Combining Research and Practice: Towards a Digital-first Model for Rehabilitation – A year in DIRECT

The biggest challenge for western companies, in the context of global opportunities, is that many of the products and services available are mostly designed for the high-income societies’ health system. To create new business opportunities in untapped or new environments in LMICs, a deep understanding of the local context and the unique challenges and needs is important. Thus, the initial focus was to identify stakeholders we can collaborate with. In research, the objectives were to understand the healthcare system, existing digital solutions, health care professionals, including community-based volunteers, and service users’ views about using such services, and the overall rehabilitation needs. In addition to understanding the possibilities of exergaming gaming in the context of special education.

Through interviews and surveys in Rwanda, we sought to understand the accessibility and availability of rehabilitation services, the most common rehabilitation needs, professionals and service users’ experiences of using Physitrack during the pilot launch of their existing solution and other digital rehabilitation/health solutions. Additionally, we are collaborating with a special education institution in Finland to examine our other partner company’s solution. The main objective is to investigate teachers and students’ experiences of exergaming and what it means in the special education context. Based on the findings, we intend to replicate the research in other settings or contexts in future to gain a better understanding of the needs. The findings from the initial research activities in Rwanda highlighted professionals’ perceptions of the system, respondents’ intentions to continue using the system, the challenges in access to rehabilitation services, the need for outreach programs about rehabilitation, and additional innovative solutions that augment existing health care activities in Rwanda.

From basic to applied research

The research results in the first phase of the project are meant to inform development of context-specific digital services that are tailored to the specific needs of the population and the healthcare system. Services that are affordable, user-friendly, and widely accessible and enable companies to offer practical solutions to existing challenges in low-resources settings. Many countries in sub-Saharan Africa, including Rwanda, have community-based health as the primary level of the health care system for most of the population.

Community health workers play a crucial role in providing primary health care to communities in low-resource settings; they are the first point of contact to the health system and thus crucial to achieving universal health coverage, making them a viable approach to promote digital rehabilitation. However, integrating digital solutions into existing community-based care systems and throughout the entire health system requires an evidence-driven model to ensure successful implementation. Thus, the second phase of the project focuses on creating a digital path connecting the lowest level of the health system, community-based health volunteers, and other health professionals with rehabilitation specialists across the health system in Rwanda. This entails setting up a test environment where we equip community-based volunteers, health centres and other professionals with appropriate devices, offer licenses and training for the digital solution/s and then investigate the interactions and their potential outcomes. This is line with the World Health Organisation’s Rehabilitation 2030 Initiative to strengthen health systems by integrating rehabilitation into all levels of health care.

Following the findings from the second phase, we will generate actionable insights related to the project’s overall goal of developing a digital-first rehabilitation model. These insights will tie specific opportunities arising from health professionals, community-based health volunteers and other service users’ needs and relate to our partners’ objectives of expanding their services to low-resource settings. In the long run, there is a need to investigate the effectiveness of such digital rehabilitation interventions in terms of health and well-being improvements and adoption by professionals and service users.