Approaches to measuring non-fatal health outcomes: Disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS) in Uganda

The measurement of disability in low-income countries is recognized as a major deficiency in health information systems, especially in Africa. The Iganga and Mayuge Demographic Surveillance System (IM-DSS) in Uganda provides a special opportunity to evaluate innovations in assessing the burden of disability in Uganda and develop population-based data to inform national health policies. The study presents new approaches to measuring disability in low-income settings. The overall goal of the proposed research is to improve the measurement of the burden of physical disabilities at Demographic Surveillance Systems. The specific objectives of this study were: (1) To screen for disability at the IM-DSS (Module A); (2) To characterize the disabilities in the IM-DSS through an in-depth disability assessment module for disabled individuals (Module B); (3) To compare these modules, and their use as a 2-module set to screen for and follow-up on disabilities at the IM-DSS. This thesis comprises 3 papers, each focusing on one of the objectives.;The first paper is entitled "Application of a new instrument to screen for Disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda". This paper goes over the development and application of a screening module for physical disabilities at the IM-DSS. The paper discusses the burden of disability at the IM-DSS, highlighting the prevalence of physical disabilities and risk factors associated with disability at the IM-DSS. The second paper is entitled "Characterizing Disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda". This paper discusses the implementation of a detailed disability assessment schedule to further characterize the physical disabilities present at the IM-DSS. The third paper is entitled "Measurement of Disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS): A comparison of two instruments". This paper provides a comparison of results from the two modules applied at the IM-DSS. It examines the correlation between the two, and assesses their applicability as a two-module set to screen for and follow-up on disabilities at the IM-DSS.