|
By
Cecilia Breinbauer, MD, MPH, ICDL Managing Director
This month the World Health
Organization and the World Bank released the first World
Report on Disability. Their goal is to facilitate the implementation of the
United Nations Convention on the Rights of Persons with Disabilities, that is,
to promote the basic human rights of social participation, education,
employment, and respectful interventions so as to improve the quality of life of
people with disabilities. This report is a significant step towards a paradigm
shift of social inclusion, but it is also evidence of the need for an improved
methodology to calculate global estimates of disability prevalence, especially
in children.
As the World Report on Disability
describes, Global Burden of Disease Project estimates that 93 million children
in the 0-14 age range experience "moderate or severe disability"—a profound
number. But the disabilities measured include only "seeing, hearing, mobility,
cognition, self-care, and communication." UNICEF’s Multiple Indicator Cluster
Surveys, administered to more than 200,000 children in 20 participating
countries, showed that between 14%-35% of children screened positive. Not
included in The World Report were results from a 2006 study that incorporated
child development questions in a household
survey of 6,300 families in Chile (p. 124). This study found that 29.9% of
children ages 1 to 5 had emerging delays with the percent rising to 35.9 of
children from the lowest income families. Similar child development questions
were incorporated in the 2006-2007
Nicaraguan Demographic Health Survey. Unfortunately, due to lack of funding,
the results of the child development module have not yet been analyzed.
Motivated by the World Report on Disability, an editorial
in the Lancet Journal concludes that "progress on the global burden of
disability will not be possible without country-specific strategies based on
good research."
Many of the child development questions, tested in
Chile and Nicaragua, were derived from the Greenspan Social Emotional Growth
Chart (SEGC) (ICDL presentation,
IADB-PAHO, May 25, 2007). The ICDL Graduate
School will support a research initiative in Thailand that will adapt
questions from the SEGC. We will also explore collaborations with policy makers
and researchers in other countries interested in building on the lessons learned
from Chile and Nicaragua.
|
|
