The need assessment exercise was conducted in December 2021 with beneficiaries from HI and partners database who were targeted in the different projects; rehabilitation, education, emergency preparedness, construction and livelihood. The purpose of the need assessment exercise was to identify the need for rehabilitation services for the Gaza population, which will guide HI to develop the future action and approach of rehabilitation service provision and feeding Palestine Rehabilitation strategy. Information was collected via a detailed questionnaire administered through phone calls and home visits from a total population of 682 participants (406 Male and 276 Females), representing ~1.3% of the people with disabilities of the Gaza Strip (PCBS, 2017). Participants were asked to identify the priority for rehabilitation services based on their needs; the barriers faced to access rehabilitation services, evaluate the availability and accessibility of rehabilitation services, and suggest solutions to overcome the obstacles of access to rehabilitation services.
The most significant findings were as follows:
• 23% of participants prioritised MHPSS services based on their needs, while home adaptation was less prioritised with 8%.
• Only 17% reported receiving rehabilitation services, while 83% didn’t.
• 61% of participants don't know about the available rehabilitation services in their locality/ governorate.
• 62.75% of participants agreed that the rehabilitation services respond to the needs of children with developmental delays.
• 63.04% of participants agreed that the rehabilitation services respond to the needs of people with cognitive and intellectual disabilities.
• 64.51% of participants agreed that the rehabilitation services respond to the needs of the elderly with disabilities.
• 51.32% of the participants agreed that they could access comprehensive rehabilitation services through a home-based program "outreach".
• 56.45% of the participants agreed that they could access comprehensive rehabilitation services through a centre-based program.
• 55.27% of surveyed respondents agreed that rehabilitation services provided respond to the needs of children with developmental delays.
• 57.03% agreed that the rehabilitation services respond to the needs of people with cognitive and intellectual disabilities
• 53.66% agreed that the rehabilitation services respond to the needs of older people with disabilities.
• 62.17% of participants agreed that persons with disabilities have equal access to the MHPSS sessions compared to the general population.
• 62.18% of participants agreed that persons with disabilities have equal access to physiotherapy sessions compared to the general population.
• 61.88% of participants agreed that persons with disabilities have equal access to occupational therapy sessions compared to the general population.
• 64.81% of participants agreed that persons with disabilities have equal access to speech therapy sessions compared to the general population.
• 58% of participants reported participating or their caregivers in the rehabilitation process. Regarding gender participation in the rehabilitation service provision, almost 73.17% of respondents’ caregivers are females (mothers and wives).
• 59% of participants reported that service providers don't share information regarding other rehabilitation services available with them at the time of discharge.
• 66% of participants disagreed that they received proper referrals as per their needs from the service providers.
• 49.27% of respondents reported that rehabilitation services are accessible.
• 18.91% of respondents reported that service providers offer sustainable rehabilitation services, which respond to long term rehabilitation needs.
In conclusion, persons with disabilities in Gaza Strip have limited access to rehabilitation services due to attitudinal, physical, communication and organisational barriers faced in the community, which decrease their functional independence and limits their participation and inclusion in the community. While, at the level of access to rehabilitation services, availability, acceptance, sustainability, accessibility, and quality are all challenging to reach. It requires collaborative efforts from the key actors in rehabilitation, including persons with disabilities, service providers, and authorities. In addition to ongoing need assessments to prioritise intervention and ensure an effective response to the needs.
To ensure efficient and effective rehabilitation intervention in future projects, the HI team and surveyed persons with disabilities recommended the following to overcome accessibility, attitudinal, communication and organisational barriers that limit the access of people with disabilities to services.
Support coordination mechanisms among rehabilitation actors and other mainstream service providers to activate referral and respond to the needs of people with disabilities,
Strengthen the capacity of Local NGOs to provide sustainable rehabilitation services through ongoing capacity building for the different departments and strengthening the organisation policies and procedures,
Support OPDs to advocate for the integration of MHPSS and adoption of a multidisciplinary approach in health service provision and conduct awareness campaigns for the community on the right of people with disabilities to access rehabilitation services,
Support the accessibility of rehabilitation centres to ensure better access for people with disabilities to services,
Enhance gender participation in the rehabilitation service provision with more roles for male caregivers,
Building capacity of local shops for maintenance of assistive devices, and
Adopt multisectoral projects to have a more significant impact on the lives of people with disabilities, like projects supporting livelihood and rehabilitation for most vulnerable people with disabilities.