International Classification of Functioning, Disability and Health (ICF)

The International Classification of Functioning, Disability and Health, known more commonly as ICF, is a classification of health and health-related domains. As the functioning and disability of an individual occurs in a context, ICF also includes a list of environmental factors.

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.

Since 2001, ICF has been demonstrating a broader, more modern view of the concepts of “health” and “disability” through the acknowledgement that every human being may experience some degree of disability in their life through a change in health or in environment. Disability is a universal human experience, sometimes permanent, sometimes transient. It is not something restricted to a small part of the population.

ICF focuses on impact. This creates a foundation and a common framework allowing all conditions to be compared using a common metric - the impact on the functioning of the individual.

Furthermore, ICF looks beyond the idea of a purely medical or biological conceptualization of dysfunction, taking into account the other critical aspects of disability. This allows for the impact of the environment and other contextual factors on the functioning of an individual or a population to be considered, analyzed, and recorded.

ICF Application

Implementation of the ICF started in 2001 following the unanimous endorsement of the classification as the framework for describing and measuring health and disability by the 54th World Health Assembly. Since then, ICF has been applied in a variety of settings at national and international level.

International and national health and disability reporting

The ICF framework was used in the Multi-Country Survey Study and the World Health Survey Program to measure health status of the general population in 71 countries. At regional level UNSD, UNESCWA and UNESCAP, in collaboration with WHO, implemented a series of workshops for African, Middle Eastern and Asian countries to improve disability statistics using the ICF framework. At national level ICF based data sets and questionnaires are currently used in a number of countries including Australia, Ireland, Mexico, Zimbabwe, and Malawi, among many others.

Several countries have started the process of streamlining ICF in their health & social information standards and legislation. Development and piloting of ICF based indicators and reporting systems for use in rehabilitation, home-care, age-care, and disability evaluation are ongoing.

Clinical and epidemiological use

In clinical settings ICF is used for functional status assessment, goal setting & treatment planning and monitoring, as well as outcome measurement. Countries, which already use ICF in a variety of clinical settings include Australia, Italy, The Netherlands….. At international level WHO is exploring the use of ICF to measure health outcomes and guide disability management in infectious disease programs such as LF and