Lessons from Disability Counting in Ecuador, with a Contribution from Primary Health Care

Inge Debrouwere, Pedro Celestino Álvarez Vera, Ximena del Carmen Pavón Benítez, Celia Katherine Rosero Arboleda, Peter Prinzie and Jo Lebeer
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Inge Debrouwere: Fundación Tapori Paladines de la Felicidad, Quito 170308, Ecuador
Pedro Celestino Álvarez Vera: Fundación Tapori Paladines de la Felicidad, Quito 170308, Ecuador
Ximena del Carmen Pavón Benítez: Fundación Tapori Paladines de la Felicidad, Quito 170308, Ecuador
Celia Katherine Rosero Arboleda: Fundación Tapori Paladines de la Felicidad, Quito 170308, Ecuador
Peter Prinzie: Dominiek Savio Institute, Dienstencentrum GID(t)S, 8830 Hooglede-Gits, Belgium
Jo Lebeer: Disability Studies, Faculty of Medicine and Health Sciences, Family Medicine & Population Health, University of Antwerp, 2610 Wilrijk, Belgium

IJERPH, 2021, vol. 18, issue 10, 1-19

Abstract: Disability data are essential for policy. Yet, the predominant use of disability prevalence for service planning reflects dichotomous counting, increasingly less compatible with current disability thinking. Difficulties relate to variations in rates, the lack of matching with needs, and the use of prevalence to compare disability situations. From the perspective of Primary Health Care (PHC), we explore methods for disability counting regarding the usefulness of prevalences in identifying persons with disabilities and meeting their needs with local service implementation. First, we analyze the methods and results of six national cross-sectional studies in Ecuador. Then, we present a case about an exploratory needs-driven method for disability counting in a local PHC setting. The analysis of variations in rates focuses the attention on reasons for and risks of a priori exclusion of persons with disabilities from services. Longitudinal disability counting as a collateral result of meeting needs in the PHC setting yields local disability data worthy of further exploration. Thinking about disability counting from a PHC scope in a developing country prompted reflection on the comparison of prevalences to evaluate disability situations. Findings invite further exploration of the needs-driven counting method, its contributions to planning local services, and complementarity with cross-sectional disability counting.

Keywords: disability; measurement; prevalence; cross-sectional studies; longitudinal studies; needs-assessment; primary health care; self-perception (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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