Abstract
Background:More than one billion people worldwide live with a disability, yet rehabilitation professionals are scarce in low- and middle-income countries. Attempts to expand access to rehabilitation services have encountered barriers on multiple levels: limited resources on the systemic level, hierarchies on the professional level, and cultural stigma on the community level.Objectives:We sought to determine if an academic-community partnership could overcome multiple levels of barriers to expand services for people with disabilities.Methods:Toward an All-Inclusive Jordan incorporates community-based rehabilitation with prelicensure health professions education to address the three primary levels of barriers to rehabilitation services in low- and middle-income countries. The yearlong curriculum includes formal training, research, and advocacy with graduate students from the United States and health professions students and community members in Palestinian refugee camps near Amman, Jordan.Findings:After two cycles of the program, 14 Jordanian volunteers have partnered with 20 graduate students from the United States. They have delivered over 300 direct rehabilitation sessions, conducted ten workshops with mothers of children with disabilities, and trained 12 community-based rehabilitation workers in the refugee camps.Conclusions:The academic-community partnership model builds on the evidence base for the success of community-based rehabilitation services in low- and middle-income countries. Its components address barriers on multiple levels to create a sustainable expansion of services to people with disabilities.
Highlights
More than one billion people worldwide live with a disability, yet rehabilitation professionals are scarce in low- and middle-income countries
Several recent international reports on the quality of health care have identified the shortcomings of health care systems globally, in low- and middleincome countries (LMIC)
This paper presents one model of how a single global health educator can contribute to scaling up the provision of rehabilitation services in a LMIC
Summary
Several recent international reports on the quality of health care have identified the shortcomings of health care systems globally, in low- and middleincome countries (LMIC). The Global Rehabilitation Alliance was formed in 2018 to supplement the development and delivery of rehabilitation universally This alliance plays a key role in advocating for rehabilitation on a systemic level but remains advisory and does not address the competition for scarce resources in LMIC that limits rehabilitation services to people with disabilities, nor does it address obstacles at the professional or community levels. While this framework would assist in strengthening education and training, articulating standards of practice, and developing performance evaluation tools, it assumes an established base of rehabilitation services within health care systems It does not address barriers on the professional level that impede referrals to therapeutic treatment. Both elements include working in the field as rehabilitation trainers and providing direct service, including assessment, treatment planning, and rehabilitation intervention for people of disabilities and their families
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