Economic Costs of Living with Disabilities and Stigma in Viet Nam

168 Pages·2013·0.93 MB·English

Economic Costs of Living
with Disabilities and
Stigma in Viet Nam
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Economic Costs of Living
with Disabilities and
Stigma in Viet Nam
Ha Noi, 2013
This report looks at cost of living with disabilities and stigma and discrimination against PWD. Findings
from this report came from a population-based survey at 8 provinces in Viet Nam. The project is led by the
Institute for Social Development Studies under the financial support of AusAID, technical support of external
consultants of the Ha Noi Medical University, Institute of Population, Health and Development, and Nossal
Institute of the Melbourne University and the Disability Resource and Development (DRD).
Economic costs of Living with Disabilities
and Stigma in Viet Nam
TABLE OF CONTENTS......................................................................................................01
LIST OF TABLES...............................................................................................................05
LIST OF FIGURES............................................................................................................08
ABBREVIATIONS.............................................................................................................11
ACKNOWLEDGEMENTS...................................................................................................12
RESEARCH TEAM............................................................................................................13
CHAPTER 1. INTRODUCTION............................................................................................15
CHAPTER 2. THE 2011 DISABILITY AND STIGMA SURVEY (2011 DSS)..............................21
2.1. General information...................................................................................................22
2.2. Definition and measurement of disability.....................................................................22
2.3. Study sample and sampling.......................................................................................23
2.4. Study tools...............................................................................................................24
2.5. The pilot and fieldwork..............................................................................................25
2.6. Data processing and analyzing...................................................................................25
2.6.1. Data entering & cleaning..................................................................................25
2.6.2. Data analysis..................................................................................................26
CHAPTER 3. DISABILITY PROFILE....................................................................................27
3.1. Disability prevalence..................................................................................................28
3.1.1. Disability prevalence.........................................................................................28
3.1.2. Main reason of disability...................................................................................31
3.1.3. Gender difference of disability...........................................................................33
3.1.4. Age variations of disability................................................................................33
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3.1.5. Urban-rural differences in disability...................................................................35
3.1.6. Disability and living arrangement.......................................................................35
3.2. Demographic characteristics of population with disabilities..........................................36
3.2.1. Gender............................................................................................................36
3.2.2. Age................................................................................................................36
3.2.3. Marital status..................................................................................................37
3.3. Health......................................................................................................................38
3.3.1. Self-assessment of current health status...........................................................38
3.3.2. Body mass index (BMI)....................................................................................38
3.3.3. Health risk behaviors.......................................................................................39
3.3.4. Health insurance.............................................................................................40
3.3.5. Utilization of health care services.....................................................................42
3.3.6. Expenditure on health care...............................................................................43
3.4. Education.................................................................................................................44
3.4.1. Net enrolment ratio in tertiary education...........................................................44
3.4.2. Ratio of girls to boys in tertiary education.........................................................43
3.4.3. School attendance...........................................................................................45
3.4.4. Completion of primary education......................................................................46
3.4.5. Expenditure on education..................................................................................48
3.5. Economic participation and income............................................................................48
3.5.1. Working status................................................................................................48
3.5.2. Reasons for not working..................................................................................49
3.5.3. Occupational structure of the current main job..................................................50
3.5.4. Job sector of the current main job....................................................................51
3.5.5. Individual income............................................................................................51
3.5.6. Household income and poverty..........................................................................53
3.6. Social and political participation.................................................................................54
3.6.1. Accessing to public transportation....................................................................54
3.6.2. Participation in socio-political or mass- organizations and activities...................55
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3.7. Life satisfaction.........................................................................................................56
3.8. Awareness of Disability law.......................................................................................57
CHAPTER 4: DISABILITY- RELATED STIGMA AND DISCRIMINATION.................................59
4.1. Introduction..............................................................................................................60
4.2. Measurement of stigma.............................................................................................60
4.2.1. Development of stigma scale...........................................................................60
4.2.2. Stigma related variables...................................................................................61
4.2.3. Disability related variables................................................................................62
4.2.4. Data analysis...................................................................................................62
4.3. Results.....................................................................................................................62
4.3.1. Stigma among people with and without disabilities............................................62
4.3.2. Variation between people with different types of disability..................................67
4.4. Discussion................................................................................................................71
4.5. Conclusion................................................................................................................72
CHAPTER 5. ECONOMIC COST OF LIVING WITH DISABILITY AND STIGMA IN VIET NAM.........73
5.1. Introduction..............................................................................................................74
5.2. Cost of living with disability and its link with stigma....................................................74
5.3. Review of available methods for estimating the cost of disability...........................75
5.4. Methods..................................................................................................................77
5.4.1. The standard of living approach.......................................................................77
5.4.2. Assessing joint-effect of disability and stigma on the cost of living....................79
5.4.3. The statistical software....................................................................................80
5.5. Results....................................................................................................................80
5.5.1. Cost of living with disability.............................................................................80
5.5.2. Joint-effect of disability and stigma on the cost of living....................................91
5.5.3. Income gap by disability status due to stigma......................................................95
5.6. Discussion and policy implication...........................................................................97
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REFERENCES.................................................................................................................99
APPENDIXES................................................................................................................105
Appendix 1. The study provinces....................................................................................106
Appendix 2. Separated analyses of stigma scores for each type of disability.....................107
Appendix 3. Screening form............................................................................................129
Appendix 4. Household questionnaire..............................................................................133
Appendix 5. Individual questionnaire................................................................................144
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List of tables
Table 1 Summary of sampling and sample 24
Table 2 Prevalence of disability by domain and degree of difficulty 28
Table 3 Prevalence of disability by domain, degree of difficulty and age 33
Table 4 Average expenditure per person for health care by disability status 34
Table 5 Average monthly salary in VND of those who have salary 52
Table 6 Average total allowance per month in the past 12 months 53
Descriptive statistics of total scale and subscale of stigma scores of people with
Table 7 63
and without disability
Table 8 Linear regression of stigma score across socio-economic groups 65
Table 9 Logistic regression model for high stigma across socio-economic groups 66
Descriptive statistics of stigma score for people without and with different levels
Table 10 67
of difficulty
Summary of results from linear regression model for stigma score, different
Table 11 69
levels of difficulty and socio-economic factors for each type of disability
Summary of results from logistic regression models for high stigma, different
Table 12 70
levels of difficulty and socio-economic factors of each type of disability
Table 13 Estimated annual cost of living with disability (any disability) 81
Table 14 Estimated annual cost of living with vision difficulty 82
Table 15 Estimated annual cost of living with hearing difficulty 82
Table 16 Estimated annual cost of living with moving difficulty 83
Table 17 Estimated annual cost of living with remembering difficulty 84
Table 18 Estimated annual cost of living with self-care difficulty 84
Table 19 Estimated annual cost of living with communication difficulty 85
Table 20 Estimated cost of living with disability by age of the person with disability 87
Table 21 Estimated cost of living with disability by gender of the person with disability 87
Table 22 Estimated cost of living with disability by living area of the person with disability 88
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Table 23 Estimated cost of living with disability by severity (OLS model) 90
Table 24 Estimated cost of living with disability by severity (Ordered logit model) 90
Estimated annual cost of living with both disability and stigma (median as the
Table 25 92
cut-off point)
Estimated annual cost of living with both disability and stigma (upper bound of
Table 26 94
inter-quartile as the cut-off point)
Decomposition of the gap in annual income between households with and
Table 27 95
without disabilities (median as the cut-off point)
Decomposition of the gap in annual income between households with and
Table 28 97
without disabilities (upper bound of inter-quartile as the cut-off)
Descriptive statistics of stigma score for people without and with different levels
Table 29 107
of vision difficulty
Linear regression model for stigma score, different levels of vision difficulty and
Table 30 108
socio-economic factors
Logistic regression model for high stigma and different levels of vision difficulty
Table 31 109
and socio-economic factors
Descriptive statistics of stigma score for people without and with different levels
Table 32 110
of hearing difficulty
Linear regression model for stigma score, different levels of hearing difficulty
Table 33 111
and socio-economic factors
Logistic regression model for high stigma and different levels of hearing difficulty
Table 34 113
and socio-economic factors
Descriptive statistics of stigma score for people without and with different levels
Table 35 114
of remembering difficulty
Linear regression model for stigma score, different levels of remembering
Table 36 115
difficulty and socio-economic factors
Logistic regression model for high stigma and different levels of remembering
Table 37 116
difficulty and socio-economic factors
Descriptive statistics of stigma score for people without and with different levels
Table 38 117
of walking difficulty
Linear regression model for stigma score, different levels of walking difficulty
Table 39 118
and socio-economic factors
Logistic regression model for high stigma and different levels of walking
Table 40 120
difficulty and socio-economic factors
Descriptive statistics of stigma score for people without and with different levels
Table 41 121
of communication difficulty
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