Prevalence of self-reported disability, activity limitation and social participation in Sri Lanka

Introduction The World Health Organization estimates that 15% of the global population has a disability. Available evidence from Sri Lanka shows variable estimates of the magnitude of disability. Objectives Determine the prevalence of self-reported disability in the adult population aged ≥18 years, and associated risk factors in a nationally representative sample in Sri Lanka. Methods The Washington Group short questionnaire was used to identify persons with self-reported disability. Data were collected from responsible adults aged ≥18 years in the selected households. A four point-scale: “no difficulty”, “some difficulty”, “a lot of difficulty” and “cannot do at all” was used. Individuals screening positive for disability were administered an additional questionnaire on activity limitations, social participation and their health and financial concerns. Results Overall 41.5% (4131) [95% CI: 40.5-42.4] reported functional difficulty in at least one domain. The prevalence of disability, i.e. a lot of difficulty or cannot do at all was 3.8% (382) [95% CI: 3.5 – 4.2], while the prevalence of “some functional difficulty” was 37.6% (3749) [95% CI: 36.7-38.6]. The prevalence of disability increased with age and was higher among females, urban residents, and those with lower education and socio-economic status. Minor degrees of functional difficulties were more common among older people, females and people with lower education. Conclusions The prevalence of disability and varying degrees of functional difficulty is high among the adult population of Sri Lanka. Evidence shows that a strategic plan is required to address the magnitude of disability and functional limitations in Sri Lanka

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. Funding: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. Translations: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section