TULAY: Co-designing Philippine community physical rehabilitation

Rehabilitation is care that can help people get back, keep, or improve functions that are needed for daily life. Unlike in the UK, where there are very effective recovery programmes, in the Philippines, these services are almost non-existent.

The four-year Tulong, Ugnayan ng Lingap At gabaY ('help, compassion, and guidance'; TULAY) project is funded by the National Institute for Health and Care Research (NIHR) and UK Aid, and commenced in October 2022. The joint team of researchers and health professionals from the UK and Philippines will work together with stroke survivors and families to develop recovery care delivered within the community setting. The project is led by the University of Plymouth, in collaboration with Universities of Southampton and St George’s London in the UK, and De La Salle University Manila in the Philippines.

We will work together with stroke survivors and families, as well as key stakeholders such as policy makers, clinicians, and patient/carer groups, as well as the Philippine Academy of Rehabilitation Medicine (PARM) and national therapy organisations, to co-design and co-produce materials to facilitate recovery care delivered within the community setting. The evidence from research strongly supports this type of help, which will be given by trained municipal and barangay (village) health workers, alongside family carers, who work in the island areas of the Philippines, away from towns and cities.

To do this, we will use a mixture of approaches to find out about current services, dig deeper to uncover what people want, and co-produce a programme, jointly with patients, carers and health workers, that meets local needs. We will train local health workers and village people to help to deliver this programme. Finally, the implementation of the programme will be evaluated, including a brief health economic analysis.

The TULAY programme will have the potential to be scaled up through policy change and adapted for other physical conditions in the Philippines and other low- to middle-income countries. This work will help add evidence to inform health policy in the Philippines to improve patient and family health using a sustainable model that reflects the diversity and culture of the Philippines.