Coordination Between Health and Rehabilitation Services in Bangladesh

Dr Wesley Pryor1, Dr Liem Nguyen1, Ms Fleur Smith1, Mr Rajib Hasan3, Mr Golam Mostafa2, Mr Faruk Jalal2, Dr Manjula Marella1

1Nossal Institute For Global Health, The University Of Melbourne, Melbourne, Australia, 2HI Bangladesh, Dhaka, Bangladesh, 3Jatiya Protibondhi Unnayan Foundation, Bangladesh

Coordination of care is a critical element of rehabilitation as it involves timely identification of the need; transfer of care between health and rehabilitation providers through effective information sharing and communication between providers and settings; flexible and adaptive care according the individual’s circumstances and needs; consistency; and establishing and maintaining a therapeutic relationship between the provider and individual. A mixed methods study involving a survey of 396 adult (18+ years) service users attending six Integrated Disability Service Centres (IDSCs) and key informant interviews with 19 key stakeholders and 19 service users of three IDSCs. Quantitative findings suggested there were delays with an average of around two years between experiencing a health problem and accessing rehabilitation. People with stroke and fractures tended to access rehabilitation earlier. Qualitative findings support survey findings with stakeholders acknowledging delays in timely referrals from health facilities to rehabilitation services. Referral pathways between medical and rehabilitation services is reported to be poor and not monitored. Awareness on the rehabilitation services provided through PSOSKs was generally poor among medical stakeholders. Misconceptions about rehabilitation in the communities, superstitious beliefs in traditional treatments, family caregivers’ role and location of services were highlighted as major factors affecting the coordination of care.




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