Analysing the sustainability of the physical rehabilitation sector in seven fragile countries through multi-stakeholder involvement using a participatory consensus tool

Background: Sustainability is identified by nearly all organisations working in global health as one of the key indicators for project evaluation. Though typically recognised as an essential component for good project management to ensure positive impact, it is rarely applied effectively in practical terms and there are very few practical methods or tools to support implementation and monitoring of sustainable interventions. Further, despite efforts of stakeholders at all levels, the rehabilitation sector is not usually at the top of policy-makers’ agendas, which often results in limited to no funding and makes the task of building sustainability even more challenging at field level

Abstract Book

Background: Clubfoot is commonest congenital deformity in babies. More than 100,000 babies born worldwide each year with Clubfoot. The main goal is to achieve a functional. pain free, planti-grade foot with good mobility. Treatment of idiopathic CTEV is serial gentle manipulations and after casting, splinting/bracing to maintain the correction. The main reason of relapse of deformity after conecticn is non-compliance to bracing program as it is a lengthy process. Aim: The aim of study is to develop a standard, light weight 8. cost effective Foot Abduction Brace to address the issues of non-compliance and to check its effectiveness. Method: It was 3 years non randomized interventional study from April 2011 to March 2014 with convenient sampling. Sample size was 1 10 patients using Dennis Brown and AORI Foot Abduction Brace were divided 'n study and control group. 30 patients using AORI Foot Abduction Brace were included in study group where as 80 patients using Dennis Brown Splint was included in control group. Study was performed at Department of Orthotics & Prosthetics of Benazir Bhutto Hospital Rawalpindi. Results: Deformity relapsed in 15% of patients in control group no relapsed was reponed in study group where P- value was <.05 that is significant. Skin damage occurred in almost 50% of patients in control group it was reported about 20% in study group with P-value = <.05 which is significant. Residual adduction was reported in >50% of patients in control goup and it was reported 0% in study group with P-value = <.001 which is highly significant. Fabrication Cost of AORI Foot Abduction Brace was is atnost half of the DB Splint. No leather and steel work is required so that an Orthotist can make it easily. It can also industriaize and easily adustable by the families. Discussion & Conclusion Clinical trials of AOFtI FAB showed very good results in maintenance of corrected CTEV as the families are more compliant with AOFtl FAB because it is light in weight have dynamic effects far Dorsi-flexion while Dennis Brown splint is relatively heavy and found poor to maintain Dorsi-flexion that leads to the relapse of equinus. Skin damage is also less in AORI FAB and it is cost effective with ease to fabricate without extensive work

Why rehabilitation must have priority during and after the COVID-19-pandemic: A position statement of the global rehabilitation alliance

COVID-19 has become a pandemic with strong influence on health systems. In many cases it leads to a disruption of rehabilitation service provision. On the other hand, rehabilitation must be an integral part of COVID-19 management. Rehabilitation for COVID-19 should start from acute and early postacute care and needs to be continued in the postacute and long-term rehabilitation phase. Of course, it should follow specific safety protocol. Additionally, rehabilitation must be kept available for all other people who are in need. From the perspective of health system, the Global Rehabilitation Alliance urges decision makers to ensure that rehabilitation services will be available for all patients with COVID-19 in the acute, post-acute and long-term phase. Additionally, it must be ensured that all other persons with rehabilitation need have access to rehabilitation services. Rehabilitation services must be equipped with personal protection equipment and follow strict hygiene measures. In particular, rehabilitation must be accessible for vulnerable populations. For that reason, rehabilitation must be kept a health priority during the COVID-19 pandemic and given adequate financial resources. Last but not least, scientific studies should be performed to clarify the impact of the pandemic on rehabilitation services as well as on the needs for rehabilitation of COVID-19 patients. 2020 Foundation of Rehabilitation Information.Scopu