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Revention, Arly Etection and Anagement of Hildhood Isabilities

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Revention, Arly Etection and Anagement of Hildhood Isabilities revention, arly etection and anagement of hildhood isabilities Training Manual For Primary Health Care Physicians This Publication Was Produced Within The Framework Of Child-Focused Community-Based Rehabilitation Project With A Support Of The European Commission, And Plan International - Egypt First Edition 2004 Association For Health and Environmental Development (AHED) Disability Program AHED is an Egyptian Non-Governmental Organization established and registered with the Ministry of Social Affairs in November 1987. It is a multi-disciplinary organization formed to assist in the development and implementation of alternative policies and systems in the areas of Health, Environment, and Disability, which are capable of responding to the needs and rights of Egyptian society as a whole, and the most disadvantaged and marginalized groups in particular. In all its work, AHED adopts the principles of equity, human rights, comprehensive integrated development and active community participation. Foreword This training manual was developed and published by the “Association For Health and Environmental Development (AHED)” within the framework of the “Child‐Focused Community‐Based Rehabilitation project”. The project is being implemented in partnership among: International organizations; Plan International – Egypt and Save the Children ‐ UK, National authorities represented by the Ministry of Health and Population, the Ministry of Education and the Ministry of Insurance and Social Affairs, and Egyptian Non‐Governmental Organizations (NGOs) working on the national level which are: the Association for Health and Environmental Development (AHED) and Caritas‐Egypt represented by SETI center for Training and Researches in Mental Disability. The project aims at establishing copmprehensive Community‐Based Rehabilitation (CBR) demostrative models in different four Egyptian Governorates, that are being implemented and will be sustained through community based organizations. The training manual aims at enhancing the role of facilities of health care services provision on the primary level in the areas of prevention, early detection and management of childhood disabilities as a part of the needed multi‐sectoral network to address the question of childhood disability in Egypt. The role of facilities of health care services provision in addressing the childhood disability has been internationally recognized. In addition, the experience of establishing demonstrative CBR models indicates that the Primary Health Care (PHC) facilities can be the main player in the prevention, early detection and initial management including the referral. This is believed to be true because of two facts. First, Egypt has a relatively huge PHC infrastructure with well geographically distributed facilities. Second, the roles of these facilities, especially in compulsory immunizations, make them a good first contact for infants and children. The manual has been made to enhance this role through providing the needed conceptual framework, knowledge and skills related to prevention, early detection and initial management of childhood disabilities. The manual was developed with the contribution of sound experts in medical and rehabilitation fields. Further development of the current manual in next editions will depend, in principle, on the feed‐back of experts as well as the primary health care physicians who can enrich the manual with their practical experiences. THE EDITOR i ii Editorial Team Chief Editor Dr. Alaa Shukrallah Childhood Disability Consultant Chairperson of AHED Board Co-Chief Dr. Nadia Hosni Dr. Abdel-Hamid Kabesh Editors Professor of Community Consultant of Rheumatology and Physical Medicine, Suez Canal University Medicine Consultant of Health Policies and Consultant, Disability Program, AHED Systems Program, AHED Editors Dr. Yasser Ebeid Coordinator, Health Policies and Systems and Disability Programs Association For Health and Environmental Development Ms. Amira Radi Dr. Ibrahim Shaban Coordinator, Disability Program Coordinator, Health Policies and Association For Health and Systems Program Environmental Development Association For Health and Environmental Development Contributors Chapter 1: Introduction to Disability Dr. Alaa Shukrallah Chapter 3: Early Detection & Disability Consultant Screening Chairperson of AHED Board Chapter 2: Risk Factors, Causes & Dr. Nadia Hosni Rizkalla Prevention of Disability Professor of Community Medicine, Suez Canal University Consultant of Health Policies and Systems Program, AHED Chapter 4: Motor & Neurological Dr. Abdel-Hamid Kabesh Disabilities Consultant of Rheumatology and Physical Medicine Consultant of Disability Program, AHED Chapter 5: Visual Disability Dr. Gamal Ezz El-Arab Ophthalmologist Medical Director of Al-Noor Foundation Chapter 6: Mental Disability Dr. Abdallah Mansour Psychiatrist Director of Airport Hospital for Mental Health Chapter 7: Hearing Disability Dr. Nadia Mohamed Kamal Professor of Audiology, ENT department Ain Shams University Coordinators Ms. Eman Hassan Dr. Hani Serag Executive Director Acting Director, Health Policies & Systems Program Association For Health & Environmental Development iii iv Training Syllabus Course Description: A hands-on, competency-based comprehensive training course for the primary health care physicians. It is designed to provide knowledge, skills and attitudes necessary for better understanding of the childhood disability question including its underlying causes and risk factors and process. It also provides the participants with effective schemes for prevention, early detection and initial management including proper referrals and follow up. Course Duration: Eight training days (6 hours a day). Language: English. Arabic language is used along the course in discussions, working groups as well as in clinical sessions. Participants: 16-20 participants from the physicians working in the primary health care facilities. Overall Objective: To assist in building the capacity of the primary health care facilities and health facilities attached to Non-Governmental Organizations (NGOs) in the area of prevention, early detection and initial management of childhood disabilities within the framework of a comprehensive community based approach. Expected Outcome: At the end of the training course, it is expected that the health team that will undergo the training will be more capable of identifying and managing impairments and disabilities in children examined at the Primary Health Care (PHC) centres and the NGOs attached health facilities and to advice on proper referrals for the different types of disabilities. Moreover, they will be more capable of giving proper advice to mothers and parents on prevention from risk factors leading to disabilities. It is also expected that relationships between the health team, that will undertake the course, will be strengthened with other sectors in the area of disability particularly with the educational and social services. In addition, the model will be monitored and evaluated by project team. Specific Training Objectives: By the end of this course, participants should be able to: 1. Display a positive understanding and attitudes towards the needs of the disabled children and their families and the disability question in general in Egypt, discriminate between different models of rehabilitation and recognise the role of community based rehabilitation (CBR) model. 1.1. Explain the process of disablement. 1.2. Identify proper interventions at different levels of the process and identify the goals of the World Programme of Action in relation to the disability question. v 1.3. Describe the role of social and environmental barriers in the disability process. 1.4. Recognise and describe the role of parents and care takers as primary actors and communities in the rehabilitation process. 1.5. Recognise the different models of rehabilitation with special focus on the role of PHC and its relationship to CBR. 1.6. Identify the size and nature of the problem of disability in Egypt and the situation of existing services. 1.7. Recognise the concept of rights of disabled people. 2. Provide appropriate advice to families on causes and risk factors of disabilities and means of prevention. 2.1. Recognise and describe causes and risk factors of the major disabling conditions of children. 2.2. Recognise important preventive measures of important disabling conditions. 3. Make early detection of impairments and disabilities in children from 0-18 years through conducting screening programmes. 3.1. Explain the concept of screening in general and developmental screening in particular, criteria for their application and their role in early detection of childhood disabilities. 3.2. Recognise and describe normal milestones of development. 3.3. Identify watch signs of developmental delays and abnormalities in child development. 3.4. Apply simple procedures for testing certain aspects and functions of development and make early detection of disability conditions (neurological & motor, visual, hearing, speech and mental). 4. Provide health care on the primary level to children with disabilities, including follow- up of their particular health problems and normal health needs (e.g. nutrition, growth etc.) 4.1. Identify common health problems relevant to children with disabilities. 4.2. Describe essential management procedures and care for the most important health problems. 4.2.1. Identify proper medical, surgical, and therapeutic interventions required in the different
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