A realist evaluation of the formation of groups of people with disabilities in northern India


  • Rebekah Young The Nossal Institute for Global Health, The University of Melbourne http://orcid.org/0000-0002-5777-9751
  • Matthew Reeve The Nossal Institute for Global Health, Melbourne, Australia.
  • Alex Devine The Nossal Institute for Global Health, Melbourne, Australia.
  • Lawrence Singh Agnes Kunze Society, Dehra dun, India.
  • Nathan Grills The Nossal Institute for Global Health, Melbourne, Australia.




Disabled Peoples’ Organisation (DPO), Disabled Peoples’ Group (DPG), low- and middle-income country (LMIC), realist impact evaluation.


Background: Disabled Peoples’ Organisations (DPOs) are organisations established by and for people with disabilities. Formation of DPOs in low- and middle-income countries is a key component of disability-inclusive development strategies. In some contexts, organisations involved in disability-inclusive development work in partnership with people with disabilities to bring together groups of people with disabilities (DPGs) that may go on to become DPOs.  While there is evidence that such groups can achieve beneficial outcomes for people with disabilities, they seem to form and function differently in different settings and little is understood about why this is the case. This study aimed to explore how and why different factors affect the development and operation of DPGs by investigating the contextual factors and mechanisms that enabled and hindered the formation and functioning of DPGs in north India.

Methods: This study adopted a realist approach to evaluation. Preliminary context-mechanism-outcome configurations were developed, tested empirically and refined by undertaking five case studies in Uttarakhand state, India.

Results: Results from this study were grouped under the broad, emergent themes of factors related to: 1) external supports; 2) community and physical environment; and 3) group composition. It was found that external entities could support the development of DPGs by advocating for the rights of people with disabilities and providing information, knowledge and funding to groups. Support from local village leadership was central to facilitating group formation and functioning, but the benefit of this support was amplified when DPGs formed strong networks with other, similar groups. DPGs displayed a capacity for stimulating positive societal changes in regard to disability through influencing societal understandings of disability and improving inclusion and participation of people with disabilities.

Conclusion: While the results of this study are specific to the context in which it was undertaken, many findings were consistent with those in the literature, suggesting that there may be common principles which can be applied to other contexts. By providing insight into the contextual factors that affected DPG formation and function, the findings of this study may assist those involved in DPG formation to adapt models and methods to better suit specific contexts.

Author Biographies

Rebekah Young, The Nossal Institute for Global Health, The University of Melbourne

Rebekah is a final year medical student studying at the University of Melbourne. She has an interest in global health and is undertaking a research placement with the Nossal Institute for Global Health.

Matthew Reeve, The Nossal Institute for Global Health, Melbourne, Australia.

Dr Matthew Reeve is a Senior Project Officer at the Nossal Institute for Global Health.

Alex Devine, The Nossal Institute for Global Health, Melbourne, Australia.

Alex Devine is a Senior Research Officer at the Nossal Institute for Global Health. 

Lawrence Singh, Agnes Kunze Society, Dehra dun, India.

Mr Lawrence Singh is a Project coordinator with Agnes Kunze Society ‘HOPE Project, Dehra dun working in partnership and networking with various national and international organisations to improve basic access to health and social services at the grass root level in the community.

Nathan Grills, The Nossal Institute for Global Health, Melbourne, Australia.

Dr Nathan Grills is a Public Health Physician and holds positions with the University of Melbourne, the Nossal Institute for Global Health, the Public Health Foundation of India, Emmanuel Health Association and Community Health Global Network. 


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How to Cite

Young, R., Reeve, M., Devine, A., Singh, L., & Grills, N. (2016). A realist evaluation of the formation of groups of people with disabilities in northern India. Christian Journal for Global Health, 3(2), 72–90. https://doi.org/10.15566/cjgh.v3i2.145

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