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Pakistan has a population of more than 200 million people, and its health system is overburdened and faced with many challenges in trying to cater to the needs of the entire population. According to available data, 47 million people, or one in five Pakistanis, could benefit from rehabilitation. Approximately 16.8 percent of the population (40.4 million Pakistanis) need one or more assistive products to support their functioning; yet, only 3.7 percent have access to the assistive products they need.

Pakistan’s government is committed to ensuring equitable access to rehabilitation and assistive technology (AT) services. Pakistan sponsored the first-ever World Health Assembly resolution on AT in 2018 and hosted the first World Health Organization (WHO) regional meeting on the importance of AT in 2018. The rapid Assistive Technology Assessment (rATA), completed in Pakistan in 2019, represents an important step in identifying unmet needs and supporting the definition and implementation of more comprehensive policies.

View the ReLAB-HS Pakistan country brief.

In Pakistan, ReLAB-HS established two “Networks of Care”—district-level “networks” of public and private health care entities that are connected to support the integration of rehabilitation services within primary care and improve the coordination of care between different levels of the health system.

ReLAB-HS is working with the national and provincial governments to transform health systems in Pakistan to integrate rehabilitation and AT services, adapt to new challenges, share learnings, and support scale-up. ReLAB-HS is focusing efforts on service delivery improvement in the Swat district of Khyber Pakhtunkhwa province and in the Thatta district of Sindh province.

In close partnership with the Ministry of National Health Services Regulations and Coordination, the WHO, academic and training institutions, national professional associations, provincial health departments, district health offices, rehabilitation professionals, primary care providers, the Lady Health Worker Programme, and community organizations, ReLAB-HS has worked to achieve the following:

  • Improved delivery and demand of quality rehabilitation and AT services at the community level
    • Co-designed rehabilitation and AT service delivery model and referral processes
    • Supported district health offices and partners to form local Technical Working Groups to promote local ownership of integrating rehabilitation into existing district structures
    • Supported stakeholders to identify and establish priority areas and action plans working toward integration and improving quality of care
    • Supported the establishment of an AT “hub” to store, manage, and distribute assistive products, enabling the provision of simple assistive products at the primary care level
  • Supported the development and implementation of plans and policies for rehabilitation and AT
    • In collaboration with the WHO and the Pakistan Health Services Academy, completed:
      • Systematic Assessment of Rehabilitation Situation (STARS)
      • Assistive Technology Capacity Assessment (ATA-C)
      • Guide for Rehabilitation Workforce Evaluation (GROWE)
    • Worked with rehabilitation professional associations to strengthen regulations for rehabilitation professions
    • In collaboration with Aga Khan University, generated evidence on how prioritization of rehabilitation can be strengthened within the policy environment

Achievements

As a result of ReLAB-HS’s contributions to date:

  • Over 4,350 more people have improved access to rehabilitation and AT services.
  • Over 3,700* trainings on rehabilitation and AT have been completed.
  • 16 rehabilitation and AT quality and integration processes have been strengthened in two local networks.
  • 8 organizations have adopted the International Rehabilitation Education and Training Toolkit.
  • 58 organizations and institutions have been strengthened.

Ongoing and future activities:

National and Provincial Levels

  • Provide technical assistance for development and implementation of national and provincial rehabilitation and AT strategic plans
  • Strengthen data capture and use to inform quality improvement efforts
  • Continue to work with rehabilitation professional associations and academic institutions to strengthen workforce development
  • Continue collaborating with local rehabilitation and AT leaders to foster a cohort of champions

District Level

  • Work with districts to:
    • Improve integration of rehabilitation and AT services
    • Strengthen workforce capacity
    • Improve the assistive products supply chain and standard operating procedures

* Reflects the number of course completions, as trainees may have completed one or more courses