Integrating rehabilitation into health systems

Many of us will need physical rehabilitation at some stage in our lives, following a disease, illness, injury or as we get older. It is estimated that one in three people – around 2.4 billion – are living with a health condition that would benefit from rehabilitation.

Rehabilitation is not a luxury, to be accessed by the few. It’s an essential health service. And yet, it is often overlooked, leaving many vulnerable people in low- and middle-income countries, especially those affected by conflict, unable to receive vital rehabilitation services.

In response, Learning, Acting and Building for Rehabilitation in Health Systems (ReLAB-HS) was created to strengthen health systems around the world so that they can address the growing need for physical rehabilitation across the lifespan. Funded by United States Agency for International Development USAID, ReLAB-HS will transform how marginalized people in low- and middle-income countries access rehabilitation, ensuring the right care is provided at the right time and in the right way, by supporting future leaders, health workers, building evidence and translating evidence and innovative methods into sustainable changes.

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Launched in late 2020, ReLAB-HS is a comprehensive five-year program that will respond to the escalating need for physical rehabilitation services in low and middle-income countries.

We will work across all levels of the health system, building technical, policy and research capacity; increasing political commitment; and inspiring leadership. ReLAB-HS will use new technology and support simple, low-cost service delivery models that expand access to rehabilitation in the home and community – where it is needed most.

Globally, about 2.4 billion people require physical rehabilitation. The need for rehabilitation extends across the entire lifespan: from children born with impairments, and young adults injured in conflicts, to older people living with chronic disease and disability. These needs are likely to rise in the future. Around the world, people are living longer, with the population aged 65 and over growing faster than all other age groups. Injuries are escalating from conflicts and emergencies, traffic accidents and rapid urbanization. The COVID-19 pandemic is further boosting demand for rehabilitation services.

ReLAB-HS will initially work in four countries: Myanmar, Pakistan, Uganda and Ukraine. These countries have been selected because they represent a range of health, human development and equity indicators, burden of disease, and conflict and disaster risks. All countries have experienced or are currently experiencing conflict as well as a complex set of conditions affecting health, healthcare and approaches to rehabilitation. These diverse health system conditions – including different health financing models, overall health system resourcing, adequacy of human resources, and varied progress in integrating rehabilitation into health systems – provide a solid basis for learning.

Responding to the growing need for rehabilitation around the world, particularly in countries torn apart by conflict, is not without its challenges. However, there are also considerable opportunities. These include developing innovative, cost-effective service delivery models at the primary care level; exploring the potential of new information technology; and investing in local infrastructure. Through this approach, ReLAB-HS will expand access to quality rehabilitation services in the community and home setting – improving health, restoring people’s independence and enhancing quality of life.