Socioeconomic and national disparities in disability distribution among population in five East African countries: insights from the demographic and health surveys.

backgroundDisability is a major public health concern worldwide, particularly in sub-Saharan Africa, including East African countries (EACs), where its prevalence remains high. Effective planning for inclusive health services requires reliable data on prevalence and distribution of disability. However, EACs lack sufficient empirical data on the issue, hindering social services planning. This study aimed to examine socioeconomic and national disparities in reporting disability among individuals aged 5 to 95 years across five EACs. METHODOLOGY: This study utilised secondary data from the most recent Demographic and Health Surveys (DHS), comprising a weighted sample of 216,420 individuals. The five EACs included were Democratic Republic of Congo, Rwanda, Malawi, Kenya and Tanzania. The dependent variable was disability status, while independent variables included demographic and socioeconomic factors. Descriptive analysis, chi-square test, and multivariable modified Poisson regression were employed to assess associations, with p-values < 0.05 indicating a significant factor.

resultsThe overall prevalence of reporting disability in the five EACs, however, it varied across countries. was 15.4%. There was variation across countries; the highest prevalence (19.75%) recoded in Kenya and the lowest (9.94%) observed in the DRC. After controlling for other covariates, females (Adjusted prevalence ratio (APR);1.04;95%CI:1.35,1.80), individuals residing in rural areas (APR;1.10;95%CI:1.04,1.16), separated/widowed individuals (APR;1.27,95%CI:1.18,1.36), individuals from the poorest households (APR; APR;1.10; 95%CI: 1.04, 1.16), individuals who are covered by health insurance (APR;1.05;95%CI:1.01,1.09) and the female headed households (APR;1.14;95%CI:1.10,1.19) had higher prevalence ratio of reporting disability compared to their counterparts. Conversely, individuals from the Malawi had (APR;0.05;95%CI:0.40,0.67) lower prevalence ratio of people reporting disability compared to those who were from the DRC. In addition, there was interaction of age and education level in relation to disability. This implies that association between age and disability may be influenced differently depending on education level of an individual.

conclusionThis study highlighted a significant disability prevalence in EACs. Its associated factors included female gender, poorer economic households, rural areas and separation. There was interaction of age and education level on influencing disability. These findings emphasize the need for targeted interventions and further research into underlying mechanisms to improve support systems for vulnerable populations.