Knowledge and use of the international classification of functioning, disability and health: a cross-sectional survey among health professionals in Pakistan

Muhammad Kashif Aakash ^1*

Marianna Capecci ²

Francesca Gimigliano ¹

Maria Gabriella Ceravolo ²

Abstract

Background: 

The International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization (WHO), provides a standardized framework for understanding and measuring health and disability. While widely adopted globally, its implementation in low- and middle-income countries (LMICs), such as Pakistan, remains inconsistent and underexplored.

Objective: 

This study aimed to assess the knowledge and practical application of the ICF among healthcare professionals in Pakistan.

Methods: 

A cross-sectional online survey was conducted using the Kobo Toolbox platform and distributed via social media to a diverse group of healthcare professionals. The survey comprised closed-ended questions across three domains: (I) demographics, education, and professional experience; (II) knowledge and utilisation of the ICF in clinical practice; and (III) clinical practice settings. A filtering question determined whether respondents claimed familiarity with the ICF. Actual knowledge was further evaluated through a four-item multiple-choice instrument; respondents answering at least two questions correctly were operationally classified as having moderate to good knowledge.

Results: 

Of the 52 respondents, 63.5% held a medical degree—including two (6.1%) with training in Physical and Rehabilitation Medicine—while 36.5% were non-medical healthcare professionals (including nurses and medical students). While 48% claimed familiarity with the ICF, only 17% demonstrated actual moderate to good knowledge upon evaluation. ICF literacy was more prevalent among those holding doctoral degrees or at least 16 years of professional experience.

Conclusion: 

These findings reveal an apparent gap between perceived and actual ICF knowledge among health professionals in Pakistan. The integration of ICF content into medical curricula, professional training, and continuing medical education (CME) is recommended to enhance disability assessment and rehabilitation planning in Pakistan.

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