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WHO
Global Disability Action Plan 2014-2021
Better Health for all people with Disability
Alarcos Cieza
Disability and Rehabilitation (DAR)
2Low ExtremeDisability
Distribution of the world population on the
disability continuum
1,000,000,000
15% of the world population
3
People in the higher levels of the continuum
have POORER health and..
• higher rates of poverty
• lower levels of education
• lower rates of employment
5
W
3
HY ?
• Physical
• Social and attitudinal
• System level
when accessing health care and programs
7
Environmental barriers
WHO global
disability
action plan
2014-2021
http://www.who.int/disabilities/acti
onplan/en/
3
http://www.who.int/disabilities/worl
d_report/2011/en/
To remove barriers and
improve access to health
services and programmes
9
1
10Disability
Distribution of needsH
ealt
h c
are
nee
ds
Low Extreme
To strengthen and extend
rehabilitation, habilitation,
assistive technology, assistance
and support services and CBR
12
To strengthen and extend
rehabilitation, habilitation,
assistive technology, assistance
and support services and CBR
13
2
14Low ExtremeDisability
Distribution of the world population on the
disability continuum
“… on an equal basis with
others”
3
To strengthen collection of
relevant and international
comparable data on disability and
support research on disability and
related services
16
3
WHO global disability
action plan 2014-2021
3
Action ?
Actors ?
• Member states
• National and international partners including
organizations of people with disabilities
• WHO
18
Who is responsible for action ?
WHO global disability
action plan 2014-2021
3
Actions ?
http://www.who.int/disabilities/actionplan/en/
20
Objective 1
• Provide technical support; develop guidelines on disability-
inclusive health systems strengthening to help to achieve
universal coverage
• Support identification of barriers to particular services through
technical assistance for collecting disability-disaggregated data on
use of services
• Design model curricula on disability for personnel working in
health care, rehabilitation and habilitation
21
Examples of actions
Objective 2
• Provide technical guidance; finalize and disseminate evidence-
based guidelines on health-related rehabilitation
• Develop relevant tools and training packages to develop and
strengthen habilitation and rehabilitation services including for
children
• Maintain and strengthen partnerships with organizations and
associations representing persons with disabilities and their
family members and/or caregivers
22
Examples of actions
23
WHO short-term priorities
24
25
WHO short-term priorities
Objective 3
• Reform national data collection systems based on the ICF
• Strengthen and build human resource capacity in the area of
disability research in a range of disciplines
• Improve disability data collection through the development and
application of a standardized model disability survey
26
Examples of actions
Dis
abli
ng b
arr
iers
–B
reak
to i
ncl
ud
e
Model Disability Survey (MDS)
28
5000
oranges1,500 Kg
29
Difficulties in … 1 2 3 4
seeing
hearing
walking
memory
self-care
communicating
“Disabled”
Difficulties in … 1 2 3 4
seeing
hearing
walking
memory
self-care
communicating
30Low ExtremeDisability
Distribution of the world population on the
disability continuum
The MDS …
1. collects data of all persons along
the disability continuum
2. measures disability
3.
4.
31
The International Classification of
Functioning, Disability and Health
The MDS …
1. collects data of all persons along the
disability continuum
2. measures disability
3. focuses on performance but also
capturing capacity
4. captures in detail environmental
factors33
Development process
34
Phase One: Mapping the situation
A. Review of existing surveys & construction of the
web-based repository
B. Statistical analysis with microdata
C. Preliminary drafting of the MDS
D. Expert Consensus
Phase Two: Finalization of the MDS
A. Cognitive testing
B. Pilot study
Phase Three: Implementation of National Disability
Surveys
December 2012
August 2014
AFRO
N=16
EURO
N=109
EMRO
N=2
AMRO
N=22
SEARO
N=7
WPRO
N=23
Identification of 179 health and disability surveys
Online repository
36
http://disabilitysurvey.checkdesign.de/
Section
3000 Functioning
Section
5000Health Conditions
& Capacity
Section
4000 Environmental
factors
Section
1000 Socio-
demographic
Characteristics
Section
6000Health Care
Utilisation
Section
2000 Work History and
Benefits
Section
7000Well-Being
1. Mobility
2. Hand and arm use
3. Self-care
4. Seeing
5. Hearing
6. Pain
7. Energy and drive
8. Breathing
9. Affect (depression and
anxiety)
INDIVIDUAL QUESTIONNAIRE
Section 3000: Functioning
10. Interpersonal relationships
11. Handling stress
12. Communication
13. Cognition
14. Household tasks
15. Community and
citizenship participation
16. Caring for others
17. Work and schooling
Development process
42
Phase One: Mapping the situation
A. Review of existing surveys & construction of the
web-based repository
B. Statistical analysis with microdata
C. Preliminary drafting of the MDS
D. Expert Consensus
Phase Two: Finalization of the MDS
A. Cognitive testing
B. Pilot study
Phase Three: Implementation of National Disability
Surveys
December 2012
August 2014
Institutions
• National Center for Health Statistics, US
• Institute for Survey Research, University of Michigan, US
• Statistics Norway, Norway
Countries
• US, Cambodia, Malawi, Nepal and China
43
Cognitive testing
Cambodia, Malawi, Nepal, Oman and Brazil (Sao
Paulo)
44
Pilot Studies
Chile, Cambodia, Philippines and Sri Lanka
National Surveys