Khan Fary, Amatya Bhasker, Sayed Tahir M, Butt Aamir W, Jamil Khalid, Iqbal Waseem, Elmalik Alaeldin, Rathore Farooq A, Abbott Geoff
Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road Parkville, Melbourne VIC 3052, Australia. E-mail:
J Rehabil Med. 2017 Jan 19;49(1):10-21. doi: 10.2340/16501977-2149.
To provide an update on disability and outline potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Pakistan.
A 6-day workshop at the Armed Forces Institute of Rehabilitation Medicine, Islamabad facilitated by rehabilitation staff from Royal Melbourne Hospital, Australia. Local healthcare professionals (n = 33) from medical rehabilitation facilities identified challenges in service provision, education and attitudes/approaches to people with disabilities, using consensus agreement for objectives listed in the GDAP.
Respondents agreed on the following challenges in implementing the GDAP: shortage of skilled work-force, fragmented healthcare system, poor coordination between acute and subacute healthcare sectors, limited health services infrastructure and funding, lack of disability data, poor legislation, lack of guidelines and accreditation standards, limited awareness/knowledge of disability, socio-cultural perceptions and geo-topographical issues. The main facilitators included: need for governing/leadership bodies, engagement of healthcare professionals and institutions using a multi-sectoral approach, new partnerships and strategic collaboration, provision of financial and technical assistance, future policy direction, research and development.
The barriers to implementing the GDAP identified here highlight the emerging priorities and challenges in the development of rehabilitation medicine and GDAP implementation in a developing country. The GDAP summary actions were useful planning tools to improve access and strengthen rehabilitation services.
提供关于残疾问题的最新情况，并概述在巴基斯坦实施世界卫生组织全球残疾行动计划（GDAP）的潜在障碍和促进因素。
在澳大利亚皇家墨尔本医院的康复工作人员协助下，于伊斯兰堡的武装部队康复医学研究所举办了为期6天的研讨会。来自医疗康复机构的33名当地医疗保健专业人员，根据GDAP中列出的目标达成共识，确定了在服务提供、教育以及对残疾人的态度/方法方面存在的挑战。
受访者就实施GDAP面临的以下挑战达成共识：熟练劳动力短缺、医疗保健系统分散、急性和亚急性医疗保健部门之间协调不佳、卫生服务基础设施和资金有限、缺乏残疾数据、立法不完善、缺乏指导方针和认证标准、对残疾的认识/了解有限、社会文化观念以及地理地形问题。主要促进因素包括：需要管理/领导机构、采用多部门方法让医疗保健专业人员和机构参与、建立新的伙伴关系和战略协作、提供财政和技术援助、未来政策方向、研究与发展。
此处确定的实施GDAP的障碍凸显了发展中国家康复医学发展和GDAP实施中出现的优先事项和挑战。GDAP的简要行动是改善服务可及性和加强康复服务的有用规划工具。
