What People with Disabilities

Teach Us About Building

Better Anti-Poverty Programs

By Lucy Simon 


Development and Communications Intern


Social and economic injustice for people with disabilities is a global challenge. People with disabilities (PWDs) face injustice and exclusion on a daily basis, even from development programs meant to assist vulnerable people. Globally, PWDs account for 20% of people living in extreme poverty, but only comprise 3-4% of people on the receiving end of developmental aid (Kelly and Wapling, 2012). At Trickle Up, we are committed to engaging and empowering PWDs through our programs so they can overcome the barriers that hold them back and help others break through, too.

“Poverty is both a cause and a consequence of disability.”


To understand and combat the forces that keep people with disabilities in extreme poverty, Trickle Up’s Monitoring and Evaluation team studied the effects of Trickle Up’s anti-poverty program, called the Graduation Approach, on 1,000 people with disabilities and their caregivers. Trickle Up’s Monitoring and Evaluation team recently published an article on their findings in the journal Enterprise Development and Microfinance that looked at results and key learning from six Trickle Up projects between 2009 and 2017 in Guatemala, Nicaragua, and Mexico.


Isabel Choc Cucul is the caregiver for her sister Adelina who has Down syndrome. Isabel is a Trickle Up participant in an integrated program in Cahabón, Guatemala. Throughout her life, Adelina was very isolated because her family feared she would not be able to participate within her community. Adelina stayed at home while her family members worked during the day. She became very fearful of new people and of the outside world. Troubles Adelina and her family faced are not uncommon to those faced by other people living with disabilities in extreme poverty. We studied our work with families like Isabel and Adelina’s to determine the best way to support them.

The review found that most participants saw major improvements in food security and nutrition, working capital, and strengthened their livelihoods. In a project in El Quiche, Guatemala, that worked with 100 female caregivers of children with disabilities, participants on average increased their working capital and savings by double the initial investment of $165 to $328 after 12 months. The longevity of the savings groups is also positive. On average, 90% of participants continued to the second cycle of savings after the first year. It is important that people can achieve these results in future programs, so we are adapting the programs to meet the specific needs of PWDs based on what we have learned.


While many of the challenges faced by participants in these six projects are also problems faced by all people in extreme poverty, we found that disability exacerbated the barriers of extreme poverty. Through these six programs, we found that there were a few issues associated with marginalization that can accompany extreme poverty, and are more pronounced among PWD populations that we needed to adapt our programs to:


  • Societal stigmatization: people with disabilities often face social and familial shame due to negative stigma and fear of the unknown
  • Self-exclusion: PWDs often fear outsiders due to isolation and rejection caused by negative social stigma, thus PWDs often do not involve themselves in the community nor development programs
  • Program accessibility: whether it be the location of savings group meetings or accommodating programming for physical or psychological disabilities, program accessibility is key for working with PWDs
  • Skilled staff: having intuitive staff who have a focused approach for the participants and are able to adapt to changing circumstances is important when working with the nuances of the needs of people with disabilities


Overcoming the negative stigma often attached to PWDs is a major part of our program. “In an integrated project in Cahabon, [Guatemala], a pregnant woman in a savings group would not agree to spend time in the same space as a participant with a physical disability and epilepsy for fear that these conditions were communicable” (J. Sanson et al., 60).  Staff quickly worked to solve the conflict; engaging the pregnant participant and the entire savings group through sensitivity exercises to assure members that there was “no basis to their fear,” enabling them to accept the other members.



Isabel not only had to support her sister Adelina, but also provide for the rest of her family. She used her seed capital to start a small bakery business, open a consumer goods store, and has even further diversified her income by sewing custom blouses and purses. While the increase in her income helped Isabel take better care of Adelina and her family, Adelina still struggled with her fear of new people. To help overcome Adelina’s fear and increase her confidence, Isabel’s savings group started meeting at her house and members would interact with Adelina during meetings.


For people with disabilities it is not solely centered on economic empowerment; it is so much more than that.  Our approach for PWDs is “designed for the poorest segment of the extreme poor, who typically face barriers associated with poverty that render conventional economic development and micro finance initiatives ineffective.” In order to eradicate extreme poverty for women and caretakers like Isabel and her sister Adelina, we have to go a little further. We have to take the time and care to adapt programming to meet individual needs, and to think more broadly about the societal and psychological implications of poverty and disability. But most of all, we must be resilient and reliable allies for families overcoming the challenges they face to full participation in the social and economic lives of their communities.


If you would like to read the full study, please contact Jo Sanson at 



Enterprise Development and Microfinance, 29:1, 49-63 


Kelly, L. and Wapling, L. (2012) Development for All Strategy: Mid-Term Review Report [pdf], Canberra, Australia: AusAid