Implementation, training and utilization’s strategy of the Implementation, training and utilization’s strategy of the International Classification of Functioning Disability and International Classification of Functioning Disability and

Health Health of the World Health Organization, ICFof the World Health Organization, ICF

Italian Ministry of Welfare Italian Ministry of Welfare and Labourand Labour

ITALIITALIAAllavoroavoro DD I N I N

Disability Italian NetworkDisability Italian Network

““ICF in Italy Project” ICF in Italy Project”

Welfare Policy DevelopmentWelfare Policy Development

IIll

Why do we need disability data?Why do we need disability data?

Disability accounts for 500 M healthy live Disability accounts for 500 M healthy live years lost worldwideyears lost worldwide

Diagnosis alone fails to predict Diagnosis alone fails to predict treatment, services and policies needstreatment, services and policies needs

Evaluate effectiveness of interventions Evaluate effectiveness of interventions Need to evaluate mainstreaming and Need to evaluate mainstreaming and

social integration social integration

The information gap in dThe information gap in diisabilitysability Health Sector: Health Sector:

Service needsService needsIntervention effectivenessIntervention effectivenessService utilization patternsService utilization patternsOutcomesOutcomesCostsCostsCost effectivenessCost effectiveness

The information gapThe information gap on disability on disabilitySocial Sector Social Sector

Lost productivity and Disability: Lost productivity and Disability: how big is the how big is the problem?problem?

Return-to-work policy: Return-to-work policy: do they work?do they work?

Anti-discrimination law: Anti-discrimination law: what effect do they what effect do they have?have?

ICFThe International Classification of Functioning, Disability and Health of the WHO(2001)

How does ICF Help?How does ICF Help?

International common language of International common language of functioning and disabilityfunctioning and disability

I. cross-cultural and languageI. cross-cultural and language

II. international standard II. international standard

III. Cross sectorial usageIII. Cross sectorial usage

What is the key message What is the key message of the ICF?of the ICF?ICF puts the notions of ‘health’ and ICF puts the notions of ‘health’ and

‘disability’ in a new light. It acknowledges ‘disability’ in a new light. It acknowledges that every human being can experience a that every human being can experience a

decrement in health and thereby decrement in health and thereby experience some disability and it clarifies experience some disability and it clarifies the essential role of the environment to the essential role of the environment to

determine disability. This is not determine disability. This is not something that happens to only a something that happens to only a

minority of humanityminority of humanity. . ICF thus ‘mainstreams’ the experience ICF thus ‘mainstreams’ the experience

of disability and recognises it as a of disability and recognises it as a universal human experienceuniversal human experience. .

Cultural changes: Cultural changes: the ICF’s revolutionthe ICF’s revolution

DEFINITION: DEFINITION:

any person in any moment of any person in any moment of life can have a health life can have a health

condition that in a negative condition that in a negative environment becomes environment becomes

disabilitydisability

From From HANDICAPPEDHANDICAPPED (ICIDH 1980 )(ICIDH 1980 )

to PERSON with disability to PERSON with disability (ICF 2001)(ICF 2001)

How does ICF Help?: How does ICF Help?: MODELMODEL

Consistent and coherent MODEL of Consistent and coherent MODEL of disabilitydisability

UniversalUniversal not minority approach not minority approach

Functioning as a Functioning as a spectrumspectrum, not , not dichotomousdichotomous

Evidence-based thresholdsEvidence-based thresholds

How does ICF Help?: How does ICF Help?: MODELMODEL

Consistent and coherent Model of Consistent and coherent Model of disabilitydisability

Multi-dimensionalMulti-dimensional

Interactive (person-environment)Interactive (person-environment)

Non-reductiveNon-reductive

Advantages ICF for Social policyAdvantages ICF for Social policy

Linkages between health information Linkages between health information health-related informationhealth-related information

Parity: disability independent of etiology Parity: disability independent of etiology (mental or physical health condition)(mental or physical health condition)

Holistic and inclusive: the lived Holistic and inclusive: the lived experience of functioning and disabilityexperience of functioning and disability

Italy. Bari, 14-16 February 2003Italy. Bari, 14-16 February 2003II National Conference on II National Conference on

DisabilityDisability

Conference reccomendation: it is reccomended the use of ICF Conference reccomendation: it is reccomended the use of ICF Classification as standard instrument for welfare policy Classification as standard instrument for welfare policy

development in Italydevelopment in Italy

Ministry of WelfareMinistry of Welfare

ICF in Italy ProjectICF in Italy ProjectICF in Italy ProjectICF in Italy Project

It is planned by Ministry of Welfare to start an action of support for the It is planned by Ministry of Welfare to start an action of support for the developement of a national consciousness of disability based on ICF principles and developement of a national consciousness of disability based on ICF principles and on ICF related instruments. To accept ICF implies to consider disability not as a on ICF related instruments. To accept ICF implies to consider disability not as a problem of “some” but as an issue for the whole community, starting from the problem of “some” but as an issue for the whole community, starting from the

Institutions. Diminish disability of a population requires a common effort and a Institutions. Diminish disability of a population requires a common effort and a multisectorial collaboration as defined by the biopsychosocial model of ICFmultisectorial collaboration as defined by the biopsychosocial model of ICF

The biopsychosocial model The biopsychosocial model proposed by ICF and Bari proposed by ICF and Bari

reccomendationsreccomendations The ICF biopsychosocial model of health and The ICF biopsychosocial model of health and

disability involves then all the sectors of disability involves then all the sectors of public policies and particularly welfare, public policies and particularly welfare, health, education, labour. health, education, labour.

Intersectoral collaborations and integrated Intersectoral collaborations and integrated approach will be the keys to identify approach will be the keys to identify solutions to decrease the disability of solutions to decrease the disability of populations and to improve social populations and to improve social integration.integration.

Italian Ministry of WelfareItalian Ministry of Welfare

“ICF in Italy” Project: Aims “ICF in Italy” Project: Aims Develop a national consciousness on ICF principlesDevelop a national consciousness on ICF principles

Data collection on health and disability in Italy Data collection on health and disability in Italy

Develop common language and intersectoral exchange of Develop common language and intersectoral exchange of information information

Develop a “Pilot project: ICF and Labour policies” with Italia Develop a “Pilot project: ICF and Labour policies” with Italia Lavoro for the the application of ICF in the labour sector for Lavoro for the the application of ICF in the labour sector for integration of person with disability in the work sectorintegration of person with disability in the work sector

Develop Training program with the scientific and technical Develop Training program with the scientific and technical support of the DIN, training will be then given to WHO for support of the DIN, training will be then given to WHO for international useinternational use

Exchange of data and information with other countries Exchange of data and information with other countries

ICF in Italy: ICF and labour ICF in Italy: ICF and labour policies Project. Actorspolicies Project. Actors

Ministry of WelfareMinistry of Welfare Italia-Lavoro agency and its branches: ICF Italia-Lavoro agency and its branches: ICF

and labour policies project coordinator and labour policies project coordinator Disability Italian Network: tecnical-Disability Italian Network: tecnical-

scientific advisory boardscientific advisory board Ministry of Health, Ministry of Education, Ministry of Health, Ministry of Education,

NGO’s, Regions, Public Administrations…NGO’s, Regions, Public Administrations… Scientifc SocietiesScientifc Societies

ICF and Labour PoliciesICF and Labour PoliciesPilot ProjectPilot Project

Implementation, training and utilization’s strategy of the Implementation, training and utilization’s strategy of the International Classification of Functioning Disability and International Classification of Functioning Disability and

Health Health of the World Health Organization, ICFof the World Health Organization, ICF

Italian Ministry of Welfare Italian Ministry of Welfare and Labourand Labour

ITALIITALIAAllavoroavoro DD I N I N

Disability Italian NetworkDisability Italian Network

WHOWHOWorld Health OrganizationWorld Health Organization

““ICF in Italy Project” ICF in Italy Project” Welfare Policy DevelopmentWelfare Policy Development

IIll

Is ICF a really necessary exercise?

In other words:

Should we really consider to describe, classify and measure the “human functioning”?

Try to find consensus on complex items such as health and disability and then open a season of strong innovations as well as of strong conflicts?

Disability Italian Network

Per fare la differenza …

Misurala con …

Change could be guided or passively accepted

The issue is NOT to decide whether to change or not.

The issue is to choose whether to positively guide or passively take the change. ICF offers a conceptual model that has the strength and the possibility to be the cultural standard and the guide for this challenge

Disability Italian Network

Per fare la differenza …

Misurala con …

The Minstry of Welfare and the The Minstry of Welfare and the ICF in Italy projectICF in Italy project

The Italian Ministry of Welfare accepts the The Italian Ministry of Welfare accepts the challenge proposed by the application of challenge proposed by the application of ICF model and in collaboration with ICF model and in collaboration with national and international organizations national and international organizations will feed back the national and will feed back the national and international community on progresses international community on progresses and developments of this project. and developments of this project.

www.who.int/classification/icfwww.who.int/classification/icf

www.minwelfare.itwww.minwelfare.it

www.eypd2003.orgwww.eypd2003.org

Contacts