International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, England.
MiracleFeet, Chapel Hill, United States of America (USA).
Bull World Health Organ. 2022 Nov 1;100(11):717-725. doi: 10.2471/BLT.22.288147. Epub 2022 Sep 19.
Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all.
在挽救 5 岁以下儿童生命方面已经取得了相当大的进展。然而,这些进展未能帮助所有儿童茁壮成长,尤其是残疾儿童。我们描述了残疾儿童和青少年日益增加的比例。我们评估了在卫生系统背景下残疾儿童和康复的现状,特别是在中低收入国家。在新生儿健康议程中,先天异常通常需要早期干预和康复。我们以阿根廷为例,说明将先天异常康复纳入卫生系统的情况。我们认为,需要康复的先天异常有可能通过以下方式加强康复系统和政策:加强初级保健和康复之间的协调;确定和了解使家庭能够参与服务的途径;提供康复人力资源;以及建立支持辅助技术和康复的系统和资源。我们提出了一些方法,供各国优先考虑和整合对先天性异常儿童的早期识别、转介和护理,以加强所有儿童的卫生系统。我们通过世界卫生组织的康复指导方针和框架确定了扩大政策和规划以及设计服务提供和劳动力战略的机会。我们认为,全球卫生界必须采取行动,确保从出生开始就建立起支持功能的康复服务,并在卫生系统中得到认可和整合,将残疾问题作为儿童健康的重点。这些步骤将加强卫生系统,确保从出生开始就发挥作用,并使所有人都能获得康复服务。