Dataset Information

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.

ABSTRACT: Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case-control study of adults (18+) with and without disabilities in North-West Cameroon and in Telangana State, India. We found that adults with disabilities were five times less likely to be working compared to age-sex matched controls in both settings. Amongst adults with disabilities, current age, marital status and disability type were key predictors of working. Inclusive programmes are therefore needed to provide adequate opportunities to participate in livelihood prospects for adults with disabilities in Cameroon and India, on an equal basis as others. These findings are of crucial importance at this stage of the Sustainable Development Agenda, to ensure that the mandate of inclusive development is achieved.

SUBMITTER: Mactaggart I

PROVIDER: S-EPMC5890974 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.

Mactaggart Islay I Banks Lena Morgon LM Kuper Hannah H Murthy G V S GVS Sagar Jayanthi J Oye Joseph J Polack Sarah S

PloS one 20180409 4

Proven links between disability and poverty suggest that development programmes and policies that are not disability-inclusive will leave persons with disabilities behind. Despite this, there is limited quantitative evidence on livelihood opportunities amongst adults with disabilities in Low and Middle Income Countries. This study adds to the limited evidence base, contributing data from one African and one Asian Setting. We undertook a population-based case-control study of adults (18+) with an ...[more]

PMID: 29630606

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Project description:Although the association between disability and multidimensional poverty has been consistently found in several studies in Low- and Middle-Income Countries. None of these studies so far has used an extended and internationally comparable questionnaire (extended Washington Group Questionnaire) and a clinical screening of disability. The purpose of this article is to calculate, compare and analyse the levels of multidimensional poverty of people with and without disabilities in Guatemala (national), in one district of Cameroon (Fundong Health District, North West Cameroon) and in one district in India (Mahbubnagar District, Telangana State). We used a case-control study approach; adults with disabilities identified in a population-based disability survey using the Washington Group Extended Questionnaire were matched to age-sex matched controls without disabilities and interviewed about their levels of access and use of different social services. Following the Alkire-Foster method, the levels of multidimensional poverty between cases and control were computed and compared. Additionally, we analysed how disability and other individual characteristics are associated with being poor in each country. The results showed that people with disabilities in all three-study settings face significantly higher levels of poverty and the intensity of their poverty is higher. In the case of Cameroon, differences in the levels of deprivation between people with and without disabilities were smaller than those observed in India and Guatemala. This might suggest that in countries with higher levels of human, economic and social development people with disabilities are being left behind by public policies aiming to reduce poverty and deprivation in basic indicators. In addition, indicators related to health contributed the most to the levels of multidimensional poverty for people with disabilities. These findings provide important evidence about the association of multidimensional poverty and disability and underline the importance of including indicators capturing individual deprivations to analyse poverty for this group.

Project description:BackgroundPersons with speech, language, and/or voice disabilities (collectively referred to as communication disabilities (CD)) represent 10% of the US population, yet their healthcare outcomes have not been described. Generally, research shows that persons with disabilities have poorer health and healthcare outcomes than their non-disabled peers.ObjectivesTo examine the health and healthcare outcomes of persons with CD compared to persons without CD.DesignRetrospective cohort study of the 2012 National Health Interview Survey, which contained the first supplemental questions on CD. We compared proportional differences in outcomes; logistic and ordered logistic regression assessed the outcome measures across CD categories, controlling for demographics, non-communication disabilities, and chronic conditions. Findings are weighted to permit national inferences.ParticipantsAdults (≥ 18 years old) were divided into 4 mutually exclusive groups: people with voice disabilities only; speech/language disabilities only; speech/language and voice disabilities; and people without CD.Main measuresChronic health conditions; self-rated health; access to care; unmet needs for care; healthcare utilization.Key resultsAdults with CD more frequently had ≥ 1 chronic condition (voice 67.9%, speech/language 68.6%, speech/language and voice 79.9%, no CD 50.1%, p < 0.001) and reported fair/poor health (voice 19.5%, speech/language 32.5%, speech/language and voice 48.3%, no CD 11.2%, p < 0.001) compared to those without CD. Adults with CD more frequently utilized healthcare compared to those without CD. However, persons with CD endorsed greater difficulties accessing care than those without CD, including identifying a usual source of care, trouble finding a physician, and delaying or foregoing care (e.g., delayed due to availability of care: voice 26.1%, speech/language 37.2%, speech/language and voice 30.8% no CD 16.1%, p < 0.001).ConclusionsPersons with CD are medically complex and experience greater challenges accessing healthcare than persons without CD. Healthcare providers need support and tools to provide equitable care that addresses the medical needs of persons with CD.

Project description:ObjectivesTo assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level.DesignCross-sectional surveys.SettingData were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-2), and one each in Cameroon, Malawi and India.Participants99 252 participants were sampled across the datasets (range: 3567-75 767), including 2494 with disabilities (93-1374).OutcomePrevalence of access to WASH at household and individual level.Data analysisAge/sex disaggregated disability prevalence estimates were calculated accounting for survey design. The Unicef/WHO Joint Monitoring Programme definitions were used to classify facilities as improved/unimproved. Multivariable logistic regression was undertaken to compare between households with/without a person with a disability, and to identify predictors of access among people with disabilities.ResultsThere were no differences in access to improved sanitation or water sources between households with/without members with disabilities across the datasets. In Bangladesh-2, households including a person with a disability were more likely to share facilities with other households (OR 1.3, 95% CI 1.1 to 1.5). Households with people with disabilities were more likely to spend >30 min (round-trip) collecting drinking water than households without in both Cameroon (OR 1.8, 95% CI 1.0 to 3.4) and India (OR 2.3, 95% CI 1.2 to 4.7). Within households, people with disabilities reported difficulties collecting water themselves (23%-80% unable to) and accessing the same sanitation facilities as other household members, particularly without coming into contact with faeces (up to 47% in Bangladesh-2). These difficulties were most marked for people with more severe impairments.ConclusionsPeople with disabilities may not have poorer access to WASH at the household level, but may have poorer quality of access within their households. Further programmatic work is needed to ensure WASH facilities are inclusive of people with disabilities.

Project description:Sickle Cell Disease (SCD) is a serious genetic disorder with astounding regional differences in childhood survival. Alarmingly, over 90% of children with SCD in SSA die before their fifth birthday. In Cameroon, approximately 7,000 children are born with SCD annually; however, most of them go undiagnosed until their fourth birthday, resulting into untold pain and suffering. Despite this, little is known about the barriers to optimal care and treatment for SCD in Cameroon. Here, we assess these barriers, and consider opportunities that could be leveraged, for a sustainable control of SCD in Cameroon. We conducted a qualitative study, with documentary analysis of key national and international policy documents related to SCD management in Cameroon; semi-structured interviews; and focus group discussions, used for data collection. Key informants were selected purposively, and met at the central level of the health system (in Yaoundé) and the operational level (Mfou health district). These were policy makers, health workers, parents with SCD children and teenagers with SCD. Several critical gaps exist which hinder SCD control in Cameroon. These include lack of a national sickle cell disease strategy, no proportional allocation of funds for SCD in the national budget, and gaps in service delivery. These are translated into healthcare providers having little knowledge on SCD, absence of SCD-specific indicators in the health information system, challenges accessing essential medicines, and limited awareness raising in communities on SCD. Still, several opportunities exist which could be leveraged for improving SCD care in Cameroon. These include the possibility of integrating SCD screening and care into well-established primary healthcare services like vaccination, antenatal care, and non-communicable disease clinics. In the light of such limited resource settings, considering opportunities for integration in existing health programs could go a long way to reduce morbidities and mortalities from SCD over the coming years.

Dataset Information

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.

Publications

Livelihood opportunities amongst adults with and without disabilities in Cameroon and India: A case control study.

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