ESTABLISHING PHYSIOTHERAPY REHABILITATION AS AN ESSENTIAL PART OF HEALTH SERVICE IN COVID 19 CONTEXT—AN EXPERIMENTAL ACCOUNT FROM NEPAL

S. Suwal¹, C. Rana²

¹Handicap International, Rehabilitation, Kathmandu, Nepal, ²Handicap International, Kathmandu, Nepal

Background: Large number of individuals, who have been infected with COVID-19, continue to experience a constellation of symptoms long past the time that they have recovered from the acute stages of their illness. Often referred to as “Long COVID,” these symptoms, which can include fatigue, shortness of breath, palpitations, cognitive dysfunction (“brain fog”), sleep disorders, anxiety, depression, and others, can persist for months and can range from mild to incapacitating. The societal impacts of these sequels are likely to be profound and long lasting. Aligning to all these symptoms a comprehensive protocol focused on Post COVID 19 rehabilitative management clinical protocol was identified to be developed by Ministry of health and population (MoHP), Nepal to overcome the long COVID symptoms. The protocol is aimed to orient any clinical professionals who are working in Post COVID-19 designated hospitals which includes rehabilitation professionals and health professionals such as physiotherapists, doctors and nurses.

Purpose: The Post COVID 19 rehabilitative management clinical protocol is aimed for multidisciplinary rehabilitation professionals including physiotherapists, rehabilitation professional associations and health professionals (doctors, nurses) to impart the knowledge on the importance of rehabilitative intervention in regard to post COVID 19 symptoms and also to increase the awareness among health professionals on the importance of referral to physiotherapists for physiotherapy and rehabilitation intervention for the Post COVID19 cases.

Methods: Technical working group (TWG) inclusive of physiotherapists under MoHP was formulated which comprised of various rehabilitation professional associations, government physiotherapists, disabled people organization, World Health Organization Nepal, public health experts, doctors, nurses and policy makers. Post COVID 19 rehabilitative management clinical protocol was developed and finalized with series of revision through TWG. Hence, the protocol has been endorsed in the leadership of MoHP.

Results: The protocol is on the process to orient 250 physiotherapists as well as health professionals under the leadership of MoHP. The development of protocol established physiotherapy rehabilitation as one of the important health services even in the pandemic context.

Conclusions: The protocol have generated a sense of ownership from MoHP on physiotherapy intervention. Orientation on the protocol needs to be conducted from MoHP to the relevant rehabilitation and health professionals for further implementation and imparting the sense of importance of physiotherapy intervention in post COVID 19 management. This has contributed on sensitizing the policy level on the importance of physiotherapy and rehabilitation in infectious diseases management.

Implications: Rehabilitation is also important in infectious diseases management. Having rehabilitation specific protocol in pandemic context through MoHP gives a message that rehabilitation is one of the important components of health during pandemic. This protocol will help increase rehabilitation access for Post COVID 19 cases experiencing post COVID symptoms hence promoting healthy living and well-being ( Sustainable Development Goal 3).

Funding acknowledgements: USAID

Keywords:
Physiotherapy intervention
Post COVID management
Health system strengthening

Topics:
COVID-19
Education: continuing professional development
Cardiorespiratory

Did this work require ethics approval? No

Reason: Ethical approval was not required because the developed Post COVID 19 rehabilitative management clinical protocol will be soon disseminated from the web pages and social sites of Ministry of health and population and Rehabilitation professional associations.