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REPs

Rehabilitation Professionals (REPs) for stroke care in China and India A comprehensive Mixed-methods Evaluation

 

REPs would help in developing a white paper for China and India on strategies for harmonizing, developing and managing the rehabilitation workforce for not just stroke care but for the care and support of people affected by any chronic conditions in similar settings like China and India.

The REPs team

Amy Unwin

Amy is a Physical Medicine and Rehabilitation resident at the University of Washington with an interest in global rehabilitation.  She took a year off during her medical education at Indiana University to participate in the Fogarty Global Health Scholars Program in Lima, Peru.  Her work in Peru included conducting a novel assessment of rehabilitation infrastructure in the country and coordinating multiple interdisciplinary stroke rehabilitation workshops at national neurologic and rehabilitation centers in Lima.  She is eager to leverage her experience and gain new skills to continue to work on improving rehabilitation systems and reducing disability from cerebrovascular disease worldwide.

Dorcas Gandhi

After completing Masters in Physiotherapy, he had the opportunity to work among those with developmental disorders, stroke, Spinal cord injuries, etc through an NGO. The challenges faced by the community due to lack of basic resources were evident and this drove his desire to generate and implement newer ideas and ways of community-based Neuro-rehabilitation. He was blessed to be part of the ATTEND trial where he was given the responsibility to train and supervise 14 hospitals across India in task-oriented, home-based and caregiver-led, a rehabilitation plan for stroke patients. His present fellowship study is exploring the use of a computer game based rehabilitation platform for upper extremity rehabilitation after stroke.

Hariklia (Harriet) Proios

Hariklia Proios obtained her B.A. in Speech Pathology and Psychology at Hofstra University, NY, and continued to earn a Masters and a doctorate degree (Ph.D.) in Speech and Language Pathology from Columbia University in 1993. She taught at the Dept. of Communication Sciences and Disorders of Montclair State University in NJ as Assistant Professor, in the area of Adult Aphasia, and received tenure in 12/1997. She then left Montclair to work as a Research Associate at the Cognitive Neuropsychology Laboratory at Harvard University and at the Spaulding Rehabilitation Hospital. In 2000, she became a research affiliate of the Neuropsychology Unit, of the Department of Neurology, at the University Hospital of Zurich. Since 2014, she is an Assistant Professor of Neurocognitive Disorders and Rehabilitation at the Department of Educational and Social Policy of the University of Macedonia, in Thessaloniki. Her research interests include adult aphasia, visual hemispatial neglect, and number processing difficulties in aphasic subjects.

Maoyi Tian

Maoyi Tian is a Senior Research Fellow, Program Head of Digital Health working in The George Institute for Global Health in China. He received his Bachelor of Electronic Engineering from the University of York, UK and his MSc of Biomedical Engineering from the University of Oxford, UK. He graduated with his Ph.D. in Biomedical Engineering from the University of New South Wales in Sydney, Australia. He was awarded the MPhil degree in Public Health at The University of Sydney in 2018. His main research focus is on using digital health for cardiovascular disease management and prevention in the primary care setting, particularly the integration of digital health into the existing health care system.

Sureshkumar Kamalakannan

He is a Wellcome Trust DBT India Alliance Research fellow in public health. He works as an assistant professor at Public Foundation of India based at the Indian Institute of Public Health in Hyderabad. He has been working as a clinician, academician and researcher since 2003 in India, Nepal and also in the U.K. He primarily teaches Health systems, policies, epidemiology and Disability. He works closely with the International Centre for Evidence in Disability (ICED) at LSHTM. As a part of his doctoral study, he developed a smartphone-enabled carer-supported educational intervention for management of physical disabilities following a stroke in India. This intervention was named as ‘Care for Stroke’. He has an undergraduate degree in Occupational therapy (India), a post-graduate degree in public health, specializing in Health programme management (India) and PhD from the London School of Hygiene and Tropical Medicine (LSHTM – UK).

Susan Marzolini

Dr. Marzolini is a Registered Kinesiologist with a Ph.D. in Medical Science and an MSc in Exercise Science from the University of Toronto, Canada. She is currently the Scientific Associate and Case Manager/Coordinator of the Toronto Rehab/University Health Network’s Risk Factor Modification and Exercise Program for people following Stroke (TRI-REPS). Her aim is to make changes to the way that risk factor modification for secondary prevention of strokes are managed and addressed and dedicated to promoting programming for this underserved population. Her academic career path evolved from her clinical work in cardiovascular rehabilitation and secondary prevention.  Through her membership in various advocacy and partnership committees, Dr. Marzolini pro-motes the optimizing of recovery and health of those with stroke and the alignment of organizations across the continuum of care including secondary prevention, rehabilitation, and recovery. This work includes helping to develop priorities and recommendations submitted to government institutions.

Yulu Shi

She is currently working as a neurologist trainee in Tiantan Hospital in Beijing. Prior to this clinical job, she did her Ph.D. on small vessel disease and stroke at the University of Edinburgh. Her Ph.D. was on investigating the mechanisms of small vessel disease which is an important factor for stroke and dementia using brain imaging methods, and on finding potential targets for the prevention and treatment of stroke and dementia. In her future career, she will work as a stroke clinician and keep on working on stroke treatment and prevention.

Asim Katbeh

Background

Globally around 15 million people suffer from strokes each year and a quarter of them experience permanent disability. Much of this burden is borne by low and middle-income countries. The increase in the prevalence of stroke and stroke-related disability may cause an overwhelming demand for rehabilitation services worldwide. Available data show significant shortages of health workforce for rehabilitation as well as limited availability of essential rehabilitation services for stroke care. Hence a comprehensive evaluation of the rehabilitation workforce for stroke care especially in China and India where 1/3rd (36%) of the world’s population lives and where the resources for rehabilitation are often limited is warranted.

 

Specific aims

  1. To assess how are rehabilitation professions structured in terms of professional training, placement, and practice
  2. To understand how are they integrated within the health system?
  3. To investigate the impact of rehabilitation professionals on the patient and caregiver experience

Methodology

The research study will be conducted in three phases:

Phase – 1: Desk review

To assess the current information related to the research study objective globally and specifically in China and India to understand the existing published literature and report from various relevant sources and utilize it for phase 2 and 3.

Phase – 2: Qualitative In-depth Interviewing

  1. To explore the way in which rehabilitation professionals for stroke care are trained, placed, developed and regulated in China and India
  2. To understand in-depth how these rehabilitation professionals for stroke care are integrated within the health system for the provision of quality care in China and India

Phase – 3: Stakeholder Consultation Leading to a white paper

  1. To identify key stakeholders who could create policy changes for the provision of stroke care through WSO recommended guidelines for rehabilitation professionals in China and India
  2.  To engage the stakeholders in an intriguing consultation process in order to come up with a white paper on opportunities for re-organizing and optimising the rehabilitation professionals for stroke care in China and India