All hospitals should be disability friendly, to ensure easy movement of disable patients. The presentation arrives at a solution to the all above disability issues to serve as a guide line.

1. DISABILITY AND REHABILITATION APPROACH
DR.N.C.DAS

2. DISABILITY AND REHABILITATION APPROACH
-Disability is the dysfunction of any part of the body or mind leading to
difficulty in performing one or more activities.
-When a disease progresses to chronic stage leads to impairment of certain
functions.
TYPES OF DISABILITY
PHYSICAL NEUROLOGICAL MENTAL
OR
LOCOMOTOR
DISABILITY
SPEECH VISUAL
HEARING

3. CONDITIONS CONTRIBUTING
Physical: Polio, Amputation, Accidents.
Hearing: Congenital, Otitis Media, Perforation, Neuro
Surgery, Acosta tic Labrnthitis
Visual: Cataract, Glaucoma, Trachoma, Vit ‘A’
department.
Speech: Congenital, Brain damage
Mental: Congenital, Cretinism, Depression,
Schizophrenia
Neural: CVA, Hemiplegia, Quadriplegia, Epilepsy

4. CAUSES OF DISABILITY
COMMUNICABLE NON COMMUNICABLE
AT BIRTH
DISEASE DISEASE
NON
GENETIC
GENETIC
CAUSES
PSYCHIATRIC
NUTRITIONAL TRAUMA &
DEFFICIENCY DRUG ABUSE
INJURY

5. MEDICAL
A. GENETIC: B. NON- GENETIC
1. Mental Retardation 1. Birth Trauma
2. Hearing Impairment 2. Asphyxia
3. Speech Impairment 3. Forceps Delivery
4. Visual Impairment 4. Malnutrition
5. Congenital Heart Disease 5. Rubella, Tetanus
6. Gentio- Urinary Mal formation 6. Drug use in Pregnancy
COMMUNICABLE DISEASE NON-COMMUNICABLE
1. Polio, TB, Leprosy 1. Hypnosis, Scoliosis, Cervical
2. Trachoma, Herpes spondy losis
3. Meningitis, Encephalitis 3. Rheumatic arthritis, Arthritis
4. Osteomyelitis, Septicarthmitis 4. CVA, Epilepsy
5. Veneral disease, HIV, AIDS 5. Cancer, OPD, Diabetes
6. Nephritis

6. A. PSYCHIATRIC B.DRUG ABUSE
-Alcoholism
- Schizophrenia -Drug Abuse
- Mental Depression
D.MAL NUTRITION
-Protein Deficiency
C. TRAUMA
-Anemia
-Vit A deficiency
-Natural Calamities -Argemon Oil Poisoning
-Trauma, Accidents

7. CONSEQUENCES OF DISABILITY
INDIVIDUAL FAMILY
EFFECTS
COMMUNITY

8. MANAGING CONSEQUENCES
 Changing attitude of people to wards
handicap.
 Preventing disability through
interventions.
 Early detection and prompt treatment.
 Rehabilitation of handicap.
 Orientation training of health staff.
 School health program for early
detection.
 Medical research.

9. PREVENTION OF DISABILITY
PRIMERY SECONDARY
PREVENTION PREVENTION
PREVENTION
TERTIARY
PREVENTION

10. PRIMERY PREVENTION
A. FOR INDIVIDUALS
• Immunisation of pregnant mothers and
infants
• Vit. A drops to children (1to 6 yrs) 6 doses at
6month interval.
• Iron and folic acid tablets to pregnant
mothers.
• Syrup iron-folic acid to children.
• These can be achieved through PHC and
NRHM efforts.

11. B. FOR COMMUNITY
i. Health education regarding high risk
pregnancy.
ii. Antenatal, natal and post natal care.
iii. Avoid early age or late pregnancy to avoid
malformation.
iv. Avoid unconsanguinous marriages to
prevent thalasaemia. Rh incompatibility.
v. Delivery by trained dai.
vi. Iodised salt for goiter prevention.

12. SECONDARY PREVENTION
1. Mile stone growth monitoring by field
workers.
2. Early detection of trachoma, night
blindness and treatment
3. School health checkup programme.
4. Mobile health checkup vans .
5. Early detection of disease and
prevent disability .

13. TERTIARY PREVENTION
1. Extensive IEC campaign to create favorable opinion
and attitude of people towards handicap.
2. Create mass and community efforts to limit
disability.
3. Schools for blinds, dumb and deaf, and mentally
retarded children.
4. Physiotherapy and occupational therapy training
institutions.
5. Grant in aid to voluntary organisations for
handicap welfare.

14. INTERVENTION FOR DISABILITY
PHYSICAL PSYCHOLOGICAL
INTERVENTIONS
VOCATIONAL EDUCATIONAL

15. A. PHYSICAL INTERVENTION
-Appropriate exercise therapy for joint movements.
-Restoring the function of affected part by physio
training.
-Provision external appliances and splints.
-Relief of pain by application of hot & cold formulation.
-Bladder and bowel exercise to control incontinence.
-Training in daily activities to restore lost function.
-Education of patients to maintain the physical status
and returning to normal life.

16. B. PSYCHO-SOCIAL INTERVENTION
-The process of rehabilitation is not complete
without psychosocial intervention.
-To raise the morals of the patient, counselling,
positive attitude and support.
-Sympathetic attitude of doctors, family members
and community support.
-Psycho therapy for depression, anxiety,
personality changes and suicidal tendency.
-Financial support, work place support to raise the
morale & take away depression.

17. C. EDUCATIONAL INTERVENTION
-Efforts to be made to continue the education.
-Integrated education for disabled child in normal school.
-Pre school training, parents counselling
-Special training in speech and language
-Orientation and mobility training for blinds
-Day to day living and practices training and skill development
D. DISABILITY FRIENDLY INFRASTRUCTURES
-
-Special parking place for disables
-Ramps with guards at the entrance
-All stair cases must have side railing, disable friendly lifts
and toilets
- Adequate number of wheel chairs for their movement.
- Special transport system for reaching various areas of
hospital.

18. E. VOCATIONAL INTERVENTION
-Efforts be made to promote vocational training for
earning according to level of disability.
- Exploring the type and extent of vocational
training suiting the level of disability.
- One should be caring, sympathetic and supportive
in assisting the disabled.
- Vocational training centers, suitable for level of
disability by GOI and their placement.

19. OBJECTIVE OF REHABILITATION
-The basic objective of rehabilitation is to
restore the physical, social and psychological
potential to a level, so that he can
independently function and carry on an
independent life.
-Prevent disability and return to normalcy.
- Maximum level of restoration through
different interventions.
-Training in vocational methods to suit working
with residual disability and earn a lively and
independently.

20. REHABILITATION APPROACHES OR STATEGIES
COMMUNITY INSTITUTIONAL
BASED BASED
STRATEGIES
OUTREACH
SERVICES

21. COMMUNITY BASED REHABILITATION
-This is a strategy of developing rehabilitation services in
the community so as to equalization of opportunity for all.
-Attempt for social integration of disabled.
-There is a collective effort of disabled, family and
community in rehabilitation.
-Along with physical exercise, health education and
vocational
-training are imparted for self independent working and
earning.

22. INSTITUTIONAL BASED REHABILITATION
-Disabled persons are provided
training in hospitals/ rehabilitation
centers.
-Exercises under supervision.
- Functions as a referral center for
community rehabilitation center.

23. OUT REACH PROGRAMMES
The experts from hospital visit the community or
home for providing education &
training to disables in :
-Self Care
-Ambulatory Effect
-Communication
-Vocational Guidance
-Camps are also organized from time to time in rural
area where community facility is not available.
-Efforts are on to integrate the community rehabilitation
centers with institutions to provide maximum
rehabilitation coverage to all parts of the country.

24. WELFARE MEASURES
a) Scholarship to physically handicap for going to school.
b) Admission quota for disables in schools and collages.
c) Seats are reserved for handicap in Govt .services.
d) Separate employment exchange for handicap.
e) Handicap friendly environment in offices and hospitals,
lifts ,toilet, ramps, wheel chairs and porters..
f) Seats are reserved for handicap persons in buses and
transports.
g) Special transport allowance to handicaps and
concessional rail
tickets with free attendants.
h) Setting up of rehabilitation centers at district and PHC
level.
I ) Availability of artificial limbs, appliances in concessional
rates.

25. hospiad
Hospital Administration Made Easy
http//hospiad.blogspot.com
An effort solely to help students and aspirants
in their attempt to become a successful
Hospital Administrator.
DR. N. C. DAS