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Publication Date

8-11-2011

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Committee members: Dr. Susan DesHarnais, Dr. Kathy Foley, Sanford Barth, PhD, Thomas Jefferson University.

Abstract

Background: The earthquake in Haiti has led to 4000 people with amputations that will require extensive rehabilitation services over their lifetime. For an intervention such as providing prosthetics that is resource intensive, sustainability will play an important role in providing a long term impact. Research that evaluates the sustainability of the prosthetic service delivery model is necessary to identify the attributes that are best suited to ensure that acute and follow up care will be provided to the amputees in a coordinated manner.

A prosthetic clinic was started in Milot in response to the earthquake in Haiti. Through the evaluation of this prosthetic clinic delivery and financing model, this study proposes to identify the barriers to improve delivery of care. The results of this study will be used to recommend strategies for establishing prosthetic clinics in low-resource settings.

Research Design and Methods: Logic model methodology was used to evaluate sustainability of the clinic. A mixed methodology was used to collect data such as direct observation, qualitative and quantitative research methods. Barriers were identified in relation to provision of sustainability. Recommendations were developed to address the key barriers that were identified.

Results: Recommendations were outlined to address the barriers such as technical performance, continuity of care and access: redesigning data infrastructure, improving patient discharge education, building a rehabilitation infrastructure and improving follow up of patients. An implementation plan for each strategy was outlined.

Conclusions: The recommendations for improving sustainability are currently being adopted by the prosthetic lab management to change delivery of care.

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