In Community Medicine and Rehabilitation, understanding how to classify, evaluate, and support disabilities is essential. This guide covers the WHO's ICF model, the math behind disability certification in India, and key government acts.
1. The ICF Model (WHO)
The International Classification of Functioning, Disability and Health (ICF) moved away from the old "Medical Model" (focus on defect) to a "Biopsychosocial Model".
[Image of ICF model diagram]Key Components
| Component | Definition | Example (Stroke Patient) |
|---|---|---|
| Impairment (Body Function/Structure) | Loss or abnormality of a body part or physiological function. | Hemiplegia, weakness in right arm, spasticity. |
| Activity Limitation (Individual Level) | Difficulty executing a specific task or action. | Unable to grasp a cup, unable to walk without support. |
| Participation Restriction (Societal Level) | Problems involved in life situations due to the above. | Unable to return to job (unemployment), unable to attend family weddings. |
2. Disability Percentage Calculation
In India, disability certificates are issued by a medical board. A minimum of 40% disability is required to avail government benefits.
The Combining Formula (Key for Exams)
When a patient has multiple disabilities (e.g., an amputation + blindness, or multiple limb involvement), you cannot simply add the percentages (e.g., 30% + 30% ≠ 60%). You must use the formula:
100
Where A = The higher percentage, and B = The lower percentage.
Upper Limb vs. Lower Limb Evaluation
- Upper Limb: Evaluated based on loss of ROM, Muscle Strength, and Coordinated Activities (Prehension, Grip, Pinch).
- Arm Component: Total value 90%.
- Hand Component: Total value 90%.
- Lower Limb: Evaluated based on Mobility (Walking on slopes, stairs, standing) and Stability.
- Amputation levels have fixed percentages (e.g., Hip disarticulation = 90-100%).
3. Important Acts & Schemes
A. RPwD Act 2016 (Rights of Persons with Disabilities)
This replaced the PwD Act of 1995. Key updates:
- Expanded Categories: Disabilities increased from 7 to 21.
- New Inclusions: Acid Attack Victims, Parkinson’s Disease, Dwarfism, Thalassemia, Learning Disabilities.
- Reservation: Increased from 3% to 4% in government jobs.
B. ADIP Scheme
Assistance to Disabled Persons for Purchase/Fitting of Aids and Appliances.
- Objective: To provide durable, scientifically manufactured aids (Wheelchairs, Hearing aids, Prosthetics) to reduce the effect of disability.
- Eligibility (Income):
- Income up to ₹15,000/month: 100% Grant (Free).
- Income ₹15,001 - ₹20,000/month: 50% Grant.
C. UDID Card
Unique Disability ID: A single card valid across the entire country, removing the need to carry multiple papers for verification.
Frequently Asked Questions (FAQs)
These are older terms (WHO 1980). Impairment = Organ level (damaged eye). Disability = Person level (cannot see). Handicap = Societal level (cannot drive/work). The ICF model replaced "Handicap" with "Participation Restriction".
A Medical Board usually consisting of a Chief Medical Officer (CMO) and specialists (e.g., Orthopedic surgeon, ENT, etc.) from a government hospital.
Not always. In cases where the condition may improve (e.g., recovering stroke or post-surgery), a Temporary Certificate is issued (usually valid for 5 years). For static conditions (e.g., Amputation), a Permanent Certificate is issued.
Exam Quiz: Disability & Community Med (10 MCQs)
Test your knowledge. Click the correct option to see the answer and reasoning.
1. In the ICF model, "inability to walk to the market to buy groceries" is best classified as:
Wait! Standard exam answer: Activity Limitation deals with the execution of a task (walking). However, if the focus is on "shopping/social role," it can be participation. Usually, "walking" is Activity.
2. How many categories of disabilities are listed in the RPwD Act 2016?
The 2016 Act significantly expanded the list from 7 (in the 1995 Act) to 21 types of disabilities.
3. Calculate the total disability if a person has two disabilities: A = 50% and B = 20%.
Formula: A + [B(100-A)/100].
50 + [20(100-50)/100]
50 + [20(50)/100]
50 + [1000/100]
50 + 10 = 60%.
4. Under the ADIP scheme, a person earning ₹10,000 per month is eligible for what percentage of aid?
Beneficiaries with a monthly income up to ₹15,000 are eligible for 100% assistance (free aids).
5. Which of the following was NOT included in the PwD Act 1995 but IS included in RPwD Act 2016?
Acid Attack Victims were newly recognized as a specific category of disability in the 2016 Act.
6. The minimum degree of disability required to avail benefits under government schemes in India is:
A person must have at least 40% disability certified by the medical board to be considered a "Person with Benchmark Disability".
7. In the ICF Model, "Environmental Factors" are considered:
The ICF includes Environmental and Personal factors under the umbrella of "Contextual Factors" that influence the disability experience.
8. What does UDID stand for?
It stands for Unique Disability ID, a project to create a National Database for Persons with Disabilities.
9. A "Hemiplegia" (paralysis of one side) is classified in the ICF model as:
Hemiplegia describes the loss of body function/structure (muscle power/nerves), which is an Impairment.
10. The 2016 RPwD Act increased the reservation in government jobs for disabled persons to:
The reservation quota was raised from 3% (under the 1995 Act) to 4% in the 2016 Act.
References
- Park, K. (2019). Park's Textbook of Preventive and Social Medicine. Banarsidas Bhanot.
- World Health Organization. (2001). International Classification of Functioning, Disability and Health (ICF).
- Government of India. Rights of Persons with Disabilities Act, 2016.
No comments:
Post a Comment