A new report released today by the World Health Organization (WHO) and UNICEF highlights the global prevalence of developmental disorders among children and adolescents and identifies urgent action needed to address disparities in access to healthcare, health status and exposure to social determinants such as poverty.
The report estimates that 317 million children and adolescents were affected by health conditions leading to developmental disabilities in 2019. Many of them experience stigma, prejudice and social exclusion. They also encounter barriers to accessing healthcare and experience poorer quality of healthcare compared to their peers.
“Our vision of leaving no one behind can only be achieved by elevating the aspirations and needs of children and adolescents with developmental disabilities from the margins to the mainstream in our work to promote the health and well-being of children around the world,” said Dr Ruwei Pearson, UNICEF Deputy Director for Health.
“From poorer health to social exclusion, children and adolescents with developmental disabilities experience significant disparities. As part of broader efforts to expand universal health coverage and promote inclusive care environments, strengthening interventions to support children and adolescents with developmental disabilities will ensure they can access the resources and services they need to lead healthy lives,” said Devora Kestel, WHO Director for Mental Health and Substance Use.
Children and young people with developmental disabilities have underlying conditions that affect the developing nervous system and cause impairments and associated disabilities in motor, cognitive, language, behavioral and sensory functioning. Through interaction with a range of barriers and contextual factors, these disabilities can prevent a child from participating fully and effectively in society on an equal basis with their peers.
Underlying health conditions that contribute to developmental disabilities include autism, intellectual developmental disability, attention-deficit hyperactivity disorder, and many other neurodevelopmental disorders listed in the International Classification of Diseases, 11th Revision (ICD-11), as well as a broader range of congenital conditions (e.g., Down syndrome) and conditions acquired at birth or during childhood (e.g., cerebral palsy).
Health disparities
It is well-documented that children with developmental disabilities have poorer health outcomes and are at higher risk of early death than their peers. The most common underlying, preventable causes of death among children and adolescents with developmental disabilities include epilepsy, choking, respiratory infections and injury.
Health disparities continue into adulthood, increasing the risk of diabetes, heart disease, obesity, respiratory disease and mental illness.
People with developmental disabilities have unmet health care needs due to a fragmented and underfunded health care system. Children and young people with developmental disabilities often have health problems that go undetected and untreated due to delayed diagnosis, long waiting lists and lack of access to care services. Lack of information, stigma and understanding about developmental disabilities also act as barriers to accessing health care.
Physical and attitudinal barriers and lack of training also contribute to inequities in health care for these children: Children with developmental disabilities experience more preventable harm during hospital stays and receive poorer quality care, with quality of care varying widely.
Framework for action
The report presents a framework for concrete actions needed to accelerate policy and systems changes to improve the health, development, well-being and participation of children with developmental disabilities.
Strengthening coordination and accountability mechanisms for improving care; promoting advocacy, leadership, participation in policies, programs and monitoring; addressing social determinants of health, well-being and participation in policies, programs and funding; addressing biases and fostering inclusive supportive environments; promoting multi-sectoral policymaking to address inequities in health care; providing services for comprehensive, person-centred and evidence-based care; informing, empowering and supporting caregivers; improving data and research; developing comprehensive plans and protocols for health emergency preparedness and response.
The global report is a call to action to accelerate change at the individual, family, community and societal levels to achieve inclusion and health equity. It argues that greater investment is needed to build responsive multisectoral systems of care for children and young people with developmental disabilities.