B. Sheehan1, A. Benyaich2, H. Aoun3, A. Chaama4, S. Sexton1, J. Arab2, H. Al Sultan2, H. Rawi2, A. Weatherhead5, D.M. Itani6
1Rehabskills Ldt., Physical Rehabilitation Sector, Lanarkshire, United Kingdom, 2International Committee of the Red Cross, Physical Rehabilitation Program, Beirut, Lebanon, 3Balamand University, Public Health, Beirut, Lebanon, 4International Society of Prosthetic and Orthotic Lebanon, Prosthetic and Orthotic, Beirut, Lebanon, 5Rehabskills Ldt., Physical Rehabilitation, Lanarkshire, United Kingdom, 6Ministry of Public Health, Prosthetic and Orthotic Committee, Beirut, Lebanon

Background: People with physical disabilities (PWD) living in Lebanon are confronted with a variety of barriers to accessing healthcare services especially rehabilitation, including prosthetic and orthotic (P&O) devices and related physiotherapy interventions. The absence of unified and standardised P&O coverage procedure in Lebanon makes access more difficult. Developing the P&O sector together with physical rehabilitation services and policies are identified as priority measures to address the needs of PWD. This benchmark statement compares the situation in Lebanon with the WHO Standards for P&O and makes recommendations for improvement utilising the 4Ps of policy, products, personnel and provision of services based on multidisciplinary approach. 

Purpose: The Benchmark Statement for P&O services in Lebanon and its recommendations aim to pave the way for the sector to progress and to develop a long-term 2030 vision. In addition, aims to provide directives to third party payers including Ministry of Public Health (MoPH) on a comprehensive financial coverage for PWD to benefit from multidisciplinary interventions that include P&O services in conjunction with physical rehabilitation interventions.  

Methods: A systematic desk review addressed key questions to review:
(1) services to improve function and participation for 3 groups of population;
(2) health conditions accessing P&O services;
(3) what policies exist
(4) what personnel provide services and
(5) what services exist in Lebanon.
The desk review and the WHO standards were utilized as key documentation for a national summit with 60 participants and subsequent workshops with service providers to help inform the final benchmarking statement. This methodology compares 60 WHO standards across the four areas of service provision with the national situation in Lebanon making recommendations for development for each standard.

Results: This benchmark statement compares the situation for P&O services in Lebanon with WHO’s international standards. It provides a baseline analysis and helps to create and develop a national strategy for information exchange about P&O to support evidence-based decision-making and sector development.
The recommendations clearly show the developments needed in four areas of the system, namely: policy, products, personnel and provision of services. Physical rehabilitation and multidisciplinary approach are highlighted as key recommendations. Publication is a decisive step towards strengthening universal health coverage and working towards the 2030 SDGs.

Conclusion(s): Based on the results and recommendations, next steps for development for the sector include:
· Working with key stakeholders to develop a long-term vision for Lebanon’s prosthetics and orthotics sector by 2030 based on multidisciplinary team approach for comprehensive physical rehabilitation.
· An implementation plan for Lebanon where key stakeholders collaboratively develop the sector via capacity building through training and mentoring, developing a 10-year action-orientated implementation plan with SMART objectives, developing campaigns and national resource bank for each area (policy, products, personnel and provision of services).

Implications: Providing comprehensive national strategy on upgrading and strengthening P&O sector into Lebanese health system including physical rehabilitation for P&O users.

Funding, acknowledgements: International Committee of the Red Cross, Ministry of Public Health of Lebanon, Rehabskills Limited, University of Balamand and ISPO Lebanon.


Topic: Globalisation: health systems, policies & strategies

Did this work require ethics approval? No
Institution: BALAMAND UNIVERSITY LEBANON, Dean of Faculty of Medicine (Dr K Nasser)
Committee: Dr Kamal Nasser Dean of Faculty Medicine
Reason: it is project evaluation (participative workshops with stakeholders) of the sector aligning 60 standards of WHO in Lebanon

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

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