Rehabilitation needs at rural primary health care settings: perspectives of health center nurses in Burera district of Rwanda.

Abstract

Background: Resource-limited countries face challenges of integrating rehabilitation services into primary healthcare. This is always hindered by many factors such as poor healthcare policy, a shortage of healthcare providers, limited knowledge among healthcare providers, and resource constraints. This study aimed to understand rehabilitation needs in primary care and explore current management practices for rehabilitation services in primary care with the goal of generating evidence to inform policies and interventions for the improvement of rehabilitation services at primary care.

Methods: The study used a descriptive qualitative study design. Data collection involved the focus group discussion (FGD) of ten health nurses from Burera District, each nurse had a minimum of one year of working experience in the outpatient services at health center. A semi structured interview guide was used during data collection to explore rehabilitation needs at primary care and to understand the current management practices of disability cases presented at health center. The data were analyzed thematically by the research team.

Results: Data analysis revealed three major themes: Nurses' understanding and experience with rehabilitation services. Disability cases presenting at the health center and their unmeet rehabilitation needs, and Navigating the current management practices of disability cases at rural health centers. Participants stressed the need for rehabilitation services by mentioning disability cases that need rehabilitation encountered at health centers. However, rehabilitation services for such disabilities are very limited at all health centers. The current management practice showed rehabilitation services that are available at few health centers such as mental and primary eye care services. In addition, participants emphasized limited involvement of nurses in rehabilitation service delivery.

Conclusion: The integration of rehabilitation services in primary care is crucial to ensure rehabilitation services for all. However, this demands strategic resource distribution, to establish rehabilitation services with specialized rehabilitation professionals at all health centers. In addition, task sharing to involve nurses and community health workers in rehabilitation service delivery at primary care will increase service availability. Furthermore, implementation of community-based rehabilitation is crucial for enhancing service accessibility and utilization mainly in rural settings.