International Classification of Functioning, Disability and Health (ICF)

The World Health Organisation (WHO) publishes reference manuals that describe and classify what it considers to be health conditions, using a numbering system. The manual for disability is the International Classification of Functioning, Disability and Health (ICF). The ICF’s well known sister manual is the International Classification of Diseases (ICD-10). Inevitably, there is some overlap.

According to WHO, the ICF’s most important purpose is as a planning and policy making tool (ICF: 2). It is the international standardisation of classifications, with a focus on functioning, that facilitates this planning through the collection of internationally comparable data on health and functionings, as determinants of needs, health services, and predictors of employment capability and performance. “ICF is a scientific tool for consistent, internationally comparable information about the experience of health and disability” (ICF:5)

It’s conceptualisation of disability is therefore based on assumptions about the need for State monitoring and intervention to look after the health, wellbeing and social inclusion of populations.

Underlying principles of ICF

The ICF’s model of disability is broadly based on the psychosocial model of disability, which combines relevant elements of both the medical model of disability and the social model of disability. “in ICF disability and functioning are viewed as outcomes of interactions between health conditions (diseases, disorders and injuries) and contextual factors” (ICF: 10) Its general principles are therefore linked to the biopsychosocial model of disability (ICF:13). These principles are:

UNIVERSALITY

“A classification of functioning and disability should be applicable to all people irrespective of health condition. Therefore, ICF is about all people. It concerns everyone’s functioning. Thus, it should not become a tool for labeling persons with disabilities as a separate group” (ICF: 14).

PARITY

“There should not be, explicitly or implicitly, a distinction between different health conditions as ‘mental’ and ‘physical’ that affect the structure of content of a classification of functioning and disability. In other words, disability must not differentiated by etiology” (ICF: 14)

NEUTRALITY

“Wherever possible, domain names should be worded in neutral language so that the classification can express both positive and negative aspects of each aspect of functioning and disability” (ICF: 14).

ENVIRONMENTAL FACTORS

“In order to complete the social model of disability, ICF includes Contextual Factors, in which environmental factors are listed. These factors range from physical factors such as climate and terrain, to social attitudes, institutions, and laws. Interaction with environmental factors is an essential aspect of the scientific understanding of the phenomena included under the umbrella terms ‘functioning and disability'” ICF:14).

WHO http://www.who.int/classifications/icf/en/ (last accessed 21 January 2017)

“In ICF, the term functioning refers to all body functions, activities and participation, while disability is similarly an umbrella term for impairments, activity limitations and participation restrictions. ICF also lists environmental factors that interact with all these components.” (ICF: 2)