4. In which ways is the initiative creative and innovative?
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From the concept, “wherever you are, doctors are ready here”
Improve rehabilitation services to achieve the goal of multidisciplinary team, composed of physiatrists, rehabilitation nurses, physical therapists, occupational therapists, prosthetic and orthotic technicians, social workers, and public health technical officers, with community participation
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5. Who implemented the initiative and what is the size of the population affected by this initiative?
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Sisaket Hospital, the head of hospital network with multidisciplinary team, has provided mobile medical unit at community hospitals offering proactive services in order to solve the problems in coordination with public and private sectors, locality, disable persons and their families. From 1994 to 2015, it was found that there were totally 45,625 persons with disabilities in Sisaket. Among those, 22,325 women and men have physical disability. Most of them were able to access rehabilitation services even though they lived in the distant area.
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6. How was the strategy implemented and what resources were mobilized?
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Because of long distances between community hospitals and Sisaket hospitals and a movement problem, disabled persons have difficulties accessing medical services. However, Affiliated Party and Network Group and the discussion over Group Line make it effective to work coordinately and also help work team well understand the disable’s problems before fieldwork. This contributes to service satisfaction and the disable in rural areas can get the most out of this service.
Financial support
- A budget funded by National Health Security Office (NHSO) together with hospital subsidies
Human resources
- Multidisciplinary team in department of rehabilitation medicine, division of social work, and The Division of Services for People with Disabilities at Sisaket Hospital
- volunteers
- Affiliated Party and Network Group in community hospitals including physical therapists, nurses, and nurse aides
- Community leaders/ village health volunteer/ local administrative organization
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7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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Sisaket Hospital
- Has a distinct concrete pattern of integrated working by multidisciplinary team for good care and rehabilitation
- Reducing congestion in hospitals
- Share and learn guidelines for rehabilitation of the disable with Affiliated Party and Network Group of disabled, the disabled, their families together with their communities
- Patient satisfaction
Community hospitals
- Personnel are able to apply working patterns to continuously improve themselves and working quality
- The disabled in responsible area can access to the full array of medical services and rehabilitation medicine
- Cut expenses on referral of disable patients to provincial hospitals
- Share and learn guidelines for rehabilitation of the disable with Affiliated Party and Network Group of disabled, the disabled, their families together with their communities
- Patient satisfaction
Community leaders/ Village health volunteers/ local administrative organization
- The disabled in responsible area can access to the full array of medical services and rehabilitation medicine
- The disabled in responsible area access necessary rights
- Share and learn guidelines for rehabilitation of the disable with public Affiliated Party and Network Group of disabled, the disabled, and their families to strengthen community empowerment
Disable persons and their families
- Cut travel expenses on
- Save time travel and waiting time in doctor’s office
- Access the compensable rights, rehabilitation services and orthosis and prosthesis
- Share and learn guidelines for rehabilitation of the disable with Affiliated Party and Network Group of disabled, and their communities
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8. What were the most successful outputs and why was the initiative effective?
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The cooperation is required to sustainably improve the rehabilitation services for persons with physical disability. The disabled, their relatives, community leaders, village health volunteers, and sub-district administrative organization have to work together to achieve such goal. Communities should give a priority to the disable, are responsible for taking care of them, and are willing to collaborate in rehabilitation services in their areas. They also ought to support disable persons in doing activities which are beneficial to themselves and communities.
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9. What were the main obstacles encountered and how were they overcome?
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Because we don’t know the exact number of people with disabilities in each district to which the mobile medical unit goes, the day when it goes to community is only known by some disabled persons dependent on the potential of communities to broadcast the information to their disabled persons. This causes some disabled persons not be able to access medical services. Moreover, the estimation of the number of disabled persons is not accurate. This problem and obstruction should be solved in order to develop comprehensive database of persons with disabilities.
To make all disabled persons register with the disability service , access rehabilitation services at nearby primary care unit, and receive necessary orthosis and prosthesis, we should encourage surveying database before the visit of mobile medical. We can also improve rehabilitation services for persons with physical disability.
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