Support for persons with disabilities (PWDs) in low- and middle-income countries typically takes the form of consumption support rather than economic-inclusion programs. This is partly because disability is often presumed to lower the returns to productive investment, thereby pitting equity against efficiency. We test this presumption with a cluster-randomized trial of a disability-inclusive graduation (DIG) program delivered by an NGO in Northern Uganda, which combined asset transfers, coaching, and skills training with disability-responsive adaptations for over 3,300 ultra-poor households. About 18 months after the program ended, treated households held substantially more productive assets and reported higher income and consumption. These gains were as large for households with a PWD as for those without, and were no smaller when a PWD—rather than another household member—managed the enterprise. The disability-specific adaptations raised program costs by 17% but lowered measured benefits by only 8%, leaving the benefit–cost ratio above one. Making livelihood programming disability-inclusive can therefore advance equity at little efficiency cost, challenging the presumption that targeting persons with disabilities entails a trade-off between equity and efficiency.
Authors: Banks, Lena Morgon; Chen, Shanquan; Davey, Calum; Islam, Kazi Eliza; Kipchumba, Elijah; Kuper, Hannah; and Sulaiman, Munshi
Type: Working Paper
Publisher: BIGD
Year: 2026
