measuring childrens disability via household surveys: the mics experience edilberto loaiza and...
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MEASURING CHILDREN’S DISABILITY VIA HOUSEHOLD SURVEYS: THE MICS EXPERIENCE
Edilberto Loaiza and Claudia Cappa
UNICEF, New York
OBJECTIVES
• Present and discuss the data collection experience on disability via the Multiple Indicators Cluster Survey (MICS) approach
• Present and discuss the main results in terms of:
– Prevalence of disability by type
– Characteristics of disabled children
• Present and discuss results on the relationship between disability and child development
DATA AND METHODS
• Data use is part of the MICS2: 1999-2001
• This round included a module for child disability
• For children 2-9 years of age
• The module was included in 22 of the 65 MICS2
• The module measures impairments, health conditions and activity limitations via ten basic questions.
What is MICS?
• Methodology developed by UNICEF to produce data needed to report on agreed indicators to measure progress toward the World Summit for Children goals agreed by governments in 1990
• Lately MICS is instrumental to monitor the MDGs, WFfC, and other major international commitments
• Capable of producing internationally comparable estimates of indicators
• Statistically sound
• Flexible — to suit country requirements (modules)
• Core questionnaires + additional situation-specific modules, and optional modules
• Reasonably inexpensive
• Can be executed in a relatively short time
• Collaboration with DHS survey programme
THE DISABILITY MODULE
• Two stage questionnaire– The ten questions module
– Medical and psychological assessment (this stage was not implemented)
• Included in 22 countries – 8 countries used modified questions
– Only 7 used the whole set of 10 questions to children 2-9 years old.
THE TEN QUESTIONS
• Movement
• Vision
• Hearing
• Understanding
• Movement
• Crisis/Fits
• Learning
• Speaking
• Mental
• Speech (for 3-9 years old)
• Naming one object (for 2 years old)
DESCRIPTIVE RESULTS
• The screening result is positive if one or more of the responses classified the child as impaired
• The last two questions were excluded from the analysis due to problems in their implementation and illogical results
• Disability prevalence ranges from 44% in Sao Tome and Principe to 4% on North Iraq.
• All plausible results
• Not for comparison across countries
Percentage of children (2-9 years old) with disablities by type of impairment. Sao Tome & Principe, MICS 2000
3 3
5
78
1011
1415
0
5
10
15
Vision Mental Movement Hearing Learning Understanding Development Crisis/Fits Speaking
Type of disability: 4 of the 9 disabilities 10% or more for a total of 44% of the children
Disability by age of the child: no clear pattern but among 2 years old greater impairment if total is greater than 20%
Percentage of children 2-9 with disabilitity by age and type. Madagascar, MICS 2000.
0
2
4
6
8
10
2 to 4 5 to 7 8 to 9
Vision Hearing Understanding Speaking
Disability by gender of the child: boys appear to have greater levels of impairment than girls
Proportion of children (2-9 years old) with disability by gender MICS 1999-2001
0
10
20
30
40
50
Sao Tome &Prince
Lesotho Madagascar Cameroon Suriname Jamaica Iraq
%
Boys
Girls
Disability by place of residence: Urban/Rural
Proportion of children (2-9 years old) with disability according to place or redidence. MICS 1999-2001
05
101520253035404550
Sao Tome &Prince
Lesotho Madagascar Cameroon Suriname Jamaica Iraq
%
Urban
Rural
Disability by place of residence: Region
Proportion of children (2-9 years old) with disability according to region of residence. Madgascar, MICS 2000
0 10 20 30 40 50
Antananarivo
Antsiranana
Toliary
Fianarantsoa
Mahajanga
Toamasina
Disability by place of residence: Region
Proportion of children (2-9 years old) with disability according to region of residence. Jamaica, MICS 2000
0 5 10 15 20
HanoverSt. Elisabeth
WestmorelandSt. Mary
St.CatherineKingston
TrelawnySt. ThomasClarendon
ManchesterSt. Andrew
St. JamesPortland
St. Ann
Disability by mothers education: more than one pattern. Further analysis required
Proportion of children (5-9 years old) disable according to mother's education. MICS 2000
0
10
20
30
40
Cameroon Lesotho Suriname
%
None Primary Secondary
Disability by household wealth: using the wealth index, different patterns are also observed
Proportion of children (2-9 years old) with disability according to household wealth, MICS 1999-2001
0
10
20
30
40
50
Sao Tome &Prince
Lesotho Madagascar Cameroon Suriname
%
Poorest 20% Second Third Fourth Richest 20%
Disability and child development: birth registration among children 2-4
Proportion of children 2-4 registered by disability status. MICS 2000-01
0102030405060708090
Cameroon Lesotho Madagascar Sao Tome &Principe
%
Yes
No
Disability and child development: vaccination and malnutrition levels among children 2-4 years of age
Proportion of children 2-4 with all vaccinatrions or stunted by disability status. Sao Tome and Principe MICS 2000
52
14
62
11
0
10
20
30
40
50
60
70
All vaccinations Stunting
%
Yes No
Disability and child development: participation in early education programs by 3-4 years old
Proportion of children 3-4 attending an early education programme by disability status. MICS 2000-01
0
5
10
15
20
25
Cameroon Lesotho Madagascar Sao Tome &Principe
%
Yes No
Disability and child development: school attendance among children 6-9 years of age
Proportion of children 6-9 years attending school by disability status. MICS 2000-01
Disability status
COUNTRY Yes No
Cameroon 75 72
Iraq* 52 70
Lesotho 84 82
Madagascar 58 56
Sao Tome & Principe 69 69
Suriname 90 92 * Three governorates only: Dohouk, Suleimaniya and Erbil.
Disability and child development in Iraq: school attendance among children 6-9 years of age
Proportion of children attending school by disability status and type of disability. North Iraq, MICS 2000
0
10
20
30
40
50
60
70
Vision Movement Crisis/fits Mental Hearing Understanding Learning Speak
%
Yes No
SUMMARY AND CONCLUSIONS
• Wide variation in total disability prevalence and in the prevalence by type of disability→ analysis of the differences between countries not possible
• Disability rates constant across ages, but the type of disability changes with age
• Higher levels of disability for boys but risk of sampling errors
• Important disparities by region
SUMMARY AND CONCLUSIONS
• No conclusive results on the relationship between mother’s education/household wealth and the presence of disability
• Children with disability disadvantaged in terms of access to vaccinations and nutritional status, but not in school participation
• Need for further and more detailed analysis and research