Prevalence and Characteristics of Disability in Post-Conflict Jaffna District, Sri Lanka (2009) Open Access

Perkins, Samantha Kylie (2015)

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Introduction: Approximately 15% of the global population lives with some form of disability. Regardless of this significant representation in the population, little is known about the health risk factors for those with disabilities in conflict-affected states. As the civil war in Sri Lanka concluded in 2009, an opportunity to address this dearth of information arose.

Objective: To describe the characteristics of the disabled population in post-conflict Jaffna District, Sri Lanka. Types and causes of disabilities were assessed, as well as sociocontextual factors that impact daily and lifetime well-being of those with disabilities. Subgroups within the disabled population were defined and differences between them were analyzed. Additionally, access to water/sanitation/hygiene and food resources and experiences of traumatic effects were analyzed in households with and without disabled persons.

Methods: A multistage cluster survey was conducted between July and September 2009 in Jaffna District, Sri Lanka. Of the 1494 households included in the general health survey, 172 individuals were identified as being disabled. Frequencies and bivariate analyses were used to describe and compare subgroups of the disabled population and households with and without disabled persons.

Results: The most common types of disability were experiencing mobility problems, paralysis, blindness, and mental disability. Common causes of disabilities were disease, congenital problems, aging, and injury. Over 48% of the population was 60 years or older. Comparisons of households with and without disabled persons revealed few differences in access to water/sanitation/hygiene and food resources. However, there were statistically significant differences in these populations when assessing lifetime experiences of lack of shelter, loss or destruction of property, ill health without access to medical care, torture, and missing or losing family members.

Conclusion: Those who provide services to the disabled population in Jaffna District, Sri Lanka, should create specific interventions that address the sociocontextual challenges of being disabled by mobility problems and aging. Additionally, caregivers and others who live with disabled persons should be considered in the implementation of services.

Table of Contents

Chapter I: Introduction and Background. 1

Statement of Problem. 1

Purpose of Project. 2

Research Questions: Disability Prevalence and Bivariate Analyses. 3

Disabilities in Emergency and Post-Conflict Settings: A Human Rights Issue. 4

Sri Lanka Background. 5

Conceptual Model. 8

Summary. 11

Chapter II: Literature Review. 12

Introduction. 12

Global Burden of Disability. 12

Disability in Areas of Conflict. 13

Disability among Refugees and Internally Displaced Persons. 17

Disability in Sri Lanka. 17

Summary of Past Work with These Data. 20

Summary. 22

Chapter III: Methods. 24

Description of the Original Study and Data Source. 24

Questionnaire Development and Delivery. 24

Survey Tools. 25

Ethical Approval and Considerations. 27

Target Study Population and Participant Selection Criteria. 27

Sample Size Calculation and Weighting. 28

Sampling. 28

Data Entry and Analysis. 30

Summary. 31

Chapter IV: Results. 32

Demographic and Household Characteristics of the Disabled Population. 32

Disability Types and Characteristics. 33

Disability Type and Characteristics Analyzed by Sex. 37

Disability Type and Characteristics Analyzed by Age. 40

Household and Mental Health Data Comparing Households with and without Disabled Persons. 41

Displacement Status. 41

Access to Water/Sanitation/Hygiene, Food, and Health Services.. 42

Differential Experiences of Traumatic Events. 44

Summary. 44

Chapter V: Discussion. 47

Characteristics of the Disabled. 47

Daily and Lifetime Affectedness among the Disabled. 49

Key Differences between Disabled Males and Females. 50

Key Associations between Age and Disability. 51

Comparisons between Households with and without Disabled Individuals. 51

Differential Access to Water/Sanitation/Hygiene, Food, and Health Services. 52

Differential Experiences of Traumatic Events. 52

Conclusions. 54

Limitations. 54

Recommendations. 56

Future Studies and Research. 56

Public Health Practice. 58

Chapter VI: References cited. 60

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