The Health in Motion Model
Health in Motion (HiM) is a model of rehabilitation services for rural communities in developing countries. Mobility is vital for people who average 6-9 hours of physical labor daily. When loss of movement, overuse injuries or chronic pain sets in for one person, the quality of life for the entire family is compromised.
Rural communities are, on average, 8 km from the nearest health facility. Most people will travel on foot to reach these services, just to access basic primary healthcare. An individual will often travel a further 40 km to access rehabilitation services. That person is likely to spend the equivalent of an entire month’s earnings for transport. Over time, many patients have found this process exhausting and futile. Many remain in pain or with limited function, whereas for others, the illness intensifies, and the family is left with the burden of caring for this person. This caring responsibility often falls on the girls and young women in the household who stop attending school to fulfill this role. With little understanding of the patient’s needs and minimal health-related support, it perpetuates a sense of helplessness for all.
In response to this comprehensive problem, the HiM model was developed. HiM promotes healthier, physically active communities through informed decision-making and a proactive approach to maintaining physical health. Strategies for injury prevention (ergonomics) are implemented, establishing healthy patterns of movement and providing care for those chronically impaired. All layers are taught and carried out directly at the community level. Through the HiM model, members of rural communities can better remain active in their essential daily activities, alleviating both the physical burden and the financial strain that immobility places on their families.
Two programs are currently available for training under HiM
The Prevention program aims to educate communities on the causes of overuse injuries and how to implement strategies to prevent such injuries (ergonomics). Community members are taught alternative movement patterns in daily activities and how to use locally available materials for home modifications beneficial to performing tasks.
Chronic Home Rehabilitation
As we look at the elderly generations who have utilized these traditional patterns of movement for decades and have been injured due to chronic overuse or degenerative limitations, there is a need to extend beyond prevention. The Chronic Home Rehabilitation program aims to assess a patient’s level of physical function and provide relevant stretches to alleviate their symptoms.
Many daily activities are steeped in tradition, therefore ingraining them with a sense of identity, worth, and value based on how these activities are performed. This poses a challenge in the form of cultural resistance, as our data found 32% of the community denied involvement, despite 92% of those who adopted the model experiencing a marked decrease in physical pain and limitations. Therefore, the onus of acceptance and sustainability rests upon individuals taking responsibility to invest in changes.
To effectively engage communities with our approach, our model employs strategies such as; empowering individuals through knowledge, employing storytelling for cultural discussions, month-by-month movement progression teaching, and community mapping, ensuring that adaptation of topics is custom-tailored to specific environments.
To be effective our programs are taught by local community members who are passionate about development and eager to shape the future by alleviating physical suffering. Through emphasizing prevention and chronic care at the grassroots level we believe that we can ultimately promote physical longevity and significantly enhance the quality of life for both patients and caregivers.
HiM provides our partner organizations with a refined, high-quality program that has been developed over time through our experience and understanding gained via effective community engagement over many years.
Through our implementation we have reached the following outcomes:
• 89% of participants in the HiM program were pain-free post implementation.
• 76% who were farming 20-45mins, before the onset of low back pain, were managing 4-5 hours pain-free post training.
• Of 32% who were stopping their income generating activities due to low back pain, all were back to managing these activities post implementation.
• Initiating 16 chronic patients in the home rehabilitation program found 9 had independent function withing 6 months.
We continue to trial and develop programs in Nkhata Bay district. This is done in partnership with the DHO (District Health Office) as well as supported by the community chiefs and traditional structures.