Survey on Living Conditions Among People with Activity Limitations 2006
Zambia, 2005 - 2006
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ZMB_2005_LCPAL_v01_M
Survey on Living Conditions Among People with Activity Limitations 2006
| Name | Country code |
|---|---|
| Zambia | ZMB |
Other Household Survey [hh/oth]
The initiative to carry out the studies in in southern Africa was developed in a joint project between Southern Africa Federation of the Disabled (SAFOD), the Norwegian Federation of Organisations of Disabled People (FFO), and SINTEF Health Research. The first seven representative studies are part of a regional initiative to establish baseline data on living conditions among people with disabilities in Southern Africa.
The Namibian survey was carried out in 2001–2002, Zimbabwe in 2002–2003, Malawi in 2003–2004, Zambia in 2005–2006, Mocambique in 2007–2008, Swaziland and Lesotho in 2009–2010. Botswana started in 2011 and will be finalized in 2014. A new study was initiated in Angola in 2013.
SINTEF has also carried out two similar studies with different funding sources. In 2005–2006 a regional study (Eastern and Western Cape) was carried out in South Africa. In 2013–2014 SINTEF has carried out a second study in Zimbabwe, funded by UNICEF and in collaboration with Ministry of Child Health and Welfare.
Major stakeholders in the countries are the following:
Namibia: National Federation of Disabled People in Namibia (NFDPN), University of Namibia, Multidisciplinary Research and Consultancy Centre (MRCC), and Ministry of Lands, Resettlement and Rehabilitation.
Zimbabwe
2003: National Council of Disabled Persons of Zimbabwe (NCDPZ), University of Zimbabwe, Departments of Psychiatry and Rehabilitation, and Ministries of Health and Child Welfare and Social Welfare.
2013–14: United Nations Childrden's Fund (UNICEF), Ministry of Child and Health Welfare.
Malawi: Federation of Disability Organisations in Malawi (FEDOMA), University of Malawi, Centre for Social Research (CSR), and Ministry responsible for People with Disabilities in the Office of the President.
Zambia: Zambia Federation of the Disabled (ZAFOD), University of Zambia, Institute of Economic and Social Research (INESOR) and Central Statistic Office (CSO).
South Africa: University of Cape Town.
Mozambique: Fórum das Associações Moçambicanas dos Deficientes (FAMOD), The National Statistics Institute (INE) and Universidade Eduardo Mondlane (UEM).
Lesotho: Lesotho National Federation of Organizations of the Disabled (LNFOD), Central Bureau of Statistics.
Swaziland: The Federation of Organizations of the Disabled in Swaziland (FODSWA) , Central Statistical Office.
Botswana: The Botswana Federation of the Disabled (BOFOD), SAFOD, University of Botswana, Statistics Botswana, Office of the President.
Nepal: The National Federation of the Disabled in Nepal (NFDN), Ministry of Health (MOH), Ministry of Women, Children and Social Welfare (MOWCSW), National Planning Commission (NPC), Ministry of Education (MOE), Valley Research Group(VARG) and Central Bureau of Statistics (CBS).
Disability and society: The last 20–30 years have seen an important change in our understanding of disability. From a previous individual perspective on causes and interventions, a social and civil rights approach has taken over. Much of the focus is now on the human and physical environment and how this might reduce or enhance an individual’s level of activity and social participation.
National policy development aimed at improving living conditions in general and among people with disabilities in particular is dependent on the availability of quality data. In many countries these have been lacking, and both the United Nations and National authorities have emphasised the need for this information in order to further develop disability policies.
Information about people with disabilities and their living conditions has the potential for contributing to an improvement of the situation faced by this group in many low-income countries, as has been demonstrated in high-income countries. The Studies on Living Conditions Among People with Activity Limitations in Developing Countries have been applied to inform policy development, for capacity building, awareness creation, and in specific advocacy processes to influence service delivery.
The studies have demonstrated that level of living conditions among disabled people is systematically lower than among non-disabled people. This implies that people with disabilities are denied the equal opportunities to participate and contribute to their society. It is in this context that people with disabilities are denied their human rights.
Zambia: As in other countries (namely Zimbabwe, Namibia and Malawi) where the survey has been conducted, the overall objective of the Survey was to contribute to the improvement of the living conditions among people with activity limitations in Zambia. In addition, the survey was intended to provide a basis on which to:
a) Develop a strategy for the collection of comprehensive, reliable and culturally adapted statistical data on living conditions among people with disabilities
b) Initiate a discussion on the concepts and understanding of “disability”
c) Include and involve people with disabilities in every step of the research process
d) Monitor the impact of government policies, programmes and donor support on the well being of the population with activity limitations.
e) Identify various forms of activity limitations that people living with disabilities face
f) Provide various users with a set of reliable indicators against which to monitor development.
g) Identify appropriate assistive devises required for specific forms of disabilities
h) Identify vulnerable groups in society and enhance targeting in policy implementation.
i) Establish appropriate skills training package for various forms of disability
Sample survey data [ssd]
- Households
- Individuals
Scope
The scope of the Survey on Living Conditions Among People with Activity Limitations includes:
DISABLED AND NON-DISABLED INDIVIDUALS : Activity limitations, Burden of disease, Education and literacy, Employment/economic activity, Income and expenses, Mortality
INDIVIDUAL CASE AND CONTROL: Activity limitations, Environmental barriers, Marital status, Health, Causes of disability, Violence and discrimination, Service gaps, Education (15 years and older)
Employment and income, Medication, Assistive devices, Thoughts and feelings about being a person with disability, Social support, Involvement in family and social life, Health and well-being, Knowledge and understanding of some common diseases.
Coverage
National
Producers and sponsors
| Name |
|---|
| The Foundation for Scientific and Industrial Research - SINTEF Health Research |
| Southern Africa Federation of Disabled People (SAFOD) |
| Norwegian Federation of Organisations of Disabled People (FFO) |
| Name | Affiliation |
|---|---|
| Zambia Federation of the Disabled | Southern Africa Federation of the Disabled (SAFOD) |
| Name |
|---|
| Norwegian Agency for Development Cooperation |
| Atlas Alliance |
Sampling
A two-stage cluster sampling procedure was applied using the National sampling frame in each country, in close collaboration with the National statistical offices who also did sample size calculations to ensure representativity at regional/provincial level. A required number of geographical units (often called Enumeration Areas, EAs) are thus sampled, with all households in these areas included in the first stage of the sampling. Then follows screening where all households in the selected areas are interviewed (normally the head of the household) using the WG 6 screening instrument.
Sampling in Zambia:
Using a sampling frame provided by the Central Statistical Office covering all provinces in the country, a total of 2885 households with at least one disabled family member and 2866 households without disabled members were sampled; altogether 5751 households. The study design allows for the following types of comparisons: between individuals with and without disabilities, and between households with and without disabled family members.
Due to the disproportionate allocation of the sample points to various strata, sampling weights will be required to correct for differential representation of the sample at national and subnational levels. The weights of the sample are in this case equal to the inverse of the product of the two selection probabilities employed.
Survey instrument
Questionnaires
The questionnaires applied in the studies were originally based on two previously applied instruments: A study on living conditions in the general population in Namibia (NPC 2000) and a national disability survey carried out in South Africa (Schneider et. al., 1999). Over the years, and in particular in the first couple of studies in Namibia and Zimbabwe, a lengthy process involving all stakeholders was carried out to align the content of the questionnaires with the context and priorities of particularly the disability movement. A disability-screening instrument was included, in the early phases drawing on the discourse preceding ICF, in later phases using the WG 6 screening instruments directly. The "ICF matrix" on activity limitations, participation restrictions and environmental barriers was also included
Four separate questionnaires are applied:
i) Household study on living conditions - a set of core indicators of living conditions for all permanent members of the household (including control households)
ii) Screening for disability; WG 6
iii) Detailed Questionnaire for people with disabilities including the Activity and Participation Matrix drawn from ICF
iv) Detailed questionnaire to individuals without disability (controls)
The questionnaires are all developed in English language and translated into local language(es)
The generic household questionnaire covered the following topics:
- Demography and Disease burden
- Education and Literacy
- Economic activities of household members
- Reproductive Health of Females aged 12 to 49 years
- Household amenities and housing conditions
- Household access to facilities
- Household asset ownership including land
- Household Income and its main source
- Household food production
- Household monthly Expenditure and rankings
- Death in the households
The detailed Disability Questionnaire covered the following topics:
- Activity Limitations and Participation restrictions
- Environmental factors
- Health
- Awareness, need and receipt of services
- Education and employment / income
- Assistive devices and technology
- Accessibility in the home and surroundings
- Inclusion in family and social life
- Health and general well-being
- Knowledge of HIV/AIDS, Malaria, TB and Diabetes.
The Control questionnaire for individuals without disabilities is a reduced version of the questionnaire applied to individuals with disability.
Data collection
| Start | End |
|---|---|
| 2005 | 2006 |
Recruitment and training
Recruitment of research assistants are carried out by the responsible body in each country (e.g. Technical Team). Specific requirements for research assistants are set in each country, including minimum formal education. Individuals with disability are particularly recruited for the data collection, but the number can vary according to the strength of the national DPO. The number of research assistants and supervisors will vary according to geographical composition of a country and the size of the population.
Screening and Data collection
Research Teams of approximately 5 - 7 persons with one vehicle and a driver travel together and collect data within pre-determined geographical as for instance a Province. Screening is either carried out as a separate activity or directly linked up to the data collection in one operation. In all the sampled areas, every household is visited and the head of the household responds to the screening question. The data from the listing/screening are entered into a data entry program. Disability prevalence is calculated from this file. Any persons who are presented with at least one "some problems" in one of the WG 6 items below qualifies as being disabled. This threshold is chosen to obtain maximum sensitivity of the screening instrument, and the responses to the 6 questions can later be applied to distinguish between impairment types and severity of disability.
Among households with at least one disabled member, a pre-decided number of households in each EA is randomly sampled. Additional EAs are drawn during the sampling process to be used whenever too few households with disabled member(s) are identified in an EA.
Zambia
The project was launched in March 2005 through a Consultative Conference of various stakeholders to fully brief them on the work being undertaken, the reasons for it and the expected outcome. Senior representatives of Research Institutions, Disabled Peoples Organizations, other Non Governmental Organisations, as well as relevant Government ministries and agencies attended this meeting.
In August 2005, 10 Supervisors (from INESOR and ZAFOD) undertook training on how to supervise the research exercise. In September 2005, 38 Enumerators were trained on how to undertake the research from which the best 207 were chosen to go into the first phase of the survey from September to November 2005 covering 5 remote provinces of Zambia namely: Northern, Eastern, Western, North Western and Luapula. From these 20 enumerators who went in the field, 6 were persons with disabilities and 4 were parents of children with disabilities and the rest were able bodied. Also from these, 9 were women and 11 were men.
From the 20 enumerators, 16 were later chosen - based on their performance in the first phase – to undertake the second phase of the research covering the remaining 4 provinces of Zambia namely Copperbelt, Central, Lusaka and Southern. The 2nd phase research work commenced in February 2006 and ended in May 2006. From these 16 enumerators, 5 were persons with disabilities and 3 were parents of children with disabilities from ZAFOD affiliates while the rest were ablebodied enumerators from INESOR and CSO.
Data processing
The research team is responsible for organizing data entry, cleaning and submission of the data file for analyses, which is carried out by SINTEF in collaboration with the local/national research group. A final report is then produced, followed by a dissemination workshop with high-level representation and press coverage.
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| Southern African Federation of the Disabled | info@safod.net | www.safod.net | |
| Advisor Hanne Witsø | Norwegian Federation of Disabled People (FFO) | hanne.witso@ffo.no | www.ffo.no |
| Professor Arne H. Eide, Dep. of Living Conditions and Health Services | SINTEF Health Research | arne.h.eide@sintef.no | www.sintef.no |