The practice of physical and rehabilitation medicine in sub-Saharan Africa and Antarctica: A white paper or a black mark?

Haig, Andrew J.; Im, Jonathan; Adewole, Deji; Nelson, Virginia S.; Krabak, Brian J.

doi:10.2340/16501977-0367

Cited by 27 publications

(23 citation statements)

References 3 publications

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“…52 km north-east of Kilifi is Malindi and 60 km south is Mombasa. Nevertheless, the gap between actual coverage and projected need would seem to be consistent with the findings from past research [2–5]. …”

Section: Discussionsupporting

confidence: 86%

“…More recently, reports of health-based rehabilitation services have revealed serious limitations in coverage and capacity [2–5]. When rehabilitation services do exist, they tend to be clustered around urban-based institutions [5,6] and are inadequately scoped to meet the needs of all service users [2]. Non-governmental organisations have arisen, usually to cater for specific areas of need that have been neglected [7].…”

Section: Introductionmentioning

confidence: 99%

“…Restricted rehabilitation services have been attributed to a dearth of appropriately qualified personnel [11–14] and an absence of professional organisations [2]. Reporting on provision in Ghana, Tinney et al [4] stated that there were no occupational therapists or physiatrists, very few speech and language therapists, prosthetists, orthotists and physical therapists, because of a lack of funding and limited government support.…”

Section: Introductionmentioning

confidence: 99%

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Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Bunning¹,

Gona²,

Odera-Mung'ala³

et al. 2013

Disability and Rehabilitation

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Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. ä Implications for RehabilitationThere needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Bunning¹,

Gona²,

Odera-Mung'ala³

et al. 2013

Disability and Rehabilitation

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“…The lack of host rehabilitation and health services infrastructure compounds the lack of rehabilitation perspective; often few or no rehabilitation services or professional providers, especially PRM physicians, exist in areas affected by natural disasters (10, 48–50). To compensate for this lack of expertise, rehabilitation training strategies are required (50, 51). Foreign rehabilitation responders can provide focused training to fellow team members as well as to local rehabilitation and non-rehabilitation providers in the field, hospital, and community settings throughout the disaster response.…”

Section: Impact Of Natural Disasters On Health and Rehabilitation Sysmentioning

confidence: 99%

Disability and health-related rehabilitation in international disaster relief

Reinhardt

Li²,

Gosney

et al. 2011

Global Health Action

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BackgroundNatural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.ObjectivesTo examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability.DesignQualitative literature review and secondary data analysis.ResultsAbsolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested.ConclusionHealth-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following natural disaster is urgently required.

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“…This is partly related to lack of common definitions and classifications, partly to poor availability and use of standard statistical sources for workforce monitoring, and partly to lack of political will to place monitoring of human resources for rehabilitation high on the health agenda - the latter itself may be related to the way societies often interpret and react to disability. For instance, Haig et al facetiously concluded, taking into account the lack of documentation on physical and rehabilitation medicine in sub-Saharan Africa, the chance of a person with a disability in sub-Saharan Africa meeting a physician with specialist skills is about the same as that for an Antarctic penguin [14]. …”

Section: Introductionmentioning

confidence: 99%

Health-related rehabilitation services: assessing the global supply of and need for human resources

Gupta

Castillo-Laborde

Landry

2011

BMC Health Serv Res

139

133

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BackgroundHuman resources for rehabilitation are often a neglected component of health services strengthening and health workforce development. This may be partly related to weaknesses in the available research and evidence to inform advocacy and programmatic strategies. The objective of this study was to quantitatively describe the global situation in terms of supply of and need for human resources for health-related rehabilitation services, as a basis for strategy development of the workforce in physical and rehabilitation medicine.MethodsData for assessing supply of and need for rehabilitative personnel were extracted and analyzed from statistical databases maintained by the World Health Organization and other national and international health information sources. Standardized classifications were used to enhance cross-national comparability of findings.ResultsLarge differences were found across countries and regions between assessed need for services requiring health workers associated to physical and rehabilitation medicine against estimated supply of health personnel skilled in rehabilitation services. Despite greater need, low- and middle-income countries tended to report less availability of skilled health personnel, although the strength of the supply-need relationship varied across geographical and economic country groupings.ConclusionThe evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice.

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The practice of physical and rehabilitation medicine in sub-Saharan Africa and Antarctica: A white paper or a black mark?

Cited by 27 publications

References 3 publications

Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Survey of rehabilitation support for children 0–15 years in a rural part of Kenya

Disability and health-related rehabilitation in international disaster relief

Health-related rehabilitation services: assessing the global supply of and need for human resources

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