Lessons from Disability Counting in Ecuador, with a Contribution from Primary Health Care.

Debrouwere Inge,Rosero Arboleda Celia Katherine,Álvarez Vera Pedro Celestino,Prinzie Peter,Pavón Benítez Ximena Del Carmen,Lebeer Jo

doi:10.3390/ijerph18105103

Abstract

Disability data are essential for policy. Yet, the predominant use of disability prevalence for service planning reflects dichotomous counting, increasingly less compatible with current disability thinking. Difficulties relate to variations in rates, the lack of matching with needs, and the use of prevalence to compare disability situations. From the perspective of Primary Health Care (PHC), we explore methods for disability counting regarding the usefulness of prevalences in identifying persons with disabilities and meeting their needs with local service implementation. First, we analyze the methods and results of six national cross-sectional studies in Ecuador. Then, we present a case about an exploratory needs-driven method for disability counting in a local PHC setting. The analysis of variations in rates focuses the attention on reasons for and risks of a priori exclusion of persons with disabilities from services. Longitudinal disability counting as a collateral result of meeting needs in the PHC setting yields local disability data worthy of further exploration. Thinking about disability counting from a PHC scope in a developing country prompted reflection on the comparison of prevalences to evaluate disability situations. Findings invite further exploration of the needs-driven counting method, its contributions to planning local services, and complementarity with cross-sectional disability counting.

Highlights

Introduction published maps and institutional affilCountries that ratify the Convention on the Rights of Persons with Disabilities will “undertake to collect appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the present Convention” [1]
The specific objectives of this paper are to (1) summarize results of Ecuadorian national surveys on disability and to reflect on the usefulness of the widely varying disability prevalences, and (2) present a longitudinal communitybased method for identifying needs of persons with disabilities that mainly relies on self-perception, and to explore if and how this method can be complementary to national cross-sectional identification methods for local disability-related service implementation
The findings of this analysis set the scene for the second part, in which we present a case report on exploratory longitudinal disability counting in a local Primary Health Care (PHC) setting in Ecuador, promoting better information systems for local disability data collection for local disability policies and service implementation

Summary

Introduction

Countries that ratify the Convention on the Rights of Persons with Disabilities will “undertake to collect appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the present Convention” [1]. Three arguments underscore the importance of disability statistics. Data are used to visualize the impact of disability as “counting disability is a political arithmetic, used to galvanize awareness of the relationship between society and disablement” [2]. Disability measurement assists in formulating disability policies and implementing programs for service provision. Comparisons of data are used to monitor the level of functioning in the population, evaluate the results of policy implementation, and assess the equalization of opportunities [3]. Comparisons of data are used to monitor the level of functioning in the population, evaluate the results of policy implementation, and assess the equalization of opportunities [3]. iations.

Objectives

Methods

Results

Discussion

Conclusion