1. Role of CBR Strategy on disability prevention and control Deepak Raj Sapkota Country Director Karuna Foundation Nepal

2. Community Based Rehabilitation- CBR An approach that promotes the culture of living together in/with diversity 5 Pillars: Health, Education, Social, Empowerment and livelihood

3. Disability Congenital and acquired Acceptance and recognition Prevention and control

4. Disability and children the number of reported childhood disabilities has increased (60’s and now) the nature and consequences of disability have changed Physical versus internal

5. Prevention (and control) Prevention and control is possible in significant ways, Appropriate pre-natal care and early childhood health care are key to prevention of disabilities, Some birth defects in pregnancy are associated with developmental delays, emotional and behavioral problems, and learning disabilities,birth defects in pregnancydevelopmental delayslearning disabilities

6. Pre-conception phase Changes in lifestyle will promote a healthy pregnancy and increase the chances of having a healthy baby while reducing risk of learning disabilities, Regular physical examinations before and during pregnancy, Pre-conception counseling may prevent some forms of genetically determined physical, mental or developmental disabilities, Pre-conception rubella immunization can prevent a range of neurological and other problems in the child,

7. During pregnancy Risks vs benefits of continuing medications during pregnancy: many drugs do pass through the uterus and are believed to affect child development, ( Paxil, a common antidepressant, is just one of many medications linked to heart defects in infants as have several common pain relievers. )linked to heart defects in infants common pain relievers. Maintain dietary needs, (taking Folate supplements to reduce risk of defects.)taking Folate supplements to reduce risk of defects

8. During pregnancy Any concerns during pregnancy, has to be shared immediately with medical professional Sharing medical history helps to know of any family history of medical issues (Genetic counseling is often helpful for prospective parents) (Genetic counseling

9. During pregnancy Spina bifida may be prevented through maternal nutritional supplementation; Fetal alcohol spectrum disorder may be prevented by avoiding alcohol consumption during pregnancy; Cerebral palsy may be prevented through high quality care prenatally and during birth;

10. Prevention at large… Prevention of some disabilities with healthy life choices is possible. Giving a child the best possible start in life is an important way to prevent disabilities. Screening newborns helps identify disabilities for Early Intervention.

11. Prevention at large… Other forms of developmental disability may be prevented through programs for healthy infant and child development, – detection and treatment of iron deficiency anemia in infancy and; – the prevention or early detection of hearing problems or speech-language pathology that, uncorrected, can result in developmental and mental health problems in later years;

12. Prevention at large… Some forms of mental disability may be prevented through mental health promotion, A wide range of physical disabilities may be prevented through injury prevention, early management, While neuro-sensory disability such as loss of sight or hearing can be prevented through a range of protective interventions,

13. And also… Technology: A blessing or a curse; while in utero diagnosis may present opportunities for early post-partum intervention or the option for termination of pregnancy;

14. CBR and Disability Prevention ???

15. Thank you…