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Papers by Pauline Kleinitz

International Journal of Environmental Research and Public Health, Feb 17, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

International Journal of Environmental Research and Public Health, Nov 3, 2021

Archives of Physical Medicine and Rehabilitation, 2022

Objective To present the development process of the World Health Organization (WHO) Systematic As... more Objective To present the development process of the World Health Organization (WHO) Systematic Assessment of Rehabilitation Situation (STARS). Design A conceptualization phase to establish its objective and identify the content for comprehensively describing rehabilitation in countries, a second phase to draft, and a third phase to refine the tool. Reviews of existing health system assessment (HSA) tools used in other areas of health as well as expert consultations occurred. Setting The WHO initiated the development of STARS because there is currently no comprehensive HSA tool for rehabilitation that supports stakeholders describing their country situation and identifying priority actions. Participants The WHO rehabilitation team, experts representing rehabilitation professions and from all WHO regions, and government and rehabilitation consumer groups. Interventions Conceptualizing, drafting, consulting, and reviewing of the WHO STARS. Main Outcomes Measures Development of a tool that is comprehensive and able to support countries to describe rehabilitation and identify priorities. Results STARS was developed in a participatory process, uses a logic model to structure the 50 components of rehabilitation selected for assessment, and assesses both capacity and performance. Conclusions STARS is the first HSA shaped to rehabilitation, has been developed by the WHO in a participatory process based on several expert consultations, and has the potential to meaningfully support governments to better understand the status of rehabilitation in their countries, define priorities for action to strengthen rehabilitation, and facilitate the monitoring of system level changes. Moreover, STARS information can be used in research to support evidence-informed policy and programs.

Health Systems & Reform

International Journal of Environmental Research and Public Health

Rehabilitation in South Africa (SA) operates independently of major health services and reforms, ... more Rehabilitation in South Africa (SA) operates independently of major health services and reforms, despite the increasing rehabilitation need. With the introduction of National Health Insurance (NHI), SA is facing another major health reform. Evidence is needed on the current SA rehabilitation situation, regarding shortcomings, opportunities, and priority strategic strengthening actions. We aimed to describe the current rehabilitation capacity in the SA public health sector, which serves the majority and most vulnerable South Africans. A cross-sectional survey was conducted in five provinces, using the World Health Organisation’s Template for Rehabilitation Information Collection (TRIC). Participants were purposively selected for their insights and experiences of rehabilitation in specific government departments, health sectors, organisations, and/or services. TRIC responses were analysed descriptively. Participants explained how timely and effective rehabilitation produced long-term ...

International Journal of Environmental Research and Public Health, 2021

The WHO Systematic Assessment of Rehabilitation Situation (STARS) tool was developed by WHO to fa... more The WHO Systematic Assessment of Rehabilitation Situation (STARS) tool was developed by WHO to facilitate effective prioritization and strategic planning for rehabilitation in countries. The objective of this paper is to present the results of the fourth phase of its development, its field testing in seven countries focusing on its completeness, usefulness, accessibility and feasibility. Field testing occurred in Jordan, Myanmar, Sri Lanka, Solomon Islands, Laos, Haiti, and Guyana. Evaluation occurred through structured interviews and rating exercises with 17 government representatives, international consultants, WHO country or regional office staff and rehabilitation experts who were actively engaged and familiar with the STARS assessment and who were knowledgeable of the rehabilitation situation in the countries. STARS was appraised as relevant, complete and accurate in describing the country situation. Areas of inaccuracy were mostly linked to challenges in describing areas of se...

Archives of Physical Medicine and Rehabilitation, 2021

Disability, CBR & Inclusive Development, 2016

Purpose: This exploratory case study was undertaken to inform capacity development of the rehabil... more Purpose: This exploratory case study was undertaken to inform capacity development of the rehabilitation workforce in member nations of the Pacific Islands Forum (PIF). Method: Participants at the 1st Pacific CBR Forum in June 2012 were key informants for this study. They comprised the disability focal points from government departments in each of the 14 countries, representatives of DPOs and disability service providers. The study was conducted in 3 phases: a template to gather data on rehabilitation workers; key informant interviews; and, stakeholder workshops to identify strengths and needs of the rehabilitation workforce in the Pacific. Results: The detailed case study findings suggest two critical drivers for rehabilitation health workforce development in the Pacific context. The first is leadership and commitment from government to serve rehabilitation needs in the community. The second is the urgent need to find alternative ways to service the demand for rehabilitation services as it is highly unlikely that the supply of specialist personnel will be adequate.

Western Pacific Surveillance and Response Journal, 2015

It is estimated that 15% of the world's population has a disability, and disasters increase their... more It is estimated that 15% of the world's population has a disability, and disasters increase their risk and vulnerability. Rehabilitation services were limited in the area of the Philippines that was affected by Typhoon Haiyan. This study describes the initial rehabilitation needs assessment and activities to increase rehabilitation services conducted in Leyte province of Region 8 after Haiyan. Method: A rehabilitation needs assessment for people with disabilities and injuries needing physical and functional rehabilitation care and assistive devices was conducted in health facilities, evacuation centres and selected municipalities in Leyte province between 9 November 2013 and 30 April 2014 by a consortium of agencies. Improvements to service delivery and referrals were documented. Results: Rehabilitation services were reduced immediately after Haiyan, but they increased in the following months and peaked four months after Haiyan. There were 2998 individuals needing medicine and rehabilitation management, functional care and assistive devices. These included persons with pre-existing disabilities whose situations had worsened and people who had sustained injuries in the typhoon. Additional improvements included rehabilitation services with provision of assistive devices at the regional hospital, development of a directory of disability services in the region and advocacy through community-based rehabilitation. Discussion: Information services and community knowledge for people with disabilities improved in Region 8 after Typhoon Haiyan, demonstrating that strengthening rehabilitation systems is a realistic goal after disasters.

Disability, CBR and Inclusive Development, Sep 7, 2016