Feasibility Assessment of the ICF Minimal Generic Set as a Disability Screening Tool in Rural Nepal

Abstract

Purpose: Nepal’s 2017 Disability Rights law provided a new national definition of disability consistent with the UN Convention on the Rights of Persons with Disabilities (CRPD). Updated measurement methods are now indicated to assess disability, suitable for use in populations where self-report tools may be sub-optimal. This study describes the development and field testing of a screening methodology using a clinical assessment conducted by trained non-professionals to score the ICF Minimal Generic Set (MGS). Method: A prospective, 2-stage assessment of disability was conducted over an eight-month period among a convenience sample of individuals aged ≥ 18, admitted to a rural District Hospital in Northeastern Nepal. After 30 hours of training, non-professional assessors completed Stage 1 screening during hospital admission, with positive screening thresholds set on the basis of MGS scores. A physiotherapist completed Stage 2 assessments in the homes of participants with long-term disability, after their hospital discharge. Results: Data from 161 participants was analysed, with 159 (98.8%) screening positive for either temporary or long-term disability. Stage 1 screening was completed independently by assessors in 8-12 minutes. Of the 35 participants (21.7%) with positive screening for long-term disability, 13 (37.1%) underwent Stage 2 detailed evaluation. Disability was confirmed in all Stage 2 assessments, indicating feasibility of the screening process. Conclusion: Disability screening conducted by trained non-professional assessors using clinical assessment to score the MGS appears to be a promising methodology, and warrants further investigation. If it is found to be valid, it could provide a powerful tool to increase the visibility of disability among some of the most vulnerable populations.