This thesis is part of the quest for an improved life and better social-economic position for people with disabilities in developing countries. Approximately 80 per cent of the people with disabilities worldwide live in developing countries. 82 per cent of the people with disabilities in developing countries live below the poverty line. Microcredit is designed to bring economical empowerment and is seen as a powerful tool to reduce poverty in developing countries. However, people with disabilities in developing countries are excluded from microcredit schemes and thus from socio-economic interventions. The current scientifically literature on microfinance and people with disabilities is of a generalized nature and is not supported with strong evidence. This research investigates the facilitating and inhibiting factors in getting access to microcredit and the expectations towards the relation with health-seeking behaviour effects, specific for people with disabilities by comparing them with other vulnerable groups. A research that is being characterized by getting evidence based conclusion from the point of view of people with disabilities themselves. Q-methodology and other research methods are used to reveal the viewpoints and opinions of the respondents. During the research 70 persons with a disability, 30 other vulnerable persons and 15 employees of microfinance offices and disabled people organizations (stakeholders) were interviewed in Uganda (East-Africa). In the current literature different exclusion mechanisms, supporting factors and resources that influence the accessibility of microcredit for people with disabilities are defined. The results of this study show new insights from people with disabilities themselves. Self-exclusion, as a consequence of lack of confidence, is an important factor according to both the current literature, as the respondents of this study. However, this study shows no significant difference between people with disabilities and the other vulnerable groups who may have low-self-esteem because of other reasons. Therefore this is not considered a specific inhibiting factor for people with disabilities. Exclusion by others is indicated differently by people with disabilities then the other vulnerable groups. Having a group loan is an inhibiting factor for people with disabilities. Although the current literature supports this conclusion, the reasons explained in the literature and by the people with disabilities themselves in this study are different from each other. In disagreement with the literature people with disabilities explain that it is not because others would not allow them, but that they prefer to work on their own and do not trust the other group members. Exclusion by staff is a specific inhibiting factor for people with disabilities. This is supported by the literature and proven in the study, because the other vulnerable people do not indicate this factor as inhibiting. Both people with disabilities as well the stakeholders agree that there is a lack of knowledge amongst the providers of microcredit about the abilities of people with disabilities. The results from the exclusion by design show a strong viewpoint on the need of a dedicated microcredit program for people with disabilities. Where the other vulnerable people indicate they do not want a special program, people with disabilities explain they would have better access to microcredit if the microcredit service was designed especially for them, because they would feel confident, respected and understood. Interestingly, the only specific exclusion mechanism in the current literature ‘exclusion from physical and informational barriers’ is not being supported by the people with disabilities in 3 this study. They explain that they are able to solve the barriers, such as mobility challenges and additional cost, without significant consequences for their businesses. The influence of family is described as one of the supporting factors in the literature, while in this study people with disabilities indicate that it is a negative influence on getting access to microcredit. They do not trust the reasons for family to be involved and are afraid that family members will take advantage of them. People with disabilities often experience a lot of discrimination and rejections during their childhood of their family members and receive very little support. It might be that this is also a reason why people with disabilities value the resources (such as having some start-up capital) that influence access to microcredit as more important than the supporting factors, while the other vulnerable people believe that the supporting factors are more important. Finally, this study also concludes a positive relation between microcredit and health-seeking behaviour and overall well-being. Interestingly, people with disabilities expect a higher effect of microcredit on their health seeking behaviour then the other vulnerable people. Thus, microcredit might be a suitable tool for people with disabilities to improve their health-seeking behaviour.

Prof. Dr. J. van de Klundert, J.M. Cramm, N.J.A. Van Exel
hdl.handle.net/2105/8442
Master Health Economics, Policy and Law
Erasmus School of Health Policy & Management

Paauwe, M.C. (2010, April). ‘Microcredit and People with Disabilities in Uganda’. Master Health Economics, Policy and Law. Retrieved from http://hdl.handle.net/2105/8442