Author/year/country | Study design | Population & sample | Disability measure | Measure of household SEC | Summary of results [Odds ratios (OR) with 95% CIs where available] |
---|---|---|---|---|---|
Anselmi et al, 2008 Brazil 16 | Prospective cohort study | 601 children of 634 randomly selected from the Pelotas birth cohort & followed up between the ages of 4 & 12 years. | Emotional and behavioural problems measured using the Child Behavior Checklist (CBCL) administered at 4 & 12 years of age | Family income | Externalising (OR .72(.52,.96)) and internalising (OR .68(.47,.98)) behaviours and attention problems (OR .57(.39,.84)) at age 12 years were significantly associated with low family income at 4 years |
Bashir et al, 2002 Pakistan 17 | Prospective cohort study | 772 children aged 4-6 years of age out of 1476 births enrolled in a birth cohort in 4 areas of Lahore with contrasting socio-economic characteristics | Mild Mental Retardation (MMR) measured as IQ in the range 50-69 measured using WISC & Griffiths tests among those initially identified using the Ten Question screening test | Four socio-economically distinct areas - village, periurban slum, urban slum & upper middle class area. [no individual or household level SES data reported] | MMR prevalence: Upper middle class 1.4% Village 4.8% Urban slum 6.1% Periurban slum 10.5% |
Bastos et al, 1995 Tanzania 18 | Cross-sectional survey | 854 children aged 6 to 16 years in schools in the Moshi and Munduli districts of northern Tanzania | Hearing loss measured by pneumotoscopy and screening audiometry | Urban v. Rural areas | Hearing loss in speech frequency range more common in urban (37%) compared with rural (18%) and high frequency loss also more common in urban compared with rural |
Durkin et al, 1998 Pakistan 19 | Cross-sectional population survey | 6,365 2-9 year old children in Greater Karachi screened in phase 1 of the survey using TQQ; 818 screening positive and 545 of those screening negative assessed in phase 2 | Identification of mental retardation by: Phase 1: TQQ screen Phase 2: clinical assessment using Stanford-Binet IQ test & adaptive behaviour scale developed for Pakistani children | Maternal education level (Some v. None) Urban v. Rural | Mild Retardation (IQ 50-70): No education OR 3.08(1.85,6.14) Rural OR 2.33(1.33,2.75) Serious Retardation (IQ < 50): No education OR 3.25(1.86,8.43) Rural OR 2.21(0.87,5.57) |
Filmer 2005 9 low & middle income countries (Jamaica, Romania, Cambodia, Indonesia, Mozambique, Burundi, Myanmar, Mongolia and Sierra Leone) 20 | 11 Nationally representative cross-sectional household surveys in 9 countries - 3 Living Standards Measurement Studies; 3 national socio-economic status surveys; 4 MICS 2 surveys; 1 DHS survey | Children & young people aged 6-17 years - population samples ranged from 1,649 in Jamaica (2000) to 64,136 in Indonesia (2000) | Impairment definitions of disability consistent with ICF's 'body functioning & structure' domain - range of different questions used | Quintiles of Household per capita consumption expenditure in LSMS & SES surveys Quintiles of index of household consumer assets & housing characteristics in DHS & MICS2 | Prevalence higher in poorest quintile compared with richest in all countries except Burundi, Cambodia, Mongolia and Mozambique - only Indonesia shows a clear social gradient across quintiles |
Filmer 2008 13 low & middle income countries (Jamaica, Romania, Cambodia, Indonesia, Mozambique, Burundi, Mongolia, South Africa, Chad, India, Colombia, Bolivia and Zambia) 4 [NB: some overlap with Filmer 2005] 20 | 14 Nationally representative cross-sectional household surveys in 13 countries - 2 Living Standards Measurement Studies; 5 national socio-economic status surveys; 2 MICS 2 surveys; 5 DHS surveys | Children & young people aged 6-17 years - population samples ranged from 5,865 in Burundi (2000) to 140,297 in India (1992) | Impairment definitions of disability consistent with ICF's 'body functioning & structure' domain - range of different questions used | Quintiles of Household per capita consumption expenditure in LSMS & SES surveys Quintiles of index of household consumer assets & housing characteristics in DHS & MICS2 | Only Indonesia & India show clear differences in disability prevalence between poorest & richest quintiles - otherwise non-significant differences |
Grut & Ingstad, 2006 Yemen 21 | Qualitative study | 28 interviews involving 38 individuals in households with disabled people, & one group interview in an institution for disabled girls [15 children; 20 adults; 2 Disabled People's Organisations] | Range of disabilities including physical, intellectual, hearing & visual [interviews of those with intellectual impairments conducted with parents in presence of the disabled person] | Specific measures not used but study does examine the impact of disability on the lives of households with disabled members particularly children and explores the association of poverty & disability | Complex relationship between disability and poverty demonstrated with insights into how disability and poverty interact to limit life chances |
Hackett et al, 1999 India 22 | Random cluster sampling for cross-sectional survey | 1326 children aged 8-12 years in 2 local government districts outside the city of Calicut, Kerala State, India | Child psychiatric disorder identified in 2 phases: Phase 1: Screening interviews using various instruments including Rutter's A2 scale plus Rutter teacher completed B2 scale Phase 2: detailed psychiatric assessment of screen positive & 93 screen negative | Poverty index based on eight household characteristics Father's occupation in 5 categories from professional to unskilled Parental education level - age ceased formal education | Externalising behaviours: associated with low occupation group, low parental education & poverty Internalising behaviours: associated with low parental education |
Ingstad & Grut, 2007 Kenya 23 | Qualitative study | 42 interviews (27 individual; 4 group; 11 secondary information) including 16 children in 7 strategically chosen districts of Kenya | Range of disabilities including physical (33), intellectual/mental (9), hearing (8) & visual (5) | Specific measures not used but study does examine the impact of disability on the lives of households with disabled members particularly children and explores the association of poverty & disability | Complex relationship between disability and poverty demonstrated with insights into how disability and poverty interact to limit life chances |
Kandamuthan, 1997 India 24 | Case-control study nested within Health and Disability cross-sectional survey of 9652 households in 1983 in an area of Trivandrum, Kerala State. | 180 children aged 0-14 years with identified disability compared with 900 controls. | Questionnaire & clinical assessment: 8 outcomes studied: total disabled; fits; speech & hearing disability; visual impairment; learning disability; strange behaviour; locomotor disability; other | 20 SES measures used but not fully stated in the paper. Following univariate analysis, maternal education, family size and absence of latrine retained in multi-variate analysis | Total disability associated with: Low maternal education - adjusted OR 2.46 (1.03,5.89); Family size > 5 - adjusted OR 3.71(2.44,5.63); have latrine - adjusted OR 0.59(0.41,0.84) |
Kuklina, 2006 Guatemala 25 | Cross-sectional study nested within a birth cohort including all pregnancies between 1996 & 1999 | 385 children at 6 months of age; 342 at 24 months of age and 404 at 36 months of age in 4 villages in Eastern Guatemala | Neurodevelopment measured using the Mental Development and the Psychomotor Development indices of the Bailey Scales of Infant Development | Maternal education and household SES based on household characteristics and possessions | Maternal education & SES were not associated with child neurodevelopment |
Loaiza & Cappa, 2005 7 low/middle income countries 26 | Cross-sectional MICS2 surveys in Cameroon, Iraq, Jamaica, Lesotho, Madagascar, Sao Tome & Principe, and Suriname during the period 1999-2001 | Children 2-9 years - sample sizes not stated | TQQ | Rural v. Urban Maternal education Wealth quintiles | Disability prevalence - tends to be higher in rural areas although varies by country; tends to be higher among less educated mothers but variable; variable relationship with wealth index - Suriname & Madagascar show social gradients in the expected direction but no significant differences in the other 5 countries |
Meeks Gardner et al, 1995 & 1999 Jamaica 27, 28 [2 papers combined as same study described] | Nested randomised control trial within a larger study | 78 stunted children & 26 non-stunted children in poor neighbourhoods of Kingston Jamaica - data collected at 12 & 24 months of age | Mental age measured using the Griffiths Global Development scores | Housing quality - measured by quality of sanitation & water supply and overcrowding Caldwell HOME inventory - quality of home environment Maternal score on Peabody Picture Vocabulary Test (PPVT) of verbal reasoning | Mental age at 12 & 24 months associated with maternal PPVT Not associated with housing quality or HOME score |
Mung'ala-Odera et al, 2006 Kenya 29 | Cross-sectional survey | 10218 out of 11416 children aged 6-9 years in the Kilifi district of Kenya (one of the poorest districts in the country - mainly subsistence farmers) | Neurological impairment measured in 2 phases: Phase 1 - TQQ screen Phase 2 - psychological & neurological assessment undertaken by trained researchers among all screen +ve & similar number of screen -ve children | Maternal education Mother not involved in economic activity Father not involved in economic activity | Moderate/severe impairment NOT associated with any of the SES measures on univariate analysis |
Natale et al, 1992 India 30 | Cross-sectional survey | 640 children aged 2-9 in households randomly sampled from 2 urban areas of Madurai, Tamil Nadu with contrasting socio-economic characteristics | TQQ screen with additional probe questions to ensure that only chronic conditions identified. TQQ responses grouped into 4 subscales - sensory; neuromotor; cognitive; verbal | Residence in one of 2 urban areas: one a slum area with residents of the lowest SES (monthly family income 10-15 US$/month); the other a slightly higher SES area (monthly family income 32-42 US$) | Overall disability: 17.4% in lowest SES area v. 8.2% in next lowest SES area In logistic regression model adjusted for age, gender, birth order & number in family OR for lowest 2.39(1.82,3.09) All subtypes except verbal significantly higher in lowest SES area |
Rischewski, 2008 Rwanda 31 | Nationwide matched case-control study (adults & children) nested within a national cross-sectional survey | 93 cases aged < 15 yrs identified in the national survey matched for age & gender with 146 controls | Musculoskeletal impairment (MSI) ranging from knock knees to quadriplegia | Per capita household expenditure; x2 household asset possession measures | MSI in children < 15 NOT associated any of the household poverty measures |
Shawky, 2002 Saudi Arabia 32 | Case-control study based on four cross-sectional cohorts | 1225 children aged 6-20 years with disabilities identified from specialist centres in Jeddah and 3405 non-disabled school children sampled from 42 boys' and 42 girls' schools | Auditory, visual & mental impairment | Maternal education; maternal working status | No maternal education associated with: auditory impairment OR 13.3 (7.2,27.8); visual impairment OR 3.7 (2.1,6.6); mental impairment OR 5.5 (3.8,8.1) - all adjusted for maternal age at birth, parity, working status, consanguinity & multiparity |
Suris & Blum, 1993 > 20 countries - high & low income 33 | Secondary data analysis of cross-sectional surveys | 10-14 yr olds in 19 countries and 15-19 yr olds in 23 countries - only rates calculated - no numbers given. Data derived from UN International Disability Statistics Database (DISTAT) | No specific definition of disability stated - total disability rates as reported to UN | % female illiteracy | % country level female illiteracy not correlated with disability rates for adolescents in either age group |
Izutsu et al, 2006 Bangladesh 34 | Cross-sectional survey | Random samples of 187 boys & 137 girls from non-slum areas and 157 boys and 121 girls from slum areas of Dhaka aged 11-18 years | Mental health problems (Affective, anxiety, somatic, oppositional defiant & conduct problems plus ADHD) assessed using the Youth Self Report questionnaire administered in their homes by trained interviewers | Residence in slum or non-slum areas | Only conduct problems associated with living in slum areas OR 3.2(1.4,7.2) adjusted for gender, age & school enrolment |
Thomas, 2005 Cambodia 35 | Qualitative study | Key informant interviews at 3 centres for disabled persons in Cambodia - interviews with staff and administrators; focus group interviews - one with 13 disabled adults & one with 4 disabled children; home visits and interviews with four disabled adults and four disabled children & their parents | Range of different disabilities | Poverty | Poverty identified as both cause and consequence of disability - discussion of mechanisms by which poverty impacts on disability and vice versa based on qualitative data |
Thomas, 2005 India 36 | Qualitative study | Field visits to 7 centres for disabled persons. Focus group interviews with 27 at one centre & 12 at another centre. Small number of individual interviews with disabled persons or parents of disabled children | Range of different disabilities | Poverty | Poverty identified as both cause and consequence of disability - discussion of mechanisms by which poverty impacts on disability and vice versa based on qualitative data |
Thomas, 2005 Rwanda 37 | Qualitative study | Key informant interviews at 3 centres for disabled persons in Rwanda - 2 focus group interviews (27 and 20 disabled persons) and 4 individual interviews. No specific reference to interviews with children or parents of children. | Range of different disabilities | Poverty | Poverty identified as both cause and consequence of disability - not specific to children |
UNICEF, 2008 18 low/middle income countries 2 | MICS3 cross-sectional surveys in Albania, Bangladesh, Belize, Bosnia and Herzegovina, Cameroon, Central African Republic, Georgia, Ghana, Mauritania, Mongolia, Montenegro, Sao Tome & Principe, Serbia, Sierra Leone, Suriname, Thailand, TYFR Macedonia and Uzbekistan during the period 2005-2008 | Children aged 2-9 years ranging from 1,537 children in Belize to 58,441 in Bangladesh | TQQ screening | Household wealth index (60% poorest v. 40% richest) Maternal education Rural/urban | Wealth index: only in 6 countries (Bangladesh, Georgia, Mongolia, Serbia, Sierra Leone & Thailand were disabled children at greater risk of living in the poorest 60% of households Low maternal education: only 6 countries show a greater risk for disabled children of living in households with mothers with low education Rural v. Urban: very little association of disability with rural living |
VanLeit et al, 2007 Cambodia 38 | Cross-sectional survey | 500 children 0-18 years with disabilities - no controls included in the study | Full range of disabilities - objective was to identify the functional status of disabled children in Cambodia | Poverty (< 1$/day) | 49% of households identified in the survey were living in poverty |