The State Initiative on Disabilities (SID) is being revamped to adopt a more comprehensive life cycle approach to disabilities.
SID is a special initiative of the Social Justice Department for the prevention, detection, early intervention, education and rehabilitation of persons with disabilities.
The Kerala State Social Security Mission (KSSM), which has been implementing SID, has proposed that selected disabilities may be identified wherein the life cycle approach – from primordial prevention to rehabilitation – may be planned and individual care plans developed in the long run for every disabled person in a locality by strengthening the involvement of local governments.
According to the first ever State Disability Census report released early this year, there are nearly eight lakh disabled persons in Kerala, of whom 33 per cent have locomotor disabilities and 17.3 per cent, multiple disabilities.
“The census revealed that 42.8 per cent of the disabilities were congenital and that 57 per cent were acquired disabilities. Much of the congenital disabilities can be prevented or managed better with early intervention initiatives within the first five years of birth,” said Mohammed Asheel, executive director, KSSM.
Critical gaps
“Our effort is to identify and address the critical gaps in our ongoing disability prevention initiatives, integrate these programmes and develop a comprehensive life cycle approach for prevention as well as rehabilitation initiatives at the grassroots. The aim is to draw up care models which go much beyond the mere distribution of assistive devices for the disabled,” he said.
“In the case of intellectual and congenital disabilities, primordial prevention should start by providing a risk-free environment for every newborn – and this would mean creating awareness on the prevention of consanguineous marriages and the importance of planned pregnancies so that every possible cause for potential disabilities in a newborn can be avoided,” Dr. Asheel added.
“Primary prevention will focus on all-vaccination initiatives, including MMR-rubella vaccination and screening to detect and correct any foetal anomalies. Early intervention initiatives, including newborn screening and correction, would form part of the secondary prevention of disabilities,” he said.
In the case of hearing impairment, universal screening for hearing need to be introduced at birth in all government hospitals. The impairment should be confirmed and the child given hearing aid within the first six months and cochlear implant, as the case may be, within 18 months. The child should be ready to be integrated into the regular schooling system by the age of three plus.
A consultative meeting of medical experts, including paediatric neurologists, psychiatrists, physical medicine specialists, rehabilitation and palliative care experts from various institutions, held here recently discussed the revamp.
It suggested improving and strengthening the system response, including improving the facilities and strengthening BUDS schools, augmenting the facilities at the District Early Intervention Centres, integrating existing disability interventions and creating better awareness about prevention and early intervention.
The census data, including the line list of disabled persons in a panchayat, will be handed over to the local governments. Under SID, comprehensive care models for each disability will be drawn up, which the local governments can integrate into their Plan projects. The ultimate aim would be to move towards care plans for every disabled at the panchayat level.
