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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