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Abstract
Purpose: The purpose of this paper is to describe the emerging pattern of disability (activity limitation) in terms of its prevalence, age and gender distribution in Rwanda. Method: A door-to-door survey was conducted in all households in villages from two districts selected through a multi-stage sampling procedure. Identified persons were screened for activity limitations using age-appropriate instruments developed from domains in the ICF. Proportions were computed and disaggregated by age group, gender, district and activity limitation. A multi-disciplinary rehabilitation team including community members participated in the development of instruments, community mobilisation, data collection and collation. Results: Prevalence rates of 8.6% (Bugesera) and 14.7% (Musanze) were obtained. The prevalence of disability was higher in adults than in children in both districts (10.4% versus 6.6% in Bugesera and 19.6% versus 7.7% in Musanze). Visual limitations occurred the most frequently in both adults and children in both districts. Mobility and mental health limitations also notably contributed to the overall disability burden. Conclusion: The prevalence of disability obtained was higher than all previously reported data for Rwanda. Despite the limitations, the findings provide useful information for planning rehabilitation services and to direct future enquiry into the epidemiology of disability in Rwanda.
It is important to design specific surveys to measure disability using contemporary methods to gauge the situation accurately and qualitatively.
Currently, the ICF provides the best framework to describe the epidemiology of disability meaningfully; it enables comparisons within and between countries and regions of the world; and enables the active participation of a wide range of rehabilitation stakeholders including PWDs and lay community members.
The vast majority of disabilities in Rwanda are limitations in visual, mobility and mental health functions.
Implications for Rehabilitation
Acknowledgements
We thank the communities that participated in this study. We acknowledge the contribution of the fourth-year Physiotherapy Honours classes’ of 2010 and 2011 from Kigali Health Institute, the rehabilitation team from Ruhengeri District Hospital, Nyamata District Hospital, Handicap International – Rwanda and Rilima Rehabilitation Centre for data collection and collation. Gratitude is extended to Julia Chevan for proof-reading the manuscript.