Pakistan is a developing country with a population of over 200 million people. The health system in Pakistan is overburdened and struggling to cater to the needs of the entire population. Pakistan’s healthcare services delivery system is split between public and private sectors. According to Pakistan’s constitution, the provinces are primarily responsible for managing and providing healthcare services, while the federal government is responsible for providing healthcare in federally administered areas. Basic Health Units and Rural Health Centers are the foundation blocks of Pakistan’s health-care system.
Service delivery is organized into preventive, promotive, curative and rehabilitative services. Most curative and rehabilitative services are provided in secondary and tertiary care health facilities. Preventive and promotional services are primarily delivered through a variety of national programs as well as by Lady Health Workers through primary healthcare institutions and outreach initiatives.
As a signatory to the Convention on the Rights of Persons with Disabilities (CRPD), Pakistan’s government is committed to ensuring that people with disabilities have fair access to rehabilitation and assistive technology services. However, the government has historically struggled to provide rehabilitation and assistive technology (AT) programs at both the national and provincial levels. There are significant barriers to individuals’ access to rehabilitation and AT services due to the lack of disability identification, referral, and follow-up systems at the primary care level. Similarly AT services lack adequate need assessment, device procurement and patient follow-up processes, as well as a lack of availability of AT products in country.
ReLAB-HS will support the development of health systems that are able to respond to rising rehabilitation requirements. ReLAB-HS will also collaborate with the national and provincial governments, to raise awareness about the importance of providing rehabilitation and AT services at all levels of care, with a focus on a set of priority conditions. We will look at how these services can be integrated into primary health care and improving coordination between healthcare providers.
The ReLAB-HS prime, Johns Hopkins International Injury Research Unit, has a longstanding working relationship with key stakeholders in Pakistan, including the Ministry of Health, Ministry of Communications, WHO’s Pakistan country office, academic institutions and NGOs. Over the past couple of decades, the JH-IIRU team has worked with these stakeholders to address multiple public health issues, including building sustainable capacity for research. The team also implements several projects in these disciplines in collaboration with local stakeholders. There is local interest in extending work to address the growing need for rehabilitation across the lifespan and preparing health systems in Pakistan to integrate rehabilitation to ensure continuity of care.
Humanity & Inclusion in Pakistan works in close collaboration with the national and provincial governments. During their time in Pakistan, HI has touched the lives of millions of marginalised and vulnerable communities, through Community-based Rehabilitation (CBR), WASH & Shelter, psycho-social support and Disaster Risk Management. HI, through ReLAB-HS, will support the government in developing an inclusive health system that responds to the growing need for assistive technology (AT), meets the increased demand for rehabilitation services, and strengthens the capacity of local AT providers, as well as sensitizes policy advocates and decision-makers to these needs.
Momentum Wheels for Humanity works to strengthen access to assistive technology and rehabilitation services. In Pakistan, recently the government, private sector and civil society have made gains in assistive technology, including new information about needs and recognition of the importance of innovative procurement and services. ReLAB-HS has the opportunity to develop locally adapted, relevant assistive technology services together with rehabilitation service delivery models.
MiracleFeet has a strong presence in over 20 low- and middle-income countries. Their work focuses on raising awareness of clubfoot treatment, providing supplies and designing and delivering training and mentoring programs to strengthen local capacity. In Pakistan, MiracleFeet’s efforts and collaboration with local partners and the government have boosted the sustainability of the national clubfoot program, which is offered in government hospitals under the auspices of the Ministry of Health.
In Pakistan over 50,000 individuals are using Physiopedia every month to improve knowledge in an effort to advance health. ReLAB-HS will reach further into this community to partner with local stakeholder organisations to generate new learning opportunities to develop rehabilitation workforce capacity.