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

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.

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 (RESYST) Framework

“…Reinforcing results from previous studies [96,97], priorities at the individual item level revolved around the need to identify barriers PWD experience in accessing rehabilitation services and to record unmet needs for rehabilitation. This information can help design targeted and effective strategies to enhance equity and responsiveness of the health system [98,99] and reflects the obligation of States under Article 31 of the CRPD to collect data on barriers PWD experience in the enjoyment of their human rights [100].…”

Stakeholders’ perceptions of policy options to support the integration of community health workers in health systems

“…No peer-reviewed literature was found to support an established procedure for conducting such studies. Accordingly, we have aligned the purpose of this paper with that earlier conducted by Darzi et al [18] though the survey questionnaire and the analytic methodology were varied slightly to suit the context of this paper. While this study may be described as a pre-intervention study, related post intervention studies [21, 22] also have been conducted.…”

“…The survey was designed to enable the collection of quantitative and qualitative data on CHW outcomes of interest, and acceptability and feasibility of policy options. A standard questionnaire (Additional file 1) was developed based on a previously published questionnaire used for the WHO health systems rehabilitation services guideline [18]. The questionnaire included the following characteristics of participants: highest academic degree attained, region represented, occupation, institution(s) represented, level of responsibility, gender and age.…”

“…The WHO guideline development process therefore allows for the input of stakeholders to be taken into account in addition to findings from the systematic evidence syntheses. Recently conducted studies have noted the significance of stakeholders’ views in the implementation of health care programmes [18, 19].…”

Increasing access to health workers in rural and remote areas: what do stakeholders’ value and find feasible and acceptable?

“…The design of the questionnaire (see additional file 1) followed that of similar questionnaires developed for previous WHO guidelines on rehabilitation services [14] and community health workers [13]. Accordingly, three broad areas were considered for assessment and discussion:…”