Levels of reported disability vary widely across countries

Prevalence of Reported Disability: MICS data shows that the percentage of children screening positive on disability varies significantly across countries, from 2 percent in Uzbekistan to as high as 31 percent in Central African Republic. A significant proportion of children are identified by their parent or caretaker as having more than one type of impairment. Disability can be attributable to several endogenous causes, such as malnutrition, infectious diseases, accidents and traumatic injuries, maternal, prenatal and neonatal health. In this sense, the likelihood for a child to have a form of disability varies depending on the country's overall level of socio-economic development. Disability rates need also to be read as an indication of how well a society recognizes children with disabilities.

Prevalence rates that fall significantly below 10 percent may indicate that severe and moderate disabilities are under-recognized or under-reported, which means that children with disabilities are missing in these statistics. They can also suggest high mortality both in utero and for children with disabilities who are under the age of five – deaths that are not captured in statistics.

Intellectual impairments are the leading reported disabilities

Forms of Reported Disability: MICS data shows that speech impairment is the leading reported disability in the vast majority of countries. A greater percentage of children screen positive on questions pertaining to intellectual disabilities (i.e. serious delay in sitting, standing or walking, difficulties in learning, speaking and understanding, and mental problems) than on those indicative of physical impairments (i.e. difficulties in hearing, seeing, walking or moving arms, occurrence of fits or crisis).

Disability may be linked to social exclusion: the case of Roma children

Reported Disability and Ethnicity: In contexts where poverty, geographical isolation and social exclusion are strongly linked to specific subgroups of the population, disability rates may vary according to ethnicity. MICS data shows that in Serbia for instance, 23 percent of Roma children who live in Roma settlements screen positive on disability compared to 11 percent for children living in the rest of the country.

Levels of reported disability vary widely within countries: the case of Sierra Leone

Reported Disability and Place of Residence:MICS data shows that the percentage of children reported to be disabled may vary importanly by place of residence and significant differences may exist across regions. Place of residence is important not only from the point of view of access to services to prevent disability but also in terms of diagnosis, treatment, rehabilitation and support for the impairments. It is also relevant in terms of economic and social development of the different areas, and as result of the presence of local risks. MICS data for Sierra Leone shows that 37 percent of children screen positive on disability in the Southern region of the country and 24 percent in the Eastern region. These two areas were heavily affected by the ten year war in Sierra Leone, but also by the conflict in neighboring Liberia.

In the rest of the country, the percentage of children who screen positive on disability is considerably less, with 14 percent in the West and 18 percent in the North. If we now look at the type of impairment, we can notice that for instance children living in the South are twice as likely to screen positive for impairments in learning and in speaking compared to children living in the rest of the country. These preliminary findings certainly need to be treated with caution and should not be used to come to straightforward conclusions. They however point at a possible link between disability and the social, economic and geographical environment where children live, and emphasize the need for detailed situation analysis at the country level.

Children screening positive on disability are less likely to be part of the standard education system

Reported Disability and Child Development: One of the main concerns embedded in the MICS exercise is to be able to identify and document the relationship between child disability and child development. MICS data shows that children reported to be disabled are less likely to attend formal education than children who screen negative on disability. With regards to early education, in four of the eight countries with available data, a significant gap in attendance rate exists between children who screen negative and children who screen positive on disability. In Jamaica, for instance, 89 percent of children who screen negative on disability attend an early education programme compared to 67 percent of children who screen positive. Data on primary education seems to confirm the existence of significant disparities in attendance rate in 4 of the 8 countries with available data.

In Macedonia for example, 89 percent of children who screen positive on disability attend primary school compared to 96 percent of children who screen negative. While no conclusion can be drawn on the reasons behind these differentials at this stage of the analysis, MICS data seems to indicate that, in some countries, children who screen positive on disability are less likely to be part of the standard education system.

Conclusion

MICS preliminary findings on disability emphasize the complexity of the issue and the need for further data collection and research. Thus, for instance, more information is needed to clarify the severity of disability, including medical follow-up testing with children who screen positive. Additional resources, including those needed for accurate diagnoses, are necessary to address childhood disabilities in the countries participating in the surveys. At the same time, an in-depth analysis of the available data needs to be pursued in order to explore the correlations between child disability and child development, as well as to identify the leading risk factors of disability and to assess the extent of social exclusion that may affect children with disabilities, including the roles and capacities of those who have direct responsibility to prevent and address it. Finally, MICS data cannot capture the reality of children with disabilities who are living in institutional care and a different data collection instrument is needed in this area.