Essays on disability and wellbeing in Uganda

Abubakar, Aisha Mohammed (2022) Essays on disability and wellbeing in Uganda. PhD thesis, University of Nottingham.

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Abstract

The thesis introduces three independent but related empirical studies on disability and wellbeing in Uganda. The first essay evaluates the short-term health and economic impacts of providing orthotic equipment to adults with lower limb disability using unique data collected during an orthotic equipment intervention between 2012 and 2013. The study adopts a before-after estimation strategy to examine changes to: (i) functional mobility and (ii) labour market outcomes, including the type of employment and monthly earnings. One year after the intervention, the effects are noticeably gendered; men exhibit an improvement in their level of functional mobility, while women face little change or a reduction in their mobility levels. In terms of labour market outcomes, for men, the intervention leads to an increase in monthly earnings, which is partly due to a switch from self- to wage employment. Earnings increase for women, although the overall effect is much smaller. Taking into account the intensity of equipment use, the Wald estimates reveal larger marginal effects on both mobility and earnings.

The second essay tracks the outcomes of a medical intervention which provided lower limb orthosis to adults with disabilities between 2012 and 2018. Six years after the intervention, over one-third of the recipients were still using their orthotic devices. However, using a discrete-time hazard model, the analysis examines the speed at which the orthotic devices failed and evaluates how personal characteristics and clinical factors acted as potential risk markers of early equipment failure. The study finds that the peak time of failure lay between the fourth- and fifth-year post-fitting, with the probability of orthosis failure being significantly lower for women, the elderly and most importantly, those who had access to follow up care compared to their respective counterparts. The study also analysed the implications of orthotics failure on life satisfaction, health-related quality of life and disability severity, which are designed to measure subjective wellbeing. Notably, the results indicate that access to follow up care improves functional efficiency, while failure of the orthosis consistently acts as a negative correlate of wellbeing.

The final essay provides some useful insights into the disability-wellbeing nexus using cross-sectional data from the Uganda Functional Difficulties Survey 2017. It adopts a multilevel modelling approach to evaluate the determinants of subjective wellbeing on a sample of disabled and non-disabled adults in Uganda. Particularly, the study analysed the relationship between wellbeing and (i) having a disability (ii) socio-psychological markers, including levels of discrimination, access to Information & Communication Technologies (ICT) as proxied by mobile phone use, and personal safety and (iii) the role of intrahousehold arrangements in disabled and non-disabled households. Although the observed effects do not occur universally, the analysis identifies the presence of disability and levels of discrimination as negative correlates of wellbeing, while feelings of personal safety, and access to ICT are positively linked to wellbeing. We also find that education and household wealth have positive interactive effects on the disability-wellbeing nexus, while ICT use may positively buffer the discrimination-wellbeing relationship. Lastly, the analysis finds that the type of household and a person’s relationship to the head of the household partly explain distributional differences in personal wellbeing.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Owens, Trudy
Bridges, Sarah
Keywords: People with disabililities, Disability, PwDs, Wellbeing, Happiness, SWB, Orthotics, Rehabilitation, Intervention, Social inclusion, Development Economics, Uganda
Subjects: H Social sciences > HV Social pathology. Social and public welfare
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > School of Economics
Item ID: 69194
Depositing User: Abubakar, Aisha
Date Deposited: 28 Jul 2022 04:40
Last Modified: 28 Jul 2022 04:40
URI: http://eprints.nottingham.ac.uk/id/eprint/69194

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