International Classification of Functioning, Disability and Health (ICF)

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The International Classificfation of Functioning, Disability and Health (ICF) is the WHO framework for measuring health and disability at both individual and population levels. ICF was officially endorsed by all 191 WHO Member States in the Fifty-fourth World Health Assembly on 22 May 2001 (resolution  WHA 54.21) as the international standard to describe and measure health and disability. It is the conceptual basis for the definition, measurement and policy formulations for health and disability. It is a universal classification of disability and health for use in health and health related sectors. ICF therefore looks like a simple health classifiation, but it can be used for a number of purposes. The most important is as a planning and policy tool for decision-makers. 

ICF is operationalized through the WHO Disability Assessment Schedule ( WHODAS 2.0). WHODAS 2.0 was developed through a collaborative international approach with the aim of developing a single generic instrument for assessing health status and disability across different cultures and settings.

ICF is a classification of health and health-related domains -- domains that help describe changes in body function and structure, what a person with a health condition can do in a standard environment (their level of capacity), as well as what they actually do in their usual environment (their level of performance).

There are three levels of human functioning classified by ICF: functioning at the level of body or body part, the whole person, and the whole person in a social context. Disability therefore involves dysfunctioning at one or more of these same levels: impairments, activity limitations and participation restrictions. 

Here are some definitions:

  • Body Functions are physiological functions of body systems (including psychological functions). 
  • Body Structures are anatomical parts of the body such as organs, limbs and their components. 
  • Impairments are problems in body function or structure such as a significant deviation or loss. 
  • Activity is the execution of a task or action by an individual. 
  • Participation is involvement in a life situation. 
  • Activity Limitations are difficulties an individual may have in executing activities. 
  • Participation Restrictions are problems an individual may experience in involvement in life situations. 
  • Environmental Factors make up the physical, social and attitudinal environment in which people live and conduct their lives..

Read more about ICF here.