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塞拉利昂残疾人士健康与康复服务协调——利益攸关方的观点。

Coordination of health and rehabilitation services for person with disabilities in Sierra Leone - a stakeholders' perspective.

机构信息

Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

National Rehabilitation Centre, Ministry of Health and Sanitation, Freetown, Sierra Leone.

出版信息

Disabil Rehabil. 2023 Jun;45(11):1796-1804. doi: 10.1080/09638288.2022.2074551. Epub 2022 May 22.

Abstract

PURPOSE

To explore stakeholders' perceptions of the coordination of health and rehabilitation services for persons with disabilities in Sierra Leone.

MATERIALS AND METHODS

A qualitative study including seven focus group discussions with health, rehabilitation, and disability organisations stakeholders in Sierra Leone. Content analysis was used for data analysis.

RESULTS

One theme emerged; poor governance in implementing disability policies, healthcare, and rehabilitation services, which included seven subthemes: insufficient implementation of healthcare policies for persons with disabilities; changes, lack of coordination and communication between ministries governing disability policies and rehabilitation services; need for accurate disability data and clinical record keeping; absence of funds and poor political priority to healthcare and rehabilitation services; continuous support for non-governmental organisations (NGOs) to provide healthcare and rehabilitation service delivery; lack of coordination between different healthcare and rehabilitation service providers and calling for increasing persons with disabilities capacity for greater inclusion in society.

CONCLUSIONS

Increasing governmental prioritisation, and ensuring coordination and trust between donors, NGOs, and governmental programmes were keys for sustainable health and rehabilitation services. Stakeholders need to ensure national coverage and equally distributed health and rehabilitation services. Including rehabilitation services and assistive technology in the Free Healthcare Initiative would contribute to implementing the Disability Act. Implications for rehabilitationPolitical prioritisation of persons with disability (PWD) need to increase to provide national coverage and equally distributed health and rehabilitation services for PWD.To ensure access to rehabilitation services and access to basic assistive technology for PWD, the government of Sierra Leone could agree on basic rehabilitation services and a priority list of assistive devices to be distributed through rehabilitation centres and funded by the Free Health Care Initiative programme or the Sierra Leone health insurance scheme.To increase access to health services for PWD, the government of Sierra Leone could ensure inclusion of PWD in the Free Health Care Initiative programme.The government, donors, and organisations providing or funding health and rehabilitation services for PWD need to mobilise and coordinate resources better and be mutually held accountable to maximise the benefits of PWD resources.

摘要

目的

探索利益相关者对塞拉利昂残疾人健康和康复服务协调的看法。

材料和方法

一项定性研究,包括塞拉利昂 7 个焦点小组讨论,参与者为卫生、康复和残疾组织的利益相关者。采用内容分析法进行数据分析。

结果

出现了一个主题;残疾政策、医疗保健和康复服务实施中的治理不善,包括 7 个副标题:为残疾人实施的医疗保健政策执行不足;负责残疾政策和康复服务的部委之间的变化、缺乏协调和沟通;需要准确的残疾数据和临床记录保存;缺乏资金和对医疗保健和康复服务的政治优先事项不佳;为非政府组织(NGO)提供持续支持,以提供医疗保健和康复服务;不同医疗保健和康复服务提供者之间缺乏协调,并呼吁提高残疾人更大程度地融入社会的能力。

结论

增加政府的优先事项,确保捐助者、非政府组织和政府计划之间的协调和信任,是可持续健康和康复服务的关键。利益相关者需要确保全国覆盖和公平分配的健康和康复服务。将康复服务和辅助技术纳入免费医疗保健倡议将有助于实施《残疾人法》。

康复的意义

需要增加对残疾人的政治优先事项,以提供全国范围内覆盖和公平分配的健康和康复服务。为确保残疾人获得康复服务和基本辅助技术,塞拉利昂政府可以就基本康复服务和通过康复中心分配的优先辅助设备清单达成一致,并由免费医疗保健倡议方案或塞拉利昂医疗保险计划供资。为增加残疾人获得医疗服务的机会,塞拉利昂政府可以确保将残疾人纳入免费医疗保健倡议方案。为残疾人提供或资助健康和康复服务的政府、捐助者和组织需要更好地调动和协调资源,并相互问责,以最大限度地发挥残疾人资源的效益。

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