Print and on-line media around the world have reported on the publication of the World Report on Disability. Dr Sunil Deepak, Head of Medical Support for the Associazione Italiana Amici di Raoul Follereau (AIFO) in Italy and member of the ILEP Technical Commission, here provides a summary of the salient points of this important Report.

Introduction

The first ever World Report on Disability was published jointly by the World Health Organization (WHO) and the World Bank, in June 2011. The overall aims of this Report are:

• to provide governments and civil society with a comprehensive description of the importance of disability and an analysis of the responses provided based on the best available scientific information; and

• to make recommendations, based on this analysis, for action at national and international levels.
In this article I would like to briefly touch on some significant parts of this Report.

Definition of Disability

The Report accepts that disability is complex, dynamic, multi-dimensional and contested. Disability seen through the framework of the International Classification of Functioning, Disability and Health (ICF), is linked to three inter-connected areas – impairments (alterations in body functions or structures), activity limitations and participation restrictions. Disability arises from the interaction of health conditions with contextual factors, both individual and environmental.

Thus, persons with similar impairments may face different degrees of barriers and disablement, depending upon the individual and environmental factors in their lives. For example, an individual using a wheel chair and living in an accessible environment may face no fewer barriers in accessing health or education services than another person with a similar impairment, who does not have a wheel chair and who does not live in an accessible environment.

Measuring Disability

As the concept of disability is dynamic and complex, measuring disability is not easy. After analysing global data, the Report considers that about one billion persons in the world have some degree of disability, and about 190 million have significant disabilities.

The Report notes that with changing life-styles and longer life-expectancy, the number of persons with disabilities related to non-communicable diseases is expected to rise in future. Other factors that could contribute towards higher numbers of persons with disabilities include accidents and stress-related conditions.

Health Care Needs of Persons with Disabilities

Not all disabilities are linked to specific health care needs. The health care needs of persons with disabilities can be categorised in three groups:

• Persons with conditions such as blindness or deafness, who may not need any specific health care for their disabling condition.

• Persons with spinal cord injury who may need health care mainly during the acute phase after the injury, or a person affected by leprosy, who needs to take medicine to treat the infection. After the acute phase, these persons require specific services to maintain their health, for example to prevent secondary conditions.

• Persons with conditions like multiple sclerosis, cystic fibrosis, severe arthritis or schizophrenia, who require regular and on-going medical care.

Common barriers faced by persons with disabilities in accessing health care services include physical barriers in the health centres and barriers related to attitudes, knowledge and skills of the health workers.

Rehabilitation

This Report defines rehabilitation as a set of measures that assist individuals, who are experiencing, or are likely to experience, disability, to achieve and maintain optimal functioning in interaction with their environments. Rehabilitation measures are designed to improve individual functioning, such as improving an individual’s ability to eat and drink independently. Rehabilitation also includes making changes to the environment of the individual, such as putting a handrail in their bathroom. However, the Report does not consider the adaptation of public buildings, for example the addition of ramps, a rehabilitation activity.

Other Areas and Recommendations

The Report touches on many other areas such as support and assistance, enabling environments, education, work and employment, and so on and makes recommendations for the future including the:

• promotion of mainstreaming and access to existing policies, systems and services;

• support for specific programmes and services for people with disabilities;

• having a national disability strategy and plan of action;

• actively involving people with disabilities at every level; and

• strengthening and supporting research into disability.

The Report also recognises the importance of the Community-based Rehabilitation (CBR) approach as part of the spectrum of rehabilitation services.

Download the Full Report

The full report is available in English, French, Spanish, Chinese and Arabic and can be downloaded from the following webpage:
http://www.who.int/disabilities/world_report/2011/report/en/index.html

Contact:
Dr Sunil Deepak sunil.deepak@aifo.it  

Categories: Technical information