Economic Inclusion of People with Disabilities in Chontales


Trickle Up is piloting the integration of Graduation into a Community-Based Rehabilitation (CBR) program for people with disabilities in Nicaragua. CBR is the most prominent approach utilized by disability-focused institutions to promote the integration of people with disabilities and reaches more than half a million people worldwide.


In partnership with CBM, a leading international disability NGO, Trickle Up is providing technical assistance support on project design, training, and implementation to ASOPIECAD, a community-based organization. The project combines Graduation with CBR to help 150 people with disabilities or caregivers of people with disabilities who are living in extreme poverty. This project is in collaboration with a national government program implemented by the Nicaraguan Ministry of Health. The goal of this project is to promote the social and economic empowerment of people with disabilities living in extreme poverty and evaluate the efficacy of integrating Graduation with CBR.


Importantly, this project will help us learn about the economic components of CBR, as Trickle Up is the first organization to combine the Graduation Approach with CBR. We hope the results of this project will benefit hundreds of CBID practitioners around the world. In addition, we hope to scale this approach in Nicaragua through government adoption to reach more people with disabilities across the country.

Project Objectives

  • Promote the economic and social inclusion of 150 people with disabilities or caregivers of people with disabilities through the integration of Graduation and Community-Based Rehabilitation
  • Evaluate the integration of CBR and Graduation, and share lessons learned and best practices to promote project replication

Project Data

Baseline data:

  • 26% of participants are adults with disabilities and 74% are caregivers of family members with disabilities, of whom 90% are women.
  • Of the people with disabilities, 39 people had an intellectual disability, 39 had a motor disability, 16 had multiple disabilities, 12 had sensory disabilities, and 7 had psychosocial disabilities.
  • Over half of people with disabilities over the age of 6 don’t know how to read or write, and 77% don’t attend school.


Data from the second quarter after distribution of seed capital:

  • 68% of participants have at least $100 (C$2,700) of accumulated earnings.
  • Participants reported increased inclusion in their families and communities, greater self-esteem, and a decrease in stress.
  • 71% of participants invested their earnings in savings, 59% in food for their household, and 36% reinvested in their businesses.


Data from the third quarter after distribution of seed capital:

  • 73% of participants have at least $100 (C$2,700) of accumulated earnings.
  • 49% of participants have updated records of their microenterprises.
  • Participants have an average of $22 (C$590) in savings.


Endline data:

  • 97% of households never or rarely face hunger today, compared to 68% at the beginning of the project.
  • 77% of participant households now consume meat at least once a week.
  • In 96% of households there are hygiene conditions and children enjoy the minimum conditions of dignity.
  • 96% of people with disabilities who visited the health center were prescribed medicine, and 96% report having been able to get medicine when they need it, 71% through health centers and 46% with their own resources (including some who used both strategies).
  • 29% of participants have already taken a loan from the savings group and 86% decided to continue in the savings group after the end of the project.
  • 84% of independent adults with disabilities report being decision-makers in their households, compared to just 53% at the beginning of the project.
  • 94% of people with disabilities participate in social activities (family or community), and 76% participate in both types.
  • 44% of children with disabilities or dependent adults with disabilities now have responsibilities related to their families’ businesses after the project.
  • Of participants who are independent adults with disabilities, 91% administrate their business themselves.
  • By working to build sustainable businesses, 64 participant households have increased their monthly per capita income on average from just $22 to $34.
  • 17 participants have been able to improve their houses, including repairing the roof and constructing or improving walls and floors.
  • 111 project participants joined a savings group, and on average they had $28 in savings at the end of the project.
  • 59% of independent adults with disabilities achieved at least 6 of the 8 criteria for Graduation and 84% achieved 5 of the 8. 63% of families with children with disabilities or dependent adults with disabilities achieved at least 5 of the 7 criteria for Graduation and 88% achieved 4 of the 7.

Juigalpa, Acoyapa, Santo Tomás, Villa Sandino, and El Coral, Chontales, Nicaragua

Start Date: 8/15/2014
End Date: 11/30/2016


Number of Participants: 150


Vulnerable Populations

Women, Rural, Urban, People with Disabilities, Extreme Poor

Project Components

Stipend for Consumption Support, Asset Transfer, Coaching, Savings/Self-Help Groups (savings and credit services), Technical Livelihood Skills Training, Financial Literacy and Capability Training, Psychosocial Support, Healthcare Services, Education Linkages and Accompaniment 

Our Partners

Asociación de Programas Integrales de Educación Comunitaria Astrid Delleman (ASOPIECAD) is a community-based NGO in Juigalpa, Chontales, Nicaragua. ASOPIECAD unites community members and leaders, families, government institutions, and other civil society organizations for the rehabilitation and inclusion of people with disabilities in rural and suburban areas of Chontales and Boaco, Nicaragua. Trickle Up and ASOPIECAD have been partners since 2014. 

CBM is an international Christian development organization committed to improving the quality of life of people with disabilities in the poorest communities of the world. CBM seeks to reduce the prevalence of diseases which cause impairments, minimize the conditions which lead to disability, and promote equal opportunities for economic empowerment, livelihood security, and full inclusion in all aspects of society for persons with disabilities. Trickle Up has been working in partnership with CBM since 2014. 

Todos Con Voz is a program of the Nicaraguan Ministry of Health serving people with disabilities in Nicaragua that began in February 2010 to promote healthy lifestyles to prevent disability, strengthen the social inclusion of people with disabilities in all areas, and help families learn to develop community-based rehabilitation organizations in the Family, Health, and Life Council. Trickle Up has worked with Todos Con Voz since 2014.