Fall Global Health Practitioner Conference 2017 Health for All: Reaching the Forgotten 200 Million Lynda Achieng, Leia Isanhart, Loretta Claiborne, Kristin Hughes Srour

1. Reaching the forgotten
200 Million
How Special Olympics and Catholic Relief
Services are expanding health access for
people with intellectual disabilities through
partnership
Presentation by:
Kristin Hughes Srour Leia Isanhart
Loretta Claiborne Lynda Achieng

3. What is Intellectual Disability?
Official definition from the American Association on
Intellectual and Developmental Disabilities (AAIDD):
“Intellectual disability is characterized by significant
limitations both in intellectual functioning and adaptive
behavior as expressed in conceptual, social, and practical
skills. This disability originates before age 18.”

4. Three key elements to the
definition
1) Significant limitations in intellectual functioning
(IQ falls at 70-75 or below)
2) Significant limitations in adaptive functioning
3) Onset prior to age 18
Intellectual disability (ID) is defined by having all three
elements.

5. Limitations in adaptive functioning
• Adaptive functioning- the collection of typical
conceptual, social and practical skills that persons
learn and use in order to live life independently and
to meet the demands and expectations of his or
her environment.
• Conceptual skills: reading, numbers, money, time, and communication
skills
• Social skills: understanding and following social rules and customs;
obeying laws; and detecting the motivations of others in order to avoid
victimization and deception
• Practical life skills: skills needed to perform the activities of daily living
-- feeding, bathing, dressing, occupational skills, and navigational skills

6. Causes/Risk Factors of Intellectual
Disability
• Prenatal
• Perinatal
• Postnatal

7. Fact
People with intellectual disabilities die
16 years prematurely because of
undiagnosed and untreated conditions.
--University of Bristol and UK Department of Health, 2013.

8. Why Do Disparities Exist?
Barriers to good health for
people with ID include:
• Insufficient provider training
• Diagnostic overshadowing
• Limited prevention education
• Limited self-advocacy
• Attitudes/Discrimination/
Discomfort/Lack of
Awareness
• Cultural Beliefs
• Increased poverty
• Poor enforcement of
laws/acts

9. SPECIAL OLYMPICS MISSION:
To provide year-round sports training and athletic competition
in a variety of Olympic-type sports for children and adults with
intellectual disabilities, giving them continuing opportunities to
develop physical fitness, demonstrate courage, experience joy
and participate in a sharing of gifts, skills and friendship with
their families, other Special Olympics athletes and the
community.

10. The Reality
On average, on a team of 10
athletes:
 3 have untreated tooth decay and 1 needs
an urgent referral to a dentist
 4 need eyeglasses and 2 have some kind
of eye disease
 3 will fail a hearing test
 3 will have low bone density
 6 will have significant problems with
flexibility, and 4 with balance, placing
them at risk for injuries
 6 will be overweight/obese and at risk for
chronic health conditions

11. Special Olympics Global Data
Health Problem Global %
Untreated tooth decay 36.4
Urgent dental referral 13.8
Eye disease 16.2
Need prescription eyeglasses 38.4
Fail hearing test 26.3
Low bone density 25
Gait abnormality 50.1
Overweight or obese (adults) 59.5

13. Why does it matter if people with
disabilities get health services?
• Calls in to question the effectiveness of
• achievement of SDG 3
• national health strategies
• health system strengthening
• vertical disease programs
• immunization efforts
• organizations’ missions
Lancet Global Health, August 2017 Assessment of progress towards
universal health coverage for people with disabilities in Afghanistan:
a multilevel analysis of repeated cross-sectional surveys. Trani et al

14. When mainstream NGOs and
Disability Groups collaborate,
opportunities unfold…

15. 15
15
Intellectual Disability
Empowerment
Agenda (IDEA)
Using Inclusive ECD as an entry point for health
services for children with intellectual disabilities
in Nairobi, Kenya

16. 16
Kenyan Constitution
Article 43: Every person has a right to the highest attainable
standard of health care
Article 53:Every child has the right to basic nutrition, shelter and
health care
But…
No training for Health Care Workers (HCW) on the health needs for
People with Disabilities (PWD)
No tailor-made services to cater for the unique needs of PWDs
Physical barriers
Social-cultural barriers
PWD do not seek out or obtain quality health care
Why

17. INSERT JOSH’s VIDEO

18. 18
Inclusive
Play
Physio
Therapy
Home
Visits
Positive
Parenting
+ WASH
+
Nutrition
Referrals
• 8 ECD centers
• 356 children with ID,
ages 0-10 and their
caregivers
• 60 community health
volunteers
• 7 Special Olympics Athlete
Leaders
• 2 project officers
• 5 physiotherapists
What

19. 19
How
• Train Health Care
Workers and Community
Health Volunteers
• Expand access to
Physiotherapy
• Healthy Athletes medical
screening and referrals
• Improve access to WASH
• Changing communities
• Reinforce nutrition and
health messages at ECD
centers and during home
visits
• Facilitate referrals to
social services
• Change social norms

20. Healthy Athletes Medical Screening
Data for IDEA Project
0
50
100
150
200
250
300
350
400
450
500
Total No.
screened
Total No.Referred Eye Care Eye Surgery Dental services Medfest Fit Fet Healthy Hearing Health Promotion
No.ofChildren
Disciplines
HEALTHY ATHLETES MEDICAL SCREENING,2015-2017
No.of Referrals No.of Referrals No.of Referrals

21. Discussion
• What is your organization’s experience with funding
or delivering programs, research and/or services for
PWD?
• What barriers has your organization faced when
including PWD in your projects?
• How have you successfully included PWD in
shaping your policies, programs and activities and
included them as beneficiaries? If you haven’t done
so, what do you think might work?
• What resources do you need to be more inclusive?
• How can CORE members collaborate to ensure
PWD are included in all global health work?

22. WILL YOU
CHOOSE TO
INCLUDE?