J Rehabil Med 2018; 50: 358 – 366
ORIGINAL REPORT
WORLD HEALTH ORGANIZATION GLOBAL DISABILITY ACTION PLAN: THE MONGOLIAN PERSPECTIVE
Fary KHAN, MBBS, MD, FAFRM( RACP) 1 – 3, Bhasker AMATYA, MD, MPH 1, 2, Baljnnyam AVIRMED, MD, PhD 4, Yoon Kyoung YI, MD 4, Batchimeg SHIRMEN, MD, MSc 4, Narantsetseg TSEGMID, MD, MSc 4, Geoff ABBOTT, MBBS, FARM( RACP) 1 and Mary P. GALEA, PhD, BAppSci( Physio), BA, Grad Dip Physio, Grad Dip Neurosci 1, 2 From the 1 Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, 2 Department of Medicine( Royal Melbourne Hospital), The University of Melbourne, Parkville, 3 School of Public Health and Preventive Medicine, Monash University, Victoria, Australia, 4 Mongolian National University of Medical Sciences, School of Medicine, Department of Rehabilitation Medicine, Ulaanbaatar, Mongolia
Objective: To provide an update on disability and rehabilitation in Mongolia, and to identify potential barriers and facilitators for implementation of the World Health Organization( WHO) Global Disability Action Plan( GDAP). Methods: A 4-member rehabilitation team from the Royal Melbourne Hospital conducted an intensive 6-day workshop at the Mongolian National University of Medical Sciences, for local healthcare professionals( n = 77) from medical rehabilitation facilities( urban / rural, public / private) and non-governmental organizations. A modified Delphi method( interactive sessions, consensus agreement) identified challenges for rehabilitation service provision and disability education and attitudes, using GDAP objectives. Results: The GDAP summary actions were considered useful for clinicians, policy-makers, government and persons with disabilities. The main challenges identified were: limited knowledge of disability services and rehabilitation within healthcare sectors; lack of coordination between sectors; geo-topographical issues; limited skilled workforces; lack of disability data, guidelines and accreditation standards; poor legislation and political commitment. The facilitators were: strong leadership; advocacy of disability-inclusive development; investment in local infrastructure / human resources; opportunities for coordination and partnerships between the healthcare sector and other stakeholders; research opportunities; and dissemination of information. Conclusion: Disability and rehabilitation is an emerging priority in Mongolia to address the rights and needs of persons with disabilities. The GDAP provides guidance to facilitate access and strengthen rehabilitation services.
Key words: disability; rehabilitation; Mongolia; World Health Organization.
Accepted Jan 3, 2017; Epub ahead of print Feb 16, 2017 J Rehabil Med 2018; 50: 358 – 366
Correspondence address: Fary Khan, Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34 – 54 Poplar Road Parkville, Melbourne VIC 3052, Australia. E-mail: fary. khan @ mh. org. au
An estimated 1 billion people worldwide have a disability, with approximately 80 % living in low-income developing countries( 1). In 2006, The United Nations( UN) General Assembly adopted the Convention on Rights of Persons with Disabilities( CRPD) to highlight disability as a human experience that occurs as an interaction of a person with a health condition or impairment with his or her environment( 2). The CRPD encourages all member states to adopt appropriate measures to eliminate discrimination and poverty, and to improve health and education of persons with disabilities( PwD)( 1, 2), and has identified rehabilitation as a care process to support physical independence, mental, social and vocational ability( Article 26)( 1). In 2011, the World Health Organization( WHO) World Report on Disability( WRD) supported implementation of the CRPD and provided comprehensive information on disability with special emphasis on rehabilitation( 1). It highlighted inadequacy in resources and inequalities in access to care for PwD, especially in low-income countries( 3 – 5). Other reports conducted in different countries( 3, 5 – 7) outline a lack of disability-inclusive policies and standards, negative attitudes / discrimination, limited provision of services and / or service delivery, inadequate funding, and limited research data.
The WHO Global Disability Action Plan 2014 – 2021( GDAP): Better Health for All People with Disability( 6) provides a list of specific actions and metrics of success to achieve the 3 main objectives listed in Box 1. These include: a human rights-based approach( empowerment
Box 1. Objectives of the WHO Global Disability Action Plan( GDAP) 2014 – 2021: Better Health for All People With Disabilities( 6)
Remove barriers and improve access to health services and programmes Strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation Strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services doi: 10.2340 / 16501977-2207
This is an open access article under the CC BY-NC license. www. medicaljournals. se / jrm Journal Compilation © 2018 Foundation of Rehabilitation Information. ISSN 1650-1977