Child disability and caregiving in low and middle income countries: Big data approach on open data

This essay is based on the assumption that a long-neglected topic of socialization, the determinants of individual differences in parental functioning, is illuminated by research on the etiology of child maltreatment. Three domains of determinants are identified (personal psychological resources of parents, characteristics of the child, and contextual sources of stress and support), and a process model of competent parental functioning is offered on the basis of the analysis. The model presumes that parental functioning is multiply determined, that sources of contextual stress and support can directly affect parenting or indirectly affect parenting by first influencing individual psychological well-being, that personality influences contextual support/stress, which feeds back to shape parenting, and that, in order of importance, the personal psychological resources of the parent are more effective in buffering the parent-child relation from stress than are contextual sources of support, which are themselves more effective than characteristics of the child.

Intellectual disability is an extremely stigmatizing condition and involves utilization of large public health resources, but most data about its burden is based on studies conducted in developed countries. The aim of this meta-analysis was to collate data from published literature and estimate the prevalence of intellectual disability across all such studies. The review includes studies published between 1980 and 2009, and includes data from populations that provided an overall estimate of the prevalence of intellectual disability. Meta-analysis was done using random effects to account for heterogeneity. Sub-group analyses were also done. The prevalence of intellectual disability across all 52 studies included in the meta-analysis was 10.37/1000 population. The estimates varied according to income group of the country of origin, the age-group of the study population, and study design. The highest rates were seen in countries from low- and middle income countries. Studies based on identification of cases by using psychological assessments or scales showed higher prevalence compared to those using standard diagnostic systems and disability instruments. Prevalence was higher among studies based on children/adolescents, compared to those on adults. Higher prevalence in low and middle income group countries is of concern given the limitations in available resources in such countries to manage intellectual disability. The importance of using standardized diagnostic systems to correctly estimate the burden is underlined. The public health and research implications of this meta-analysis have been discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.