11 | Care in Low and Middle-Resource Countries

Challenges to Comprehensive Care in a Middle-Income Country

General Introduction

The World Health Organization (WHO) estimates that 80 percent of people with disabilities live in developing countries. In fact disability rates are disproportionally higher in lower than in higher-resource countries.1 2

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Healthcare Provision After Injury

Mr. Dee's Story

Mr. Dee, a 41-year old farmer, lived and worked in a rural area of Northern Thailand. A fall resulted in a spinal cord injury (SCI) that had a drastic impact on his life and livelihood.

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Interviewing Mr. Dee

Assessment

Mr. Dee and the rehabilitation team began the assessment of his functioning status by identifying problems and needs as seen from his own perspective as well as from the perspective of the health professionals on his rehabilitation team. For the health professionals' perspective, a list of ICF categories was used as a guide.

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Assessment of Functioning – Basis for Setting Goals

Goal-setting/Determination of Intervention Targets

In consideration of the assessment results documented on the ICF Assessment Sheet, an ICF functioning profile for Mr. Dee was developed. The ICF Categorical Profile enabled Mr. Dee and his rehabilitation team to visualise the asssessment results and indicate the long-term and short-term goals.

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Moving Around Using Equipment

Assignment and Intervention

Every intervention target that was determined during the assessment phase was allocated to corresponding member(s) of the rehabilitation team during the assignment phase of the Rehab-Cycle®. The respective team member was responsible for addressing the intervention targets with specific interventions during the intervention phase.

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Evaluation

After about six weeks of rehabilitative interventions, Mr. Dee's functioning was re-evaluated to see how well he had progressed.

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Living Situation in Rural Thailand

Discussion

The case study of Mr. Dee highlights some strengths and limitations of spinal cord injury (SCI) rehabilitation in low and middle-resource countries.

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Literature

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11 | Care in Low and Middle-Resource Countries