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Box 1. Guiding principles and recommendations of the National Disability, Health and Rehabilitation Plan for Egypt
A. Guiding principles to improve health, functioning and quality of life for all persons with disability in Egypt, include:
1. The Ministry of Health and Population( MOHP) should take a central role in promoting health( including all areas of health-related rehabilitation) for persons with disabilities in Egypt.
2. Health-related rehabilitation and health policies and services should be coordinated with other aspects of an inclusive development policy including Ministries of Social Solidarity, Education, Labor, Justice and others.
3. Rehabilitation for persons with congenital and acquired disabling health conditions( including trauma, chronic noncommunicable diseases, musculoskeletal pain, neurological and mental health conditions) should be given a high priority in healthcare planning and service provision, and must be seen as universal health coverage. This must include early detection at the primary healthcare level.
4. Rehabilitation as a health strategy( which is equal to prevention, health promotion and curative care) must be implemented in all phases( acute, post-acute, long-term care, including community-based rehabilitation) and levels of medical care( primary, secondary, and tertiary care), and should include early detection and intervention.
5. Establish regular consultations among ministries and authorities about disability and rehabilitation topics( mainly the Ministry of Health and Population, Ministry of Social Solidarity, Ministry of Education Ministry of Justice, and maybe other Ministries that are responsible for related activities, such as labor, community planning, transport, etc.)
B. Recommended actions and projects that should be taken in order to improve health, functioning and quality of life for all persons with disability in Egypt, include:
1. Define disability as a priority of health policies, and rehabilitation as a major health strategy to be implemented in all sectors of healthcare( rehabilitation as universal health coverage), and establish a sector for disability and rehabilitation( equal to prevention, health promotion and curative care) within the MOHP with competencies to implementation disability and rehabilitation policies and services within the health system and in collaboration with other ministries.
2. Include detection of the prevalence of disability in all health surveys, including the need for rehabilitation, assistance and support, and possible barriers for patients with disabilities to access health services.
3. Ensure that all persons with disability have access to rehabilitation and health services and are included in the health insurance.
4. Implement training programs for missing rehabilitation professions( occupational therapists, prosthetists and orthotists, speech and language therapists, visual and auditory trainers) as well as primary healthcare rehabilitation workers, and ensure that every health professional receives basic training on disability and rehabilitation issues.
5. Apply the comprehensive rehabilitation implementation matrix to develop and implement health-related rehabilitation services in acute, post-acute and long-term care, including all primary healthcare centers and including people with all ages and all types of disability.
6. Translate relevant international documents on disability and rehabilitation into Arabic language( using the most understood Arab dialect) and make culturally adapted explanations( of definitions).
7. Develop feasible and culturally accepted tools to use the ICF in health reporting and clinical assessment of disability and functioning( including cultural and language adaptation, intuitive descriptions of domains, development of patient questionnaires) by a team of experts( eventually including international expertise).
8. Establish a registry of( existing and planned) rehabilitation service implementation projects( including different stakeholders), evaluate the projects and ensure that they will be implemented if evaluated successfully.
9. Perform a model survey on functioning and disability in children with cerebral palsy using the ICF Core Set for children and youth with cerebral palsy.
10. Develop a curriculum for Primary Health Care Rehabilitation Workers and start the training as soon as possible.
11. Set up a database of health professionals and services working with / for persons with disability( in order to identify gaps and to facilitate transferals).
12. Develop descriptions of roles of all rehabilitation professions( PMR, PT, OT, SLT, nurses and others) in rehabilitation teams( with participation of the syndicates of all professions) and possibly with an external moderator.
ICF: International Classification of Functioning, Disability and Health; PMR: Physical and Rehabilitation Medicine; PT: physiotherapist; OT: occupational therapist; SLT: speech and language therapist.
tology and Ain Shams University, Physiotherapy Faculty of Cairo University, Speech Faculty of Medicine of Cairo University, Physiotherapy Department of Cairo Governate, Caritas Egypt, as well as specialists in Neurology and Disability and Physiotherapy, and the mother of an autistic child. After a consensus-oriented discussion of each recommendation the participants could vote on the relevance of each recommendation.
The resulting recommendations are summarized in Box 1.
DISCUSSION
Although this was the first time a technical consultation for the development of a National Disability, Health and Rehabilitation Plan had been carried out, overall the consultation was successful and led to recommendations with a good level of consensus among stakeholders in the country.
Methodologically, the consultant( CG) used open source data on Egypt, its health system, www. medicaljournals. se / jrm