Handicap International experience in Afghanistan - CBM

Prevalence Threshold with Regard to the Screening Questionnaire:27 Questions2.7%Threshold1Severe Difficulties inFunctioning4.8%Threshold2Inclusion of Less SevereDifficulties in FunctioningPrevalence Thresholds with Regard to Abilities in EverydayFunctioning: 9 Dimensions.If we consider answers to the health questionnaire, according to the 9 dimensions defined above, the thresholdcan be put at various levels of severity of limitations. One option is to take into consideration the answers‘very severe difficulty or inability’ to any one of the dimensions. In this configuration, the rate of prevalenceis 2.2%. If we add people with the score of ‘severe difficulty’ to any of the dimensions, the rate of prevalenceincreases to 10.8%. Then, if we add people scoring a level of ‘moderate difficulty’, the rate becomes 36.7%.Finally, if we add people with the score of ‘mild difficulty’ to any of the dimensions, the prevalence ratebecomes 58.9%. In other words, in the latter situation people with ‘no difficulty’ are only 41.1%!2.2%Threshold110.8%Threshold236.7%Threshold358.9%Threshold4Very SevereDifficulties on atleast 1 DimensionVery Severe/SevereDifficulties on at least1 DimensionVery Severe/Severe/Moderate Difficulties on atleast 1 DimensionVery Severe/ Severe/Moderate/Mild Difficulties on atleast 1 DimensionAn Over-representation of Males among Persons with DisabilityThe first conclusion that we can draw regarding the overall profile of Afghans with disability is that there are(significantly) more males than females.Figure 2. Sex-Ratio of the Non-Disabled and Afghans withDisability• Non-Disabled Females • Non-Disabled Males • Females with Disability • Males with DisabilityIt is important to note that in the overall NDSA sample, the male-female ratio of the non-disabled is 0.95(958 women for 1000 men). In the sample of persons with disability the ratio is 0.70 (700 women for 1000men). This shows an under-representation of women that can be due to several reasons: high visibility ofthe physically disabled who are mostly men, as well as stigmatization of other forms of disability, especiallymental, that are more prevalent amongst women. Another explanation is that women have less severedifficulties, so they do not fall into the ‘very severe’ category. This will be discussed in the following sectionsof this report.8 Understanding the Challenge Ahead