A young girl communicates to a male doctor using sign language while her mother looks on. They are in the doctor's office. The girl is wearing a yellow top.

People with disabilities experience significant health inequalities compared to those without disabilities. In this area of work, PAHO seeks to improve health equity and inclusivity of the health system for people with disabilities in line with key Regional and Global human rights frameworks.

A boy in a red top reaches forward to read braille from a book that sits in front of him. His hands and book are in focus and his face and background are more blurred. His eyes are closed. The blurry background is a room with a table and chairs, possibly a school.

Persons with disabilities include those 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 According to the World Report on Disability, around 15% of the population lives with some form of disability. Women are more likely to experience disability than men and older people more than young.

In recent years, the understanding of disability has moved away from a physical or medical perspective to one that takes into account a person’s physical, social and political context. Today, disability is understood to arise from the interaction between a person’s health condition or impairment and the multitude of influencing factors in their environment.

Great strides have been made to make the world more accessible for people living with disability; however, much more work is required to meet their needs.

Key facts

Almost 12% of the Latin American and Caribbean population is thought to live with at least one disability, representing around 66 million people.
All countries and territories of the Region have signed the UN Convention on the Rights of Persons with Disabilities. 34 countries have ratified The convention .
17 Countries have signed the Inter-American Convention on the Elimination of All Forms of Discrimination Against Persons with Disabilities
People with disabilities are 2-4 times more likely to die in disasters and emergencies than those without disabilities.
Many health facilities and services are inaccessible for people with disabilities. Barriers that are faced by people with disabilities include inaccessible health spaces, communications barriers, lack of training of professionals, financial barriers.

A young woman with Down syndrome is practicing yoga on a yoga mat. She wears a red top and grey yoga pants. Her legs are crossed and her hands are together by the sternum in a "prayer" pose. She gazes down to the ground a few feet in front of her as if in meditation. The room behind her is empty with a wooden floor and a concrete wall and a single potted plant that is climbing up the wall.

PAHO Response

The disability programme provides leadership and technical cooperation to member states on the needs and inclusion of people with disabilities within public health programming. This involves a particular focus on four specific areas:

promoting health equity for people with disabilities in the Americas, through accessible and inclusive health systems;
improving inclusive emergency preparedness and response mechanisms (led by PAHO’s emergency department);
strengthening the collection of data and evidence on disability;
promoting community based inclusive development/community based rehabilitation as a means to implementing the CRPD and empowering people with disabilities and their communities.

As disability and development is a multisectoral approach, PAHO collaborates with different agencies of the UN and international system to advance these efforts. This includes the Organisation of American States (OAS), the United Nations Economic Commission for Latin America and the Caribbean (CEPAL), the Interamerican Development Bank (IDB), United Nations Children's Fund (UNICEF), UN Women, the United Nations Population Fund (UNFPA), the UN Partnership to Promote the Rights of Persons with Disabilities (UNPRPD), the United Nations Office for Disaster Risk Reduction (UNDRR), and others.

PAHO also works to strengthen habilitation, rehabilitation and assistive technologies for all people, including those with disabilities.

Data/Statistics

Number of countries and territories that are implementing national disability and rehabilitation plans:

17 out of 52 countries

Number of countries and territories with specific legislation on disability: :

25 out of 52 countries

Number of countries and territories with a disability component in their disaster and emergency risk management plans:

8 out of 52 countries

Number of countries and territories with a Community Based Rehabilitation Strategy:

16 out of 52 countries

Number of countries and territories that use the ICF in their disability certification systems:

15 out of 52 countries

(all data based on the final report of the 2014-19 PAHO Plan of Action on Disabilities and Rehabilitation)

Rehabilitation services at PAHO/WHO

WHO: Disability

Strategic Partners

To support and address issues on improving health equity for people with disabilities, PAHO has a number of partners that we engage with and work alongside. These include:

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COVID-19 and Disabilities

COVID-19 has had a significant impact on people with disabilities. It is imperative to ensure that public health messaging is accessible to all people and the COVID-19 services are inclusive of populations of people with disabilities and non-discriminatory against people with disabilities.

Many people living in long term residential or care settings – which have seen significant outbreaks of COVID-19, are people with disabilities including older persons with disabilities.

PAHO has engaged in a series of activities and webinars to support an inclusive COVID-19 response.

PAHO has also been hosting a weekly roundtable with a group of disability stakeholders since May 2020 to share and exchange on disability in the COVID response in the Region.

Webinar on Disability and health in the COVID-19 context: Sharing experiences (Recording in Spanish with international sign language interpretation)

World Health Organization's Disability considerations during the COVID-19 outbreak (PDF)

A man wearing a black coat and black pants and a white mask is in a power wheelchair crossing a crosswalk. His left hand is on the armrest/control knob. It is nighttime with buildings and city lights in the background.

Accessible wheelchair ramp with yellow handrails leading to a hospital. A blue and white handicap symbol is painted on the ramp's entrance point.

Inclusive Health

What is inclusive health and why is it important?

Inclusive health is achieved when people with disabilities are able to access health services on an equal basis with people without disabilities. Currently, many people with disabilities face significant barriers in accessing healthcare, which contributes to worse health outcomes among this population. For example, according to a report by the London School of Hygiene and Tropical Medicine in 2019, people with disabilities may have higher health needs yet lower health access. It is vital that the health system is designed to ensure that all people, including those with disabilities have full access services and to better health and social inequities. Health inclusion is important because it provides the people with disabilities to experience the same benefits/access to health promotion and services as people who do not have a disability.

What is PAHO doing on inclusive health?

PAHOs advisor on disability and rehabilitation is the focal point for inclusive health at the organisation. PAHO works with member states to examen the barriers that people with disabilities may face in accessing health services and explores opportunities to build towards an inclusive health system.

A fundamental aspect of PAHO’s work is to collaborate with organisations of persons with disabilities, who are the experts in building accessible and inclusive systems.

Specific activities that PAHO is undertaking in inclusive health include:

Support to develop inclusive health national policy
Studies to assess inclusivity of health services
Support and guidance on strengthening inclusive health practices
Facilitation of engagement between the health sector and disability community
Development of health materials in accessible formats

A flood barrier with sandbags is visible in the foreground. Behind it is extensive flooding with flooded homes. A rescue team wearing orange waterproof clothing and yellow helmets can be seen standing in the middle of the flood pushing a red inflatable rescue raft

Disability inclusion in emergencies

What is disability inclusive disaster preparedness and response and why is it important?

During disasters and emergencies people with disabilities living in the impacted community may be particularly vulnerable. Frequent studies have shown that people with disabilities may be excluded from emergency responses.

What is PAHO doing on disability inclusive disaster preparedness and response?

PAHO, led by the emergency department, has a focus on inclusive disaster risk preparedness and response for people with disabilities. Specific activities that PAHO is undertaking include:

Development and implementation of INGRID-H: A toolkit for Disability Inclusion in Hospital Disaster Risk Management tool
Engagement with organisations of persons with disabilities before and during emergency situations to identify and respond to barriers and needs.
Planning and support to countries to ensure emergency plans and policies include people with disabilities.

The midsection of a man walking towards the camera holding a white cane in his right hand. The man wears grey pants with a white t-shirt and open blue shirt. A brick building is visible behind him. Tactile paving is on the ground in the form of two sets of three lines, running towards the camera along the pavement.

Data and disability

What is disability and data collection and why is it important?

The first ever World Report on Disability was published by the World Bank and WHO in 2011, collating the best available evidence on disability. Despite this, data on disability is still extremely limited in many countries. Data on plays a vital role in policy-making, budgeting, programming, and identification of areas for research. As such as it is a vital component improving the inclusion of people with disabilities.

What is PAHO doing on disability and data collection?

The International Classification of Functioning, Disability and Health (ICF). PAHO supports countries to implement the International Classification of Functioning, Disability and Health within their data systems. The ICF is a versatile model that can be adapted to be used in various ways across different sectors of work. Examples of where PAHO has supported ICF implementation are:

Development and implementation of ICF based tools within health systems information to measure population functioning and health outcomes.
Integration of ICF based tools in disability certification systems.
Implementation and collection of ICF data for clinical practice

Model Disability Survey

The Model Disability Survey is a comprehensive household survey that can be implemented as a standalone survey or with other national surveys. The survey does not specifically target households of people known to have a member with a disability, but rather surveys a random selection of households to capture all people living with disabilities. The survey, which is administered as a questionnaire, enables a detailed analysis of barriers to inclusion across many sectors of life that people with disabilities face. Countries to have implemented the MDS to date are Chile (2015) and Costa Rica (2018)

A women is in running shoes and leggings running on a beach towards a setting sun. The photo is focussed on the back of her two legs, one of which is a prosthesis

Community Based Inclusive Development/Community Based Rehabilitation

What is Community Based Rehabilitation/Community Based Inclusive Development?

CBR/CBID is a comprehensive approach to disability inclusive development. Originally developed by the WHO, it is a multisectoral approach that aims to facilitate communities to engage, empower and include people with disabilities to be fully participating members of their community. CBR/CBID includes 5 pillars in the areas of health, education, livelihood, social and empowerment.

What is PAHO doing on Community Based Rehabilitation/Community Based Inclusive Development?

PAHO supports CBR/CBID activities in the Americas. We work with the CBR Americas network which includes several subregional nodes. Every 4 years a Regional CBR/CBID congress is held. The next is due to take place in Antigua and Barbuda in 2022 (delayed from 2021 due to COVID-19)