Relevance of

Physical Rehabilitation
as a health service
Solomon Fasika Demissie MSc. PT
Lecturer
Physiotherapy Department
University of Gondar

04/24/2024 1
 Morbidity statistics related to
physical rehabilitation
• According to estimates of the WHO 2011;

– 17.6 % of a population of Ethiopia may have

disabilities

– This could imply that Ethiopia, with a population

of some 90 million, could have as many as 15.8
million persons with disabilities

04/24/2024 2
• The majority of these are people with physical
disabilities,

• All of them could need physical rehabilitation

interventions

• The maximum number of physiotherapy

practitioners in Ethiopia, to be 364
04/24/2024 3
 Physical rehabilitation service in
Ethiopia
• The physical rehabilitation services available in
the country are limited and concentrated in
the urban centers

• Especially, people with disabilities living in

rural areas can scarcely access physical
rehabilitation services

04/24/2024 4
What is the role of physiotherapy?
• Do we think about the great gift we have
(to move, bend, lift, throw or push etc….without limitation)

• An injury or illness can take away those abilities

• How can we maintain, restore and regain physical

strength and function?

• Treating a simple ankle sprain or to help a stroke

survivor walk, talk and eat again
04/24/2024 5
 Challenges of physical rehabilitation in
Ethiopia
• Lack of basic therapy equipment
• Limited assessment tools
• Physical space
• Human power limitations (physiotherapists and others)
• Overall system limitations
– poor organization,
– lack of autonomy for rehabilitation professionals,
– disorganized referral systems
• Less attention from the health service,
– MoH needs to take more responsibility in rehabilitation matters

04/24/2024 6
 Mission statement , MoH. HSDP IV;
(2010 – 2015)
• “To reduce morbidity, mortality, and disability
and improve the health status of the Ethiopian
people through providing and regulating a
comprehensive package of promotive,
preventive, curative and rehabilitative health
service via a decentralized and democratized
health system”. (FMOH. HSDP IV 2010)

04/24/2024 7
 Gaps in physical rehabilitation
• There is no further declare in the HSDP IV document of;
– how rehabilitation services specifically, are to be provided
within the health system

• In the latest EHRIG launched in May 2010;

– Physical rehabilitation is again noticeable by its absence from
the hospital structure

• This is in contradiction to the mission statement above

• However, the gap was filled during the 2012 Ethiopian

standard, hospitals requirement
04/24/2024 8
 Possible recommendations
• Improve the accessibility of service in physical
rehabilitation sector

• Expand the physical rehabilitation service to

meet the need

• Improve the service of existing hospitals to

provide quality physical rehabilitation services
04/24/2024 9
• Create an essential Collaboration with other
sectors (e.g. DPO, professional associations)

• Raise awareness about physical rehabilitation

services at different level

• Improve the Human resources development and

training (e.g. University has role)

04/24/2024 10
• To ensure the quality of service is at
acceptable levels

• To develop a quality control system

– e.g. FMHACA

04/24/2024 11
 Good practice
• In 2003, Physiotherapy education started as first of its
kind in Ethiopia
• In the presence of many challenges;
– The development of Physiotherapy training has changed the
access to rehabilitation service in Ethiopia
• In 2005, CBR service started at University of Gondar
– The CBR program is increasingly known and able to reach the
rural community
• However, a structural embedment in the health system is
lacking
• Still people in the more rural areas have little or no
access to rehabilitation service
04/24/2024 12
 References
1. Arasho, B. D. Mehila, Z. Bernhard, S. Zenebel, G. (2008) ‘Neurology Training and
Practice in Ethiopia’ Sudanese Journal of Public Health, 3 (2), 49- 60
2. Biruk, L. W. (2006) ‘Permanent Civilian Musculoskeletal disability following injury-
17 Year trends.’ East and Central African Journal of Surgery, 11, 41- 48
3. Bower, J. H. Zenebe, G. (2005) ‘Neurologic services in the nations of Africa.’
Neurology, 64, 412–415
4. Japanese International Cooperation Agency (2002) ‘Country Profile on Disability:
Federal Democratic republic of Ethiopia.’ JICA
5. Menken, M. Munsat, T. L. Toole, J. F. (2000) ‘The global burden of disease study;
implications for neurology.’ Archives Neurology, 57, 418-420
6. Tirussaw, T. (1998), Persons with Disabilities of High Achievement Profile in
Ethiopia, Radd Barner.
7. United Nations Children’s Fund -UNICEF (1988), Rehabilitation International
Technical Support Program to Prevent Childhood Disabilities and to Help Disabled
Children Vol. 7, UNICEF.
8. World Confederation for Physical Therapy (2011) ‘Policy statements.’ WCPT

04/24/2024 13
 Thank you

04/24/2024 14