Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.

Andrea J Darzi,Alana Officer,Elie A Akl,Ola Abualghaib

doi:10.1186/s12955-016-0406-x

Abstract

BackgroundThe World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders’ perceptions are an essential factor to take into account in the guideline development process.The aim of this study was to assess stakeholders’ perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes.MethodsWe disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale.ResultsTwo hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, ‘Increasing access’ and ‘Optimizing utilization’ were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. ‘Fewer hospital admissions’, ‘Decreased burden of care’ and ‘Increasing longevity’ were the services rated as least critical (57 %, 63 % and 58 % respectively).In terms of services, ‘Community based rehabilitation’ and ‘Home based rehabilitation’ were found to be both definitely feasible and acceptable (75 % and 74 % respectively). ‘Integrated and decentralized rehabilitation services’ was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for ‘Task shifting’, most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively).ConclusionThe majority of stakeholder’s perceived ‘Increasing access’ and ‘Optimizing utilization’ as most critical amongst rehabilitation outcomes. The feasibility of the ‘Integrated and decentralized rehabilitation services’ was perceived to be less than their acceptability. The majority of stakeholders found ‘Task shifting’ as neither feasible nor acceptable.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-016-0406-x) contains supplementary material, which is available to authorized users.

Highlights

The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services
Survey questionnaire We developed our own survey questionnaire, as we could not identify any published validated questionnaire to assess stakeholders’ perceived feasibility and acceptability of rehabilitation services and the values they attach to rehabilitation outcomes
The results showed variability in the perception of feasibility and acceptability in relation to ‘integrated and decentralized rehabilitation services’ (61 % and 71 % respectively). 37 % and 36 % respectively of stakeholders rated ‘task shifting’ as definitely feasible and definitely acceptable

Summary

Introduction

The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. There are over one billion people with disabilities in the world, of whom between 110-190 million experience very significant difficulties This corresponds to about 15 % of the world’s population [1]. People living with disability have poorer health, lower education achievements, less economic involvement and higher rates of poverty than people without disabilities [1]. These poor socioeconomic outcomes are largely due to the widespread barriers faced by people living with disabilities in accessing health, education, employment and information related services [2, 3]. Disability is complex and the interventions required to overcome the consequences of disability are multiple, systemic, and vary depending on context [4]

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