Update from the ISPRM WHO Liaison Committee

Chair: Carlotte Kiekens
President’s Cabinet Liaison – WHO Focal point: Walter Frontera
Secretary: Vanessa Seijas
Advisor: Christoph Gutenbrunner

Scope of the ISPRM-WHO-Liaison Committee

Since 1999 ISPRM has held an official relationship with the WHO as a non-State actor and collaborated with the Disability and Rehabilitation (DAR) team. As a Non-Governmental Organization (NGO), ISPRM has to contribute substantially to WHO activities according to agreed and accepted collaboration plans, including the participation of ISPRM in WHO meetings and collaboration in the network of WHO partners.

For the last eight years this committee was led by Christoph Gutenbrunner who, with the support of Boya Nugraha as Secretary, did an excellent job. I am very honoured to have been given the opportunity to take over this responsibility since last summer. Furthermore I can announce that very recently we appointed our Colombian colleague Vanessa Seijas as the new secretary to the committee.

In October we finalized the new collaboration plan (2018-2020) between WHO and ISPRM. This will contribute to the implementation of Sustainable Development Goals (SDG), especially the SDG 3 (Health) with a focus on persons with disabilities, and persons who have short- or long-term disabling health conditions. The collaboration plan will concentrate on the implementation and dissemination of WHO tools that contribute to the integration of rehabilitation in universal health coverage and to achieving the goals of “Rehabilitation 2030: A call for action”, the WHO Global Disability Action Plan 2014-2021 and the World Health Assembly (WHA) resolution on improving access to assistive technology.

The current committee organigram has two main pillars.

The first one aims to Strengthen rehabilitation and the specialty of PRM across the world, and more in particular in low and middle income countries. Upon request from the WHO, this group will provide support in implementing and in disseminating the WHO Support Package for Rehabilitation. Moreover it will support WHO in the development of a package of rehabilitation interventions for health conditions. There are two working groups. Wouter De Groote chairs one on “Capacity building” and Luz Helena Lugo Agudelo leads the group working on “Rehabilitation in primary care”.

The second pillar aims to Standardize rehabilitation reporting. This goal will be achieved by means of three projects.

  1. Promoting ICF implementation in rehabilitation clinics including the development of ICF clinical tools and preparation for international data collection trials (Chair: Masahiko Mukaino).
  2. Learning Health System for Spinal Cord Injury (LHS-SCI) – a joint effort of ISCoS and ISPRM to implement the recommendations of the International Perspectives on Spinal Cord Injury (IPSCI). An International Spinal Cord Injury (InSCI) Community Survey will provide the epidemiological basis for the LHS-SCI. Further steps in this joint endeavor include stakeholder dialogs and policy briefs. (Chairs: Christoph Gutenbrunner and James Middleton; coordinator: Christine Thyrian.
  3. Development of an International Classification of Service Organization in Rehabilitation (ICSO-R) (Chair: Christoph Gutenbrunner).

Participation in WHO meetings

This fall the ISPRM-WHO-Liaison Committee participated in two regional WHO meetings.

First, “The 68th session of the WHO Regional Committee for Europe” was held in Rome in September 2018. Boya Nugraha and Carlotte Kiekens participated on behalf of ISPRM.

ISPRM prepared a statement with regard to Agenda item 5b: “Implementation of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy framework for health and well-being, and review of the joint monitoring framework.”

You can read the statement here.  The statement was read by Boya Nugraha in a video-recording that it is included on the WHO website:

We summarize some of the highlights of this meeting:

We noticed that, in contrast with other parts of the world, in Europe little to no attention is given to rehabilitation, even though there was the Rehabilitation 2030: A call for action. However we were able to make some contacts within WHO as well as with other non-State actors and hope to collaborate to increase the importance of Rehabilitation, also in Europe.

Secondly, in October our committee participated in the “The 69th session of  the WHO Regional Committee for the Western Pacific” in Manila. There, ISPRM was represented by our colleague from The Philippines Reynaldo Rei-Matias. Rehabilitation was an explicit agenda point and ISPRM was the only NGO given the opportunity to give an oral statement that you can read here and you can view below:

https://www.facebook.com/ISPRMsociety/videos/196045554624630/?eid=ARAijvCtv4QlJwkTmh6p6F7C63v_NGZVWB-HDbXyLRe7Y1ocgK7nXP4_6n86Bmq3bfDy5TDR_zLmy2Cd

The main points of discussion were:

  • Removing barriers and improving access to health services and programs
  • Strengthening and extending rehabilitation, assistive technology, and community-based rehabilitation
  • Existing funding not adequate to meet the large unmet rehabilitation needs including assistive technology
  • Strengthening collection of relevant and internationally comparable data on disability and support research on disability and related services

Key conclusions and priority areas for action were the following:

  1. Ministries of health are on the way to fully identifying and addressing barriers experienced by persons with disabilities when accessing general health services; a more systematic and strategic approach is encouraged.
  1. There is very limited rehabilitation available in most lower and upper middle-income countries even though it is an essential health strategy; it is suggested that rehabilitation requires more significant planning and investment by ministries of health.
  1. Provision of assistive technology is inadequate; stronger leadership, financing and development of comprehensive programs that include a wide range of technology are encouraged.
  1. Community-based rehabilitation remains an important strategy for increasing access to services in lower and upper middle-income countries, yet programmed management and evaluation requires development; governments are encouraged to increasingly fund and support programs with a strong community focus.
  1. The Pacific island countries experience particularly large deficits in rehabilitation services and many governments are experiencing ongoing challenges to respond; political prioritization and collective action at national and Regional levels are suggested to strengthen both central and community-based services.
  1. The rehabilitation workforce is limited and can be weak, contributing to the slow development of rehabilitation services; greater knowledge, attention and action to address the specific challenges of the rehabilitation workforce are suggested.
  1. Good-quality, comparable disability data are limited and often under-utilized; knowledge, planning and better utilization of disability data are suggested.
  1. People with disability play an important role in change; increased engagement of people with disability and their representative organizations in health planning and delivery is required.

Further to the regional meetings, on 25-26 October 2018, a Global Conference on Primary Health Care took place in Astana, Kazakhstan, to renew the Alma-Ata Declaration of 1978, a commitment to primary health care to achieve universal health coverage and the Sustainable Development Goals. The Global Conference endorsed a new declaration which emphasizes the critical role of primary health care around the world, refocusing efforts to ensure that everyone everywhere is able to enjoy the highest attainable standard of health: The Declaration of Astana. It is stated that promotive, preventive, curative, rehabilitative services and palliative care must be accessible to all, through the life course.

Our President, Walter Frontera represented ISPRM and participated in three events dedicated to the development and implementation of rehabilitation services at the primare care level, rehabilitation for older persons, and the development of multidisciplinary rehabilitation teams.

Steering Group of the WHO Rehabilitation Competency Framework

Lastly, we are very happy to announce that two ISPRM representatives have been selected to be part of the Steering Group of the WHO Rehabilitation Competency Framework. This Framework has been set up within the vision of the WHO Workforce 2030 Strategy and Rehabilitation 2030 with the aim to develop a strong multidisciplinary rehabilitation workforce that is suitable for country context, and promote rehabilitation concepts across all health workforce education. Both Rochelle Dy, Chair of the ISPRM Education Committee and Maria-Gabriella Ceravolo, President of the European Board of PRM will be members of the steering group on behalf of ISPRM.

On behalf of the members of the committee I wish you all a very  happy and productive 2019. We are looking forward to share our work with you in Kobe,

Warm season’s greetings,

Carlotte Kiekens