[Contribution of public health to paediatric physical disability rehabilitation units]

Approximately 4% of children in North America and Europe live with a chronic disability. Most countries have developed a range of specialized health services to meet the specific needs of these children. However, an increasing number of authors argue that more public health activities should be offered to children with disabilities in order to promote social participation and to ensure more efficient organization of these services. The objectives of this article are: 1) to describe the needs of children with physical disabilities that can be met bypublic health activities, 2) to present the Quebec health care system and discuss the inclusion of public health principles in paediatric rehabilitation services, and 3) to propose ways to improve integration of these principles.

The needs of children with disabilities are described according to categories of needs from the Life Needs Model: basic skills; applied skills; needs support, education and information for children, family and community. The patterns of paediatric rehabilitation services and service organization in Quebec were analysed.

Services for children with physical disabilities are primarily intended to develop basic and applied skills. The mandate of institutions delivering specialized services and waiting lists could limit the possibilities to provide services able to meet all of the needs of disabled children. Integration of public health activities would ensure greater complementarity and further promote social participation. Some approaches providing interesting avenues to further integrate public health in paediatric rehabilitation services are discussed.