Soins de réadaptation à base communautaire au Sénégal : quand le numérique améliore l’accès et la qualité des services

Introduction

Evaluation of the implementation of a telerehabilitation for community-based relays (CBR) trained to care for children with cerebral palsy and their family (CP) in Senegal.

Methodology

Prospective observational study comparing 2 rehabilitation usual care procedures for children with CP, accompanied by CBR: telesupervision group (TSG) and no telesupervision group (NTSG). The TSG benefited from remote monitoring, via 5 telesupervision sessions, one session every 6 weeks, while the NTSG benefited from the usual CBR monitoring.

Results

Thirty-nine children were included in the study, including twenty in the telesupervised group. Mean age 8.44 years, 69% GMFCS V, 72% malnourished and 64% below the poverty line. In both groups, children improved their GMFM score, autonomy and nutritional status. Compared to the initial situation, a significant improvement in dressing function was observed in the TSG (P = 0.019). Telesupervision improved the CBR's technical, ethical and communication skills (P ≤ 0.0001), as well as the families theoretical knowledge and body care practice (P = 0.002, P = 0.008). Telesupervision reduced distances travelled, duration of care and financial costs (P ≤ 0.0001).

Conclusion

Telesupervision is a solution to the lack of qualified rehabilitators in Senegal. It reduces costs, improves family involvement and CBR skills. The system is simple, accessible and meets the standards of evidence-based approaches.