Fundación Tapori Paladines de la Felicidad, Quito 170308, Ecuador.
Department of Psychology, Universidad Politécnica Salesiana-Sede Quito, Quito 170308, Ecuador.
Int J Environ Res Public Health. 2021 May 12;18(10):5103. doi: 10.3390/ijerph18105103.
Disability data are essential for policy. Yet, the predominant use of disability prevalence for service planning reflects dichotomous counting, increasingly less compatible with current disability thinking. Difficulties relate to variations in rates, the lack of matching with needs, and the use of prevalence to compare disability situations. From the perspective of Primary Health Care (PHC), we explore methods for disability counting regarding the usefulness of prevalences in identifying persons with disabilities and meeting their needs with local service implementation. First, we analyze the methods and results of six national cross-sectional studies in Ecuador. Then, we present a case about an exploratory needs-driven method for disability counting in a local PHC setting. The analysis of variations in rates focuses the attention on reasons for and risks of a priori exclusion of persons with disabilities from services. Longitudinal disability counting as a collateral result of meeting needs in the PHC setting yields local disability data worthy of further exploration. Thinking about disability counting from a PHC scope in a developing country prompted reflection on the comparison of prevalences to evaluate disability situations. Findings invite further exploration of the needs-driven counting method, its contributions to planning local services, and complementarity with cross-sectional disability counting.
残疾数据对于政策制定至关重要。然而，服务规划中普遍使用残疾流行率来进行二分法计数，这与当前的残疾思维越来越不兼容。困难涉及到发病率的差异、与需求不匹配以及使用流行率来比较残疾情况。从基层医疗保健（PHC）的角度出发，我们探讨了残疾计数方法，包括流行率在识别残疾人和满足他们的需求方面的有用性，以及当地服务实施的情况。首先，我们分析了厄瓜多尔六个全国性横断面研究的方法和结果。然后，我们提出了一个关于在当地 PHC 环境中探索性需求驱动的残疾计数方法的案例。发病率的变化分析将注意力集中在预先排除残疾人服务的原因和风险上。在 PHC 环境中满足需求的纵向残疾计数产生了值得进一步探索的当地残疾数据。从发展中国家的 PHC 角度思考残疾计数，促使我们对流行率的比较进行评估，以评估残疾情况。研究结果进一步探讨了需求驱动的计数方法，以及它对规划当地服务的贡献，以及与横断面残疾计数的互补性。
