accessibility allows more persons with disabilities to contribute to the performance and income of the companies they work for. Accessibility is visible. Indirect impact on caretakers and families. If persons with disabilities can work, they rely less on national allowances. If persons with disabilities can work and earn a salary, they can become consumers. If persons with disabilities and their family members can work more, they can become taxpayers, thus contributing to the country’s development. Persons with disabilities are potential tourists and travelers. The cost-effectiveness of accessibility. Part 1: The Narrative | Technical Note on Accessibility | 29  | Why Accessibility Matters 1. Accessibility allows more persons with disabilities to work, and therefore to contribute to the development and increase of a country’s gross domestic product (GDP). The economic costs of disability are not only felt in the private sphere at the level of the individual and the family. Disabilities also result in significant public costs. A 2009 study by the International Labour Office (ILO) concluded that the economic losses related to disability are both large and measurable, ranging from 3 to 7 percent of GDP.22 Persons with disabilities are an untapped talent pool: in the United States, only 31 percent of persons with disabilities are employed, compared to 75 percent of persons without disabilities. In the United Kingdom it is 53.2 percent of persons with disabilities compared to 81.8 percent of persons without disabilities; in China, only 6.5 percent of persons with disabilities are employed, and in India, 25 percent.23 2. Accessibility allows more persons with disabilities to contribute to the performance and income of the companies they work for. In a survey by Accenture24 it was highlighted that companies who invested in disability inclusion had 28 percent higher revenue; that they doubled their net income; and that they had a 3 percent profit margin increase. Further analysis shows that companies led by executives who are focused on disability engagement are growing both sales (2.9x) and profits (4.1x) faster than their peers. The survey identified the qualitative business benefits of greater innovation, increased productivity, a better work environment, and employee engagement.25 3. Accessibility is visible. Accessibility, both of infrastructure and of digital services, is a visible feature. Every time citizens go out of their homes or use a website, they experience directly, and in a very powerful way, the existence or the lack of accessibility in their environment. Similarly, an accessible environment can contribute to creating a positive image of a country especially in relation to the international community, by communicating 22 Buckup, S. 2010. The Price of Exclusion: The Economic Consequences of Excluding People with Disabilities from the World of Work Employment. Sector Working Paper No. 43. Geneva: International Labour Organization. 23 Accenture. 2000. Enabling Change. Getting to Equal 2020: Disability Inclusion. 24 AAPD and Disability:IN. 2018. Getting to Equal 2018: The Disability Inclusion Advantage. Accenture. 25 Accenture. 2000. Enabling Change. Getting to Equal 2020: Disability Inclusion. 30 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  respectability, democratic concern about the well-being of all citizens, and a high level of development and advancement of the country. 4. Indirect impact on caretakers and families. If persons with disabilities need less support and help from others because of improved accessibility in their environment, caretakers and family members can also spend more time working, producing, and consuming. The indirect costs of disability are significant: the responsibility of care in lower-income countries primarily falls on family members, who must take valuable time away from earning daily wages and/or schooling. In Nicaragua, family members spent 10 hours a day, on average, caring for a family member with disabilities; this has a considerable impact on their employment prospects and home life.26 5. If persons with disabilities can work, they rely less on national allowances. Without the economic autonomy gained through work, individuals with disabilities may become more reliant on social assistance programs. Although still relatively limited in coverage, the availability of such programs is increasing across low- and middle-income countries as part of the broader umbrella of social protection, which is gaining recognition as an effective tool for economic and social development.27 In 1989, the World Health Organization noted that the aggregate costs of blindness to the national economy in India, including a minimal subsistence allowance for blind people, amounted to approximately $4.6 billion per year (Gooding 2006).28 26 Singal, N. 2007. Conceptualising Disability and Education in the South: Challenges for Research. University of Cambridge, RECOUP Working Paper 10, pg. 4. 27 Morgon Banks, L. and S. Polack. 2015. The Economic Costs of Exclusion and Gains of Inclusion of People with Disabilities: Evidence from Low- and Middle-Income Countries. CBM and London School of Hygiene & Tropical Medicine, pg. 43-44. 28 Singal, N. 2007. Conceptualising Disability and Education in the South: Challenges for Research. University of Cambridge, RECOUP Working Paper 10, pg. 4. Part 1: The Narrative | Technical Note on Accessibility | 31  | Why Accessibility Matters 6. If persons with disabilities can work and earn a salary, they can become consumers. Due to a general lack of awareness, persons with disabilities are often an overlooked customer segment; but with an estimated worldwide population of 1 billion, persons with disabilities constitute an emerging market the size of China plus the European Union. Their friends and family, who act on their emotional connection to persons with disabilities, adds another 3.4 billion potential consumers. Together, they control more than $13 trillion in annual disposable income. The aging population is also adding to the number of persons with disabilities daily, making it the fastest- growing minority. As their physical and cognitive realities change, their need and desire to remain active in society dovetails with the demands of persons with disabilities. Consumers that care about the disability market are increasingly directing their loyalty, and their consumer spending, to companies that support social principles in their hiring and production.29 Existing markets for assistive and adaptive tech is estimated to be $26 billion by 2024, nearly doubling from $14 billion in 2015. Zion Market Research estimates $31 billion in 2024, and an annual growth rate of 7.4 percent. In addition, it is estimated that the global adaptive clothing market will surpass $392.67 billion by 2026.30 7. If persons with disabilities and their family members can work more, they can become taxpayers, thus contributing to the country’s development. Increasing labor force participation of both persons with disabilities and their caregivers increases a country’s potential tax base. Because the tax systems of many low- and middle-income countries lack coverage and efficiency - particularly in their ability to capture taxes from the informal sector - any additions to the tax base, in theory, should lead to increases in government revenue. 29 Donovan, R. 2020. Design Delight from Disability. 2020 Annual Report: The Global Economics of Disability. Return on Disability. 30 Coherent Market Insights. 2018. Adaptive Clothing Market Size, Trends, Shares, Insights, Forecast - Coherent Market Insights. 32 | Technical Note on Accessibility | Part 1: The Narrative Why Accessibility Matters |  In the Philippines it was estimated that excess unemployment among individuals with unrepaired cleft lips and palates cost the government between $8 and $9.8 million in lost tax revenue. Such budgetary increases, attained through adding persons with disabilities and their caregivers to the tax base, could help free up funds for other public projects.31 8. Persons with disabilities are potential tourists and travelers. Enhancing accessibility can increase economic development, since expanding access to museums, monuments, cultural sites and events, hotels and other tourist accommodations, as well as shopping and traveling can increase market size and revenues. Many studies have attested to the economic outcomes that can accrue to businesses and industry when accessible facilities are provided. Accessibility contributes to tourism activity and occupancy, increases the customer base and market share, reduces the effects of seasonality, exploits competitive advantages, improves profitability, and enhances destination competitiveness.32 In 2012, the tourism demand in the EU generated €786 billion of gross turnover and €394 billion of Gross Domestic Product (GDP), equivalent to 3 percent of the total EU 27 GDP (27 European Union countries), and 8.7 million persons employed within the EU, considering direct, indirect, and induced contributions. Other countries may develop their tourism industries further by incorporating accessibility into their landmarks.33 If addressed at an urban scale, accessibility can become a very visible and powerful attractor for diverse groups of tourists and visitors, including persons with disabilities and those accompanying them, whether they are 31 Morgon Banks, L., and S. Polack. 2015. The Economic Costs of Exclusion and Gains of Inclusion of People with Disabilities: Evidence from Low- and Middle-Income Countries. CBM and London School of Hygiene & Tropical Medicine, pg. 43-44. 32 Gillovic, B., and A. McIntosh. 2020. Accessibility and Inclusive Tourism Development: Current State and Future Agenda. Sustainability 12(22): 972. 33 GfK Belgium. 2014. Economic Impact and Travel Patterns of Accessible Tourism in Europe. Presentation of the Key Study Findings (10 January 2014). Part 1: The Narrative | Technical Note on Accessibility | 33  | Why Accessibility Matters family members or not. The EU, for example has created the “Access City Award” to recognize and celebrate a city's willingness, ability, and efforts to become more accessible and to guarantee equal access to fundamental rights; to improve the quality of life of its population; and to ensure that everybody—regardless of age, mobility, or ability—has equal access to all the resources and pleasures cities have to offer. 9. The cost-effectiveness of accessibility. Implementing accessibility has, ultimately, a very limited cost, especially if compared to the many benefits described above. Several studies have shown that the incidence of accessibility costs in the building sector and transportation sectors, for example, are quite low, especially if embedded into and harmonized from the planning phase of a project. For additional details on the cost of accessibility, please refer to Chapter 5.B.9 “Budget for Accessibility and Related Human Resources.” 34 | Technical Note on Accessibility | Part 1: The Narrative Accessibility in the World Bank Project Cycle |  4 Accessibility in the World Bank Project Cycle Part 1: The Narrative | Technical Note on Accessibility | 35  | Accessibility in the World Bank Project Cycle When considering accessibility, one should also think about the access chain: that is, how can accessibility be considered through each stage of the project cycle. From stakeholder engagement and planning to implementation and monitoring, applying the principles of accessibility is a crucial step in meeting the World Bank’s twin goals. Given the importance of accessibility to the World Bank’s mission and vision, there are several entry points for ensuring accessibility across Bank sectors. Considerations about accessibility should be prioritized and meaningfully addressed during the initial negotiations with borrowers, as well as in the most relevant phases and documents of the project cycle (in particular identification, preparation, and implementation). By incorporating these accessibility features into all of its projects, the World Bank can make meaningful strides toward universal accessibility. Specific recommendations about the project cycle are provided in PART 2 of this Technical Note. Figure 4: Project Cycle Guidance 36 | Technical Note on Accessibility | Part 1: The Narrative Accessibility in Operations |  5 Accessibility in Operations Part 1: The Narrative | Technical Note on Accessibility | 37  | Accessibility in Operations Photo: © Roman Zaiets, Shutterstock Accessibility needs to be a cross-cutting guiding principle during the design and implementation of all World Bank-supported projects. This applies not only to new projects, but also to ongoing ones that should be revised and reoriented toward more inclusive approaches. However, the impact that the Bank can have is not limited to the way a specific project is designed and implemented; it is also in a unique position to influence how a borrowing country will address accessibility overall in the coming years. Therefore, the Bank and its teams (including TTLs, E&S specialists, and PIUs) should contribute to the promotion of accessibility in a borrowing country at all levels, far beyond what a specific project can aim for and achieve.34 This influence can be exerted regardless of whether the project concerns a sector of intervention that is directly related to the domains of accessibility (infrastructure and urban development, transportation, or ICT) or a sector focusing on other topics where accessibility is still a crucial requirement (such as education, health, disaster risk reduction or social protection). In both cases, to have a larger impact, a project should ideally adopt a holistic approach, and should aim to realize all of the main conditions for accessibility:  A clear institutional commitment that defines the way forward, that involves persons with disabilities, and that orients the operationalization strategies with measurable goals and clear timelines; 34 For this reason, this note includes references to elements that are not necessarily relevant to a project, but that should be taken into account - for example, a negotiation argument with a borrowing country. 38 | Technical Note on Accessibility | Part 1: The Narrative Accessibility in Operations |   A strong corpus of knowledge about accessibility embedded in the local institutional, technical, academic, and humanitarian community;  A significant number of practical interventions that realize accessibility and make it real for persons with disabilities in the country;  A robust effort of the capitalization of best practices and lessons learned to strongly root accessibility within local culture and expertise for long-term developments. Part A of this section of the Narrative provides insights and examples of what should be promoted by World Bank-supported interventions in a country; Part B provides many examples of how to do so. Table 1 below provides a summary of the topics that will be discussed later on. Table 1: Summary of the five conditions for accessibility and the possible activities to achieve them What (Conditions) How (Activities) Participation of Persons with Disabilities and their Representative Bodies Institutional  Advocacy and awareness raising; Commitment  Assessment and data collection for informed commitment;  Institutional framework for operationalization (laws, policies, strategies);  Budget for accessibility Operationalization  Standards and guidelines;  Authorization processes;  Monitoring bodies;  Certification bodies;  Procurement systems and rules Part 1: The Narrative | Technical Note on Accessibility | 39  | Accessibility in Operations What (Conditions) How (Activities) Participation of Persons with Disabilities and their Representative Bodies Empowerment  Involvement and consultation of OPDs;  Awareness raising of all stakeholders;  Capacity development;  Incentives for the private sector Enactment  Realization of accessibility interventions in new or existing settings;  Widespread mainstreaming through nongovernmental organizations (NGOs) and decentralized actors;  Incentives for the private sector;  Awareness raising of stakeholders Durability  Capitalization and sharing of good practices and lessons learned;  Research and innovation;  Communities of Practice 40 | Technical Note on Accessibility | Part 1: The Narrative What to Promote: A Holistic Approach for Accessibility |  5.A What to Promote: A Holistic Approach for Accessibility Part 1: The Narrative | Technical Note on Accessibility | 41  | What to Promote: A Holistic Approach for Accessibility Photo: © Vach Cameraman, Shutterstock 5.A.1. Institutional Commitment Institutional commitment to accessibility is essential for establishing obligations and requirements; providing the main tracks to follow; providing concrete boundaries regarding budget and timeline; and facilitating monitoring from the national, local, and international communities. Developing this commitment is a fundamental condition upon which the World Bank can have a great influence, especially in the initial phases of a project (identification and preparation). In many contexts, institutions are far from fully understanding the importance of accessibility, which is still often seen as a measure that requires great expenditure and effort to benefit only a small percentage of the population. During the initial negotiations with a borrower, World Bank teams have an essential role to play in advocating for an effective enhancement of accessibility through a project, in order to ultimately support the borrowing country in fulfilling its obligations toward the national and international community. Although this advocacy should be substantiated with rights-based arguments, it can be greatly reinforced by demonstrating the economic and social benefits of a more accessible society. 42 | Technical Note on Accessibility | Part 1: The Narrative What to Promote: A Holistic Approach for Accessibility |  While laws are constantly changing, the UN Department of Economic and Social Affairs provides a list of key legal documents for persons with disabilities that exist in each country.35 For additional information on how to promote institutional commitment please refer to Chapter 5.B.5 “Advocate and Raise Awareness.” 5.A.2. Operationalization Effective local operationalization strategies are essential in order to switch between theory and practice; to determine the practical ways to do so; and to define roles and responsibilities, delays, and sanctions. While many countries have progressive policies on disability inclusion, there is often a gap between what is on paper and what occurs in practice. Hence, implementation plans must translate inclusion goals into concrete targets that are monitored and assessed in evaluations.36 To turn policies into actual, practical implementation of accessibility measures, several steps are needed, for example:  Definition of the minimum standards to be achieved, and dissemination of guidance in how to better use and understand them (for example, standards for accessible constructions, websites, equipment, etc.);  Establishment of implementing mechanisms that make accessibility standards mandatory, and of authorization processes that require compliance with such standards (for example, building permits, or access to procurement processes for products and services);  Creation of monitoring mechanisms and bodies capable of ensuring compliance;  (Ideally) the establishment of certification bodies to be responsible for officially giving the “green light,” and of predefined standard operating procedures (SOPs) in 35 United Nations. Department of Economic and Social Affairs. n.d. Disability Laws and Acts by County/Area. 36 World Bank. 2017. Including Persons with Disabilities in Water Sector Operations: A Guidance Note. World Bank, Washington, DC. Part 1: The Narrative | Technical Note on Accessibility | 43  | What to Promote: A Holistic Approach for Accessibility case the relevant stakeholders (building contractors, designers, Web developers, or suppliers of IT equipment) fail to comply with accessibility standards. In 2005, a United Nations survey of 114 countries found that many had policies on accessibility, but had made little progress in carrying them out. Of those countries, 54 percent reported no accessibility standards for outdoor environments and streets; 43 percent had none for public buildings; and 44 percent had none for schools, health facilities, and other public service buildings. Accessibility standards therefore need to be incorporated into building regulations. The delays caused by the denial of permits for construction or occupancy should provide an incentive for builders and developers to comply with the rules. If there are no design reviews or inspections, the law can require effective penalties for noncompliance, and a mechanism for identifying noncompliance and correcting the offense. Government funding agencies—including those that fund health care facilities, transportation, and schools—can also review building plans as part of their approval process, using consistent standards.37 For additional details on accessibility standards please refer to Chapter 5.B.12 “Apply Accessibility Norms and Standards.” 5.A.3. Enablement Empowerment of persons with disabilities To promote accessibility it is essential that, first and foremost, persons with disabilities and their representative organizations are active actors in the processes that can lead to better accessibility in all sectors, and that they are able to influence decision makers, policies, and processes.38 Persons with disabilities need to be able to represent their rights and needs in terms of accessibility, and to advocate for them at all levels, as recognized actors in the process.39 For this reason, institutional procedures should be in place to regularly consult 37 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. 38 References can be found in the World Bank Environmental and Social Framework (ESF), particularly in ESS10: Stakeholder Engagement and Information Disclosure. 39 UNICEF, Innocenti. 2007. Promoting the Rights of Children with Disabilities, Digest n°13. 44 | Technical Note on Accessibility | Part 1: The Narrative What to Promote: A Holistic Approach for Accessibility |  with persons with disabilities (using disability-inclusive mechanisms), or to include them and their representing organizations in all of the relevant committees. Capacity development of all relevant stakeholders In addition to the empowerment of persons with disabilities, developing the competencies of local stakeholders is another essential step in practical implementation; facilitating durability and sustainability over time; and allowing for autonomy from external technical support. The gap between creating an institutional and policy framework and enforcing it has been ascribed to various factors, including limited available research and information and the lack of a disability-awareness component in the training curricula of a variety of professionals (urban planners, architects and construction engineers, Web developers, designers, communications experts, event planners, IT specialists, etc.).40 Developing a core expertise about accessibility is essential in both the short and medium term in order to make it possible that every action aims to improve accessibility; and in the long term, to allow local actors to emancipate themselves from external support and become independent in the systematic addressing of accessibility-related issues. 40 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. Part 1: The Narrative | Technical Note on Accessibility | 45 Photo: © Halfpoint, Shutterstock  | What to Promote: A Holistic Approach for Accessibility Insight: In a low-capacity environment, projects often use external consultants to fill important knowledge gaps. However, excessive use of external technical assistance, remunerated at a much higher rate, often creates tension between the local and international staffs, which can result in a lack of knowledge transfer between the two groups. There is a need to balance good project implementation support with long-term sustainability by ensuring that adequate capacity is transferred to the staff of municipal offices. Projects can support knowledge transfer by embedding external technical assistance into the local institutional structure (for example, the technical offices of municipalities, ministries of public works, and other ministries).41 For additional details on how to empower stakeholders on accessibility please refer to Chapter 5.B.6 “Strengthen Capacities.” Table 2: Recommended actors whose capacities should be developed, and suggested activities Actor Type of Activity Decision makers, local authorities Sensitizations, Awareness Raising Civil society organizations and organizations of persons Sensitizations, with disabilities (OPDs) Trainings of Trainers Actors in charge of monitoring and authorizing (e.g. Technical trainings, technical units in municipalities, ministries of public Coaching works, ministries of education) Actors in charge of technical development and Technical trainings, implementation - architects, engineers, urban planners, Coaching Web designers, media managers, event organizers, university teachers, communications and IT specialists - as well as companies and businesses 41 World Bank. 2020. Maputo Urban Transformation Project (P171449). Maputo, Mozambique. 46 | Technical Note on Accessibility | Part 1: The Narrative What to Promote: A Holistic Approach for Accessibility |  Actor Type of Activity Students in fields associated with accessibility impacts University curricula or mitigation: for example, architecture, engineering, communications, IT Stakeholders working in the development and Sensitizations, humanitarian sectors (UN agencies, national and Awareness Raising international NGOs, institutional donors) Funding institutions (institutional donors, international Sensitizations, development banks) Awareness Raising 5.A.4. Enactment An efficient enactment of accessibility is essential in order to address the needs related to all disabilities; to cover all of the areas affected by accessibility; to ensure a large impact on beneficiaries; and to ensure that every intervention is done properly. Ideally this should be done on a national scale, targeting those mechanisms and stakeholders (including in the private sector) who would influence the process, regardless of the specific sector. All infrastructure (new and existing), all products and goods, all digital services, and all communication-related products and processes should be addressed. However, if there is no will or capacity to address the accessibility issue overall, sectoral approaches (for example in education, health, or DRR) can still be adopted, to introduce the topic and pave the way for larger-scale interventions. For further details on how to enact accessibility projects, please refer to Chapter 5.B.11 “Plan and Implement Accessibility.” 5.A.5. Durability The durability of accessibility interventions is essential in order to ensure the repetition of good experiences, allow scaling up, facilitate independence from external support, and promote further improvements. It is important to make sure that the results of a project, or the improvement of accessibility in a country will last over time and not be only a temporary priority due to particular (and Part 1: The Narrative | Technical Note on Accessibility | 47  | What to Promote: A Holistic Approach for Accessibility temporary) circumstances (committed decision makers, peak public attention on the topic, the availability of external technical support, exceptional, or one-off funding). It is important to reinforce the capacity of local stakeholders as much as possible, so that accessibility becomes a systematic component of their everyday work. Therefore, in addition to trainings and coaching, the conditions for a continuous learning process should also be facilitated. Another important condition for the durability of an accessibility intervention is that the community buys into this implementation, understands its importance, and is committed to safeguarding it. Even well-conceived accessibility features might not last over time if users (and not only persons with disabilities) do not ensure that they will be properly used, maintained, and supported. A perfectly accessible website can become less usable by persons with visual and hearing impairments if new digital content is uploaded in nonaccessible formats (videos without captions or descriptions, or text files produced without following accessibility rules). Similarly, a well-designed curb ramp becomes useless if someone parks a car in front of it; a tactile strip on a sidewalk can become dangerous if street vendors install their stalls across it, or if some people park motorbikes on it; and a flat and accessible pathway in a schoolyard can become a hazard if cracks and holes appear in it over time. Ultimately, accessibility is an evolving characteristic: to ensure its durability, attention must be paid to its maintenance and ownership. In some local contexts it is a good practice, for example, to set up community-based monitoring committees that can be sensitized to the topic and assigned the responsibility of providing an overview of the conditions and the appropriate use of accessibility features on a regular basis. Changes in use can hinder the durability of an accessibility-related intervention. For example, if in a building that is provided with an accessible wayfinding system the layout of the building changes and some rooms are swapped, unless the wayfinding system is updated the building will become an inaccessible labyrinth for persons with (and without) disabilities. Similarly, if in a bus the information concerning the itinerary is provided in multiple formats (audio, in writing on a display, with interactive maps) but it is not updated when the bus has to temporarily modify its itinerary, then this information becomes useless and potentially very confusing for persons with certain types of disabilities. 48 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  5.B How To Do It: Strategies for Enhancing Accessibility Part 1: The Narrative | Technical Note on Accessibility | 49  | How To Do It: Strategies for Enhancing Accessibility Photo: © Irina Borsuchenko, Shutterstock 5.B.1. Prepare or Comply with International and Regional Frameworks for Accessibility Accessibility is a human right for persons with disabilities; as such it is recognized in various international and regional treaties, conventions, and policy documents. With the social and human rights model the focus shifts from the disability of a person to the environment in which this person lives, and states are responsible for making this environment (political, legal, social, physical) inclusive and accessible. All states are accountable, especially if they have ratified, adopted, or endorsed international agreements regarding accessibility. The international community and the United Nations in particular have monitoring mechanisms in place to assess whether this compliance is effective, and to what extent; and they can demand adjustments and corrections if need be. Compliance with international agreements can also be a condition for receiving funds or support from international donors and financial institutions. The obligation to improve accessibility in a country is based on treaties and agreements. The highest international framework, which defines the principles concerning disability and accessibility, is the UN Convention on the Rights of Persons with Disabilities (CRPD). The CRPD makes accessibility an important legal mandate for the 184 countries around 50 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  the world that have ratified it.42 This seminal document has made accessibility a legally enforceable, cross-cutting issue, relevant to all sectors in all countries. Article 9 specifically addresses accessibility and calls on countries to take measures to alter environments in ways that enable persons to participate fully in all aspects of life.43 The CRPD is legally binding: signing the treaty creates the obligation not to violate it, whereas ratifying the Convention creates the obligation to take all necessary measures to enforce its principles. The Committee on the Rights of Persons with Disabilities is the body of independent experts that monitors implementation of CRPD. In 2014, the Committee issued General Comment n°2 on Accessibility, providing clarification and suggestions concerning the reporting duties of state parties, as well as insights on definitions and fundamental principles.44 All states’ parties to the CRPD must submit regular reports to the Committee explaining how these rights are being implemented.45 Examples of country reports on implementing the CRPD: Monaco_Country Report on CRPD_2019 Pakistan_Country Report on CRPD_2019 Civil Society Organizations (CSOs) can also produce shadow reports on the implementation of CRPD at the country level; this can provide useful insight into how CSOs perceive the adherence of national interventions and strategies to international and regional law and commitments. Examples of Shadow Reports on Implementing CRPD: New Zealand, Shadow Report on the Implementation of the CRPD, 2014 42 As of October 7, 2021. Check United Nations Treaty Collection for an updated list of state parties. 43 CRPD Art.9: To enable persons with disabilities to live independently and participate fully in all aspects of life, States Parties shall take appropriate measures to ensure to persons with disabilities access, on an equal basis with others, to the physical environment, to transportation, to information and communications, including information and communications technologies and systems, and to other facilities and services open or provided to the public, both in urban and in rural areas. 44 In particular, comment n°2 explicitly recognized that “access to the physical environment and public transport for persons with disabilities is a precondition for freedom of movement” and that “access to information and communication is seen as a precondition for freedom of opinion and expression” (Article 2). 45 OHCHR. n.d. Committee on the Rights of Persons with Disabilities. Part 1: The Narrative | Technical Note on Accessibility | 51  | How To Do It: Strategies for Enhancing Accessibility Azerbaijan, Shadow Report on the Implementation of the CRPD, 2013 UK, Shadow Report on the Implementation of the CRPD, 2017 It is important to note that the CRPD Committee processes (including national reports and shadow reports), as well as monitoring the processes concerning other treaties (e.g. Convention on the Rights of the Child or Convention on the Elimination of All Forms of Discrimination Against Women), can be helpful for advocacy and be informative for task teams as background information on context, constraints, status of implementation, opportunities, etc. Agenda 2030 for sustainable development, adopted in 2015 by the UN General Assembly, defines 17 interlinked global objectives to be pursued by the international community in the coming decades. These are called the Sustainable Development Goals (SDGs). Disability inclusion and accessibility are an essential condition for the achievement of many of the SDGs, in particular the ones whose targets explicitly include persons with disabilities: SDG 4 (Education), SDG 8 (Employment), SDG 10 (Reduced Inequalities), SDG 11 (Sustainable Cities and Communities) and SDG 17 (Partnerships). SDG 11 is particularly relevant, as it has two targets that concern accessibility.46 Implementing and monitoring the SDGs is not a legal obligation. However, countries that signed the adoption of Agenda 2030 have implicitly committed to working toward the achievement of the SDGs and, consequently, to striving for more effective accessibility.47 Issued from the “Habitat III” UN conference in Quito, Ecuador, in 2016, the New Urban Agenda (NUA)48 represents a commitment to work toward better inclusion in cities: it is also an operational tool to help municipalities identify the specific actions that need to be taken to reach this goal. The implementation of NUA is an accelerator for the achievement of the SDGs (SDG 11 in particular), and it has been negotiated with the active participation of persons with disabilities, so that 14 paragraphs specifically mention disability, and 25 mention older persons as stakeholders in and beneficiaries of inclusive urban development. 46 SDG11.1: “By 2030, ensure access for all persons to adequate, safe and affordable housing and basic services and improve slums.”; SDG11.2: “By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all and improve road safety, including through the expansion of public transport, with special attention to the needs of persons in vulnerable situations, women, children, persons with disabilities, and older persons.” 47 United Nations. Department of Economic and Social Affairs. n.d. Sustainable Development Goals (SDGs) and Disability. 48 United Nations. 2017. The New Urban Agenda - Habitat III (habitat3.org). 52 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Implementing NUA is an implicit commitment for all members of the UN General Assembly, which endorsed it in December 2016.49 The Sendai Framework for Disaster Risk Reduction is a 15-year agreement with seven targets and four priorities for action, which aim to achieve the substantial reduction of disaster risk and losses in lives, livelihoods, and health, and in the economic, physical, social, cultural, and environmental assets of persons, businesses, communities, and countries.50 Accessibility is included in many articles, but in particular in Priority 4, which promotes gender-equitable and universally accessible approaches during the response and reconstruction phases. By endorsing the Charter on Inclusion of Persons With Disabilities In Humanitarian Action, stakeholders commit to rendering humanitarian action inclusive of persons with disabilities by lifting barriers they face in accessing relief, protection, and recovery support, and ensuring their participation in the development, planning, and implementation of humanitarian programs. This charter is open for endorsement by various stakeholders, and by October 2021 many countries, including Afghanistan, Colombia, Ecuador, El Salvador, Guatemala, Nigeria, Samoa, and Thailand, had signed it. The Marrakesh VIP Treaty makes the production and international transfer of specially adapted books for blind or persons with visual impairment easier. This is done by establishing a set of limitations and exceptions to traditional copyright law. By January 2021, 79 contracting parties (105 countries) around the world had ratified or acceded to the Marrakesh Treaty.51 By endorsing the Global Compact on Inclusive and Accessible Cities city leaders and other stakeholders commit to implementing six key principles that advance inclusive urban development and include persons with disabilities and older persons as key stakeholders and beneficiaries of municipal policies, plans, and services. By creating a community of practice the Global Compact and Campaign supports stakeholders at multiple scales in identifying and removing barriers for persons with disabilities and older persons, and supporting their ability to increase their participation in public life. The overall goal is to 49 The New Urban Agenda offers an opportunity for the global community to address several global urban challenges associated with growing inequalities, social exclusion, extreme poverty, high unemployment among women and youth, and the increase in disaster and climate risk. The agenda is clear on the need for accessible and affordable housing, better transport, good air quality, efficient waste management, adequate public spaces, enhanced participation, resilience of cities, and disaster risk reduction, among others. All these require sufficient planning and resilient strategies that can be supported by national urban policies. 50 International Disability Alliance. n.d. Disability-Inclusive Disaster Risk Reduction. 51 World Intellectual Property Organization. n.d. Marrakesh Treaty (wipo.int). Part 1: The Narrative | Technical Note on Accessibility | 53  | How To Do It: Strategies for Enhancing Accessibility incentivize and transform 100 cities to be more inclusive, accessible, and resilient by 2030. This charter is open for endorsement by cities as well as various stakeholders. By October 2021 there are 30 cities that have signed on, and more than 50 organizations. Other international and regional instruments that include provisions for disability inclusion and accessibility: Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Persons with Disabilities in Africa Incheon Strategy to “Make the Right Real” for Persons with Disabilities in Asia and the Pacific, and the "Beijing Declaration", including the Action Plan to Accelerate the Implementation of the Incheon Strategy 52 52 The Incheon Strategy provides the first set of 10 regionally agreed, disability-specific development goals, 27 targets, and 62 indicators, enabling the region to track progress towards improving the quality of life, and the fulfilment of the rights of the region’s 690 million persons with disabilities, most of whom live in poverty. For each goal of the Incheon Strategy, the Beijing Declaration and Action Plan specifies a set of policy actions to be taken by governments, civil society stakeholders and ESCAP. 54 | Technical Note on Accessibility | Part 1: The Narrative Photo: © stockpexel, Shutterstock How To Do It: Strategies for Enhancing Accessibility |  Convention on the Rights of the Child: Article 23 53 Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and General Recommendation 18 of the UN Committee on the Elimination of Discrimination against Women 54 Inter-American Convention on Protecting the Human Rights of Older Persons. Article 26. UN Declaration on the Rights of Indigenous Peoples, Articles 21 and 22. Vienna Declaration and Programme of Action, Sections 63, 64, 65. 5.B.2. Prepare or Comply with National and Local Frameworks for Accessibility States not only have to report to the international community, they also must report to internal entities like OPDs and CSOs. They can be asked to align with international frameworks but also to respect national and local regulations and agreements such as constitutional articles, adopted laws and standards, or approved policies.55 National and local legislation on accessibility is also enforceable by individuals, and justiciable through courts and tribunals. Accessibility inclusion in national and local government urban policies, programs, and action plans leads to the development of budget allocation; accessibility guidelines, standards, and codes; capacity-building programs; and technical resources. Policies can mandate accessibility requirements in public procurement processes and decision making. Importantly, they can also promote the inclusion of disability in reporting requirements, longitudinal assessments, and impact evaluations. Policies on inclusive services can also clarify the roles and responsibilities of various ministries and departments, and can create pathways for successful collaboration and coordination between the relevant government authorities.56 53 CRC Article 23 recognizes that a child with mental or physical disabilities is entitled to enjoy a full and decent life, in conditions that ensure dignity, promote self-reliance, and facilitate the child’s active participation in the community. See also articles 2, 7, 24 on education and 25 on health. 54 CEDAW: The Committee asks state parties to CEDAW to report on "measures they have taken to ensure that disabled women have equal access to education and employment, health services, and social security and to ensure that they can participate in all areas of social and cultural life.” 55 UN list of national policies on persons with disabilities 56 World Bank. 2017. Including Persons with Disabilities in Water Sector Operations: A Guidance Note. World Bank: Washington, DC. Part 1: The Narrative | Technical Note on Accessibility | 55  | How To Do It: Strategies for Enhancing Accessibility Example of an accessibility policy: UN ESCAP “Accessibility for All: Good Practices of Accessibility in Asia and the Pacific to Promote Disability-Inclusive Development” Example of a strategy in the ICT sector that includes accessibility: The Philippines’ Digital Strategy 57 Policies and strategies concerning accessibility should be based on and include information collected about the specific situation of a country, including good practices as well as gaps, identified needs, and other relevant data. For more detail on what data to collect and how, please refer to Chapter 5.B.7 “Collect and Manage Accessibility Data.” Policies and strategies should also be created with the active participation of OPDs and other CSOs, honoring the “nothing about us without us” motto58, so that the most concerned groups can actively contribute to identifying the needed interventions and to assuring the technical quality of activities that will affect them, directly or indirectly. For additional detail on how to engage persons with disabilities, please refer Chapter 5.B.3 “Ensure Meaningful Participation.” 5.B.3. Ensure Meaningful Participation According to the ninth Secretary-General of the United Nations, Antonio Manuel de Olivera Gutierrez, “societies will never achieve the SDGs without the full participation of everyone, including persons with disabilities. We simply cannot afford to ignore or marginalize the contributions of 1.5 billion people. Upholding the rights of persons with disabilities is a moral imperative, but it is not an act of charity. It is a recognition of human rights and 57 Commission on Information and Communication Technology. n. d. The Philippine Digital Strategy. Transformation 2.0: Digitally Empowered Nation. The Commission on Information and Communication Technology, in collaboration with government, private sector and civil society stakeholders from across the Philippines. 58 International Day of Disabled Persons 2004 | United Nations Enable. 56 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  a practical necessity, if we are to build healthy, sustainable societies that will benefit everyone, those with disabilities, and those without.”59 The meaningful participation of persons with disabilities (including children) at all stages of a project is essential in order to ensure that all human needs are captured and considered; that the project will be endorsed by everyone; and that it will reach the greatest number of people. E&S specialists of the World Bank can provide great support both by ensuring that a project appropriately promotes social inclusion, and by helping to advise on disability- inclusive stakeholder engagement. Participation in Decision Making and Policymaking The initial phases of a project, including assessments, have to be conducted in consultation with persons with disabilities and their representative organizations in order to ensure, from 59 Remark by António Guterres, United Nations Secretary-General, to the 11th session of the Conference of State Parties to the Convention on the Rights of Persons with Disabilities, 12 June 2018. Part 1: The Narrative | Technical Note on Accessibility | 57 Photo: © Ruslana Lurchenko, Shutterstock  | How To Do It: Strategies for Enhancing Accessibility the earliest possible stage, that no needs have been overlooked, and to set up corrective mechanisms if need be. It is particularly important to realize that persons with disabilities are not a homogeneous group. Not only do different types of disability create different types of barriers; but even persons who have the same disability may face considerably different difficulties, depending on the specific type and the degree of the disability. Therefore, it is essential to make sure that when engaging OPDs, that different types and degrees of disabilities are represented. The Liaoning Urban Transport Project demonstrated the role of disability-inclusive public participation processes in supporting accessibility for persons with disabilities and older persons. Although initial proposals focused on urban development and road expansion, public consultations led to increased emphasis on improved and accessible sidewalks, pedestrian needs, secondary roads, and improved traffic management. Capacity Development of OPDs, and Their Involvement in Monitoring and Follow-Up OPDs and persons with disabilities should receive training and capacity development aimed at enhancing their ability to advocate for improved accessibility, but also to actively support and advise ongoing interventions. Their contribution in revising every activity of a project to ensure that it is accessible to all should be sought regularly, to improve the project’s performance but also to ensure that their engagement in project implementation is substantial and meaningful. Persons with disabilities and OPDs should be actively involved in specific assessments to identify accessibility barriers before, during, and after the implementation of a project. Ethiopia's One WASH National Program (P167794) employed a multisectoral approach to improving WASH across the country, particularly for persons with disabilities. By holding continual and inclusive public consultations for persons with disabilities, the national standards bodies integrated standards of inclusive designs for all WASH facilities for all school and health clinics. 5.B.4. Assess Accessibility Accessibility audits (or assessments) can help identify the barriers that exist for persons with disabilities in social, virtual, and physical spaces. They can be conducted for the 58 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  purpose of education or sensitization; or to collect the technical information needed for an accessibility renovation. Regardless of their specific nature or purpose, accessibility auditing should always include consultation or involvement with persons with disabilities and their representing organizations. Assessments can be performed on project design documents as well as on existing entities (for example a building, or a website). Assessments for Informed Decisions Accessibility assessments at the country level should be conducted during the first stages of a World Bank-supported project in order to determine gaps at the policy, operationalization, or capacity level, and to identify any negotiations that may need to be initiated with the borrower. For additional information, please refer to Chapter 5.B.5 “Advocate and Raise Awareness.” Assessments for Awareness Raising Participatory accessibility assessments can be a powerful sensitization tool for various stakeholders during trainings, special events, or awareness-raising campaigns. In such cases, it is essential to plan the assessment as a participatory event, where persons with disabilities can provide their input and share their experiences; this should also help garner media coverage for the event. It is also helpful to determine how aware the local general public is about accessibility issues, barriers, or social and economic implications. This assessment could have the twofold objective of collecting data, while at the same time sensitizing the public and raising awareness; and the results could inform necessary actions for strengthening local capacities later on. Insight: Useful guidance can be found in Handicap International’s “Conduct an Accessibility Audit in Low- and Middle-Income Countries,” June 2014. Assessments of the Private Sector Assessing the willingness and capacity of the private sector to design and produce accessible goods and services in various sectors can also be a powerful way to collect relevant information and sensitize stakeholders to accessibility issues. Including Part 1: The Narrative | Technical Note on Accessibility | 59  | How To Do It: Strategies for Enhancing Accessibility private businesses is crucial, because they are not allowed to install or develop barriers to accessibility; the goods and services they provide to the public must comply with accessibility requirements, and therefore can help drive research and innovation; thus they can play a leadership role in achieving sustainable development through accessibility. This means that they can, on the basis of the principles of corporate social responsibility, invest in different aspects of accessibility. (Participatory) Mapping of Cities One interesting way to explore accessibility of urban areas is to conduct a participatory mapping of some neighborhoods. Such assessments consist in involving a group of people, including persons with various disabilities, in taking a journey through predefined areas of the city, with the purpose of identifying and locating accessibility barriers (a pedestrian crossing without a curb cut, a protruding obstacle in the middle of a sidewalk, a flight of steps at the entrance of a public building, etc.). Eventually, such data can be uploaded onto online digital maps and become useful information for persons with disabilities. Examples: Accessibility Mapping: Urban Digital Wayfinding for People with Reduced Mobility | Mobility and Transport (europa.eu) Application of Accessibility Maps. Cities from a Different Perspective (iadb.org) Project “Sidewalk,” University of Washington Technical Assessments/Audits Conducting an accessibility assessment is helpful in the conceptualization and design phase of projects, whether it concerns new interventions or improvements of existing ones. In the first case, the assessment will concern project documents like technical drawings or a website mock-up, while in the second case it will concern, for instance, an existing building or website. The assessment should be composed of either a real or virtual site visit, often guided by checklists of accessibility features to be assessed, and an assessment report that registers the collected information and compares them with accessibility standards. Generally, it is most appropriate to engage experts to conduct accessibility assessments regularly (every 3-5 years) to ensure that everything is in conformity with current regulations. During an assessment, accessibility should be checked in relation to various types of disabilities, including how the space, product, or service may be made accessible to persons with physical, sensory, or cognitive disabilities. It is helpful to follow the RECU steps (Reach, Enter, Circulate, and Use) to make sure no elements have been overlooked. 60 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Besides auditing physical spaces (including means of transportation), it is also critical to assess communication-related activities (for example, the way a conference is organized, or how public television addresses the needs of persons who are deaf or blind), as well as online platforms and forums. With the rise of the internet, e-governance platforms, and online grievance mechanisms, there are significant investments in online spaces, and auditing their accessibility ensures inclusion in these processes. 5.B.5. Advocate and Raise Awareness Promoting accessibility is an essential means for achieving effective and meaningful institutional commitment; greater involvement of all sectors of society; and wider understanding and support from the public at large. A human rights-based approach can substantiate that accessibility is not a voluntary choice or an act of goodwill, but a right for persons with disabilities, and an obligation that governments must fulfill. Such an approach can be based on the regional and international frameworks for accessibility (CRPD, Agenda 2030, the SDGs, and national policies and strategies), but it should also highlight other important aspects:  Accessibility is an obligation for states, especially those that have ratified the CRPD; and its implementation is monitored at the international level.  Accessibility is a condition for inclusion (together with non-discrimination and participation); it is necessary in order to ensure persons with disabilities their fundamental rights to freedom of movement, freedom of opinion, and the right to education, health, food, etc.  Accessibility is beneficial for all members of society; it is a shared value not only for persons with disabilities but also for older people, children, pregnant women, persons with temporary injuries, etc.  Accessibility boosts dignity and self-esteem because it allows persons with disabilities to live their lives in a more independent way, and become less reliant on other people’s help, and more self-confident.  More accessible environments allow persons with disabilities to fully reach their potential as human beings in the domain of their choice.  Accessible ICT and digital services can play a paramount role in the protection of persons with disabilities who are victims of violence, or in need of support for other reasons. Part 1: The Narrative | Technical Note on Accessibility | 61  | How To Do It: Strategies for Enhancing Accessibility  Accessibility is necessary in order to enforce the right of persons with disabilities to public and political participation (for example, the right to access a polling station and be able to vote as a private citizen; or to access political facilities and be able to participate in discussions and votes in official capacities.  Accessibility of early-warning mechanisms, of temporary shelters, of evacuation processes, etc. are critical life-saving measures in emergency preparedness and response, allowing persons with disabilities not to be left behind in cases of natural disaster, conflict, or other emergencies. It is also paramount for persons with disabilities to have access, on an equal basis with others,60 to care and support in cases of forced displacement (refugee camps, temporary shelters, WASH infrastructure, collective centers, etc.).  In global emergencies like the COVID-19 pandemic, the availability of accessible information strategies and tools (for example, information in multiple accessible formats; or accessible handwashing stations) is vital to ensure that persons with disabilities are aware of essential health-related information and instructions, and can protect themselves as well as everyone else can. 60 Keeping in mind that in most cases, vulnerable and disadvantaged people need more support, more opportunities, and more resources to achieve the same results, such as safe, secure shelter, health, education, and so on. 62 | Technical Note on Accessibility | Part 1: The Narrative Photo: © Akimov Igor, Shutterstock How To Do It: Strategies for Enhancing Accessibility |  In some cases, an approach based on economic arguments can be useful to complement the rights-based approach, since persons with disabilities may be perceived as an expense for the state and the society in general, forgetting that they are also economic power holders (as consumers and travelers) and producers (as workers). This capacity, however, is severely hindered by the lack of accessibility in various sectors. Below are some examples of practical arguments in favor of a national effort toward accessibility enhancements:  Accessibility allows more persons with disabilities to work (and therefore contribute to the development and increase of a country’s GDP).  Accessibility allows persons with disabilities to be more independent (so caretakers and family members can spend more time working, producing, and consuming).  If persons with disabilities can work, they rely less on national allowances (and these funds can then be used elsewhere).  If persons with disabilities can work and earn a salary, they can become consumers (and contribute to the economy of the country).  If persons with disabilities and their family members can work more, they also become taxpayers (and contribute to the country’s development).  Accessibility improvements would allow more persons with disabilities to travel (contributing to developing tourism-related activities).  Accessibility is visible (and therefore can affect the way a country is perceived internationally).  Accessibility is not very expensive (and the cost-effectiveness is generally high). For additional details on advocacy topics, please refer to Chapter 3 “Why Accessibility Matters.” 5.B.6. Strengthen Capacities One of the obligations set out in Article 9(2) of the CRPD requires trainings on accessibility for “stakeholders,” which includes “authorities that issue […] broadcasting boards and ICT licenses, engineers, designers […] transport authorities, service providers, members of the academic community and persons with disabilities and their organizations. Training should Part 1: The Narrative | Technical Note on Accessibility | 63  | How To Do It: Strategies for Enhancing Accessibility be provided not only to those designing goods, services and products, but also to those who actually produce them.” In order to make accessibility real on a large and impactful scale, knowledge about accessibility should become, to various degrees, a common background understood and accepted by a variety of stakeholders in a country. Adapting “Bloom’s taxonomy,”61 the overall objective should be to:  Inform the general public about accessibility issues (“knowledge”).  Raise awareness (“comprehension”) of decision makers from both the public and the private sector so that they can effectively orient accessibility strategies.  Train practitioners (“application”) so that they are capable of practically implementing accessibility in their field of work.  Provide experts with all of the tools, research, and exchanging opportunities essential for maintaining state-of-the-art knowledge on the topic (“mastery”). Training of Organizations of Persons with Disabilities (OPDs) As a condition for meaningful participation, OPDs and persons with disabilities should be one of the first targets of sensitizations and trainings about accessibility. It is not uncommon that a person with one disability is not aware of the difficulties faced by persons with different disabilities, and in some contexts the step that goes from understanding barriers to identifying possible solutions, is not always taken by OPDs. Therefore, persons with disabilities should be active participants in every stage of the process, from advocacy to data collection and assessment, to capacity development and enacting accessibility. To do so, they often need to be trained first. In addition, in some contexts persons with disabilities are not overly proficient in the use of features that can facilitate the production and sharing of accessible information (for example, communicating in sign language, or using a screen reader to access digital information); therefore specific trainings on these topics should be provided as well, whenever possible. Raising Awareness among Donors and Funding Institutions Increasingly development donors have included disability and accessibility in their overall policies, but the country representatives often may not have the tools, experience, or resources needed to concretely implement these policies. This gap can be a significant barrier to the actual implementation of accessibility measures. 61 Bloom, B.S.1956. Taxonomy of Educational Objectives. The Classification of Educational Goals. Longmans, Green and Co LTD. London, United Kingdom. 64 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Sensitizing the General Public The general public as well is an important target, because individuals and their representative organizations can have a great impact on decision makers. They can also contribute directly to profound changes in attitudes and behaviors such as no longer parking cars on parking spaces dedicated to persons with disabilities, not using accessible toilets as storage areas for cleaning items, not blocking access ramps with flowerpots, and so on. India outlined its provisions for accessibility in the Persons with Disabilities Act, 1995 and also in building bylaws. Research in four districts of Gujarat, India carried out by a local development organization, UNNATI - Organization for Development Education, identified accessibility to physical spaces as a keyway of mainstreaming the rights of persons with disabilities. A project was launched to build awareness on accessibility in the region; increase the capacity for local action; build strategic alliances for advocacy by setting up an informal “access resource group” that would bring together architects, builders, designers, engineers, persons with disabilities, and development and rehabilitation professionals; stage public events highlighting what has been done to improve access; conduct media training; hold workshops on accessibility, including national policies on disability and access; and produce educational materials.62 Training Professionals In many contexts, professionals in architecture, engineering, urban development, and construction are not trained in the principles of accessibility during their academic studies. Therefore, they need to be the first target of advanced accessibility trainings, so that they not only understand the importance of the topic but can also technically implement it at various levels. The same applies to professionals in communications, Web design, event planning, etc. Trainings could be provided on voluntary basis, but they could also be part of the continuous professional development provided by associations like the boards of architects and engineers. Certification of completion of such training could be a requirement for applying for public positions, or submitting an offer on a public bid. Persons in charge of the 62 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. Part 1: The Narrative | Technical Note on Accessibility | 65  | How To Do It: Strategies for Enhancing Accessibility maintenance of buildings (such as the staff of logistics divisions) or of Web portals, should also be sensitized and trained on how to ensure that accessibility measures are not hindered by the misuse of spaces and equipment, or by uploading inaccessible content to websites over time. As part of the training for professionals and academics, attention should be paid to the importance of creating the conditions that will allow practitioners, students, and teachers with disabilities to join professional boards or enroll in university courses. In recent years, the Malaysian government has made it a priority to increase public awareness of the needs of persons with disabilities and to encourage young designers to create more innovative and inclusive designs. Local authorities in the country require architects and builders to adhere to the Malaysian Standard Codes of Practice in order for their building plans to be approved. After a building is constructed, an “access audit” examines its usability by persons with disabilities. The purpose of this audit is to increase awareness among planners and architects about how to construct barrier-free environments for persons with disabilities; to ensure, in both new buildings and the retrofitting of old buildings, the use of universal design concepts, and adherence to the standard codes that relate to persons with disabilities; and to evaluate access to existing public buildings and recommend improvements.63 Coaching Professionals Even though professional training is an essential component of capacity development, a training is often a short and intensive experience. During a training, an incredible amount of useful information can be acquired by participants, but they will not necessarily be able to immediately put what they have learned into practice. The capacity development process should therefore plan for long-term coaching as well: for example, periodic refreshments of acquired knowledge, and/or ad hoc support to revise planned accessibility interventions or assess ongoing ones; opportunities to exchange extensively with persons with disabilities and to have them test proposed solutions, and so on. 63 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization, Chapter 6 “Enabling Environments.”. 66 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Training of Trainers (ToTs) It is essential to ensure that accessibility competencies and skills are increased for all stakeholders, including those who are working on capacity reinforcement, to facilitate a cascade effect. OPDs should be the first targets of ToTs so they are empowered in their role of active promoters of accessibility in their various contexts. Development and humanitarian actors should also be trained, so they can embed accessibility-related capacity development in their projects and activities with local and grassroots organizations. Academic Education Knowledge about accessibility should be embedded and mainstreamed into university research and professional education, and should be made available to practicing professionals and manufacturers as part of their continuing professional development.64 Education, along with technical assistance on enforcement procedures, is essential in order to improve awareness of the need for accessibility as well as understanding of universal design. Educational programs should be targeted to all those involved in enforcing accessibility laws and standards, including persons with disabilities, design educators and 64 Lawson, A. 2017. Accessibility of information, technologies and communication for persons with disabilities, Contribution to the Council of Europe Strategy on the Rights of Persons with Disabilities. Council of Europe. Part 1: The Narrative | Technical Note on Accessibility | 67 Photo: © areporter, Shutterstock  | How To Do It: Strategies for Enhancing Accessibility professionals, government regulators, business owners and managers, building developers and contractors, communication and media specialists, graphic and Web designers, and digital developers. Schools of architecture can be a focus of education and research efforts for both students and practicing professionals. The International Islamic University in Malaysia recently introduced barrier-free architecture as an elective subject in its Bachelor of Architecture program. In addition, the new Kaed Universal Design Unit at the university’s Kulliyyah School of Architecture and Urban Design seeks to create awareness of design issues for children, persons with disabilities, and older people; conduct research and develop new technologies; disseminate information; and educate both the design profession and the public on design regulations.65 Capacity Development Within the World Bank Capacity development on accessibility is also a strategic issue for World Bank teams. TTLs and E&S specialists (but also procurement specialists and other Bank members) should be trained on the topic and, wherever relevant, they should be provided with coaching to help them apply key accessibility analyses and stakeholder engagement, to identify risks, develop mitigation measures, and incorporate design recommendations into their projects. For additional information on accessibility and the project cycle, please refer to the Project Cycle Guidance (in Part 2 of this Technical Note). Project implementing units should also be supported in approaching the technical aspects of accessibility, and guided throughout the process of developing assessments, inclusive design, practical implementation, etc. For additional information on accessibility technical recommendations, please refer to the Technical References (Part 4 of this Technical Note). 65 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization, Chapter 6 “Enabling Environments.” 68 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  5.B.7. Collect and Manage Accessibility Data The lack of data (especially disaggregated data) on persons with disabilities is a significant challenge for policymakers, development practitioners, and advocates of inclusion. When groups are invisible in the data, their needs are often invisible in policies and programs as well. Disability-inclusive data gathering is essential for developing evidence-based action plans and appropriate resource allocation planning.66 Data collection on accessibility could be a specific objective of a project (for the purposes of research, projects, programs, or policies). It could be part of the advocacy strategy toward borrowing countries; or it could be the first step of an infrastructure, urban, or transportation project (during the accessibility assessment). The lack of information on accessibility is particularly evident because of the difficulty in determining which data to collect and how to do it. Below are some suggestions on how to support accessibility data collection in a country. Budget Allocated for Accessibility Improvements One useful piece of information that should be collected to orient accessibility strategies and reporting is the budget that a country allocates for accessibility in public interventions related to urban development, infrastructure, digital development, education, health, etc. Countries should be encouraged to have specific budget lines to allow for long-term accessibility planning to facilitate specific fund allocation and monitoring. Budget analysis can not only inform decisions about the most efficient and effective use of public funds for persons with disabilities; it can also:  Raise awareness about the needs and rights of persons with disabilities;  Inform policy and budget debates;  Identify gaps in spending and problems in service delivery;  Describe trends in spending and assess their impact. 66 World Bank. 2017. Including Persons with Disabilities in Water Sector Operations: A Guidance Note. Washington, DC: World Bank. Part 1: The Narrative | Technical Note on Accessibility | 69  | How To Do It: Strategies for Enhancing Accessibility In Kazakhstan, IBP (International Budget Partnership) partner “Namys” used budgetary analysis to identify problems in the procurement process for goods and services intended for persons with disabilities.67 Percentage of Building Permits for Projects that Include Accessibility Features In countries where accessibility is not yet an official requirement for being granted a building authorization, it would be useful to assess how many building permits have been delivered to projects that have considered accessibility issues compared to the total number of permits delivered. This would help establish the efficacy of a national accessibility strategy and its implementation. The ESCAP Guide on Disability Indicators for the Incheon Strategy provides interesting suggestions on objectives and indicators for accessibility projects. In particular, “Goal 3: Enhance access to the physical environment, public transportation, knowledge, information and communication” suggests measuring, among other indicators, “INDICATOR 3.7 Availability of mandatory technical standards for barrier-free access that govern the approval of all designs for buildings that could be used by members of the public, considering internationally recognized standards, such as those of the International Organization for Standardization (ISO).” Percentage of Institutional Websites Compliant with Accessibility Standards Digital accessibility should also be assessed; this can be done, for example, by evaluating compliance with the accessibility standards of institutional websites. The conformity could be measured relative to official national standards (if they exist) or to international recommendations. (The EU suggests compliance with the Web Content Accessibility Guidelines (WCAG) 2.1 Level AA). 67 Ramkumar, V. 2008. Our Money, our responsibility: a citizen's guide to monitoring government expenditures, pg. 65. 70 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  The ESCAP Guide on Disability Indicators for the Incheon Strategy provides interesting suggestions concerning objectives and indicators for accessibility projects. In particular, “Goal 3: Enhance access to the physical environment, public transportation, knowledge, information and communication” suggests measuring “INDICATOR 3.4 Proportion of accessible and usable public documents and websites that meet internationally recognized accessibility standards” and “INDICATOR 3.9 Availability of mandatory technical standards for barrier-free access that govern the approval of all ICT-related services, such as websites for the public, considering internationally recognized standards, such as those of the ISO.” Number of Accessible Public Buildings One practical (though not exhaustive) way to measure accessibility in a country or a city is to assess some of the existing public buildings (for example airports, train stations, institutional buildings, public universities, public hospitals) and establish a rating system. If the country has adopted specific minimum standards for accessibility this rating system could be official, and even certified; or it could be an informal assessment. For additional details on accessibility assessment and certification, please refer to Chapter B.5.4 “Assess Accessibility.” DIAGNÓSTICO-DE-ACCESIBILIDAD-DE-LOS-SISTEMAS-BRT-EN-MÉXICO.pdf The ESCAP Guide on Disability Indicators for the Incheon Strategy provides interesting suggestions concerning the objectives and indicators for accessibility projects. In particular, “Goal 3: Enhance access to the physical environment, public transportation, knowledge, information and communication” suggests measuring, “INDICATOR 3.1 Proportion of accessible government buildings in the national capital” and “INDICATOR 3.2 Proportion of accessible international airports.” Feedback from Persons with Disabilities An important way to collect information on accessibility intervention is to collect feedback from users themselves, not just from government authorities or groups that work on behalf of persons with disabilities - in other words, persons with disabilities. Part 1: The Narrative | Technical Note on Accessibility | 71  | How To Do It: Strategies for Enhancing Accessibility This can be done, for example, during post-occupancy evaluations of new, retrofitted, or completely renovated buildings and infrastructure. Satisfaction surveys and grievance mechanisms can also specifically include questions about accessibility. 5.B.8. Ensure Capitalization and Knowledge Management Communities of Practice Local, national, and international communities of practice around accessibility should be encouraged and facilitated: “A community of practice is a group of people who share a common concern, a set of problems, or an interest in a topic and who come together to fulfill both individual and group goals. Communities of practice often focus on sharing best practices and creating new knowledge to advance a domain of professional practice.”68 Examples: Roundtable Discussion: Accessibility Lessons Learned From the 2020 Elections | U.S. Election Assistance Commission (eac.gov) 68 Creating Communities of Practice. 2016. What is a community of practice? 72 | Technical Note on Accessibility | Part 1: The Narrative Photo: © Thuwanan Krueabudda, Shutterstock How To Do It: Strategies for Enhancing Accessibility |  UCLG Community of Practice (United Cities and Local Governments) ACCESSIBLE EC Project (accessible-eu.org) Accessibility in the Time of COVID-19: Lessons Learned from the Shift to Distance Learning - Accessing Higher Ground Examples of good practices to be shared and learned from (at the city level): AccessibleNYC – Mayor’s Office for People with Disabilities (MOPD) Contact - MOPD (nyc.gov) Project Open House - MOPD (nyc.gov) Disability, Access, and Inclusion | Brisbane City Council Events and Communication Campaigns To ensure its durability, accessibility should systematically be on the agenda of national and international events regardless of the topic; but particular attention should be paid whenever the event concerns urban, infrastructure, or digital development. For example, in events such as the “World Urban Forum” accessibility should be promoted as an overarching issue, as well as a subject for dedicated side events. Countries should also be encouraged to celebrate official days dedicated to vulnerable groups with accessibility-related conferences, public events, awareness campaigns, or sharing of research papers (for example, during the International Day of Persons with Disabilities69 or the Global Accessibility Awareness Day70, but also Indigenous Peoples Day71, International Women’s Day,72 or World Children’s Day73. ) Public events should also be organized and conducted with accessibility in mind; they can become an opportunity to display good practices. 69 https://www.un.org/en/observances/day-of-persons-with-disabilities 70 https://globalaccessibilityawarenessday.org/ 71 https://www.un.org/en/observances/indigenous-day 72 https://www.internationalwomensday.com/about 73 https://www.un.org/en/observances/world-childrens-day Part 1: The Narrative | Technical Note on Accessibility | 73  | How To Do It: Strategies for Enhancing Accessibility Research Bodies/Use of Collected Accessibility Data An important step toward ensuring durable efforts in establishing accessibility is promoting accessibility-related research and innovation with contributions from academia, the private sector, and global federations and associations of persons with disabilities; and using all of the collected data about accessibility within a country to inform reports addressed to various stakeholders who are in a position to improve or shift national priorities. 5.B.9. Budget for Accessibility and Related Human Resources The costs associated with accessibility are numerous, ranging from the development of standards for disability-inclusive design (these are not costly if they are done upfront and applied at scale) to the actual cost of the infrastructure (whether digital or physical), to the “soft” costs of awareness-raising, capacity development, and monitoring. Public Budgeting for Accessibility Government budgets are at the core of sustainable development. The budget is the government’s most powerful economic tool for meeting the needs of its people, especially those of poor and marginalized communities. The most well-intentioned public policy has little impact on a goal unless it is matched with sufficient public resources to ensure its effective implementation regardless of changes of government and/or parliaments. The decisions made in government budgets - and how those decisions are implemented on the ground - have a direct and transformative impact on people’s lives. Evidence shows that the best way to manage public funds efficiently and equitably is through budget systems that are transparent, inclusive, and monitored through strong, independent oversight institutions. On the other hand, lack of fiscal transparency and limited public participation and oversight undermine fiscal discipline, increase borrowing costs, undermine the efficiency of public services, and create opportunities for corruption and other leakages. It is relevant to point out that the lack of accessibility to information and communications for all persons is a condition of transparency for good governance, and when citizens with disabilities are not informed due to lack of accessibility, it weakens democracies. 74 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  The 2030 Agenda and the Addis Ababa Action Agenda on Financing for Development call for governments to report on their spending and progress toward the achievement of the SDGs. The 2030 Agenda specifically commits to building “effective, accountable and inclusive institutions at all levels,” and the Addis Ababa Action Agenda pledges to “increase transparency and equal participation in the budgeting process.” 74 Accessibility Features are Not Very Expensive Scientific data about the actual cost of accessibility are very limited, but some studies have shown that accessibility features are in general not as expensive as is often thought. A study from the World Bank75 offers many interesting insights on the costs and benefits of accessibility in the transport sector. It identifies 71 items that would improve the accessibility of various means of transportation and infrastructure, and classifies them according to both their overall and marginal costs (that is, the cost of making basic transport system features more accessible for persons with disabilities compared with the cost of implementing “standard,” or less accessible, infrastructure or services). The study shows that in terms of overall cost, 60 percent of the analyzed accessibility features are considered cheap or very cheap, 35 percent moderately expensive, and only 5 percent expensive. In terms of marginal costs, 70 percent of the analyzed accessibility features are considered cheap or very cheap, 27 percent moderately expensive, and only 3 percent expensive.76 74 Utilizing National Budgets or National Public Finance Systems - SDG Accountability Portal 75 World Bank. 2013. Improving Accessibility to Transport for People with Limited Mobility, A Practical Guidance Note. Sustainable Development Department Middle East and North Africa Region. 76 According to this study, low marginal cost = less than 5 percent of the total implementation cost of the basic transport feature; medium marginal cost = 5 to 10 percent of the total implementation cost of the basic transport feature; high marginal cost = more than 10 percent of the total implementation cost of the basic transport feature. Part 1: The Narrative | Technical Note on Accessibility | 75  | How To Do It: Strategies for Enhancing Accessibility For more information about accessibility in the transportation sector, please refer to the Thematic Fact Sheet n°3 on Transportation. Retrofitting Compared to Implementation from the Beginning of a Project It is more costly to retrofit projects and renovate physical spaces for accessibility than to integrate universal design principles from the outset. Providing fully accessible facilities increases building costs by as little as 0.5 to 1 percent if they are planned, designed, and implemented from the beginning.77 Humanity and Inclusion (Handicap International) estimates that this is the case for new buildings or facilities and that the additional costs are as little as 1 to 2 percent for public buildings.78 Even refurbishment costs can be significantly reduced when adaptations are properly planned and managed. The cost of retrofitting for accessibility after a building is completed is far greater. Various studies show that for new construction projects, including accessibility from the outset can add an estimated additional 1-4 percent to the total costs.79 Conversely, retrofitting buildings to comply with universal access standards can be 5 percent or more of the initial construction costs.80 Given the limited information on the topic it would be useful if, for example, within World Bank projects, disaggregated bills of quantities clearly highlighting the specific accessibility features, products, and services were required from service providers, so that accessibility products and services can be accounted for separately. Example: The Hassiba Ben Bouali School in Algeria conducted an accessibility audit and included ramps, marked pedestrian crossings, wider doors, railings, and accessible WASH facilities; it cost them 1,044,225 Algerian dinars (around $8,144). 77 Metts, R. L. 2000. Disability Issues, Trends and Recommendations for the World Bank, Social Protection Discussion Paper No.0007, World Bank. 78 Plantier-Royon. E., P. Geiser, and H. Nouvellet. 2009. How to Design and Promote an Environment Accessible to All? Policy Paper, Handicap International. 79 O’Keefe, P.B. 2007. People with Disabilities in India: From Commitments to Outcomes. Washington, DC: World Bank Group. 80 Snider, H., and N. Takeda. 2008. Design for All: Implications for Bank Operations. Washington, DC: World Bank Group. 76 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Estimated Budget for Accessibility-Related Maintenance Various sources agree that the overall cost of annual maintenance for a new building is around 1 to 4 percent of the initial cost of the building. If this percentage is applied to the percentage of the building’s overall budget dedicated to accessibility features, it seems reasonable to say that the yearly maintenance cost related to accessibility features for a new building would amount to less than 0.1 percent of the initial cost of the building. Websites and Other Digital Services Nonphysical universal design components, particularly in Web design, have even lower costs since accessibility principles (such as using contrasting colors, alternative texts, logical headings, and audio-descriptions or subtitles) are design choices that can be implemented at the outset of the project with no extra cost. Considering accessibility when designing a new website or app does not represent an extra cost because it does not entail adding special features, plug-ins, or add-ons, and it does not need extra time from the developer. It only requires doing the same things in a slightly different way, so the only cost is the one related to the developer’s knowledge in the subject matter. Things change slightly for retrofitting an existing website or apps. There the only expenditure is connected to the hourly cost of the Web accessibility expert, but the actual modification of the site needs to be preceded by an accessibility assessment of the existing Web service, always performed in consultation with persons with disabilities and their representative organizations, as well as older persons. The time needed to perform these Part 1: The Narrative | Technical Note on Accessibility | 77 Photo: © Neeraz Chaturvedi, Shutterstock  | How To Do It: Strategies for Enhancing Accessibility two services largely depends, for example, on the complexity of the service, the number of pages that need to be upgraded, or the amount of content that needs to be modified. It would be good to consider as well the costs related to the time and creation of user- group feedback, including organizations of persons with disabilities among others. In developing apps and websites there is typically a beta period where user groups are asked to provide feedback; during this period, ensuring explicit representation, vetting, and feedback on accessibility from persons with disabilities is key. Cost of Noncompliance and Sanctions (for Private Stakeholders) In more developed contexts, where accessibility regulations and minimum standards are adopted, and where judicial proceedings are efficient, noncompliance with accessibility requirements can become a financial burden for stakeholders who fail to meet their obligations; they can be sued by users and asked to pay fines to government agencies, and sometimes suitable compensation to the complainants. When pecuniary sanctions for noncompliance are established by institutional bodies, these can become double-edged swords. The will to avoid fees can be an incentive for implementing accessibility when building a new mall, or upgrading a business’s website); but on the other hand, local authorities might be attracted by the income that can potentially be generated by these sanctions and might not be very proactive in addressing the problems behind the noncompliance. One possible solution is to encourage, at the policy level, the compulsory reinvestment of the money collected through these fees in accessibility-related public budget lines for the implementation of accessibility improvements in public spaces, or areas of public interest Example: Lawsuits for Web inaccessibility in the USA (Deque) 5.B.10. Enhance Implementation Mechanisms Creating National Bodies for Collecting Data and Reporting on Accessibility At the institutional level, states should be supported in establishing high-level monitoring 78 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  bodies to follow up on advancements, identify indicators, provide data and figures, and help identify macro corrective strategies, including sanctioning mechanisms. 81 In France an Interministerial Observatory on Accessibility and Universal Design (OBIACU) was established in 2010. It was charged with the role of seeking, recording, evaluating, and disseminating examples of good practice in accessibility and universal design. The observatory has a membership that includes representatives of various territorial authorities, the government, organizations of persons with disabilities, accessibility professionals and experts, and economists.82 Example of Accessibility Monitoring Report: Rapport Obiaçu 2012 Example of Country Disability and Accessibility Reports: ANED country reports (European Union Academic Network of Experts on Disability) Developing Accessibility-Sound Authorization Processes The building sector is normally organized around authorization steps that every new construction has to go through before any work can begin, to make sure that the project complies with technical and administrative requirements (maximum allowed surface, structural safety, measures for fire protection, etc.). Failing to show compliance with such requirements results in the refusal of building authorizations, such as a building permit. Such authorization processes should include accessibility among the requirements, so that every new construction is accessible to all. Example of the country requesting accessibility for building permits: MONACO, CRPD country report: […] The adaptation of an existing built environment belonging to a public person providing a public service must be carried out within five years of the entry into force of the law. […] building permits for establishments open to the public are issued only if “the construction project provides that the parts 81 CRPD, art. 33.1 82 Lawson, A. 2017. Accessibility of information, technologies and communication for persons with disabilities, Contribution to the Council of Europe Strategy on the Rights of Persons with Disabilities. Council of Europe. Part 1: The Narrative | Technical Note on Accessibility | 79  | How To Do It: Strategies for Enhancing Accessibility open to the public are adapted for use”; […] Any authorization for constructing a building for industrial or office use is issued only if the project ensures: “(1) that the common spaces are adapted; (2) there are several adapted toilet facilities; (3) that the external spaces of buildings are adapted.” Initiatives in other sectors should be regulated by similar accessibility-sound regulation processes. For example, the compliance to accessibility principles should be mandatory for websites (at least for institutional services), for commercial products and equipment, for public transportation means, and so on. In France the legal obligation to comply with Web accessibility prescriptions (RGAA 4.1) applies to the Web services of the State and local authorities and public establishments dependent on them, as well as to organizations in charge of a public service mission, and to companies whose turnover exceeds a certain threshold. Developing Technical Monitoring Bodies Municipalities or other entities issuing building authorizations should set up official mechanisms that clarify roles, responsibilities, deadlines, sanctions, and requirements. Besides an official monitoring body, a network of local action organizations is essential for supporting the process. Such a network can also share information and help local building officials review building plans, ensuring that a lack of knowledge among officials and designers does not undermine the goals of the law. In Norway, after a monitoring exercise found that few local communities had carried out any accessibility planning, the government set up pilot projects around the country, to make local communities better able to provide accessibility for persons with disabilities. In Winnipeg, Canada, a local action group worked with the municipal administration to assess barriers, and make recommendations for their removal. 80 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  In Kampala, Uganda, following the development of accessibility standards in association with the government, a National Accessibility Audit Team was created by the Uganda National Association on Physical Disability.83 Developing Technical Certification Bodies When accessibility standards are defined and become a legal requirement, public or private certification bodies can be created to assess, upon request, the level of accessibility compliance for buildings or websites, and eventually to deliver an accessibility “label.” This certification could be a “visibility booster” for the entity that receives it, but it could also become a condition for opening to the public a newly realized building. In addition, the World Bank might decide, in the long term, to include such certifications among its criteria for the selection of a service provider for infrastructure works or digital services. Example of certifications for accessible buildings in France: Certification BAC (Bâtiment Accessible Certifié) Certification CERTIVEA Example of certification for accessible ICT (Information and Communications Technology): In Malta, government and commercial websites are audited and certified by the Foundation for Information Technology Accessibility (FITA), which also assists service providers in ensuring that their ICT products are accessible to persons with disabilities in Malta and Gozo.84 5.B.11. Plan and Implement Accessibility Accessible Urban Development Large projects for urban development are excellent opportunities to enforce accessibility on a meaningful scale. Governments and decentralized authorities should address the accessibility of infrastructure as an “urban” problem to begin with, keeping in mind the 83 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. 84 Foundation for Information Technology Accessibility (FITA) Malta. Part 1: The Narrative | Technical Note on Accessibility | 81  | How To Do It: Strategies for Enhancing Accessibility principle of the continuous chain of movement. In fact, even if accessible buildings are important as such, they are useless if dispersed around a nonaccessible urban environment, and connected by nonaccessible roads and transportation systems, therefore unreachable for persons with disabilities. Local authorities should promote or support urban development intervention that acknowledges that accessibility is an essential criterion to be considered from the beginning. It is much easier and more effective to address accessibility along with other urban renovation projects in a harmonized way, rather than having to address it later on as a remedial action. This principle applies to territories that are highly urbanized, but also to periurban and rural areas, including islands. In 2019 the Freetown City Council in Sierra Leone launched the project ”Transform Freetown” with the objective to “Transform Freetown through 11 priority sectors using an inclusive approach, underpinned by innovation and data-driven performance management.” Among the priorities for human development, disabilities have been explicitly included, even though to date the plan has mainly remained on paper due to a lack of resources and implementing strategies. Another example is the plan for the capital city of Benin Porto Novo Ville Verte, funded by Agence Française de Développement (AFD), aimed at transforming in a sustainable and inclusive way the lagoon areas and the historical center of the city. 82 | Technical Note on Accessibility | Part 1: The Narrative Photo: © IEP in Mali, World Bank How To Do It: Strategies for Enhancing Accessibility |  Several other good practices can be found in the report Good Practices in Accessible Urban Development (2016) from UN DESA. Finally, cities that receive the EU “Access City Award” are great examples of what can be achieved with a strong political will and the active participation of all stakeholders. Pilot Interventions and Representative Buildings As an alternative to, or in addition to urban transformation, accessibility can be tackled with ad hoc interventions on specific buildings that are particularly iconic or representative of a particular context. Applying all the principles of accessibility to the new headquarters of a well-respected public university, to a museum or important cultural event, or to a hospital or an institutional building, can turn it into an exemplary pilot intervention with an intrinsic awareness-raising purpose. The House of Disabled People’s Organisations, Denmark ("The most accessible office building in the world" according to the Zero Project award). The controversial but iconic Seattle Museum of Pop Culture (formerly EMP Museum), considered to be one of the most accessible museums in the world. The Smithsonian American Art Museum holds bimonthly America InSight verbal description tours for visitors who are blind or have low vision. Led by specially trained docents, these interactive tours help visitors learn about the collection through rich verbal descriptions and sensory experiences. The Ed Robert Campus in Berkeley successfully integrates universal design principles within architectural design methodologies. Accessibility Improvements of Institutional Websites Accessibility should also be tackled from the perspective of digital technologies. National governments or local institutions can plan and implement overall strategies that aim, for example, to update existing institutional Web services and tools to make them more accessible to all, especially persons with disabilities. This upgrading normally builds upon Part 1: The Narrative | Technical Note on Accessibility | 83  | How To Do It: Strategies for Enhancing Accessibility the Web Content Accessibility Guidelines (WCAG) and translates them into national policies and/or strategies with specific perimeters, deadlines, and implementing bodies. According to the Australian Web Accessibility National Transition Strategy (2010) WCAG 2.0 is applicable to all online government information and services. Conformity to such requirements for accessibility is compulsory for all government websites owned and/or operated by government under any domain. This includes both external (public-facing or private) and internal (closed community) sites; in other words, it is required for all internet, intranet, and extranet sites. This strategy is quite accurate in defining timelines, work plans, and responsibilities. Another example is the Circular 4/2017 by the Department of Information and Communication Technologies of the Philippines (DICT), which was issued to “prescribe the Philippine Government policy on web accessibility and accessible ICT practices.” However, the policy has not yet been published. Role of Local and Regional Governments Local and regional governments have a vital role to play in the development, formulation, execution, monitoring, and evaluation of programs, policies, and services. Unfortunately, international frameworks often fail to adequately engage with local governments. There is a robust municipal movement to implement the inclusion targets of the SDGs. These capabilities include coordinating across sectors and scales by aligning local, regional, national, and international efforts. Role of CSOs and NGOs In low- and middle-income countries, CSOs and NGOs (both national and international) can be effective allies for disseminating expertise about accessibility, and also for implementing it, since they often address infrastructure renovations in their projects. Sensitizing and training these actors is a crucial step for disseminating accessibility principles; and encouraging development donors to include compliance with accessibility standards among the criteria for obtaining a grant could help to achieve this objective. Contextualization Accessibility improvements should be addressed, keeping in mind the context and the specific feasibility of proposed interventions. Sometimes the optimal solutions - that is, those that comply with all of the locally applicable accessibility requirements - are 84 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  impossible, or not realistic in the short term. Some of the provisions might therefore need to be temporarily adjusted to fit the specific context, honoring the principle of "reasonable accommodation." In such cases it should also be recognized that reasonable accommodation is not an alternative to ensuring full accessibility in a service, which should always remain the ultimate goal. This also means that, in some cases, having a performance-based reference could be more useful than a prescriptive one. For more information about accessibility standards, please refer to Chapter 5.B.12 “Apply Accessibility Norms and Standards.” In many low- and middle-income countries (LMIC) it might not be possible to achieve compliance with standards due to a lack of materials, products, time, or expertise. In such cases, adaptations might be required, and standard accessibility products and solutions could be temporarily replaced by local substitutes. For example, in a small village, demanding the use of prefabricated tactile tiles to create guiding strips for persons who are blind may be unreasonable, given the difficulty of finding them in local markets, and the cost of importing them from abroad. In such circumstances, finding alternative, locally-based solutions can be a temporary way to respond to Part 1: The Narrative | Technical Note on Accessibility | 85 Photo: © Bill45, Shutterstock  | How To Do It: Strategies for Enhancing Accessibility the immediate need of installing tactile surfaces without imposing disproportionate burdens to the implementing partner. For example, a tactile paving created not with prefabricated tiles but by stamping a tactile pattern directly onto the concrete surface of a landing might work. Installing an elevator in a multistory building can seem the best option to ensure the vertical circulation of persons with mobility impairments. However, if the building is old and it lacks either sufficient space or structural strength for an elevator, this might not be possible. Similarly, in countries with systemic power cuts and electricity failures, elevators can become a threat to security or, at least, an unreliable means of circulation. In that case a partial solution might be to place the most relevant services on the ground floor of the building, so that they are accessible to persons using a wheelchair; to implement accessibility improvements related to other types of disabilities on other floors of the building; and to set up evacuation procedures or tools to be used - for example, evacuation chairs - when an elevator is in place, but is likely to stop working or not be usable. Durability and Maintenance Although a thorough design is likely to tackle the majority of potential accessibility issues, only after the building has been used for a while it is possible to determine with whether users with disabilities are actually satisfied with the implemented solutions. For this reason, it is important to ensure that a participatory post-occupancy accessibility evaluation is conducted, preferably during the period under warranty. This evaluation should consider the following factors:  Poor Execution of the Works by the Builder. This might include, for example, a ramp surface that is not properly realized, handrails that are not properly fixed, toilet seats not properly installed, and so on. In such cases a site visit during the period of warranty can identify any problems that are the responsibility of the builder and demand that they be corrected at the builder’s expense.85 It is important to note that when they are done poorly, accessible features can be worse than useless for persons with disabilities; they may actually become hazards. (For example, ramps that are dangerously steep, tactile strips that do not properly warn of a potential danger, or 85 OPDs and accessibility experts should also be involved during the design and construction stages to ensure that the executed works comply with accessibility principles and regulations. 86 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  accessible technology that relies on the internet in areas with an unreliable network or power supply).  Changes Made in the Building by managers/owners such as rooms used for purposes other than the ones described in the wayfinding panels, switches for newly installed fans that are not compliant with accessibility standards, and the like. In such cases, the site visit can identify the accessibility issues related to these new elements, and recommendations can be made for how to mitigate or solve them.  Misuse of the Building Vehicles parked in the accessible parking bays, objects stored inside an accessible toilet, plants growing at the bottom of a ramp and hindering its use by persons using a wheelchair are some of the most common examples of this. A post-occupancy evaluation can identify such practices and provide users with recommended “Dos and Dont’s.” 5.B.12. Apply Accessibility Norms and Standards Standards are essential for implementing accessibility. An inclusive public procurement, for example, needs to clearly define the accessibility requirements that suppliers of products, works, services, or goods must comply with. If a country has adopted an accessibility decree that simply states that every new construction has to be accessible for persons with disabilities without explaining what this means and what the minimum requirements are to comply with the law, implementing the law will be difficult and ineffective. National accessibility measures vary regarding the specific obligations and the level of detail provided. Generally speaking, accessibility requirements can be divided into three levels (which may be expressed in one or more documents):  General Accessibility: A general law or code states that a product or a service should be made accessible to persons with disabilities, but not necessarily how this should be done (for example, a general discrimination law may state that taxis should be made accessible to persons with disabilities).  Specific Accessibility Requirement: A law or regulation gives specific criteria that a product or service must have in order to make it more accessible for persons with disabilities, but does not necessarily specify the technical requirements (for example, a law or regulation might state that taxis should allow persons using a wheelchair to enter safely).  Detailed Technical Specification: A law or code gives detailed rules for the design of a product or service, the following of which could be either voluntary or compulsory Part 1: The Narrative | Technical Note on Accessibility | 87  | How To Do It: Strategies for Enhancing Accessibility (that is, a regulation or standard may say that “the slope of the floor between any two points shall not exceed 11 degrees”).86 To date there is only one universal set of recommendations for accessible websites-- WCAG 2.1 - whereas a variety of accessibility standards can be consulted to determine, for example, the correct size and layout for an accessible toilet, the sufficient number of accessible parking bays in a building, the appropriate design of a curb ramp on a pavement, the necessary characteristics of an elevator, etc. Some countries have national standards, more or less well developed: when they do, that should be the main reference, but when the standards are not detailed enough, or there aren’t any, other sets of standards can fill the gaps. For example, the “ISO 21542:2021, Building Construction - Accessibility and Usability of the Built Environment” should be used. Whenever a mandatory standard is more permissive than the ISO or other relevant standards (that is, less favorable to persons with disabilities), it must be replaced with a more favorable one. Standards can be supported by guidelines in order to better clarify them and make them more easily understood for the professionals in charge of implementation and monitoring. This is important when the standards are very complex or need interpretation. The OGCIO “Web Accessibility Handbook” about the WCAG 2.0 standards (Hong Kong, 2019) is an example of helpful guidelines making the WCAG recommendations more understandable. Sometimes accessibility standards are produced as a technical document at the local level, before a national applicative law clarifying deadlines, perimeter, responsibilities, or sanctions for noncompliance is approved. In such cases, standards will contribute to raising awareness in communities about the importance of accessibility, but will remain a tool mainly used on a voluntary basis. Example: Recueil des normes minimales d’accessibilité à l’usage des communes du Bénin (2014) 86 National accessibility requirements and standards for products and services in the European single market: overview and examples_ Academic Network of European Disability experts (ANED), 2013. 88 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  In terms of perimeter and application, standards can be local, national, regional, or international. National (and sometimes local and regional) standards are legally binding, while international ones are universally recognized references which should form the basis of other standards being developed. For example ISO 21542:2021, Building Construction - Accessibility and Usability of the Built Environment) should be used as a reference in countries that do not yet have national standards for infrastructure accessibility. Likewise, the WCAG 2.1 recommendations for accessible Web content are not binding as such, but they can be used to inform legally binding national regulations. As a general rule, in a supranational perspective, keeping in mind that different contexts might require different approaches, the following standards are the recommended references for accessibility in various sectors. Accessible Infrastructure ISO 21542:2021, Building Construction - Accessibility and Usability of the Built Environment. This is an international reference that can be integrated with other standards if needed. National ones must be considered, but standards from other countries can be helpful when they seem relevant. For example:  The British Building Regulations for Access to and Use of Buildings87  The ADA Standards for Accessible Design  The Dubai Universal Design Code Accessible Websites and Web Apps WCAG 2.1 (w3.org). This is the international reference,88 which can be integrated with other standards if needed. National ones must be considered, but standards from other countries can also be useful when they seem relevant. For example:  Référentiel général d'amélioration de l'accessibilité (RGAA Version 4.1), France (2021) apples WCAG 2.1 to French norms for digital accessibility. Accessible ICT Products and Services EN 301 549 V2.1.2 (European standard for accessibility requirements for ICT products and services). This accessibility standard covers all Information and Communication 87 HM Government. 2015. The Building Regulations 2010: Access to and use of buildings. Volume 2 – Buildings other than dwellings. 2015 Edition. 88 The previous version (WCAG 2.0) is equivalent to the ISO/IEC 40500:2012. Part 1: The Narrative | Technical Note on Accessibility | 89  | How To Do It: Strategies for Enhancing Accessibility Technology (ICT), including many digital products such as cell phones, printers, ATMs, electronic documents, software, Web content and more. These standards are harmonized with WCAG and cover aspects that are not Web-related. Accessible Non-Web ICT, Specifically Non-Web Documents and software  Guidance on Applying WCAG 2.0 to Non-Web Information and Communications Technologies (WCAG2ICT) (w3.org)  EN 301 549 V2.1.2 (European standard for accessibility requirements for ICT products and services). Chapter 10. However, these guidelines may not always be easy to use, especially with the accessibility recommendations for commonly used files (Word, PowerPoint, Excel). More user-friendly guidance for accessible files can be found on Microsoft’s website. Published Works (Copyright, Sharing, Adaptation) Marrakesh VIP Treaty to Facilitate Access to Published Works for Persons Who Are Blind, Visually Impaired, or Otherwise Print-Disabled. The treaty creates a set of mandatory limitations and exceptions to copyright for the benefit of the blind, visually impaired, and otherwise print-disabled (VIPs). 90 | Technical Note on Accessibility | Part 1: The Narrative Photo: © OlegD, Shutterstock How To Do It: Strategies for Enhancing Accessibility |  There are also national applications of the treaty, for example: The Directive and Regulation for Implementation of the Marrakesh Treaty in EU Law. Accessible Transportation To date there is no specific and comprehensive international standard for accessible transportation. Some references can be found in broader national accessibility standards, such as The Dubai Universal Design Code, Section C. In addition, some countries have national regulations that can be used as a reference.  Canada Accessible Transportation for Persons with Disabilities Regulations  USA ADA Accessibility Guidelines for Transportation Vehicles Design standards for transportation and road systems are often managed at the city level, and there are interesting examples of accessibility measures adopted by municipalities (among them Greater Nottingham (UK), Mexico City (Mexico), and the City of Mississauga (Canada). Accessibility in Humanitarian Action Various tools exist to provide guidance toward better accessibility within this sector, including WASH and shelter operations. The main ones are:  Humanitarian inclusion standards for older people and people with disabilities (“Minimum Standards”)  Inter-Agency Standing Committee (IASC) guidelines for “Inclusion of persons with disabilities in humanitarian action”  All Under One Roof “Disability-inclusive shelter and settlements in emergencies”  Inclusive Post-Disaster Reconstruction: Building Back Safe and Accessible for All  WaterAid’s Compendium of Accessible WASH Technologies Finally, it is relevant to mention the guidance tools produced on various topics by associations or federations of persons with disabilities worldwide: for example “The Guidelines on Providing Access to Public Health Information in National Sign Languages During the Coronavirus Pandemic” developed by the World Federation of the Deaf and the World Association Of Sign Language Interpreters; or "Making Information Accessible for All,” a tool developed by the European Blind Union. Part 1: The Narrative | Technical Note on Accessibility | 91  | How To Do It: Strategies for Enhancing Accessibility 5.B.13. Promote Accessibility-Sound Procurement Public procurement is a fundamental, crucial component of democratic governance, poverty reduction, and sustainable development. From building roads and power stations to purchasing pharmaceuticals and securing trash-collection services, efficient use of public resources contributes to better delivery of services. Public procurement also serves as a significant policy instrument, which governments can use to propel changes in public service delivery, create fiscal space and jobs, and stimulate private sector growth. Increasingly, low- and middle-income countries and donor agencies are recognizing the importance of strong procurement systems to build viable partnerships and collaboration between private and public sector actors and resources.89 General Comment No. 2 of the Committee on the Rights of Persons with Disabilities states that “States Parties must consider their laws on public procurement to ensure that their public procurement procedures incorporate accessibility requirements […] It is unacceptable to use public funds to create or perpetuate the inequality that inevitably results from inaccessible services and facilities.” Accordingly, accessibility requirements should be embedded in any legislation or policy document regulating the payment of public funds by way of grants, research funds, or international aid.90 It should also be noted that the procurement strategy for a project has to examine market capacity to respond to accessibility needs since, depending on the specification, suppliers may not be available locally and new ones may need to be found. Ripple Effects of Procurement While including accessibility in procurement may be limited initially, these policies could drive a more inclusive market full of accessible goods and services, leading to a broader, more cost-effective array of options eventually. Public policies like Section 508 of the US Rehabilitation Act91 incentives to the market for the design, development, procurement, and broader deployment of increasingly accessible ICTs. These policies lead to greater innovation, competition, and choice for accessible technology in the marketplace. Today, policies like Section 508 are also driving the creation of new development tools for accessible technology and better accessibility training for technology professionals. 89 World Bank. 2020. Procurement for Development. 90 Lawson, A. 2017. Accessibility of information, technologies and communication for persons with disabilities Contribution to the Council of Europe Strategy on the Rights of Persons with Disabilities, pg. 4-6. Council of Europe. 91 U.S. Access Board. n.d. Rehabilitation Act (access-board of 1973.gov). 92 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  […] Recently the Australian Government Management Office in the Department of Finance, which is the public procurement body, put out a tender request for ICT hardware. A highly desirable requirement in the request was that products and services meet the Section 508 guidelines and/or EN 301 549. Accessible ICT hardware is also shipped and sold in countries that may not yet have strong accessibility requirements. Because governments are large employers, their investment in accessible ICT products and services helps to create inclusive workplaces and support the employment of persons with disabilities. Industry representatives also cited the positive ripple effects of inclusive public procurement policies. They point to accessibility as an increasingly important criterion in purchasing decisions of large nongovernmental clients for their consumer products as their customers become more aware of accessibility-related issues. The same accessibility features created for large enterprise customers are in the products available to individual consumers, who cannot demand individually customized products the way a government agency can.92 Table 3: Types of Accessibility-Related Products or Services Type of Product or Service Examples Mainstream product or  Traffic light with integrated acoustic alarm service that works for differentiated for green and red. persons with or without Ergonomic office chairs with adjustable elements  disabilities (height, armrests, seat, backrest, etc.).  Touristic booths that provide visual, tactile, and audio information simultaneously (braille text on keyboards, screen, and audio messages).  Design of public buildings or spaces that complies with accessibility standards and principles.  Buses with extending platforms, low floors or kneeling devices, to allow access for persons using a wheelchair. 92 G3ict. 2015. CRPD Implementation: Promoting Global Digital Inclusion through ICT Procurement Policies & Accessibility Standards. G3ict: The Global Initiative for Inclusive ICTs. Part 1: The Narrative | Technical Note on Accessibility | 93  | How To Do It: Strategies for Enhancing Accessibility Type of Product or Service Examples  Public online services usable by persons with and without disabilities (websites, apps, etc.).  Doors with handles that facilitate pushing and pulling regardless of the prehensile capacity of a person.  Office equipment whose controls allow for voice or tactile input and do not depend on touch panels exclusively. Product, work, or service  SLI (Sign Language Interpretation) during public adapted for persons communication events, in the appropriate with certain types of language. disabilities Adapted IT equipment (half keyboards, foot  mouses, braille printers, etc.).  Grab rails for accessible toilets (fixed or drop-off).  Educational facilities equipped with hearing loops (at least in certain classrooms, if it is not possible to have it everywhere).  Computers and laptops in public offices equipped with a screen reader.  Telecommunications relay services to support interconnection of persons who are deaf, hard of hearing, deafblind, or who have a speech disability. Product provided with  ATM machine/printer/copier with tactile keys, instructions accessible for with instructions written in large fonts and with persons with disabilities explanatory drawings, and with the link to an audio-descriptive instructions file. Set a Benchmark For Accessibility When establishing accessibility requirements and bid evaluation criteria, wherever possible, choose an existing standard as the benchmark for accessibility. This provides vendors with 94 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  clear expectations and supports a fair and equitable bidding process. It also organizes clear criteria for evaluating the bids. Request for Bid Approach: Refer to precise standards Pros: Clarity on what is demanded, uniformity Cons: No space for innovation Request for Proposal Approach: Refer to a description of the desired performance Pros: Larger space for innovation Cons: Less uniformity and consistency between offers, need for experienced human resources to assess the quality of offers Although there are accessibility-related standards for many different types of products, services and works/facilities, here are a few of the more commonly used standards:  National/Regional Level: Whenever available, and up to a certain amount, compliance to national standards can be required for every relevant procurement of products, works, or services. For example, the ADA standards or Section 508 (USA), the BS standards (UK), the UAE accessible building code, the Standards d’accessibilité du Quebec, or the Accessibility requirements suitable for public procurement of ICT products and services in Europe (EN 301549:2014). Part 1: The Narrative | Technical Note on Accessibility | 95 Photo: © spotters_studio, Shutterstock  | How To Do It: Strategies for Enhancing Accessibility  ISO Accessibility Standards: When national or regional standards for accessible buildings and infrastructure do not exist or are not exhaustive, or if the bid requires international competition, compliance with ISO standards should be required.  WCAG 2.1: When national or regional standards for Web accessibility do not exist or are not exhaustive, compliance with WCAG 2.1 standards should be required. NOTE: For large bids, the World Bank requires international procurement based on international standards, to promote competition, transparency, and equality among bidders.93 For more detail about accessibility standards please refer to Chapter 5.B.12 “Apply Accessibility Norms and Standards.” Inclusive Procurement in the World Bank As several clients have adopted technical procurement standards based on universal design and accessibility (Beijing Declaration and Incheon Strategy; EU Declaration), the World Bank’s work should include these policies and procedures in order to support clients in this important area of inclusion. For others, encouraging the use of existing strategies where national ones are not in place can be a way of further increasing accessibility in procurement. So far, the World Bank is reviewing its procurement practices, guidance, and requirements to enhance accessibility in procurement. By continuing to increase staff awareness, enhance borrower guidelines, plan procurement, and specify accessibility, it is possible to have even greater inclusion of persons with disabilities in procurement. Enhancing Staff Awareness and Capacity for Procurement The World Bank Procurement, E&S Policy and Global Disability teams have worked together and taken several steps to help strengthen guidance and support on accessibility for staff and borrowers. Content on procurement, disability, and universal access has been added to the Labor Deep Dive staff training. As part of 93 World Bank. 2016. Bank Guidance: Thresholds for procurement approaches and methods by country 96 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  this four-day course, the training team ran an exercise on the disability inclusion considerations in the design of an infrastructure project. They had individuals play different roles in the process (Borrower, TTL, E&S specialist, and procurement specialist) to highlight the different perspectives and thought processes each person contributes when incorporating disability considerations into the design and procurement of a project. For example, in one scenario, the E&S specialist had done some research on various accessibility features, such as ramps and curb cuts, to include in design and procurement discussions. By specifically focusing on accessibility in the simulation, and providing specialists with technical information on how to design ramps, sidewalks, etc., staff can develop greater awareness of the available resources and considerations for accessibility in projects. Corporate Procurement: Diversity of Suppliers94 Operational procurement is not the only section that can contribute to enhancing accessibility through the World Bank’s work. The Bank is committed to also making its corporate procurement more oriented toward inclusion and accessibility when purchasing services or goods to be used by Bank staff. Supplier diversity, for example, is a highly valued strategic initiative at the World Bank. The Bank promotes increasing and improving the business participation of diverse suppliers such as minority, women, and disabled-owned business enterprises (DOBE) in its procurement process. Where possible, the World Bank can encourage its primary suppliers to engage with diverse suppliers and report these efforts at performance status meetings. Kenya has an affirmative action law on public procurement that requires all public procuring entities to reserve not less than 30 percent of their procurement spent for enterprises owned by youth, women, and persons with disabilities.95 94 World Bank. Tier 2 Suppliers Diversity Program, Guidance Note for Vendors. (Requires World Bank login). 95 Gender and Equality in Public Procurement. n.d. Republic of Kenya. Part 1: The Narrative | Technical Note on Accessibility | 97  | How To Do It: Strategies for Enhancing Accessibility A DOBE is a business that is at least 51 percent owned, controlled, operated, and managed by one person with a disability. To be recognized as such and become a supplier for the World Bank, a DOBE must be certified by an official body (for example Disability: IN)96 5.B.14. Involve the Private Sector In addition to implementing accessibility, the private sector has a great role to play in developing research and innovation. Accessibility industries, designers, and service providers should be actively encouraged through public procurement policies or other incentives to invest in the activities listed in the table below: Table 4: Research and Innovation for Accessibility: examples of what companies can do in terms of accessibility research and innovation Item Example Invest in developing new  Prefabricated Movable Ramps products, or improving  Speech-To-Text Smart Systems existing ones  Screen Readers in Local Languages (especially for smartphones)97  More Accessible Tablets, Laptops, and Smartphones  Smart Orientation Systems  Audio Enhancing Systems 96 Disability:IN. n.d. Get Certified. Operated means being actively involved in the daily management of the business. Controlled means exercising the power to make policy decisions. 97 Although in low-income countries access to laptops or computers is limited, smartphones are very common, including among persons with disabilities. However, persons who are blind and are not necessarily educated have a lot of difficulties in using them due to the limited number of languages covered by available screen readers. For example, Talkback (for Android) is available in only five languages (English, French, Spanish, Italian, and German). Voiceover (for IOs) is available in almost 30 languages, but due to the cost of Apple products, this system is much less common in low-income countries. 98 | Technical Note on Accessibility | Part 1: The Narrative How To Do It: Strategies for Enhancing Accessibility |  Item Example  More accessible videoconferencing tools and software  Accessibility-related Mobility Assistive Devices  Independent Living Skills (ILS) Assistive Devices (to help with cooking, personal hygiene, mobility)  Tactile Tiles for Internal and External Use, Accessible Playground Equipment, etc. Invest in developing new  Video/Text Relay Services services, or improving  Sign Language Interpretation existing ones  Live Captioning  Interpretation Systems for Persons Who Are Deafblind  Assessment and Improvement of Accessibility For Websites  Provision of EPUBs, Daisy, and Other Reading Tools, Consistent with the Marrakesh Treaty  Provision of Subtitles, Audio Descriptions, and Transcriptions for Audiovisual Supports  Translation of Standard Written Documents into Easy-To-Read Formats Many useful references are provided by the UN ESCAP guide “Accessibility for All: Good Practices of Accessibility in Asia and the Pacific to Promote Disability- Inclusive Development” Private sector actors can also have other major roles in large development strategies around accessibility. For example, real estate developers could be effective partners in promoting and implementing universal design solutions in large-scale interventions. Part 1: The Narrative | Technical Note on Accessibility | 99  | Conclusion 6 Conclusion 100 | Technical Note on Accessibility | Part 1: The Narrative Conclusion |  The World Bank has a key opportunity to raise borrower awareness about the importance of accessibility and the use of universal design principles from multiple points of view: obligations toward both the international community and national and local stakeholders; the legal, social, and economic implications of accessibility or the lack of it; the ethical responsibility to not discriminate against persons on the basis of their disability; and the need to comply with international standards and regulations. Borrowers are required to take into account the needs of persons with disabilities in large development projects supported by the Bank. This obligation, however, also entails a great opportunity to initiate long-term, large-scale and major-impact actions to improve the lives of at least 15 percent of the world’s population98 (since accessibility is also very important for many other groups, including children, older people, women and girls, persons with temporary injuries, etc.). Accessibility interventions for infrastructure, mobility, communication strategies, and ICT have overarching implications for every sector of society; therefore, they offer the potential for strategic development. “Thinking accessibility” can lead to profound changes in society: to relevant technical innovations that are beneficial to all, to urban environments that provide better living conditions for all, and, more generally, to a world that recognizes a society’s diversity as a strength. The World Bank has made notable strides in enhancing accessibility in its practices and operations over the past few years. However, it is essential to continue to strive for equity and inclusion for persons with disabilities in order to meet the commitments on disability- inclusive development. By continuing to engage with persons with disabilities and by implementing some of the good practices drawn from these examples, the World Bank can continue its positive trajectory toward greater inclusion. 98 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. Part 1: The Narrative | Technical Note on Accessibility | 101  | Appendixes 7 Appendixes 98 World Health Organization and the World Bank. 2011. World Report on Disability. Geneva, Switzerland: World Health Organization. 102 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Appendix A: Glossary Accessibility The World Bank Environmental and Social Framework defines accessibility as “the degree to which the physical and social environment, transportation, information and communications, and services that are open and available to the public can be accessed by persons with disabilities.”99 Accessible route According to Humanity & Inclusion (Handicap International) an accessible route is “a continuous, unobstructed path connecting all accessible elements and spaces of a building or facility.”100 Assistive Sevices The World Health Organization defines assistive devices as “those whose primary purpose is to maintain or improve an individual’s functioning and independence to facilitate participation and to enhance overall well-being. They can also help prevent impairments and secondary health conditions.”101 Chain of movement According to 2005 French Disability Law, “A chain of movement, which includes the built environment, road systems, public space facilities, transport systems and hubs, is accessible if organized so that these are accessible in their entirety for persons with disabilities or reduced mobility.”102 Accessible route According to Humanity & Inclusion (Handicap International) “An accessible route must allow access to the main entrance, or one of the main entrances, of a building from the site access point. The choice and design of this route are such that they facilitate the continuity of the chain of movement with the exterior of the site. The accessible route must be the common or one of the common routes.”103 99 World Bank. 2018. Good Practice Note on Non-Discrimination and Disability. Environment & Social Framework for IPF Operations. Washington, DC: World Bank. 100 Nouvellet, H. 2014. Conduct an Accessibility Audit in Low- and Middle-Income Countries. Handicap International. 101 World Health Organization (WHO). 2016. Priority Assistive Products List. Improving access to assistive technology for everyone, everywhere. Geneva: WHO. 102 République Française, 2005. Loi n° 2005-102 du 11 février 2005 pour l’égalité des droits et des chances, la participation et la citoyenneté des personnes handicapées 103 Nouvellet, H. 2014. Conduct an Accessibility Audit in Low- and Middle-Income Countries. Handicap International. Part 1: The Narrative | Technical Note on Accessibility | 103  | Appendixes Investment project financing (IPF) World Bank IPF indicates the provision for project “loans, credits, grants, or guarantees by the Bank from its resources or from trust funds financed by other donors and administered by the Bank, or a combination of these.104 Unlike commercial lending, Bank IPF not only supplies borrowing countries with needed financing but also serves as a vehicle for sustained, global knowledge transfer and technical assistance. This includes support to analytical and design work in the conceptual stages of project preparation, technical support and expertise (including in the areas of project management and fiduciary and environmental and social activities) during implementation, and institution building throughout the project.105 Reasonable accommodation The Convention on the Rights of Persons with Disabilities defines reasonable accommodation as “necessary and appropriate modifications and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis with others of all human rights and fundamental freedoms.”106 Universal access The World Bank Environmental and Social Framework defines Universal access as “Unimpeded access for people of all ages and abilities, which should be incorporated into project design for new facilities and reviewed for existing facilities. The principle of universal access is echoed throughout the Environmental and Social Framework, as applying these principles offers an opportunity to minimize impacts and make projects more inclusive and accessible for all”.107 Universal design According to the World Bank Environmental and Social Framework Universal Design is the composition and design of an environment that meets the needs of all people so it can be accessed and used by all, regardless of their age, size, ability, or disability. By considering the diverse needs and abilities of all throughout the design process, universal design creates products, services, and environments that meet peoples' diverse needs.108 104 Bank Policy: Investment Project Financing 105 Investment Project Financing (IPF) (worldbank.org) 106 United Nations. UN Convention on the Rights of Persons with Disabilities, Article 2 - Definitions § 107 World Bank. 2018. Good Practice Note on Non-Discrimination and Disability. Environment & Social Framework for IPF Operations. Washington, DC. 108 World Bank. 2018. Good Practice Note on Non-Discrimination and Disability. Environment & Social Framework for IPF Operations. Washington, DC. 104 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  List of Acronyms World Bank related acronyms: CEGGB Gender and Economic Inclusion Group DAF Disability Accommodation Fund E&S Specialists Environmental and Social Specialists ESF Environmental and Social Framework ESMS Environmental and Social Management Systems ESS4 Environmental and Social Standard 4 FCV Fragile, Conflict, and Violent FI Financial Intermediaries GFDRR Global Facility for Disaster Reduction and Recovery GM Grievance Mechanism HDNSP Human Development Network Social Protection HECED Education ECA IAWT4 Transport West Africa and Nigeria IDDDR Director Digital Development IPF Investment Project Financing ITRGK Infrastructure Transport Global Knowledge LA Loan Agreement OPCS Operations Policy and Country Services OPSEF Environmental and Social Functions OPSIS ESF Implementation Support OPSPR OPCS Procurement PAD Project Appraisal Document PCN Project Concept Note PIU Project Implementation Unit SAWS4 SURR Social Development Africa 1 Part 1: The Narrative | Technical Note on Accessibility | 105  | Appendixes SCD Systematic Country Diagnostic SEP Stakeholder Engagement Plan SSIDR Social Sustainability & Inclusion Global Director SSIGL Social Sustainability & Inclusion Practice Manager SURGP Urban Global Partnerships SURR Social, Urban, Rural and Resilience SWAGL Global Solutions Water TT Task Team TTL Task Team Leader Other acronyms: AAC Augmentative and Alternative Communication AUSAID Australian Agency for International Development CART Communication Access Real Time Translation CBM Christian Blind Mission CEDAW Convention on the Elimination of All Forms of Discrimination Against Women CPF Country Partnership Framework CRC Convention on the Rights of the Child CRPD Convention on the Rights of Persons with Disabilities CSO Civil Society Organization DOBE Disabled-owned Business Enterprise DPO Disabled People’s Organization DRR Disaster Risk Reduction ECLAC United Nations Economic Commission for Latin America and the Caribbean HRIE Human Rights, Inclusion and Empowerment Umbrella 106 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  IASC Inter-Agency Standing Committee ICT Information and Communication Technology IDA International Development Association ILO International Labor Organization ILS Independent Living Skills ISO International Organization for Standardization IT Information Technology IURD Institute of Urban and Rural Development LMIC Low- and Middle-Income Countries LMP Labor Management Procedure NUA New Urban Agenda ODF Open Defecation-Free OECD Organisation for Economic Co-operation and Development OHCHR Office of the United Nations High Commissioner for Human Rights OPD Organization of Persons with Disabilities RECU Reach, Enter, Circulate, Use SDG Sustainable Development Goals SLI Sign Language Interpretation SOP Standard Operating Procedure TWSI Tactile Walking Surface Indicator UD Universal Design UDL Universal Design for Learning UN United Nations UNDESA United Nations Department of Economic and Social Affairs VIP Visually Impaired, and Otherwise Print Disabled WASH Water, Sanitation and Hygiene WCAG Web Content Accessibility Guidelines WHO World Health Organization Part 1: The Narrative | Technical Note on Accessibility | 107  | Appendixes Appendix B: The World Bank and Accessibility Environmental and Social Framework (ESF) Including persons with disabilities and expanding equitable opportunities for them are at the core of the World Bank’s work to build sustainable, accessible, and inclusive communities, aligned with the World Bank’s dual goals to end extreme poverty and promote shared prosperity. These goals can be achieved only when everyone, including persons with disabilities, is included. The Environmental and Social Framework (ESF) includes provisions for both the World Bank and borrowers to protect and include the interests of persons with disabilities. The Environmental and Social Standards (ESSs) achieve this by requiring the borrower to conduct full assessments, taking into account the needs of the disadvantaged or vulnerable, and providing safe working conditions with reasonable accommodations, accessible communications, and inclusive stakeholder engagement. The ESF Directive on Addressing Risks and Impacts on Disadvantaged or Vulnerable Individuals or Groups, and the ESF Good Practice Note on Non-Discrimination and Disability provide additional requirements and guidance for World Bank staff. There are several entry points across the ESS to address disability, in general, and universal access. Accessibility may be relevant, for example, under the following ESSs:  ESS1 Assessment and Management of Environmental and Social Risks and Impacts. The Environmental and Social Assessment identifies risks and impacts on people with disabilities, along with requirements for mitigation and differentiated measures for addressing them. Employing social baselines that are inclusive is particularly important to assess and mitigate project risks to persons with disabilities and to design inclusive and accessible consultation processes and grievance mechanisms.  ESS2 Labor and Working Conditions. Clarifies the legal requirements for employment and disability, including reasonable accommodation in the workplace. Labor management procedures (LMPs) that can help address disabilities are 108 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  identified, as are discriminatory processes and the accessibility of worker grievance mechanisms. LMPs can initiate measures for addressing the risks of inaccessibility and discrimination.  ESS3 Resource Efficiency and Pollution Prevention. Differentiated impacts of pollution and/or disruptions in service provisions for persons with disabilities should be identified. For example, roads affected by construction traffic may become impassable for persons with mobility-related disabilities.  ESS4 Community Health and Safety. Requires the borrower to apply the concept of universal access for new buildings and structures in project design, wherever technically and financially feasible. The borrower must assess risks and include differentiated measures for persons who may be disproportionately affected, such as those with disabilities, in all aspects of health and safety. This includes measures that address emergency response, road and traffic safety, transmission of communicable diseases (as a result of the presence of project workers), gender-based violence, and violence against children.  ESS5 Land Acquisition. Assessment and baseline surveys with respect to physical and/or economic displacement should include the needs of persons with disabilities. Compensatory measures to address inequality can be included as benefits, since persons with disabilities may endure greater hardships due to the loss or disruption of livelihoods and/or physical resettlement than others. In cases of physical resettlement, discussions with project-affected persons with disabilities should include accessible housing design and other needs, such as safe transportation during relocation.  ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources. Borrowers identify the differentiated impacts of biodiversity loss on persons with disabilities. For example, ensuring that persons with disabilities are part of decision making related to conservation initiatives and the sustainable management of living natural resources; considering how they can have continued access to and/or use of marine, freshwater, and terrestrial habitats and other natural resources to support their livelihoods and personal enjoyment; and including the accessibility and livelihood needs of project- affected persons with disabilities in assessments.  ESS7 Indigenous Peoples. Borrowers identify culturally appropriate inclusion of Indigenous persons with disabilities and develop specific differentiated mitigation measures in consultation with affected persons. Indigenous persons with disabilities often experience multiple and layered and intersecting forms of discrimination and face barriers to the full enjoyment of their rights based on their Indigenous Part 1: The Narrative | Technical Note on Accessibility | 109  | Appendixes status as well as their disabilities. Differentiated measures could include providing accommodations for culturally appropriate and accessible education or health care, considering the impacts of a project on their lands, territories, and natural resources, and on the livelihoods of persons with disabilities. This is important to ensure measures are in line with their right to culture. Indigenous persons with disabilities should also be included in the monitoring and evaluation, stakeholder consultation, and grievance mechanism.  ESS8 Cultural Heritage. Any impacts that might affect persons with disabilities and that include specific measures to provide or enable them to have access to tangible and intangible sites of cultural importance should be identified.  ESS9 Financial Intermediaries (FIs). FIs are required to monitor and manage the environmental and social risks and impacts of their portfolio and FI subprojects, and to monitor portfolio risk, as appropriate to the nature of intermediated financing. This includes developing and maintaining disability-inclusive Environmental and Social Management Systems (ESMS) to assess, manage, and monitor the risks and impacts of subprojects; implementing policies and procedures (including labor and grievance mechanisms) consistent with nondiscrimination and accessibility on the basis of disability; and providing reasonable accommodation where technically and financially feasible. ESMSs should include measures to identify and mitigate impacts, exclusion risks, and discrimination against persons with disabilities, for example, by considering the accessibility needs of persons with disabilities and the support they may need to submit proposals and applications to a financial intermediary.  ESS10 Stakeholder Engagement and Information Disclosure. Requires specific measures and/or assistance to facilitate the meaningful participation of stakeholders, including persons with disabilities, during consultations. (For example, considering the means of participation; availability of information in accessible formats prior to discussion or consultation events; the accessibility of venues; and translation services for the hearing impaired.) These should be incorporated into the Stakeholder Engagement Plan and the development of an inclusive and accessible Grievance Mechanism (GM). The social assessment should include baseline information on persons with disabilities to inform stakeholder engagement and GMs. ESF and Corporate Indicators The World Bank uses various corporate indicators to track project and portfolio elements, based on the ESSs. One such indicator under ESS4 relates to universal access: 110 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |   Is the concept of universal access being applied?  [IF YES] Does the project design include accessibility features?  [IF YES] Does the project design have differentiated measures for persons with disabilities? The ESF corporate indicators are completed by Environmental & Social (E&S) specialists before appraisal, as part of the E&S assessment work required to prepare the Appraisal Environmental and Social Review Summary. Where ESS4 is relevant to a particular operation, this and other ESS4 corporate indicators must be completed by E&S specialists. IDA19 and IDA 20 (International Development Association) IDA19 and IDA20 offer an important opportunity to accelerate the World Bank’s impact on disability-inclusive development. Disability inclusion is a cross-cutting theme in IDA19, embedded in six policy commitments across three special themes of Governance; Jobs and Economic Transformation; and Fragility, Conflict, and Violence. In addition, IDA19 sets out investments in disability-disaggregated data, differentiated interventions across sectors, and the promotion of inclusion through accessible physical environments and technologies. IDA20 includes a policy commitment under the Human Capital Special Theme on universal access: To promote inclusive societies, support at least 18 IDA countries to meet the needs of persons with disabilities by implementing the principles of non-discrimination, inclusion, and universal access as per the ESF, through projects in education, health, social protection, water, urban, digital development and/or transport. 10 Commitments In 2022, the World Bank announced 10 commitments concerning disability-inclusive development. These commitments emphasize the importance of considering universal access and accessibility standards when implementing projects. The commitments include, for example:  Technology and Innovation Ensuring that all World Bank-financed digital development projects are disability- sensitive, including through the use of universal design and accessibility standards.  Transport Ensuring that all World Bank-financed urban mobility and rail projects that support public transport services will be disability-inclusive by 2025. Part 1: The Narrative | Technical Note on Accessibility | 111  | Appendixes  Inclusive Education Ensuring that all World Bank-financed projects and programs in education will be disability-inclusive by 2025. Many countries have their own accessibility standards and/or guidelines; however, the ISO also addresses accessibility in the standards they develop. This includes guidance on built environments, products, services, and procurement.109 Disability Inclusion and Accountability Framework The Disability Inclusion and Accountability Framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities: nondiscrimination and equality; accessibility; inclusion and participation; and partnership and collaboration. Accessible World Bank Buildings and Offices Many countries have local or national guidelines for the accessibility of spaces, including buildings. These guidelines are often developed in consultation with persons with disabilities and are regulated by a ministry or statutory boards to ensure the use of best practices for accessibility in public spaces. Constructing or renovating buildings with these localized guidelines in place, and holding consultations with persons with disabilities will help ensure that buildings and offices are truly accessible to them. Much of the imperative for accessible buildings and offices is ensuring that persons with disabilities can be included in the workforce. Even though the changing world of work might not be as office-centric as it used to (particularly given that the COVID-19 pandemic has led many companies to implement flexible telework policies), it is still important to have accessible furniture and facilities and reasonable accommodations in workplaces, common areas, cafeterias, washrooms, and offices, to make them more inclusive. Modeling the Way—The Disability Accommodation Fund The Disability Accommodation Fund (DAF) allows persons with disabilities who work with the World Bank—including consultants and staff—access to reasonable accommodations to support their work. This fund provides support for persons with disabilities to enable them to complete their work responsibilities with reduced barriers. For example, the fund has supported the installation of strobe alarms in 109 ISO, “Accessing My World, n.d. 112 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  offices to alert persons with hearing impairments in emergency situations. Recently, the World Bank adopted the Washington Group model on functionality, as opposed to the medical model of disability, meaning that support is based on functional accommodation to support work, rather than on a medical diagnosis. This models not only the World Bank’s commitment to support the inclusion of persons with disabilities in the workforce, but also demonstrates to the Bank’s partners how internal policies can enhance accessibility in the workplace. Part 1: The Narrative | Technical Note on Accessibility | 113  | Appendixes Appendix C: Accessibility and the World Bank Sectors of Operation The World Bank operates in a variety of sectors that are affected to various degrees by the lack of accessibility. For example, supporting interventions in the education sector should not overlook the accessibility of school infrastructure, pedagogical materials and techniques, and possibly the larger issue of how children with disabilities can physically get to school if public transportation, pavements, and the road system are not accessible. In addition, the more that education relies on distance learning, the more online platforms, and digital tools must be made to be accessible for all. The same applies to sectors like health, employment, agriculture, or Disaster Risk Reduction (DRR), where accessibility- related components linked to infrastructure and communication should always be considered. The “sectoral focuses” in this Appendix of the Narrative tackle the basic overall issues related to accessibility in these sectors as well as the ones specific to each sector. However, there are other sectors of intervention (Water, Infrastructure, Transportation, Urban Development and ICT) where accessibility issues are so specific that they require a deeper analysis. The accessibility considerations that are valid for such sectors can be used in an overarching way in all other sectors as well. PART 3 of this Technical Note on Accessibility develops these five specific sectors through the “Thematic Fact Sheets” that accompany this Narrative. Figure 5: Thematic Fact Sheets 114 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Sectoral Focus 1: Accessible Agriculture There are important links between poverty, malnutrition, and disability that make it important to consider accessibility in agriculture. For persons with disabilities who are living in rural areas, access to tools, resources, and land can facilitate participation in the agricultural economy, which can help address poverty, malnutrition, and hunger among this population. However, to become more accessible as a sector, investment is needed in order to ensure that persons with disabilities have access to agricultural opportunities. This can include loans and funding opportunities specifically designed to support persons with disabilities who are employed in the agricultural sector; supporting the development and purchase of adaptive tools and assistive devices that allow persons with disabilities to work on farms; and adaptive training to equip farmers with disabilities with the appropriate agricultural skills. Similarly, supporting policies that allow persons with disabilities to have equal land ownership and inheritance rights, and participation in irrigation governance and community-based agricultural collectives can help reduce barriers to participation in the agricultural sector. Agro-Processing, Productivity Enhancement, and Livelihood Improvement Support (APPEALS) Project in Nigeria (P148616) The APPEALs project seeks to enhance the agricultural productivity of small and medium-scale farmers, and to improve value addition along priority value chains in participating states. During an implementation support mission, the task team conducted a sensitization presentation on persons with disabilities to the APPEALS team and client stakeholders, including members of the state steering and technical committees that included commissioners of agriculture, permanent secretaries, and program managers for agricultural development programs. Following the presentation, under APPEALS, the Women and Youth Empowerment Program (WYEP) team has opened a window for persons with disabilities and decided that 20 percent of the WYEP beneficiaries will be persons with disabilities. The team planned to convert key project documents into accessible formats by translating them into braille, infographics, and audio versions. In addition, the project planned to promote assistive technologies for farmers with disabilities. Part 1: The Narrative | Technical Note on Accessibility | 115  | Appendixes Table 5: Key Challenges and Actions for Accessibility in Agricultural Sector Operation Type of Challenges in Accessing Considerations for Disability Agricultural Operations Reducing Barriers Physical  Tools often require significant  Invest in accessible tool (mobility, force or mobility to operate. design and procurement. dexterity, and  Certain techniques or crops  Ensure that agricultural physical may require significant training is open to persons strength) physical labor. with physical disabilities,  The need to travel long and is held in accessible distances to fields and spaces (with ramps, irrigation. elevators, accessible washrooms, etc.).  Limited access to inclusive trainings on agricultural activities. Visual  Uneven ground and holes in  Smooth the ground, the ground create a danger of considering safety issues. slipping and falling.  Ensure that training is  Materials and tools for open to persons with visual community agricultural or impairments, and that irrigation management may materials / information on not be accessible. agricultural activities are available in braille, large  Barriers that are not detected by the guide cane, for print or screen-reader example those that are at formats, as well as formats the same height as the upper with audio description of limbs or head of the person images. (like the branches of trees).  Provide accessible tools tailored for persons with visual impairments.  Eliminate barriers at heights that are not detected by 116 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Agricultural Operations Reducing Barriers the guide cane. If there are irregularities inherent to the nature of the terrain that cannot be eliminated (e.g. ravines or cliffs), these must be blocked, for example, with meshes or bars that prevent blind workers from falling into them.  Conduct community workshops on accessibility in agriculture. Hearing  Participation in meetings  Incorporate captioning, sign about community agriculture language, or alternative and irrigation management forms of participation into may not always be in community and stakeholder accessible formats. meetings.  Difficulty communicating  Work to reform land with suppliers to buy ownership laws to include necessary agricultural goods. transfer to persons with disabilities.  Accessible and alternative format procurement for supplies, e.g., SMS, email, or other paper/text-based services.  Conduct community workshops on accessibility in agriculture. Part 1: The Narrative | Technical Note on Accessibility | 117  | Appendixes Type of Challenges in Accessing Considerations for Disability Agricultural Operations Reducing Barriers Speech  Meetings on community  Incorporate other forms agricultural or irrigation of participation (e.g. proxy management may not be or written submissions, accessible to those with communications via SMS) difficulty speaking. for community meetings, trainings, and stakeholder engagement.  Conduct community workshops on accessibility in agriculture. Cognitive  Difficulty communicating  Conduct community (memory, needs. workshops on accessibility thinking and in agriculture.  Limited inclusive agricultural problem- training.  Incorporate persons with solving, disabilities into agricultural reading and trainings by developing language plain-language training comprehen- tools and instructions. sion, ability to pay attention or follow instructions) Psychosocial  Social isolation and exclusion  Provide alternative may impede access to formats for participation in community meetings/ community meetings and information on agricultural stakeholder engagement and irrigation decisions. (I.e. text or proxy).  Difficulty communicating  Conduct community needs. workshops on accessibility in agriculture. 118 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  For more information and additional resources on this topic please see: AgrAbility. 2020. AgrAbility: Program Description. Drain, A., A. Shekar, and N. Grigg. 2018. Participatory Design with People with Disability in Rural Cambodia: The Creativity Challenge. The Design Journal 21(5): 685–706. Field, W. E., and P. Jones. 2006. Disability in Agriculture. Agricultural Medicine: A Practical Guide, edited by J.E. Lessenger. New York: Springer, 70–80. Groce, N.E., J. London, and M.A. Stein. 2014. Inheritance, Poverty, and Disability. Disability & Society 29(10): 1554–68. Leonard Cheshire Disability. 2013. Disability and Urban Agriculture: An Innovative Approach. Leonard Cheshire Disability and Inclusive Development Centre: University College London. Unknown author. 2013. Sustainable Income in Agribusiness for Persons with Disabilities. New Agriculturalist. Sectoral Focus 2: Accessibility in Social Protection Programs One way to enhance inclusion and improve equity for persons with disabilities is through social protection programs. Building resilience, equity, and opportunity in such programs with persons with disabilities in mind offers an opportunity to reduce the barriers to economic participation and inequities that persons with disabilities often face. Including persons with disabilities in social programs has three key components.  First, ensuring that there are appropriate provisions in public policies to specifically include persons with disabilities in social services, social insurance, training, and job programs. Engaging with persons with disabilities in order to learn how persons can be supported in these programs; developing staff competencies; ensuring that the services provided are adequate for their needs; and that the service delivery mechanisms are accessible is essential.  Second, ensuring the physical accessibility of spaces related to these programs is a key component. This means, for example, ensuring that the social service office Part 1: The Narrative | Technical Note on Accessibility | 119  | Appendixes is accessible, and that there is accessible transportation to social service programs or employment, and accessible information to access services or participate in job programs. Incorporating accessible features into the program design enables addressing the specific needs of persons with disabilities and improves the economic status, human capital formation, and health of persons with disabilities.  Finally, an important part of social protection is employment and skills training for persons with disabilities. While many persons with disabilities want to be and can be engaged in employment, stigma and lack of accessibility in workplaces often act as barriers to their participation. In addition, persons with disabilities may not have access to adequate training or education for certain jobs; improving opportunities for education and skills and vocational training tailored to their skills, interests, and needs can increase their participation in the workforce. The social protection approach should include awareness-raising programs clarifying that the right to work of persons with disabilities can be enforced through policies that promote accessibility and reasonable accommodation, together with eliminating prejudices, stereotypes, and other harmful practices. Awareness-raising programs should reach out to hiring decision makers, as well as to all other workers. This could also happen in connection with trade unions, which should also consider the needs of workers with disabilities. The Albania Social Assistance Modernization Project (P122233) has included specific aims to enhance the physical accessibility of regional offices. This $2.5 million investment provides persons with disabilities access to the regional offices in Tirana, Elbasan, and Durres. This project includes access to services, disability assessments, and the opportunity to file complaints. This was done by developing and implementing regulations on accessibility for persons with disabilities in public buildings, spaces, and services, with the result that buildings are accessible and compliant with local regulations. Since the project supported scale-up of disability assessment reform for persons seeking social insurance, the government further enhanced accessibility in six health centers where the assessments had taken place. Through various verification checklists and monitoring, the team ensured that they improved on specific aspects of accessibility at the regional offices, and made the spaces more inclusive to persons with disabilities. 120 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Table 6: Key Challenges and Actions for Accessibility in Social Protection Programs Type of Challenges in Accessing Considerations for Disability Social Protection Programs Reducing Barriers Physical  No ramps or elevators at  Build ramps, railings, (mobility, social protection offices, elevators, wide doorways, dexterity, and training facilities, or etc. in public buildings, physical workplaces. training centers, and offices. strength)  Workplaces that do not  Provide workplace training have space for wheelchairs, to reduce stigma against crutches, or walkers. persons with disabilities.  Washrooms and common  Develop the concept of areas are not accessible "labor flexibility," to be (stairs, too small, no grab applied according to the rails, etc.). needs of workers with disabilities.  Stigma or unwillingness to provide reasonable accommodations may Example: Shorter hours, or prohibit persons with frequent resting periods. disabilities from pursuing jobs in line with their interests and abilities. Visual  Relying on others to apply,  Provide alternative formats process, and access social for applying, processing, security allowances because and accessing benefits. of the lack of alternative  Provide workplace training formats (screen readers or to reduce stigma against braille). persons with disabilities.  Limited assistive technology in workplaces. Part 1: The Narrative | Technical Note on Accessibility | 121  | Appendixes Type of Challenges in Accessing Considerations for Disability Social Protection Programs Reducing Barriers  Materials for school or  Alternative formats trainings are only available in (braille, screen readers, print. and compatible software) for participation in skills training, workplace, and social protection.  Machinery and technology  Adapt machinery and used in the workplace may technology with contrasting require visual cues and not colors, large buttons, etc. have alternatives like raised  Develop the concept of buttons, or safety features. "labor flexibility," to be applied according to the needs of workers with disabilities. Example: Shorter hours or frequent resting periods. Hearing  No sign language  Provide sign language interpreters or other ways to interpreters and other communicate with officers or alternative formats for colleagues. applying, processing, and accessing benefits.  Having to rely on others to apply, process, and  Establish funds for assistive access social security technologies in job allowances because there programs and trainings. are no alternative means of  Provide workplace training communication. to reduce stigma against  School and skills trainings persons with disabilities. may be conducted orally,  Develop the concept of with no other available "labor flexibility," to be format. applied according to 122 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Social Protection Programs Reducing Barriers  Stigma or unwillingness the needs of workers with to provide reasonable disabilities. accommodations may prohibit persons with hearing Example: Shorter hours, or difficulties from pursuing frequent resting periods. jobs in line with their interests and abilities. Speech  Difficulty communicating  Provide workplace training needs to social protection to reduce stigma against agencies and coworkers. persons with disabilities.  Stigma or unwillingness  Promote participation to provide reasonable in alternative formats accommodations may (for example, written prohibit persons with hearing texts) for large meetings, difficulties from pursuing presentations, or trainings. jobs in line with their  Develop the concept of interests and abilities. "labor flexibility" to be applied according to the needs of workers with disabilities. Example: Shorter hours or frequent resting periods. Cognitive  Stigma or unwillingness  Provide workplace training (memory, to provide reasonable to reduce stigma against thinking and accommodations may persons with disabilities. problem- prohibit persons with solving, disabilities from pursuing Part 1: The Narrative | Technical Note on Accessibility | 123  | Appendixes Type of Challenges in Accessing Considerations for Disability Social Protection Programs Reducing Barriers reading and jobs in line with their  Create simplified forms language interests and abilities. and processes to facilitate comprehen- accessing benefits.  Difficulty navigating social sion, ability protection programs to  Increase availability of skills to pay access benefits. and job training programs. attention or follow  Having to relying on others  Develop the concept of to apply, process, and access "labor flexibility," to be instructions) social security benefits. applied according to the needs of workers with  Limited access to inclusive skills or vocational training. disabilities. Example: Shorter hours, or frequent resting periods. Psychosocial  Stigma or unwillingness  Allow flexible workplace to provide reasonable leaves and psychosocial accommodations may support policies and prohibit persons with programs. disabilities from pursuing  Provide workplace training jobs in line with their to acknowledge and support interests and abilities. persons with psychosocial disabilities.  Develop the concept of "labor flexibility," to be applied according to the needs of workers with disabilities. Example: Shorter hours or frequent resting periods. 124 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  For more information and additional resources on this topic please see: International Labour Organization. 2020. No One Left Behind, Not Now, Not Ever: Persons with Disabilities in the COVID-19 Response. Geneva: International Labour Organization. International Labour Organization. 2010. The Price of Excluding People with Disabilities from the Workplace. Geneva: International Labour Organization. Karr, V., A. van Edema, J. Sims, and C. Brusegaard. 2017. No One Left Behind: A Review of Social Protection and Disability at the World Bank. Disability and the Global South 4(1): 1112–42. Ng, A.K.Y., L.K. Elder, and A. Hasan. 2020. Human Capital and Disability: Why It’s Important to Invest in All People. Washington, DC: World Bank. (Requires World Bank login). Packard, T.G., U. Gentilini, M.E. Grosh, P.B. O’Keefe, R.J. Palacios, D.A. Robalino, and I.A. Santos. .2019. Protecting All: Risk Sharing for a Diverse and Diversifying World of Work. Washington, DC: World Bank Group. World Bank Group. 2020. Sourcebook on the Foundations of Social Protection Delivery Systems. Washington, DC: World Bank Group. Sectoral Focus 3: Accessibility in Disasters and Fragile, Conflict, and Violent (FCV) Settings Disaster and Fragile, Conflict, and Violent (FCV) settings have various impacts on individuals and communities, depending on the risk factors, social networks, support, and access to resources. Persons with disabilities may be at greater risk of the impacts of disasters and FCV settings, as they are often disproportionately hurt; they may face difficulties in accessing vital information; and they might struggle to escape and reach safe areas or to find and access food, security, water, health care, work, and basic services. In addition, the prevalence of disability may increase in these settings, as disasters and conflict may have an impact on physical and mental health and well-being. Therefore, accessibility is a critical component of projects focusing on resiliency and FCV settings, because including persons with disabilities in the development and deployment of disaster plans plays a critical role in ensuring that everyone shares in preparedness, recovery and “building back better” efforts. Part 1: The Narrative | Technical Note on Accessibility | 125  | Appendixes Post-disaster contexts can also provide an excellent opportunity to integrate accessibility standards within inclusive reconstruction strategies and activities. Therefore, accessibility can reduce the negative effects of a disaster on persons with disabilities and disasters can even turn into an opportunity to promote accessibility within the reconstruction process. Emergency Demobilization and Reintegration Projects (P075129 and P112712) Following the genocide in Rwanda, many ex-combatants were left with permanent physical disabilities. With support from the World Bank and the Government of Rwanda, the Rwanda Demobilization and Reintegration Commission helped to rehabilitate these ex-combatants. They received tailored support for their disabilities, with over 800 receiving accessible housing to support independent living. In addition, they received appropriate assistive technology, and vocational and skills training so they could gain meaningful employment in specialized cooperatives and production workshops. It should be noted that accessible, affordable housing and job opportunities were limited for ex-combatants with disabilities before this project; addressing the issues of housing security, skill development, and accessibility has helped them to be rehabilitated and included in their communities. The program has since been integrated into a national law, and similar programs are being implemented across the country to rehabilitate and include ex-combatants with disabilities in their communities. Table 7: Key Challenges and Actions for Accessibility in Disaster and FCV Settings Type of Challenges in Accessing Considerations for Disability Disaster and FCV Settings Reducing Barriers Physical  Limited accessible  Provide accessible routes to (mobility, infrastructure, worsened by basic services. dexterity, and damage in disaster, conflict,  Develop and monitor physical and violent situations. compliance on disaster strength) preparedness and recovery plans to include evacuations 126 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Disaster and FCV Settings Reducing Barriers  Limited accessible or support for persons with infrastructure, worsened by physical disabilities. damage in disaster, conflict,  Mobilize community and violent situations. members to provide  Uneven roads or transport preparedness and disruptions. evacuation support.  Limited access to assistive  Provide durable assistive technologies. devices that are usable on Shelters are often not uneven surfaces.  accessible.  Provide ramps, elevators, Inaccessible transportation wide doorways, and railings  to shelters. in shelters or temporary housing.  Provide accessible transportation to shelters.  Implement inclusive reconstruction strategies. Visual  Uneven roads or disrupted  Provide accessible and safe transport because of conflict routes to basic services. means that going outside has  Provide alternative forms unknown hazards; persons of audio communication with disabilities may have (radio, speech-to-text) to rely on others to navigate about the disaster and any outside their homes. updates, particularly when  Early warning alerts may the warning involves maps require reading text or or color coding. viewing maps, or may be  Ensure that shelters and reliant on color coding, and temporary accommodation unavailable in alternative have clear pathways, formats. high-contrast flooring, Part 1: The Narrative | Technical Note on Accessibility | 127  | Appendixes Type of Challenges in Accessing Considerations for Disability Disaster and FCV Settings Reducing Barriers  Limited access to assistive and clear signage to safely technology or news, so must guide persons with visual rely on others for timely impairments. information.  Work with OPD networks  Crowded shelters or to communicate important temporary accommodation messages. may be difficult to navigate.  Implement inclusive reconstruction strategies. Hearing  Early warning alerts may be  Provide SMS or visual auditory and not available in alternative formats of alternative formats. emergency alerts.  Limited access to news/  Ensure that all alerts updates on the situation. and briefings have sign- language interpretation  Having to rely on others to get information on the and/or closed captioning. situation.  Work with networks of OPDs to communicate important messages.  Implement inclusive reconstruction strategies. Speech  Difficulty expressing needs or  Provide alternative forms challenges. of accessing therapies/ supports.  Therapies or other forms of support may not be  Facilitate the interaction accessible. of the person with speech disability with those who are in charge of the emergency and their environment. 128 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Disaster and FCV Settings Reducing Barriers  Implement inclusive reconstruction strategies. Cognitive  Complex explanations and  Provide plain-language (memory, recovery plans. information on the crisis thinking and through multiple sources.  Limited access to news or problem- situation updates.  Support programs with solving, psychosocial support for reading and  Preparedness training, for example, drills, may result persons with cognitive language impairments. in additional trauma if not comprehen- sion, ability properly presented and  Provide clear instructions on explained to persons with the nature of the training. to pay cognitive challenges. attention  Implement inclusive reconstruction strategies. or follow instructions) Psychosocial  Supports and trainings may  Increased availability of be difficult to follow and psychosocial support in access. a variety of formats (in- person, online, text, etc.).  Implement inclusive reconstruction strategies. For more information and resources on this topic, please see: Age and Disability Consortium. 2018. Humanitarian inclusion standards for older people and people with disabilities. CBM International, HelpAge International and Handicap International. Global Facility for Disaster Reduction and Recovery. 2017. Disability Inclusion in Disaster Risk Management. Washington, DC: World Bank Group. Part 1: The Narrative | Technical Note on Accessibility | 129  | Appendixes Robinson, A., A. Mortlock, C. McClain-Nhlapo, M. Koistinen, D.S. Raja, M. Lo, N. Islam- Maswood, and E. Shenfeld. 2020. Disability-Inclusive Disaster Recovery. Disaster Recovery Guidance Series. Washington, DC: World Bank Group. World Bank. 2016. Resources for Psychosocial Support in Fragile and Conflict-Affected Settings. World Bank. 2019. Ex-Combatants with Disabilities in Rwanda Regain Their Autonomy and Rebuild Their Lives. Project Video. Sectoral Focus 4: Inclusive Education and Accessible Schools Education is a critical component in improving human capital formation; when it is inclusive it can be transformative in bringing persons with disabilities out of poverty. However, inaccessible facilities, lack of support, and cultural norms often limit access to education for children with disabilities. The use of a twin-track approach, where there are both mainstream learning programs that are inclusive of all learners, including those with disabilities, and targeted supports to address the specific needs of children with disabilities, can help change this situation. Ensuring Universal Design for Learning (UDL), in which programs are presented, represented, expressed, and tested in various ways, to showcase different learning methods for different learners, is another helpful strategy. When improving school infrastructure, considering how universal design principles can be implemented in the learning, recreation, and WASH facilities in both mainstream schools and schools for children with disabilities is another critical component for ensuring inclusion. In addition, national education policies can help support universal access to education and educational resources that support learning. Rwanda’s Quality Basic Education for Human Capital Project (P168551) Overcrowding of basic school infrastructure is a growing problem for schools in Rwanda. A World Bank project has invested in reducing overcrowding by constructing new schools, classrooms, and latrines. As part of this project, all construction must adhere to the local building code regulations, which include key inclusive universal design features, such as ramps and accessible latrines. 130 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  By coupling inclusive design principles with new construction, these schools will be more accessible to children with disabilities and will help increase equity in school participation and achievement for children and youth with disabilities. Table 8: Key Challenges and Actions for Accessibility in Education and Schools Type of Challenges in Accessing Considerations for Disability Education and Schools Reducing Barriers Physical  Navigating uneven, unstable,  Slip-resistant, smooth (mobility, narrow, steep, or slippery surfaces, ramps, and dexterity, and surfaces with or without an elevators to ensure access to physical assistive device. all spaces in the school. strength) Inaccessible modes of   Wider door frames. transportation.  Supports and/or grab bars  Opening, closing, and along walls. latching doors, fences, and closets.  Free, accessible transportation provided  Difficulty squatting over to students who require it. pit latrines, balancing, and needing to sit.  Adapted and assistive devices for learning.  Holding, lifting, and carrying learning materials. Visual  Difficulty in identifying  Incorporate hazards, such as holes and contrasting colors and obstructions around the safety mechanisms in school property, including in all classrooms. the classrooms, dining areas, common areas, toilets, and schoolyard spaces. Part 1: The Narrative | Technical Note on Accessibility | 131  | Appendixes Type of Challenges in Accessing Considerations for Disability Education and Schools Reducing Barriers  Difficulty in accessing  Provide information learning materials displayed (including alerts) in audio on the board or around format (including sirens, the classroom, or relayed recorded messages, or through print, text-only beeps on phones). information on video-based  Make learning materials programs, or signing print- available in accessible based documents and forms. electronic formats on  Navigating new surroundings USB drives, websites, and when all signage is in text. through email.  Inability to distinguish  Provide screen readers, between colors (for example, braille displays, to differentiate between the magnification software and wall and door of a classroom) devices, voice recognition due to low vision. software and audio descriptions.  Provide adapted and assistive devices for learning. Hearing  Difficulty in accessing  Provide SMS text information given orally. messaging or print as a way of accessing important  Video learning programs without captions or information in the interpretation. community.  Hearing sirens and other  Install flashing lights to sounds that alert scheduling alert scheduling changes changes, or emergencies. (class changes, lunch times, breaks) or emergencies.  Facing barriers in communicating and  Have local sign language interacting with teachers, interpretation or alternative 132 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Education and Schools Reducing Barriers students, staff, and forms of communication administration who do not available for community know local sign language. meetings and consultations.  Provide adapted and assistive devices for learning. Speech  Facing barriers in  Provide alternative forms communicating and of communication/ interacting with participation in classes teachers/ students/staff/ and other extracurricular administration. activities, such as through text or other written forms,  Relying on others to express their views and needs. and alternative methods of conducting activities.  Provide adapted and assistive devices for learning. Cognitive  Difficulty in communicating  Provide information (memory, learning needs. in alternative formats, thinking and including visual or  Needing information in problem- alternate formats (visual, simplified language, solving, audio, or tactile) to aid or tactile learning reading and comprehension. opportunities. language  Needing navigation and  Allow for alternative forms comprehen- of participation. memory aids in finding, sion, ability accessing, and using school  Provide adapted and to pay spaces. assistive devices for attention learning. or follow  Relying on others to express their views and needs. instructions) Part 1: The Narrative | Technical Note on Accessibility | 133  | Appendixes Type of Challenges in Accessing Considerations for Disability Education and Schools Reducing Barriers Psychosocial  Difficulty in communicating  Provide alternative forms learning needs. of communication/ participation for classroom  Needing navigation and memory aids in finding, settings and other accessing, and using school extracurricular activities, spaces. such as through text or written form.  Relying on others to express their views and needs in  Use clear, plain language, educational settings. and high-contrast signage in all school spaces.  Provide adapted and assistive devices for learning. For more information and resources on this topic please see: Alasuutari, H.K. and S. Powers. 2021. Criteria for the World Bank’s Disability-Inclusive Investment Project Financing (IPF) in Education. Washington DC: World Bank Group. Hayes, A., A. Turnbull and N. Moran. 2018. UNIVERSAL DESIGN FOR LEARNING TO HELP ALL CHILDREN READ: Promoting Literacy for Learners with Disabilities (First Edition). Washington, DC: USAID. International Standards Organization (ISO). 2020. Accessing My World. Light for the World. 2014. Towards an Inclusive Learning Environment for Students with Disabilities: Developing Architectural Design Guidelines for Accessible Educational Facilities. McClain-Nhlapo, C., R.K. Singh, A.H. Martin, H.K. Alasuutari, N. Baboo, S.J. Cameron, A. Hayes, and others. 2020. Pivoting to Inclusion: Leveraging Lessons from the COVID-19 Crisis for Learners with Disabilities. Washington, DC: World Bank. 134 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Topping, B. 2014. Access to School and the Learning Environment I - Physical, Information and Communication. New York: UNICEF. UNICEF. n.d. Accessible Textbooks for All. Sectoral Focus 5: Accessible Health Care and Services Persons with disabilities often face significant barriers at various points in health systems, which limits their access to prompt, appropriate, accessible, quality health care. Incorporating accessible means of conveying information and communication into health care is very important in providing free and informed consent for treatments, surgeries, or other procedures. Many persons with disabilities also have underlying medical conditions and needs; therefore, improving the accessibility of health care services and facilities is a critical gap for improving general well-being, health outcomes, and human capital in a society. Since persons with disabilities represent a significant proportion of the population, addressing inaccessibility of health systems and services will be a critical step to achieving the SDG goal of Universal Health Coverage by 2030. There are several places where barriers exist for persons with disabilities within health systems. For example, the perceived need and the decision to seek health care can be directly shaped by previous negative experiences with the accessibility and acceptability of care. Training health care staff in disability-related information, skills, and sensitization can help to create more accessible and friendlier experiences for persons with disabilities. Cost can also present a significant barrier in accessing health services, particularly for persons with disabilities. The cost of accessible transport may be prohibitive in general, and/or more expensive for persons with disabilities. Therefore, on top of the cost of health care services, considering not only health coverage, but also travel can ensure greater accessibility for persons with disabilities. Finally, the lack of physical accessibility of health care services can often limit access for persons with disabilities. Many health care centers, clinics, and posts, particularly in rural areas, were not built with universal design principles in mind, making it imperative that any future projects consider accessibility standards early in the design process. Additionally, for persons who require alternative formats, such as persons with hearing and visual impairments, it is often difficult to obtain accessible services and information, particularly on short-term notice or in emergency situations. For many who rely on sign language interpretation, a lack of interpreter often has a negative impact on both the acceptability and the quality of the care they receive. Part 1: The Narrative | Technical Note on Accessibility | 135  | Appendixes Example: Sightsavers, an NGO working in more than 30 countries, developed an Inclusive Eye Health initiative in Bhopal, India. By integrating accessibility considerations into an existing urban eye health program, the team increased accessibility and inclusion within this health project. They began by conducting accessibility audits of local primary health centers and a tertiary hospital to see how they could improve physical access to service provision. They also addressed some of the stigma and service provision gaps for persons with disabilities by training health care providers with information on accessibility, universal design, and disability. By creating a more inclusive environment, and equipping service providers with the tools they need to serve persons with disabilities in an appropriate, rights-based way, they improved access to health care for persons with disabilities. Following the success of this project, they expanded it to serve persons with disabilities across India as well as in Ethiopia and Mozambique. Table 9: Key Challenges and Actions for Accessible Health Services Type of Challenges in Accessing Considerations for Disability Health Care and Schools Reducing Barriers Physical  Limited accessible transport  Retrofit and incorporate (mobility, options. ramps and elevators into dexterity, and Facilities that do not have medical facilities.  physical ramps, elevators, or other  Retrofit and incorporate strength) accessibility measures. ramps and elevators into Medical equipment or medical facilities.  machinery that requires  Purchase equipment that standing or transferring from can be used sitting down a wheelchair. and in a wheelchair; and/ Distance to facilities and or adjustable, scales, exam  within large hospitals. tables, etc.  Limited appropriate and  Increase access to inclusive health advice. community health services and community-based rehabilitation. 136 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Health Care and Schools Reducing Barriers  Limited assistive technology  Provide transportation (e.g., walkers, wheelchairs, stipends and accessible crutches). transportation for getting to appointments.  Consider using telehealth/ telemedicine interventions where appropriate to reduce transport and facility inaccessibility.  Provide low-cost, quality assistive technology through primary health care centers and pharmacies. Visual  Lack of accessible transport  Provide health care to clinics. information and websites in accessible formats.  Limited health care information and instruction  Develop special health care in alternative formats (braille, financing programs for screen-reader format, etc.). persons with disabilities to defray costs.  Reliance on others for appointments, resulting  Provide low-cost, quality in breaching of patient assistive technology confidentiality. through primary health care centers and pharmacies.  Lack of providers.  Limited assistive technology (such as eyeglasses, white canes). Hearing  Limited awareness of where  Generate and disseminate and when to seek care. resources on health care Part 1: The Narrative | Technical Note on Accessibility | 137  | Appendixes Type of Challenges in Accessing Considerations for Disability Health Care and Schools Reducing Barriers  Communication barriers with providers who provide health care workers, meaning services in sign language. that patients must bring  Include the cost of Sign someone with them in order Language Interpreters to communicate. among the expenses that  Limited transport options. can be claimed to the national health system from  Lack of trained specialized persons with disabilities. health care workers.  Poor follow-up.  Raise awareness of health care workers through  Limited assistive technology interdisciplinary training (hearing aids). programs on disability.  Provide low-cost, quality assistive technology through primary health care centers and pharmacies. Speech  Difficulty expressing needs  Raise awareness of health and symptoms of medical care workers through ailments. interdisciplinary training programs on disability.  Lack of trained health-care providers.  Facilitate the use of accessible technologies for persons with speech-related disabilities. Cognitive  Lack of trained health-care  Raise awareness of health (memory, providers. care workers through thinking and interdisciplinary training  Lack of accessible transport problem- to clinics. programs on disabilities. solving, 138 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Type of Challenges in Accessing Considerations for Disability Health Care and Schools Reducing Barriers reading and  Limited knowledge, skills,  Provide low-cost, quality language and awareness of health care assistive technology comprehen- workers. through primary health care sion, ability centers and pharmacies.  Inadequate sexual and to pay reproductive health care attention because of stigma. or follow instructions) Psychosocial  Difficulty expressing needs  Raise awareness of health and symptoms of medical care workers through ailments. interdisciplinary training programs on disabilities.  Poor understanding of health care workers.  Include community-based supports targeted at serving persons with psychosocial disabilities in health care interventions. For more information and resources on this topic please see: International Standards Organization (ISO). 2020. Accessing My World. Kuper, H., and P. Heydt. 2019. The Missing Billion: Access to Health Services for 1 Billion People with Disabilities. London: London School of Hygiene and Tropical Medicine. Pregel, A., T. Vaughan Gough, E. Jolley, S. Buttan, and A. Bhambal. n.d. Ensuring Universal Access to Eye Health in Urban Slums in the Global South: the Case of Bhopal (India). Sightsavers International/Sightsavers India. UN DESA. 2016. Toolkit on Disability for Africa: Inclusive Health Services for Persons with Disabilities. New York: United Nations. Part 1: The Narrative | Technical Note on Accessibility | 139  | Appendixes Appendix D: Minimum Accessibility Requirements There is no universal accessibility standard that can be followed always and in every situation: standards differ from country to country and if they are not detailed enough, a more specific standard might need to be applied to at least some accessibility-related topics. This Note does not provide a “turnkey solution” for technical recommendations: instead, it encourages all teams to check the national standards applicable to their own contexts and complete them using the ISO, or other relevant standards, as needed. To clarify the main points of accessibility to attend to when addressing infrastructure activities, PART 4 of this Technical Note on Accessibility provides insights on good practices through the “Technical References” attached to this Narrative. Figure 6: Technical References 140 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Appendix E: Additional Reading and Resources On Built Environments AusAID. 2013. Accessibility Design Guide: Universal Design Principles for Australia’s Aid Program Canberra, ACT: Australian Government. Building Construction Authority. 2019. Code on Accessibility in the Built Environment. Singapore: Government of Singapore. Centre for Excellence in Universal Design. n.d. Building for Everyone: Technical Guidance on Accessibility. DID4All Resources. Guidelines and Standards for Accessibility. Gurung, G. 2012. Accessibility Guidelines for Making Barrier-Free Environment. Handicap International. 2014. Conduct an Accessibility Audit in Low- and Middle- Income Countries. ISO. n.d. Accessing My World. ISO. https://www.iso.org/accessing-my-world.html National Disability Authority. n.d. Make Your Buildings More Accessible. Pacific Regional Infrastructure Facility (PRIF). 2017. Improving Accessibility in Transport Infrastructure Projects in the Pacific Islands. Uganda National Action on Physical Disability (UNAPD). 2010. Accessibility Standards: A Practical Guide to Create a Barrier-Free Physical Environment in Uganda. Ministry of Gender, Labour, and Social Development. Part 1: The Narrative | Technical Note on Accessibility | 141  | Appendixes On Virtual Environments How to Consider Accessibility and Inclusion for Online and In-Person Events – Recordings and Resources (Requires World Bank login). Digital Accessibility Guidelines for Creating Content (Requires World Bank login). Representing People with Disabilities in Work Bank Content (Requires World Bank login). Discussing Digital Accessibility with Colleagues and Vendors (Requires World Bank login). Digital Accessibility Learning Resources and Tools (Requires World Bank login). Cornell University, Division of Human Resources. Accessible Meeting & Event Checklist. New York, USA. European Disability Forum (EDF). EDF Guide for Accessible Meetings for All. Brussels, Belgium. Mabita, N. 2020. Accessible Online Participation. European Disability Forum (EDF). G3ict (The Global Initiative for Inclusive ICTs). Publications. World Bank Commitments, Directives, and Documents World Bank. 2021. Addressing Risks and Impacts on Disadvantaged or Vulnerable Individuals or Groups. Bank Directive. Washington DC: World Bank. World Bank. 2018. Non-Discrimination and Disability. Good Practice Note. Environment & Social Framework for IPF Operations. Washington DC: World Bank. World Bank. 2018.10 Commitments on Disability-Inclusive Development. World Bank. 2018. Disability Inclusion and Accountability Framework. Washington DC: World Bank. Information on the World Bank’s Internal Disability Accommodation Fund (Requires World Bank login). 142 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Staff Guide on Disabilities at the World Bank. (Requires World Bank login). Quick Tips to Promote Disability Inclusion. (Requires World Bank login). World Bank Policies for Staff with Disabilities World Bank Group. n.d. Health & Safety Directorate (HSD) - World Bank Group Disability Accommodation Fund & Disability Parking (Requires World Bank login). World Bank Group. n.d. Staff Guide: Disabilities at the World Bank Group. (Requires World Bank login). Accessibility Standards ASEAN (THE ASSOCIATION OF SOUTHEAST ASIAN NATIONS). ASEAN Digital Masterplan 2025. General Comment No. 2 on Article 9: Accessibility in the UN Convention on the Rights of Persons with Disabilities. Government of the Republic of Uganda. 2010. Accessibility Standards: A Practical Guide to Create Barrier-free Physical Environment in Uganda. Uganda National Action on Physical Disability and Ministry of Gender, Labour and Social Development. Gurung, G. 2012. Accessibility Guidelines for Making Barrier-Free Environment. Government of Singapore. n.d. Accessibility: Navigating Singapore with Ease NFD-N, and Kathmandu Metropolitan City, 2018. Report on Accessibility Audit in Kathmandu, Nepal: Kathmandu. Government of Nepal. Tokyo 2020 Accessibility Guidelines. On Inclusive Procurement Economic and Social Commission for Asia and the Pacific. 2018. Beijing Declaration, including the Action Plan to Accelerate the Implementation of the Incheon Strategy. Fifth Session of the Working Group on the Asian and Pacific Decade of Persons with Disabilities, 2013-2022, Bangkok. Part 1: The Narrative | Technical Note on Accessibility | 143  | Appendixes European Union. 2014. Directive 2014/24/EU of the European Parliament and of the Council of 26 February 2014 on public procurement and repealing Directive 2004/18/EC Text with EEA relevance. G3ict. 2015. CRPD Implementation: Promoting Global Digital Inclusion through ICT Procurement Policies & Accessibility Standards. International Disability Alliance. 2015. Public procurement and the Convention on the Rights of Persons with Disabilities: Rights in Practice. Draft Background paper, Promoting the rights of one billion persons with disabilities. International Telecommunication Union (ITU). 2019. Accessible Europe 2019 Background Paper: Standards in the Procurement of Accessible ICT Products and Services. ITU. United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP). 2019. Disability-Inclusive Public Procurement: Promoting Universal Design and Accessibility. UN Reports and Documents Convention on the Rights of Persons with Disabilities (CRPD). United Nations, Department of Economic and Social Affairs (UNDP). 2019. Disability and Development Report. Realizing the Sustainable Development Goals by, for and with persons with disabilities, 2018. New York: UNDESA. United Nations. n.d. United Nations Disability Inclusion Strategy. United Nations, Department of Economic and Social Affairs (UNDP). 2018. Disability Inclusive Development in UNDP. Guidance and entry points. New York, USA. United Nations Special Rapporteur on the Rights of Persons with Disabilities, Committee on the Rights of Persons with Disabilities, and Special Envoy of the Secretary- General on Disability and Accessibility. 2020. International Principles and Guidelines on Access to Justice for Persons with Disabilities. Geneva: United Nations. 144 | Technical Note on Accessibility | Part 1: The Narrative Appendixes |  Budgeting and Accessibility Costs Handicap International France, Cambodia Program. 2008. How to Build an Accessible Environment in Developing Countries. Based on the Cambodia Program's experience. Manual #1 - Introduction & Accessibility standards. Phnom Penh, Cambodia. Fuglerud, K.S., T. Halbach and I. Tjøstheim. 2015. Cost-benefit analysis of universal design Literature review and suggestions for future work. Norsk Regnesentral (Norwegian Computing Center). Oslo, Norway. HCMA Architecture + Design. 2020. Rick Hansen Foundation Accessibility Certification™ Cost Comparison Feasibility Study. Rick Hansen Foundation. Sample Accessibility Improvement Costs. On Indigenous Peoples with Disabilities United Nations, Economic and Social Council. 2013. Study on the situation of indigenous persons with disabilities, with a particular focus on challenges faced with regard to the full enjoyment of human rights and inclusion in development New York, USA. United Nations. 2008. Declaration on the Rights of Indigenous Peoples (Articles 21 and 22). United Nations, Enable. International Norms and Standards Relating to Disability. Part V. Persons with Disabilities and Multiple Discrimination – rights of Special Groups. No. 6. Rights of Indigenous Populations. Part 1: The Narrative | Technical Note on Accessibility | 145 Inside back cover