Available online 4 May 2023, 101481

Children with disabilities have been low on the agenda of child health, including in Sierra Leone, and there are still many gaps in our knowledge and understanding of the issue.

To estimate the prevalence of children with disabilities in Sierra Leone using functional difficulty as a proxy and to understand the factors associated with disabilities among children two to four years living in Sierra Leone.

We used cross-sectional data from the Sierra Leone 2017 Multiple Indicator Cluster Survey. Disability was defined using a functional difficulty definition with additional thresholds used to define children with severe functional difficulty and multiple disabilities. Logistic regression models estimated odds ratios (OR) of childhood disability and how they were associated with socioeconomic factors and living conditions.

Prevalence of children with disabilities was 6.6% (95% confidence interval (Cl) 5.8- 7.6%) and there was a high risk of comorbidity between different functional difficulties. Children with disabilities were less likely to be girls (adjusted odds ratio (AOR) 0.8 (CI 0.7 - 1.0) and older (AOR 0.3 (CI 0.2 - 0.4)), but more prone to be stunted (AOR 1.4 (CI 1.1 - 1.7)) and have younger caregivers (AOR 1.3 (CI 0.7 - 2.3)).

The prevalence of disabilities in young Sierra Leonean children was comparable to other countries in West and Central Africa when using the same measure of disability. Preventive as well as early detection and intervention efforts are recommended to be integrated with other programs, e.g vaccinations, nutrition and poverty reducing programs.

The project has been funded through Swedish regional ALF funding. ALF is the abbreviation in Swedish of an agreement between the central government and seven regions on physician education and clinical research. The data collection was done through the Multiple Indicator Cluster Survey and not funded through the study.

This study utilized data collected during the Sierra Leone 2017 Multiple lndicator Cluster Survey 28, at the time of submission the most recent data available. It is a household survey with a two-stage sample design developed to ensure estimates on national, regional, and district levels as well as for urban and rural areas, with census enumeration areas selected using probability proportional to size. The main sampling strata were urban and rural areas in each district and a systematic sample

The study included 7,117 children between two to four years old (weighted number 7,090), with an even distribution of age and sex (Table 2). Undernutrition was common within the study population, especially stunting which affected 30% of the children. Most of the caregivers had pre-primary or no education (64%) and were living in rural areas (62%). Less than 20% of caregivers interacted regularly with their child in the preceding days (defined as interacting four or more times during a

The aim of this study was to estimate the percentage of disability among children two to four years in Sierra Leone using functional difficulty as a proxy, as well as to understand the associations of these difficulties with possible risk and protective factors. We found that the overall reported percentage of children with disabilities was about 7%, and that having a functional difficulty in one domain greatly increased the probability of having a functional difficulty in another domain. We

Children with disabilities are common in Sierra Leone, and the percentage is comparable to estimates from other countries in West and Central Africa. To help improve the well-being of children with disabilities, the results from this study can be used to guide policy development in Sierra Leone and West and Central Africa. Characteristics that could inform policy and programming include that children with functional difficulties are more likely to be boys, young, stunted, and have young

Helena Frielingsdorf has received ALF funding for other studies 2022. Otherwise none to declare.

© 2023 Published by Elsevier Inc.