Improving quality of life of children with disability in North Gondar zone, Ethiopia 2014: an innovative project

Abstract

Background: According to the 2011 World Health Organization report an estimated 650 million people with disability live in the world, of which 80% is from the developing countries where rehabilitation services are poor. In the same year, an estimated 17.6% population (15 million people) lives with disability in Ethiopia, of which 3-4 million are children. Though, the community based rehabilitation and the health extension workers are the primary contact workforces in the community, these fieldworkers do not have specific skill training on screening children with disability which resulted in less number of referral of children with disability for rehabilitation in North Gondar zone. The zone has a total of 22 districts inhabiting nearly 3 million population. The number of children referred for rehabilitation in the past year was only 152 with mean age of 13.6 years. Hence, skill training and linking health extension workers with community based rehabilitation workers is beneficial in screening of children with disabilities and improving the referral system. Purpose: The purpose of this project is to improve the quality of life of children with disability in North Gondar zone by early detection, referral and intervention through capacity building of community based rehabilitation and health extension workers. Methods: This project was implemented in collaboration with Dutch pediatric physiotherapists, University of Gondar, and North Gondar zone health bureau. This project covers 11 districts. SWOT analyses were done on screening skills and referral of deviant development and disabilities in children among community based rehabilitation and health extension workers. Training of trainers was conducted for the Ethiopian physiotherapists by the Dutch physiotherapists. Then training on normal and abnormal child development along with screening skills and early intervention was delivered for 78 trainees for five days at the University of Gondar in September 2014. At the end of the training, the trainees were deployed to the community with basic assessment tools such as screening tools for developmental delay, the Pediatric Evaluation of Disability Inventory and flash cards on frequently seen disabilities. The second part of the training will be carried in January 2015 with focus on intervention and continuity and sustainability of the acquired skills. Results: As this is an ongoing project, the effectiveness of the project will be evaluated at the beginning of the second phase in January 2015. Conclusion(s): This innovative project on capacity building of physiotherapists, community based rehabilitation workers and health extension workers stimulates mutual cooperation concerning children with disabilities. We hope to double the number of referrals (from 152 to 300 children per year) with lower age during referral. Once the success of the project is observed, it will have an input in the primary healthcare policy of the country, by integrating disability screening and referrals in the job description of health extension workers. Implications: Once the success of the project is observed, it will have an input in the primary healthcare policy of the country, by integrating disability screening and referrals in the job description of health extension workers.