The challenge

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. Alongside this many COVID-19 survivors will require long-term care including rehabilitation.

Rehabilitation is a crucial part of health systems and service delivery. Rehabilitation is a mix of services, people and systems. It is described as a ‘set of measures’ to restore independence, improve health and wellbeing, avoid unnecessary impairment and disability and enhance quality of life. Ensuring health systems respond to growing need for long-term health care to address the growing prevalence of chronic diseases is overdue. Rehabilitation can help break the cycle of injury that can trap individuals, families and communities in poverty, enabling people to work, access education and be enjoy their basic rights. It can help overcome stigma, shame and discrimination experienced by persons with disabilities.

Despite the clear benefits of physical rehabilitation, many governments in low and middle-income countries have not prioritized or invested in this vital service. Health systems around the world are struggling to cope. There is a critical shortage of skilled rehabilitation professionals: as few as ten per million in many low- and middle-income countries. Rehabilitation services are often expensive, of poor quality and inaccessible outside cities. Services should be provided in or carefully coordinated with the health system, and yet they are often fragmented or split across health and social protection systems. Reliable data, which would shed light on rehabilitation needs, is lacking. In addition, the potential of new information technology has not yet been realized.

As a result, the unmet need for physical rehabilitation is vast and urgent. More than half of people living in low- and middle-income countries who require rehabilitation services do not receive them. Vulnerable and marginalized people, including those living in conflict settings, are most affected.