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Disability is a development issue, with widespread poverty, inequality and violation of human rights. Recent estimates suggest that more than one billion people are living with some form of disability. Persons with disabilities are over-represented among the world's poor, and significant labour market disadvantage helps maintain the link between poverty and disability in many country contexts. The costs of disability are particularly acute in low- and middle-income countries (those with gross national income per capita of less than $12,616), where up to 80 per cent of people with disabilities of working age can be unemployed, around twice that for their counterparts in high-income countries. When people with disabilities do work, they generally do so for longer hours and lower incomes, have fewer chances of promotion, are more likely to work in the informal labour market, and are at greater risk of becoming unemployed for longer periods. The barriers faced by people with disabilities globally in accessing and sustaining paid work is a profound social challenge. There is now growing recognition of employment as a key factor in the process of empowerment and inclusion into society, and the role of interventions to improve labour market outcomes for disabled people is receiving increased international attention. It is therefore both vital and timely to increase understanding of the impacts of available programmes, in order to ensure that they are effective in delivering positive outcomes for people with disabilities and provide value for money.

A key finding of this review is the overall scarcity of robust evidence, as indicated by the relatively few studies that met the inclusion criteria. Although the evidence in general showed positive results, [the authors] need to be wary of drawing strong inferences from the findings of this body of literature. Not only is the number of impact evaluations limited, but most used designs in which conclusively attributing causality is not possible. [The] assessment of the evidence does not allow [the authors] to develop practical suggestions on what interventions are likely to work, for whom, and when. Clearly, there is an urgent need for investment in high quality impact evaluations of interventions to support people with disabilities in accessing the labour market in low- and middle-income settings. To build the evidence base further, it is therefore important that many more of the interventions currently in existence in low- and middle-income countries are rigorously evaluated, and the results are reported and disseminated widely. The methodological inconsistencies and weaknesses of the current evidence base, and specific knowledge gaps, suggest a number of future research priorities.

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