Reply To: Discussion Forum 1

[[email protected]]

• How does the proposed intervention fit with the priorities of your organizations?
Looking at the inner context, telerehabilitation fits within the organization priorities as there is a priority/mission to ensure healthy populations, and telerehabilitation enables greater access and availability of rehab services for all. It also fits within the larger national rehab strategy and goals of ensuring greater and equitable access to rehab services, particularly for those within remote/rural areas. It also enables economies of scale as you are able to use less resources but reach more people, and this helps address some of the challenges related to shortage or rehab/AT professionals. The only challenge is the lack of ICT infrastructure in the country. While there is a strategy to strengthen ICT across the country, how and where telerehabilitation will be delivered will have to be closely aligned with ICT priorities.

• How does it fit with community values, including the values of diverse cultural groups?
Now looking at the outer context, telerehabilitation fits in terms of values related to affordability and access. However, Tanzania is a very person-centered culture where relationships are very important and in-person care and service is needed to build relationships. For this reason, there may be some populations that may be hesitant to use telerehabilitation but I believe that the values of affordability (i.e. reducing transport costs/opportunity costs associated with travelling to get rehab services, particularly for those in remote areas) and accessibility (being able to access care closer to home) will outweigh some of the importance placed on in-person care.

• What strategies could you use to target key stakeholders’ awareness, knowledge, attitudes, and intention to integrate the new intervention?
Engagement of key stakeholders at the design of the implementation and in the implementation process itself will be very important. Engaging with clinical staff, management, key policy makers/decision makers, and clients/users in various capacities will be important to raise awareness, knowledge, attitudes and intention of the intervention.

• What strategies could you use to target the motivation and capability of individuals and organizations to engage in implementation process strategies to integrate the new intervention?
Anchoring messages on what telerehabilitation can do for rehab services in the country and targeting these messages to each different stakeholder group will be important. In addition, providing individuals and staff within an organization with the right training and tools to effectively deliver the intervention is one way to motivate and engage them. Staff can be involved in the design of the intervention (i.e. how to roll it out, where to roll it out, where to pilot, etc.) and this will make them have more ownership towards the intervention.