Rehabilitation scene

By Zehra Zaidi for ReLAB-HS   

Many people across the globe are not able to access the rehabilitative services they need. Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS) has the opportunity to address rehabilitation service gaps across the continuum of care within a health system using Information Communication Technology (ICT).   

The need for integrated rehabilitation is driven by multiple factors, including pre-pandemic global epidemiologic transition from infectious to non-communicable diseases, increased injuries due to rapid urbanization and motor vehicle injuries, higher life expectancy, rapidly ageing populations, and growing migrant communities.  In order to address the health needs of populations, rehabilitation services must be integrated into health service delivery models. ICT can deliver tools to bring care closer to patients in need of rehabilitation services and can facilitate effective self-management strategies. Hearing directly from stakeholders is a key part of ReLAB-HS’s strategy for developing telerehabilitation technology that will provide patients with better access to rehabilitation services in hard-to-reach areas in Uganda. 

ReLAB-HS members traveled to Uganda for the official ReLAB-HS launch in February and stayed on to gain a better understanding on how technology could be most useful in that country.  

One of the core aspects of ReLAB-HS is providing patient-centered care and currently, most health care services are centralized in more populous cities. ReLAB-HS is working to build technology that can provide care where people live. 

The ReLAB-HS telerehabilitation platform will be built using a person-centered approach and identifying key pilot stakeholders will ensure that the users are involved in all aspects of the development process. During the Uganda visit, team members had one-on-one interviews with persons with disabilities, advocacy group members, local information technology developers, non-governmental organization employees and rehabilitation specialists. During the interviews, they found out challenges in the current patient/provider journeys in the health system, including:   

  • Lack of clear referral processes between different levels within the health system 
  • Limitation of access to rehabilitation services due to distance barriers and cost 
  • Lack of comprehensive rehabilitation data at all levels of the health system 
  • Inability to identify and assess conditions locally where patients reside 

After further analysis, it was clear that technology could help decrease the burden of some of these issues.  By leveraging a robust telerehabilitation platform, rehabilitation services and care can be brought to areas where the patients reside. The existing health infrastructure in country (Community Health Workers and Health Centers) could be engaged along with technology to extend to rehabilitation care to areas where it is currently inaccessible. ReLAB-HS will work with each country team to ensure streamlined engagement of stakeholders, including Ministry of Health officials. 

Key pilot groups were also identified during the trip. Gulu Hospital and the Demographic Surveillance Site in Iganga-Mayuge expressed interest in working with ReLAB-HS to explore how telerehabilitation can be implemented.    

In addition to telerehabilitation, the team is also exploring the development of a health information exchange (HIE) layer.  The HIE will help to ensure that any technology efforts are built to scale and for interoperability with other health systems that are already deployed in country.    

By taking an aggressive two-pronged approach – HIE and Telerehabilitation Mobile application, ReLAB-HS is confident that the solution could significantly strengthen the health system for rehabilitation care.  All technology will be built according to the Principles for Digital Development.  

ReLAB-HS will explore how a Telerehabilitation solution can be developed for each focus country – with the understanding that there will be a need to adapt to the local context, from the first version of a telerehabilitation platform, to a sustainable solution. Ultimately, the implementation will add to the sparse evidence base on how telerehabilitation can be used for individuals needing access to rehabilitation services in low- and middle-income countries.   

ReLAB-HS is made possible by the generous support of the American people through the United States Agency for International Development.