Wednesday, January 30, 2013

ABSTRACT FOR THE NATIONAL CONFERENCE OF NIMH TO BE HELD IN MARCH 2013

Dear All

In continuation to the earlier posting made on this subject, i have submitted the Abstract for presentation in the Conference to be held during 7-8th March by NIMH at Secunderabad.  It has been approved for presentation and pasted the same below for dissemination as:
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3As IN INSTITUTIONAL BASED EARLY IDENTIFICATION AND INTERVENTIONS FOR CWDDs – OPPORTUNITIES WITH CBR

Lakshmi Narayana N
Director, Geo Rehabilitation Centre
Guest Faculty – NIMH
Hyderabad.
ABSTRACT

Key words: Poverty, Interventions, Rehabilitation, Mainstreaming, Sustainability, Availability, Accessibility, Affordability, Scalable, Replicable.

The stage of Early Identification and Early Intervention (EI & EI) of children with developmental disabilities (CWDDs) is critical in the total spectrum of Disability Rehabilitation. The delay in EI & EI results for severe consequences in all the developmental areas and further complicates the DR with limited results. It further complicates the prevention of disabilities in general and particularly the secondary and tertiary prevention.

The early intervention services confined with institutional based model have been limited by the number of early intervention centres (EICs), poor accessibility and non affordability in general and particularly for the targeted groups living in the rural areas. The initiatives made by the Government and NGOs have resulted for limited reach and left many who needs to be reached. The poor participation of parents / family members in the intervention and its continuity at home environment has become barrier in addition to other community barriers for mainstreaming with sustainable solutions. Though all these initiatives concentrates for the age group of 3-6 years, the children with 0-3 years have got limited access for support from parents as well as from the centres which complicates the process of early identification and early interventions. 

The Disability Acts which insists for equal opportunities, protection of rights and full participation in an inclusive environment were limited by resources, services, and its sustainability. Further, UNCRPD and amendment of Disability Acts insists CBR for mainstreaming CWDDs with right based strategies and interventions which are appropriate and cost effective with better adoptability. The Censes 2012 indicates higher percentage of PWDs which is alarming and further emphasizes for an effective early identification and interventions to check the dynamics of disability and its consequences on poverty & development.     

CBR has got several advantages over the IBR in terms of availability, accessibility and affordability (3As) as the CWDDs will be reached at their home / community environment with the participation of the parents and other stakeholders. The disability registry by the PRI with the support of ICDS, PHC and other health workers improves the identification as early as possible. The interventions based on CBR approach which utilizes the local resources to the maximum extent will address the needs of the CWDDs of 0-6 years covering health, social and pre-academics. IBR and CBR works as complimentary to each other where the mild and moderate which comes around 70% can be addressed at the community level leaving others for specialized services at IBR. The initiative of moving towards Disability Free Society (DFS) has ignited the stakeholders and more needs to be done.

            The paper presents the advantages and disadvantages of the institutional approach adopted in parts of Andhra Pradesh for early identification and early intervention and opportunities with CBR approach in maximizing the reach of CWDDs in terms of both quantitatively and qualitatively. CBR is scalable, replicable and sustainable in addressing the needs of the CWDDs with improved 3As which can be redesigned matching to the dynamics of disability, poverty and development. 

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Looking forward for better sharing and reflections...

All the best. 

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