Journal of Rehabilitation Medicine 51-10 | Page 89

Prevalence of disability in Morocco
Fig. 2. Prevalence of disability in Morocco according to geographical
region. 1: Oued Ed-Dahab-Lagouira; 2: Laâyoune-Boujdour-Sakia
el Hamra; 3: Guelmim-Es Smara; 4: Souss-Massa-Drâa; 5: Gharb-
Chrarda-Beni Hssen; 6: Chaouia-Ouardigha; 7: Marrakech-Tensift-Al
Haouz; 8: Oriental; 9: Grand Casablanca; 10: Rabat-Salé-Zemmour-
Zaër; 11: Doukkala-Abda; 12: Tadla-Azilal; 13: Meknès-Tafilalet; 14:
Fès-Boulemane; 15: Taza-Al Hoceima-Taounate; 16: Tanger-Tétouan.
Table V. Prevalence of disability according to socio-demographic
variables and geographical distribution, multivariate analysis
Age groups
18–39 years
40–59 years
60 years and above
Marital status
Single
Married
Divorced
Widower
Education level
Illiterate
Primary school
High school
College/university
Occupation
Employed
Unemployed
Housewife
Student
Retired
Geographical region
R1-2-3: Regions of Southern Sahara
R4: Souss-Massa-Drâa
R5: Gharb-Chrarda-Beni Hssen
R6: Chaouia-Ouardigha
R7: Marrakech-Tensift-Al Haouz
R8: Oriental
R9: Grand Casablanca
R10: Rabat-Salé-Zemmour-Zaër
R11: Doukkala-Abda
R12: Tadla-Azilal
R13: Meknès-Tafilalet
R14: Fès-Boulemane
R15: Taza-Al Hoceima-Taounate
R16: Tanger-Tétouan
OR 95% CI
1
3.92
11.69 –
3.51–4.39
10.30–13.28
1
0.77
0.91
1.46 –
0.68–0.88
0.72–1.15
1.24–1.71
1
0.61
0.47
0.35 –
0.55–0.67
0.42–0.53
0.29–0.45
1
3.29
1.13
1.07
1.81 –
2.97–3.66
1.03–1.24
0.80–1.44
1.59–2.07
0.62
0.72
0.39
0.46
0.30
0.53
0.27
0.36
0.33
0.94
0.87
0.61
0.60
1 0.54–0.72
0.60–0.86
0.32–0.48
0.39–0.54
0.25–0.37
0.44–0.64
0.22–0.33
0.29–0.44
0.27–0.40
0.80–1.10
0.74–1.02
0.51–0.72
0.50–0.71
-
OR: odds ratio; 95% CI: 95% confidence interval.
p-value
< 0.001
–
< 0.001
< 0.001
< 0.001
–
< 0.001
0.458
< 0.001
< 0.001
–
< 0.001
< 0.001
< 0.001
< 0.001
–
< 0.001
0.006
0.630
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
< 0.001
0.472
0.106
< 0.001
< 0.001
-
809
CI = 0.68–0.88, p < 0.001) and widow/widower with
significantly higher prevalence of disability (OR = 1.46,
95% CI = 1.24–1.71, p < 0.001) compared with the
single population. As for education, prevalence of
disability was significantly lower in the populations
with higher educational levels. Compared with the
professionally active population, the categories unem-
ployed (OR = 3.29; 95% CI = 2.97–3.66; p < 0.001),
housewives (OR = 1.13; 95% CI = 1.03–1.24; p = 0.006)
and retired (OR = 1.81; 95% CI = 1.59–2.07; p < 0.001)
were significantly associated with higher prevalence
of disability.
As for occupation, in the younger group (age range
15–59 years), only the unemployed (OR = 3.59, 95%
CI = 3.15–4.05, p < 0.001) and retired (OR = 3.58,
95% CI = 2.94–5.05, p < 0.001) were confirmed to
be significantly associated with higher prevalence of
disability compared with the employed population;
whereas in the older group, housewives (OR = 1.40,
95% CI = 1.09–1.80, p = 0.008) were also experiencing
a significantly higher prevalence of disability, along
with the unemployed and retired, compared with the
still economically active (employed) population.
With comparable socio-demographic variables, the
prevalence of disability is still significantly higher is
the north region (R16 = Tanger-Tétouan), than in the
rest of the rest of the country.
DISCUSSION
This survey found that 9.5% of the adult Moroccan
population, representing 2,166,285 persons (12), have
different degrees of impairments and limitations in
functioning. There was an 85% increase in overall
prevalence of disability over a period of 10 years
(2004–2014) (9), which could be explained, at least in
part, by the use of the 2014 survey of a larger screening
spectrum of disabilities, based on the WG Short Set
of Questions on Disability. The latter is based on the
“bio-psycho-social” ICF model, which transformed our
understanding of disability from impairment-based to
activity-limitation-based. One of the main strengths of
the ICF model is that it improves the comparability of
disability prevalence and data across different popula-
tions and contexts (13).
The overall prevalence of disability in Morocco
(9.5%) is lower than the worldwide estimation of
disability (15.6%) according to the world health sur-
vey conducted in 59 countries representing 64% of
the world population in 2002–2004 (14). The lower
prevalence of disability in lower income countries is
usually explained by data collection for a narrow set
of impairments, yielding lower estimates of disability
(1). Hence, this lower prevalence rate of disability
J Rehabil Med 51, 2019