Evaluation of Orthotic Services in the Gaza Strip
Saeda Mohammed Yaqub Albarawi
سائدة محمد يعقوب البرعاوي
Access to orthotic services is very important for people with disabilities to achieve mobility, independence and to fulfil human rights. The purpose of this study is to evaluate orthotic services provided at the Artificial Limb & Polio Center and Hamad Hospital in Gaza. Methodology A cross-sectional study was conducted using quantitative & qualitative methods including surveying 262 participants, and checking their records complemented with a facility checklist and 8 key informant interviews with service providers and policy makers, and 5 focus group discussions with beneficiaries and service providers. Data collection took place in July through August 2020 and was conducted by the researcher herself and a physiotherapist with a response rate 85.1%. Data entry model was designed for quantitative data using the Statistical Package for Social Sciences version 25 program for data entry and analysis and open coding thematic analysis was used to analyze the qualitative stuff. Findings Most of users of the orthotic services were children (83.1%), one third presented with foot problems, followed by Genu Varum/Valgum (19.5%) and cerebral palsy (13.7%). The main reason of disability they are encountered is idiopathic or congenital (71.3%), and they are provided mainly with a ready-made device (70%). The mean satisfaction score about the services they received in general was 3.73/5 which is higher than the satisfaction about device itself (3.2/5). Among participants, 33.8% didn’t show compliance in using their devices, with the highest reported mean score about device was durability (3.83/5), and the lowest mean satisfaction score was about the affordability domain (2.14/5). Regarding quality of life, only 11% elicited a score above 70%. There were no statistically significant variations in satisfaction among the participants in relation to demographic characteristics (gender, age, area of residence), as well as with regard to the number of orthosis received. Only few files (7.6%) included orthotic assessment form, and only (17.6%) included progress notes. Although, 90.1% of referrals showed clear documentation of the request of devices; still records are lacking information and history of patients Both facilities are properly equipped, had adequate stock of materials and tools required for the production of orthotics, and they produce wide range of orthotic devices that are relevant to population’s needs. However, caveats include inadequate motivation, and lack of satisfaction about working status, salaries, recognition, and poor working conditions. Conclusions Orthotic services need further integration into the routine package of health services. Also, it is important to standardize orthotic service through development of guidelines and protocols and increasing coordination and continuity of care in service provision.