WHO functioning and disability disaggregation tool ( FDD11)-此為英文文檔

WHOFunctioningandDisabilityDisaggregationTool(FDD11)

FDD11aimstomeasure1)distributionofdisabilityinthepopulation;and2)prevalenceofmild,moderateandseverelevelsofdisability.Thetoolisdesignedtobeusedasatoolfordisaggregationofotherindicatorsbydisability.

Rationale

Today,overonebillionpeopleorabout16%oftheglobalpopulationlivewithsignificantdisability,andthisnumberisincreasing(1).Whilepeoplewithdisabilityareaverydiversegroup,theycommonlyhavelessaccesstohealthservices,educationandworkopportunities,andaremorelikelytoliveinpovertythanthosewithoutdisability.

Disaggregateddataisfundamentaltounderstandhowtheinequitiesthatpeoplewithdisabilityfacegloballycanbeaddressed.Morespecifically,disaggregateddatacanrevealcausesoftheexclusionfromdifferentareasoflife,highlightwhereinequalitiesexistandbringoutfurtherspecificsthatareessentialforeffectiveprogrammeplanningandinclusivepolicies(2).Recognizingitsimportance,the2030SustainableDevelopmentAgendaaffirmsthatdatashouldbedisaggregatedbydisabilityinadditiontoage,gender,income,ethnicity,race,geographiclocationandothercharacteristicsinordertoachievetheconceptof“l(fā)eavingnoonebehind”(3).

Currently,thereisaglobalneedforcoherent,comparableandreliabledataondisabilityandforaninstrumentthatcanbeusedbycountriesnotjustfordatacollectionbutalsotoallowfordatadisaggregationbydisability(2).Toaddressthis,WHOhasdevelopedanewdisabilitydisaggregationtool(FDD11)derivedfromtheWHOModelDisabilitySurvey(MDS),whichhasalreadybeenimplementedinmorethan15countriesandhasshownexcellentpsychometricproperties(4).Theinstrumentcapturesdisabilitybyassessingdifficultiesexperiencedwhenundertakingvariousactivitiesduetoahealthproblem.

Experienceandevidence

ThequestionsinthistoolwerederivedfromtheMDSasastandaloneinstrumentforcollectionanddisaggregationpurposes.Morespecifically,the11questionsconstitutedaseparatemoduleonintrinsiccapacitythatwaspartofthebriefversionoftheMDS.

WHOdevelopedafullversionoftheMDSin2014toanswertheglobalcallforcollectionofcomparableandcomprehensivedisabilitydata.TheMDSrepresentedanevolutionintheconceptofdisabilitymeasurementassessingthreeaspectstofullydescribetheexperienceofdisability–1)capacity,definedasthesynthesisofallintrinsicphysicalandmentalcapacitiesofaperson,determinedbytheirhealth

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conditionorimpairments;2)functioning,definedastheoutcomeoftheinteractionbetweentheindividual’scapacityandfeaturesoftheenvironment;and3)environmentalfactorsthataffecttheindividual’slivedexperienceofdisability(5).

CountriesrequestedabriefversionoftheMDStobeusedasamodulethatcouldbeintegratedintoexistingsurveystoallowformonitoringdisabilityprevalenceorcollectinginformationonenvironmentalbarriersforevidence-informedpolicymaking(4).ThebriefMDSwasdevelopedthroughanexpertconsensusprocessandanalyticalwork(6).Thecapacitymoduleinparticularincluded11questions,whichconstitutetheFDD11disaggregationtool.FDD11wascreatedasaseparateinstrumentfortwomainreasons–1)toallowforaquickintegrationinexistingsurveyswhencountriesneedtouseaveryshortinstrument,and2)tocaptureacomprehensivefunctioninginformationwhendisaggregatingbydisability.Thetoolmeasuresdifficultiesinthefollowingfunctioningdomains-seeing;hearing;walkingorclimbingsteps;rememberingorconcentrating;washingalloverordressing;sleeping;doinghouseholdtasks;joiningcommunityactivities,suchasfestivities,religiousorotheractivities;feelingsad,low,worriedoranxious;gettingalongwithclosepeopleincludingfamilyandfriends;andbodilyachesandpain.

Questionnaire(11questions)

Interviewer:ThenextquestionsaskaboutdifficultiesyoumayhavedoingcertainactivitiesbecauseofaHEALTHPROBLEM.Pleasethinkaboutthelast30daystakingbothgoodandbaddaysintoaccount.Iwantyoutoanswerthefollowingquestionsonascalefrom1to5where1meansnodifficultyand5meansyoucannotdotheactivity.PleaseanswerthesequestionsWITHOUTtakingintoaccountanyhelp.

Question

Howmuchdifficultydoyouhave

1

None

2

3

4

5Extreme

1

seeingthingsatadistance?Howmuchdifficultydoyouhave

1

2

3

4

5

2

hearing?

Howmuchdifficultydoyouhave

1

2

3

4

5

3

walkingorclimbingsteps?Howmuchdifficultydoyouhave

1

2

3

4

5

4

rememberingorconcentrating?

Howmuchdifficultydoyouhave

1

2

3

4

5

5

washingalloverordressing?

Howmuchdifficultydoyouhave

1

2

3

4

5

6

sleepingbecauseofyourhealth?

1

2

3

4

5

3

Howmuchdifficultydoyouhavedoinghouseholdtasksbecauseof

8

7

yourhealth?

Becauseofyourhealth,howmuchdifficultydoyouhavewithjoiningcommunityactivities,suchas

1

1

2

2

3

3

4

4

5

5

9

festivities,religiousorother

activities?

Howmuchdifficultydoyouhavewithfeelingsad,low,worriedor

1

2

3

4

5

anxiousbecauseofyourhealth?

Becauseofyourhealth,howmuchdifficultydoyouhavegettingalong

10

withpeoplewhoareclosetoyou,includingyourfamilyandfriends?

Howmuchbodilyachesorpaindo

1

2

3

4

5

11

youhave?

1

2

3

4

5

Indicatorcalculation

Disabilityisunderstoodasacontinuum(orscale)rangingfromnodisabilitytoveryhighlevelsofdisability.Throughthistool,thegoalistoobtainacontinuum,ormetricalscale,ofdisabilityrangingfromzero(nodisability)to100(severedisability),inlinewiththeWHOInternationalClassificationofFunctioning,DisabilityandHealth.

Whendataisanalysed,the11questionsinthemoduleareusedtoconstructametricalscaleofdisability,whereanindividualdisabilityscoreisestimatedforeveryrespondentusing.Havingcreatedthemetricalscaleandestimatedthescoreforeachrespondent,distributionsofdisabilityscoresareobtainedforthecountryorregionpopulation.Thesedistributionscanbeobtainedforthecompletesampleandwhendataisdisaggregated,forspecificgroups,forinstancemenandwomen,forpersonsbelongingtodifferentagegroupsorforemployedandunemployedpersons.

Toconstructthismetricalscale,aRaschanalysisshouldbeused,becauseitprovidesarobustmethodologyto:

-Confirmthatallquestionsusedaremeasuringasingleconcept,i.e.disability,

-Createvalidintervalscaleswithtruemetricalproperties,

-Createindividualscores,consideringthatquestionshavedifferent“weights”,intermsoflevelofdisabilitythattheycapture,

-Testthestructuralvalidityofthegeneratedscales,and

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-Provideanestimateofreliability.

MoredetailsonhowtoapplyaRaschanalysiswillbeincludedinthemanualforimplementationoftheFDD11tool.

References

1.Globalreportonhealthequityforpersonswithdisabilities.Geneva:WorldHealthOrganization;2022(/iris/handle/10665/364834)

2.Abualghaib,O.,Groce,N.,Simeu,N.,Carew,M.T.,&Mont,D.2019.Makingvisibletheinvisible:whydisability-disaggregateddataisvitalto“l(fā)eaveno-onebehind”.Sustainability,11(11),3091.

3.UnitedNations.2015.Transformingourworld:the2030AgendaforSustainableDevelopment.NewYork,USA

4.WorldHealthOrganization.2021.Strengtheningthecollectionofdataondisability.Accessat:

/activities/collection-of-data-on-disability

5.Sabariego,C.,Fellinghauer,C.,Lee,L.,Posarac,A.,Bickenbach,J.,Kostanjsek,N.mChatterji,S.,Kamenov,K.,CiezaA.2021.Measuringfunctioninganddisabilityusinghouseholdsurveys:MetricpropertiesofthebriefversionoftheWHOandWorldBankModel