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United Nations
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Aims of ICIDH-2ICIDH-2 is a multi-purpose classification designed to serve various disciplines and different sectors. Its specific aims can be summarized as follows:
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Although ICIDH-2 is inherently a health-related classification, it is also used by other sectors. Thus, it has been accepted as one of the United Nations social classifications and is referred to in and incorporates the Standard Rules on the Equalization of Opportunities for Persons with Disabilities. As such, ICIDH-2 provides an appropriate instrument for the implementation of stated international human rights mandate as well as national legislation.
ICIDH-2 offers a conceptual framework for information that is applicable to personal health care. It is also useful for the study of healthcare systems, in terms of both evaluation and policy formulation.
There is a widely held misunderstanding that ICIDH-2 is only about people with disabilities; in fact, it is about all people. The functional states associated with all health conditions at the body, individual or society levels can be described using ICIDH-2. In particular:
It must be noted that ICIDH-2 does not cover the functional states that are not health related, such as those brought about by socio-economic factors independent of health conditions. For example, people may be restricted in their participation because of their race, gender, religion or other socio-economic categories, but these are not health-related restrictions of participation as classified in ICIDH-2.
As a classification, ICIDH-2 does not model the process of functioning and disability. However, it can be used to describe the process by providing the means to map the different dimensions and domains. ICIDH-2 provides a multi-perspective approach to the classification of functioning and disability as an interactive and evolutionary process.
It is possible to conceive the dimensions of functioning and disability as a continuum or as a multidimensional co-existence. In a continuum approach, boundaries need to be drawn between body functions, activities and participation. For example, a function should only be in one dimension. A multidimensional approach, however, allows various functions to be viewed in different dimensions at the same time.
A variety of conceptual models have been proposed to understand and explain disability and functioning. These may be expressed in a dialectic of the "medical model" versus the "social model". The medical model views disability as a personal problem, directly caused by disease, trauma or other health condition, which requires medical care provided in the form of individual treatment by professionals. Management of the disability is aimed at cure or the individual's adjustment and behaviour change. Medical care is viewed as the main issue, and at the political level the principal response is that of modifying or reforming healthcare policy.
The social model of disability, on the other hand, sees the issue mainly as a socially created problem and principally as a matter of the full integration of individuals into society. Disability is not an attribute of an individual but rather a complex collection of conditions, many of which are created by the social environment. Hence, the management of the problem requires social action, and it is the collective responsibility of society at large to make the environmental modifications necessary for the full participation of people with disabilities in all areas of social life. The issue is therefore an attitudinal or ideological one requiring social change, which at the political level becomes a question of human rights.
ICIDH-2 is based on an integration of these two extreme models. In order to capture the integration of the various dimensions of functioning, a "biopsychosocial" approach is used. Thus, ICIDH-2 attempts to achieve a synthesis, thereby providing a coherent view of different dimensions of health at the biological, individual and social levels.
ICIDH-2 is available on the Internet at: http://www.who.int/icidh/. The full English, French and Spanish text can be downloaded from the WHO site only in the Adobe Portable Document Format ® (PDF). However, this format of the document is not easily accessible to persons using assistive devices, who have low levels of telecommunications infrastructure or who use mobile computing and wireless Internet devices. WHO also published on its site in Adobe the ICIDH Field Trial Documents. A hypertext searchable version of ICIDH is available, but the full text is only available in Adobe.
36 International Classification of Functioning and Disability, Beta-2. Geneva, World Health Organization, 1999. Available at: http://www.who.int/icidh/index.htm