Disabilities

Health

Child Health, Immunization, Maternal and Newborn Health

© UNICEF/NYHQ2011-1642/Giacomo Pirozzi

Azerbaijan, 2011: Allahshukur Resulov holds his mother’s hand during a physical therapy session at the Mushvig Day Centre for Children with Disabilities.

All children have the right to health. The rights guaranteed in the Convention on the Rights of the Child (CRC), the Millennium Development Goals (MDGs) and all other documents and statements pertaining to the right to health are no less relevant for children with disabilities. 

In addition, the Convention on the Rights of Persons with Disabilities (CRPD) speaks specifically to the right of persons with disabilities to equal access to all health resources.

Promoting equal access to health services

UNICEF’s support to health systems improvements, whether through participation in sectoral strategic planning or more grassroots level efforts, provides a great opportunity for working towards equal access to health services. These opportunities can be used to further promote changes in service delivery so that children with disabilities and their families are assured equal access to services, including to the physical environment, to information and communication, and provided additional services in response to their specific needs. It is imperative that those who work in child health (health care workers at every level, as well as those who work in UN agencies, government ministries and civil society) are equipped with knowledge and awareness of the needs and the possibilities for improving the health of children with disabilities. 

Training on disability for health care professionals and public health experts is a critical component in improving inclusive health care delivery and essential in strengthening advocacy in the area of health, Early Childhood Development, immunization and access to reproductive health services. Training content should also include explanation about the correlation between disability and Non-Communicable Diseases; disability and nutrition and disability prevention and immunization. 

Improving strategies for early screening, intervention and referral

The global child survival  Strategies for early identification and screening are mentioned under the thematic section of Early Childhood Development (ECD)
call to action “A Promise Renewed” aims at accelerating gains in child survival so that all countries reduce child mortality to 20 or fewer deaths per 1,000 live births by 2035. In this call it is important to include children with disabilities.  Therefore community Integrated Management of Childhood Illnesses (IMCI) and related interventions provide useful entry points to strengthen and support families to meet specific needs for care for children with disabilities. 

Community health workers and outreach workers of Community Based Rehabilitation programmes can assist in identifying those children who are ‘hidden’ and often denied the full range of services they require. These interventions should also aim to build the responsibility and capacity of communities to assist families in providing support for children with disabilities, including diagnosis and referral, and in acceptance of these children and of their disability as an aspect of human diversity.

Key Resources

• World Report on Disability - Summary version - This recent publication from WHO and the World Bank has systematically reviewed and summarized much of the existing literature on health and the social determinants of health relating to persons with disabilities globally. Not specifically on children and adolescents, but contains much of the data available.  It is a point of reference for all future work in the field, WHO/World Bank, 2011.
  
  
• Developmental Difficulties in Early Childhood:  Prevention, early identification, assessment and intervention in low and middle-income countries. Systematic review of current work on developmental difficulties, with a strong emphasis on reviewing and summarizing data from the global South, as well as the established literature from developed countries, WHO, 2012. 
  
  
• Community Based Rehabilitation Guidelines - Recent review and summary of Community Based Rehabilitation efforts, with clear outlines as to how CBR can contribute to approaches in health, education, social, livelihood and empowerment.  CBR is one of several approaches to disability, but this Guide offers many ideas and approaches to working with disabled populations and should be reviewed even if a CBR approach is not being undertaken, WHO, 2011.
  
  
• Disabled Village Children - This book is the most recent revision of a community based approach to rehabilitation and social inclusion for children with disabilities.  By the author of ‘Where There is No Doctor’ it remains a standard reference in the literature. Two additional publications from The Hesperian Foundation provide comparable suggestions specifically for children who are deaf and children with are blind. You can request a copy through this website, The Hesperian Foundation, 2009.
  
  
• Childhood disability in low- and middle-income countries - Overview of screening, prevention, services, legislation, and epidemiology. Important discussion of how epidemiologists currently conceptualize and address the identification and enumeration of disabled children within a population, Maulik PK, Darmstadt GL. Paediatrics, 2007.
  
  
• Health Care and the UN Disability Rights Convention - This article explores the right to health as framed by the UN Convention on the Rights of Persons with Disabilities as well as the implications for their implementation, The Lancet, 2009.