Households with disabled people have lower standards of living than others
Representative surveys on living conditions confirms that households with disabled members have lower standard of living than others. This is one of the result of three representative studies of the Living Conditions of People with Disabilities in Southern Africa carried out in 2002 in Namibia, in 2003 in Zimbabwe and in 2004 in Malawi.
This article was copied with permission from the newsletter of the Southern African Federation of the Disabled (SAFOD) Disability Front Line (No. 29 October 2004). Representative surveys on the “Living Conditions Among Disabled People” in three countries in Southern Africa: Malawi, Namibia, Zimbabwe.
Bulawayo – Households with disabled members have lower standards of living than households with no disabled persons. This is one of the main results of three representative studies on the “Living conditions among People with Activity Limitations” in three Southern African countries of Namibia, Zimbabwe, and Malawi.
These studies are the result of an international cooperation between SAFOD, the Federation of Organisations of Disabled People in Norway (FFO), the Norwegian research centre SINTEF, and the respective governements and institutions of higher learning of these countries. The Namibia report was published in 2003, the Zimbabwe report in February 2004 and the Malawi report was launched in September 2004. The project was funded by the Norwegian Agency for Development Co-operation (NORAD) through Atlas Alliance. In addition to the study itself, a capacity building component in each of these countries was an important part of the collaboration. Organisations of people with disabilities and individuals with disabilities played a particularly active role during the development of the design as well as in the data collection. It is recommended that the results from this study are considered, together with other relevant sources, as a basis for dialogue between authorities, professionals and organisations of people with disabilities, for setting priorities, and for developing concrete measures within selected areas of priority.
Data
The data from the surveys showed that people with disability have a lower standard of living and less access to services than others as shown by several indicators: - School attendance is low: 28% to 35% have never attended school. - Vocational training: 91% have never attended to any vocational training. - Accessibility at home: 27% have no access to a toilet, and 7% have no access to a bedroom. - Access to services, facilities and institutions: Workplaces, magistrate offices, banks, etc., are accessible to less than 30% of individuals with disabilities. - Lack of assistive devices: Only 36% of those in need of assistive devices have received the support.
The study design was developed in close collaboration with a broad range of stakeholders. Organisations of people with disabilities and individuals with disabilities have played a particularly active role during development of the design and the collection of data. Based on previous studies in the region, the research instrument comprises a study on living conditions among households with and without disabled members, a screening instrument (for disability), a section with specific questions to individuals with disabilities, and a matrix that represents an operationalisation of core concepts from the International Classification of Functioning, Disability and Health (ICF). Using a sampling frame provided by the National Statistical Offices a total of about 1500 households with at least one disabled family member and 1500 households without disabled members were sampled in the three countries. In general, the patterns observed (both similarities and differences) between people with and without disabilities demonstrated in Namibia and Zimbabwe were replicated in Malawi. 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. With regards to demographics, households with disabled members were found to have higher mean age and they were larger, having more children than did control households.
Households with disabled members having more children than others
These and other socio-demographic differences may be the result of certain coping mechanisms that have been established in households with disabled members, mechanisms intended to cater particularly to the increased care duties found in these households. As was found in both Namibia and Zimbabwe, also in Malawi school attendance is clearly lower among persons with disabilities. Among children 5 years of age or older, 35% of those with disabilities had never attended school, while the corresponding figure for non-disabled was 18%. Interestingly, however, school performance (measured as highest school grade completed) was not different between the two groups.
35 % of disabled children have never attended school
Among those who had attended school, 13% of those with disabilities had completed Form 1 – 4 as their highest grade, while the corresponding figure for non-disabled was 14%. This result is different than that found in the previous studies where we found that among those who had attended school, performance was lower among those with disabilities, i.e. 14 fewer of those with disabilities achieved higher levels of education. Though no official unemployment figures could be found, unemployment in Malawi is high – and we find among our sample a high proportion of both people with and without disabilities who are “not currently working”. However, significantly more (about 58%) of those with disabilities are unemployed compared the non-disabled sub-sample (53%).
Significantly more disabled people are unemployed
While these figures are not meant to represent official unemployment figures, they provide an indication of the current situation in Malawi. Unemployment data collected from Namibia and Zimbabwe were, in fact, higher in both countries indicating perhaps that Malawi is in a better economic situation than its neighbours. While indicators of unemployment are high, it was however shown that among the same group of potentially economically active persons 15 – 65 years of age, 41% of those with disabilities had acquired some skill, compared to slightly fewer, 39% of those without disabilities. This is most likely a reflection of what is offered to children/persons with disability, i.e. skills training is (more) common in the special education services for persons with disabilities.
Slighly more disabled people have acquired skills
Similar results were obtained in Namibia and to an even larger extent in Zimbabwe where an extensive system of specialized services for individuals with disabilities, in particular employment opportunities in sheltered workshops, have existed in that country since 1950’s. Furthermore, mean monthly salaries, for those who provided that information, were lower among those with compared to those without. On most indicators the comparison between the two types of households revealed expected differences; that is, households with disabled members have lower standards of living than the control households. This is demonstrated when assessing employment (fewer households with a disabled family member have someone working) household income, housing standard, and access to information. The age distribution of people with disability interviewed in our study is found to be relatively evenly distributed, and this deviates somewhat from the population age distribution in Malawi. Twenty percent of our sample for example comes from the age group 10 years or younger. Corresponding population figures place about 30% of the population in that group reflecting an under-representation in that age group. Also about 29% of our sample is in the age group over 50 years which, compared to the population figure of 10%, represents an over-representation.
43% report on physically, 42% on sensory and 11% on intellectual disability Around 43% of those with disabilities have a self-reported physical disability (major or minor disability, paralysis), and 42% reported sensory impairments (seeing, hearing and communication), while intellectual disabilities, learning disorders and emotional disorders accounted for 11% of reported cases. It is interesting to note that these figures are similar to those reported in both Namibia and Zimbabwe. The major causes of disability were reported to be either the result of illness, birth-related or congenital, and accidental. Over half of the respondents reported onset of disability before the age of 5 years, indicating a serious challenge to health services for mothers and children in the country. Among services available to persons with disabilities, health services and traditional healers were found to be available for the majority of those with disabilities, with about 60% of those who needed these particular services having actually received them. At the other end of the scale, the most noticeable shortcomings with regards to service provision were vocational training, welfare services, assistive device services and counselling services.
Most noticeable shortcoming in vocational training and welfare services Vocational training and welfare services were received by about 5% of those who claimed that they needed them. An assessment of various forms of assistance that may be needed by individuals with disabilities in performing daily life activities showed that a large majority of respondents claimed to need emotional support, surpassing all other types of assistance required. Economic support, or assistance with finances, was the second most often mentioned form of assistance needed. It is interesting to note that, within the family, the role of the individual with a disability does not appear to be much affected by their disability status. While an overview of accessibility to different services, facilities and institutions gives a mixed picture, it is clear that certain of these facilities are not generally accessible to all.
Hotels, banks, schools and workplaces are not accessible
Hotels and banks are accessible to less than 10% of individuals with disabilities. Places of worship, health care clinics, hospitals, shops and public transport are on the other hand reported to be accessible by the majority of those with disabilities (over two-thirds). The most notable shortcomings are schools, accessible to only 20% and the workplace, accessible to only 26% of the disabled population. The mixed picture demonstrated with regards to accessibility indicates that the potential exists for improving accessibility for people with disabilities. Assistive devices are used by less than one fifth (17%) of those surveyed with disabilities. It is interesting to note that this figure is similar to the corresponding figure for Namibia (18%) but slightly lower than that reported for Zimbabwe (26%). It is further shown that most of the devices in use are functioning well (64%). Depending on the type of device in use, between 35 and 65% have received instructions on their use. With respect to maintenance, about 7% of devices are maintained through government services, about 40% assumed responsibility themselves (or through their families) and another 40% claimed that their device was either not maintained or that they couldn’t afford maintenance/repairs.
One fifth of the disabled are using assistive divices
As was found in Namibia, a higher share of devices is supplied by private sources in Malawi, reflecting a stronger tradition of privately initiated and organised services for individuals with disabilities in those countries. In contrast, the supply of devices in Zimbabwe is more balanced between private and public sources. It was found that individuals with mental/emotional impairments needed more help in their daily activities than did those in other disability categories. This group also reported more activity limitations and restrictions in social participation than others. Individuals with mental/emotional problems thus reported that they experience more barriers to full participation in society. These results mirror those found in the surveys carried out in Zimbabwe and Namibia. Activity limitation and participation restriction scores are similar for both sexes. These scores are not meant to be gender dependent – or to differentiate between genders – but to classify according to ability to carry out/perform activities under different circumstances. In contrast, analyses reveal slightly higher service needs score for men and a significantly higher daily activity help score for women. The individual items in the daily activity help score in particular can be seen as more gender specific. The constructed disability severity scores are further assessed with respect to self-reported physical and mental health. We find that, apart from the service needs score, the daily activity help score, and activity limitation and participation restriction scores are correlated with these health indices. That is, poorer health status (either physical or mental) is associated with increased need for help with daily activities, and higher degrees of activity limitation and restrictions in social participation.
The more severe an individual’s disability, the lower the level of school attendance and employment
Assessing the constructed scores based on activity limitations and participation restrictions with respect to indicators of living conditions revealed that both scores are associated with indicators of living situation. The more severe an individual’s disability as measured through limitations in daily life activities and restrictions in social participation, the lower the level of school attendance and employment. The three surveys are available at the: Disability Documentation, Resource and Training Centre of Southern Africa, PO Box 2247, Bulawayo, Zimbabwe, or can be downloaded on the SAFOD web-site: www.safod.org or can be downloaded from this webpage, see below