Reply To: Discussion Forum 1

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In order to gather useful information about the current rehabilitation needs and the current status of the health system, I would examine both quantitative and qualitative data from various sources. These sources would range from the household and community level up through the national or regional level. I would explore global levels for reference as I assess the needs of the current local situation. Data sources include patient surveys at the micro – household level, patient charts, facility registers and logbooks, district and national summary reports. Patient surveys at the household level will give a more granular, personalized look at needs, as the scope of surveillance zooms out to facility, district and national levels the data can provide information on trends, or geographic needs. This may assist in understanding equitable distribution of resources to meet the needs of the entire population, and to identify resource gaps where vulnerable populations may have increased need for services. The WHO categorizes data resources into three groups: user level, facility or program level, andpopulation level. These different groups support outcome evaluation, service and quality assurance, and policy respectively. I would also want to explore more specific data bases such as military, education data bases, NGO reports that may not be engaged in local ministry of health, social security and socia registries.
There are different data bases that indicate rigor of current health system These each have their own unique advantages and disadvantages. The WHO Global Health Observatory provides population level indicators in the dementia and post stroke populations. Multiple Indicators Cluster Surveys (MICS) by UNICEF is an international household health survey canvassing 130 indicators. This is useful to compare data across different countries but does not identify rehab specific needs – perhaps as rehab grows in importance in the health industry, this survey can be adapted to assist rehabilitation in health systems. DHS – or Demographic and Health Surveys by USAID is also commonly used for population level data but not yet specific to rehab needs. That said, it can offer insight into resource allocation as it provides indicators into public health levels across regions. I think I would utilize the MICS because it seems to have robust data that is comparable across the world. It would need adaptations that shed light on rehab specific needs. I do not have much experience in developing surveys but feel this is a key priority as we learn about assessing and strengthening the role of rehabilitation in health systems.
To assess an intervention, I would use the CFIR – or consolidated Framework for Implementation Research. This focuses on 5 areas: intervention, outer setting, inner setting, the individual and process. Monitoring is a continuous process required the reliance on the following indicators: SMART objectives, goals, key informant interviews, cost, surveys. To ensure adequate monitoring an evaluation, I would have personnel dedicated to this aspect, structure a uniform way to capture and disseminate information so the entire multidisciplinary team is aware of overall progress, or lack thereof.