DELIVERING PHYSIOTHERAPY INTERVENTIONS TO CLIENTS IN PROVINCIAL/MUNICIPAL HOSPITAL IN THE CONTEXT OF COVID-19 PANDEMIC

P. Shrestha1, J. Karanjit1, M.B. Shah1, P. Shrestha1
1Handicap International Nepal, Kathmandu, Nepal

Background: Following the Nepal earthquake 2015, the need of establishment of Physiotherapy/Rehabilitation (PT/R) services at seven Provincial/Municipal Hospitals in six remote and hilly districts was perceived due to the increased demand of physiotherapy and rehabilitation need after the earthquake. Handicap International (HI) Nepal in collaboration with Ministry of Health and Population (MoHP) and supported by United Kingdom Government under Nepal Health Sector Support Programme II established seven establishments of PT/R Units in 6 hospitals to address the unmet need of PT/R services. These PT/Rehab units continued till the date with funding support from Ministry of Foreign Affairs Luxembourg.
On 23 January 2020, the first case of COVID-19 was reported in Nepal. From April 2020, the Out Patient Department (OPD) services including PT/R services were closed in the country due to increasing COVID-19 cases. During this pandemic to reduce the surge in necessity of rehabilitation, PT/R services were resumed following 2 interim guidelines developed by MoHP in facilitation of HI Nepal in regards to the delivery of service in acute setting and OPD setting during COVID-19 situation.

Purpose:
  1. To deliver PT/rehabilitation services to needy patients at the time of COVID-19
  2. To detect how the services were delivered in the PT/R unit during COVID-19 pandemic;
  3. To identify the number of patients treated at PT/R Unit, via phone call and Tele-rehab during COVID-19 pandemic in Provincial/Municipal Hospitals;

Methods: Assessment was conducted following the interim guideline (MoHP) and assessment forms developed by HI and World Health Organization Disability Assessment Schedule was measured for all the patients. After the initial assessment completed in the PT/R Units, the patients were followed up via Phone call and Tele-rehab.

Results:
  • Clients served to responds the physiotherapy and rehabilitation need of people with impairments, functional limitation and disability:
    PT/R Unit: April – August: 679 (Female: 342; Male: 337)
    Phone follow-up/Tele Rehab: 215 (Female: 121; Male: 94)
  • Services delivered: PT/R service in the unit delivered by using Personal protective equipment (only while treating COVID-19 positive cases) and use of safety measures and hygiene materials.

Conclusion(s): In the COVID-19 situation, following the national safety guidelines and protocols, PT/R services are being delivered to patients who have access to units and internet/phone. But the people in remote locations of the districts do not have access to PT/R services. The COVID-19 pandemic has taught us that the previously successfully running units need to adapt their services to the new situation so that they can run and deliver services effectively.

Implications: Pandemic situations should also be included in Municipal/Provincial hospital preparedness plans for which a mechanism should be prepared, resources allocated, and role clarification done. New ways need to be identified to reach people in remote areas. Tele-rehab can be used as an alternative method to continue follow-up service for patients who does not have access health facilities.

Funding, acknowledgements: Ministry of Foreign Affairs Luxembourg (MOFALUX)

Keywords: COVID-19, Physiotherapy and rehabilitation, Rural areas

Topic: COVID-19

Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: It describes innovative ways in which established methods have been adapted to meet the changing needs of practice.


All authors, affiliations and abstracts have been published as submitted.

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