Handicap-International Challenges of the Sustainability of physical rehabilitation sector Nepal, January 2013

Handicap-International For the Policy makers For the Services providers For the users / DPO For the facilitators bodies For the Donors

For the Policy makers As 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 Handicap-International

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 Handicap-International

For the Services providers Provide an accessible, client/family-focussed service that meets their needs Establish good linkages with other actors Implement high quality service management Handicap-International

For the Services providers Provide an accessible, client/family-focussed service that meets their needs Interview them to decide on their goals Use appropriate technology that balances quality of care with affordability Respect their fundamental rights Treat the client as a whole person Provide needed services or refer to other service providers Be friendly, show empathy etc Language, gender balance etc Provide services that aim to to prevent impairment, if possible Handicap-International

For the Services providers Establish good linkages with other actors Collaborate with other service providers Eg: 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 Handicap-International

For the Services providers Implement high quality service management Develop a database of client information Basic demographics Evidence that client needs are met Use existing structures rather than replicate them Invest in continuing education of clinical, technical and administrative staff Be innovative in identifying funding sources Establish standard procedures to ensure good quality, ethical service provision Handicap-International

For the Services providers Implement high quality service management (cont.) Educate the community about services and benefits Advocate Own salaries, take care of staff About services Be transparent in all management areas (eg: HR, finances etc) Use a quality improvement system Work with the government right from the start Use local resources, if possible Handicap-International

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 Handicap-International

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 Handicap-International

For the facilitators bodies 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 Handicap-International

For the facilitators bodies …through… Renewed emphasis on promoting and using evidence Of good models Of achievement of targets Of quality Specific The technology challenge HR development approaches Handicap-International

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 Handicap-International

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. Handicap-International

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 Handicap-International

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