MEASURING CHILDREN’S DISABILITY VIA HOUSEHOLD SURVEYS: THE MICS EXPERIENCE

Edilberto Loaiza and Claudia Cappa

UNICEF, New York

OBJECTIVES

• Present and discuss the data collection experience on disability via the Multiple Indicators Cluster Survey (MICS) approach

• Present and discuss the main results in terms of:

– Prevalence of disability by type

– Characteristics of disabled children

• Present and discuss results on the relationship between disability and child development

DATA AND METHODS

• Data use is part of the MICS2: 1999-2001

• This round included a module for child disability

• For children 2-9 years of age

• The module was included in 22 of the 65 MICS2

• The module measures impairments, health conditions and activity limitations via ten basic questions.

What is MICS?

• Methodology developed by UNICEF to produce data needed to report on agreed indicators to measure progress toward the World Summit for Children goals agreed by governments in 1990

• Lately MICS is instrumental to monitor the MDGs, WFfC, and other major international commitments

• Capable of producing internationally comparable estimates of indicators

• Statistically sound

• Flexible — to suit country requirements (modules)

• Core questionnaires + additional situation-specific modules, and optional modules

• Reasonably inexpensive

• Can be executed in a relatively short time

• Collaboration with DHS survey programme

THE DISABILITY MODULE

• Two stage questionnaire– The ten questions module

– Medical and psychological assessment (this stage was not implemented)

• Included in 22 countries – 8 countries used modified questions

– Only 7 used the whole set of 10 questions to children 2-9 years old.

THE TEN QUESTIONS

• Movement

• Vision

• Hearing

• Understanding

• Movement

• Crisis/Fits

• Learning

• Speaking

• Mental

• Speech (for 3-9 years old)

• Naming one object (for 2 years old)

DESCRIPTIVE RESULTS

• The screening result is positive if one or more of the responses classified the child as impaired

• The last two questions were excluded from the analysis due to problems in their implementation and illogical results

• Disability prevalence ranges from 44% in Sao Tome and Principe to 4% on North Iraq.

• All plausible results

• Not for comparison across countries

Percentage of children (2-9 years old) with disablities by type of impairment. Sao Tome & Principe, MICS 2000

3 3

5

78

1011

1415

0

5

10

15

Vision Mental Movement Hearing Learning Understanding Development Crisis/Fits Speaking

Type of disability: 4 of the 9 disabilities 10% or more for a total of 44% of the children

Disability by age of the child: no clear pattern but among 2 years old greater impairment if total is greater than 20%

Percentage of children 2-9 with disabilitity by age and type. Madagascar, MICS 2000.

0

2

4

6

8

10

2 to 4 5 to 7 8 to 9

Vision Hearing Understanding Speaking

Disability by gender of the child: boys appear to have greater levels of impairment than girls

Proportion of children (2-9 years old) with disability by gender MICS 1999-2001

0

10

20

30

40

50

Sao Tome &Prince

Lesotho Madagascar Cameroon Suriname Jamaica Iraq

%

Boys

Girls

Disability by place of residence: Urban/Rural

Proportion of children (2-9 years old) with disability according to place or redidence. MICS 1999-2001

05

101520253035404550

Sao Tome &Prince

Lesotho Madagascar Cameroon Suriname Jamaica Iraq

%

Urban

Rural

Disability by place of residence: Region

Proportion of children (2-9 years old) with disability according to region of residence. Madgascar, MICS 2000

0 10 20 30 40 50

Antananarivo

Antsiranana

Toliary

Fianarantsoa

Mahajanga

Toamasina

Disability by place of residence: Region

Proportion of children (2-9 years old) with disability according to region of residence. Jamaica, MICS 2000

0 5 10 15 20

HanoverSt. Elisabeth

WestmorelandSt. Mary

St.CatherineKingston

TrelawnySt. ThomasClarendon

ManchesterSt. Andrew

St. JamesPortland

St. Ann

Disability by mothers education: more than one pattern. Further analysis required

Proportion of children (5-9 years old) disable according to mother's education. MICS 2000

0

10

20

30

40

Cameroon Lesotho Suriname

%

None Primary Secondary

Disability by household wealth: using the wealth index, different patterns are also observed

Proportion of children (2-9 years old) with disability according to household wealth, MICS 1999-2001

0

10

20

30

40

50

Sao Tome &Prince

Lesotho Madagascar Cameroon Suriname

%

Poorest 20% Second Third Fourth Richest 20%

Disability and child development: birth registration among children 2-4

Proportion of children 2-4 registered by disability status. MICS 2000-01

0102030405060708090

Cameroon Lesotho Madagascar Sao Tome &Principe

%

Yes

No

Disability and child development: vaccination and malnutrition levels among children 2-4 years of age

Proportion of children 2-4 with all vaccinatrions or stunted by disability status. Sao Tome and Principe MICS 2000

52

14

62

11

0

10

20

30

40

50

60

70

All vaccinations Stunting

%

Yes No

Disability and child development: participation in early education programs by 3-4 years old

Proportion of children 3-4 attending an early education programme by disability status. MICS 2000-01

0

5

10

15

20

25

Cameroon Lesotho Madagascar Sao Tome &Principe

%

Yes No

Disability and child development: school attendance among children 6-9 years of age

Proportion of children 6-9 years attending school by disability status. MICS 2000-01

Disability status

COUNTRY Yes No

Cameroon 75 72

Iraq* 52 70

Lesotho 84 82

Madagascar 58 56

Sao Tome & Principe 69 69

Suriname 90 92 * Three governorates only: Dohouk, Suleimaniya and Erbil.

Disability and child development in Iraq: school attendance among children 6-9 years of age

Proportion of children attending school by disability status and type of disability. North Iraq, MICS 2000

0

10

20

30

40

50

60

70

Vision Movement Crisis/fits Mental Hearing Understanding Learning Speak

%

Yes No

SUMMARY AND CONCLUSIONS

• Wide variation in total disability prevalence and in the prevalence by type of disability→ analysis of the differences between countries not possible

• Disability rates constant across ages, but the type of disability changes with age

• Higher levels of disability for boys but risk of sampling errors

• Important disparities by region

SUMMARY AND CONCLUSIONS

• No conclusive results on the relationship between mother’s education/household wealth and the presence of disability

• Children with disability disadvantaged in terms of access to vaccinations and nutritional status, but not in school participation

• Need for further and more detailed analysis and research