State of the World's Children 2013 - Unicef

are particularly important. Developmental
screening is an effective means of detecting disability
in children. 56 It can take place in primaryhealth-care
settings, for example, during immunization
visits or growth monitoring check-ups
at community health centres. The purpose of
screening is to identify children at risk, to refer
them for further assessment and intervention
as needed, and to provide family members with
vital information on disability. Screening involves
vision and hearing examinations as well as
assessments of children’s progress against such
developmental milestones as sitting, standing,
crawling, walking, talking or handling objects.
Health-care systems in high-income countries
provide numerous opportunities to identify and
manage developmental difficulties early in a
child’s life. But interventions to improve young
children’s development are becoming increasingly
available in low- and middle-income countries.
These include such interventions as treating iron
deficiency, training caregivers and providing
community-based rehabilitation. 57
Recent studies in high- and low-income countries
have shown that up to 70 per cent of children
and adults newly diagnosed with epilepsy
can be successfully treated (i.e., their seizures
completely controlled) with anti-epileptic drugs.
After two to five years of successful treatment,
drugs can be withdrawn without danger of
relapse in about 70 per cent of children and
60 per cent of adults. However, approximately
three quarters of people with epilepsy in lowincome
countries do not get the treatment
they need. 58 The treatments exist – efficient
dissemination is often lacking.
The detection and treatment of impairments is
not a separate area of medicine but an integral
aspect of public health. Nevertheless, policymakers
and researchers typically characterize these
measures as being in competition for resources
with measures to promote the health of people
without disabilities. 59 This merely serves to
perpetuate discrimination and inequity.
Children with disabilities who overcome the
discrimination and other obstacles that stand
between them and health care may yet find that
the services they access are of poor quality.
Children’s feedback should be invited so facilities
and services can be improved to meet their
needs. In addition, health workers and other professionals
dealing with children stand to benefit
from being educated about the multiple issues
of child development and child disability and
from being trained to deliver integrated services
– where possible, with the participation of the
extended family. International cooperation can
play an important role in efforts to make higherquality
services available to children identified as
having or at risk of developing disabilities, and in
changing the competitive approach to allocating
resources described in the preceding paragraph.
Inclusive education
Education is the gateway to full participation
in society. It is particularly important for children
with disabilities, who are often excluded.
Many of the benefits of going to school accrue
over the long run – securing a livelihood in
adult life, for example – but some are almost
immediately evident. Taking part at school is an
important way for children with disabilities to
correct misconceptions that prevent inclusion.
And when these children are able to attend
school, parents and caregivers are able to find
time for other activities including earning a
living and resting.
In principle, all children have the same right to
education. In practice, children with disabilities
are disproportionately denied this right. In consequence,
their ability to enjoy the full rights
of citizenship and take up valued roles in society
– chiefly, through gainful employment – is
undermined.
Household survey data from 13 low- and middleincome
countries show that children with disabilities
aged 6–17 years are significantly less
likely to be enrolled in school than peers without
A STRONG FOUNDATION
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