Abstract
Background: This qualitative study addresses the critical challenges within the rehabilitation services sector in Guyana, where disparities in healthcare access and quality are prominent. Guyana's diverse socio-economic landscape presents unique barriers that prevent equitable access to rehabilitation, particularly for populations in rural and underserved areas. By examining the interplay of cultural, systemic, and resource-related factors, this research aims to uncover the root causes of these disparities. The study leverages local insights to propose targeted interventions, striving to create a more inclusive and effective rehabilitation sector in Guyana.
Approach: In collaboration with the Breadfruit Collective and the Ministry of Health in Guyana, this initiative brought together physiotherapists and individuals with disabilities for a series of qualitative interviews. Engaging a total of eleven participants six physiotherapists and five patient ;the study was anchored in community-based participatory research methods. This approach ensured that the voices of participants shaped the development of solutions, emphasizing Personal and Public Involvement (PPI) and co-design to align closely with the cultural and contextual nuances of the community.
Results: Our study uncovered significant disparities in the perception and delivery of rehabilitation services across Guyana. Healthcare providers identified substantial training gaps, compounded by systemic gaps in support and resources, which hindered their ability to deliver culturally competent care. Conversely, patients reported a notable lack of personalized and collaborative approaches in their treatment, highlighting a disconnect between the services provided and their actual needs.
Enhancing these findings, patients who had access to high-quality physiotherapy shared overwhelmingly positive experiences. They emphasized that their physiotherapists were attentive and actively engaged, validating their experiences and focusing on their specific needs. This patient-centered approach significantly improved their conditions and overall well-being.
On the provider side, physiotherapists who benefited from strong mentorship and support reported a marked improvement in their ability to handle complex cases. This supportive environment was essential, providing them with the confidence and resources necessary for effective and empathetic care.
These insights underscore the crucial role of supportive and attentive relationships in rehabilitation. They highlight the urgent need for enhanced training and mentorship programs, as well as fostering a culture of patient-provider collaboration, to bridge the gaps between current practices and patient-centered care, ultimately improving the quality and effectiveness of rehabilitation services throughout Guyana.
Implications: The insights from this study highlight an urgent call for a paradigm shift towards more inclusive and community-driven healthcare models in Guyana. Advocating for the integration of culturally sensitive and community-engaged strategies within local health policies and rehabilitation services is essential. Looking forward, this research will inform policy reforms and guide the development of targeted interventions, aspiring to serve as a model for enhancing healthcare equity in similar socio-cultural settings. Aligned with the NACIC2024 theme of "Community-enabled population health and wellbeing," this research directly engages with the second and third pillars of Integrated Care, emphasizing the importance of grounding health care in local context and collaboration with community partners.