24 research outputs found
Fatores associados com a dificuldade no acesso de idosos com deficiência aos serviços de saúde
Childhood disability and socio-economic circumstances in low and middle income countries : systematic review
Background: The majority of children with disability live in low and middle income (LAMI) countries. Although a
number of important reviews of childhood disability in LAMI countries have been published, these have not, to our
knowledge, addressed the association between childhood disability and the home socio-economic circumstances
(SEC). The objective of this study is to establish the current state of knowledge on the SECs of children with
disability and their households in LAMI countries through a systematic review and quality assessment of existing
research.
Methods: Electronic databases (MEDLINE; EMBASE; PUBMED; Web of Knowledge; PsycInfo; ASSIA; Virtual Health
Library; POPLINE; Google scholar) were searched using terms specific to childhood disability and SECs in LAMI
countries. Publications from organisations including the World Bank, UNICEF, International Monetary Fund were
searched for. Primary studies and reviews from 1990 onwards were included. Studies were assessed for inclusion,
categorisation and quality by 2 researchers.
Results: 24 primary studies and 13 reviews were identified. Evidence from the available literature on the
association between childhood disability and SECs was inconsistent and inconclusive. Potential mechanisms by
which poverty and low household SEC may be both a cause and consequence of disability are outlined in the
reviews and the qualitative studies. The association of poor SECs with learning disability and behaviour problems
was the most consistent finding and these studies had low/medium risk of bias. Where overall disability was the
outcome of interest, findings were divergent and many studies had a high/medium risk of bias. Qualitative studies
were methodologically weak.
Conclusions: This review indicates that, despite socially and biologically plausible mechanisms underlying the
association of low household SEC with childhood disability in LAMI countries, the empirical evidence from
quantitative studies is inconsistent and contradictory. There is evidence for a bidirectional association of low
household SEC and disability and longitudinal data is needed to clarify the nature of this association