Abstract
BACKGROUND: Approximately 80% of individuals with disability reside in low- and middle-income countries where community-based rehabilitation (CBR) has been used as a strategy to improve disability. However, data relating to disability severity among CBR beneficiaries in low-income countries like Uganda remain scarce, particularly at the community or district level. OBJECTIVES: To describe severity of disability and associated factors for persons with physical disabilities receiving CBR services in the Kayunga district of Uganda. METHODS: A cross-sectional sample of 293 adults with physical disabilities receiving a CBR service in the Kayunga district was recruited. Disability severity was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS2.0), and analyzed as a binary outcome (low: 0-9, high: 10-48). Inferential statistics using odds ratios were used to determine factors associated with impairment severity. FINDINGS: The mean WHODAS 2.0 score of persons with physical disabilities was 12.7 (standard deviation = 8.3). More than half (52.90%) of people with physical disabilities reported a high level of functional impairment. Increased disability severity was significantly associated with limited access to assistive devices (adjusted odds ratio [AOR] = 4.55, 95% confidence interval [CI]: 1.87-14.08, P < .001), and increased use of medical health care (AOR = 5.55, 95% CI: 1.84-16.79, P = .002). CONCLUSION: These findings suggest a high level of moderate to severe functional impairments in persons with physical disabilities receiving CBR in Kayunga district. These data provide support for efforts to enhance CBR's ability to liaise with local health care, education, and community resources to promote access to needed services and ultimately improve the functional status of persons with disabilities in low-resource settings.