A Geographical Analysis of Childhood Disability Distribution in Batticaloa District – A Path to Inclusiveness through Community-Based Rehabilitation

The Sustainable Development Goals underscore the importance of “leaving no one behind”, emphasising the inclusion of disabled persons. Rehabilitation plays a pivotal role in enabling individuals with disability, through active interventions, to achieve optimal functioning in their environment.In Sri Lanka, human resources and facilities for ideal rehabilitation for children are limited to major hospitals. In our clinical practice, we find many children with fixed disabilities, mainly due to defaulted follow-up, owing to financial constraints and difficulty in transportation of the disabled child.In this study, we have looked into the geographical distribution of children with disability to assess the feasibility of having quality rehabilitation programmes in the community, closer to or at their homes, which would greatly improve the outcomeIn May and June 2024, Public Health Midwives (PHM) entered information about disabled children using a Google Form. We performed a descriptive analysis of the collected database.A total of 858 children were identified with disabilities in the Batticaloa district. High numbers, disproportionate to the population distribution, were observed in the Vaharai and Koralaipattu Central areas, which are the most remote from the Teaching Hospital Batticaloa. Only 27 (3%) lived in the Batticaloa MOH area. A geographical mapping showed that many of these children lived far away from the Teaching Hospital Batticaloa and the nearby health facilities. The disabilities identified were learning disability (n = 202, 23.5%), developmental delay (137, 16%), locomotor dysfunction (86, 10%), cerebral palsy (n = 60, 7%), autism (19, 2.2%) and Down syndrome (21, 2.4%). The exact disability was not recorded in 333 (38%) children.Based on the distribution of children in Batticaloa district and the availability of human resources in the district, organising community-based rehabilitation near the child’s home or at their own homes is justified.