The population of India crossed the one billion mark a long time ago and with expanding population, comes issues of health. At present, the entire public health expenditure is about 30%. This includes both curative and preventive services along with other miscellaneous elements.
When it comes to physiotherapy or community-based rehabilitation, the public of the country tends to prefer it. One reason for it is the economic value CBR provides as compared to institution-based rehabilitation.
CBR is not new to the nation; it has been prevalent for decades. Skilled professionals have been offering rehabilitation across the land in some health conditions. To name a few:
• trained caregivers for stroke
• trained workers from community for psychosis,
• speech-language pathology services for children with cleft palate
• ophthalmologist trained community workers for the blind
• trained workers for persons with disabilities
• medical staff for neuritis
• home care advisors who were supervised by a counsellor
• a psychiatrist for dementia
• leisure specialists for spinal cord injured community dwellers
• mental health workers trained from the community for schizophrenia
• community health workers for the acute coronary syndrome
• for other health conditions such as rehabilitators for stroke survivors
While much has been done in the field, the scope of improvement is still massive. One model that can help integrate physiotherapy services at the community level, as well as the institution level, is explained below. The model hopes to create a more holistic method of treatment for communities.
For a patient, the primary mode of contact is the hospital. Using the patient, a physiotherapist then makes initial contact with their community. It means we need to build an institution level first contact of patients. When they come in for preventive or curative services, an inward chain that moves towards the community of the patient can be created. This chain can then be used for community-based rehabilitation.
The chances are that such a practice is already present in a lot of countries, especially India. But there are no publications and documentation surrounding it. Those are needed to understand if the model is truly feasible or not. If it turns out to be ineffective, a new method will need to be built to promote CBR.
The good news is that community physiotherapy is an emerging field in India. It signifies that rapid developments in this field have been made over the past few decades and more is yet to come.