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