Reply To: Discussion Forum 1

[Oda Msuha]

1.Evidence needed to identify the factors and levels posing the greatest barriers to rehabilitation in my population includes
– qualitative and quantitative data infrastructures,(ie presence or absence of ramps) cultural and political barriers with luck of funding to facilitate rehabilitation services, few or limited number of expertise together with present of marginalized social categories like gender and socioeconomic status of the individual in need of rehabilitation services.
2.How does my own professional expert and organizational access suggest where I might be most effective in developing and launching an intervention;
Since I am general practitioner I might be effective in either levels from primary (ie includes from household intervention as our institution involved in home based care to community level) and according to the context and condition expertism.

3. Formative research needed to understand the precise intervention would be;
-Qualitative research, where individual or client will be interviewed to learn more about the challenge they face to obtain rehabilitation services and knowledge about rehabilitation care that will suggest the best intervention that will help improve access to care and address individual health inequities. Also it will aid in assessing the acceptability of the intervention.

4. When considering potential intervention, the following factors related to implementation are needed to consider;
– acceptability – is intervention agreeable to the situation
-Adoption- looks on commitment of stakeholders to the intervention
-Cost- is the suggested intervention cost effective
-Feasibility – can it be successful if carried out in our setting or organization
-Fidelity can it be carried out according to the intended protocol
– Penetration to what extent can the chosen intervention be integrated across sittings.
– Sustainability, can it be sustainably maintained in the long term
The given intervention should be (timely, safe and patient centered)

5 Implicit biases that may be at work in my culture or contex may include
Biases against persons based on their
Gender, Ethnicity, Race, Income level, Social status, Education level, Employment, health status, Mental status etc
These may impact those individuals interaction with rehabilitation care as;-
Individual may face disparities in the assessment and diagnosis of conditions requiring Rehabilitation as patient may receive inaccurate diagnosis based on their race, gender or /and socioeconomic status.
Certain group may receive less attention or less treatment options (recommendations) due to their gender or social status.
Patient from marginalized social categories (ie race, gender etc) May face barriers like limited referrals, limited availability of care.
Adherence and outcome may be poor because patient or individuals who are discriminated in their care may not adhere to rehabilitation plan or attended follow up appointment or trust their care provider. Addressing these biases involve awareness, training and system change to ensure equity to access to rehabilitation care to all population.