Child disabilities Multiple Indicator Cluster Surveys- MICS3 Analysis and Report Writing Workshop Panama City, July 12-20, 2006.

Child disabilities

Multiple Indicator Cluster Surveys- MICS3Analysis and Report Writing Workshop

Panama City, July 12-20, 2006

Indicators

Percentage of children 2-9 years of age with at least one of the reported disabilities

Goals World Fit for Children (WFFC)Protecting children against abuse, exploitation and violence and under general protection to• Adopt special measures to eliminate discrimination against children on the basis of race, color, sex, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status and ensure their equal access to education, health and basic social servicesMillennium Development Goals (MDGs)The MD declaration calls for the protection of children against abuse, exploitation and violence but no goal, target or indicator is included

Why to measure children’s disabilities?

Reasons:

• Identify the magnitude of the problem as well as its characteristics• Evaluate impact of programs and interventions based on trends

Child disabilities Numerator: Percentage of children 2-9 years of age with at least

one of the reported impairments: (1) delay in sitting, standing or walking,

(2) difficulty seeing, either in the daytime or at night,

(3) appears to have difficulty hearing,

(4) difficulty in understanding instructions,

(5) difficulty walking or moving arms or has weakness or stiffness of limbs,

(6) has fits, becomes rigid, loses consciousness,

(7) does not learn to do things like other children his/her age,

(8) cannot speak or cannot be understood in words,

(9) appears mentally backward, dull or slow.

Denominator:

Total number of children 2-9 years of age surveyed

Data sources/methods

• Administrative records• Population census• Household surveys

DISABILITY DA To be administered to caretakers of all children 2 through 9 years old living in the household. For household members below age 2 or above age 9, leave rows blank I WOULD LIKE TO ASK YOU IF ANY CHILDREN IN THIS HOUSEHOLD AGED 2 THROUGH 9 HAS ANY OF THE HEALTH CONDITIONS I AM GOING TO MENTION TO YOU.

DA1. Line no.

DA2. Child’s name

DA3. COMPARED

WITH OTHER

CHILDREN, DOES OR DID

(name) HAVE

ANY SERIOUS

DELAY IN

SITTING, STANDING, OR

WALKING?

DA4. COMPARED

WITH OTHER

CHILDREN, DOES (name)

HAVE

DIFFICULTY

SEEING, EITHER IN THE

DAYTIME OR

AT NIGHT?

DA5. DOES

(name)

APPEAR TO

HAVE

DIFFICULTY

HEARING?

(USES

HEARING AID, HEARS WITH

DIFFICULTY , COMPLETELY

DEAF?)

DA6. WHEN YOU

TELL (name)

TO DO

SOMETHING, DOES HE/SHE

SEEM TO

UNDERSTAND

WHAT YOU

ARE SAYING?

DA7. DOES (name)

HAVE

DIFFICULTY IN

WALKING OR

MOVING

HIS/HER ARMS

OR DOES

HE/SHE HAVE

WEAKNESS

AND/OR

STIFFNESS IN

THE ARMS OR

LEGS?

DA8. DOES

(name)

SOMETI MES

HAVE FITS, BECOME

RIGID, OR

LOSE

CONSC-IOUSNESS?

DA9. DOES

(name)

LEARN TO

DO THINGS

LIKE

OTHER

CHILDREN

HIS/HER

AGE?

DA10. DOES (name)

SPEAK AT ALL

(CAN HE/SHE

MAKE HIM OR

HERSELF

UNDERSTOOD

IN WORDS; CAN SAY ANY

RECOGNIZABLE

WORDS)?

DA11. (For 3-9 year olds): IS (name)’S

SPEECH IN

ANY WAY

DIFFERENT

FROM NORMAL

(NOT CLEAR

ENOUGH TO

BE

UNDERSTOOD

BY PEOPLE

OTHER THAN

THE

IMMEDIATE

FAMILY)?

DA12. (For 2-year-olds): CAN (name) NAME AT

LEAST ONE

OBJECT

(FOR

EXAMPLE, AN ANIMAL, A TOY , A

CUP, A SPOON)?

DA13. COMPARED

WITH OTHER

CHILDREN

OF THE

SAME AGE, DOES

(name)

APPEAR IN

ANY WAY

MENTALLY

BACKWARD, DULL OR

SLOW?

LINE NAME Y N Y N Y N Y N Y N Y N Y N Y N Y N Y N Y N

01 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2

02 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2

03 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2

04 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2

Which countries included this module in MICS3?

• 6 out of 7• Belize, Jamaica, and Suriname • Cuba, Dominican Republic, Guyana, and Trinidad and Tobago did not• Mongolia?

SPSS Program

• Generates basic table: CP.10• Generates

– the percentage of children 2-9 years of age with at least one disability

– The percentage of disable children by type of impairment

Table CP.10: Child disability

3-9 years 2 years

Delay in sitting,

standing or walking

Difficulty seeing,

either in the daytime or at

night

Appears to have

difficulty hearing

No under-standing of instr-uctions

Difficulty in walking, moving

arms, weak-ness or stiffness

Have fits, become

rigid, lose concious-

ness

Not learning to do things

like other children

his/her age

No speak-ing cannot be

under-stood in words

Appears mentally

back-ward, dull, or slow

Speech is not normal

Cannot name at least one

object

Region

Region 1

Region 2

Region 3

Residence

Urban

Rural

Age of child

2-4 1 2

5-6 na

7-9 na

Mother's education

None

Primary

Secondary +

Wealth Index Quintiles

Poorest

Second

Middle

Fourth

Richest

Ethnicity/Language/Religion

Group 1

Group 2

Group 3

Total

Percentage of children 2-9 years of age with disability reported by their mother or caretaker according to the type of disability, Country, Year

Number of children 2-9 years of age

Percent-age of children 2-

9 years of age with at least one reported disability

Percentage of children 2-9 years of age with reported disability by type of disability

Methodological issues

• Screens for children identified as experiencing disability/impairment

• Based on WHO International Classification of Functioning, Disability and Health, 2001

• Adapt to country conditions and language

Methodological issues

• In WHO framework, child’s functioning is an interaction/relationship between health condition and contextual factors

• The MICS3 measurement of disability looks specifically at activity limitations and participation restrictions

• Need to compare with contextual factors (age, gender, ethnicity, health, school attendance, etc.)

• Analysis should explore associations between existing impairments in participating in children’s activities and contextual factors.

Methodological issues

• Module was implemented in 25 countries in MICS2 with little analysis

• Recommendation was to follow screening with a physical examination of children to identify false positives and false negatives

• We agreed that when including the module, interviewers must be properly trained, data must be cleaned, appropriate tabulations produced, and there must be adequate analysis and presentation of results.

Thanks!