According to 2011 data, one in seven people around the world lives with a disability. Eighty per cent of these individuals live in a low- or middle-income country where rehabilitation services—services to help them function to the best of their ability—are wanting or even non-existent. And the health and demographic profiles of populations are changing: people are living longer and with more chronic and disabling health conditions. That’s why the World Health Organization (WHO) has noted that strengthening rehabilitation is emerging as a key challenge facing health systems in the 21st century.
The global trends in health and aging require a major scaling up of rehabilitation services in countries around the world, and in low- and middle-income countries in particular. Strengthening service delivery and ensuring adequate financing are fundamental to making rehabilitation available and affordable for those who need it. Recognizing the need for evidence-based guidelines for developing and strengthening rehabilitation services, in 2012, WHO put out a call for research proposals to support the development of a roadmap to provide recommendations to governments and other relevant actors on how to develop, expand and improve the quality of rehabilitation services.
An Institute for Work & Health (IWH) team, headed by Scientist Dr. Andrea Furlan, was selected to conduct systematic reviews and provide syntheses of the available research evidence on several key questions. Using the framework that IWH has developed and used over many years in its Systematic Review Program, the team searched the scientific and “grey” (i.e. not peer-reviewed) literature for studies that addressed the questions, making sure no relevant studies were left out. More than 8,000 studies were identified and assessed for quality.
Five rehab services recommendations rely on IWH syntheses
In February 2017, WHO hosted Rehabilitation 2030: a call for action. The meeting was attended by a broad range of stakeholders, including government officials, organizations representing rehabilitation service user groups and rehabilitation providers, major professional organizations, and research institutions. The objectives of the meeting included drawing attention to the increasing needs for rehabilitation and the urgency of addressing profound unmet needs, and highlighting the role of rehabilitation in achieving the UN Sustainable Development Goals (SDGs), in particular, its necessity in achieving SDG 3: to ensure healthy lives and promote well-being for all at all ages.
An important feature of the meeting was the release of the WHO report, Rehabilitation in health systems and subsequent discussion. Aimed primarily at low- and middle-income countries, the report sets out evidence-based recommendations to help government leaders and health policy-makers develop or extend rehabilitation services and deliver them equitably within existing health systems. Five of the nine recommendations contained in the report relied on the evidence synthesized by the IWH research team.
Furlan hopes the document will have far-reaching impact. This could affect one billion people, she says.
The world will be a better place if these people have the rehabilitation services to enable them to participate in life, in the workforce, in leisure activities—and to be productive members of society.