[8315.1] Childhood Disability in Low and Middle Income Countries: A Review
Pallab K. Maulik, Gary L. Darmstadt. Mental Health, Johns Hopkins School of Public Health, Baltimore, MD; International Health, Johns Hopkins School of Public Health, Baltimore, MD.
BACKGROUND: Studies about childhood disability are lacking in low and middle income (LAMI) countries. Data is needed, however, to guide the development of evidence based public health interventions.
OBJECTIVE: A review was undertaken to find out the amount and quality of research in the area of childhood disability in LAMI countries, in order to gain a better understanding of the current epidemiological patterns, interventions and available services.
DESIGN/METHODS: Electronic databases PubMed, Embase and PsycInfo - were searched using specific words. Articles addressing our objectives were initially identified from the abstracts. More detailed review was done once the complete articles were obtained. Other articles were included based on hand search of the references of the articles chosen initially. The Cochrane Review was scanned to find if any similar review had been done earlier. Information related to study design, study population, screening tools, interventions, services, legislation and epidemiology were entered into a database and analyzed. Descriptive analysis and qualitative information about the studies was tabulated.
RESULTS: 80 relevant articles were identified, 51% from low income countries. Almost 60% of studies were cross-sectional and 10% were RCT and cohort studies. About of studies were community-based and 66/80 studies were on epidemiology. Only of studies were on interventions and only 6/80 mentioned legislation. Overall childhood disability rates varied between 0.4-12.7%. Hearing and intellectual disability were the most commonly researched areas. Ten Questionnaire was the most commonly used screening tool to assess disability. While some interventions were identified, including some large scale programmes in
India on iodized salt, RCTs were few and specifically looked at family-based interventions for children with intellectual disability. Some information about prevalence was available, but the quality of studies was variable. Information about available services and legislation was inadequate.
CONCLUSIONS: There are large gaps in knowledge about childhood disability in LAMI countries, and little research has been done to generate evidence-based practice. Public health awareness is limited and is reflected in the poor quality of research, especially related to legislation and services.