The Navajo Area Indian Health Service provides comprehensive child healthcare services. This report further documents the need for allocating and managing medical and developmental resources for the prevention and treatment of disabling conditions among Navajo children. A multi-disciplinary, multi-agency committee was convened to report on the efforts to expand and coordinate services for physically and mentally handicapped Navajo children. Additionally, it was the intention of the committee to keep the need for improved developmental disability service in the forefront of Navajo leadership discussion.A geographically distributed sample of 60 disabled Navajo children located in one of the four IHS Service Units - Fort Defiance, Chinle, Gallup, or Shiprock - was chosen. A select group of developmental specialist consultants created an information gathering strategy that would permit a peer review by a consulting group. They established an audience of local health care clinicians and social and educational providers to receive, comment on, and react to the findings of this study. Through a Navajo professional, interviews of the parents of the children were completed to ascertain perceptions of the medical care provided by the Navajo Area Indian Health Service and its referral agencies. Complete medical care management data was collected using established interview procedures. Finally, all information was provided in such a manner to be useful to both the health provider and the parent. The primary medical care provided once the child had entered the medical care system was adequate and appropriate; however, the specialty intervention and care associated with developmental problems was not. Documentation of early childhood development, progress and delay was not utilized. Specialty assessments such as hearing, fine and gross motor abilities, cognitive and language skills, social and psychological development were not administered. Treatment resources were not available for at-risk children who would probably not recover or develop without treatment. Finally, there were no long-term plans for these disabled children. Not all service gaps can be met by a medical care system. The study recommended that self care and health maintenance should be learned in childhood and maintained through further schooling. The emphasis should be on development rather than disease. Allocation of resources should follow this plan. A caseworker should be assigned to each handicapped or chronically ill child. A mini-health book should be created to record immunization records. Local support could be raised by having workshops and showing films to the community. More help should be provided to the doctor to, allow for these recommendations to be completed. Additionally, the report lists eight issues for improvement that should become the focus of the health consumer, Tribe, community, Navajo Area IHS, or physicians.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-29).
Evaluation of medical services to developmentally disabled Navajo children. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-29). 1982