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Learning from experience: Guidelines for locally sourced and cost-effective strategies to modify existing household toilets and water access

WORLD VISION
CBM Australia
2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HOME MODIFICATIONS FOR WASH ACCESS
This document is one of two developed in the Jaffna District and describes the strategies which were used to assist people with disabilities to access toilet and water facilities at their own home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka. Houses and toilet structures in the region were made of brick and concrete. No new toilets were built and modifications involved only minor work to existing household structures, water points and toilets.

NOTE:
The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Evaluating the impact of a community–based parent training programme for children with cerebral palsy in Ghana

ZUURMOND, Maria
et al
January 2017

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"Cerebral palsy is the most common cause of physical disability in children worldwide, and yet in most low resource settings there are few services available to support children with cerebral palsy or their families. Research is required to understand the effectiveness of community and/or home based programmes to address this gap. This 2-year study aimed to evaluate a participatory caregiver training programme called ‘Getting to know cerebral palsy’ in Ghana. The training programme consisted of a monthly half-day support group with training, and a home visit, delivered across eight sites in Ghana over 10 months. A total of 76 families and children were included at baseline and 64 families followed up one year later at endline. Children were aged between 18months and 12 years with a mean of 3.8 years and a range of severity of cerebral palsy. Nearly all (97%) the caregivers were female and the father was absent in 51% of families. The study was a pre-post intervention design using mixed methods to evaluate the impact. A baseline and endline quantitative survey was conducted to assess caregiver quality of life (QoL) and knowledge about cerebral palsy and child feeding, health, and nutrition outcomes. Qualitative data was collected to explore the impact and experiences of the training programme in more depth".

Standards for prosthetics and orthotics

WORLD HEALTH ORGANISATION (WHO)
2017

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This document provides a set of standards and a manual for implementation to support countries in developing or improving high-quality, affordable prosthetics and orthotics services. Its aim is to ensure that prosthetics and orthotics services are people-centred and responsive to every individual’s personal and environmental needs. Implementation of these standards will support Member States in fulfilling their obligations under the CRPD and in meeting the SDGs, in particular Goal 3. With these standards, any government can develop national policies, plans and programmes for prosthetics and orthotics services of the highest standard. This document has two parts: the standards and an implementation manual. Both parts cover four areas of the health system:

• policy (governance, financing and information);

• products (prostheses and orthoses);

• personnel (workforce);

• provision of services

Rehabilitation in health systems

WORLD HEALTH ORGANISATION (WHO)
2017

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This document provides evidence-based, expert-informed recommendations and good practice statements to support health systems and stakeholders in strengthening and extending high-quality rehabilitation services so that they can better respond to the needs of populations. The recommendations are intended for government leaders and health policy-makers and are also relevant for sectors such as workforce and training. The recommendations and good practice statements may also be useful for people involved in rehabilitation research, service delivery, financing and assistive products, including professional organisations, academic institutions, civil society and nongovernmental and international organisations. The recommendations focus solely on rehabilitation in the context of health systems. They address the elements of service delivery and financing specifically. The recommendations were developed according to standard WHO procedures, detailed in the WHO handbook for guideline development

Physiotherapy care for adults with paraplegia due to traumatic cause: A review

GUPTA, Nalina
RAJA, Kavitha
October 2016

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Abstract

 

 

Purpose: This review aimed to identify the practice guidelines/ recommendations for physiotherapy management in acute /post-acute/ chronic/long-term phase of rehabilitation of clients with paraplegia due to traumatic causes.

 

Methods: Of the 120 articles retrieved, 26 met the inclusion criteria. After quality appraisal, 16 articles were included in the study. Data were extracted under the sub-headings: physiotherapy care in acute, chronic and long-term community stage; expected outcomes; effect of physical interventions; morbidities; wheelchair characteristics and standing.

 

Results: There is strong evidence in support of strength and fitness training, and gait training. Parameters of strength training (frequency, duration and intensity) vary. There is lack of evidence on passive movements, stretching, bed mobility, transfers and wheelchair propulsion. Preservation of upper limb functions is an important consideration in caring for clients with paraplegia.

 

Conclusion: Many areas of rehabilitation interventions remain inadequately explored and there is a need for high quality studies on rehabilitation protocols. Client preferences and feasibility are other areas that should be explored.

 

Limitations: The search criteria of articles in the English language or articles translated in English is a reason for this limitation. Articles related to advanced therapeutic interventions such as robot-assisted training, and transcranial electrical and magnetic stimulation were excluded from the study.

WCPT report : the role of physical therapists in disaster management.

SKELTON, Peter
SYKES, Catherine
et al
March 2016

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This report has two main aims: to highlight the need for physical therapist involvement in disaster management and particularly in Emergency Medical Teams (EMTs); and to brief physical therapists who want to work in the field, and national and international agencies who are already working in the field. Following an introduction to the topic of disasters, the paper outlines in separate sections the three phases of disaster management most relevant to physical therapists: preparedness; response; and recovery. Each section includes information on the role of physical therapists and details guidelines and resources to support practice in disaster management. Case studies include: Nepal, 2015 April earthquake; 2011- great East Japan earthquake; integration of rehabilitation professionals into the UK Emergency Medical Team; Nepal, 2011 onwards; Phillipines, typhoon Sendong, 2011;  Phillipines, typhoon Haiyan, November 2013; Haiti, 2011- physical therapy in post-earthquake recovery and reconstruction; Pakistan, earthquake Oct 2005; Phillipines, typhoon Bopha 2012-2013.

Rehabilitation in sudden onset disasters.

September 2015

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The role of rehabilitation professionals in responding to Sudden Onset Disasters (SODs) is evolving rapidly, and our professions increasingly find themselves at the forefront of emergency response teams. At the same time, there is a movement towards the professionalisation of the humanitarian response sector, in particular Emergency Medical Teams, and a recognition that specialist training is required to prepare professionals for work in an austere humanitarian environment. The intended audience of the manual are physiotherapists and occupational therapists who may deploy to provide rehabilitation in the immediate aftermath of a sudden onset disaster. It was developed to support volunteers on the UK International Emergency Trauma Register (UKIETR), but with the aim of being relevant to all rehabilitation professionals interested in rapid deployment to austere environments. The content is restricted to the context of sudden onset disasters such as an earthquake or tsunami, and has been developed to support work in an austere environment, where the type of equipment and support that is normally available has been disrupted. UKIETR professionals are UK based volunteers who receive specialist training to prepare them for international deployment as part of team in response to emergencies. They may be deployed within a multi-disciplinary foreign medical team in a field hospital scenario, or as part of a more specialist ‘cell’ offering niche medical, surgical or rehabilitation services. The manual is designed to complement the three day core rehabilitation training run by Handicap International which all UKIETR members must attend. It is a clinical manual, and the contents are directly linked to modules taught on the core training course. In addition there are a number of ‘cheat sheets’ and patient education resources at the back of the manual which are designed to be used in the field. Chapters include: rehabilitation and the UKIETR; introduction to rehabilitation following sudden onset disasters; amputee rehabilitation; spinal cord injury; peripheral nerve injury; fractures; burns and soft tissue injury; and acquired brain injury

How rehabilitation can help people living with HIV in Sub-Saharan Africa : an evidence-informed tool for rehab providers

Canadian Working Group on HIV and Rehabilitation
University of Toronto
University of Zambia
March 2015

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The aim of this e-module (or pdf) is to enhance knowledge about HIV care among rehabilitation providers in Sub-Saharan Africa (SSA) to help address the needs of people living with HIV. The resource is divided into 5 sections: the role of rehabilitation in the context of HIV in SSA; what rehabilitation providers need to know about HIV in SSA; rehabilitation interventions that can help people living with HIV in SSA; what rehabilitation providers need to know about caring for children and youth living with HIV in SSA; concepts and tools for measuring rehabilitation outcomes in HIV in SSA. This current resource is a comprehensive adaptation of the 2014 Canadian e-Module for rehabilitation providers in Sub-Saharan Africa which was developed from "A Comprehensive Guide for the Care of Persons with HIV Disease (Module 7)", published by Health Canada and the Wellesley Central Hospital, Toronto, Canada, published in 1998.

The evolution of community physiotherapy in India

RAJAN, Pavithra
February 2014

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Despite the urgent need for physiotherapy services for underprivileged communities, Community Physiotherapy is not a sought-after specialisation in India. Physiotherapists tend to serve in institutions rather than at community level, as a result of which this field of healthcare has stagnated. This article, based on an interview with one of the country’s eminent community physiotherapists, gives a first person account of the evolution of community physiotherapy in India and provides qualitative inputs to deal with the prevalent issues. While the need for services has increased, there has been no matching growth in the pool of physiotherapists willing to work in the community. Several recommendations have been made, including changes in approach to community physiotherapy by both physiotherapists as well as community organisations in India.

The provision of wheeled mobility and positioning devices

GARTON, Francesca
URSEAU, Isabelle
July 2012

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This policy brief provides an overview of Handicap International’s 2012 policy paper on the provision of wheeled mobility and positioning devices (WP&MD) for people with disabilities
PP Brief No 9
Note: this policy should be read in conjunction with Handicap International’s rehabilitation policy paper which provides a broad framework for understanding the organization’s work on rehabilitation, including WP & MD

Rehabilitation services unit annual report 2010

URSEAU, Isabelle
Ed
2011

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This 2010 annual report, produced by Handicap International’s rehabilitation services unit, illustrates the activities of the unit, the programmes and the key strategies and approaches for improving access to rehabilitation services. It would be useful to those who work with rehabilitation services in the field of disability and development

Rehabilitation technical unit annual report 2009

URSEAU, Isabelle
Ed
2010

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This report details the programmes supported by Handicap International’s rehabilitation technical unit. It also explores the strategies, project approaches and activities implemented by the unit in 2009. It is interesting to anyone interested in rehabilitation services in the field of disability and development

Physical therapy roles in community-based rehabilitation : a case study in rural areas of north eastern Thailand

NUALNETR, Nomjit
2009

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"This action research aimed to explore how physical therapists could enhance the quality of life for persons with disabilities via a community-based rehabilitation (CBR) strategy...The findings revealed that physical therapists had numerous roles in CBR, depending on the community’s circumstances. They need a high degree of flexibility and a wide range of skills to contribute to CBR. The preparation of such physical therapists requires development of a more client-centered community-oriented education programme"
Asia Pacific Disability Rehabilitation Journal, Vol 20, No 1

Primary health care and community based rehabilitation : implications for physical therapy

BURY, Tracy
2005

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[Author's abstract]: The World Confederation for Physical Therapy (WCPT) is committed to the development of Primary Health Care and Community Based Rehabilitation (CBR). The number of disabled people is increasing steadily with only a minority receiving accessible and appropriate rehabilitation services. The terms primary health care and community-based rehabilitation are open to interpretation, although internationally recognised statements/ definitions exist. The general concepts and principles involved are generally agreed worldwide but the nature of services referred to by the terms varies internationally. There is a need for a stronger orientation towards rehabilitation in primary health care services, balanced with the current emphasis on health promotion and disease prevention. Health care systems vary worldwide; this requires a flexible, responsive and innovative approach to developing services that are reflective of local needs, environments and available resources. Physical therapy provision is insufficient for the needs of most countries, therefore service delivery models need to be developed that result in the skills and knowledge of physical therapists meeting the needs of a higher proportion of those in need. Additionally, physical therapy professional education needs to equip physical therapists with the appropriate knowledge and skills to work in a variety of settings as well as promoting the value of working in these settings. Physical therapists and others should be aware of the implications of the international review of CBR and ready to take appropriate action

Moving away from labels : a school for all

CBR NETWORK (SOUTH ASIA)
2005

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This manual describes the process of developing inclusive education practices in India and the need for future development. It outlines practical information and includes templates of individual education plans for children with disabilities in mainstream schools to aid their learning. The manual aims to enable families and teachers at the grassroots level to include all children into neighborhood schools

Preliminary guidelines for the implementation of community based rehabilitation (CBR) approaches in rural, remote and Indigenous communities in Australia

KUIPARS, P
ALLEN, O
September 2004

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This article summarises a forum of health professionals that was held in Brisbane in 2003 to discuss the potential for CBR approaches to be used in remote, rural and indigenous communities regions in Australia. The forum identified principles and guidelines for the development of CBR and recognised that CBR has yet to make a significant impact on the service system in Australia. Forum members noted its potential, and called for recognition of the need for greater community involvement in disability services, the need to develop appropriate training frameworks, and the need to redirect resources to such community models. This article is useful to people with disabilities, rural community members, indigenous people, policy makers and health professionals
Rural and Remote Health 4 (online), No 291

Disability assessment schedule : WHODAS II

WORLD HEALTH ORGANISATION (WHO)
February 2000

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This resource is a questionnaire developed by WHO to assess the health condition and level of function of disabled people. It is available in 16 languages and comes with a training manual

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