Lucy Montoro Rehabilitation Network mobile unit: an alternative public healthcare policy

The aim is to analyze rehabilitation services provided by a mobile rehabilitation clinic (MU) in nine regions of the State of São Paulo, demonstrating the distribution of orthoses, prostheses and other mobility aids for persons with physical disabilities according to age groups and impairments, as well as the number of persons with physical disabilities as estimated by Brazilian official data sources.

The number of persons with disabilities in each region was obtained through estimations from the 2010 Brazilian IBGE Census. The number of assistive technologies suppliers and technicians were provided by the Brazilian Technical Orthopedics Association (ABOTEC). Patients were referred to the MU by Regional Health Departments. After examination of a multidisciplinary team, assistive devices are prescribed and delivered according to patients' needs. Data on patients were also assessed according to questionnaires on their age, diagnosis, gender, marital status and education level.

From 2009 to 2011, the MU went through 15,000 km providing rehabilitation services through the Public Health System to 1801 patients. Additionally, 3328 devices were delivered in this period. Different age, diagnosis, gender, marital status and schooling profiles are highlighted in each of the analyzed regions.

Data on patients' profiles were made available through services provided by the MU--including the average index of 1.85 devices delivered to each patient and demand projections--which can be used in the planning of public policies. The MU made rehabilitation services more accessible, trained professionals, raised awareness on the correct delivery and use of assistive devices, and identified and organized people's demand in each region. Implications for Rehabilitation Delivering prostheses, orthoses and other mobility aids fulfills the rights of persons with disabilities to personal mobility with the greatest possible independence, as foreseen by the Convention on the Rights of Persons with Disabilities, increasing their participation in society on an equal basis with others. The direct impact of actively reaching out into the community to provide quality rehabilitation services and assistive devices increases the level of access of persons with disabilities to health services and equalizes opportunities. Outreach initiatives to deliver rehabilitation services in the community must include a capacity-building component. Building the capacities of local practitioners and health personnel will further empower both these professionals and persons with disabilities, diminishing attitudinal barriers. Reaching out into the community allows gathering data on the prevalence of health conditions, local need and demand for assistive devices and rehabilitation services, and informs decision-making.