Survey to identify and map the prevalence, needs, and barriers faced by persons with disabilities and their caregivers to inform targeted interventions and policy development Turkana West Sub-County for both refugees and host community.
1.0 INTRODUCTION
1.1 Background
Kakuma refugee camp is in the North-Western region of Kenya. The camp was established in 1992 following the arrival of the “Lost Boys of Sudan”. During that year, large groups of Ethiopian refugees fled their country following the fall of the Ethiopian government. Somalia had also experienced high insecurity and civil strife causing people to flee. The camp is on the outskirts of Kakuma town, which is headquarters for Turkana West Sub- County of Turkana County. There were 288,206 refugees and registered asylum seekers at Kakuma Refugee Camp and Kalobeyei Integrated Settlement as of 31st May 2024.[1] Refugees are hosted in Turkana West Sub-County with a population of 239,627 (KNBS 2019).
An estimated 1 billion people — 16% of the world — live with some form of disabilities, according to the World Health Organization (WHO). And 80% of those people live in developing countries. The last census estimated that around 2.2 per cent of the population (0.9 million) of Kenya live with a disability which is most likely an underestimation. In Turkana West Sub-County 2, 395 persons with disability were identified excluding refugees (KNBS 2019).
The Convention on the Rights of Persons with Disabilities strengthened the rights of persons with disabilities with dedicated articles on work and employment (art. 27) and adequate standard of living and social protection (art. 28). This article outlines the obligation on States to recognize the right of persons with disabilities to work on an equal basis with others; this includes the right to the opportunity to gain a living by work freely chosen or accepted in a labor market and work environment that is open, inclusive and accessible to persons with disabilities. The convention further recognizes the right of persons with disabilities to an adequate standard of living for themselves and their families, including adequate food, clothing and housing, and to the continuous improvement of living conditions, and shall take appropriate steps to safeguard and promote the realization of this right without disability discrimination.
In 2015, the adoption of the 2030 Agenda for Sustainable Development was framed around the pledge of leaving no one behind. It calls for a commitment to ensure that all 17 Sustainable Development Goals (SDGs), comprising 169 targets, are achieved for the benefit of all members of society. It emphasizes reaching those furthest behind first, which inevitably includes persons with disabilities and their families.
1.2 Justification
Everyone as a member of the society has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality. This is a principle enshrined in the Article 22 of the Universal Declaration of Human Rights states that everyone has the right to work, to free choice of employment, to just and favorable conditions of work and to protection against unemployment
These Conventions and declaration focus on the challenges faced by persons with disabilities and call for improvements in their access to services, and in their participation in all aspects of life including economic inclusion. To achieve these goals, there is a need for improved data collection internationally. The current lack of accurate data impedes the development, implementation and evaluation of policies and programs that would improve the lives of persons with disabilities. 
Globally, persons with disabilities have been among the most excluded from forms of employment and entrepreneurship – a situation that is compounded during emergencies and protracted crises. Ensuring a disability-inclusive humanitarian action in emergency contexts is key to preventing or stopping the exclusion of persons with disabilities from their right to quality life. To ensure no one is left behind, even in the most difficult circumstances, it is important to have high-quality data that accounts for all the population. However, the scarcity of reliable data, particularly in low- and middle-income countries, can prevent the fulfillment of this obligation. Little is known about the number and characteristics of persons with disabilities and the barriers they face in accessing labor markets and entrepreneurship. Even less is known about their living conditions and quality of life, or the opportunities presented in enhancing access to the labor market, entrepreneurship and decent work.
Persons with disabilities are recognized under international conventions, such as the United Nations Convention on the Rights of Persons with Disabilities, which mandates equal access to work, social protection, and an adequate standard of living. The 2030 Agenda for Sustainable Development further reinforces the commitment to leave no one behind, including persons with disabilities. These Conventions and declaration focus on the challenges faced by persons with disabilities and call for improvements in their access to services, and in their participation in all aspects of life including economic inclusion. To achieve these goals, there is a need for improved data collection internationally. The current lack of accurate data impedes the development, implementation and evaluation of policies and programs that would improve the lives of persons with disabilities
Despite these frameworks, data on the prevalence and conditions of persons with disabilities in Kenya, particularly in refugee settings like Kakuma Refugee Camp and Kalobeyei Settlement, is severely lacking. The World Health Organization estimates that 16% of the global population lives with disabilities[2], yet national data in Kenya suggests an underreporting, with only 2.2% of the population identified as having disabilities.
In the context of Kakuma and Kalobeyei, anecdotal evidence and limited studies indicate significant barriers to accessing essential services, labor markets, and entrepreneurial opportunities for persons with disabilities. Local community leaders and NGOs have reported that many persons with disabilities remain hidden and underserved due to cultural stigma and a lack of targeted interventions.
This survey aims to fill these critical data gaps, providing accurate, disaggregated data on the prevalence and living conditions of persons with disabilities. The findings will directly inform the development of inclusive policies and programs, ensuring that interventions by the Kenyan government, Turkana County Government, ILO, UNHCR, and partner organizations are effectively tailored to the needs of this vulnerable population. By aligning with stakeholder goals, this survey will enhance the quality of life for persons with disabilities in Turkana West Sub-County, ensuring no one is left behind in humanitarian efforts.
1.3 General Objective of the Study
To Identify and map the prevalence, needs, and barriers faced by persons with disabilities and their caregivers to inform targeted interventions and influence policy environment in Turkana West Sub-County for both refugees and host community.
1.4 Specific Objectives of the Study
- Determine the prevalence of various types of disabilities across different demographic groups (age, gender, ethnicity) within the population in Turkana West Sub County including Kakuma and Kalobeyei Integrated Settlement.
- Identify barriers, including physical, attitudinal, and systemic, that people with disabilities face in accessing labor markets and entrepreneurship opportunities.
- Assess the socio-economic needs, protection risks, and access to basic services (healthcare, education, social protection) of persons with disabilities and their caregivers
- Develop evidence-based policy recommendations to enhance the inclusion and well-being of persons with disabilities in the refugee setting.
2.0 METHODOLOGY AND STUDY DESIGN
2.1 Target population and Sample Size
The study will target all children, adults and caregivers/providers of support for persons with disabilities in Turkana West Sub-County including Kakuma and Kalobeyei settlement.
Sample size Determination and distribution:
- Kakuma refugee camps
First, the Sample size determination will be made up of the households in the Kakuma refugee camps which, according to the UNHCR, stand at 40,035. Therefore, using Krejci and Morgan’s (1970) formula for calculating sample size, the recommended sample for the population is 381 respondents. Based on these formulae, the research will target 381 households located in the Kakuma refugee Camps. The inclusion criteria, therefore, will be based on the households.
The target population will be arrived at using stratified Sampling. The Kakuma camps will be divided into strata based on the existing camps, and each of them, an equal number of households will be selected based on known characteristics: namely. There is a person with a disability living in that household. Since the Kakuma refugee camps are divided into 7 locations, namely: Kakuma1, Kakuma2, Kakuma3, Kakuma4, Kalobeyei V1, Kalobeyei V2 and Kalobeyei V3: in each of the 7 locations 54 households will be targeted and this will make a total of 378.
- Kakuma Host
Secondly, the Sample size determination for host community will also be made up of the households which at 36,075. Therefore, using Krejci and Morgan’s (1970) formula for calculating sample size, the recommended sample for the population is 381 respondents. Based on these formulae, the research will target 381 households located in the Kakuma host community. The inclusion criteria, therefore, will be based on the households.
The target population will be arrived at using stratified Sampling. The Kakuma community will also be divided into strata based on the existing villages, and each of them, an equal number of households will be selected based on known characteristics: namely. There is a person with a disability living in that household. Since the Kakuma host community is divided into 12 main villages, namely: 1.Nadapal village, 2. Towokayeni village , 3. Komudei village ,4. Highland ,5. Kiwanja ndege village ,6. Nauren regae village, 7.Nayanaeemeyan village, 8. Legio maria village, 9. IDP canan village, 10.morulongole village, 11. Adaak village, 12.Kakuma Town: in each of the 12 villages 31 households will be targeted and this will make a total of 372. A total of 750 Households will be reached for interviews.
Summary of sample determination and distribution
Population Breakdown:
The study will target children, adults, and caregivers/providers of support for persons with disabilities in Turkana West Sub-County, including both Kakuma Refugee Camp and Kalobeyei Settlement, as well as the host community.
Sample Size Calculation:
Using Krejci and Morgan’s (1970) formula, the recommended sample size is 381 households each for the refugee camps and the host community. A stratified sampling method will be employed to ensure representation across different camps and villages.
Distribution:
Kakuma Refugee Camps:
- The camps are divided into 7 locations: Kakuma 1, Kakuma 2, Kakuma 3, Kakuma 4, Kalobeyei V1, Kalobeyei V2, and Kalobeyei V3.
- 54 households from each location will be sampled, totaling 378 households.
Host Community:
- The host community is divided into 12 main villages.
- 31 households from each village will be sampled, totaling 372 households.
Total Sample Size:
The total number of households to be surveyed is 750.
Sampling Frame:
The sampling frame will be constructed using updated records from the UNHCR and KNBS databases, ensuring comprehensive coverage and accurate sampling.
Sampling Technique:
- A stratified random sampling method will be used within each stratum.
- Random selection will be conducted to ensure unbiased representation.
- Pilot testing will be carried out to validate the sampling approach and make necessary adjustments.
Community Involvement:
Community leaders and local organizations will be engaged in the sampling process to enhance participation and data reliability.
2.2 Sampling Frame
The researchers/enumerators will use the updated children’s and adults records from the UNHCR/KNBS databases as the sampling frame. The frame will contain the name of the county, identifier, Numerator’s name, the name of the refugee center, the village code, the name of the village, Zones, Blocks and GPRS.
3.0 DATA COLLECTION
The study will adopt a mixed methodology approach including both quantitative and qualitative data collection tools for KII (key informant interviews) and observation. The prevalence of disability will be determined using the UNICEF Child Functioning Module 2 to 4 and 5- to 17-year-old respondents and Washington Short Enhanced Set for 18 and above -year-old respondents (Annex 1). These tools are the internationally recognized tools for identification and determination of disability prevalence globally.
The questionnaire will be uploaded into a mobile phone Kobo collect/Survey CTO/ODK data collection application. The enumerators will use smartphones with this application to perform the survey. The data collected will be sent directly to an online dashboard which will increase the data collection’s efficiency. The fact that GPS will be taken also will increase the reliability of the data and thus enhance daily data quality inspection.
Community mobilizers/assessors will be trained on these tools, which they will then use to screen and map out the identified persons. The analysis will therefore produce disability identifiers based on the choice of the severity threshold or cut-off; “a lot of difficulty” or “cannot do at all.” These two choices are the recommended cut-off/ severity threshold for international comparisons. Medical reports, psychological reports, physical appearance, and observation will complement CFM and WG.
Expand Qualitative Methods:
Focus Group Discussions (FGDs): Including FGDs can provide deeper insights into community perceptions and experiences, which can complement KIIs and observations.
Enhanced Training
Cultural Sensitivity Training: Ensure that enumerators are trained in cultural sensitivity and ethical considerations, especially given the diverse backgrounds of the refugee population.
Disability Inclusion Training: Extend training to cover aspects of disability inclusion comprehensively, ensuring that enumerators are equipped to handle various disabilities sensitively and appropriately.
Use of Additional Tools
Audio and Video Tools: Integrating audio and video recordings (with consent) for qualitative data can capture nuanced information that might be missed in written records.
Community Engagement
Community Advisory Groups: Establishing advisory groups consisting of local community leaders and representatives from disabled persons’ organizations to guide and validate the data collection process.
Feedback Mechanisms: Setting up mechanisms for participants to provide feedback on the survey process can improve data collection and address any issues promptly.
Data Validation: Triangulation of Data: Employing triangulation by cross-verifying data from multiple sources (survey, KIIs, FGDs, medical reports) to enhance validity.
Pilot Testing
Conducting a pilot test of the survey tools and methodology in a small section of the target population to identify and rectify any issues before full-scale implementation.
4.0 ETHICAL CONSIDERATIONS
Informed consent
Informed consent will be sought from all participants before participating in the study. Each respondent will be adequately informed of the aims, methods, and the anticipated benefits of the study. This will be done in a language that the respondent can understand very well. The respondents will be informed that interviews will be audio recorded where necessary. The respondents will also be informed of the right to decline from participation or to withdraw consent to participate at any time without reprisal. For the respondents not able to legally provide consent for their participation such as children and youth with disability incapable of providing consent, it will be sought from their parents or caregivers/providers of support before participating in the study.
Privacy and confidentiality
Confidentiality will be strictly observed at all times. All interviews will take place in convenient places where privacy and confidentiality of the respondents will be maintained. All raw data will be protected as confidential and availed only to the research team. Security of personal and/or sensitive data will be maintained at all stages of the study.
Risks and benefits
There are no foreseeable risks associated with this study. This study also does not offer any direct benefits to the study participants. However, the study findings are expected to contribute important information to implementers and policy makers in the Kenyan government and other stakeholders interested in the provision of programs and services targeting support services to children and youth with disabilities.
Respect to target population values and cultural beliefs
The study will respect the target population’s traditional values, culture, beliefs, and social practices. This will be done through training of the surveyors.
5.0 ANALYSIS AND REPORT WRITING
High quality data systems will be employed to ensure good quality data. This will be done by generating edit specifications and tabulation plans for each module which will then inform the kind of tables or indicators to be generated.
Data Analysis
The survey will employ a rigorous data analysis approach to ensure comprehensive and accurate results. The analysis will be conducted using the following methods:
Quantitative Data Analysis
Descriptive Statistics: Basic descriptive statistics (mean, median, mode, standard deviation) will be calculated to summarize the data.
Inferential Statistics: Inferential statistical methods, such as chi-square tests, t-tests, and regression analysis, will be employed to identify significant relationships and differences within the data.
Software: Statistical analysis will be performed using software such as SPSS, Stata, or R, ensuring robust and reproducible results.
Disaggregation: Data will be disaggregated by age, gender, and other diversity factors, following the principles outlined in the survey objectives.
Qualitative Data Analysis
Thematic Analysis: Key informant interviews and observational data will be analyzed using thematic analysis to identify common themes and patterns.
Software: Qualitative data analysis software such as NVivo or ATLAS.ti will be used to organize and analyze the data systematically.
Triangulation: Qualitative findings will be triangulated with quantitative data to validate and enrich the results.
Data Cleaning and Management
Data Cleaning: Procedures will include checking for and addressing missing data, outliers, and inconsistencies.
Data Management: Data will be stored securely and managed in compliance with ethical standards and data protection regulations.
Reporting and Validation
Generation of Tables and Indicators: Based on predefined edit specifications and tabulation plans, relevant tables and indicators will be generated.
Draft Report: A draft report will be prepared and validated through consultations with stakeholders to ensure accuracy and relevance.
Final Report: The final report will be compiled, incorporating feedback from the validation process, and will be disseminated to inform policy and programming.
6.0 DURATION OF STUDY
1. Adoption of Disability Survey Protocol: April -May
2. Contracting of consultant: July – August
a) Publishing of Expression of Interest: July
b) Reviewing and shortlisting of consultants: August
c) Interviewing shortlisted consultants: August – September
3. Multi stakeholder Inception workshop organized with relevant government representatives, OPD, relevant INGOs and UN/development agencies: September
4. Development of the data collection tools.
a) Drafting questionnaire: September
b)Technical committee to review the draft questionnaire: September
C). Piloting: September
5. Training Enumerators and Supervisors: October
6. Data collection and data entry (surveys, FGDs, KIIs): Octobrt
7. Data analysis and draft report: October
8. Multi stakeholder consultation workshop on the draft report: November
9. Finalization of report: November
7.0 FUNCTIONS OF THE CONSULTANT
- Conduct technical workshop to review the data collection Survey Tool including tools to identify barriers and opportunities as stipulated in objective 2 & 3
- Training of Data Enumerators and Supervisors and piloting (including conference costs)
- Renumeration for Enumerators during the training
- Renumeration for Enumerators during data collection
- Provide field work allowance (if any) to the Inbusiness steering committee technical team conduct field supervision role
- Data Analysis and Development of the Draft Report.
- Conduct Report review & validation workshop of the report
- Conduct workshop for validation and presentation of the final report
- Editing, design & layout of the final report
- Publish the report
8.0 PROPOSED QUALIFICATIONS FOR THE CONSULTANT
- Experience in conducting a similar study targeting economic inclusion
- Experience in refugee set up and working with OPDs
- Demonstrated knowledge on the IASC guidelines
- Experience working with persons with disability (disability inclusion)
- Knowledge using CFM, WG tools and economic inclusion assessment tools
- Masters in Social Sciences (M&E is an added advantage)
- Experience working with persons with disability
- Experience disability inclusive communication and trainings/facilitation
- Lived experience of disability will be a plus
ANNEXES
For a more details and annexes follow the link below:
[1] Kenya Infographics – 31 August 2022 (unhcr.org)
[2] https://www.who.int/news-room/fact-sheets/detail/disability-and-health
How to apply
Interested consultants should submit their technical and financial proposals (maximum 7 pages) together with summarised evidence of the work that they have done to NBOprocurement@ilo.org quoting ‘RFP: Disability Inclusion Survey’ in the subject line not later than Sunday 11th August 2024. Only shortlisted applicants will be contacted in 3 weeks after submitting.
