Full project title:
Inclusive Medical Rehabilitation for Persons with Disability due to Leprosy, Lymphatic Filariasis (LF) and Diabetes Mellitus (DM) in Indonesia
Project coordination
Netherlands Leprosy Relief Indonesia
Partners
Diponegoro University Semarang (Indonesia)
VU University Medical Center (the Netherlands)
Aim: This study has systematically and comprehensively collected information about enabling and disabling factors influencing the successful provision of inclusive medical rehabilitation services for persons with disability due to leprosy, lymphatic filariasis and diabetes mellitus. Knowledge and models that are generated from this research will be used for advocacy and to improve services.
Final project summary
Medical rehabilitation in Indonesia is still limited in its availability and accessibility to the majority of people needing it. For people living in poverty, lack of information and insufficient insurance coverage are only some of the barriers hindering access to medical rehabilitation. Persons affected by neglected and socially stigmatised diseases such as leprosy are still rejected in many hospitals in Indonesia. Diabetes Mellitus (DM) as a modern lifestyle disease is more and more common also in rural areas. Prevention and care of wounds is not usually part of rural health centres, while on the other hand the same services are generally offered to persons affected by leprosy in the same centres. There is, thus, a need to develop and improve inclusive medical rehabilitation services for all.
This study set out to map the existing gap in accessibility, availability, acceptability and quality of rehabilitation services in Indonesia. This was done from the perspective of persons most excluded and poor – persons disabled by leprosy and by lymphatic filariasis (LF). Persons with disabilities due to diabetes were also included to explore how services can be combined and become more comprehensive. Data was collected both from affected persons and from different service providers, using several quantitative and qualitative methods. Persons affected by leprosy participated in data collection and in analysis.
Generally, results of data collection showed different perceptions on providing integrated service for leprosy, LF, and DM. Health professionals agreed that health care for the three diseases could be done in one place, especially for wound care. It will also enhance the awareness of other patients about each other’s diseases. Although the two leprosy referral hospitals had been providing medical rehabilitation for leprosy and DM patients, such as: surgery, amputation, physiotherapy and providing the daily activities aids, they had no experience in providing medical rehabilitation for LF. Respondents agreed that providing care to the three conditions will save costs. However, there was also some fear on the possibility of disease transmission and stigma. Moreover, there was also limited human resources to provide rehabilitation in one place. Results indicate there should be a clear task division between units and facilities.
Impact
Denny HM, Darmawan Y, Ginandjar P, Widjanarko B, Sriatmi A, Umamah A, Sakundarno M, Prasetyanti W (2019). Inclusive medical rehabilitation for persons with disability due to leprosy, lymphatic filariasis, and diabetes mellitus: Mapping the gap in three leprosy endemic districts in Indonesia. BioRxiv, pp. 1-14