Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up. Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics. Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator. Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level

Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up.Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics.Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator.Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level. 

ISPRM discussion paper: Proposing a conceptual description of health-related rehabilitation services.

There is a need for a comprehensive classification system of health-related rehabilitation services. For conceptual clarity our aim is to provide a health-related conceptual description of the term rehabilitation service . First, we introduce a common understanding of the term rehabilitation , based on the current definition in the World Health Organization\u27s World Report on Disability, and a conceptual description of rehabilitation agreed upon by international Physical and Rehabilitation Medicine organizations. From a health perspective, rehabilitation can be regarded as a general health strategy with the aim of enabling persons with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning. Secondly, we distinguish different meanings of the term service , that have originated in management literature. It is important to distinguish between micro, meso and macro level uses of the term service . On a meso level, which is central for the classification of rehabilitation services, 2 aspects of a service, i.e. an offer of an intangible product and an organizational setting in which the offer is upheld, are both essential. The results of this conceptual analysis are used to develop a conceptual description of health-related rehabilitation, which is set out at the end of this paper. This conceptual description may provide the basis of a classification of health-related rehabilitation services, and is open for comments and discussion

Using concept mapping to develop a human rights based indicator framework to assess country efforts to strengthen rehabilitation provision and policy: the Rehabilitation System Diagnosis and Dialogue framework (RESYST)

Abstract Background Rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of “leaving no one behind” countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. Methods A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. Fifty-six individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. Forty-one participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by a select number of participants. Results A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The indicator framework was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r = .58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two–tiered priority set of indicators. Conclusion Concept mapping was successful in generating a shared model that enables a system’s view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The Rehabilitation Systems Diagnosis and Dialogue framework provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems. Despite agreement on the importance and feasibility of 59 indicators, further research is needed to appraise the applicability and utility of the indicators and secure a realistic assessment of rehabilitation systems

Methodological considerations in injury burden of disease studies across Europe: a systematic literature review

Background: Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods: We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results: We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions: Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond. © 2022, The Author(s)

Evaluation of an implementation strategy for a World Health Organization (WHO) public health report: The implementation of the International Perspectives on Spinal Cord Injury (IPSCI) in Romania

Aim: This paper aims to evaluate a strategy for the implementation of public health policy recommendations from the World Health Organization’s (WHO) report “International Perspectives on Spinal Cord Injury” in Romania. More specifically, it seeks to: a) evaluate implementation actions with a focus on a number of people reached and status of completion at 12 months follow-up; b) describe implementation activities undertaken in the course of one year, and; c) evaluate perceived barriers and facilitators of implementation at 12 months follow-up. Methods: A cross-sectional design was adopted with two surveys administered in 2014/15 among key implementers in Romania. The questionnaires contained open-ended, multiple choice and 5-point Likert scale questions. Results on the implementation status, implementation activities performed and self-reported barriers and facilitators were analysed and reported using descriptive statistics. Results: Implementation completion rate was 75%, with 4390 persons directly or indirectly benefiting from the implementation-related activities listed in the final implementation plan reporting. A broad range of implementation experiences was reported. Most common activity types were delivery of services, technical trainings, implementation coordination and development meetings. Most useful tools and processes were the Romanian language version summary of the report, educational meetings, and local consensuses processes. Reported outcomes included the direct output produced, evidence of services provided, and individual or organizational level impact. Most barriers were named for the policymakers and academia as stakeholder groups and most facilitating influences for the private sector, with dependence of policymakers on constituency interest scoring highest barrier and the general availability of European Commission and European Structural Funds highest facilitator. Conclusion: The surveys proved to be both feasible and useful tools to expand our understanding of implementation and to supplement the more standard used implementation strategies at country level

Nine years of war and internal conflicts in Syria: a call for physical rehabilitation services

The Syrian civil war, which initiated in 2011, has been one of the most devastating conflicts of recent decades. Based on the World Health Organization and Handicap International 2017 report, about 3 million people are injured and living with disabilities in Syria, which about half of them have permanent disabilities including 86,000 amputees. More importantly, approximately 30,000 people are added to the disabled in Syria every month. In response, various international organizations and NGOs have developed initiatives and established programmes to increase access to rehabilitation services for people with disabilities in Syria and other regions where refugees live. However, further effective policies are needed to address the needs of disabled people in this Warn-torn country