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Voices of the Marginalised


From 2012 to 2016, Sightsavers, HelpAge International and ADD International conducted a research study, Voices of the Marginalised, to share the experiences and perspectives of people with disabilities and older people living in developing countries. The aim was to share their experiences in terms of social, political and economic inclusion in order to influence national and global policymakers, while strengthening efforts to provide accessible quality services at a local level. The study was first conducted in Bangladesh and then in Tanzania, with the respective support of two research institutes: the Institute of Development Studies (IDS) in the UK and Ifakara Health Institute in Tanzania.


A man scattering feed for a chicken.

©HelpAge International


Why is this important?

There is a growing recognition of inequalities which arise from marginalisation, where those in excluded situations rarely have the opportunity for their voices to be heard. This invisibility is exacerbated by a lack of relevant data. Voices of the Marginalised provides a real opportunity to build a body of qualitative data so governments and development actors understand better the barriers confronting people with disabilities and older people.

Bringing partners together (bridging research and policy, along with tangible recommendations) is essential to improve the quality of life and participation of the most excluded people. This research comes at a time when governments are reevaluating their national priorities as well as their spending and accountability mechanisms in the light of the 2030 Agenda and the Sustainable Development Goals (SDGs).


A woman with three children sitting together.

©HelpAge International


How did we do it?

The methodology used for this project was a community-based participatory approach, aiming to involve equitably community members, organisational representatives and external researchers in order to share resources and exchange knowledge. We brought together people with disabilities and older people who actively took part in the project by becoming researchers, being trained to collect and analyse stories from peers in rural and urban areas. Staff from local organisations were also trained as researchers to gather stories from colleagues working with people with disabilities and older people.

The stories shared highlight not only the stigma and discrimination people with disabilities and older people are often faced with, but also their challenges in claiming their rights, finding employment, and accessing health care and other public services.




The research study was conducted in two sites: Bhashantek, an urban slum in the capital of Dhaka and Cox’s Bazar, a rural area in southeast Bangladesh. Eleven community peer researchers collected 70 stories while seven NGO peer researchers spoke with staff from more than 40 organisations. Peer researchers included people with disabilities, older people and representatives of local NGOs working on disability or aging. They all analysed the stories collected in a workshop and identified 13 emerging issues that particularly affect people with disabilities and older people in Bangladesh.

They are:

  • Accidents and disasters
  • Livelihoods
  • Access to education
  • Medical treatment
  • Family support
  • Exclusion and mistreatment
  • Superstition
  • Access to services
  • Mobility
  • Marriage
  • Land
  • Rape and sexual abuse
  • The role of grassroots community-based organisations

There was significant overlap in the 13 issues identified as critical to both groups, and issues were also very interrelated – for example, a lack of livelihood impacted someone’s ability to access health care. The stories gathered illustrate how transformative, for instance, an income can be in terms of independence, status and self-esteem. Poor access to services, mainly as a result of poor infrastructure, also has a huge impact, and so does the everyday discrimination and exclusion faced by people with disabilities and older people.



Sightsavers clip from Work With Us, produced by Real Time as part of Participate: Knowledge from the margins for post-2015

National launch of the findings





A woman speaking into a microphone, standing in front of a projector screen with a presentation on it.



Key findings from Voices of the Marginalised:


Work and dignity are rare

I am living by borrowing from other people and relatives here and there. I am just surviving. I only get the disability allowance.

– Imran, aged approximately 45


People with disabilities and older people are commonly viewed as a burden on the household. Often they are abandoned and many move to urban areas to beg.

Public services are inaccessible

Because she was disabled and poor, she couldn’t study… Generally in our country, girls are neglected. If they are disabled there is no end to their suffering.

The twin effects of discrimination and poverty mean older people and those with disabilities are frequently unable to access public services, in particular health care and education. Girls with disabilities find it particularly difficult to access education and when they do, they can face the additional problem of bullying and discrimination.


Bullying and violence are everyday experiences

Children used to tease and beat my granddaughter. She couldn’t concentrate on the classwork for long.

– Grandmother of 13-year-old Abida


The research study in Tanzania was conducted in two sites: the rural settings of Nachingwea and in Kibaha Urban Municipal Council. Twenty-nine peer researchers collected 106 stories from people with disabilities, older people and staff working in local NGOs on disability (physical, visual, hearing, intellectual, albinism and mental health) or ageing.

The peer researchers were asked to identify the main issues faced by persons with disabilities and older people in all stories, why they thought they happened and how they were connected. They analysed these stories in a workshop and identified eight emerging issues that particularly affect people with disabilities and older people in Tanzania. They are:

    • Access to education
    • Health services
    • NGO issues
    • Poverty, income and dependence
    • Witchcraft and albinism mistreatment
    • Family difficulties and marriage breakup
    • Sexual violence and gender issues
    • Poor treatment from family and taking advantage of people with disabilities

Analysis was also triangulated by Sightsavers researchers coding 36 interviews that examined all the experiences without assigning importance to them, asking the research question: How did participants experience ageing and disability?

The stories were of participants experiencing ageing, disability, or a combination of both, on an individual, interpersonal (the interaction with friends, family and community) and societal level.


The launch event for the Tanzania study will be held on 12 October 2016 – this page will be updated with photos and presentations from the event shortly afterwards.

Report documents


Hear my voice: old age and disability are not a curse. A community-based particpatory study gathering the lived experiences of persons with disabilities and older people in Tanzania
Available soon: Summary in Swahili
Available soon: Full report

Voices of the Marginalised: Innovative and participatory research for better and inclusive policymaking
January policy update (2016)

We can also make change: Piloting participatory research with persons with disabilities and older people in Bangladesh
Summary (2015)
Full report (2015)
Available soon: Bangladesh summary in Bengali (2015)
Briefing (2013)

Other publications featuring Voices of the Marginalised


Available soon: Hear my voice: a community-based participatory study gathering the lived experiences of people with disabilities and older people in Tanzania (from Knowledge for Disability Inclusive Development Journal)

Response to the Questionnaire of the Independent Expert on the enjoyment of all human rights by older persons on best practices in the implementation of existing law related to the promotion and protection of the rights of older persons (from OHCHR – scroll down to civil society responses)

Action research process with older people and people with disabilities in Bangladesh (from Knowledge from the Margins – An anthology from a global network on participatory practice and policy influence)

Old age, disability and mental health: data issues for a post-2015 framework (ODI background note)

Integrating older age, disability and mental health issues into household surveys: progress and outstanding gaps (ODI background note)

Voices of the Marginalised and Post-2015 Development Goals (written evidence submitted to the International Development Committee Inquiry on Post-2015 Development Goals)

Disability in the Post-2015 Framework (paper accepted under the ‘Addressing inequalities’ global thematic consultation)

Inequalities relating to health and the life course: disability, mental illness and older age (paper accepted under the ‘Addressing inequalities’ global thematic consultation)

Voices of the Marginalised: persons with disabilities, older people, people with mental health issues (paper accepted under the ‘Addressing inequalities’ global thematic consultation)




Sightsavers clip from Work With Us, produced by Real Time as part of Participate: Knowledge from the margins for post-2015




Steff, M. (March 2016). Innovation through empowerment: The Voices of the Marginalised project. UN Side-event; 54th Session of the Commission for Social Development (CSocD54).


Steff, M., Greenwood, M., Bakar, F., Mwifadhi M., & Bechange S. (February 2016). Hear my voice: Lived experiences of older people and people with disabilities in Tanzania (at 44 mn 59 s.). International Conference: Evidence in Global Disability and Health. International Centre for Evidence in Disability; London School of Hygiene & Tropical Medicine.

Steff, M. (April 2013). Inequalities and the voices of the marginalised study. At ODI during the following event: “How should inequality feature in a post-2015 agreement?


Sightsavers blogs


Violence against women with disabilities by Marion Steff and Margo Greenwood (22 March 2016)

Participatory research can help leave no one behind by Marion Steff (11 February 2016)

We can also make change by Fred Smith (12 November 2013)

Voices of the marginalised by Marion Steff (17 April 2013)



Other blogs


UNSDN: The Key to Agenda 2030? The Inclusion of People, All People! by Marion Steff (29 February 2016)

ADD International: Participatory research can help leave no one behind: an innovative approach by Polly Meeks and Marion Steff (9 February 2016)

HelpAge International: Voices of the marginalised: Older people and people with disabilities heard by policymakers by Shegufta Sharmin (17 August 2015)

UNSDN: Speaking for ourselves: how innovative research is breaking barriers by Marion Steff (22 June 2015)

HelpAge International: Voices of the marginalised in Bangladesh by Barbara Dockalova (9 April 2013)

HelpAge International:  Post-2015: Capturing the voices of the marginalised by Anders Hylander (21 August 2012)



Work with us (September 2013): Voices of the Marginalised consortium was part of the Participate Initiative which organised an exhibition of research findings. The event focused on the experiences of marginalised people and those living in greatest poverty, and their visions for change. The exhibition was displayed on the streets of New York and at the United Nations headquarters, UNICEF and The NYU Gallantin School of Individualised Study.

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