R-FIT

Key strategies for integrating rehabilitation and assistive technology (AT) in health systems include generating demand, building leadership, strengthening the workforce, and strengthening local service arrangements.

As countries build evidence for unmet needs and develop strategic plans to address them, health planners and other stakeholders need practical guidance on what works, what steps to take, and how to target limited resources in the most effective ways. It is also essential that new interventions are systematically adjusted to suit local contexts, while recognizing that conditions in local health services may also require adjustment for new interventions to be introduced, successful, and sustained.

The Rehabilitation Framework for Integration Toolkit (R-FIT) will guide local actors with key steps and tools to support them in selecting and adapting interventions based on recent evidence and good practices that are relevant to local conditions. The R-FIT will be developed to complement and draw on findings from analyses and guides, such as the World Health Organization’s (WHO) Rehabilitation in Health Systems: Guide for Action, focusing on how to implement solutions to deliver on strategic plans and solve priority challenges.

The R-FIT will guide stakeholders in setting up local arrangements and assessing readiness, including access to necessary information, such as findings from relevant analyses. The aim is to generate buy-in and establish coordination mechanisms necessary to decide on and implement local actions.

Key steps in choosing options for integration after assessing local rehabilitation performance and integration will be outlined in the R-FIT, including a menu of existing standards and goals to select from, along with relevant actions and examples of evidence-based interventions to address them. This will include guidance and tools for describing and revising local service arrangements to make progress toward priority goals and introduce priority interventions. This aims to provide a method for systematically describing how rehabilitation and AT intersect with other health services and to identify necessary short- and long-term changes.

The R-FIT will also include steps and guidance to adapt and introduce specific interventions, including introducing training and service changes for primary health care workers (such as the WHO’s Basic Rehabilitation Package Clinical Resource), assistive product procurement, assistive product training, and local governance mechanisms.

The R-FIT will be developed in consultation with ReLAB-HS collaborators to identify the most useful guidance at each key implementation step and by drawing on current evidence. Its development will be supported by an advisory group comprised of ReLAB-HS partners, local collaborators, and external groups who are potential implementers of rehabilitation and AT interventions at local levels and might benefit from guidance and tools.