Abstract
BackgroundComprehensive data is key for evidence-informed policy aiming to improve the lives of persons experiencing different levels of disability. The objective of this paper was to identify the environmental barriers — including physical, social, attitudinal, and political barriers — that might become priorities for cross-cutting policies and policies tailored to the needs of persons experiencing severe disability in Cameroon.MethodsA secondary analysis of data obtained with the WHO Model Disability Survey was completed in the Bankim Health District (N = 559) using random forest regression to determine and compare the impact of the environmental factors on the experience of disability.ResultsThe physical environment had by far the highest influence on disability, with transportation, toilet of the dwelling, and the dwelling itself being the most important factors. Factors inside one’s own home (toilet of the dwelling, and the dwelling itself) were the most important for persons with moderate and severe disability, followed by attitudes of others and issues with accessing health care.ConclusionOur study provides country policy makers with evidence for setting priorities and for the development of evidence-informed policies for the Bankim Health District in Cameroon.
Highlights
Comprehensive data is key for evidence-informed policy aiming to improve the lives of persons experiencing different levels of disability
World Health Organization (WHO) currently supports the collection of disability data through the WHO and World Bank model disability survey (MDS) The MDS is grounded in the International Classification of Functioning, Disability, and Health (ICF) [3], and operationalizes disability as a universal experience that lies on a continuum ranging from no to extreme disability [4]
By providing a ranking of the most hindering barriers experienced by persons with mild, moderate, or severe disability, we provide stakeholders with the evidence needed for prioritization of policies and public health investments in light of limited resources
Summary
Comprehensive data is key for evidence-informed policy aiming to improve the lives of persons experiencing different levels of disability. The objective of this paper was to identify the environmental barriers — including physical, social, attitudinal, and political barriers — that might become priorities for cross-cutting policies and policies tailored to the needs of persons experiencing severe disability in Cameroon. The United Nations’ 2030 agenda for sustainable development includes disability as a central priority in five of the 17 sustainable development goals (SDGs) In the spirit of “leaving no one behind” [1], the SDGs recognize persons with disability in the areas related to education, economic growth, reducing inequality, sustainability of cities and communities, and availability of data. Comprehensive disability data can meaningfully contribute to the effective development of targeted disability policy by defining priorities at the micro-, meso- and macro-level. The ICF describes the environmental context as a determinant (together with health conditions) of disability. Environmental factors are extrinsic to the individual and include, but are not limited to: the natural and human-made changes to the environment (rural versus urban settings); the climate (for instance, very dry or mountain regions), the social context (for instance, having or not having family support or support of friends); the attitudinal context (for instance being treated with respect by neighbours or health professionals or not); the health system (for instance having access to health services or whether health services are at all available)
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