Rehab Mobile Service
Sisaket Hospital

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Nowadays, in Thailand there are an increasing number of the disabled with different types of disabilities. This has affected the country and the disable themselves. For the last ten years, Thai government has been giving priority to improving the quality of life of disabled people by carrying out the 4thNational Development Plan for the Life Quality of the Disabled (2012-2016), the strategic plan to frame and guide the process of developing the life quality of the disabled. It is based on the 12th National Social and Economic Development Plan (2017-2021) The ultimate goals are to protect the rights of persons with disabilities, to improve the life quality, to achieve their full potential, and to be the equal part of their society. These conform to the current National Development Plan in terms of the respect of others, equity and human rights so that disabled persons acquire the rights and protection from the government. However, in fact there is still unfairness of the disabled in several ways, especially the access of health services due to insufficient services. Community hospitals lack healthcare providers and prosthesis and orthosis for ample services together with the insufficiency of places and equipment, which is not convenient for disabled persons to access and make use of them. Moreover, the disabled going to district hospitals which are staffed by professional health care providers normally wait for three hours and a half on average in addition to costly expense due to movement difficulties. 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. From the study we found that rate of disability per person in 2009-2014 was 1.62, 2.39, 2.72, 2.97, 3.16 and3.28 respectively. Sisaket Hospital as the provincial hospital staffed by medical specialists provided mobile medical rehabilitation unit at community hospitals to help persons with physical disability easily access medical services. This project had been planned to improve and support better life quality for disabled persons. We believe that if they are taken good care of and are well support despite the disabilities, they may be satisfied with themselves, perhaps much more than the ordinary persons.

B. Strategic Approach

 2. What was the solution?
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.

 3. How did the initiative solve the problem and improve people’s lives?
Due to the concentrated medical services in cities, lack of specialized health care services in rural areas, congestion of population, waiting time and travel expenses to access medical services at provincial hospital, 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 such problems in coordination with public and private sectors, locality, disable persons and their families. 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

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
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

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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.
 6. How was the strategy implemented and what resources were mobilized?
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

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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

 8. What were the most successful outputs and why was the initiative effective?
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.

 9. What were the main obstacles encountered and how were they overcome?
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.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
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. 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.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
No.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
Sisaket Hospital by Multidisciplinary team has provided mobile medical unit to the rural area where the medical services are difficult to access. It improves the life quality of people.

Contact Information

Institution Name:   Sisaket Hospital
Institution Type:   Government Department  
Contact Person:   Duanchay Pho-ngam
Title:   Doctor  
Telephone/ Fax:   +(66)4 561 1503
Institution's / Project's Website:  
E-mail:   kultida_sskh@hotmail.com  
Address:   859 Kasikam Road
Postal Code:   33000
City:   Meaung Sisaket District
State/Province:   Sisaket
Country:  

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