Role of CBR Strategy on disability prevention and control

1
Role of CBR Strategy on disability prevention
and control

• Deepak Raj Sapkota
• Country Director
• Karuna Foundation Nepal

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Community Based Rehabilitation- CBR

• An approach that promotes the culture of living
  together in/with diversity
• 5 Pillars Health, Education, Social, Empowerment
  and livelihood

3
Disability

• Congenital and acquired
• Acceptance and recognition
• Prevention and control

4
Disability and children

• the number of reported childhood disabilities has
  increased (60s and now)
• the nature and consequences of disability have
  changed
• Physical versus internal

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Prevention (and control)

• Prevention and control is possible in significant
  ways,
• Appropriate pre-natal care and early childhood
  health care are key to prevention of
  disabilities,
• Some birth defects in pregnancy are associated
  with developmental delays, emotional and
  behavioral problems, and learning disabilities,

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Pre-conception phase

• Changes in lifestyle will promote a healthy
  pregnancy and increase the chances of having a
  healthy baby while reducing risk of learning
  disabilities,
• Regular physical examinations before and during
  pregnancy,
• Pre-conception counseling may prevent some forms
  of genetically determined physical, mental or
  developmental disabilities,
• Pre-conception rubella immunization can prevent a
  range of neurological and other problems in the
  child,

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During pregnancy

• Risks vs benefits of continuing medications
  during pregnancy many drugs do pass through the
  uterus and are believed to affect child
  development, (Paxil, a common antidepressant, is
  just one of many medications linked to heart
  defects in infants as have several common pain
  relievers. )
• Maintain dietary needs, (taking Folate
  supplements to reduce risk of defects.)

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During pregnancy

• Any concerns during pregnancy, has to be shared
  immediately with medical professional
• Sharing medical history helps to know of any
  family history of medical issues (Genetic
  counseling is often helpful for prospective
  parents)

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During pregnancy

• Spina bifida may be prevented through maternal
  nutritional supplementation
• Fetal alcohol spectrum disorder may be prevented
  by avoiding alcohol consumption during pregnancy
• Cerebral palsy may be prevented through high
  quality care prenatally and during birth

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Prevention at large

• Prevention of some disabilities with healthy
  life choices is possible. Giving a child the best
  possible start in life is an important way to
  prevent disabilities.
• Screening newborns helps identify disabilities
  for Early Intervention.

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Prevention at large

• Other forms of developmental disability may be
  prevented through programs for healthy infant and
  child development,
• detection and treatment of iron deficiency anemia
  in infancy and
• the prevention or early detection of hearing
  problems or speech-language pathology that,
  uncorrected, can result in developmental and
  mental health problems in later years

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Prevention at large

• Some forms of mental disability may be prevented
  through mental health promotion,
• A wide range of physical disabilities may be
  prevented through injury prevention, early
  management,
• While neuro-sensory disability such as loss of
  sight or hearing can be prevented through a range
  of protective interventions,

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And also

• Technology A blessing or a curse
• while in utero diagnosis may present
  opportunities for early post-partum intervention
  or the option for termination of pregnancy

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CBR and Disability Prevention

• ???

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• Thank you