Counting disability: emerging consensus on the Washington Group questionnaire
Authors: Nora E Groce, Daniel Mont
Journal: The Lancet Global Health (2017)

In November, 2016, at the fourth meeting of the Inter-agency and Expert Group on Sustainable Development Goal (SDG) Indicators in Geneva, a group of leading UN agencies, civil society actors, and independent experts issued a statement1UNDP, International Labour Organization, UNICEF, WHO, Office of the High Commissioner for Human Rights, United Nations Population Fund, United Nations Special Rapporteur on the rights of persons with disabilities, United Nations Partnership to Promote the Rights of Persons with Disabilities, International Disability Alliance, International Disability and Development Consortium, Disability data disaggregation. Joint statement by the disability sector, 2016 http://www.washingtongroup-disability.com/wp-content/uploads/2016/01/Joint-statement-on-disaggregation-of-data-by-disability-Final.pdf (accessed March 25, 2017).Google Scholar strongly supporting the Washington Group on Disability Statistics' Short Set of Questions (WGSS)2Washington Group on Disability Statistics, Short set of disability questions. http://www.washingtongroup-disability.com/washington-group-question-sets/short-set-of-disability-questions (accessed March 23, 2017).Google Scholar as the preferred method to use with the SDGs to number the world's population of people with a disability. Further support quickly followed at the UN World Data Forum in Cape Town.3International Disability and Development ConsortiumIDDC at the UN World Data Forum. 2017https://www.iddcconsortium.net/news/iddc-un-world-data-forumGoogle Scholar The UN Statistical Commission and the UN's Economic Commission for Europe's Council of European Statistics has recommended the WGSS for collection of disability information for the upcoming 2020 round of censuses, and the UK Department for International Development is promoting the method for use in its international development activities. These recommendations are the latest in a growing body of endorsements for a method that can be quickly and inexpensively added to censuses, surveys, and research efforts to generate disaggregated, internationally comparable data that provides new insights into how people with disabilities fare in global health and development efforts. Demand for such data is increasing. A billion people worldwide—15% of the world's population—live with a disability, and this population is disproportionately poorer and more marginalised than their non-disabled peers.4WHOWorld report on disability. 2011http://www.who.int/disabilities/world_report/2011/enGoogle Scholar Ratification of the UN Convention on the Rights of Persons with Disabilities5UNConvention on the Rights of Persons with Disabilities (CRPD). 2006https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.htmlGoogle Scholar by more than 160 countries since 2006, and the SDGs' call to "leave no one behind" has substantially raised demand for accurate disability data. Historically, it has been difficult to number people with physical, intellectual, sensory (ie, deafness, blindness), and mental health impairments. Disability questions often are not included in censuses and surveys, or the statistics collected are inaccurate because of poor clarity of definitions or stigma that makes respondents reluctant to identify themselves or household members as disabled. Broad acceptance of the easily implementable WGSS tool represents a major step forward. The tool has been refined since 2001 by the Washington City Group, which was established under the UN Statistical Commission to improve international cooperation on disability data collection. The Washington City Group is composed of representatives from National Statistics Offices from more than 140 nations, as well as UN agencies, international non-governmental organisations, and organisations for people who are disabled.6Altman BM International measurement of disability.in: Purpose, method and application. Springer International Publishing, Cham2016Crossref Google Scholar The method relies on self-reporting rather than clinical assessment and can be administered by data collectors or self-administered. The WGSS includes just six questions and four response categories of severity, focusing on core functional domains: seeing, hearing, walking, cognition, self-care, and communication. The questions are specifically designed to avoid the traditional problems faced by disability-related questions by not requiring respondents to label themselves or others as disabled. In the past decade, the WGSS has been extensively tested and validated in all regions of the world, to ensure its accuracy and universality. Taking less than 2 min to administer and addressing not just the presence or absence, but the type and severity, of disability, the WGSS is designed to be easily added to a range of tools, including censuses and household surveys. The findings can be disaggregated and analysed in conjunction with broad demographic and household data collected in the same instrument (ie, sex, education, employment, income, and access to water and sanitation). Thus, findings of the WGSS provide not just the disability prevalence but also allow analysis by type and severity of disability compared with non-disabled peers. Collection of accurate disability data is important because disability is an issue that cuts across many sectors. With a sufficient sample size, it is possible to answer such questions as are deaf men more likely than deaf women to have more education? Or, what are the employment rates of adults with intellectual disabilities in rural areas compared with non-disabled peers or individuals who are intellectually disabled in urban areas? Because the WGSS can be added to a range of data collection tools—for example, censuses and the Household Income and Expenditure Survey—not only can data be disaggregated by disability in individual tools but data collected with different tools can be compared. The WGSS will also help different ministries understand how the populations they serve relate to each other. The WGSS is one of several new disability-related methods under development. The Washington Group on Disability Statistics itself has already developed and validated an extended set of questions on disability for more in-depth data collection and, in collaboration with UNICEF, a new Module on Child Functioning for children aged 2–17 years.7UNICEFModule on Child Functioning concept note. 2017https://data.unicef.org/resources/module-child-functioning-concept-noteGoogle Scholar Modules on education and employment are being tested. WHO is developing a World Model Disability Survey8WHO, Disability and rehabilitation. Model Disability Survey. http://www.who.int/disabilities/data/mds/en (accessed May 23, 2017).Google Scholar for use as a stand-alone, in-depth data collection instrument. The WGSS has several limitations. No question fully captures mental health impairments and the WGSS is not intended for children younger than 5 years. However, as a validated tool ready for immediate use that is available in many languages, already used in 69 national censuses, and soon to be added to an additional 29 national censuses, the WGSS provides a quick, effective, and inexpensive way to generate disability data for governments, civil society, and research. We declare no competing interests. The authors are supported by funding from the Department of Foreign Affairs and Trade, Government of Australia.