World report on disability (June 2011)
The first ever World report on disability, produced jointly by
WHO and the
World Bank ,
suggests that more than a billion people in the world today
experience disability.
People with disabilities have generally
poorer health, lower education achievements, fewer economic
opportunities and higher rates of poverty than people without
disabilities. This is largely due to the lack of services
available to them and the many obstacles they face in their
everyday lives. The report provides the best available evidence
about what works to overcome barriers to health care,
rehabilitation, education, employment, and support services, and
to create the environments which will enable people with
disabilities to flourish. The report ends with a concrete set of
recommended actions for governments and their partners.
This pioneering World report on disability will make a
significant contribution to implementation of the Convention on
the Rights of Persons with Disabilities. At the intersection of
public health, human rights and development, the report is set
to become a "must have" resource for policy-makers, service
providers, professionals, and advocates for people with
disabilities and their families.
Download = World report on disability (June 2011) 3.4MB
Report Contents
Foreword ix
Preface xi
Acknowledgements xiii
List of contributors xv
Introduction xxi
Understanding disability
1
What is disability? 3
Environment 4
The diversity of
disability 7
Prevention 8
Disability and human
rights 9
Disability and
development 10
Disability – a global
picture 19
Measuring disability 21
Prevalence of disability
– difficulties in functioning 24
Country-reported
disability prevalence 25
Global estimates of
disability prevalence 25
Health conditions 32
Trends in health
conditions associated with disability 32
Demographics 34
Older persons 34
Children 36
The environment 37
Health conditions are
affected by environmental factors 37
Disability and poverty
39
Developed countries 39
Developing countries 39
Needs for services and
assistance 40
Costs of disability 42
Direct costs of
disability 43
Indirect costs 44
Conclusion and
recommendations 44
Adopt the ICF 45
Improve national
disability statistics 45
Improve the
comparability of data 46
Develop appropriate
tools and fill the research gaps 46
General health care 55
Understanding the health
of people with disabilities 57
Primary health
conditions 57
Risk of developing
secondary conditions 58
Risk of developing
co-morbid conditions 59
Greater vulnerability to
age-related conditions 59
Increased rates of
health risk behaviours 59
Greater risk of being
exposed to violence 59
Higher risk of
unintentional injury 60
Higher risk of premature
death 60
Needs and unmet needs 60
Addressing barriers to
health care 62
Reforming policy and
legislation 65
Addressing barriers to
financing and affordability 66
Addressing barriers to
service delivery 70
Addressing human
resource barriers 77
Filling gaps in data and
research 80
Conclusion and
recommendations 81
Policy and legislation
82
Financing and
affordability 82
Service delivery 82
Human resources 83
Data and research 83
Rehabilitation 93
Understanding
rehabilitation 95
Rehabilitation measures
and outcomes 95
Rehabilitation medicine
97
Therapy 100
Assistive technologies
101
Rehabilitation settings
101
Needs and unmet needs
102
Addressing barriers to
rehabilitation 103
Reforming policies,
laws, and delivery systems 104
National rehabilitation
plans and improved collaboration 105
Developing funding
mechanisms for rehabilitation 106
Increasing human
resources for rehabilitation 108
Expanding education and
training 110
Training existing
health-care personnel in rehabilitation 111
Building training
capacity 112
Curricula content 112
Recruiting and retaining
rehabilitation personnel 112
Expanding and
decentralizing service delivery 114
Coordinated
multidisciplinary rehabilitation 114
Community-delivered
services 114
Increasing the use and
affordability of technology 117
Assistive devices 117
Telerehabilitation 118
Expanding research and
evidence-based practice 119
Information and good
practice guidelines 120
Research, data, and
information 121
Conclusion and
recommendations 121
Policies and regulatory
mechanisms 122
Financing 122
Human resources 122
Service delivery 122
Technology 123
Research and
evidence-based practic 123
Assistance and support
135
Understanding assistance
and support 138
When are assistance and
support required? 139
Needs and unmet needs
139
Social and demographic
factors affecting demand and supply 140
Consequences for
caregivers of unmet need for formal support services 141
Provision of assistance
and support 142
Barriers to assistance
and support 144
Lack of funding 144
Lack of adequate human
resources 144
Inappropriate policies
and institutional frameworks 145
Inadequate and
unresponsive services 145
Poor service
coordination 145
Awareness, attitudes,
and abuse 147
Addressing the barriers
to assistance and support 147
Achieving successful
deinstitutionalization 147
Creating a framework for
commissioning effective support services 149
Funding services 149
Assessing individual
needs 150
Regulating providers 151
Supporting
public-private-voluntary services 151
Coordinating flexible
service provision 152
Building capacity of
caregivers and service users 155
Developing
community-based rehabilitation and
community home-based
care 156
Including assistance and
support in disability policies and action plans 156
Conclusion and
recommendations 157
Support people to live
and participate in the community 157
Foster development of
the support services infrastructure 157
Ensure maximum consumer
choice and control 158
Support families as
assistance and support providers 158
Step up training and
capacity building 158
Improve the quality of
services 159
Enabling environments
167
Understanding access to
physical and information environments 170
Addressing the barriers
in buildings and roads 172
Developing effective
policies 173
Improving standards 173
Enforcing laws and
regulations 175
The lead agency 175
Monitoring 175
Education and
campaigning 176
Adopting universal
design 177
Addressing the barriers
in public transportation 178
Improving policies 179
Providing special
transport services and accessible taxis 179
Universal design and
removing physical barriers 180
Assuring continuity in
the travel chain 182
Improving education and
training 183
Barriers to information
and communication 183
Inaccessibility 184
Lack of regulation 185
Cost 185
Pace of technological
change 186
Addressing the barriers
to information and technology 186
Legislation and legal
action 186
Standards 188
Policy and programmes
189
Procurement 190
Universal design 191
Action by industry 191
Role of nongovernmental
organizations 192
Conclusion and
recommendations 193
Across domains of the
environment 193
Public accommodations –
building and roads 194
Transportation 194
Accessible information
and communication 195
Education 203
Educational
participation and children with disability 206
Understanding education
and disability 209
Approaches to educating
children with disabilities 210
Outcomes 211
Barriers to education
for children with disabilities 212
System-wide problems 212
School problems 215
Addressing barriers to
education 216
System-wide
interventions 217
School interventions 220
The role of communities,
families, disabled people, and children with disabilities 223
Conclusion and
recommendations 225
Formulate clear policies
and improve data and information 226
Adopt strategies to
promote inclusion 226
Provide specialist
services, where necessary 227
Support participation
227
Work and employment 233
Understanding labour
markets 236
Participation in the
labour market 236
Employment rates 237
Types of employment 238
Wages 239
Barriers to entering the
labour market 239
Lack of access 239
Misconceptions about
disability 240
Discrimination 240
Overprotection in labour
laws 240
Addressing the barriers
to work and employment 240
Laws and regulations 240
Tailored interventions
241
Vocational
rehabilitation and training 245
Self-employment and
microfinance 247
Social protection 248
Working to change
attitudes 249
Conclusion and
recommendations 250
Governments 251
Employers 251
Other organizations:
NGOs including disabled people’s organizations,
microfinance
institutions, and trade unions 252
The way forward:
recommendations 259
Disability: a global
concern 261
What do we know about
people with disabilities? 261
What are the disabling
barriers? 262
How are the lives of
people with disabilities affected? 263
Recommendations 263
Recommendation 1: Enable
access to all mainstream policies, systems and services 264
Recommendation 2: Invest
in specific programmes and services for people with disabilities 265
Recommendation 3: Adopt
a national disability strategy and plan of action 265
Recommendation 4:
Involve people with disabilities 265
Recommendation 5:
Improve human resource capacity 266
Recommendation 6:
Provide adequate funding and improve affordability 266
Recommendation 7:
Increase public awareness and understanding of disability 267
Recommendation 8:
Improve disability data collection 267
Recommendation 9:
Strengthen and support research on disability 267
Conclusion 268
Translating recommendations into
action 268
Member
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