National burden of disabilities in Bangladesh and its socio-demographic correlates: A 2021 cross-sectional analysis.

Abstract

Disability remains an important public health and social challenge, particularly in low- and middle-income countries (LMICs), including Bangladesh. However, nationally representative evidence on its burden, distribution, and associated factors remains limited. This study estimated the national prevalence and patterns of disability in Bangladesh and examined their sociodemographic correlates. This cross-sectional study analysed data from 155,025 participants in the 2021 National Survey on Persons with Disabilities (NSPD). Disability status (yes or no) was the primary outcome. Explanatory variables were measured at the individual, household, and community levels. Multilevel mixed-effects logistic regression models, stratified by age group (0-17 years [children] and 18-95 years [adults]), were used to examine factors associated with disability. The prevalence of disability was 2.79% (95% CI 2.69-2.91). Physical disability (42.44%) and visual impairment (14.11%) were the most commonly reported types, and 11.60% of persons with disabilities reported multiple disabilities. Overall, disability was more prevalent among males, although sex-specific patterns differed by age. Among children, girls had 31% higher adjusted odds of disability than boys (adjusted odds ratio [aOR] 1.31, 95% CI 1.13-1.52), whereas no significant sex was observed among adults (aOR 1.06, 95% CI 0.95-1.19). In both age groups, the odds of disability increased with years of schooling and household wealth. Among adults, housewives, students, and blue-collar workers had higher odds of disability than agriculture workers. Higher community-level literacy was associated with higher odds of disability among adults, whereas the association was reversed among children. The findings support strengthening community-based disability identification and referral in Bangladesh through existing primary health-care services, particularly in underserved populations and areas. Coordination between the Ministry of Health and Family Welfare and the Department of Social Services could improve access to existing social protection, rehabilitation, and assistive-device services.