Sex differences and factors associated with disability among Ghana's workforce: a nationally stratified cross-sectional study

Abstract

Objective: This study was conducted to estimate the prevalence of disability and associated factors and further quantify the associated sex differential among Ghana's workforce aged 15+ years.

Design: A nationally stratified cross-sectional study.

Setting: Ghana.

Participants: Individuals aged 15 years and above.

Outcome measure: Disability that limits full participation in life activities.

Methods: Three predictive models involving Poisson, logistic and probit regression were performed to assess the association between disability and covariates. Modified Poisson multivariate decomposition analysis method was employed to assess sex differential and associated factors using Stata V.16.

Results: The prevalence of disability was 2.1% (95% CI 1.2 to 2.4), and the risk of disability among males was approximately twice compared with females (Poisson estimate: adjusted prevalence ratio (95% CI)=1.94 (1.46 to 2.57); logistic estimate: aOR (95% CI)=2.32 (1.73 to 3.12)). Male sex increased the log odds of disability by 0.37 (probit estimate, aβ (95% CI)=0.37 (0.23 to 0.50)). The variability in age group, marital status, household (HH) size, region, place of residence, relationship to HH head, hours of work per week and asset-based wealth were significantly associated with disability-based sex differential. (Significant increased endowment: β×10^-3 (95% CI×10^-3)=-37.48 (-56.81 to -18.16) and significant decreased coefficient: β×10^-3 (95% CI×10^-3)=42.31 (21.11 to 63.49).) All disability participants were challenged with activities of daily living, limiting them in full participation in life activities such as mobility, work and social life.

Conclusion: The magnitude of experiencing disability among working males was nearly twice that of females. Sex differentials were significantly associated with age groups, marital status, HH size, region of residence, relationship to HH head, hours of work per week and wealth. Our findings amass the provisional needs of persons living with a disability that are indicators to consider to achieve the United Nations Convention on the Rights of Persons with Disabilities Article 10. In addition, formulation of workplace policies should adopt a gender-sensitive approach to reduce disparities and eliminate disability in the target population.

Keywords: epidemiology; occupational & industrial medicine; public health.