The intersection between health and education : meeting the intervention needs of children and youth with disabilities

Abstract

Improving developmental outcomes for children and youth with disabilities (CYWD) in low- and middleincome countries requires the removal of access barriers perpetuating the patterns of exclusion of persons with disabilities in general. In South Africa, an upper middleincome country with stark characteristics of inequality, intervention and support are hampered by inadequate coordination, and confusion regarding roles and responsibilities between key stakeholders in the health and education sectors. The World Disability Report highlights poor coordination of services, inadequate staffing, and poor staff competencies as critical in determining the quality, accessibility, and adequacy of services for persons with disabilities. The South African National Departments of Health and Basic Education both have individual as well as coordinated policies that should facilitate the participation of CYWD in environments important to their health, development and academic abilities. However, there is a disjuncture in how these policies are implemented at provincial, district, hospital, and school level when children transition between these sectors. Drawing on bioecological systems theory, the chapter explores how intersectoral collaboration in the health and education sectors is affected by poor coordination and integration at various levels of the system for CYWD. The chapter further proposes how rehabilitation professionals working in these two sectors and delivering intervention services at grassroots level, can start to use a biopsychosocial approach, such as the International Classification for Functioning, Disability and Health, to transform their practices and improve coordination of roles and responsibilities. This would allow CYWD to transition more seamlessly between these sectors, mitigating the systemic barriers that lead to inadequate health, development and academic outcomes for disabled children.