​​Disability Measurement in Residential Care Facilities in Kenya​

Though research has been conducted on children with disabilities and on children in residential care settings, the intersections of these two topics has yet to be explored in depth. Notably, there is a lack of information surrounding disability measurement within residential care settings, highlighting a gap in the literature. It is estimated that a child with a disability is 17 times more likely to be placed in an institutionalized care setting than a child without a disability, and girls are more likely to be placed in an institution than boys. This report details research conducted in Kenya. ​​This study was being conducted as part of Changing the Way We Care (CTWWC), a global initiative on care reform, including in Kenya. The initiative seeks to influence key stakeholders – including governments, families of children living in residential care, and donors - to provide, safe, and nurturing family care for children and pathways for children in residential care to return to their families and ​communities. The purpose of this study was to plan and implement a pilot project to undertake the ​measurement of disability amongst children in residential care and to support the dissemination and use ​of findings in Kenya. ​For CTWWC, the goals were three-folds. ​◼ Be part of a global discussion on how to measure prevalence of disability amongst children, ​including children in care ​◼ Fulfil its commitment to disaggregate our results by disability status and learn about a vulnerable ​group of children ​◼ Equip case managers with knowledge and tools to identify children’s needs to help begin the ​process of addressing them ​The quantitative study involved implementing the UNICEF Child Functioning Module (CFM) using cross-sectional study design. The tool is administered to the caregiver of a child, mostly mothers. The tool has two versions, one for children between 2 years to 4 years of age with a total of 16 questions, and second for children between 5-17 years of age with 24 questions. There are eight domains covered in 2-4 years version including vision, hearing, mobility, fine motor, communication, learning, playing and controlling behavior. While 13 domains are covered in 5-17 years version. These include vision, hearing, mobility, self-care, communication, learning, remembering, concentration, accepting change, controlling behavior, making friends, anxiety and depression. ​The data collection was conducted with support from CTWWC staff and partners working with residential facilities for children in the participating facilities. This study was a collaboration between Changing the Way We Care (CTWWC) and Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health. This report was written by Nukhba Zia, Sarena Ho, Joab Wako, Joanna Wakia, Abdulgafoor M Bachani. ​