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1.What evidence do I have (or need) to identify those factors and levels posing the greatest barriers to rehabilitation in my population?
-The greatest barriers to rehbailitation in Nepal could be lack of adequate HR, Infrastructures, financing, leadership and integration of rehabilitation at all levels of healthcare system. There has been significant awareness among the leading entities in the government, stakeholders and user groups but still a lot more to do as an action in every corners of Nepal. Many developments, researches, studies are in place but need to align those evidences in practice. Need to apply evidence informed decision making in coming days.

2.How does my own professional expertise and organizational access suggest where I might be most be effective in developing and launching an intervention?
– At present, I am working as capacity building officer. Working closely with government entities at Institutional level and Intersectoral level would be effective.
3.What formative research might be needed to understand the precise intervention that would be most appropriate and impactful towards overcoming the challenges I identify?
-Rehabilitation gaps analysis(assessment) could be important at present to overcome challenges.

4.When considering potential interventions, what factors related to implementation do I need to consider?
-Implementation factors: at present implementation cost, penetration and sustainability needs to be considered.

5. What implicit biases may be at work in my culture or context and how do those implicit biases impact an individual’s ability to access and benefit from rehabilitation?
-implicit biases related to the socioeconomic status, disability, age, gender, and sexual orientations. Those factors impact the individuals ability to access and benefit from rehab in terms of affordability, effectiveness, equity, and time.

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Facilitating Telerehabilitation Implementation
1. Targeting Key Stakeholders’ Awareness, Knowledge, Attitudes, and Intention

Awareness Campaigns:
– Presentations and workshops
– Educational materials
– Online presence

Knowledge Enhancement:
-Training programs
-Webinars and e-learning
-Resource portals

Attitude Adjustment:
-Role models and champions
-Patient testimonials
-Addressing concerns

Intention to Integrate:
-Pilot programs
-Incentives
-Policy and procedure alignment

Targeting Motivation and Capability for Implementation

Motivation:
-Clear value proposition
-Goal setting
-Feedback mechanisms

Capability:
-Skill development
-Technical support
-Resource allocation

Organizational Engagement:
-Leadership buy-in
-Implementation teams
-Interdepartmental collaboration

Continuous Improvement:
-Monitoring and evaluation
-Iterative feedback
-Success celebrations

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Hello All,

My expectations from this module would be;
1. How rehabilitation is integrated in the health system-methods, principles
2. How do we come to develop standard rehabilitation services package?

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Yes, Nepal has adapted the WHO guide for action for development of National Rehabilitation Strategic plan. There are so many among which WHO, Handicap International, CBM, Help Age, Karuna Foundation, Independent Center for Living, local NGOs, private hospital are the few names who are working to meet the rehabilitation needs. According to the voices of services users, family and caregivers, access to rehabilitation is inadequate, out of pocket expenditure is high while accessing the services and comprehensive rehabilitation needs has not been fully addressed.

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4.Post your reflections on building strong leadership and increasing political support for rehabilitation of your country on the discussion board.
In order to build strong leadership and political support for rehabilitation following points can discussed further:
a. Develop leadership skills of political leaders: develop leadership training in the context of rehabilitation and its integration approach in global health programs at National, Provincial and Local level.
b. Effective collaboration: Building partnerships among different stakeholders across various sectors including government, private and civil society. Leaders building partnerships and facilitating cooperation.
c. Advocacy and Political Engagement: strategic advocacy to raise awareness about rehabilitation needs and benefits. conduct lobbying, public campaigns, and engaging with political stakeholders to secure commitment and resources.
d. Community Involvement: empowering local communities including user groups to take an active role in rehabilitation efforts.

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