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Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all. Des progres considerables ont ete realises pour sauver la vie des enfants de moins de cinq ans. Pourtant, ces avancees n'ont pas permis a tous les enfants de s'epanouir, en particulier lorsqu'ils presentent un handicap. Dans ce document, nous faisons etat de la prevalence croissante du handicap chez les enfants et adolescents. Nous evaluons la situation actuelle des enfants porteurs de handicap ainsi que leur readaptation au sein des systemes de sante, surtout dans les pays a revenu faible et intermediaire. Dans le cadre du programme de sante neonatale, les anomalies congenitales necessitent souvent des interventions et une readaptation rapides. Nous utilisons l'exemple de l'Argentine, un pays oU la readaptation fait partie integrante du systeme de sante en cas d'anomalie congenitale. Nous estimons que les anomalies congenitales impliquant une readaptation sont susceptibles de renforcer les systemes et mesures en la matiere grace a: l'amelioration de la coordination entre les soins primaires et la readaptation; l'identification et la comprehension des parcours qui permettent aux familles d'entrer en contact avec de tels services; la mise a disposition de ressources humaines competentes dans ce domaine; et enfin, grace au developpement des mecanismes et ressources qui soutiennent les technologies d'assistance et la readaptation. Nous proposons aux pays des pistes favorisant un diagnostic precoce, un transfert et une prise en charge des enfants souffrant d'anomalies congenitales, afin de consolider le systeme de sante et d'en faire beneficier l'ensemble de la population. En outre, nous recensons les moyens d'etoffer les politiques et programmes, mais aussi d'elaborer des strategies de prestation de services et de gestion des effectifs conformes aux lignes directrices et cadres relatifs a la readaptation formules par l'Organisation mondiale de la Sante. Selon nous, la communaute sanitaire internationale doit agir pour faire en sorte que les services de readaptation soient pris en compte, acceptes et integres dans les systemes de sante afin de contribuer au bon fonctionnement des la naissance, et que le handicap figure parmi les priorites en ce qui concerne la sante infantile. De telles actions renforceraient les systemes de soins de sante, assureraient un developpement optimal des la venue au monde et rendraient la readaptation accessible a toutes et tous. Se han hecho progresos considerables para salvar la vida de los ninos menores de 5 anos. Sin embargo, estos avances no han permitido que todos los ninos prosperen, en particular los ninos con discapacidades. En este articulo, se describe la creciente prevalencia de la discapacidad entre los ninos y adolescentes. Se evalua la situacion actual de los ninos con discapacidad y la rehabilitacion en el contexto de los sistemas sanitarios, en particular los de los paises de ingresos bajos y medios. Dentro de los programas de salud neonatal, las anomalias congenitas suelen requerir una intervencion y rehabilitacion tempranas. Se menciona a Argentina como ejemplo de un pais en donde la rehabilitacion de las anomalias congenitas esta integrada en el sistema sanitario. Se argumenta que las anomalias congenitas que requieren rehabilitacion tienen el potencial de fortalecer los sistemas y las politicas de rehabilitacion mediante: el fortalecimiento de la coordinacion entre la atencion primaria y la rehabilitacion; la identificacion y la comprension de las vias que permiten a las familias participar en los servicios; la provision de recursos humanos para la rehabilitacion; y la creacion de sistemas y recursos que apoyen la tecnologia de asistencia y la rehabilitacion. Asimismo, se proponen mecanismos para que los paises den prioridad e integren la identificacion, derivacion y atencion tempranas de los ninos con anomalias congenitas, con el fin de fortalecer los sistemas sanitarios para todos. Se identifican las oportunidades para ampliar la politica y la planificacion y para disenar estrategias de prestacion de servicios y de personal a traves de las directrices y los marcos de la Organizacion Mundial de la Salud para la rehabilitacion. Se sostiene que la comunidad sanitaria mundial debe actuar para asegurar que los servicios de rehabilitacion para apoyar el funcionamiento desde el nacimiento esten bien establecidos, aceptados e integrados dentro de los sistemas sanitarios, y que se de prioridad a la discapacidad dentro de la salud infantil. Estas medidas reforzarian los sistemas sanitarios, asegurarian el funcionamiento desde el nacimiento y harian que la rehabilitacion fuera accesible para todos., Introduction There are at least three complementary reasons why countries should urgently prioritize rehabilitation services to promote functioning from birth. First, while remarkable gains in child survival have been made [...]

Poverty amongst families with a child with disability adversely impacts child and family quality of life. We aimed to identify existing approaches to livelihood support for caregivers of children with developmental disabilities in low- and middle-income countries. This mixed-method study incorporated a scoping literature review and online stakeholder survey. We utilised the World Health Organization community-based rehabilitation (CBR) matrix as a guiding framework for knowledge synthesis and descriptively analysed the included articles and survey responses. We included 11 peer-reviewed publications, 6 grey literature articles, and 49 survey responses from stakeholders working in 22 countries. Identified programmes reported direct and indirect strategies for livelihood support targeting multiple elements of the CBR matrix; particularly skills development, access to social protection measures, and self-employment; frequently in collaboration with specialist partners, and as one component of a wider intervention. Self-help groups were also common. No publications examined effectiveness of livelihood support approaches in mitigating poverty, with most describing observational studies at small scale. Whilst stakeholders describe a variety of direct and indirect approaches to livelihood support for caregivers of children with disabilities, there is a lack of published literature on content, process, and impact to inform future programme development and delivery. Disability and poverty are interlinked, but little is known on approaches to livelihood support for caregivers of children with developmental disabilities in low- and middle-income countries. Stakeholders report direct and indirect strategies for livelihood support targeting multiple livelihood elements; particularly skills development, access to social protection measures and self-employment; frequently in collaboration with specialist partners, and as one component of a wider intervention. Improved reporting of livelihood targeted activities inclusive of evaluation of feasibility, acceptability and impact would support wider implementation of effective livelihood programmes for caregivers of children with disability. [ABSTRACT FROM AUTHOR]

This commentary examines the provisions for early childhood development (ECD) in the global action plan for rehabilitation published by the World Health Organisation (WHO) within the context of the United Nations' Sustainable Development Goal (SDG) for inclusive education. The meeting reports of the WHO Rehabilitation 2030 for 2017 and 2019 and the related documents were reviewed along with ECD policy documents from WHO, UNICEF, UNESCO, and the World Bank. The importance of a life-course approach to rehabilitation for the health and wellbeing of persons with disabilities was highlighted in the Rehabilitation 2030. However, the critical and foundational role of rehabilitation in ECD for children with disabilities to facilitate inclusive education, especially in low- and middle-income countries as envisioned by the SDG 4.2, was not clearly addressed. Children under 5 years with developmental delays and disabilities who are not developmentally on track in health and psychosocial wellbeing require timely rehabilitation to ensure that they benefit from inclusive education. The culture and practice of rehabilitation should be nurtured from infancy as an indispensable component of ECD to adequately prepare children with developmental disabilities for inclusive education and ensure effective rehabilitation services over the life course. Rehabilitation is an integral and critical component of early childhood development to optimise school readiness for children with developmental disabilities. Routine newborn screening, developmental assessment, and surveillance of children from birth are foundational to any effective rehabilitation in early childhood. Global investment to promote and support rehabilitation services from early childhood within the health systems and across all levels of service delivery including community settings is warranted to achieve the sustainable development goals for children with disabilities. [ABSTRACT FROM AUTHOR]