Abstract
BackgroundApproximately 80% of individuals with disability reside in low- and middle-income countries where community-based rehabilitation (CBR) has been used as a strategy to improve disability. However, data relating to disability severity among CBR beneficiaries in low-income countries like Uganda remain scarce, particularly at the community or district level. ObjectivesTo describe severity of disability and associated factors for persons with physical disabilities receiving CBR services in the Kayunga district of Uganda. MethodsA cross-sectional sample of 293 adults with physical disabilities receiving a CBR service in the Kayunga district was recruited. Disability severity was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS2.0), and analyzed as a binary outcome (low: 0-9, high: 10-48). Inferential statistics using odds ratios were used to determine factors associated with impairment severity. FindingsThe mean WHODAS 2.0 score of persons with physical disabilities was 12.7 (standard deviation = 8.3). More than half (52.90%) of people with physical disabilities reported a high level of functional impairment. Increased disability severity was significantly associated with limited access to assistive devices (adjusted odds ratio [AOR] = 4.55, 95% confidence interval [CI]: 1.87-14.08, P < .001), and increased use of medical health care (AOR = 5.55, 95% CI: 1.84-16.79, P = .002). ConclusionThese findings suggest a high level of moderate to severe functional impairments in persons with physical disabilities receiving CBR in Kayunga district. These data provide support for efforts to enhance CBR's ability to liaise with local health care, education, and community resources to promote access to needed services and ultimately improve the functional status of persons with disabilities in low-resource settings.
Highlights
Approximately 15% of the world’s population lives with some form of disability, with an estimated 1 billion people experiencing disability mostly in developing countries.[1]
The study population consisted of Kayunga district residents with mobility, visual, and hearing impairments who were participating in community-based rehabilitation (CBR) services delivered through the different community-based organizations (CBOs) in the district
Factors found to be independently associated with an increased likelihood of reporting more severe disability after controlling for confounders were: spending 8-15 years in school (OR = 2.51, 95% confidence interval (CI): 1.09-5.75, P = .030) compared with those who spent 0-7 years in school, lack of access to assistive devices (OR = 4.55, 95% CI: 1.87-14.08, P = .000) compared with those with access, and using conventional medical health care (OR = 5.55, 95% CI: 1.84-16.79, P = .002) compared with those who opted for traditional healers
Summary
Approximately 15% of the world’s population lives with some form of disability, with an estimated 1 billion people experiencing disability mostly in developing countries.[1] In Uganda, persons with disabilities account for 19% of the population.[2] Physical impairments represent one of the primary sources of disability in Uganda overall. In Kayunga district, physical disabilities account for 25% of all disabilities.[3]. 80% of individuals with disability reside in low- and middle-income countries where community-based rehabilitation (CBR) has been used as a strategy to improve disability. Data relating to disability severity among CBR beneficiaries in low-income countries like Uganda remain scarce, at the community or district level
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