Pinilla-Roncancio, Mónica; Schwa z, Na alie; Smi h, Pamela; S ampini, Ma co
Wo king Pape
Adap ing mone a y po e y lines o e lec he cos s o
disabili ies: An empi ical applica ion o Pe u
IDB Wo king Pape Se ies, No. IDB-WP-01720
P o ided in Coope a ion wi h:
In e -Ame ican De elopmen Bank (IDB), Washing on, DC
Sugges ed Ci a ion: Pinilla-Roncancio, Mónica; Schwa z, Na alie; Smi h, Pamela; S ampini, Ma co
(2025) : Adap ing mone a y po e y lines o e lec he cos s o disabili ies: An empi ical applica ion
o Pe u, IDB Wo king Pape Se ies, No. IDB-WP-01720, In e -Ame ican De elopmen Bank (IDB),
Washing on, DC,
h ps://doi.o g/10.18235/0013630
This Ve sion is a ailable a :
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1
Adap ing Mone a y Po e y Lines o e lec
he Cos s o Disabili ies: An Empi ical
Applica ion o Pe u
Mónica Pinilla-Roncancio
Na alie Schwa z
Pamela Smi h
Ma co S ampini
WORKING PAPER No IDB-WP-01720
In e -Ame ican De elopmen Bank
Social P o ec ion and Labo Ma ke s Di ision
July 2025
2
Adap ing Mone a y Po e y Lines o e lec
he Cos s o Disabili ies: An Empi ical
Applica ion o Pe u
Ti le Line 3
Mónica Pinilla-Roncancio*
Na alie Schwa z**
Pamela Smi h***
Ma co S ampini**
* Uni e sidad de los Andes o Colombia
** In e -Ame ican De elopmen Bank
*** Sociedad y Discapacidad (SODIS) o Pe u
In e -Ame ican De elopmen Bank
Social P o ec ion and Labo Ma ke s Di ision
July 2025
3
Ca aloging-in-Publica ion da a p o ided by he
In e -Ame ican De elopmen Bank
Felipe He e a Lib a y
Adap ing mone a y po e y lines o e lec he cos s o disabili ies: an empi ical
applica ion o Pe u / Mónica Pinilla-Roncancio, Na alie Schwa z, Pamela Smi h,
Ma co S ampini.
p. cm. — (IDB Wo king Pape Se ies; 1720)
Includes bibliog aphical e e ences.
1. Po e y-Pe u. 2. People wi h disabili ies-Social aspec s-Pe u. 3. Social policy-
Pe u. I. Pinilla-Roncancio, Mónica. II. Schwa z, Na alie. III. Smi h, Pamela. IV.
S ampini, Ma co. V. In e -Ame ican De elopmen Bank. Social P o ec ion and
Labo Ma ke s Di ision. VI. Se ies.
IDB-WP-1720
JEL Codes: I32; I38.
Keywo ds: Po e y, Po e y Line, Pe sons wi h Disabili y, Pe u, Social P og ams,
Public Policy.
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he In e -Ame ican De elopmen Bank, i s Boa d o Di ec o s, o he coun ies hey ep esen .
4
Abs ac
1
Pe sons wi h disabili ies incu ex a cos s o li ing (e.g., o pe sonal assis ance,
assis i e de ices, medical ca e, anspo a ion), which a e no cap u ed in mone a y
po e y lines. This has se e al nega i e consequences. Fi s , go e nmen s
unde es ima e he a e o po e y among pe sons wi h disabili ies. Second, many
pe sons wi h disabili ies a e e oneously excluded om social p og ams. Finally, e en
o hose pe sons wi h disabili ies who a e decla ed eligible, he alue o he bene i s
se by he go e nmen s is likely o be insu icien ( o example, o close he po e y
gap). These p oblems can be a oided by assigning hem a highe weigh when
calcula ing pe -capi a income, known in he li e a u e as an “equi alence scale.” We
es ima e a co ec ion o he s anda d, unadjus ed po e y line based on na ionally
ep esen a i e su ey da a om Pe u and complemen he analysis wi h in o ma ion
om ocus g oups and in e iews wi h pe sons wi h disabili ies, ca egi e s, and public
se an s. We es ima e ha each pe son wi h disabili ies should be coun ed as 1.47
pe sons wi hou disabili ies when calcula ing he household pe -capi a income: his
is equi alen o saying ha a pe son wi h disabili ies equi es an income o 1.47 po e y
lines o be conside ed non-poo . This adjus men would imply ha an addi ional 15.1%
o indi iduals li ing in a household wi h pe sons wi h disabili ies would be classi ied
as poo , and hence would be eligible o ecei e social p og ams. I also implies ha he
mone a y alue o hei social p og ams should be 47% highe han o pe sons
wi hou disabili ies. E en hough his co ec ion alone is no enough o ensu e ull
pa icipa ion in socie y, i is a c i ical pa o add essing he ex a cos s o li ing aced
by indi iduals wi h disabili ies.
1
Mónica Pinilla-Roncancio is Assis an P o esso a he Uni e sidad de los Andes o Colombia; Pamela
Smi h is Execu i e Di ec o o he NGO Socie y and Disabili y (SODIS) o Pe u; Ma co S ampini and Na alie
Schwa z a e wi h he Social P o ec ion and Labo Ma ke s Di ision o he In e -Ame ican De elopmen
Bank (IDB). The au ho s hank Ludo ico Ca a o, Daniel Mon , Alexand e Co e, and Mo gon Banks o hei
expe guidance and ad ice h oughou he elabo a ion o he s udy. Special hanks go o all he ocus
g oup and in e iew pa icipan s who kindly p o ided us wi h insigh s on hei expe iences and
pe spec i es. The au ho s also hank Da id E ans, Pablo Iba a án, Rebeca Solano, Ca halina Ga cía
San ama ía and an anonymous pee e iewe o hei commen s and sugges ions. The documen was
p oo ead by Ch is ine N. Smi h. Any emaining e o s a e he sole esponsibili y o he au ho s. The
opinions exp essed in his pape a e hose o he au ho s and do no necessa ily e lec he iews o he
IDB, i s Boa d o Di ec o s, o he coun ies hey ep esen .
5
1. The sho comings o mone a y po e y lines in add essing he cos s o
disabili ies
Pe sons wi h disabili ies a e a highe isk o expe iencing po e y han indi iduals
wi hou disabili ies (UNDESA, 2024; Banks, Kupe , and Polack, 2017; Be linski, Du yea,
and Pe ez-Vincen , 2021), o a leas wo easons. Fi s , households wi h pe sons wi h
disabili ies ha e lowe incomes, due o: (i) limi ed access o educa ion, employmen ,
and inancial se ices o pe sons wi h disabili ies; (ii) he ac ha amily membe s
o go schooling and job oppo uni ies o p o ide suppo o hose wi h disabili ies
(UNDESA, 2024; Mon e al., 2022). Second, o achie e any gi en le el o wellbeing,
people wi h disabili ies incu subs an ial ex a cos s o mee hei needs and o e come
ba ie s (Mi a e al., 2017). These include disabili y-speci ic expendi u es, such as cos s
o assis i e de ices, pe sonal assis ance, o special housing a angemen s, as well as
highe spending on gene al i ems, such as medical ca e, anspo a ion, o ood o
special die s (Mon , 2023; Mon e al., 2022).
When coun ies measu e po e y and assess eligibili y o social p og ams, hey a ely
make adjus men s o he ex a cos s incu ed by households wi h pe sons wi h
disabili ies. In gene al, hey compa e pe -capi a income wi h po e y lines ha
measu e he minimum le el o consump ion o income ha households equi e o
co e hei basic needs, including ood, heal h, educa ion, and housing (Ra allion,
1998). They apply di e en me hodologies o selec he baske o goods and se ices
ha de e mine he alue o he po e y line (Dea on and Zaidi, 2002; Dea on, 1997). In
mos cases, hey se di e en po e y lines o di e en egions (e.g., u ban e sus
u al) o accoun o egional a ia ions in consump ion pa e ns and p ices. Howe e ,
hey ypically make no co ec ion o he ex a cos s o disabili ies.
Failing o accoun o hese ex a expendi u es has a leas h ee nega i e
consequences. Fi s , go e nmen s unde es ima e he a e o po e y among pe sons
wi h disabili ies. Second, many pe sons wi h disabili ies a e e oneously excluded om
social p og ams. Finally, e en o hose who a e decla ed eligible, he alue o he
bene i s ( o example, o close he po e y gap) is he same o pe sons wi h and
wi hou disabili ies and is likely o be insu icien o he o me . These p oblems could
be co ec ed by ei he es ablishing a highe po e y line o pe sons wi h disabili ies,
o by assigning hem a highe weigh when calcula ing pe -capi a income ( o be
compa ed wi h he unadjus ed po e y line). The la e app oach is known in he
li e a u e as an equi alence scale.
In ecen yea s, some La in Ame ican coun ies ha e a emp ed o add ess hese
p oblems. In 2016, Panama es ablished a highe po e y line o he assessmen o
eligibili y o ecei e he Angel Gua dián cash ans e p og am, which a ge ed
pe sons wi h se e e disabili ies in a si ua ion o ex eme po e y.
2
Mo e ecen ly, Cos a
Rica has wo ked on adap ing i s po e y line o accoun o ex a cos s associa ed wi h
2
Resolución n. 544, Gace a O icial N° 28167, República de Panamá, ma es 29 de no iemb e de 2016. This
po e y line was se a a highe le el han o he Red de Opo unidades p og am, which a ge ed pe sons
wi hou disabili ies in a si ua ion o ex eme po e y.
6
disabili y.
3
Mo eo e , he go e nmen has also es ablished a baske ha accoun s o
ca e dependence (mild, mode a e, and se e e). This baske has been app o ed and is
cu en ly in he p ocess o being inco po a ed in o he Na ional In o ma ion Sys em
and Single Regis y o S a e Bene icia ies (Sis ema de In o mación Nacional y Regis o
Único de Bene icia ios del Es ado, SINIRUBE). Sec ion 3 explains Cos a Rica’s
de elopmen and cu en s a e o he disabili y po e y line.
In his pape , we es ima e a co ec ion o he measu emen o po e y o pe sons wi h
disabili ies based on he equi alence-scale app oach. Ou es ima es a e based on
na ionally ep esen a i e su ey da a om Pe u, and complemen ed wi h in o ma ion
om ocus g oups and in e iews wi h pe sons wi h disabili ies, ca egi e s, and public
se an s. We es ima e ha each pe son wi h disabili ies should be coun ed as 1.47
pe sons wi hou disabili ies when calcula ing he household pe -capi a income ( his
is equi alen o saying ha a pe son wi h disabili ies equi es an income o 1.47 po e y
lines o be conside ed non-poo ). This adjus men would imply ha an addi ional 15.1%
o pe sons wi h disabili ies would be classi ied as poo , and hence would be eligible o
ecei e social p og ams. I also implies ha he mone a y alue o hei social
p og ams should be 47% highe han o pe sons wi hou disabili ies.
Ou s udy ep esen s one o he i s a emp s o ecognize he ex a cos s o
disabili ies in he measu emen o po e y in La in Ame ica, wi h a iew o os e ing
g ea e inclusion o pe sons wi h disabili ies in means- es ed social p og ams. This is a
e y impo an opic o he social p o ec ion agenda in La in Ame ica and he
Ca ibbean, gi en ha pe sons wi h disabili ies cons i u e an inc easing sha e o he
popula ion o he egion. App oxima ely one ou o e e y se en people in he egion
li es wi h a disabili y and, due o as popula ion aging, he numbe o pe sons wi h
disabili ies is o ecas o inc ease o 150 million by 2050 (Be linski, Du yea, and Pe ez-
Vincen , 2021).
The emainde o his pape is o ganized as ollows. Sec ion 2 analyzes income and
expendi u e pa e ns o households wi h and wi hou membe s wi h disabili ies in
Pe u. We show ha households wi h pe sons wi h disabili ies end o ha e lowe
incomes, a di e en household expendi u e composi ion, and a e mo e likely o
pe cei e hei income as inadequa e o co e hei basic needs. We hen p esen how
he po e y assessmen o pe sons wi h disabili ies can be co ec ed and illus a e
how hese adjus men s a ec he es ima ion o he po e y a e and po e y gap in
he coun y. Sec ion 3 ou lines Cos a Rica’s ini ia i es o modi y he po e y line,
p o iding an example o a coun y in he egion ha has wo ked on adjus men s o
accoun o disabili y- ela ed ex a cos s. Sec ion 4 discusses he limi a ions o ou
s udy and sugges s a enues o u u e esea ch.
3
Sis ema Cos a icense de In o mación Ju ídica (SCIJ):
h p://www.pg web.go.c /scij/Busqueda/No ma i a/No mas/n m_ ex o_comple o.aspx?pa am1=NRTC&n
Valo 1=1&nValo 2=55141&nValo 3=60414&s TipM=TC
7
2. Po e y and disabili ies in Pe u
2.1 Cha ac e is ics o pe sons and households wi h and wi hou disabili ies
Acco ding o da a om he 2022 Na ional Household Su ey (Encues a Nacional de
Hoga es, ENAHO), 5% o Pe u’s popula ion aged i e o abo e, o 1.5 million indi iduals,
li e wi h a disabili y; 1.5%, o 461 housand pe sons, li e wi h mul iple disabili ies. In
15.1% o Pe u ian households, he e is a leas one pe son wi h disabili ies; o hose,
85.6% ha e one membe wi h disabili ies, 12.8% ha e wo, and 1.3% ha e h ee o mo e
pe sons wi h disabili ies.
4
To de ine i a pe son li es wi h a disabili y, we e e o he
Washing on G oup ques ions included in he ENAHO, which use ac i i y limi a ions o
cap u e unc ioning di icul ies as a p oxy o disabili y. We de ine an indi idual as a
pe son wi h disabili ies i he indi idual epo s li ing wi h a leas one o he
di icul ies included in he su ey (walking, seeing, hea ing, emembe ing, and/o
concen a ing). Mo e in o ma ion on he household su ey and he de ini ion o he
disabili y a iable is p o ided in Annex A1.
Table 1 shows key desc ip i e s a is ics. Pe sons wi h disabili ies in Pe u a e, on
a e age, much olde han indi iduals wi hou disabili ies: 57 e sus 35 yea s old. They
a e much less likely o wo k (46% e sus 73%). When hey wo k, hey a e mo e likely o
be sel -employed (50% e sus 37%), and hey ha e lowe le els o schooling (5 yea s
e sus 8). They a e mo e likely o be household heads (40.4% e sus 31.2%) and li e in
u al a eas (20.5% e sus 16.8%).
Households wi h membe s wi h disabili ies a e sligh ly la ge , ha e ewe child en
unde 18, and mo e adul s aged 60 and abo e, on a e age. While he e a e no
s a is ically signi ican di e ences in he sex o he household heads be ween he wo
g oups, ewe o hose heading a household wi h disabili ies a e wo king compa ed o
hei coun e pa s (73.4% e sus 85.5%).
4
The ENAHO is no speci ically designed o cap u e da a on disabili ies, and hese igu es a e likely o
unde es ima e he eal p e alence o disabili ies in Pe u.
8
Table 1. Main cha ac e is ics o pe sons and households, by p esence o disabili ies
Pe sons wi h
disabili ies
Pe sons wi hou
disabili ies
Di e ence
Age (yea s)
57
35
22***
Female
51.6%
49.9%
1.7%**
Household head
40.4%
31.2%
9.2%***
Yea s o schooling
4.9
8.0
-3.1***
Wo king
46.0%
73.1%
-27.1%***
Sel -employed (condi ional on
wo king)
50.4%
37.0%
13.4%***
Li es in u al a eas
20.5%
16.8%
3.7%***
Households
wi h membe s
wi h
disabili ies
Households
wi hou
membe s wi h
disabili ies
Di e ence
Numbe o household membe s
4.8
4.3
0.5***
Numbe o child en aged below 18
1.4
1.6
-0.2***
Numbe o adul s aged 60 and abo e
1.0
0.4
0.6***
Female household head
35.5%
32.5%
3.0%**
Household head is wo king
73.4%
85.5%
-12.1%***
Sou ce: Au ho s’ elabo a ion based on da a om he 2022 ENAHO.
No e: Numbe o obse a ions = 5,642 indi iduals. Households wi h membe s wi h disabili ies a e de ined
as households ha include a leas one membe wi h disabili ies. Signi icance le els: * p < 0.05, ** p < 0.01,
*** p < 0.001.
2.2 Households wi h membe s wi h disabili ies ha e lowe incomes
On a e age, li ing in a household wi h a leas one membe wi h a disabili y educes
income le els by 12.8% compa ed o being pa o a household wi hou membe s wi h
a disabili y, a e con olling o o he household cha ac e is ics. Fo pe -capi a
income, he gap is 12.5% (Table 2). These igu es a e es ima ed h ough linea
eg ession models in which he na u al loga i hm o income is he dependen a iable,
and con ols include household size, numbe o child en, numbe o olde membe s,
a ea o esidence, p o ince, and cha ac e is ics o he household head, including sex,
educa ion, and wo king s a us.
15
Table 4. E ec s o disabili y and income on he pe cei ed s anda d o li ing
Pe cei ed adequacy o household
income
Household wi h a membe wi h disabili ies (b1)
-0.127***
(0.011)
Log income (b2)
0.332***
(0.006)
O he con ols
Yes
Sou ce: Au ho s’ elabo a ion based on da a om he 2022 ENAHO.
No e: Numbe o obse a ions= 111,631. O dinal p obi eg ession model. The dependen a iable is he
pe cei ed adequacy o household income, which is he household head’s pe cep ion o how good he
household income is o co e household needs ( e y bad, bad, good, e y good). The independen
a iables a e household wi h membe s wi h disabili ies, de ined as a household ha includes a leas one
membe wi h a disabili y, log o household income, numbe o pe sons in he household, numbe o
household membe s aged unde 12 and hose aged 60 and o e , a ea o esidence, p o ince, and
cha ac e is ics o he household head, such as sex, age, educa ion le el, and wo king s a us. S anda d
e o s in pa en heses. Signi icance le els: * p < 0.05, ** p < 0.01, *** p < 0.001.
The second s ep o ou app oach implies calcula ing he equi alence scale, i.e., he
weigh ha needs o be assigned o a pe son wi h disabili ies when calcula ing pe -
capi a income. Zaidi and Bu cha d (2005) show ha his is calcula ed as ollows:
(1) 𝐸𝑞𝑢𝑖𝑣𝑎𝑙𝑒𝑛𝑐𝑒 𝑆𝑐𝑎𝑙𝑒= 1
⌊𝑒𝑏1
𝑏2⌋
On a e age, using he pa ame e s shown in Table 4, his is equal o 1.47. This means
ha , when di iding o al household income by household size o calcula e pe -capi a
income, each pe son wi h disabili ies needs o be coun ed as 1.47 membe s (ins ead
o 1 used o pe sons wi hou disabili ies). In a household o 2 membe s, o example,
pe -capi a income will be calcula ed by di iding o al household income by 2.47.
The equi alence scale is highe in smalle amilies due o he absence o economies o
scale. I we epea he whole analysis p oposed in his sec ion o amilies o one
membe , we ind ha he equi alence scale o a pe son wi h disabili ies who li es
alone is on a e age equal o 2. In o he wo ds, when di iding income o ob ain pe -
capi a income, a household composed o one pe son wi h disabili ies is equi alen o
a household ha consis s o wo membe s wi hou disabili ies.
2.6 Po e y incidence and gap, when accoun ing o disabili y- ela ed ex a cos s
We apply he co ec ion o he ex a cos s o disabili ies o he calcula ion o he
po e y headcoun and po e y gap o he o al popula ion and o households wi h
membe s wi h disabili ies, using 2022 ENAHO da a. The incidence o po e y in he
whole popula ion inc eases om 29.6% o 31.9%. When looking only a he popula ion
wi h disabili ies and hei amilies, ou co ec ion inc eases he es ima ion o he
po e y headcoun om 35.0% o 50.1%. This means ha ou co ec ion changes he
classi ica ion om non-poo o poo o 760 housand indi iduals li ing in a household
wi h a leas one membe wi h disabili ies (Table 5). The po e y gap inc eases by 0.7
16
pe cen age poin s o he whole popula ion and 4.4 pe cen age poin s o he
popula ion wi h disabili ies and hei amilies.
Table 5. Po e y incidence and po e y gap, o al popula ion and popula ion wi h
disabili y, using o icial and co ec ed measu es
Popula ion
Po e y
Incidence,
o icial
Incidence,
co ec ed
Gap,
o icial
Gap,
co ec ed
To al
29.6%
31.9%
4.8%
5.5%
Indi iduals in
households wi h
pe sons wi h
disabili ies
35.0%
50.1%
5.6%
9.9%
Sou ce: Au ho s’ elabo a ion based on da a om he 2022 ENAHO.
3. Adjus ed po e y line in Cos a Rica
Ins ead o using he equi alence scale app oach shown in he p e ious sec ion, Cos a
Rica has been wo king on he in oduc ion o adjus ed po e y lines ha inco po a e
he cos o a disabili y baske . This al e na i e app oach pu sues he same objec i es:
(i) a oid he unde es ima ion o po e y among pe sons wi h disabili ies; (ii) accoun
o he cos s o disabili ies when assessing po e y o de e mine eligibili y o social
p og ams; (iii) co ec he de ini ion o he alue o mone a y bene i s o pe sons wi h
disabili ies.
In 2016, he go e nmen o Cos a Rica app o ed he ‘Law o he P omo ion o Pe sonal
Au onomy o Pe sons wi h Disabili ies’ (Law No. 9379), which manda es he inclusion
o a disabili y baske (Canas a De i ada de la Discapacidad) in he assessmen o he
economic condi ions o pe sons wi h disabili ies. Consequen ly, he Mixed Ins i u e o
Social Assis ance (Ins i u o Mix o de Ayuda Social, IMAS) de eloped and implemen ed
he Disabili y Po e y Line (Línea de Pob eza po Discapacidad) in 2017 o be e
add ess he needs o households wi h pe sons wi h disabili ies (IMAS, 2017). The model
classi ies a household as li ing in po e y i i s pe -capi a income does no co e he
cos o he disabili y baske , which a ies by ype o disabili y (physical, audi o y, isual,
cogni i e, psychosocial, o a combina ion o hese), in addi ion o he egula basic
baske (Canas a Básica No ma i a). The model was inco po a ed in o IMAS’s
a ge ing p ocesses (Sis ema de In o mación de la Población Obje i o) and
Bene icia y A en ion Sys em (Sis ema de A ención a Bene icia ios), used o iden i y
bene icia ies o social p og ams (ibid.).
Mo e ecen ly, wi hin he amewo k o he Na ional Sys em o Ca e and Suppo o
Adul s and Olde Adul s in Si ua ions o Dependency (Sis ema Nacional de Cuidados
y Apoyos pa a Pe sonas Adul as y Pe sonas Adul as Mayo es en Si uación de
Dependencia), IMAS, wi h suppo om he IDB, has wo ked on e ining and
s anda dizing he measu emen o i s disabili y baske s (as well as i s baske s o ca e
dependence) (IMAS and IDB, 2025). The goal is o he Na ional In o ma ion Sys em
17
and Single Regis y o S a e Bene icia ies (Sis ema de In o mación Nacional y Regis o
Único de Bene icia ios del Es ado, SINIRUBE), which consolida es da a on social
p og am use s, o u ilize he Washing on G oup sho se o ques ions o iden i ying
pe sons wi h disabili ies.
This me hodological upda e o he disabili y baske es ima ion es ablishes an a e age
amoun o addi ional expendi u e by ype o disabili y ( a ying by physical, senso y,
and men al disabili ies) based on in o ma ion ob ained h ough consul a ions wi h
o ganiza ions se ing pe sons wi h disabili ies, ca egi e s, and public se an s. The
alue o he disabili y baske is added o he alue o he egula basic baske o e lec
he ex a cos s aced by pe sons wi h disabili ies (ibid.).
6
This disabili y baske is
cu en ly unde consul a ion by he Na ional Council o Pe sons wi h Disabili ies
(Consejo Nacional de Pe sonas con Discapacidad) – which has pa icipa ed in he
e iew and consul a ion p ocess o he upda e o he disabili y baske led by IMAS –
bo h a he ins i u ional le el and wi h he popula ion wi h disabili ies, be o e being
inco po a ed in o SINIRUBE o use in social p og ams.
Based on hese ecen calcula ions, he po e y line o pe sons wi h disabili ies is
es ima ed o be be ween 1.4 and 3.3 imes he coun y’s cu en o icial po e y line,
depending on he ype o disabili y.
4. Limi a ions and u u e esea ch
This s udy has some limi a ions. Fi s , disabili y cos s can a y signi ican ly by ype and
deg ee o disabili y (UNICEF, 2023; CIP, 2024). Fo example, pe sons wi h hea ing
di icul ies ace di e en ba ie s and cos s han indi iduals wi h mobili y
impai men s. An a e age es ima e hides his a ia ion. Un o una ely, he ENAHO da a
did no allow di e en ia ion among di e en deg ees o disabili y, due o lack o
in o ma ion on he se e i y o he di icul ies expe ienced. In he u u e, i would be
use ul o eplica e he analysis wi h da a ha con ain in o ma ion on he se e i y o
disabili ies ( o example, using Mexico’s Na ional Su ey o Household Income and
Expendi u e (Encues a Nacional de Ing eso y Gas o de los Hoga es, ENIGH)).
Simila conside a ions hold o pe sons wi h disabili ies in di e en age g oups. The
ex a cos s associa ed wi h disabili ies can a y g ea ly be ween child en and olde
people. Un o una ely, he sample size o he ENAHO does no allow conduc ing age-
speci ic analysis.
The e o e, e en hough he S anda d o Li ing (SoL) app oach se es o iden i y he
a e age unde es ima ion o po e y, a single adjus men is insu icien o add ess he
di e en ex a cos s people incu (Mon , 2023).
6
In acco dance wi h he manda e and de ini ions o Law No. 10192: C ea ion o he Na ional Sys em o
Ca e and Suppo o Adul s and Olde Adul s in Si ua ions o Dependency (Sis ema Nacional de Cuidados
y Apoyos pa a Pe sonas Adul as y Pe sonas Adul as Mayo es en Si uación de Dependencia), 2022, A icle
3.
18
Second, he SoL me hod es ima es cu en expendi u es. These can be less han wha
is needed, since indi iduals may no be able o a o d he goods and se ices hey
need, be unawa e o hei exis ence, o hese may no be a ailable. This may lead o an
unde es ima ion o he addi ional inancial esou ces people equi e o co e basic
needs.
A hi d impo an limi a ion o ou analysis is ha we ocus on minimum needs as
de ined by he po e y line. These all sho o p omo ing ull pa icipa ion in socie y.
Full pa icipa ion equi es add essing all unme needs (e.g., he cos o ull
pa icipa ion in educa ion and labo ma ke s, o example h ough he p o ision o
pe sonal assis ance). I can be pu sued h ough he Goods and Se ices Requi ed
me hod, which de e mines he ype and ex en o speci ic goods and se ices needed
o ull pa icipa ion by indi iduals wi h di e en ypes o disabili ies and le els o
suppo needs (Mon e al., 2022).
Finally, po e y in ou analysis is de ined by he pe -capi a household income.
Assuming a pe -capi a app oach in mo ing om household- o indi idual-le el
expendi u e does no accoun o in a-household dynamics and po en ial imbalances
o esou ce alloca ion o indi iduals wi hin he household.
To imp o e he analysis and unde s anding o disabili y- ela ed ex a cos s and co ec
he assessmen o po e y among pe sons wi h disabili ies, u u e su eys could: (i)
o e sample pe sons wi h disabili ies; (ii) include he ull se o he Washing on G oup
disabili y ques ions; (iii) include ques ions ega ding goods and se ices associa ed
wi h disabili y (e.g., assis i e echnology o ca e).
5. Re e ences
Banks, M. L., Kupe , H., and Polack, S. (2017). Po e y and disabili y in low- and middle-
income coun ies: a sys ema ic e iew. PLOS ONE, 12(12): e0189996.
Be linski, S., Du yea, S., and Pe ez-Vincen , S. M. (2021). P e alence and Co ela es o
Disabili y in La in Ame ica and he Ca ibbean: E idence om 8 Na ional
Censuses. PLOS ONE, 16(10): e0258825. h ps://doi.o g/10.1371/jou nal.
pone.0258825.
Ca a o, L., Robinson, A., Hakeem, B., Manlapaz, A., and Agcaoili, R. (2023). Disabili y-
ela ed cos s o child en wi h disabili ies in he Philippines.
h ps://pubmed.ncbi.nlm.nih.go /37444151/.
CIP – Cen e o Inclusi e Policy (2024). The Di ec Cos s o Disabili y o Families in
Tamil Nadu: A s udy epo on he goods and se ices equi ed by pe sons wi h
disabili ies in Tamil Nadu o ull and e ec i e pa icipa ion. h ps://inclusi e-
policy.o g/wp-con en /uploads/2024/06/Di ec -Cos s-o -Disabili y- o-Families-
in-Tamil-Nadu_June-2024.pd .
Dea on, A. (1997). The analysis o household su eys: A mic oeconome ic app oach o
de elopmen policy. Washing on, D.C.: The Wo ld Bank.
Dea on, A., and Zaidi, S. (2002). Guidelines o cons uc ing consump ion agg ega es
o wel a e analysis. Washing on, D.C.
19
IMAS – Ins i u o Mix o de Ayuda Social (2017). Medición po el mé odo de línea de
pob eza inco po ando la canas a de i ada de la discapacidad en el Sis ema de
In o mación de la Población Obje i o y el Sis ema de A ención a Bene icia ios
del Ins i u o Mix o de Ayuda Social. Subge encia de Desa ollo Social.
IMAS – Ins i u o Mix o de Ayuda Social, and IDB – In e -Ame ican De elopmen Bank
(2024). Elabo ación de p opues a sob e canas a de dependencia y discapacidad
pa a se inco po ada en me odología de alo ación de la si uación de pob eza
según dependencia y discapacidad que ealiza SINIRUBE en Cos a Rica.
P oduc o 3: P opues a de con enido de la(s) canas a(s) de la dependencia y/o
de la discapacidad, a pa i de la e isión de no ma i as, uen es especializadas
y consul as con las ins i uciones del SINCA, OBS y población usua ia.
Unpublished manusc ip .
Mi a, S., Palme , M., Kim, H., Mon , D., and G oce, N. (2017). Ex a cos s o li ing wi h a
disabili y: A e iew and agenda o esea ch. Disabili y and Heal h Jou nal, 10(4):
475–484. h ps://doi.o g/10.1016/j.dhjo.2017.04.007.
Mon , D. (2023). Es ima ing he ex a disabili y expendi u es o he design o inclusi e
social p o ec ion policies. h ps://www. on ie sin.o g/jou nals/ ehabili a ion-
sciences/a icles/10.3389/ esc.2023.1179213/ ull.
Mon , D., Co e, A., Hanass-Hancock, J., Banks, L. M., G igo us, V., Ca a o, L., Mo is, Z.,
and Pinilla-Roncancio, M. (2022). Es ima ing he ex a cos s o disabili y o
social p o ec ion p og ams. UNPRPD, 1–47. h ps://www.social-
p o ec ion.o g/gimi/Ressou cePDF.ac ion?id=57850.
INEI – Ins i u o Nacional de Es adís ica e In o má ica (2017). Me odología pa a la
medición de la pob eza mone a ia. Lima.
INEI – Ins i u o Nacional de Es adís ica e In o má ica (2019). Pe il sociodemog á ico
de la población con discapacidad, 2017.
h ps://www.inei.gob.pe/media/MenuRecu si o/publicaciones_digi ales/Es /Lib
1675/lib o.pd .
Ra allion, M. (1998). Po e y lines in heo y and p ac ice. LSMS Wo king Pape No. 133.
Ra allion, M., and Lokshin, M. (2001). Iden i ying wel a e e ec s om subjec i e
ques ions. Economica, 68(271), 335–357.
Ra allion, M., and Lokshin, M. (2006). Tes ing po e y lines. Re iew o Income and
Weal h, 52(3), 399–421.
UNDESA – Uni ed Na ions Depa men o Economic and Social A ai s (2024). Disabili y
and De elopmen Repo 2024: Accele a ing he ealiza ion o he Sus ainable
De elopmen Goals by, o , and wi h pe sons wi h disabili ies.
h ps://social.desa.un.o g/publica ions/un- lagship- epo -on-disabili y-and-
de elopmen -2024.
UNICEF – Uni ed Na ions Child en’s Fund (2023). The Cos o Raising a Child wi h
Disabili ies in Geo gia: The Goods and Se ices Requi ed o he Equal
Pa icipa ion o Child en wi h Disabili ies.
h ps://www.unice .o g/geo gia/media/8421/ ile/The%20Cos %20o %20Raising
%20a%20Child%20wi h%20Disabili ies%20in%20Geo gia.pd .
20
Washing on G oup on Disabili y S a is ics (2013). Washing on G oup on Disabili y
S a is ics: Sho se o ques ions on disabili y, 2013.
h ps://www.cdc.go /nchs/da a/washing on_g oup/WG_Sho _Measu e_on_Dis
abili y.pd .
Zaidi, A., and Bu cha d , T. (2005). Compa ing incomes when needs di e : Equi alising
o he ex a cos s o disabili y in he UK. Re iew o Income and Weal h, 51(1),
89–114.
6. Annex
A1. Da a and me hodological conside a ions
The 2022 ENAHO is a na ionally ep esen a i e su ey ha p o ides in o ma ion on he
popula ion’s li ing condi ions. I is adminis e ed o indi iduals aged i e and abo e in
andomly selec ed households. I is he o icial sou ce o da a used by he coun y o
measu e income po e y.
To de ine i a pe son has a disabili y, we e e o he Washing on G oup ques ions
included in he ENAHO. These use ac i i y limi a ions o cap u e unc ioning
di icul ies as a p oxy o disabili y. The se o Washing on G oup ques ions was
de eloped by he Washing on G oup on Disabili y S a is ics o p o ide a s anda dized
and compa able measu e o disabili y o use in censuses and su eys. The ENAHO
p o ides in o ma ion on unc ional di icul ies in walking, seeing, hea ing,
emembe ing, and/o concen a ing by implemen ing an app oxima ion o he
Washing on G oup's Sho Se o Ques ions (Washing on G oup on Disabili y S a is ics,
2013). I does no include a se e i y scale, no in o ma ion on di icul ies ela ed o he
domain o ac i i ies o daily li ing. We de ine an indi idual as a pe son wi h disabili ies
i he o she epo s li ing wi h a leas one o he unc ional di icul ies included in he
su ey.
Fo he de ini ion o po e y, we ollow he me hodological s eps p oposed by he
Na ional Ins i u e o S a is ics and In o ma ics (INEI) o Pe u (INEI, 2017), which also
accoun s o sel -consump ion. The po e y line is de ined based on he composi ion
o consump ion o he popula ion in he second quin ile o he dis ibu ion o pe -
capi a expendi u e in Me opoli an Lima. The ood expendi u e in his g oup is
complemen ed by a non- ood componen , whose alue is es ima ed h ough an
Engel coe icien .
7
A pe son is iden i ied as li ing in po e y i he indi idual li es in a
household wi h pe -capi a expendi u e no exceeding he po e y line o he
depa men o esidence.
7
The Engel coe icien measu es he p opo ion o income spen on ood. I is based on he obse a ion
ha he p opo ion o he budge ha households alloca e o ood dec eases as hei o al income
inc eases. The e o e, a highe coe icien sugges s ha a household spends a la ge pa o i s income on
ood, which indica es a lowe s anda d o li ing.
21
A2. Addi ional in o ma ion on in e iews and ocus g oups
We conduc ed in e iews and ocus g oup discussions o collec in o ma ion on: (i)
how disabili y a ec s households’ socioeconomic si ua ion; (ii) spending pa e ns o
households wi h membe s wi h disabili ies; (iii) s a egies households use o co e
hei basic needs; and (i ) he pe cep ions o pe sons wi h disabili ies and hei amilies
on po e y and economic ulne abili y mo e gene ally.
This quali a i e pa o he s udy was conduc ed be ween June and July 2024 and
included 32 key in o man s (Table A1). These included adul pe sons wi h disabili ies,
amily ca egi e s, and wo o icials om he Regional O ice o he A en ion o
Pe sons wi h Disabili ies o he Regional Go e nmen o Callao and he Municipal
O ice o he A en ion o Pe sons wi h Disabili ies o Chancay. In e iewed pe sons
wi h disabili ies and hei ca egi e s we e membe s o households li ing in po e y
acco ding o he Household Ta ge ing Sys em (Sis ema de Focalización de Hoga es)
o Pe u. This in e sec o al and in e go e nmen al sys em p o ides socioeconomic
in o ma ion o he selec ion o use s o po e y- a ge ed public in e en ions.
The ocus g oups and in e iews we e conduc ed in he dis ic o Ven anilla in
Me opoli an Lima (u ban) and he dis ic o Chancay in he p o ince o Hua al ( u al).
The selec ion o hese loca ions was based on he dis ibu ion o pe sons wi h
disabili ies in Pe u and he exis ing suppo ne wo ks o he Pe u ian NGO Sociedad
y Discapacidad (SODIS) o he iden i ica ion o pa icipan s wi h disabili ies.
Acco ding o he 2017 Na ional Census, he p o ince o Lima egis e s he highes
pe cen age o pe sons wi h disabili ies (INEI, 2019). The quali a i e s udy conside ed
di e en ypes o disabili ies.
Table A1. Key in o man s and me hods o in o ma ion collec ion
Type
Numbe o
pa icipan s, by a ea
Type o disabili y
Me hod
Adul pe sons wi h
disabili ies
10; 5 u ban, 5 u al
Physical, isual,
audi o y,
psychosocial
In e iews
Ca egi e s o pe sons
wi h disabili ies
22; 11 u ban, 11 u al
Physical, au ism,
ce eb al pa alysis,
in ellec ual,
mul iple disabili y
Focus g oups (5
o 6 pa icipan s
pe g oup)
Public se an s o
p og ams and se ices
o pe sons wi h
disabili ies
2; 1 u ban, 1 u al
-
In e iews
Sou ce: Au ho s’ elabo a ion.
No e: U ban e e s o he dis ic o Ven anilla and u al o he dis ic o Chancay.
Fo indi idual in e iews, p io i y was gi en o p o iles o people wi h disabili ies who
can communica e and exp ess hei will wi hou he need o suppo o in e p e hei
exp essions o s o ies. In e iews wi h people wi h hea ing disabili ies we e
accompanied by a sign language in e p e e .
22
The ocus g oup discussions and in e iews we e conduc ed in pe son and used semi-
s uc u ed guides. These we e designed o explo e he composi ion o household
expenses, including ood, heal h, educa ion, anspo a ion, and basic household
se ices. In addi ion, he s udy sough o gain insigh s in o he s a egies used by
households wi h membe s wi h disabili ies o co e hei basic needs, including
disabili y- ela ed expenses. P io o he in e iews and ocus g oup discussions,
pa icipan s p o ided in o med consen and illed in a o m on hei
sociodemog aphic cha ac e is ics, which p o ided addi ional con ex ual in o ma ion
o he analysis. Pa icipan s had he oppo uni y o ask ques ions be o e con i ming
hei olun a y pa icipa ion and signing he consen o m. Visually impai ed pe sons
we e eques ed o gi e hei consen e bally.
On a e age, in e iews las ed app oxima ely 50 minu es, whe eas ocus g oup
discussions las ed 120 minu es. All in e iews we e audio- eco ded and ansc ibed
e ba im. Two andomly selec ed ansc ip s we e c i ically ead o iden i y ini ial
hemes and ca ego ies o de elop he codebook. Then, indi idual in e iews and one
g oup in e iew we e coded sepa a ely, and he c i e ia o he analysis we e e i ied
and uni ied. Subsequen ly, each in e iew was analyzed wi h he use o he quali a i e
analysis so wa e ATLAS. i o iden i y simila i ies and di e ences in he pa icipan s’
s o ies, conside ing cha ac e is ics such as ype o disabili y, gende , and o igin. The
da a a e con iden ial, we e secu ely s o ed, and only accessible o he esea ch eam
o he quali a i e s udy. The in o ma ion was anonymized. The s udy p o ocol,
in o med consen o ms, and da a collec ion ools we e e iewed and app o ed by he
E hics Commi ee o Social Sciences, Humani ies, and A s o he Pon i icia
Uni e sidad Ca ólica del Pe ú.
