Poster Presentation Asia Pacific Stroke Conference 2024

Co-design of a community-based stroke rehabilitation and recovery program for Indonesia (#354)

Yudi Hardianto 1 2 , Tara Purvis 1 , Elizabeth Lynch 3 , Richard I Lindley 4 5 , Michele Callisaya 6 , Andi Masyitha Irwan 7 , Noor Azah Abd Aziz 8 , Dominique A Cadilhac 1 9
  1. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
  2. Department of Physiotherapy, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  3. College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
  4. The George Institute for Global Health, Barangaroo, NSW, Australia
  5. University of Sydney, Camperdown, NSW, Australia
  6. Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia
  7. Department of Gerontological Nursing, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  8. Department of Family Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
  9. Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia

Background/Aims

Access to rehabilitation and support services for survivors of stroke in Indonesia is limited. A community-based program could improve access to stroke rehabilitation therapies. The aim of this study was to co-design a stroke rehabilitation program to be implemented in Indonesian community health centres (Puskesmas).

Methods 

Three co-design workshops were conducted during August–October 2023 with 30 participants. The workshops were held online (2 hours) and face-to-face in Makassar, Indonesia (6 hours). Participants included stroke experts/academics, clinicians (neurologists, general practitioners, nurses, and physiotherapists), survivors of stroke and their caregivers, policymakers, and representatives from the Indonesian National Health Insurance Agency. Document analysis of the notes and decisions made during the meetings and reflections from the research team were summarised.

Results 

Stakeholders reported several challenges in providing community-based stroke rehabilitation. These included a shortage of health professionals trained in stroke care, insufficient knowledge about stroke among survivors of stroke and caregivers, limited referral from hospitals to Puskesmas, and a lack of policy and funding mechanisms to support stroke rehabilitation in Puskesmas. The need for a broader program of support was identified, incorporating education, stroke prevention, rehabilitation therapies, and long-term support for survivors of stroke and caregivers.

Conclusion 

To our knowledge, this is the first attempt to co-design a community-based stroke rehabilitation and recovery program for Indonesia. The need to address education and training for health professionals and provide a broad program for therapy and support was highlighted. The next steps include implementing and evaluating the feasibility of this proposed program.