How to Make Development Projects Work for People with Disabilities

Around one in six people on earth lives with a disability. That is more than a billion people. Most of them live in low- and middle-income countries. And in far too many development projects, they are still an afterthought.

This is not just unfair. It is a waste. When a road is built, a school is opened, or a cash transfer is rolled out, leaving people with disabilities out means the project reaches fewer people, does less good, and often costs more to fix later.

The good news is that we now know what works. Over the past two decades, governments and organisations across the world have tested different ways to include people with disabilities. Some of these methods have strong evidence behind them. This article walks through the ones that have delivered real results, with examples from different countries, and ends with what all of this means for Rwanda.

A quick note on language. When we say “mainstreaming disability,” we simply mean building disability into the everyday work of a project, rather than treating it as a separate side activity. That idea sits at the heart of everything below.

1. Count people properly before you plan

You cannot include people you cannot see. For years, disability numbers in many countries were guesses, and usually far too low. Old census questions asked things like “Are you disabled?” People said no, even when they had real difficulty seeing, hearing, or walking, because of stigma or because they did not think of themselves as “disabled.”

A better tool now exists. The Washington Group Short Set of Questions asks about function instead of labels. It asks whether a person has difficulty seeing, hearing, walking, remembering, with self-care, or with communication. This simple change picks up far more people, and it lets you compare results across countries.

The numbers show why the tool matters. A 2021 study by Mactaggart and colleagues, published in the International Journal of Environmental Research and Public Health, analysed surveys across seven countries and found that disability rates ranged widely depending on how the question was asked, from about 3 percent in Vanuatu to 14 percent in Turkey. The same study found that using a wider threshold of “some difficulty or more” raised the counts five to ten times higher [1]. The lesson is clear: how you count changes who gets counted.

Three examples of this working in practice:

• Nepal, India, and the Maldives all ran population surveys using the Washington Group questions, producing the kind of reliable data that lets planners design services around real needs rather than guesses. These were among the seven countries in the 2021 Mactaggart study [1].
• Cameroon and Guatemala used the same tools, which meant their results could be compared and pooled with other countries for the first time [1].
• The trend is global. According to a 2016 review by Mitra Loeb on international census data, about 30 countries had adopted the six Washington Group questions in their national census by the 2010 round [2]. A 2017 presentation to the UN Statistics Division by Jean-Michel Durr shows the wider picture: the number of countries collecting any disability data in their census rose from 19 in 1970 to around 120 by 2010 [3].

The takeaway for any project: put good disability questions into your baseline survey and your monitoring system from day one. If you skip this step, everything after it is built on sand.

2. Use the twin-track approach

This is the most widely used idea in disability-inclusive development, and for good reason. The twin-track approach means doing two things at once.

Track one: make your main project accessible to everyone. If you build a health centre, make sure a wheelchair user can enter it. If you run a training programme, make sure a deaf person can follow it.

Track two: run some disability-specific activities alongside, to help people who need extra support catch up and take part on an equal footing. This might mean providing a wheelchair, sign language training, or one-to-one support.

According to the Governance and Social Development Resource Centre (GSDRC) at the University of Birmingham, the twin-track approach is the most commonly referenced method used by UN agencies, donor governments, and NGOs [4]. The key is balance. As development practitioner Lana Woolf explains, both tracks matter because they complement each other, and mainstreaming on its own, done badly, can slide into token gestures that leave people no better off [5].

Three examples:

• Nigeria: A 2022 doctoral study at the University of Massachusetts Boston examined five development projects using the twin-track approach. It found that clear policy at national and international levels made a real difference to what happened in the field, and that combining mainstream and targeted support was central to reaching people who would otherwise miss out [6].
• The World Bank’s education work: According to the World Bank’s Inclusive Education Initiative, the twin-track approach is central to the Bank’s commitment to disability inclusion in education, shaping projects across many countries through teacher training, accessible materials, and better policy [7].
• Lao PDR: As described by the United Nations Development Programme (UNDP), development partners paired mainstream services with targeted support for organisations run by people with disabilities, building their capacity while also opening up wider decision-making [8].

The practical point: do not choose between an inclusive main project and disability-specific support. You usually need both.

3. Involve people with disabilities in the design, not just at the end

There is an old slogan in the disability movement: “Nothing about us without us.” It means people with disabilities should help shape any decision that affects them, from the first planning meeting to the final evaluation.

This is more than a courtesy. People with disabilities know the barriers they face better than anyone. As the UNDP puts it, their lived experience is exactly the knowledge that makes decisions work [9]. Bring them in late and you get a project designed around wrong assumptions, with accessibility bolted on as an expensive afterthought. As one 2026 analysis by Pivotal Accessibility notes, a one-hour consultation cannot make up for their absence from months of planning [10].

The usual way to do this is to work with Organisations of Persons with Disabilities, often called OPDs. These are groups led and run by people with disabilities themselves. It is worth being careful here: a group that provides services to people with disabilities is not the same as one that is led by them. For real, representative input, you want the second kind [10].

Three examples:

• Lao PDR: According to UNDP, development partners trained OPDs in disability data collection so the country could better understand the barriers people faced, and supported 11 OPDs across 10 provinces to feed their lived experience directly into the country’s official human rights review [8].
• The CRPD negotiations: As legal scholar Gauthier de Beco documents in Disability in International Human Rights Law (Oxford University Press, 2021), when the world’s countries drew up the UN Convention on the Rights of Persons with Disabilities, disabled people’s organisations took part in the talks in a way rarely seen before, shaping the treaty and pushing the whole disability rights movement forward [11].
• Global survey evidence: A 2021 study in the journal Disabilities, drawing on the International Disability Alliance’s global survey, found OPDs repeatedly stressing the need to be part of planning, monitoring, and evaluation, not just consulted once and forgotten [12].

The practical point: budget time and money to involve OPDs from the start, and pay for the real costs of their participation, such as transport, interpreters, and accessible venues.

4. Build accessibility in from the start

It is far cheaper to build a ramp than to knock down a wall and add one later. The same is true for information, transport, and services. Designing things to work for everyone from the beginning, sometimes called universal design, saves money and reaches more people.

Accessibility is not only about buildings. It covers whether a blind person can read your materials, whether a deaf person can follow your meeting, and whether someone using a wheelchair can reach the toilet at your event. The gaps here are huge. Writing for the World Economic Forum in 2019, disability advocate Yetnebersh Nigussie cited World Health Organization figures showing that only 5 to 15 percent of children who need assistive devices such as wheelchairs or hearing aids can actually get them, and only about 1 percent of learning materials are available in formats blind and partially sighted people can use [13].

Three examples from inclusive education, where accessibility has been tested hard:

• Burkina Faso: In the same World Economic Forum article, Nigussie describes how a Light for the World project in the district of Garango succeeded in getting children with disabilities into mainstream schools. It also had a knock-on effect: when disabled children went to school, the family members who used to care for them at home, often mothers and sisters, were freed up to work or study themselves [13].
• Ghana: According to a 2022 study posted on medRxiv, Ghana made inclusive education a central goal in its Education Strategic Plan, and since then children with and without disabilities have increasingly learned together, with most students with visual impairments now in mainstream schools [14].
• Rwanda (a preview of what is coming below): According to the World Bank, after joining its Inclusive Education Initiative, Rwanda’s Ministry of Education supported the University of Rwanda in setting up a model inclusive school with a resource centre offering therapy and counselling [15].

The practical point: write accessibility into your designs, budgets, and contracts at the start. Retrofitting is always slower and more expensive.

5. Make social protection reach people with disabilities

Disability and poverty feed each other. Disability can push a family into poverty through lost income and extra costs, and poverty makes disability harder to live with. Cash support and other social protection can break this cycle, but only if it actually reaches people with disabilities.

The evidence that cash helps is strong. A 2025 study by Silverstein and colleagues in the International Journal of Social Welfare looked at cash transfers across Malawi and Zambia and found they cut illness more among children in households with the greatest functional difficulties than in households without disability [16]. In other words, the money did the most good exactly where the need was greatest.

Three examples:

• Nepal: The country runs a Disability Allowance, an unconditional cash transfer tied to a disability ID card system. According to a 2019 study by Banks and colleagues at the London School of Hygiene & Tropical Medicine, in one studied district 37 percent of people with disabilities received social assistance, compared with 21 percent of people without disabilities, showing the system was reaching the right people [17]. Nepal’s approach has been widely praised as a model of disability-inclusive design.
• Kenya: As reported by the World Food Programme (WFP), the government runs a cash transfer for people with severe disabilities, and county programmes like the one in Wajir, supported by the WFP, give a disability allowance that helps families buy the right food and cover extra costs [18].
• Zambia: According to UNICEF, the national Social Cash Transfer programme includes people with disabilities, and UNICEF-supported emergency transfers reached thousands of families during COVID-19 and drought, alongside work to build a national disability registry [19].

The practical point: design cash and support schemes with clear, fair ways to identify people with disabilities, involve them in the design, and keep the application process simple and accessible.

6. Open up jobs, carefully

Work is where inclusion often falls down. Many countries use employment quotas, rules that say a share of jobs, often 3 to 5 percent, should go to people with disabilities. Quotas can help, but the evidence says they need enforcement and support to work.

Three examples with honest results:

• Germany: Firms with more than 20 staff must fill 5 percent of posts with people who have severe disabilities. According to the World Report on Disability by the World Health Organization and the World Bank (2011), private firms reached about 3.4 percent while government employment reached about 7.1 percent [20]. So the public sector met the target while private firms fell short, a common pattern.
• Chile: A 1 percent quota introduced in 2018 was studied using detailed administrative records. According to a 2023 Inter-American Development Bank report by Duryea and colleagues, it raised the number of people with disabilities working in affected firms by 15 to 20 percent, showing that a well-tracked quota can shift real hiring [21].
• Ethiopia: According to a 2019 International Labour Organization (ILO) report on quota schemes, Ethiopia’s civil service rules give qualified candidates with disabilities preference in recruitment, promotion, and deployment, a lighter-touch approach used by several countries [22].

Quotas alone are not magic. They work best alongside other support, such as vocational training. A 2020 study by Streibelt and colleagues in the Journal of Occupational Rehabilitation found that people with disabilities in Germany who completed a one-year retraining programme worked an extra 405 days on average and earned around 24,000 euros more over the following eight years than they would have without it [23]. Skills and support turn a job target into a real career.

The practical point: if you use a quota, back it with enforcement, training, and workplace support, or it will stay a number on paper.

What This Means for Rwanda

Rwanda has a strong foundation to build on. It has ratified the UN disability convention and its optional protocol, has a National Council of Persons with Disabilities (NCPD), a National Policy on Disability and Inclusion, and treats disability as a cross-cutting issue in its national development plans. As the NCPD’s own planning documents state, Rwanda does not intend to leave any citizen behind, and specific steps will be taken so people with disabilities can take an active part [24]. The political will is there. The task now is to turn it into consistent practice on every project.

Here is how the six best practices above apply directly to Rwanda.

Count properly. Rwanda’s disability numbers show exactly why the counting tool matters. According to the National Institute of Statistics of Rwanda (NISR), the 2012 Population and Housing Census, using function-based questions close to the Washington Group set, found a prevalence of about 5 percent [25]. But the Disability Data Initiative, drawing on Rwanda’s 2019–20 Demographic and Health Survey, put the share of adults with any level of functional difficulty at around 25 percent [26]. Both can be true; they measure different things. For any project, the message is to use the Washington Group questions in your baseline, be clear about which threshold you are using, and never assume the “5 percent” figure captures everyone who faces barriers.

Use the twin-track approach. Rwanda already leans this way. According to the African Disability Rights Yearbook (University of Pretoria, 2018), the country combines inclusive education with targeted support like TVET courses for people with hearing and visual impairments [27]. Projects should copy this balance: make the main activity accessible to all, and add specific support where people need to catch up.

Involve OPDs. Rwanda has an active disability movement, including the umbrella body NUDOR and groups like the Rwanda National Union of the Deaf, as reported by Rwanda Dispatch [28]. The African Disability Rights Yearbook also notes a Disability Coordination Forum that meets regularly [27]. Any project working in Rwanda should bring these organisations in at the design stage, not just to validate a finished plan.

Build accessibility in. Rwanda’s poverty data shows the stakes. According to the Disability Data Initiative, people with a lot of functional difficulty are far more likely to be multidimensionally poor, at around 81 percent, than people with no difficulty, at 63 percent [26]. Accessible buildings, transport, and information are not extras here; they are what stops a project from quietly excluding its poorest intended beneficiaries.

Strengthen social protection. Rwanda’s social protection system, run through the Local Administrative Entities Development Agency (LODA) and anchored in programmes like the Vision 2020 Umurenge Programme (VUP), is a natural home for stronger disability inclusion. The lessons from Nepal, Kenya, and Zambia apply directly: use a fair and simple way to identify people with disabilities, involve them in the design, and recognise the extra costs disability brings.

Open up jobs. As Rwanda pushes its jobs and skills agenda, the Chilean and German experiences are worth studying. A target only works if it is tracked and enforced, and if it comes with real training and workplace support so that people with disabilities can build lasting careers, not just fill a slot.

The Bottom Line

Including people with disabilities is not a favour or a box to tick. It is what makes a development project actually work for the whole community it claims to serve. The methods are proven. Count people properly. Run both tracks at once. Bring people with disabilities into the room early. Build access in from the start. Make sure support reaches them. Open real doors to work.

Rwanda has the policies and the political will. The next step is to make sure every project, every survey, and every budget lives up to the promise of leaving no one behind.

References

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This article was prepared by Lambda Research & Learning Advisors, Kigali. For research, evaluation, and advisory support on disability inclusion and social protection, contact us at frutayisire@lambdapartners.org.