Monitoring and evaluation of health disparities for people with disability in low- and middle-income countries: A scoping review.

Abstract

People with disability experience health inequities and mostly live in low- and middle-income countries (LMIC), as this is where most of the world's population resides. Despite this, existing evidence on health equity for people with disability mostly comes from high-income settings. Monitoring and evaluation of health equity is crucial for countries to address and track progress towards goals, such as the highest attainable standard of health for people with disability. This scoping review aimed to summarise the available literature on approaches and indicators used in LMIC to compare health-related outcomes between people with and without disability. We included peer-reviewed articles published between 2008 and 2024 that compared health-related outcomes between people with and without disability. We identified 59 eligible studies, from a broad range of LMIC. Disability indicators varied, with most studies using one of multiple Washington Group (WG) sets to enable disaggregation of data by disability status. Survey data was most frequently used, with only two studies using administrative data. A wide range of health-related outcomes were explored, with themes of maternal and child health, and human immunodeficiency virus (HIV)-related outcomes emerging as key areas of focus. Disparities were consistently found, with almost all included studies finding poorer outcomes for people with compared to people without disability. There was a noticeable lack of action taken to improve future policy or monitoring and evaluation or to enact real and meaningful change in health equity for people with disability.