Development of high-quality physical therapy practices and rehabilitation in Nepal. A challenge for both male and female

Dhulikhel Hospital (DH) is an independent, not-for-profit, non-government institution with the mission to provide quality health care services mainly to the rural and disadvantaged people. The hospital has extensive outpatient clinical services and 17 rural outreach health centers. DH is a university hospital and runs in collaboration with Kathmandu University for all its medical programs and is the first University to start a Bachelor of Physiotherapy program in Nepal, and a Master program is in development

The Department of Physiotherapy at Dhulikhel Hospital (DH) is the obvious location to expand its existing services to provide rehabilitation needs. The physiotherapists at DH are specialized in different areas such as musculoskeletal, cardiopulmonary, neurological, pediatric, women’s health, and community-based rehabilitation. This team of physiotherapists provides care to a large number of patients in every in-patient department including surgery, general medicine, neurology, women’s health, intensive care unit orthopedics, and pediatrics. The department also runs a complete out-patient service within the premises of DH. The physiotherapists also participate in community care to the patients in remote areas via regional camps.

There is a large unmet demand for physiotherapy services in local Nepalese communities. This unmet demand for physiotherapy in Nepal has become even more problematic following the increased prevalence of non-communicable diseases where many hospitalized patients in the acute phase as well as chronic patients, need physical therapy services.
Nepal is a patriarchal society and women are majorly responsible for taking care of the house, childcare, and fieldwork. Being a patriarchal society the women are not empowered in making decisions for themselves even when it comes to seeking health care for their health problems. Also, the literacy rate is lower in females compared to males in Nepal. Hence, female holds a subordinate position in society.
However in physiotherapy profession more female are involved compared to male, influencing the possibilities to increase our profession.

Need for rehabilitation
In Nepal, there is a limitation of general rehabilitation centers in Nepal. Patients who require ongoing physiotherapy have little to no opportunity for continued rehabilitation. Therefore, patients are being discharged as soon as the acute care terminates. Continued and follow-up care has been intermittent or absent. Patients return home with no support, minimal or no family education, or continuing therapy. This presentation will outline the need to construct, equip, and provide rehabilitation services to the patient. Thereby the Rehabilitation Center will serve as a nexus for training rehabilitation.
Especially short intensive approaches are fitting in the Nepali healthcare system, training the specific goals relevant for the daily activities in patients. Upcoming intervention in the pediatric field is the functional intensive therapy (FiTCare) for children with cerebral palsy.
Emporing parents and especially mother is essential in this treatment.

PhD and Professors
In Nepal at present, female physiotherapists with Ph.D. working in Nepal are approximately 2-3 in number. It is important that the physiotherapy profession have females with higher studies such as Ph.D. as they could play an important role in decision-making related to policies for the physiotherapy profession. In Nepal, if there are more female physiotherapists with Ph.D., then the physiotherapy profession could set a benchmark in a society where there is discrimination in access to higher education in Nepal.