Childhood disabilities are a cause of major concern causing significant handicap to the affected children. At least one in ten children are born with or acquire a physical, mental or sensory impairment, 50% of these can be prevented or postponed (l). It is important to detect and manage these disabilities early for interventional measures to have a perceptible impact on the quality of life. Conventional surveys are expensive and take time to conduct. This study was conducted to rapidly identify disabilities among children below 14 years of age using Key informant approach(2).

The study was conducted in Mograhat II rural block in West Bengal. Nine villages were selected using multi-stage random sampling. In each village key informants were identified, explained about childhood disabilities and were asked to identify children with disabilities. These children were examined by a postgraduate medical student, their mothers were interviewed and medical records were reviewed. Eighty-three children with 135 disabilities were identified among 5922 under-14-year children (point prevalence 14/1000 children) in a total population of 15708 in 9 villages. Disabilities identified (Table I) included mental retardation - 30.1%, learning disability - 27.7%, speech disability - 22.9%, bone deformity -15.6%, disability due to chronic disease - 15.6%, hearing disability - 14.4%, post polio disability - 13.2% and cerebral palsy - 9.6%. Forty-one percent of the children were aged 5 to 9 years, 53% were males, 45.8% of the disabilities were of congenital origin.

Cerebral palsy (G80)

8

9.6

1.3

Postpolio deformity (B91)

11

13.2

1.8 

Mental retardation
    Mild (F.70)-15; Moderate (F.71); 
    Severe (F. 72)-4 

25

30.1

4.2 

  Total number of disabled children 83; total number of disabilities 135. 

The prevalence of childhood disability varies depending on the method of disability detection. The prevalence in our study was more than that estimated through routine reporting in Ethiopia - 1.9/1000 children under 14 years(3) but lower that estimated by house- to-house surveys using ten questions in Eastern Jeddah(4) (36.7/1000), and Bangladesh (22/1000 2-9 year children)(5). The proportion of types of disabilities identified in our study is similar to that found in Bangladesh(5) where mental retardation 36%, speech disability 27%, hearing disability 18%, vision disabilities 7% were the major disabilities identified. Similar findings have been reported in Eastern Jeddah(4). In our study 55% of the disabilities were acquired indicating that more than half of the disabilities could have been prevented. In Safdarjung hospital, New Delhi it was found that 45.5% of the disabilities could have been prevented. In general also, it has been estimated that about half of childhood disabilities can be prevented(1).

Since childhood disabilities cause preventable chronic childhood morbidity often leading to life-long handicap and consider-able strain to the families of the children affected(1), it is important to detect and mange these disabilities early. Detection methods that are rapid, simple and feasible for application in rural settings are required. Using the key informant approach we were able to quickly identify the major types of childhood disabilities. This approach can be used as a preliminary method for disability detection awaiting more rigorous surveys. Comparative studies need to be conducted to determine the sensitivity and specificity of key informant surveys. The key informant approach has the advantage of involving local people in the detection of disabilities thus bringing out participation by the community. These key informants can be further trained so that they can act as local resource personnel for provision of primary information, counseling and care for children with disabilities at the community level.

S. Chakraborty,
D. Dutt,
Department of Public Health Administration,
All India Institute of Hygiene
and Public Health,
110, Chittaranjan Avenue,
Kolkata 700 073,
India.
Correspondence to:
Dr. Debashis Dutt,
E-mail: [email protected]  

1. UNICEF. Childhood disability: Its prevention and rehabilitation. In: Report of Rehabilitation International to the executive board of UNICEF. (E/ICEF /L 1410-26). UNICEF: New York 1980: p 31.

2. Khan NZ. Best resource use for disabled children. World Health Forum 1998; 19: 47-52.

3. World Health Organization (WHO). World health statistics Annual 1990. WHO. Geneva 1991: 55-73.

4. Milaat WA, Ghabrah JM, Al-Bar HM, Abalkhail BA, Kordy MN. Population based survey of childhood disability in eastern Jeddah using ten questions tool. Disability Rehabilitation 2001; 23: 199-203.

5. Zaman SS, Khan NZ, Islam S, Banu S, Dixit S, Shrout P, et al. Validity of the ten questions for screening serious childhood disability: Results from urban Bangladesh. International J Epidemiol 1990; 19: 613-620.