First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
Limited evidence on the design and implementation of social protection programmes for people with disabilities in low- and middle-income countries constrains understanding of how their impacts could be improved. The Disability Allowance programme in the Maldives is a non means-tested, monthly cash transfer targeting people with disabilities. Using qualitative methods, process evaluation was used to examine the intervention design, implementation, and likelihood of achieving its intended objectives. There were important strengths of the programme, including the broad definition of disability. We find that delivery could be strengthened through providing greater clarity on eligibility criteria and strengthening human resources to widen the programme’s reach. Intervention fidelity was challenged by inconsistent practice among implementers and lack of established protocols. Most importantly, the absence of linkages with the Medical Welfare scheme that provides assistive devices potentially limits the likelihood of the programme achieving intended objectives.
Globally, people with disabilities are disproportionally affected by poverty. Social protection policies, including cash transfers, are key strategies to address poverty “in all its forms”, but it is currently unclear how such programmes affect people with disabilities. This study examines differences in the impact of the Lesotho Child Grant Programme (CGP) on food security, health, education and livelihoods between people with and without disabilities using data from a community randomized control trial. Overall, this study finds the CGP had significant and differential impacts for people with disabilities across multiple health indicators (e.g. increased health expenditures, self-rated health, likelihood of seeking healthcare). The CGP also had an impact on food security, decreasing the number of months households with and without members with disabilities faced extreme food shortages. There was also a modest but significant and differential impact of the CGP on the engagement of people with disabilities in paid work. The CGP only had an impact on school enrolment for children without disabilities, however the difference in impact was non-significant and likely due to underpowered sample sizes. Overall, people with disabilities receiving the CGP still experienced high levels of absolute deprivation, and were generally still worse off compared to people without disabilities, indicating a need for adapted or complementary social protection and other poverty alleviation programmes.
This article describes the differential mortality of Argentina’s disability pension beneficiaries during the 2015–16 period, based on National Social Security Administration (Administración Nacional de la Seguridad Social – ANSES) payment records. It compares data for those with an assessed disability with overall population data, as well as with available international data (from Canada, Chile, Mexico, and the United States of America). In addition to breaking down mortality rates for people with disabilities by age and sex, it also factors in duration of benefit, establishing an inverse correlation between benefit duration and mortality.
This article investigates to what extent instrument substitution between early exit pathways took place in Europe between 1995 and 2015. Using Eurostat aggregate data on labour market inactivity and employment rates among the population aged 55–64 in 19 European countries, we analyse substitution effects between pathways and overall spill-over effects into non-employment. In spite of a strong decline in early exit and rises in older workers’ employment rates, findings suggest that instrument substitution was common especially between early retirement and disability. Reductions in early exit coincided with considerable spill-overs into non-employment, yet these spill-overs were limited when pathways contracted simultaneously.
In 2008, Great Britain overhauled its disability benefit programme by introducing a new disability determination process called the Work Capability Assessment and a new earnings replacement programme called Employment and Support Allowance. This article examines the British reforms from the perspective of the United States, which may consider changes to its disability benefit programme, the Social Security Disability Insurance programme, in the near future. The article provides an overview of the steps leading to the reform in Great Britain, details how the new programme operates, reviews research on its initial implementation and effects, and identifies lessons for the potential reform of the disability benefit programme in the United States.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.
Early retirement schemes and disability insurance in the Netherlands have undergone several reforms in recent decades. The reforms have increased incentives for older workers to continue working and have decreased the roles of “substitute pathways” into retirement. This article gives an overview of the reforms and, using administrative data for workers in the health care sector, tests a number of hypotheses about the labour market participation of older workers. The results offer two main findings: i) that the Dutch reforms have indeed been effective, as the labour force participation rate of older workers has increased; and ii) the concept of “substitute pathways” has become less relevant as the use of disability insurance has been closed off as an exit route to early retirement. Nevertheless, caution is required before generalizing the implications of these Dutch findings to other OECD countries.
This article analyses the risk of disability facing workers who contribute to the Argentinian Integrated Social Security System (Sistema Integrado Previsional Argentino— SIPA). Using administrative records as our source of data for the period 2000‐2006, the results indicate that 1.46 workers per 1,000 became disabled annually during that period. The risk of disability rates were higher for men than for women, but increased with age for both sexes. The risk of disability rates have also been broken down by pathology and social security scheme, taking the effects of age and sex into account. To conclude, international comparisons are presented.
In this paper we explore the reasons for the apparent convergence in sickness and disability policies across the OECD, asking whether and to what extent policy convergence should be seen as a product of policy learning. We conclude that convergence is the result of policy imitation more than policy learning and that learning (from past mistakes) is more likely within countries than across borders. Given limited evidence on what really “works”, when it comes to designing policies that both provide adequate income security and still encourage labour‐force participation, governments look abroad or to bodies like the OECD for possible models and ideas to underlie a reform. However, translating those ideas into workable policies requires great sensitivity to the institutional and political‐economic context — especially the role of the social partners and the nature of policies in existence. When it comes to policy implementation, such contextual learning may be crucial.