BACKGROUND INFORMATION

The consequences of past conflict and natural disasters have affected the development of El Salvador’s economy and healthcare system. Poor people in rural and urban areas have limited access to health services. The Ministry of Health offers physical rehabilitation services for free, but the national reference centre providing these services faces budgetary constraints, especially for acquisition of material and hiring qualified staff. An autonomous governmental institution under the president’s office is currently developing a national policy addressing disability. The Don Bosco University (UDB) in El Salvador hosts the only internationally accredited prosthetic/orthotic school in Latin America.

To increase and ensure people’s access to rehabilitation services, we help improve the structure and sustainability of El Salvador’s physical rehabilitation sector. During field visits and meetings, we support the national physical rehabilitation authorities in developing a strategic plan of action, especially concerning coordination and resource allocation. We help them attend and/or organize local and regional events where they can meet with other stakeholders of the sector and exchange views and best practices with their counterparts in the region.

Helping enhance the knowledge and capacity of people working in the sector, and the quality of services they provide, is a big part of our work in the country. To this end, the SFD has developed a lasting partnership with UDB that started in 2004. We provide the university with guidance and recommendations for developing and implementing educational/training materials, including modules for administrators at physical rehabilitation centres and courses for other service providers. We help teachers at the university hone their skills, by, for example, facilitating their attendance at courses/training abroad. The university also receives financial support and raw materials/components. Furthermore, we help it explore linkages with the national reference centre, specifically on the possibility of students completing clinical placements at the centre.

RESOURCES USED (As at September 2016)

  • CHF 244’051 Budget 2016
  • CHF 176’487 Expenditure as at September 2016
  • 47 working days of P&O expert

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MAIN ACTIVITIES AND ACHIEVEMENTS (Jul-Sep 2016)

  • The Dean and the P&O director of the UDB attended the AMLAR (Asociación Médica Latinoamericana de Rehabilitación) congress in August 2016. The objective of his participation was to analyze the possibilities to develop medical prescription course with rehabilitation doctors of the region. Indeed understanding of prescription for P&O services varies according to the professional background of the prescribing doctor (General Practitioner or Physiatrist). This joint collaboration (AMLAR, UDB, SFD) will help using a common or raising knowledge on P&O device prescription.
  • 14 professionals from 3 countries (2 from Ecuador, 3 from Haiti, 6 from Nicaragua) and 3 (2 orthopaedic technician and 1 physiotherapist) from ISRI have participated to a clinical orthotic short course at UDB. An external physiotherapy lecturer (HUG in Geneva) gave support to UDB during this course. Read more
  • 14 P&O technicians sponsored by the SFD from different countries follow academic training run by the UDB. 3 of them (out of 5) have succeeded their ISPO examination in July 2016.
  • The SFD concluded the order of raw material for ISRI (58’943 CHF transport included). The delivery is planned during the first week of October 2016. Materials and components were also ordered for UDB for an amount of 20’000 CHF.
  • UDB Director attended a training session organized by the SFD on the use of its Beneficiary Satisfaction Questionnaire and Quality Assessment of Assistive Products. After this training, UDB’s Director participated as an instructor in another session for Nicaraguan & Salvadorian participants (Nicaragua Red Cross, CENAPRORTO, UNAM, ISRI). The implementation of the assessment tools is planned in 2017 in both El Salvador and Nicaragua. The objective of this training is to offer SFD partners the possibility of measuring the impact of services by interviewing service users, and to assess the quality of the P&O services they receive.
  • UDB continues to play an essential national and regional role for strengthening the capacity of P&O services in the region. Thanks to its network, the SFD has selected 14 students from neighboring countries and financed their scholarships to attend UDB, which in turn contributes to the financial support to UDB and to its international reputation. In collaboration with UDB, the SFD follows-up the students; 2 meetings were organized with the students at UDB, and monthly video conferences are held with the UDB teachers. Mock exams were organized by our SFD expert in Managua to help students following the distance learning course prepare for their exams.
  • UDB and SFD organized its first meeting with the Paralympic Sport organization. The beneficiaries’ selection criteria were discussed and agreed upon. Based on this work, a second meeting is planned before the end of 2016 to select the beneficiaries.
  • 6 key staffs from ISRI and 1 from CONAIPD attended the Uniendo Fronteras congress. Thanks to SFD support, meetings/contacts with other service providers and orthopaedic materials distributor and participation at various orthopaedic workshop during congress were possible. This initiative contributes to fostering peer-to-peer professional exchange in the region.
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During the courses sessions given by the University Don Bosco (UCB) and the SFD in San Salvador, the participants had the opportunity to take care of some little patients, like the boy on the picture.

Read more about the short course at UDB.

INDICATORS (As at September 2016)

Physical Rehabilitation National Entity

  • Existence of National plan: No
  • Budget for physical rehabilitation: n/a
  • Number of professionals employed by the entity: 0

Qualified professionals employed by our partners’ rehabilitation centers

  • 20 P&Obreakdown-by-gender-and-age_el-salvador_q3_2016
  • 32 Physiotherapists
  • 3 other therapists

 

 

 

 

 

Quality of services delivered by our partners

  • Technical assessment form: n/a
  • Beneficiary satisfaction: n/a

Beneficiaries’ statistics – Trainings (jan-sep 2016)

  • 3 persons received a clinical orthotic short course
  • 2 persons received an academic training on the implementation of assessment tools

Beneficiaries’ statistics – Services (jan-sep 2016)

  • 1’231 physical rehabilitation services provided by our partners

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CHALLENGES AND NEXT STEPS

  • The absence of a specific entity in charge of the physical rehabilitation sector at central level (MoH) is an obstacle to develop further the sector. The absence of needs assessment as well as the lack of coordination and supervision mechanisms refrains the scaling up of our actions.
  • Although ISRI will eventually succeed to import raw materials, the SFD is still required to facilitate the international supply of materials, as the ISRI alone would not have been able to import the materials at a reasonable cost. The State’s importation system does not allow ISRI the autonomy it needs.
  • Due to the nomination of a new director at ISRI, the stock and procurement procedures were reviewed. Currently, the stock is managed at the central level and the rehabilitation director is not involved in the stock management process.
  • The SFD continues its work with UDB, ISRI and CONAIPD to facilitate the creation of the physical rehabilitation entity. The CONAIPD president was invited by SFD to participate to the Uniendo Fronteras congress. However, there is no real progress toward the objective yet. This topic will be discussed again when a new ISRI and a new CONAIPD president will be nominated.