Health, education and well-being for children with deafblindness: a secondary analysis of 36 Multiple Indicator Cluster Surveys.

OBJECTIVE

To examine the health, education and social inequities experienced by children with deafblindness in low- and middle-income countries.

DESIGN

Secondary analysis of 36 Multiple Indicator Cluster Surveys (2017-2020), using age-adjusted modified Poisson models to compare outcomes between children with and without deafblindness.

SETTING

36 low- and middle-income countries.

PATIENTS: 446 233 children aged 2-17, including 232 children with deafblindness.

MAIN OUTCOME MEASURES: Education (primary school attendance rate, secondary school attendance rate, early childhood education and the Early Childhood Development Index), health (stunting, wasting, health insurance, diarrhoeal disease and acute respiratory infection) and well-being (inadequate supervision, violent discipline, living arrangements, birth registration and poverty status) were measured.

RESULTS

Children with deafblindness faced inequities in health and education indicators compared with children with other disabilities and children without disabilities. Children with deafblindness had consistently lower school attendance rates across school ages (primary: adjusted Prevalence Ratio (aPR) 0.30 (0.18 to 0.50); secondary: aPR 0.42 (0.20 to 0.87)), had worse Early Childhood Development Indices (aPR 0.35 (0.22 to 0.55)) and had 2-3 times higher prevalence of nutritional disorders (stunting: aPR 1.24 (1.03 to 1.50); wasting: aPR 2.79 (1.99 to 3.92)). However, there were non-significant differences in well-being indicators, such as poverty, inadequate supervision, birth registration and living situation. Children with deafblindness were also less likely to experience violent discipline.

CONCLUSION

Children with deafblindness constitute a heterogeneous group of children with disabilities. They face persistent barriers in accessing education and have poorer health, which must be addressed through building more disability-inclusive health and education systems.