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Sunday 17 May 2015

Benefits Of Improving The Physiotherapy Situation In Nepal

In Nepal, physiotherapy is a relatively new profession compared to more developed countries.  Physiotherapy training did not exist before 1980's (World Confederation of Physical Therapy (WCPT) file).  Because of the rising number of children with disabilities, few international nongovernmental organisations investigated the needs for services for people with disabilities.  As a result, it was decided that Nepal needed rehabilitation centres to help people with disabilities and training for local people to become physiotherapists.   However, the programs were at certificate or diploma level.  The curriculum was based on the western physiotherapy curriculum and taught in English by western physiotherapy as there were no local physiotherapists available at that time to contribute their insights.  Recently, teaching was taken over by local physiotherapists with a support of expatiates from various countries. In 2009 another significant change occurred in physiotherapy education in Nepal.  Kathmandu University with help of ASPN and Dhulikhel Hospital established four-year degree courses in physiotherapy.  In addition, to increase the number of local teachers, KU sent Nepalese's physiotherapists abroad to gain higher degrees in physiotherapy. However, the curriculum in university schools of physiotherapy was based on a curriculum designed in developed countries where the needs of patients and their cultural backgrounds might be different from those of Nepalese patients and local teachers working currently on the curriculum to design it to fit into Nepalese culture and patients' needs.
The Nepali Physiotherapy Society was established and with other Nepali physiotherapy organisation they are the professional body for physiotherapists in Nepal.  Their  aim to support their members and help them to provide reasonable standards of patient care.    In 2004 NEPTA  became a member of the World Confederation of Physical Therapy.  This membership of international organisations may change the attitude of the Nepalese public and may influence the government's attitude towards physiotherapy professions. Nepalese therapists work in governmental and non-governmental health settings, mainly in general hospitals, rehabilitation centres, out-patient clinics and home.  In some clinical settings in Nepal, physiotherapists may not involved in assessment and evaluation of patients and were not expected to do much more than apply some form of heat, massage or electrical stimulation on the prescription of a physician.  As yet, there is no specialisation within physiotherapy, with most physiotherapists treating a range of conditions from with back problem to stroke patients.  This is may be because there are limited continuing professional development programmes, although a few physiotherapists have had the opportunity to travel abroad to attend special courses and training.  Accordingly, there is urgent need to change the situation of physiotherapy in Nepal in order to provide high quality services for Nepalese people who use our physiotherapy services, this also may help to change public and government attitudes toward the profession, consequently increasing the autonomy of physiotherapists.
There should be continual development to improve the services, in this brief paper I am presenting the benefit of improving the physiotherapy situation and education in Nepal:
 Community benefits:
  • Nepal becomes more consistent with world in rehabilitation (globalisation).
  • Nepalese's medical doctors can concentrate on their job and not interfering with physiotherapy business.
  •  Nepalese's people will work longer, happier and increasing economic growth for Nepal.
  • Medical costs decline by decreasing injuries, surgeries, medication use, imaging needs etc.
Patients' benefits:
  • Improve patients quality of life
  • Provides better care for patients
  • Prevention of injuries or permanent disablement
  • Slower deterioration of chronic problems
  • Patient gets fair treatment to a higher standard
Physiotherapy profession benefits:
  • Improve the economic situations of physiotherapists and their families.
  • Allows access to international assistance and recognition by international professional bodies.
  • Allows development of high degree in physiotherapy in Nepal(Masters, Doctorate degrees)
  • Will allow for an advisory role in education and regulation of physiotherapy
  • Organizing conferences/events for networking and knowledge exchange between therapists
  • Allows for better communication between physiotherapists, government and other organizations
  • Central contact for physiotherapists for information
  • Advocate for the profession of physiotherapy (patient information regarding services and diagnosis).
  • Improves the ability of the therapist to do their job properly
  • Expands the knowledge base of the physiotherapist
  • Improves the skills of the physiotherapist
  • Improves the attributes of the physiotherapist
  • Improve teamwork in the healthcare setting
Conclusions: In order to provide better quality services for people with disabilities and receivers of physiotherapy services in Nepal,there are urgent need to change the management, quantity and the quality of physiotherapy in Nepal. This will benefit the community, patients and physiotherapy professions.