Conducting Surveys on Disability: A Comprehensive Toolkit

Various Sources of Information for
Detecting Disability
The design of the “screener” for disability can rely on different
methods. It is, however, essential to rely on existing tools that
have been tested and used worldwide as they offer consistency
for identifying and measuring disability.
The screening tool aims to identify the different types of disability
that might exist within a given household. It is composed of
several sections related to different types of difficulties. Each
section consists of a series of questions. The design, phrasing
and choice of questions in the screening are based on existing
bibliography and tools, discussions with experts in the country
and abroad, as well as interviews and pre-tests with persons
with disability. For the NDSA the screening tool was based on:
• Advice and inputs from experts on disability and persons
with disability, and organisations of Afghans with
disability;
• Use of documents, mainly the ICF and the WHODAS II;
• Pre-tests on the field to ensure that the wordings of the
questions were understood and did not reflect stigma and
prejudice.
A large number of surveys have made the mistake of relying on
one person as a source for detecting the presence of a person
with disability within a given household. The surveyors, more
often that not, have limited experience with disability, or, when
they are health and social workers, have experience with specific
types of disability. Moreover, the training of the survey team is
often too short, limited to visible disabilities or those that are
culturally accepted and easily identified. All this can lead to an
under-evaluation of the disability prevalence rates.
For a survey on disability that aims at establishing prevalence
rates, researchers need to devise a screening methodology that
is not based on the judgement of one or more surveyors only. The
screening questions can be determined according to different
sections: physical, psychological, intellectual and sensorial.
These questions relate to the concept of what is disabling
in order to lead a fulfilling life within the community and in
society. In defining the screening process there may be various
considerations. The term itself is often disabling: ‘disability’ in
many cultures refers to socially acceptable forms of disability,
ignoring other forms, such as mental disability.
The designing of questions that are not stigmatising and that are
presented in a non-threatening manner for the interviewees and
their families, remains a difficult task.
As a result various sources can be used to validate the detection
of a person with disability within the household:
• The screening tool;
• The opinion of the surveyor
These may be confirmed (or not) by the interviewee’s point of
view.
• The interviewee’s opinion regarding his/her own condition.
Detecting disability through an adapted and unbiased tool is
one of the main pre-requisites to carrying out any survey on the
subject of disability. Examples of surveys that have been carried
out in other countries have shown that there is a serious risk
of wrong estimation or underestimation if the screening tool is
dependent solely on the survey team, especially if the training
was insufficient or inadequate.
Using a screening tool does, however, present a limitation, which
seems difficult to avoid. The questions of the screening tool
are asked to the head of household. Therefore, there is a risk
of underestimating the existence of disability conditions among
household members. The ideal solution would be to interview
each member of the household with the screening tool. This is
practically impossible for a survey, more so in a country like
Afghanistan. People are out in the fields, villages are often
Different Sources of Information to Determine the Presence of a
Person with Disability within the Household:
• The opinion of the surveyors was important and allowed us to curb the risk of families stating having a person with
disability in the hope of getting some state support.
• The screening tool which consisted of a list of 27 simple questions that addressed different types of disability.
• Self-perception of the interviewee: this was asked for persons who were interviewed after having been screened as
having some form of disability. At the end of the entire questionnaire, he/she was asked if she/he saw her/himself as
disabled or not.
Elaborating Relevant Tools
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