To integrate rehabilitation services into the basic health care delivery system and foster local government ownership, thereby increasing access to essential rehabilitation services in Madhesh Province, Nepal.
Evidence-Based Advocacy and Public-Private Partnership Approach
The partnership between Prerana, USAID’s PRA, and Lalbandi Municipality was established through advocacy and collaboration. A Memorandum of Understanding (MoU) allowed Prerana to operate from a public facility provided free of charge. Lalbandi Municipality allocated funding for rehabilitation services, while USAID’s PRA supplied necessary equipment and technical support.
Summary
Resource Optimization: Lalbandi Municipality provided 3,700 sq. feet of rental space for the Prerana Rehabilitation Center, valued at $4,540 annually, and covered renovation expenses of $5,317.50. Funding for rehabilitation services totaled $2,658.75 for FY 2020/2021, $4,557.86 for FY 2021/2022, and $2,658.75 for FY 2022/2023. The municipality also allocated an additional 6,912 sq. feet of land for future expansion, while the Ministry of Health and Population of Madhesh Province contributed $14,927.50 for construction.
Quality: Client satisfaction was high, with 30 clients interviewed upon discharge . The center employs qualified physiotherapists, prosthetists, and orthotists, and implements Continuing Professional Development. An Integrated Rehabilitation Management System ensures efficient information management, availability equipment, supplies and adherence to standard clinical practices.
Equity: Rehabilitation services are provided to all individuals regardless of age, gender, ethnicity, religion, or economic status. The center offers free physiotherapy services to residents of Lalbandi Municipality, contributing to Universal Health Coverage. Cost-sharing arrangements with neighboring municipalities help reduce out-of-pocket expenses. Additionally, free tele-rehabilitation services and outreach activities are conducted to reach hard-to-access populations.
The collaboration between local government and Prerana exemplifies a successful public-private partnership model which significantly enhances access, quality, and equity in physical rehabilitation services, leading to positive health outcomes for those in need. Strong local government ownership ensures responsiveness in service delivery, while collaboration with civil society organizations raises public awareness and increases client referrals. This collaborative effort has also facilitated the establishment of essential physiotherapy and prosthetics services, creating a sustainable framework that positively impacts individuals in the community.
This model can be replicated in other localities, demonstrating the importance of local government ownership, continuous advocacy, and multi-level stakeholder engagement in strengthening rehabilitation inclusive health systems at local level.
Health System Strengthening
Basic Care Level Rehbailitation
