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Original Research Articles

A Framework for Healthcare Provision to Children with Intellectual Disability

Authors:

Zinia T Nujum ,

Department of Community Medicine, Medical College, Thiruvananthapuram, Kerala, IN
About Zinia T

Associate Professor (CAP), Community Medicine. Special areas of interest include communicable disease prevention, nutrition, disability prevention and rehabilitation.

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TV Anilkumar,

Department of Psychiatry, Medical College, Thiruvananthapuram, Kerala, IN
About TV

Professor in Psychiatry. Special training in child psychiatry from NIMHANS. Charge officer of child and adolescent psychiatry clinic of Medical College, Thiruvananthapuram.

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K Vijayakumar,

Department of Community Medicine, Medical College, Thiruvananthapuram, Kerala, IN
About K

Professor & Head, Community Medicine. A public health activist, working towards the upliftment of society by propagating research methods throughout India.

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TS Anish,

Department of Community Medicine, Medical College, Thiruvananthapuram, Kerala, IN
About TS

Assistant Professor, Community Medicine. Administrative Medical Officer of Rural Health Centre, Vakkom. Special area of interest is communicable disease epidemiology.

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Hisham Moosan

Department of Community Medicine, Medical College, Thiruvananthapuram, Kerala, IN
About Hisham

Junior Resident, Department of Community Medicine. Joined Health Services Dept, Kerala in 2009 as Assistant surgeon. Worked in the capacity of Primary health centre Medical Officer, Block Medical Officer and District Leprosy Officer (Addl Charge) in Wayanad District.

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Abstract

Purpose: The Kudumbashree mission, an initiative of the Government of Kerala state in India, has collaborated with Local Self Governments to set up ‘Buds’, a special school system for individuals with intellectual disability. The objectives of this study were to evaluate the structure and functioning of ‘Buds’ schools, to identify the healthcare needs of the students, and to conceptualise a framework for healthcare provision.

Methods: A cross-sectional survey was conducted among 202 children at 11 registered ‘Buds’ schools in Kerala. A multidisciplinary team consisting of a psychiatrist, public health personnel and a social worker from the Medical Colleges of Kerala, visited the institutions. Data collection consisted of abstraction from medical records, interviews with parents, and clinical assessment and prescription of intervention by the specialists concerned. A pre-tested semi-structured questionnaire was used for every child. Using both quantitative and qualitative techniques, the public health personnel in the team evaluated the structure and functioning of the schools.

Results: The most commonly associated condition was epilepsy, seen in 11.9% of the children, while 28.2% had behavioural problems. The medicines needed were mainly anti-epileptics and drugs for behavioural problems. Interventions for self help and social skill training were also among the important requirements. The infrastructure and other facilities were poor in many schools, with the average student to teacher ratio at 14:1. While these institutions were well utilised, functioning was good only in 27.2% of the schools. Healthcare services and visits by healthcare personnel were far from adequate.  This study proposes a framework in which the Medical Colleges and Health Services can function together to deliver healthcare services to children at these schools, with linkages from the District Mental Health Programme (DMHP).

Conclusion and Recommendation: Evidence that these schools are well utilised indicates a need to propagate this initiative in other areas of the state, country and other countries. However, improvements in infrastructure, human resources and other logistics are required. Besides, the healthcare needs of these children have to be addressed. A comprehensive healthcare programme through the existing system, using a multidisciplinary approach, needs to be developed.

How to Cite: Nujum, Z.T., Anilkumar, T., Vijayakumar, K., Anish, T. and Moosan, H., 2013. A Framework for Healthcare Provision to Children with Intellectual Disability. Disability, CBR & Inclusive Development, 23(4), pp.54–66. DOI: http://doi.org/10.5463/dcid.v23i4.154
Published on 05 Feb 2013.

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