handicap-international challenges of the sustainability of physical rehabilitation sector nepal,...

Handicap-International

Challenges of the Sustainability

of physical rehabilitation sector Nepal, 24-29 January 2013


For the Policy makers

For the Services providers

For the users / DPO

For the facilitators bodies

For the Donors

For the Policy makersAs a policy maker I should understand what PR is (to educate myself)

Policy guidelines leading to strategic action plans and PR is a part of primary health care

Outcomes/impact of the project proposal are clearly defined

Profile of the donors/implementers in respect of PR project completed and its outcomes


For the Policy makers

Identification and importance of the components of the project: core component

Local capacity to handle the core component of the project and the means and mechanisms in place to built the local capacity, to take over the continuity of the core component (training of the local partner and transfer of technology/skills to the local people



Provide an accessible, client/family-focussed service that meets their needs

Establish good linkages with other actors

Implement high quality service management


For the Services providers Provide an accessible, client/family-focussed service that meets their needs

Interview them to decide on their goalsUse appropriate technology that balances quality of care with affordabilityRespect their fundamental rightsTreat the client as a whole person

Provide needed services or refer to other service providersBe friendly, show empathy etcLanguage, gender balance etc

Provide services that aim to to prevent impairment, if possible



Establish good linkages with other actors

Collaborate with other service providersEg: staff education, complementary services

Build referral networks within the Rehab. Sector and also externally

Eg: with acute care or community with DPOs, professional societies etc



Implement high quality service management

Develop a database of client informationBasic demographicsEvidence that client needs are met

Use existing structures rather than replicate themInvest in continuing education of clinical, technical and administrative staffBe innovative in identifying funding sourcesEstablish standard procedures to ensure good quality, ethical service provision



Implement high quality service management (cont.)Educate the community about services and benefitsAdvocate

Own salaries, take care of staffAbout services

Be transparent in all management areas (eg: HR, finances etc)

Use a quality improvement systemWork with the government right from the startUse local resources, if possible


For the users / DPO

To advocate and lobbying for services, through unified voice of users groups,( DPO’s & Parents associations)

To be involved in Service provision in all stages, not only as a passive recipient of services, complain about the quality, support service delivery, members of the working committees,

To get education about the services, national policies and international documents, etc.

To support development of qualitative services and use of existing resources in the community, such as primary health centres


For the users / DPO

To demand services and continuum of services

To collaborate/work together with different stakeholders (service providers, other Civil Society Organizations, Governments, INGO’s, etc.) and to share info with them on disability and needs of persons with disabilities

To establish cooperation and coordination on international level through their respected organizations

To advocate for Insurance system in service provision



Facilitate interaction, identification of best practices, coordinated efforts, HR development

Advocate (for): increased emphasis on rehab, accountability to commitments. (TO): to states, peers, other agencies on rehab, capturing local capacity.

Reflect: on own capacity, accountability, quality



…through…Renewed emphasis on promoting and using evidence

Of good modelsOf achievement of targetsOf quality

SpecificThe technology challengeHR development approaches


For the donors

Ensure National Strategy / Policy on the PR Sector exists / support to develop one

Educated on the rehab sector, understand WHO recommendations

Realise sustainability is a long term process, think longer term, adapt their funding cycle

Get Rehab included in the MDG II


For the donors

Ensure program are comprehensive and holistic, encourage collaboration with org to give comprehensive services, coordination incase of multi donor funding

Take disability as one of the selection criteria, sign to UNCRPD, should be equally important as good governance etc.


For the donors

Should not be implementers, should be accessible to local partners, work in partnership with local partnershave a knowledge of the country situation and adapt accordingly, rathering than imposing

Have faith in the local actors, in developing countries, funding channelled through foreign international organisations


For the donors

Post conflict countries – disability not funded whereas it is a result fo the conflict

Funding on: prevention, research on cases to invest rehabilitation, local sustainability initiatives, balance funds between service providers and users


handicap-international challenges of the sustainability of physical rehabilitation sector nepal,...

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