« Challenges of the Sustainability of physical rehabilitation sector »

1. «  Challenges of the Sustainability of physical rehabilitation sector  » Participants’ expectations January 24-29, 2013

2. Short synthesis of the Participants composition 40 participants are expected: From 21 different countries: 3 from Europe 8 from Africa 9 from Asia Australia 5 14 20 1

3. Short synthesis of the Participants composition 40 participants 14 HI Field staff 17 Partners 9 Facilitators invitees 35 % 43 % 23 % 30 Men 13 Women 70 % 30 %

4. Synthesis of the Participants feedback 33 presentations received from the participants 84 suggestions have been analysed :

5. Participants’ experiences 10 10 2 18 Titre du document

6. Expectations Synthesis Sustainability determinants 1 Actors’ roles in Sustainability 2 Sustainability in its environment 3 Sustainability of Rehabilitation in its system 4 Components of sustainability 5

7. Expectations Synthesis Sustainability determinants 1 19 references in 12 forms : « What are the most essential factors to enable sustainability?” « Finally, what are the policies and practices needed to ensure the sustainability of rehabilitation services?” “What are the determinants of sustainability, and how do we facilitate them?” « What are the conditions necessary to set up successful framework for rehabilitation centre handover ?”

8. Expectations Synthesis Actors’ roles in Sustainability 2 23 references in 13 forms: “Strategy/ies to mobilize other relevant actors (health, professional association, local authorities, services users, private company…) into the handover process?” « The seminar may define cooperation modes between stakeholders : Government, Private sector and international organization (HI) in the technical and financial aspects, for the projects sustainability »

9. Expectations Synthesis Partners “How to build a lasting relationship with differents Partners » “How to ensure the partners allocate equal resources to the places where is more necessary?” Users representatives “How people with disabilities are included in decision making process” “Should we consider internal initiatives in our country supported by civil society organizations (DPOs) more demanding?”

10. Expectations Synthesis Donors “How donors are positioned with respect to the sustainability of services?” International organizations “Are international organizations strong enough or willing enough to define strict Sustainability time bound and to respect the time frame for exit action plan?” “Sustainability of rehabilitation services in perspective of WHO and other Organizations.” “What is the role of HI among other stakeholders and its contribution to build sustainable services? In particular, what is our role when engaging with users, policy makers and service providers?”

11. Expectations Synthesis Sustainability in its environment 3 6 references in 6 forms: “How to adjust sustainability to the specific context and constraints of each country ?” “What are the limits in our capacities and the limits in the external environment that we should be able to identify to reach attainable objectives?”

12. Expectations Synthesis Sustainability of Rehabilitation in its system 4 5 references in 4 forms: “what factors are needed for improved coordination of physical rehabilitation systems within broader health and social systems?” “To what extent is linkage with mainstream health services related to sustained rehabilitation services?”

13. Expectations Synthesis Components of sustainability 5 Financial aspects 7 references in 6 forms: “Is it realistic to say that physical rehabilitation sector in developing countries could be financially sustainable?” “what should be sustainable way of financing rehabilitation services (in context of low income countries like Nepal?”

14. Expectations Synthesis Plan / monitoring of Sustainability 7 references in 7 forms: “Which benchmarks to build sustainable services do we consider essential while operating in complex or rapidly changing environments?” “How to plan for a sustainable P&O service in Sri Lanka” Sustainability & Quality 4 references in 4 forms: “Do we sometimes sustain poor services? Is that ok?” “What are the main indicators on sustainable professional development in regard to quality VS access to rehabilitation services?”

15. Expectations Synthesis Sustainability and exclusion “How to ensure long term sustainable rehabilitation services for people with disabilities who cannot afford it by themselves?”

16. Conclusion