Handicap International experience in Afghanistan - CBM

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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
The Age Distribution of Persons with Disability is Quite Differentfrom that of the Non-Disabled PopulationThe majority of persons with disability are in the 0 to 14 years age group. The Afghan population is young;50.2% people are under age 15 11 . However, compared to the total, the proportion of persons with disabilityunder age 15, or even under age 20, is lower than the same proportion in the age group above 45.Figure 3: Typology According to Gender and Age40• Persons with Disability • Non-Disabled353025201510501 to 9Years Old10 to 19Years Old20 to 29Years Old30 to 39Years Old40 to 49Years Old50 to 59Years Old60 Years Old& AboveIn other words, Afghans with disability are under-represented in categories under 20 years age and overrepresentedafter the age of 35. The proportion of persons with disability under the age of 25 in the totaldisabled population is less than the same proportion in the overall sample. The gap is higher for the youngestand diminishes with increasing age. The situation is almost at equilibrium for the 25-34 age category.The proportion of persons with disability is high after age 45, and even higher after age 60. This was foundto be a statistically significant result. When people survive until the age of 60, the probability of becomingdisabled is high: 15% of the persons with disability are older than 60, when this age group represents lessthan 5% of the overall population.Figure 4: Rate of Prevalence by Province (Trends)JAWZJANBALKH KUNDUZ TAKHAR BADAKHSHANHERATFARAHNIMROZBAGDHISHELMANDFARYABGHORSARIPULDAYKUNDIURUZGANKANDAHARBAMYANZABULSAMANGANGHAZNIBAGHLANPARWANKABULWARDAKLOGARPAKTIKAPENJSHIRKAPISAPAKTYAKHOSTNURISTANKUNARLAGHMANNANGARHARNational Disability Survey in AfghanistanPrevalence by Province (2005)0.0% to 0.9%1.0% to 1.9%2.0% to 2.4%2.5% to 3.4%3.5% to 3.9%4.0% to 4.5%NB: Prevalence rates are trends, with a larger CI than for the national prevalence rate11UNDP (2004), “Security with a Human Face: Challenges and Responsibilities”, Afghanistan National Human Development Report,Kabul. Data quoted are from the MICS, 2003.Prevalence and Typology9
Page 3 and 4: Islamic Republic of AfghanistanUNDE
Page 5 and 6: ContentsAcknowledgementsAbbreviatio
Page 8: Figure 25 : Retention, Transition a
Page 11 and 12: AbbreviationsAFAs : AfghanisBPHS :
Page 13 and 14: PrefaceThe National Disability Surv
Page 15: IntroductionAs the process of recon
Page 18 and 19: Figure 1. Sampling Stages of NDSA1s
Page 20 and 21: A variety of subjects and fields ad
Page 22 and 23: • Beliefs and expectations of wha
Page 26 and 27: The proportion of persons with disa
Page 28 and 29: Mental disability shows a much more
Page 30 and 31: The effectiveprevalencerate of seve
Page 32 and 33: to a maximum of 37.4% unable to coo
Page 34 and 35: Table 3. Proportion of Persons with
Page 36 and 37: Table 4: Proportion of Persons with
Page 38 and 39: Figure 9. Distribution of Persons w
Page 40 and 41: Figure 12: Distribution of Persons
Page 42 and 43: Comparing the situation between mal
Page 44 and 45: Figure 17. Number of Visits to Heal
Page 46 and 47: Table 5: Yearly Average Expenses (A
Page 48 and 49: 32 Understanding the Challenge Ahea
Page 50 and 51: A crucial aspect that influences ac
Page 52 and 53: Table 6 highlights the advantage th
Page 54 and 55: Figure 26: Retention, Transition an
Page 56 and 57: to take this into consideration whe
Page 58 and 59: • Boys with physical disability a
Page 62 and 63: Figure 32: Distribution of Persons
Page 64 and 65: to others: usually they benefit fro
Page 66 and 67: Figure 37: Distribution of Active P
Page 70 and 71: According to NRVA 2003, poverty is
Page 72 and 73: means that the average living space
Page 74 and 75:
Figure 43: Distribution of Persons
Page 76 and 77:
Figure 46: Distribution of Househol
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62 Understanding the Challenge Ahea
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The inability tobear children is am
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The situation is somewhat different
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Figure 51: Distribution of Persons
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706050• Landmine/UXO Survivors•
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ConclusionInclusion is a major fact
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of persons with disability 48 . Thi
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GHOSH N., MOHIT A., MURTHY R.S. (20
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The National Disability Survey in A
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Handicap International experience in Afghanistan - CBM

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