Rehabilitation and universal health coverage: Rehabilitation is a fundamental health service for people with a wide range of health conditions, throughout all stages of the life-course, and during all phases of acute, sub-acute and long-term care. Rehabilitation addresses the impact of a health condition on the person’s life by focusing primarily on improving their functioning and reducing the experience of disability. Rehabilitation focuses on the functioning of an individual and not the disease. It does this through a strong emphasis on educating and empowering people to manage their health conditions, adapt to their situation and remain as independent and active as possible. By doing this, rehabilitation enables greater participation in education, employment and community life, with far-reaching health, social and economic benefits.
Rehabilitation is an increasingly important health service in light of ageing populations and the rising prevalence of noncommunicable diseases (NCDs).1 Furthermore, as access to health care interventions expands, rehabilitation is needed to maximize their effectiveness and impact. Currently, however, the
need for rehabilitation greatly exceeds its availability.2
Substantial unmet need for rehabilitation compromises the social and economic outcomes of health care and hinders
realization of the Sustainable Development Goals (SDGs). Achievement of SDG 3, “Ensure healthy lives and promote well-being for all across all ages”, can only be possible through universal health coverage (UHC). UHC necessitates that health services address the full range of health needs of the population, including the availability of
health promotion, prevention, treatment, rehabilitation and palliative care.3
There is already substantial unmet need for rehabilitation in many low- and middle-income countries and, due to current health trends and the widespread under-prioritization of rehabilitation by ministries of health, these unmet needs are likely to increase. Further prioritization of rehabilitation within health is urgently needed to meet the needs of millions of people around the world.
Responding to the Rehabilitation 2030 Call for action
In February 2017, in response to the urgent need to strengthen rehabilitation worldwide, WHO launched the Rehabilitation 2030 initiative, and raised a “Call for action”. This call identified 10 areas for concerted attention to
reduce unmet needs for rehabilitation. Among these is the need to strengthen rehabilitation leadership, planning and
integration across health care, incorporating rehabilitation into UHC and integrating rehabilitation data across health
information systems.
To assist countries in strengthening rehabilitation, the World Health Organization (WHO) has developed this guide,
the Rehabilitation in health systems: guide for action. This resource leads governments through health system strengthening practices with a focus on rehabilitation. It facilitates leadership and planning for rehabilitation through a situation assessment and strategic planning process, and it strengthens rehabilitation information and accountability through the development of systems that support rehabilitation monitoring and evaluation.
The four phases, 12 steps, accompanying guidance and tools are outlined in the diagram. Strengthening health systems to provide rehabilitation for all who need it is a priority and essential to achieving universal health coverage.
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