Implementation, training and utilization’s strategy of the International Classification of Functioning Disability and Health of the World Health Organization, ICF Italian Ministry of Welfare and Labour ITALIAlavoro D I N D I N Disability Italian Network “ICF in Italy Project” Welfare Policy Development IlIlIlIl

Why do we need disability data? Disability accounts for 500 M healthy live years lost worldwide Disability accounts for 500 M healthy live years lost worldwide Diagnosis alone fails to predict treatment, services and policies needs Diagnosis alone fails to predict treatment, services and policies needs Evaluate effectiveness of interventions Evaluate effectiveness of interventions Need to evaluate mainstreaming and social integration Need to evaluate mainstreaming and social integration

The information gap in disability Health Sector: Service needs Intervention effectiveness Service utilization patterns OutcomesCosts Cost effectiveness

The information gap on disability Social Sector Lost productivity and Disability: how big is the problem? Return-to-work policy: do they work? Anti-discrimination law: what effect do they have?

ICF The International Classification of Functioning, Disability and Health of the WHO (2001)

How does ICF Help? International common language of functioning and disability I. cross-cultural and language II. international standard III. Cross sectorial usage

What is the key message of the ICF? ICF puts the notions of ‘health’ and ‘disability’ in a new light. It acknowledges that every human being can experience a decrement in health and thereby experience some disability and it clarifies the essential role of the environment to determine disability. This is not something that happens to only a minority of humanity. ICF thus ‘mainstreams’ the experience of disability and recognises it as a universal human experience.

Cultural changes: the ICF’s revolution DEFINITION: any person in any moment of life can have a health condition that in a negative environment becomes disability

From HANDICAPPED (ICIDH 1980 ) to PERSON with disability (ICF 2001)

How does ICF Help?: MODEL Consistent and coherent MODEL of disability Universal not minority approach Functioning as a spectrum, not dichotomous Evidence-based thresholds

How does ICF Help?: MODEL Consistent and coherent Model of disability Multi-dimensional Interactive (person-environment) Non-reductive

Advantages ICF for Social policy Linkages between health information health-related information Parity: disability independent of etiology (mental or physical health condition) Holistic and inclusive: the lived experience of functioning and disability

Italy. Bari, February 2003 II National Conference on Disability Conference reccomendation: it is reccomended the use of ICF Classification as standard instrument for welfare policy development in Italy

Ministry of Welfare ICF in Italy Project It is planned by Ministry of Welfare to start an action of support for the developement of a national consciousness of disability based on ICF principles and on ICF related instruments. To accept ICF implies to consider disability not as a problem of “some” but as an issue for the whole community, starting from the Institutions. Diminish disability of a population requires a common effort and a multisectorial collaboration as defined by the biopsychosocial model of ICF

The biopsychosocial model proposed by ICF and Bari reccomendations The ICF biopsychosocial model of health and disability involves then all the sectors of public policies and particularly welfare, health, education, labour. Intersectoral collaborations and integrated approach will be the keys to identify solutions to decrease the disability of populations and to improve social integration.

Italian Ministry of Welfare “ICF in Italy” Project: Aims Develop a national consciousness on ICF principles Develop a national consciousness on ICF principles Data collection on health and disability in Italy Data collection on health and disability in Italy Develop common language and intersectoral exchange of information Develop common language and intersectoral exchange of information Develop a “Pilot project: ICF and Labour policies” with Italia Lavoro for the the application of ICF in the labour sector for integration of person with disability in the work sector Develop a “Pilot project: ICF and Labour policies” with Italia Lavoro for the the application of ICF in the labour sector for integration of person with disability in the work sector Develop Training program with the scientific and technical support of the DIN, training will be then given to WHO for international use Develop Training program with the scientific and technical support of the DIN, training will be then given to WHO for international use Exchange of data and information with other countries Exchange of data and information with other countries

ICF in Italy: ICF and labour policies Project. Actors Ministry of Welfare Ministry of Welfare Italia-Lavoro agency and its branches: ICF and labour policies project coordinator Italia-Lavoro agency and its branches: ICF and labour policies project coordinator Disability Italian Network: tecnical-scientific advisory board Disability Italian Network: tecnical-scientific advisory board Ministry of Health, Ministry of Education, NGO’s, Regions, Public Administrations… Ministry of Health, Ministry of Education, NGO’s, Regions, Public Administrations… Scientifc Societies Scientifc Societies

ICF and Labour Policies Pilot Project Implementation, training and utilization’s strategy of the International Classification of Functioning Disability and Health of the World Health Organization, ICF Italian Ministry of Welfare and Labour ITALIAlavoro D I N D I N Disability Italian Network WHO World Health Organization “ICF in Italy Project” Welfare Policy Development IlIlIlIl

Is ICF a really necessary exercise? In other words: Should we really consider to describe, classify and measure the “human functioning”? Try to find consensus on complex items such as health and disability and then open a season of strong innovations as well as of strong conflicts? Disability Italian Network

Change could be guided or passively accepted The issue is NOT to decide whether to change or not. The issue is to choose whether to positively guide or passively take the change. ICF offers a conceptual model that has the strength and the possibility to be the cultural standard and the guide for this challenge Disability Italian Network

The Minstry of Welfare and the ICF in Italy project The Italian Ministry of Welfare accepts the challenge proposed by the application of ICF model and in collaboration with national and international organizations will feed back the national and international community on progresses and developments of this project.

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