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Before the advent of DALYs (and the earlier but related idea of quality-adjusted life years [QALYs]), health-outcome measures typically relied on mortality (an exception was the method of disability-free life expectancy and its complement, the number of years lived with a disability).1 In view of the wide range of effects that various health conditions can engender, the approach of using only mortality was judged inadequate. According to the World Bank's 1993 global burden of disease study,2 DALYs have three major objectives: \"to facilitate the inclusion of nonfatal health outcomes in debates on international health policy, to decouple epidemiological assessment from advocacy so that estimates of the mortality or disability from a condition are developed as objectively as possible, and to quantify the burden of disease using a measure that could be used for cost-effectiveness analysis\". Prevention of disabilities is an important goal, but there are two key types: (1) prevention of medical conditions that lead to body function or structure limitations; and (2) prevention of the social and environmental conditions that stop people with those types of limitations from being able to participate in social and economic activities.

Ghana’s Disability Fund aims to build the capacity of persons with disabilities, particularly those outside of formal employment, to engage in livelihood generation activities as a way to reduce poverty. The objective of this paper is to investigate the kind of knowledge that exists on the District Assemblies Common Fund program, understand the experience of beneficiaries when they access the program, and examine the benefits on beneficiaries’ livelihoods. The research consisted of five focus group discussions with 35 beneficiaries, key informant interviews with six member organizations of Ghana Federation of Disability Organizations, and interviews with eleven Disability Fund Management Committees members. This research found the experiences of beneficiaries on the program are varied yet the program on the whole has had a positive outcomes on their livelihoods. Persons with disabilities who participated in this study demonstrated knowledge of the program. Beneficiaries further described issues relating to the quality of purchased items, the procurement process, as well as reductions and changes to requested items. Disability-specific issues in accessing the funds were also noted. These limited the effectiveness of the Fund to meet its stated goals. The findings of the study can inform the Common Fund Secretariat efforts to improve the performance of the fund as well as the advocacy of the disability movement. The findings are also relevant to the design and implementation of other social protection programmes in low-and middle-income countries.

Through a series of focus group discussions conducted in northern and central Vietnam, this study gives voice to the lived economic experience of families with disabilities and how they manage the economic challenges associated with disability. The dynamic of low and unstable income combined with on-going health care and other disability-related costs gives rise to a range of coping mechanisms (borrowing, reducing and foregoing expenditures, drawing upon savings and substituting labour) that helps to maintain living standards in the short-run yet threatens the longer-term welfare of both the individual with disability and their household. Current social protection programs were reported as not accessible to all and while addressing some immediate economic costs of disability, do not successfully meet current needs nor accommodate wider barriers to availing benefits.

This article investigates the impact of exposure to United States air force bombing during 1965–75 on the disability status of individuals in Vietnam in 2009. Using a combination of national census and US military data and an instrumental variable strategy which exploits the distance to the former North–South border as a quasi-experiment, the article finds a positive and significant impact of bombing exposure on district level disability rates 40 years after the war. The overall effect of bombing on the long-term disability rate among the Vietnamese population is highest among heavily bombed districts. Districts in the top bombing quintile experience a 25% relative increase in the rate of disability attributable to bombing compared with districts in the lowest bombing quintile. Effects are highest on the prevalence of severe disability and among cohorts before the war’s end. A smaller, yet significant, effect is found among cohorts born after the war. The article finds further evidence of indirect channels through which bombing may have impacted on long-term disability including adverse effects on nutritional environment and human capital attainment. These findings add to the evidence from Vietnam and indicate that wars inflict costs on the health of human populations that last longer than those relating to economic growth and welfare.

Disability is significantly correlated with poverty in Vietnam, according to data from the 2006 Vietnam Household Living Standards Survey, especially when the extra costs of living with a disability are taken into account. This disability-poverty link is also associated with lower educational attainment, an important factor in determining poverty and productive economic activity in general, both for household-based businesses and wage employment. Not taking into account these associations and the extra costs of disability will make some poor disabled people invisible in poverty statistics and impede efforts to reduce poverty.

This paper describes the Washington Group project to test a short battery of disability questions developed for national censuses. The study used an unusually structured cognitive test protocol and was administered to a total of 1,290 respondents selected from convenience samples in fifteen countries in Central and South America, Asia and Africa. The test protocol consisted of the six core disability questions followed by questions designed to illustrate: (1) whether core questions were administered with relative ease; (2) how core questions were interpreted by respondents; (3) the factors considered by respondents when forming answers to core questions; and (4) the degree of consistency between responses to core questions and a set of more detailed functioning questions. Additionally, demographic and general health sections allowed for an examination of comparability, specifically, whether test questions performed consistently across all respondents, or if nationality, education, gender or socio-economic status impacted the ways in which respondents interpreted or considered each core question.

Purpose - The purpose of this paper is to examine the impact of international remittances on different household welfare indicators including child education, assets, durable goods, and reservation wages of other working age household members. It examines how international remittances are spent for production and consumption by receiving households.Design methodology approach - This paper uses fixed-effect regressions to estimate the impact of international remittances on household spending in Vietnam using Vietnam Household Living Standard Surveys 2006 and 2008.Findings - It is found that most of international remittances are spent on housing and land, debt repayment and saving. A small proportion of remittances are used to buy durable goods. Remittances are not spent in production as well as living consumptions. The effect of international remittances on consumption-based poverty is very limited.Originality value - The findings from this paper suggest that current international remittances are not an effective measure for poverty reduction in the short-run in Vietnam.

Poverty and disability are interrelated, but data that can disentangle to what extent one causes the other and vice versa is not available. However, data from Vietnam allows us to examine this interrelationship in a way not done previously. Using small area estimation techniques, we uncover three findings not yet found in the literature. First, disability prevalence rates vary significantly within a country even at the district level. Second, the poverty gap between people with and without disabilities also varies at the district level. And most importantly, the size of that gap lessens based on district characteristics that can be affected by policy. Districts with better health care and infrastructure, such as road and health services, show less of a link between disability and poverty, supporting the hypothesis that improvements in infrastructure and rehabilitation service can lessen the impact of disability on families with disabled members.

Disability is complex and multifaceted, complicating governments' efforts to collect the high-quality, comprehensive data necessary for developing, implementing, and monitoring policies. Yet data are needed to obtain information on functioning in the population, to identify the population with disabilities, and to disaggregate indicators of well-being by disability to determine whether people with disabilities are participating in society to the same extent as those without disabilities. In this article we discuss the need for data harmonization to improve disability research and policy. We describe standard question sets on disability developed for inclusion in surveys and administrative systems, as well as the need for coordination of both statistical and administrative data systems. Until disability data become more harmonized, it will not be possible to support the development of comprehensive, evidence-based policies and programs to address the needs of the population with disabilities.