[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.

[Oda Msuha]

1. -Telerehabilitation could fit within our organization/country particularly in a way of expanding health care accessibility as a single staff can reach out many client including those who come from remote areas and those with difficult transport requirement example those who are using wheelchair which is too costful to higher a private means of transport with the barrier of infrastructures. Thus through Telerehabilitation it will help to promote health care outcome but challenges is lack of awareness of the technology, training for provider and limited internet network in some areas.
-Telerehabilitation will fit with most of community values as it promotes family and community support as the patient does not need to travel far away from home in order to access service is it will be within their reach and this can help to speed recovery as the patient will be happy to see his/her family member with her or him.
also in terms of cost, its cost effective because no need for transport cost. also the patient will be comfortable has she/he wont need to travel far to acquire service.
again it can promote equity as both urban and rural individuals will be able o access the same quality of care this also enhance population from primary care hospital to get similar service
Also it saves time.
2.Dissemination strategies which will involve developing evidence informed interventions thorough employing cost effective data and promoting it to targeted specific group and tell out how it has been beneficial or has help in the community by holding meetings with them to strengthen the evidence to whom and what conditions the intervention has been effective and/or not helpful
– capacity building strategies which will involve providing training , technical assistance, tools and facilitation to support implementation process by knowing how costful and what the resources are needed. also it will help to establishing opportunity to peer networking together with experties so has to promote or improve services to the organization

[Oda Msuha]

The following are the indicator that I will use to monitor the success of the intervention
– rehabilitation integrated into health plan which will measure number of relevant health plan that includes rehabilitation at the activity level.
– Rehabilitation expenditure that tells annual national expenditure in relation to annual Health expenditure.
-rehabilitation personnel density which gives the number of each rehabilitation team present to facilitate service delivery.
-rehabilitation bed shows total number of rehabilitation bed available example that needed for injured patients, compared to total population.
– number of rehabilitation personnel available in tertiary hospitals to ensure proper delivery of rehabilitation services.
– Availability of multidisciplinary service for people with complex needs. It measures population who can access multidisciplinary rehabilitation services due to complex needs.

[Oda Msuha]

1. First I will gather the data about the people with needs of rehabilitation services and or but have not got the service yet by using population survey and resource records that will give information on problem distribution and resource respectively which will aid on performance
-Effectiveness will be another aspect which will guide me how the intervention is effective as it bring about positive or negative results.
– Adoption as it involves institution support for the service delivery and also aid in follow up as it help in knowing patient adherence or compliance to intervention will be an aspect of focus
-Implementation of the planned intervention to ensure that the intervention is delivered properly to obtain intended outcome, as it takes into consideration on cost and time needed for intervention as well as adaptation.
-Again Maintenance of the intervention given when access to intervention at both individual and system level is given in which program and policy become part of the routine of the organization practice to bring about positive results or outcomes.

[Oda Msuha]

To build a strong leadership and obtain political support one should
Access the situation and decide what leadership style to use in given situation. Thus
Assessment of role and values of rehabilitation to the population health should be done.
Strengthening the government planning and leadership capacity for rehabilitation within Ministry of Health proportionally to the scale and scope required.
Integrating rehabilitation data in Health Management Information Systems to ensure proper and evidence based decision making.
Increase political commitment to rehabilitation to achieve the investment that is required to expand rehabilitation services.
To address financial and geographical barriers to access and inefficiencies in service delivery.
To increase rehabilitation workforce and accessibility of assistive products.

[Oda Msuha]

4. Upon building strong leadership and increasing political support for Rehabilitation services education and awareness about the importance and benefits or rehabilitation need to be addressed to the stakeholders and the population.

Engage stakeholders such as community organizations, health care providers and advocacy group to show how how rehabilitation aligns with their goals and values.

Use of data and evidence from successful rehab programs to demonstrate their effectiveness on improving individual quality of life and its cost effectiveness.

Advocacy and representation by empowering individual with disability to become advocates for rehabilitation by sharing their need and experience and encourage their involvement in policy discussion and decision making processed to to develop inclusive policies that prioritize access to rehab service to people with disability.

Public engagement and awareness campaigns about importance of rehabilitation for people with disability through use of social media, community outreach to share some of resilience and empowerment.

Advocate legal protection and right that ensure equal access for rehabilitation services for individual with disability

[Oda Msuha]

1. I think leaders can be taught not born. Though some people are born with characteristics of a leader like being confident and courageous enough to make decisions on tough situations like what Winston Churchill and George Marshall did and manage to achieve what they achieved that made them to be recognized as born leaders, I think a good leader is someone who invest on daily self improvement through education, reflection and engagement like Nelson Mandela who did not poses any political influence and leadership, he learned and improved to become a better visionary leader.

2.Following my self assessment through emotional intelligence questionnaire I found myself having strength on self awareness and motivating oneself while I need to give attention on social skills areas, managing emotions and learn to be empathetic.

3.Vision of CCBRT is “to provide accessible specialized health care for all Tanzanian in need”. from its establishment which was 1994 in Tanzania the organization has been evolved significantly from its focus on rehabilitation services only to encompass an comprehensive approach to health care delivery, through community engagement and advocacy to promote disability rights, maternal health and health care access
Also MUHAS vision which states “A University excelling in quality training of health professionals, research and public services with a conducive learning and working environment”. from 1963 when was founded as a medical school focus on training medical professionals to meet country health care needs to 2007 were it become university and broadened its scope to include other health related field and 2027 to present as continue to evolve its vision to integrating research, community engagement and international collaboration into its strategic plan.

[Oda Msuha]

Also feasibility, acceptability and adaptability of selected intervention are key factor to facilitate implementation again considering resource requirements, sustainability and how they will be monitored and evaluated while integrated with existing system.
Some of biases that affect rehabilitation intervention include social economic bias, disability bias and beliefs bias that impact rehabilitation services on quality of care and treatment plan.

[Oda Msuha]

After surveying and obtain number of people with disability, i will assess the targeted group to find out their needs and barriers toward accessibility of rehabilitation services.
considering few number of rehabilitation expertise who are specialized in certain rehabilitation field like orthopedics, neurology, pediatric, Cardiopulmonary e.t.c I would like to engage on rehabilitation research towards new intervention to enhance development and implementation of rehabilitation strategic plan on improving rehabilitation services in my population.
Needs assessment, stakeholders analysis and context analysis which include social-economic, cultural and environment challenges together with quantitative and qualitative data collection on people with disability needs with expert consultation will be the most appropriate and impactful towards overcoming rehabilitation challenges.

[Oda Msuha]

I Have learned that Rehabilitation is essential to all individual with in need include both with acute and chronic conditions, not for those with long lasting impairment only. it has to be available for any one and from primary health centers. it is not an option after other intervention has failed to bring better result. thus it should start earlier enough.

[Oda Msuha]

Hello everyone! My name is Oda Msuha a physiotherapy officer at muhimbili National Hospital -Mloganzila with 5 years experience working on outpatient and inpatient clients with different conditions like orthopedic, neuromusculoskeletal, pediatric and more. I expect to gain knowledge on various models of rehabilitation, assistive technology, interdisciplinary approach and policy frameworks in improving healthy system

[Author]

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