1. Measuring disability in South Africa: Data gaps & challenges Population Statistics Division Statistics South Africa 7 December 2016

2. Presentation outline Background Defining & measuring disability
Data sources in South Africa
Indicators
Questions & comments

3. Background
Disability measurement content, methodologies and indicators need to be clearly defined, data sources identified and clear targets set
Inadequate disability statistics continue to hinder efforts made at all levels of planning in allocating resources aimed at improving the lives of persons with disabilities
Output data on disability statistics need some further validation prior to input into health metrics models such as the Sullivan Method of measuring health life expectancy

4. Defining & measuring disability
Harmonization of definitions and concepts across sectors critical
Use of WG questions in Censuses and surveys provide improved approach of measuring disability
Focus on the level of difficulty experienced in the six domains – Seeing, communicating, hearing, walking, remembering and concentrating, and self-care.

5. Data sources on disability indicators
Frequency
Type of questions on disability
General Household Survey
Annual
Washington Group (WG)
Assistive device usage
Large Sample Community Survey
10-year cycle
Censuses
Decennial (ten years)
Administrative data from collective living quarters
Proposed to be annual

6. Questions in Census 1996 & 2001 Census 1996:
Does (the person) have a serious sight, hearing, physical or mental disability?
1 = Yes
2 = No
If Yes, Circle all applicable disabilities
1 = Sight (serious eye defects)
2 = Hearing/speech
3 = Physical disability (paralysis)
4 = Mental disability
Census 2001:
Does (the person) have any serious disability that prevents his/her full [participation in life activities) such as education, work, social life?)
Mark any that apply.
0 = None
1 = Sight (blind/sever visual limitations)
2 = Hearing (deaf, hard of hearing)
3 = Communication (speech impairment)
4 = Physical (e.g. Need a wheelchair, crutches)
5 = Intellectual (various learning difficulties)
6 = Emotional (behavioral, psychological)

7. Questions in GHS 2009 – 2015 & Census 2011

8. Community Survey 2016

9. Coverage Censuses Surveys
Census covers all household in SA - data available at very low levels of disaggregation
Exclusions : institutions, transients, homeless, children below the age of five
Surveys
Disability a rare event affected by sample size
Makes analysis using more than 2 dimensions (such as age, sex, race, province) rather unreliable

10. Census 2011 disability statistics

11. Out of calculation Seeing Hearing Communicating
Within universe for calculation of disability index
Seeing
Hearing
Communicating
Walking or climbing stairs
Remembering /Concentrating
Self Care
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
77 205
58 451
75 583
91 163
Total
Out of calculation
Do not know
23 372
20 791
21 864
16 340
35 694
63 164
Cannot yet be determined 52 47
12 248
5 799
29 259
Unspecified/missing

12. The disability index used in this report is based on multiple basic action difficulties in seeing, hearing, communicating, walking, remembering/concentrating, and self-care
EXCLUSIONS FROM ANALYSIS
Population that was enumerated in institutions such as prisons and hospitals ( )
Transients and the homeless (59 057)
Data for children below the age of five excluded due to reporting errors ( )
The disability index is calculated based on population that responded on the various disability types
Unspecified/missing cases, “do not know” and “cannot yet be determined” were excluded

13. Community Survey 2016

14. Gaps and limitations Misreporting and bias
No data on child disabilities (ages 0-4 years)
Frailty in old age exaggerating disability at ages 60+
Under reporting due to cultural beliefs
Subjectivity of the WG questions. Responses based on self-assessment rather than scientific methods of testing for presence or absence of the condition

15. Gaps and limitations Not all assistive devices are covered
Coverage & high non-response
Sample Size for annual General Household Survey about households - limited to disaggregation of data at provincial level & hence no small area statistics
Census 2011 (disability questions only asked of hh based population)
Some disability types not measured at all
Not all assistive devices are covered

16. Initiatives in narrowing data gaps
The Washington group together with UNICEF have collaborated to produce a more effective module in measurement of disabilities among children (2-17 years old)
Stats SA together with DSD and UNDP conducted a research study to test childhood disability module in South Africa

17. Census 2011 and CS 2016 compared: Six domains

18. INDICATORS
Disability prevalence by province: Census 2011 and Community Survey 2016

19. INDICATORS
Disability prevalence by age: Census 2011 and Community Survey 2016

20. INDICATORS
Disability prevalence by age: Census 2011 versus Community Survey 2016

21. Disability prevalence by population group: Census 2011 and Community Survey 2016

22. Assistive devices

23. Education and income: Census 2011

24. Education and income

25. Use of Census 2011 disability input data into health metrics models (Sullivan Method)
Age
Male
Female
Life Expectancy
Disability Free Life Expectancy 50
21.3
17.0
26.5
19.4 51
20.7
16.5
25.8
18.8 52
20.1
15.9
25.1
18.1 53
19.6
15.4
24.4
17.5 54
19.1
14.8
23.7
16.9 55
18.5
14.3
23.1
16.3 56
18.0
13.8
22.4
15.7 57
13.3
21.7
15.1 58
12.8
21.1
14.5 59
16.4
12.3
20.4
13.9 60
11.8
19.7 61
11.3
12.7 62
14.9
10.9
12.2 63
10.4
17.9
11.6 64
14.0
10.0
17.3
11.1 65
13.5
9.5
16.6
10.5 66
13.1
9.1
16.0 67
12.6
8.7 68
8.3
9.0 69
7.9
8.5 70
11.4
7.5
13.7
8.0 71
7.2
7.6 72
10.6
6.8 73
10.3
6.5 74
9.9
6.2
11.7
6.4 75
9.6
5.9
6.0

26. Recommendations on addressing data gaps challenges
Stats SA together with relevant stakeholders will continue advocating for a specialised survey to measure disability given the challenges on data gaps
Use administrative sources of data to collect and report information on disability very critical

27. Thank you!