Provision and use of physical rehabilitation services for adults with disabilities in Rwanda: A descriptive study

Physical rehabilitation interventions address functional deficits caused by impairments that affect someone's performance. Whilst rehabilitation is important, it is assumed that these services are either minimal or nonexistent in low-resource settings. Our data expand on the data from the Situation Assessment of Rehabilitation in the Republic of Rwanda report to describe rehabilitation services and who access them at public and semiprivate facilities (primarily funded by the private sector).Objectives: This article describes the use of the outpatient physical rehabilitation services across nine health facilities, the characteristics of adults attending these health facilities and some of the facilitators and barriers they encounter when attending rehabilitation. Method: Data were collected between September and December 2018 from the heads of departments and adult patients attending outpatient rehabilitation services funded by the government, international nongovernmental organizations or faith-based organizations. Results: Two hundred and thirteen adults were recruited from nine facilities. There is a sixfold difference in the number of rehabilitation personnel between public and semiprivate hospitals in these facilities' catchment areas. However, most participants were recruited at public facilities (186 [87%]), primarily with physical disorders. Patients reported that family support (94%) was the most crucial facilitator for attending rehabilitation, whilst transportation cost (96%) was a significant barrier. Conclusion: Rehabilitation service availability for Rwandan adults with disabilities is limited. Whilst family support helps patients attend rehabilitation, transportation costs remain a significant barrier to people attending rehabilitation. Strategies to address these issues include developing triage protocols, training community health workers and families. Contribution: Data on rehabilitation service provision in Rwanda and most African countries are either non-existent or very limited. These data contain important information regarding the services provided and the people who used them across different health facilities (public versus private) and urban versus rural settings). To improve rehabilitation service provision, we first need to understand the current situation. These data are an important step to better understanding rehabilitation in Rwanda

Bilan comparartif de deux annees d'activites du service de medecine physique et readaptation du CHU de Yopougon (2001-2002)

RESUMEIl s'agit d'une etude retrospective realisee dans le service de Medecine Physique et de Readaptation du CHU de Yopougon faisant le bilan comparatif de deux annees d'activites (du 1er Janvier 2001 au 31 Decembre 2002). L'objectif etait de mettre en evidence l'influence du nouveau cadre de travail sur les activites du service afin de contribuer a l'amelioration de la prise en charge des patients en reeducation. Nous avons analyse les caracteristiques epidemiologiques; cliniques et socioprofessionnelles portant sur 1640 dossiers de patients recus en reeducation. Il ressort de cette etude que: *les sujets de sexe masculin predominaient (sex ratio de 1;5). *les affections de l'appareil locomoteur predominaient chez l'adulte (66;49pour cent) et chez l'enfant (53;40pour cent). *les pathologies chirurgicales predominaient chez l'adulte (58;03pour cent) et chez l'enfant (50;35pour cent). *la prise en charge en reeducation se faisait apres une therapeutique initiale (80;79pour cent). *la plupart des patients admis en reeducation (70;78pour cent) avaient beneficie d'une prescription de seance de reeducation. *69;07pour cent des patients ont correctement suivi leur reeducation. *le fort taux d'abandon (30;93pour cent) etait lie aux difficultes financieres et aux problemes socio-professionnels causes par le handicap. *l'efficacite de la reeducation sur toutes les pathologies est reelle (87;05 pour cent) avec une reprise professionnelle sans amenagement ni changement de poste de travail (76pour cent). *la reeducation interesse d'avantage le personnel medical de part les origines diverses des demandes de soins de reeducation. Les differentes pathologies et leurs prises en charge ont tres peu variees d'une annee a l'autre car le nouveau service de MPR reste encore non valorise