What Does Gender and Inclusion Mean for Clinical Practice?

The recent ReLAB-HS Gender and Advocacy Webinar taught me 4 things I need to change about my practice.

The fundamental concept behind rehabilitation is to help people participate in the world around them. This is accomplished by helping people achieve their health goals and return to  activities which add quality of life. But what happens when accessing services is unequal? Sadly this is the reality for many around the world.

As a clinician, I can understand the theory behind gender equality and social inclusion for access to care,  but how does this translate into my day-to-day clinical practice?

I recently attended a ReLAB-HS Gender and Advocacy Webinar, which explored the newly published ReLAB-HS Factsheet: Rehabilitation through a gender lens.   It was a good reminder that around the world at least 1.2 billion people cannot access rehabilitation services they desperately need.

Gender Shouldn’t Limit Access to Rehabilitation But It Does

Breaking this 1.2 billion down helps us see that inequity of accessing service is not equally distributed amongst the population. By far women are less likely to access rehabilitation care because of additional barrier they face, and when they do, are more likely to experience poorer outcomes.

What is important to me as a clinician and what can I do today, at the level of a service provider, to close the current gap between need and services offered? The ReLAB-HS webinar highlighted 4 important areas which we can have an impact as a service provider.

  1. Availability:  Understanding the needs of your community and modelling your availability around this need e.g are your clinic opening hours appropriate for your community? And are you receiving rehabilitation referrals for those who truly need it?
  2. Accessibility: Is your clinic or hospital in a good geographical location? Can it be accessed through public transportation?  Is the building adapted for all ability levels?
  3. Affordability:  Unfortunately, we still live in a world where free healthcare for all is not yet a reality.  Rehabilitation and assistive technology services are financial burdens to many and health insurance is not yet a universal right.  What can you do at the clinical level to make healthcare services more affordable?
  4. Acceptability: We can all agree that rehabilitation services and assistive technologies are not a “one size fits all” type of care.  As a clinician, do you take into account an individual’s diversity with your service delivery? Do you adapt your services and equipment to meet the needs of children, women, men and different levels of ability, for example?

This is a great example from the webinar that highlights that gender barriers continue to exist for access to rehabilitation services.

Four Practical Steps for Your Place of Work

Another aspect to consider is what can be done at the level of decision-makers and policy level in order to be more inclusive.  There are meaningful changes that can be made to facilitate access to care and assistive devices for people of all backgrounds.

Here are some practical changes that can be made at the level of your place of work:

  1. Investing in a gender-inclusive and responsive rehabilitation workforce – Ensure your staff and colleagues have gender and inclusion training and are comfortable translating their training into practice.
  2. Think outside the box – Develop mobile clinics, virtual consultations, group classes and home-based care  to meet the need of your diverse community.
  3. Listen to their needs – Consult people of all genders and persons with disabilities, throughout the rehabilitation planning process.  Give them a voice and action the appropriate changes in your clinic.
  4. Stay informed – Consult the research on gender and inclusion and see what practical recommendations can be applied to your clinic.

As clinicians, we are invested in helping people maintain their function and participate in their world; this includes all people of different genders, abilities, ages and backgrounds.  What else can you do as a clinician to promote inclusion and diversity in your clinical practice?

If you would like to learn more, Physioplus in partnership with ReLAB-HS, will be launching an Introduction to Gender Equality and Social Inclusion (GESI) in clinical practice course in the coming months.

ReLAB-HS is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and is implemented under cooperative agreement number 7200AA20CA00033. The consortium is managed by prime recipient, Johns Hopkins Bloomberg School of Public Health.