Leonard Cheshire Disability and Inclusive Development Centre
Abstract
While it is widely assumed that disability, poverty and health are closely linked, this is the
first critical review on the subject that explicitly asks: ‘What is the current evidence base
for the link between poverty, disability and health in low- and middle-income countries?
The methods used have been adapted from the EPPI Centre (EPPI-Centre, 2007) and the
work of Greenhalgh (Greenhalgh, Robert, Macfarlane, Bate, Kyriakidou, & Peacock, 2005)
A total of 964 papers were identified and, of these, 293 were selected for further review
based on appropriateness of fit. An initial review of the 293 papers, paying particular
attention to those papers that presented an evidence base, found only 27 papers (9.2% of
total papers reviewed) met the established inclusion criteria for a critical review. Widening
these inclusion criteria did not produce significantly more evidence based papers for
review. Thus, the most significant finding from this study is the current lack of strong
evidence on the links between disability, poverty and health in LMICs upon which to build
global policy and programming. Within the group of papers available for review, we
identify a small but growing evidence base that indicates that there are substantial links
between disability, poverty and health; however emerging research indicates that these
links are more complex and nuanced than is currently assumed. We conclude with a call
for more attention to building an evidence base on the interactions between disability,
poverty and health. The absence of a robust evidence base that explicitly links these
issues, in conjunction with the lack of appropriate benchmarks and indicators to measure
disability rights commitments (including poverty reduction), will otherwise result in a
“democratic deficit”