Abstract
BackgroundThere is increasing interest in the collection of globally comparable disability data. Context may influence not only the rates but also the nature of disability, thus locally collected data may be of greater use in service delivery planning than national surveys.ObjectivesThe objective of this article was to explore the extent to which two areas, both under-resourced but geographically and socially distinct, differed in terms of the prevalence and patterns of disability.MethodA cross-sectional descriptive survey design was utilised, using stratified cluster sampling in two under-resourced communities in the Western Cape, South Africa. Nyanga is an informal urban settlement in Cape Town and Oudtshoorn is a semi-rural town. The Washington Group Short Set of questions was used to identify persons with disabilities (PWD), and a self-developed questionnaire obtained socio-demographic information.ResultsThe overall prevalence of disability was 9.7% (confidence intervals [CIs] 9.7–9.8) and the proportion of PWD was significantly different between the two sites (Chi-Sq = 129.5, p < 0.001). In the urban area, the prevalence rate of any disability was 13.1% (CIs 12.0–14.3) with 0.3% (CIs 0.1–0.6) reporting inability to perform any function at all. In contrast, the semi-rural community had a lower overall prevalence rate of 6.8% (CIs 6.0% – 7.8%) but a higher rate of those unable to perform any function: 1% (CIs 0.07–1.4). Disability was associated with gender, age, unemployment and lower income status in both areas.ConclusionDeprived areas tend to show higher disability prevalence rates than the National Census estimates. However, the discrepancy in prevalence and patterns of disability between the two under-resourced areas indicates the need for locally specific data when planning health interventions.
Highlights
According to the World Report on Disability, data on disability should be collected to estimate the prevalence of disability, plan appropriate services and to monitor equalisation of opportunities for people with disabilities (World Health Organization & World Bank 2011), among other reasons
Great emphasis has been placed on obtaining comparable data (Madans et al 2004; Mont 2007a; World Health Organization 2001); the results of this study show that the simple reporting of only the prevalence of disability fails to capture the differences between communities
This study has demonstrated that small-scale surveys can provide more nuanced data on disability than National Census data
Summary
According to the World Report on Disability, data on disability should be collected to estimate the prevalence of disability, plan appropriate services and to monitor equalisation of opportunities for people with disabilities (World Health Organization & World Bank 2011), among other reasons. Acknowledging the poor access to rehabilitation services by people with disabilities in South Africa (Maart & Jelsma 2013), the Department of Health (DoH) in the Western Cape commissioned two surveys of disability to inform the planning of appropriate services in the province. The introduction of the ICF and its conceptualisation of disability led to the realisation that prevalence would be greatly influenced by contextual differences across population. Context may influence the rates and the nature of disability, locally collected data may be of greater use in service delivery planning than national surveys
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