[[email protected]]

1. What evidence do I have (or need) to identify those factors and levels posing the greatest barriers to rehabilitation in my population?

Resp : To identify those factors posing the greatest barriers to rehabilitation in my population, i need evidence concerning the already existing rehab services and the level of their integration through systematic assessment of rehab in the healthcare system. I will also need to have information related to environmental factors that can be obtained through censuses, social registries or population surveys. I can also use some of the frameworks like the iPARIHS or CFIR or TDF to identify those barriers.

2. How does my own professional expertise and organizational access suggest where I might be most be effective in developing and launching an intervention?

Resp : As a physiotherapist in the CSO sector and with multilevel experience, i think i might be effective while developing and launching an intervention at individual, household, institutional and community level. Particularly i may also intervene very partially at superstructural level while supporting other multidisciplinary teams.

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?

Resp : I think that a literature and documentation review combined with focus group discussions and in depth interviews might all be appropriate and impactful in deciding which strategy to use to overcome the identified challenges.

4. When considering potential interventions, what factors related to implementation do I need to consider?

Resp : Factors to consider are Acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration and sustainability.

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?

Resp : Like in other common context, implicit biases at work in my context include mainly income level, educational attainment, employment status, health status, mental health status, …

[[email protected]]

2. What indicators will you use to monitor the success of the intervention on an ongoing basis? What steps will you take to ensure adequate monitoring and evaluation of the intervention?

Resp : Indicators I will use to monitor the success of the interventions will be :
– Percentage of stroke patients who have improve in functioning on the total population of stroke patients who needed Rehab and AT services
– Number of stroke patients who access rehab services across the city
– Number of rehab services available for stroke patients per level of the healthcare system
– Number and category of rehab professional (personnel) available in the multidisciplinary team of healthcare

[[email protected]]

1. Using your knowledge of the frameworks, what aspects of the intervention will you focus on to guide your planning and eventual success of the intervention?

Resp : Aspects of the interventions to consider to guide my planning and eventual success of my interventions will be based on the RE-AIM framework and are as follow:
– how am I going to reach the targeted population (stroke patients for the city);
– how likely is my intervention going to be successful at achieving the desired outcome;
– What will be the likelihood that my intervention will be feasible in the given setting
– how likely is my intervention going to be delivered as intended;
– how am I going to incorporate my intervention to be delivered over the long term.

[[email protected]]

2. Using the Telerehabilitation as a case study, put yourself in the shoes of an implementation facilitator, and reflect upon how to facilitate the Telerehabilitation using the following discussion prompts:

• What strategies could you use to target key stakeholders’ awareness, knowledge, attitudes, and intention to integrate the new intervention?

Response: communication strategies like messages on the benefits of telerehab through medias, one to one communication with sensitization flyers or other mass communication tools, organizing training sessions to targeted groups, …

• 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?

To target the motivation and capability of insividuals and organizations, i can distribute prototype of the telerehab and encourage periodic reporting on the use and regular follow up, i would also put in place networks to encourage experience exchange among users, organize continuous training sessions, put in place reward and accountability systems for organizations which integrated the new strategies, …

[[email protected]]

1. Leadership behavior can be taught vs leaders are born. What do you think? Provide your rationale and an example of a born and made leader.

I beleive that some leaders are born depending on the inherent personality traits that characterise their lineage. But that doesn’t exclude the fact that they need to be taught to acquire leadership skills and maturity, instead their leadership potential may be lost or misused. Others are not born but can become depending on the environment in which they are raised in case it’s one which promotes leadership. Then, they can learn it and become leaders. For example, first borns in families tend to look like born leaders. They tend to develop independance and autorithy skills.

2. Post your reflections on your strengths, areas that need attention, and development priorities as identified by the emotional intelligence questionnaire on the discussion board.

As identified by the emotional intelligence questionnaire, i found myself to possess many of the characteristcs of a leader and fall into the team manager leadership style. Nevertheless, some areas of improvements like social skills development need more attention. Also, i tend to be easily demotivated and discouraged when my team members are not copping and evolving as intended.

3. Research some vision statements of various organizations. Post at least two such statements on the discussion forum and explain how these may have evolved.

Lilian fund’s vision : We Want inclusive societies with equal rights and opportunities for children and young people with a disability.
World Physiotherapy’s vision is to move physiotherapy forward so the profession is recognised globally for its significant role in improving health and wellbeing. Though it has the name changed, the vision statement remained the same. An organization which started woth 11 organizations members to actually more than 120 members have surely evolved in its vision to impact more region in the world.

4. Post your reflections on building strong leadership and increasing political support for rehabilitation of your country on the discussion board.

In my country, leadership and political support have evolved from the past 10 years in the health sector, where the ministry of health invests in developping physiotherapy services accross the country. But there is a need to train stakeholders on the broader concept of rehabilitation to optimize government investment. In fact, political leaders tend to depend on external finanacial and technical support to support and sustain rehab services. Building strong leadership may happen if governmental bodies nominated rehab professionals as focal points to technically support gouvernment efforts to support rehabilitation.

[[email protected]]

1. Using Telerehabilitation as a case study, put yourself in the shoes of an implementation facilitator, and reflect upon the fit of Telerehabilitation using the following discussion prompts:
• How does the proposed intervention fit with the priorities of your organizations?
• How does it fit with community values, including the values of diverse cultural groups?

Response : The proposed intervention fit with the priorities of our organization which intends to improve access of the population to rehab services. Telerehab seems to be an innovative way to ease the offer of rehab services at the lowest cost and with the potential to reach the most remote located clients… Actually, the use of technologies to improve communication and the spread of information and knowledge is gaining place inside diverse cultural groups. Community values may not hinder the fitness of telerehab as an intervention, but some factors like low maintenance, misuse and damage, language barriers, mindset…may negatively affect the implementation outcomes and sustainment.

[[email protected]]

The most predominant models are medical and social. Moral models are no longer predominant because the disability and inclusion movement, advocacy efforts and NGOs work made the social model progressively be advanced over the moral model. The moral model was sustained by the fact that our country is a predominant christian country where every situation has a belief related to it.
As a therapist, when i see someone with a disability i tend to think with the medical model without minimizing the importance of the social model, though i was raised with the moral model.

[[email protected]]

In my country, rehabilitation services are available in different locations. Those services are mostly physical therapy and prosthetic and orthotic services. Physiotherapy services are included in more than 40 hospitals and clinics and more than 20 outpatients centers. Most of them are concentrated in the urban area. Some programs deliver community based rehabilitation for children with disability but are very few. Prosthetic and orthotic services are very few and are all delivered in outpatients centers. The interdisciplinary principle is used in some few outpatient centers, but is not comprehended by other health workers. Those available rehabilitation services seem to be isolated in their functioning though many of them are integrated into hospitals and clinics. Other rehabilitation services are not available. A national mental health program have recently started the integration of psychological care into all levels of the health system care with a concentration at the community level.

[[email protected]]

physiotherapy, orthotic and prosthetics, community based rehabilitation, physical and rehabilitation medical consultation, club foot programs…

[[email protected]]

I have learned that rehabilitation needs are increasing over the years and are unmet in most of the countries especially in low and middle income countries. Nevertheless, initiatives have been taking place to respond to those needs and over the last years and efforts are still being made. What is also important is to know that rehabilitation care is as essential in the universal health coverage as promotive, preventive, curative and palliative care

[[email protected]]

Rehabilitation is a set of interventions for optimal functioning, better quality of life and participation

[[email protected]]

Hello everyone, My name is Ella. I am a physiotherapist from Burundi with 8 years of clinical, management, teaching and community projects experience in the field of disability and rehabilitation. I am passionate about contributing to the integration of rehabilitation into the health system of my country and eager to improve my knowledge and skills through this course. I expect to have opportunities of learning and networking from other countries.

[Author]

Posts