Presentation on theme: "Intersectoral coordination in the provision of care for specially abled persons Dr. Prashant Ghodam Moderator: Dr. Chetna Maliye."— Presentation transcript:
Intersectoral coordination in the provision of care for specially abled persons Dr. Prashant Ghodam Moderator: Dr. Chetna Maliye
Framework Introduction Magnitude Disabled population in India, Maharashtra & Wardha Health and Socioeconomic outcomes Rights of Persons with Disabilities Legislations Intersectoral collaboration Convergence of various Ministries Government Initiatives Challenges / Scope References
Introduction What is Disability? “is an umbrella term, covering impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure. Activity limitation is a difficulty encountered by an individual in executing a task or action Participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.“ (WHO) ‘A person with restrictions or lack of abilities to perform an activity in the manner or within the range considered normal for a human being’.(NSS)
Introduction Disability: A restriction or inability to perform an activity in the manner or within the range considered normal for a human being, mostly resulting from impairment. Impairment: Any temporary or permanent loss or abnormality of a body structure or function, whether physiological or psychological. An impairment is a disturbance affecting functions that are essentially mental (memory, consciousness) or sensory, internal organs (heart, kidney), the head, the trunk or the limbs. Handicap: This is the result of an impairment or disability that limits or prevents the fulfilment of one or several roles regarded as normal, depending on age, sex and social and cultural factors. (The International classification of impairments, disabilities and handicaps )
Magnitude About 15% of the world's population have a disability Severe enough that it limits their participation in family, Community and political life. Eighty percent of those people live in low and middle income countries, where often access to basic health and social services is limited. In India PWD comprise between 5 and 8 % of the Indian population. Rates of disability are increasing due to population ageing and increases in chronic health conditions, among other causes. People with disabilities have less access to health care services and therefore experience unmet health care needs.
Disabled Population in India, Maharashtra & Wardha: 2011
Proportion of Disabled Population India and States/UTs
Disabled Population by Sex and Residence India: 2011 ResidenceMalesFemalesTotal Rural10,408,168 (2.43) 8,223,753 (2.03 % ) 18,631,921 (2.24 % ) Urban4,578,034 (2.34 % ) 3,600,602 (1.98 %) 8,178,636 (2.17 %) Total14,986,202 (2.41 % ) 11,824,355 (2.01 %) 26,810,557 (2.21%)
Disabled population by type, India TypesRuralUrbanTotal Seeing350259015298735032463 Hearing339182116791865071007 Speech13037836947521998535 Movement403551914010855436604 Mental Retardation10255604800641505624 Mental Illness495826227000722826 Any other329252916344824927011 Multiple Disability15842935321942116487
Disabled Population by Sex and Residence Maharashtra: 2011 ResidenceMalesFemalesTotal Rural9507817153541666135 Urban7415045557531297257 Total16922851271107 2963392
Disabled population by type, Maharashtra TypesRuralUrbanTotal Seeing3212662527865032463 Hearing237739235532473271 Speech240835232775473610 Movement363353185065548418 Mental Retardation9231867891160209 Mental Illness339722478158753 Any other270742239994510736 Multiple Disability10591058433164343
Disabled Population by Sex and Residence Wardha: 2011 ResidenceMalesFemalesTotal Rural12277910021377 Urban461232527864 Total168891235229241
Disabled population by type, Wardha TypesRuralUrbanTotal Seeing500816746682 Hearing30949854079 Speech9994021401 Movement573723818118 Mental Retardation13077182025 Mental Illness10003181318 Any other20297802809 Multiple Disability22036062809
Health and Socioeconomic outcomes People with disabilities face widespread barriers in accessing services, such as those for health care (including rehabilitation), education, transport and employment. Poorer health than the general population. Higher rates of poverty than people without disabilities. Low educational achievement. Reduced economic participation. Increased dependency and restricted participation.
Health and Socioeconomic outcomes Secondary conditions: Pressure ulcers, UTI, osteoporosis and pain. Comorbid conditions: Prevalence of diabetes in people with schizophrenia is around 15% compared to a rate of 23% for the general population. Age related conditions: People with developmental disabilities show signs of premature ageing in their 40s and 50s. Health risk behaviours: PWD have higher rates of risky behaviours such as smoking, poor diet and physical inactivity. Premature death: It is found that people with mental health disorders and intellectual impairments had a lower life expectancy.
Rights of Persons with Disabilities o India as a signatory of UN Convention on the Rights of Persons with Disabilities Right to Life and Personal Liberty Right to Live in the Community Right to Integrity Protection from torture or cruel, inhuman or degrading treatment or punishment Protection from Abuse, Violence and Exploitation Protection and Safety of Persons with Disabilities in Situations of Risk Right to Home and Family Reproductive Rights of Persons with Disabilities Freedom of Speech Right to Political Participation Access to Justice
Legislations The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 A person with disability means ‘a person suffering from not less than forty percent of any disability as certified by a medical authority. It lays down specific measures for the development of services and programmes for equalising opportunities for the enjoyment of right to education, work, housing, mobility and public assistance in case of severe disability and unemployment. It include blindness, low vision, hearing impairment, locomotor disability or cerebral palsy, mental retardation, mental illness and persons cured of leprosy.
Legislations National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999. To execute the mandated responsibilities, a Central Co- ordination Committee and State Co-ordination Committees representing major development ministries, Members of Parliament and disability NGOs and having a woman with disability as a member have been envisaged in a multi-sector model. The institution of Chief Commissioner in the Centre and Commissioner for Persons with Disabilities in States has been proposed. Their mandate is to redress individual grievances, provide safeguards to the rights of PWD, monitor implementation of disability related laws, rules and regulations, and oversee utilisation of budget.
Intersectoral collaboration Intersectoral Action (Intersectoral collaboration) : Activities and strategies involving several components of the body politic (e.g., the health sector, the education sector, the housing sector) that, working together, can enhance health conditions more effectively than when working independently of one another. (JM Last. A Dictionary of Public Health. Oxford, UK: Oxford University Press, 2007.)
Intersectoral colla…. Intersectoral collaboration and interagency cooperation is the necessary for mainstreaming of disability issues into the major development agenda. In the Asian and Pacific region, experiences in pursuance of the fulfilment of targets in many policy areas under the Agenda for Action during the Asian and Pacific Decade of Disabled Persons, have clearly proven such necessary.
Intersectoral colla…. Whole United Nations system and intergovernmental agencies as well as many non- governmental organizations are engaged to further strengthen interagency cooperation, including education, health, labour, telecommunication, economic and social development and other fields, with a view to achieving an inclusive, barrier-free and rights-based society for persons with disabilities in Asia and the Pacific in the twenty-first century.
Convergence of various Ministries Ministry of Social Justice & Empowerment Ministry of Health and Family Welfare Ministry of Women and Child Development Representative of the Ministry of Human Resource Development Ministry of Housing and Urban Poverty Alleviation Ministry of Communications and Information Technology Ministry of Civil Aviatation Ministry of Rural Development Ministry of Urban Development Ministry of Finance Ministry of Defence, Govt of India Ministry of Youth Affairs & Sports
Government Initiatives Ministry of Health and Family Welfare o National Leprosy Eradication Programme Involvement of NGO ILEP Agencies WHO Support o National Programme for Control of Blindness Private Practitioners NGOs o National Iodine Deficiency Disorders Control Programme Health Education and Publicity.(Information, Education and Communication, IEC) o National Mental Health Programme (NMPH) Barriers to Implementation of the Programme: Negative attitude of general practitioners, primary care physicians and other specialists. NGOs/Voluntary Organizations do not find this field attractive
Challenges/ Scope o More collaboration among the GOs, NGOs, and the PWDs themselves should be pursued. o Responses to the needs of the sector with disability, to maximize the funds and resources. o Need of more intensive advocacy programs to raise the levels of awareness and knowledge about the rights of PWDs & recognize the importance of the role of partnerships between private and government sectors for the empowerment of PWDs. o Technical assistance to local government to continually improve management capabilities, improving the quality of services and thereby ensuring program sustainability at the local level. o More research is needed, not just about the lives of people with disabilities, but also about social barriers, and how these can be overcome.
References 1.World Health Organization and World Bank. World report on disability. Geneva, World Health Organization, 2011. 2.The Report on Disability – Census of India 2011 by Office of Registrar General & Census Commissioner, Government of India. 3.People with Disability in India: From Commitments to Outcomes by Human Development Unit, South Asia Region, The World Bank. 4.The Draft on Rights of persons with disabilities bill 2012, Government of India, Ministry of Social Justice & Empowerment, Department of Disability Affairs September, 2012 5.Disability at a Glance 2008 & 2009 by UNESCAP. 6.WHO, Disability and health, fact sheet 352; Available from: http://www.who.int/mediacentre/factsheets/fs352/en/ 7.Annual Report (2010) of Ministry of Social Justice & Empowerment, Government of India. 8.National Policy for Persons with Disabilities 2006, Ministry of Social Justice and Empowerment, Government of India; No.3-1/1993-DD.III. 9.WHO, UNESCO, ILO. International Disability and Development Consortium. Community- based rehabilitation: CBR guidelines. Geneva, World Health Organization, 2010. 10.Kumar S.G., Roy G, Kar S.S, Disability and Rehabilitation Services in India: Issues and Challenges, J Family Med Prim Care. 2012 Jan-Jun; 1(1): 69–73.