世界发展银行-Disability-Measurement-in-Household-Surveys-_-A-Guidebook-for-Designing-Household-Survey-Questionnaires_37页_1mb

Summary of Disability Measurement in Household Surveys: A Guidebook for Designing Household Survey Questionnaires

Core Content

This guidebook provides a comprehensive overview of disability measurement in household surveys, emphasizing the importance of inclusive data collection to support disability-inclusive development. It outlines the conceptual frameworks, key definitions, and practical methods for measuring disability across various survey programs.

Main Points

• Disability as a Human Condition: Disability is recognized as an integral part of the human condition, influenced by both individual and environmental factors. It is not merely a medical issue but also a social and environmental construct.
• Disability in the SDGs: Disability is increasingly acknowledged as a central issue in the Sustainable Development Goals (SDGs). The 2030 Agenda for Sustainable Development explicitly references disability, underscoring the need for inclusive development and data collection.
• Disability Data Collection: Disability data can be collected through household surveys, which allow for the stratification of samples to ensure adequate representation of people with disabilities. These data are crucial for understanding disparities and designing effective policies.
• World Bank Commitment: The World Bank has committed to supporting disability-inclusive development, including the scaling up of disability data collection and the use of global standards such as the Washington Group (WG) and World Health Organization (WHO) frameworks.

Key Methods for Disability Measurement

2.1 Conceptual Framework

• The International Classification of Functioning, Disability and Health (ICF) is the primary conceptual framework used for disability measurement. It classifies disability as a combination of body functions, body structures, activities, and participation, influenced by environmental and personal factors.
• The ICF highlights the bidirectional relationship between health conditions and environmental factors, as well as the impact of social relationships and stress on functioning.

2.2 Short Sets of Questions

• Washington Group Short Set (WG-SS): This set includes six core functional domains: seeing, hearing, walking, cognition, self-care, and communication. It avoids stigmatizing language and uses response options such as "No, no difficulty", "Yes, some difficulty", "Yes, a lot of difficulty", and "Cannot do it at all".
• WHO World Health Survey (WHS-SS): This set is used to assess disability in adults, focusing on participation and activity limitations.
• WHO Disability Assessment Schedule 2.0 (WHODAS 2.0-SS): This tool measures disability across domains such as mobility, self-care, and communication, and is designed for use in surveys.
• DHS-SS: The Demographic and Health Surveys program includes a disability module that is adapted for use in health and demographic surveys.

2.3 Extended Sets of Questions

• Washington Group Extended Set (WG-ES): This includes more detailed questions on functioning, such as the WG-ES-C for children and WG-ES-P for school participation.
• WHO Model Disability Survey (MD-ES): This extended set includes the WHODAS 2.0-ES and WHS-ES, offering a more comprehensive assessment of disability across multiple dimensions.

Challenges in Implementing Disability Modules

• Sampling Issues: Low prevalence of disability in random samples can lead to insufficient data for accurate analysis. Strata specific to disability are recommended to ensure adequate sample size.
• Environmental Factors: Many disability modules do not include environmental factors, which are crucial for understanding the full impact of disability on participation.
• Mental Health: The inclusion of mental health questions is challenging due to low literacy rates and limited mental health support in many low- and middle-income countries. These questions require careful design and testing.
• Child Disability: The WG Child Functioning Module is more suitable for collecting data on children with disabilities, as the standard WG-SS does not cover this group.

Conclusion

This guidebook supports the use of the Washington Group Short Set in multi-topic household surveys to enhance the collection of disaggregated disability data. It emphasizes the need for a holistic approach to disability measurement, integrating both individual and environmental factors, and aligning with global standards and the SDGs. The guidebook also highlights the importance of mental health and child disability data, which require specialized approaches due to their complexity.

Key Definitions

• Functioning: Includes body functions and structures, as well as activities and participation.
• Participation: Refers to a person's involvement in life situations such as education, employment, and civic life.
• Impairment: A significant deviation or loss in body function or structure.
• Environment: The external context that affects an individual's functioning and participation, including physical, social, and attitudinal factors.

References and Tools

• The guidebook references the Convention on the Rights of People with Disabilities (CRPD), which frames disability as a human rights issue.
• It also includes tables that compare disability question sets, and provides a list of figures including the ICF framework.
• Annexes offer additional information, such as SDGs that address disability directly or indirectly, and a comparison of disability modules across different surveys.

Recommendations

• Disability modules should be integrated into multi-topic household surveys to ensure comprehensive and representative data.
• Surveys should include environmental and personal factors to better understand the lived experiences of people with disabilities.
• Special attention should be given to mental health and child disability data, requiring additional resources and methodological work.