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A ray of hope for persons with disabilities

Dr. Shahidur Rahman
WORLD Health Organization (WHO) recognizes disability as a global public health issue, a human rights issue and as a precondition to development. And that is so because persons with disabilities experience greater unmet needs of health and rehabilitation and poorer health than the general public. On the other hand disability is a human rights issue because persons with disabilities experience inequalities and are subject to multiple rights violations including violations of dignity, abuse, prejudice and disrespect because of their disability, and they are denied autonomy. What needs to be understood is that disability is neither simply a biological nor a social phenomenon, but a condition that arises from the relationship between health condition and context.
However, disability is a universal reality. Everyone is expected to experience limitations in functioning at some point in his or her life. Following the International Glassification of Functioning, Disability and Health, this draft action plan uses the term "disability" as an umbrella term for impairments, activity limitations, and participation restrictions, denoting the negative aspects of the interaction between an individual (with a health condition) and his /her contextual factors (environmental and personal factors).This action plan is relevant to all persons who experience disability. The beneficiaries are both those persons who have long term impairments - those who are traditionally understood as disabled, such as wheelchair users, persons who are blind or deaf or persons with intellectual impairments or mental health conditions - and also the wider group of persons who experience difficulties in functioning due to a wide range of health conditions such as chronic and non-communicable diseases,
infectious diseases, neurological disorders and conditions that result from the ageing process. The term "persons with disabilities", consistent with the terminology used in the GRPD, is used throughout this action plan.
While much of the mission of WHO is dedicated to primary prevention - avoiding death and disability - the focus of this action plan is on improved health and well-being for persons with disabilities. Therefore prevention-related activities in this plan focus only on early identification and intervention to prevent the development of secondary or co-morbid health conditions that are often associated with disability, prevention of the development of new impairments and prevention of existing impairments becoming worse through improving access to healthcare and populationbased public health programs and barrier removal.
An overview of the global disability situation
More than one billion people currently experience disability, which is approximately 15% of the world's population. Of this number, between 110 million and 190 million adults experience very significant difficulties in functioning. The number of people who experience disability will continue to increase due to ageing population and a global increase in chronic health conditions. National patterns of disability are influenced by trends in health conditions and environmental and other factors - such as road traffic crashes, natural disasters, conflict, diet and substance abuse.
Unfortunately, persons with disabilities face widespread barriers in accessing services such as those for healthcare (including rehabilitation), education, employment, social services including housing and transport. These barriers include inadequate legislation, policies and strategies; lack of service provision; problems with the delivery of services,
negative attitudes and discrimination, lack of accessibility, inadequate funding and lack of participation in decisions that directly affect their lives.
These barriers contribute to the disadvantages experienced by persons with disabilities. And such people, particularly those in developing countries, experience a poorer health status than persons without disabilities, as well as higher rates of poverty, lower rates of educational participation and employment, increased dependency and restricted participation.
Structure ofThe Action Plan 2014-2021
The vision of the action plan focuses on where persons with disabilities and their families enjoy the highest attainable standard of health. The overall goal is to contribute to achieving health, well-being and human rights for persons with disabilities. It has the following three objectives:
1) To address barriers and improve access to healthcare services and programmes.
2) To strengthen and extend habilitation and rehabilitation services, including community based rehabilitation, and assistive technology.
3) To support the collection of appropriate and internationally comparable data on disability, and promote multi-disciplinary research on disability. The writer is Professor of Physical Medicine and Rehabilitation at BBSMMU.