Evaluation of health impacts of a disability-inclusive graduation programme among ultra-poor people with disabilities in Uganda: secondary analysis of a cluster randomized trial

作者：Chen S, Banks LM, Kipchumba E, Davey C, Sulaiman M, Kuper H · 发表于：EClinicalMedicine · 年份：2025 · DOI：10.1016/j.eclinm.2025.103318 · 被引用次数：43 · 研究领域：Disability、Graduation approach、Healthcare access、Poverty reduction、Randomized controlled trial、Uganda

BACKGROUND: People with disabilities experience significant health inequalities and barriers to healthcare access globally. While poverty alleviation interventions show promise for improving health outcomes, evidence specifically for people with disabilities remains limited. This study evaluated the effectiveness of a disability-inclusive graduation (DIG) programme on health outcomes among ultra-poor people with disabilities in Uganda. METHODS: We conducted a two-arm, parallel cluster-randomized controlled trial in four districts of Northern Uganda. Clusters were randomly assigned to either the DIG intervention (96 clusters) or control group (89 clusters). This analysis focused on households with people with disabilities, as identified by the Washington Group Short Set questions and verified by BRAC programme managers. Households in treatment clusters received up to 18 months DIG intervention between December 2020 and June 2022, combining asset transfers, cash support, skills training, financial inclusion activities, and disability-specific services including rehabilitation and assistive devices. The primary outcome was experience of illness/injury in the past 3 months, assessed at both first follow-up (immediately post-intervention) and second follow-up (about 16 months post-intervention), with secondary outcomes including unmet health needs, mental health status, unmet assistive product needs, and healthcare expenditure. Effects were estimated using linear mixed-effects re...