Reply To: Building strong leadership and increase political support for rehabilitation

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There are some good opportunities to develop and strengthen international standard rehabilitation in Mongolia currently. Right now, there is solid support for developing rehabilitation and integrating rehabilitation services into the health system. Although a rehabilitation mandate is already included in high-level governance documents, up to now there has not been the sustained rehabilitation leadership supported by MOH that is needed for developing effective rehabilitation policy and for forward-looking strategic planning. Inter-sectoral planning and coordination at all levels is needed. Also, there have been few opportunities for rehabilitation stakeholders to come together and collaborate in designing rehabilitation policy, rehabilitation standards, implementation guidance, and systems to monitor and evaluate progress in moving towards evidence based, international standard rehabilitation.
1. Strengthen the leadership, planning, and coordination
There are three types of ‘rehabilitation’ (in inverted commas to represent the loose use of this term) in Mongolia. The first is the rehabilitation observed in health facilities and in sanatoria and based on physical and traditional treatments, and which is linked with traditional medicine. The second is rehabilitation treatments from an earlier Soviet era, primarily electrical and physical treatments which are the most frequently seen, most familiar to all and found at all levels of the health system. And third, international standard rehabilitation provided by rehabilitation personnel trained in rehabilitation based on international standards. The latter is by far less prevalent in Mongolia and found mainly in some national centers and state hospitals in Ulaanbaatar. Building and strengthening this international standard rehabilitation in Mongolia must consider this historical and current context.
International standard rehabilitation is distinct from both other types of treatments which are called rehabilitation in Mongolia. The melding of these three understandings about rehabilitation into one concept, loosely called rehabilitation, is exacerbated by the regulatory framework of laws and Ministerial Orders. Leadership and planning are crucial for the successful strengthening of the sector based on understanding international standard rehabilitation, and the effective and efficient use of resources to underpin international standard, evidence-based rehabilitation. The leadership of rehabilitation in Mongolia requires a multi-stakeholder and multi-disciplinary rehabilitation structure to widen the platform from which it operates and increase the collaborative planning processes.