Rehabilitation Contexts: Difference between revisions
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The effects of healthcare-related inequalities are most evident in low-resource settings, that are often not explicitly defined, and where umbrella terms which are easier to operationalise, such as ‘low-to-middle-income countries’ or ‘developing countries’, are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.<ref>Badenhorst M, Hanekom S, Heine M. [https://pubmed.ncbi.nlm.nih.gov/34083239/ Unravelling'low-resource settings': a systematic scoping review with qualitative content analysis.] BMJ global health. 2021 Jun;6(6).</ref>[[File:Bmjgh-2021-June-6-6--F3.large.jpg|center|frameless|1000x1000px|Figure. 1 Nine major themes that describe a low-resource context.|alt=]] | The effects of healthcare-related inequalities are most evident in low-resource settings, that are often not explicitly defined, and where umbrella terms which are easier to operationalise, such as ‘low-to-middle-income countries’ or ‘developing countries’, are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.<ref>Badenhorst M, Hanekom S, Heine M. [https://pubmed.ncbi.nlm.nih.gov/34083239/ Unravelling'low-resource settings': a systematic scoping review with qualitative content analysis.] BMJ global health. 2021 Jun;6(6).</ref>[[File:Bmjgh-2021-June-6-6--F3.large.jpg|center|frameless|1000x1000px|Figure. 1 Nine major themes that describe a low-resource context.|alt=]] | ||
== Conflict and Disasters Contexts == | == Conflict and Disasters Contexts == | ||
From the first world war to more recent disasters, such as the 2015 Nepal earthquake and the 2020 explosion in Beirut, Lebanon, the importance of integrating rehabilitation into emergency responses to conflicts and disasters has been clear. The World Health Organization emergency medical team standards and recommendations for rehabilitation, launched in 2016, signaled significant progress in recognising the role that rehabilitation professionals play and the necessity of early intervention. However, while the emergency medical community takes strides towards integrating early rehabilitation in conflict and disaster response, early rehabilitation remains an emerging area. | From the first world war to more recent disasters, such as the 2015 Nepal earthquake and the 2020 explosion in Beirut, Lebanon, the importance of integrating rehabilitation into emergency responses to conflicts and disasters has been clear. The World Health Organization emergency medical team standards and recommendations for rehabilitation, launched in 2016, signaled significant progress in recognising the role that rehabilitation professionals play and the necessity of early intervention. However, while the emergency medical community takes strides towards integrating early rehabilitation in conflict and disaster response, early rehabilitation remains an emerging area.<ref>Lathia C, Skelton P, Clift Z. Early rehabilitation in conflicts and disasters. HI. Accessed from [https://hi.org/sn_uploads/document/36199-Humanity--Inclusion-Clinical-Handbook-web_1.pdf Humanity--Inclusion-Clinical-Handbook.]</ref> | ||
Rehabilitation professionals face unique challenges associated with complex trauma, injury surge and resource scarcity that many have never encountered before. Practical guidance to deliver quality early rehabilitation in these contexts is essential if conflict and disaster response is to evolve beyond its life- and limb-saving mandate to deliver care that maximises patient outcomes. Rehabilitation professionals need to be equipped with the knowledge and skills to meet patient needs and navigate the demands of emergency medical response. In humanitarian emergency situations such as during or post-conflict and natural disaster situations, the need for basic functional rehabilitation services is overwhelming and critical to preventing disability and improving the lives of people with disabilities. | Rehabilitation professionals face unique challenges associated with complex trauma, injury surge and resource scarcity that many have never encountered before. Practical guidance to deliver quality early rehabilitation in these contexts is essential if conflict and disaster response is to evolve beyond its life- and limb-saving mandate to deliver care that maximises patient outcomes. Rehabilitation professionals need to be equipped with the knowledge and skills to meet patient needs and navigate the demands of emergency medical response. In humanitarian emergency situations such as during or post-conflict and natural disaster situations, the need for basic functional rehabilitation services is overwhelming and critical to preventing disability and improving the lives of people with disabilities. |
Revision as of 18:41, 7 August 2021
Original Editors - Naomi O'Reilly and ReLAB-HS
Top Contributors - Naomi O'Reilly, Vidya Acharya, Kim Jackson, Tarina van der Stockt, Lucinda hampton, Oyemi Sillo, Jess Bell and Ashmita Patrao
Introduction[edit | edit source]
The World Health Organisation defines social determinants of health as ‘the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life’, which are largely responsible for health inequalities, including inequity.[1] In other words, a holistic view of the context in which healthcare is provided, is key to improving health equity. The biggest gains in health may not necessarily be achieved by improving healthcare alone but also through strategies to improve these social determinants.
One of the most important factors in rehabilitation are the contextual factors, as this goes a long way to help rehabilitation professionals understand and assess the psychological, emotional state and well-being of the individual throughout the course of their rehabilitation. We know that the environment is known to have significant impact on treatment generally, therefore, the circumstances surrounding rehabilitation, from the situation before, during and after the event leading to a loss in function are all important factors to consider throughout the rehabilitation process.[2] The context in which rehabilitation occurs greatly influences the range and availability of rehabilitation services and their utilization.
Low Resource Contexts[edit | edit source]
The effects of healthcare-related inequalities are most evident in low-resource settings, that are often not explicitly defined, and where umbrella terms which are easier to operationalise, such as ‘low-to-middle-income countries’ or ‘developing countries’, are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.[3]
Conflict and Disasters Contexts[edit | edit source]
From the first world war to more recent disasters, such as the 2015 Nepal earthquake and the 2020 explosion in Beirut, Lebanon, the importance of integrating rehabilitation into emergency responses to conflicts and disasters has been clear. The World Health Organization emergency medical team standards and recommendations for rehabilitation, launched in 2016, signaled significant progress in recognising the role that rehabilitation professionals play and the necessity of early intervention. However, while the emergency medical community takes strides towards integrating early rehabilitation in conflict and disaster response, early rehabilitation remains an emerging area.[4]
Rehabilitation professionals face unique challenges associated with complex trauma, injury surge and resource scarcity that many have never encountered before. Practical guidance to deliver quality early rehabilitation in these contexts is essential if conflict and disaster response is to evolve beyond its life- and limb-saving mandate to deliver care that maximises patient outcomes. Rehabilitation professionals need to be equipped with the knowledge and skills to meet patient needs and navigate the demands of emergency medical response. In humanitarian emergency situations such as during or post-conflict and natural disaster situations, the need for basic functional rehabilitation services is overwhelming and critical to preventing disability and improving the lives of people with disabilities.
Early Rehabilitation is now recognised as being an integral part of a patient’s recovery in conflicts and disaster situations. Starting in acute care, early rehabilitation can help prevent complications, speed recovery, and help ensure continuity of care. Rehabilitation professionals working in early rehabilitation need skills across a wide range of clinical areas, and in conflicts and disasters need to be able to manage challenges including large surges in patient numbers, limited equipment, and complex clinical presentations[5]. Due to advances in response, management and post medical care in disaster situations, high mortality rates has gradually transitioned to an increased morbidity rates.
Natural Disasters[edit | edit source]
Victims of natural disasters now have higher chance of survival; they may however, have disabilities which may significantly impact their physical and psychological health and affect their quality of life, patients with pre-existing disabilities and co-morbidities are also at the risk of higher mortality rate.[7][8] Rehabilitation in natural disaster situations should be of utmost concern due to the vulnerability of the victims, some areas which need interventions in disaster situation include; [2]
- Collaboration and governance
- Capacity building
- Person-centered multidisciplinary care
- Improved communication
- Increased public awareness and active participation/inclusion of disaster survivors/family/community partners
- Strengthen evidence-based information, education and access to information
- Strengthen community-based rehabilitation.
Resources[edit | edit source]
Low Resource Settings[edit | edit source]
- Promoting the Development of Young Children with Cerebral Palsy: a Guide for Mid-Level Rehabilitation Workers
- Promoting the development of infants and young children with spina bifida and hydrocephalus : a guide for mid-level rehabilitation workers
- Promoting independence following a spinal cord injury : a manual for mid-level rehabilitation workers
- Physical and functional rehabilitation in long-standing (long-term) refugee camps
- A Market Landscape and Strategic Approach to Increasing Access to Digital Assistive Technology in Low- and Middle- Income Countries
Rehabilitation in Sudden Onset Disasters[edit | edit source]
- Rehabilitation in Sudden Onset Disasters
- Responding Internationally to Disasters
- The Role of Physical Therapists in Disaster Management
Early Rehabilitation in Conflict and Disasters[edit | edit source]
- Early Rehabilitation in Conflict and Disasters Field Handbook
- Early Rehabilitation in Conflict and Disasters Online Training
- Early Rehabilitation in Conflict and Disasters YouTube
References [edit | edit source]
- ↑ World Health Organization. Social determinants of health. WHO Regional Office for South-East Asia; 2008.
- ↑ 2.0 2.1 Khan F, Amatya B, Rathore FA, Galea MP. Medical Rehabilitation in Natural Disaster in the Asia Pacific Region: The Way Forward. International Journal of Natural Disaster Health Security. 2015: 2(2); 6 - 12
- ↑ Badenhorst M, Hanekom S, Heine M. Unravelling'low-resource settings': a systematic scoping review with qualitative content analysis. BMJ global health. 2021 Jun;6(6).
- ↑ Lathia C, Skelton P, Clift Z. Early rehabilitation in conflicts and disasters. HI. Accessed from Humanity--Inclusion-Clinical-Handbook.
- ↑ WHO. Early rehabilitation in conflict and disasters
- ↑ Early Rehabilitation in Conflicts and Disasters. Early Rehabilitation in Conflicts and Disasters: What is Early Rehabilitation?. Available from: https://youtu.be/BdHpvTGdnAA[last accessed 30/06/2021]
- ↑ Rehinhardt JD, Li J, Gosney J, Rathore FA, Haig AJ. Disability and Health-related Intervention in International Disaster Relief. Journal of Global Health Action. 2011. 4:7191
- ↑ Rathore FA, Gosney J, Reinhardt JD, Haig AJ, Li J. Medical Rehabilitation after Natural Disasters: Why, When and How?. Archives of Physical and Medical Rehabilitation. 2012. 93(10);1875 - 81
- ↑ Early Rehabilitation in Conflict and Disaster: Nepal Earthquake Response Pushpak Newar. Available from: https://youtu.be/4Kj663QOba8 [last accessed 30/10/17]