WHO Global disability plan 2014-2021

1. WHO
Global Disability Action Plan 2014-2021:
Better health for all people with disability
Alarcos Cieza
Blindness and Deafness Prevention,
Disability and Rehabilitation

2. Disability is
the outcome between health condition and
environmental factors
The International Classification
of Functioning, Disability and
Health

3. Environmental factors Personal factors
Health condition
Impairment in
body functions
& structures
Activity
limitation
Participation
restriction
Model of Functioning, Disability and Health
3

4. Persons with disabilities include those who have
long-term physical, mental, intellectual or sensory
impairments which in interaction with various
barriers may hinder their full and effective
participation in society on an equal basis with
others.
4

5. 3
http://www.who.int/disabilities/worl
d_report/2011/en/

6. • First ever UN General
Assembly high-level meeting
on disability
• Commitment to global
disability inclusive
development agendas
• Urgent action to improve
health care, rehabilitation, and
strengthen data
6
United Nations High Level Meeting on Disability
General Assembly, 23 September 2013

7. (6) to prepare, in consultation with
other organizations of the United
Nations system and Member States and
within existing resources, a
comprehensive WHO action plan
with measurable outcomes, based on
the evidence in the World report on
disability, in line with the Convention
on the Rights of Persons with
Disabilities and the report of the High-
level Meeting of the United Nations
General Assembly on Disability for
consideration, through the Executive
Board, by the Sixty-seventh World
Health Assembly.
7
WORLD HEALTH ASSEMBLY WHA66.9

8. WHO global
disability action
plan 2014-2021
8
WORLD HEALTH ASSEMBLY WHA67
http://www.who.int/disabilities/actionplan/en/

9. • Disability prevalence is
increasing
• Disproportionately
affects vulnerable
populations: women,
older people and poor
households
9
Global Situation

10. 10Low ExtremeDisability
Distribution of the world population on the
disability continuumNumberofpersons
15% of the world
population
Environment
Internal capacity

11. • Education
• Employment
• Social & political life
• Community
participation
• Health
11
People with disabilities face barriers in all
areas of life

12. Barriers to health care
12

13. Costs are a major barrier
13

14. Barriers also prevent access to rehabilitation
and assistive devices…..
14
which can enable people with disabilities to
participate and be independent

15. 1. To remove barriers and improve access to health
services and programmes.
2. To strengthen and extend rehabilitation, habilitation,
assistive technology, assistance and support
services, and community-based rehabilitation.
3. …
15
Objectives

16. Disability Rates from national surveys across the World
0
5
10
15
20
25
30
35
Syria
Bangladesh
Tunisia
Lebanon
Sudan
Algeria
Benin
Thailand
Brazil
Libya
SriLanka
Jordan
Japan
Malawi
Philippines
Egypt
Italy
China
Colombia
Germany
Netherlands
Sweden
Austria
Spain
USA
Canada
Uruguay
Australia
NewZealand
Norway
Source: DISTAT – UNSD 2003

17. 1. To remove barriers and improve access to health
services and programmes.
2. To strengthen and extend rehabilitation, habilitation,
assistive technology, assistance and support
services, and community-based rehabilitation.
3. To strengthen collection of relevant and internationally
comparable data on disability, and support research
on disability and related services.
17
Objectives

18. Indicators of
success
1.3 – Proportion of
persons with
disabilities who
have access to the
health services that
they need.
Inputs from
WHO Secretariat
Member States
National and
international
partner
18
For each objective …
Actions
1.2 Develop
leadership and
governance for
disability-inclusive
health
1.3 Remove
barriers to
financing and
affordability

19. Disability in WHO
Triple track approach
1. Mainstreaming disability within the
organisation WHO
Task Force on Disability
WHO buildings, information products, employment
opportunities are inclusive of and accessible to people with
disabilities, in compliance with the CRPD

20. Disability in WHO
Triple track approach
2. Mainstreaming Disability in technical work and
programmes of other units and department
– Ageing and Life Course
– Department of Mental health and substance abuse
– Maternal, Newborn, Child and Adolescent Health
– Public Health, Innovation and Intellectual Property
– Health Statistics and Informatics
– Health systems financing
– Chronic Diseases and Health Promotion
– Management of Noncommunicable Diseases
– Prevention of Noncommunicable Diseases
– Emergency response

21. Disability in WHO
Triple track approach
3. Mainstreaming disability in the
implementation activities of the Disability
Action Plan

22. • Guidance on disability inclusive Universal
Health Coverage
• Guidance on disability inclusive public health
22
Objective 1
To remove barriers and improve access to
health services and programmes

23. • Work with countries so that rehabilitation
services are part of Universal Health Coverage
• Minimum Standards for Rehabilitation in
Emergencies: A Guidance Document for Foreign
Medical Teams
• CBR as a strategy or Community-Based
Inclusive development
23
Objective 2
To strengthen and extend
rehabilitation,…, and CBR

24. • The Model Disability Survey is per definition a
survey that mainstream disability
24
Objective 3
To strengthen collection of relevant and
internationally comparable data on
disability ...

25. Disablingbarriers–Breaktoinclude
Model Disability Survey (MDS)

26. Environmental factors Personal factors
Health condition
Impairment in
body functions
& structures
Activity
limitation
Participation
restriction
Model of Functioning, Disability and Health
26

27. Environmental factors Personal factors
Impairment in
body functions
& structures
Activity
limitation
Participation
restriction
27

28. 28
Impairment in
body functions &
structures
Activity
limitation
Participation
restriction

29. 29
Problems in every day life Intrinsic capacity

30. 30
Intrinsic capacity

31. I4040: How much of a
problem do you have with
joining community
activities, such as festivities,
religious or other activities?
32
Difficulties in
in capacity
N No
problem
Problem
No 27 96.3 3.7
Mild 144 95.1 4.9
Moderate 200 77.0 23.0
Severe 128 43.0 57.0
Difficulties in
in capacity
N No
problem
Problem
No 27 96.3 3.7
Mild 142 94.4 5.6
Moderate 197 83.2 16.8
Severe 122 55.7 44.3
I4042: How much of a
problem did you have with
voting in the last elections?

32. I3057: Do you get to make
the big decisions in your
life? For example, like
deciding where to live, or
who to live with, how to
spend your money.
33
Difficulties in
in capacity
N Yes No
No 27 74.1 25.9
Mild 144 69.4 30.6
Moderate 200 58.5 41.5
Severe 127 55.1 44.9

33. I4048: How much of a
problem is using public or
private transportation?
34
Transportation
Difficulties in
in capacity
N No
problem
Problem
No 27 74.1 25.9
Mild 143 70.6 29.4
Moderate 200 44.0 56.0
Severe 122 20.5 79.5
I3006: To what extent does
the transportation you need
or want to use make it easy
or hard for you to use it?
Difficulties in
in capacity
N Facili-
tating
Hinde-
ring
No 27 100.0 0.0
Mild 144 97.2 2.8
Moderate 199 95.0 5.0
Severe 127 78.0 22.0

34. 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
http://www.who.int/disabilities/data/en/

35. Institutions
• Statistics Norway, Norway
• National Center for Health Statistics, US
• Institute for Survey Research, University of Michigan, US
Countries
• Cambodia, China, Malawi, Nepal, Norway and US
• UK
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Cognitive testing

36. • Finished: Cambodia, Chile and Malawi
• Planned: Brazil
• Regional survey: Pakistan
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Pilot Studies

37. FUNCTIONING
Broad environment:
- Hindering or facilitating environment
- Support and relationships
- Attitudes
- Access to information
Functioning questions
CAPACITY
General Health Question
WG 6 Questions
Additional capacity questions
Health conditions
PERSONALASSISTANCE, ASSISTIVE DEVICES
AND FACILITATORS
Personal assistance
Assistive devices: mobility and self-care, seeing,
hearing & communication
Facilitators: education, work and at home
Health conditions
WORK HISTORYAND BENEFITS
23 Questions based on ILO survey
HEALTH CARE UTILISATION
Inpatient care
Outpatient care or care at home
Responsiveness of the health system
SATISFACTION, PERSONALITY AND WELL-
BEING
CHILDREN

38. 41
National Disability Surveys
• In process: Chile, Sri Lanka, Oman

39. • Regional Implementation
1. Training on data collection
2. Training on data analyses
• Continue the MDS development
– Full version (1 hour)
– Brief version (20 minutes)
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Next steps

40. Alarcos Cieza, MSc, MPH, PhD
Blindness and Deafness Prevention,
Disability and Rehabilitation (DAR)
World Health Organization
Avenue Appia 20
1211 Geneva 27
Switzerland
Tel.: +41 22 791 1998
Fax: +41 22 791 4874
Email: ciezaa@who.int
Website: www.who.int/disabilities/
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41. 2001 2006 2010 2013 2014 2015
DFAT WHO Partnership
2008 2011
WHO Task Force on Disability
Disability staff from WHO from
central budget
2008 2011
IMPACT