Improving joint health and access to care for people with haemophilia in Honduras

Three years of investment in rehabilitation and multidisciplinary care are delivering lasting change.

Listening to the impact on the ground

After three years of sustained collaboration, the Healthy joints for people with haemophilia in Honduras programme has officially come to a close. Implemented between 2022 and 2025 with the support of the Novo Nordisk Haemophilia & Haemoglobinopathies Foundation (NNHF), the programme aimed to strengthen rehabilitation services, build national expertise, and improve quality of life for people living with haemophilia. As the project concludes, attention is turning to those closest to its impact – people with haemophilia – to understand how care has evolved and what has changed in daily practice.

From limited access to more comprehensive care

When the programme began in 2022, access to rehabilitation for people with haemophilia in Honduras was limited. Many patients were already experiencing arthropathy and chronic joint damage due to a lack of regular physiotherapy, insufficient equipment, and limited follow-up. Rehabilitation services were unevenly distributed across the country, making preventive care difficult to access.

Building rehabilitation capacity nationwide

Strengthening physiotherapy services became a central pillar of the programme. Specialised rehabilitation equipment was procured, and two Honduran physiotherapists and physiatrists completed intensive training in Monterrey, Mexico, under the guidance of Dr Laura Villarreal and her team. This training strengthened local expertise in haemophilia-specific rehabilitation and joint health management. To expand access beyond the capital, a national physiotherapy care network was established in partnership with Teletón Honduras, a non-profit organisation operating six rehabilitation centres across the country. As part of this collaboration, a Teletón physiotherapist received specialised training abroad and later cascaded this knowledge to colleagues across the network. This significantly improved geographical access to rehabilitation services nationwide.

A shift toward prevention and multidisciplinary care

For physiatrist Dr Ricardo Bulnes, who has been closely involved in training and follow-up activities, the changes are evident in daily practice. Compared to previous years, joint health is now addressed earlier, and rehabilitation is increasingly integrated from a preventive perspective rather than as a response to advanced damage.

As he explains, “In recent years, we’ve seen a significant improvement, not only in joint care, but in how patients and healthcare professionals understand and approach rehabilitation as a preventive tool.” This shift reflects stronger training, better coordination between disciplines, and a growing emphasis on education for both patients and their families.

In recent years, we’ve seen a significant improvement, not only in joint care, but in how patients and healthcare professionals understand and approach rehabilitation as a preventive tool.

Dr Bulnes also highlights improved collaboration across healthcare teams. The programme has supported a more multidisciplinary approach that brings together physiotherapists, haematologists, and other healthcare professionals, resulting in more comprehensive and higher-quality care than in the past.

Measurable improvements in daily life

The programme directly benefited 392 people with haemophilia across Honduras. A musculoskeletal care survey conducted in 2025 among 44 participants illustrates the tangible impact of these changes:

• 100% reported an improvement in quality of life
• 77% experienced greater ease in daily activities such as walking or climbing stairs
• 75% followed recommendations provided by their physiotherapist
• 68% increased their level of physical activity

These outcomes reflect a broader shift in how haemophilia care is delivered. Rehabilitation and patient education are now recognised as essential components of comprehensive care, rather than optional additions.

Closing a chapter and looking ahead

As the programme came to end in 2025, its impact continues to be felt on the ground. For physiatrists like Dr Bulnes, the difference is visible not only in improved joint health, but also in more confident people with haemophilia, better-informed families, and healthcare teams working together more effectively. The goal is to ensure that the progress achieved over these three years continues to benefit people with haemophilia well long-term by providing ongoing education for healthcare professionals, people with haemophilia and their caregivers.