Sustainable and Interdisciplinary Rehabilitation Services for Persons with Severe Disabilities in Binh Dinh and Quang Nam Provinces (HOLD MY HAND)

The project was funded by USAID with a total value of US $1,993,592 and was implemented by the Institute of Population, Health and Development (PHAD) as the prime organization and Catholic Relief Services (CRS) as a sub-grantee. The project focused on two main objectives: to deliver home-based care (HBC) for 600 persons with severe disabilities in Binh Dinh and Quang Nam province, and to strengthen 10 interdisciplinary rehabilitation service units at provincial and district hospitals in Binh Dinh province. The project was structured and approved with a total of 19 milestones and project deliverables for three years, starting on August 14th, 2018, to August 13th, 2021. Despite facing challenges in obtaining government approval and the COVID-19 pandemic, the project achieved its objectives and targets. Key results included the provision of home-based care for 630 persons with severe disabilities, exceeding the project target of 600, and the improvement of rehabilitation services and systems in provincial and district hospitals in the two provinces. Additionally, 13 rehabilitation units in Binh Dinh province improved their capacity for providing interdisciplinary rehabilitation services, exceeding the original target of 10 units. The project also contributed to the development of occupational therapy (OT) and speech therapy (ST) professions, providing training to 32 rehabilitation therapists and 209 rehabilitation service providers and health management staff on gender-based violence (GBV). A sustainable model for interdisciplinary rehabilitation with physical therapy (PT), OT, and ST services for persons with severe disabilities was strengthened through the development of guidelines on standard operating procedures (SOP) in Binh Dinh. The project made significant contributions to the rehabilitation and health system in Binh Dinh, including service delivery, health workforce development, medical products and technologies, health information systems, and leadership and governance. The project's home-based care delivery was particularly unique and practical for persons with disabilities, who often face challenges in accessing health facilities due to their health conditions, economic status, and lack of personal assistants. Regular monitoring and tracking data revealed that persons with severe and very severe disabilities faced many challenges, but their ability to perform daily living activities (ADL) and functions improved slightly (approximately 20.8%) as a result of the home-based care. Family caregivers demonstrated a great improvement in care skills and frequency of care attention to persons with disabilities, and persons with severe disabilities who had ulcer pressure improved their situations thanks to the improved care skill of their caregivers. Caregivers reported positive impacts from the project, including improved skills, reduced energy and strength expenditure, and increased time efficiency. The project team observed that caregivers found it easier to take care of persons with disabilities thanks to the knowledge and skills they learned, and that the project had positive impacts on both persons with severe disabilities and their caregivers.