Gender sensitivity in health service provision in Afghanistan from 2012-2013

there was no relationship between disability perception and diagnosis or gender. Methods: With a mixed method design, team members interviewed clients using the WHO Disability Assessment Schedule (DAS) 2.0 to quantify self-perception of disability and a researcher-designed Home Observation Data (HOD) Form to describe client environments. Using consecutive sampling, thirty-five potential participants were screened by phone and 31 were interviewed, based on inclusion/ exclusion criteria. Twenty-eight clients fully met the criteria at the time of the initial in-person client encounter. Researchers analyzed the data using quantitative methods for the DAS summary scores, with two non-parametric tests to consider scores and client-related factor relationships. Qualitative methods consisted of HOD theme analysis. Findings: Complete DAS key question data were available for 12 female and 16 male clients. Fifteen had non-hemorrhagic cerebrovascular accidents and 13 had other neurologic conditions, mainly spinal cord injury. Analysis of data supported the hypothesis that clients perceived moderate to severe levels of disability. There was one client with no perceived disability, one at the extreme level, and 16 at the moderate to severe levels. There was no relationship with diagnosis or gender. Environmental barriers within homes and surroundings appeared to play a major role in home and community reintegration for those clients with continuing physical challenges to their mobility and function. Interpretation: This small-sample study verified the hypothesis that clients perceived moderate to severe levels of difficulty post rehabilitation discharge. The research results documented the situation at one point in time, verified the literature for similar clients in less-resourced countries, provided programming considerations for Kachere staff with future clients, and supported potential use of the WHO DAS 2.0 for similar research applications. Study limitations included the small sample size and selection convenience, use of a client self-assessment tool with subjectivity from personal and experiential factors. They restrict population generalizability based on the results beyond the focus of this study. The strengths of this study were the integration of the literature with rehabilitation center need, replicable design, use of an interprofessional team approach for the environmental assessment, and the research findings’ implementation potential. Funding: University of Maryland Center for Global Education Initiatives. Abstract #: 02SEDH012