Article Text
Abstract
Background Globally, the need for rehabilitation to improve functioning is increasing. Despite being an essential service to achieve Universal Health Coverage, the availability of and access to rehabilitation services remains a gap in low-and-middle-income countries (LMICs). Limited rehabilitation workforce, concentration in urban, tertiary-care centers, high out-of-pocket costs further increase this gap impacting population health. Technological innovations in rehabilitation service delivery have focused on service provision but are limited in systematic approaches to coordinate rehabilitation care across various levels of health systems. To address this gap, “RehabConnect” a service delivery application for primary care (PHC) providers was developed.
Objective Assess the feasibility of implementing RehabConnect to integrate rehabilitation care at the primary care level- in Northern and Eastern Uganda
Description RehabConnect operates on an open-source platform, The app includes various interfaces that capture data on patient demographics, rehabilitation need, care plan based on a patient-centered approach, plans for follow-up visits, and referral information for rehabilitation professionals. The app was implemented in Northern and Eastern Uganda across 10 primary care facilities and six rehabilitation facilities. 60 PHC providers and 10 rehabilitation professionals were trained.
Outcomes and Learnings Using a decision support system, the app in its initial phase has strengthened the capacity of the PHC providers to assess for rehabilitative needs, manage basic rehabilitation care, and make referrals, and coordinate advance rehabilitation care with rehabilitation professionals. It has also resulted in better communication among PHC providers and rehabilitation professionals who also serve as mentors for the PHC providers.
Implications The app has shown promising results at various levels. At the systems level, the app has supported the integration of rehabilitation at the PHC level. At the workforce level, it has strengthened the capacity of the PHC providers, and at the service delivery level, it has improved access to rehabilitation services by bringing services near to where communities are, and better coordination of care between PHC providers and rehabilitation professionals.
Conclusion: As a Digital Public Good, RehabConnect can be implemented in other LMICs interested in expanding rehabilitation services to the PHC level to address growing rehabilitation needs from injuries and other chronic conditions.