# Validation of the World Health Organization Disability Assessment Schedule‐II for Measuring Women With a History of Potentially Life‐Threatening Maternal Conditions at Six Months Postpartum in Tigray, Northern Ethiopia

## TL;DR

This study validates the Tigrigna version of the WHO disability assessment tool for women with severe maternal health issues in Ethiopia.

## Contribution

The study confirms the reliability and validity of the WHODAS 2.0 Tigrigna version for measuring disability in women with life-threatening maternal conditions.

## Key findings

- The Tigrigna version of WHODAS 2.0 showed excellent internal consistency (Cronbach's α coefficients = 0.98).
- Convergent validity between 36-item and 12-item versions was strong (r = 0.909–0.981).
- The tool is reliable and valid for assessing disability in women with severe maternal morbidity.

## Abstract

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a popular tool for evaluating functioning and disability in a range of population demographics and medical situations. However, very little is known about the WHODAS 2.0's validity and reliability, particularly when dealing with potentially life‐threatening maternal conditions (PLTCs). The aim of this study was to evaluate the validity of the WHODAS 2.0 Tigrigna version.

This cross‐sectional study was conducted in Tigray, northern Ethiopia, from December 15 to 20, 2023. Following translation and back translation, women who had experienced PLTCs during a recent pregnancy, childbirth, or postpartum period were administered the 36‐item WHODAS 2.0 in Tigrigna version 6 months after the childbirth. In total, 121 women with a history of PLTCs participated. Cronbach′s α was used to evaluate internal consistency in all six WHODAS 2.0 domains, while Spearman′s correlation coefficient was used to evaluate convergent validity. With confirmatory factor analysis, construct validity was also examined.

All domain scores of the Tigrigna version of the WHODAS 2.0 indicated excellent internal consistency (α = 0.917–0.978 for 36 items and α = 0.874–0.940 for 12 items), while the Cronbach′s α coefficients for the summary score were 0.981 and 0.952 for 36 and 12 items, respectively. The convergent validity between the 36‐item and 12‐item WHODAS 2.0 showed a strong correlation between similar constructs (r = 0.909–0.981).

Despite the small sample limitation, the WHODAS 2.0 tool adapted to the Tigrigna version indicated an acceptable reliability and validity and therefore could be applied to women with a history of PLTCs at 6 months postpartum.

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) of the Tigrigna version has strong internal consistency (Cronbach's α coefficients = 0.98). The convergent validity between the 36‐item and 12‐item WHODAS 2.0 indicated a strong correlation (r = 0.909–0.981) within similar domains. The WHODAS 2.0 Tigrigna version is reliable and valid to measure the disability level within severe maternal morbidity patients.