At this meeting, a document that included the WHO recommendations, entitled “Rehabilitation in health systems”, was launched (2). The document is based on scientific evidence concerning rehabilitation service implementation and intensive discussions of an international panel of experts. It comes to 7 main conclusions:
This document also includes a practice statement on assistive products, which states: “Financing and procurement policies should ensure that assistive products are available to everyone who needs them” and that “adequate training should be offered to users to whom assistive products are provided”.
Since the enactment of the United Nations (UN) Convention on the Rights of Persons with Disabilities (3) a growing consensus is that steps should be taken to ensure that all people experiencing disability should have access to qualified rehabilitation services. In 2011, the WHO provided data on the prevalence of disability worldwide and documented gaps in rehabilitation service provision (4). As a result, the World Health Assembly adopted the “Global Disability Action Plan 2014–2017: Better health for all people with disabilities” identified as 2 of its objectives: “to strengthen and extend rehabilitation, habilitation, assistive technology, assistance and support services, and community-based rehabilitation” and “to strengthen collection of relevant and internationally comparable data on disability and support research on disability and related services” (5).
In light of the UN Sustainable Development Goals (6) the availability of health services is seen as one of the preconditions for sustainable country development. This can be achieved only if rehabilitation, as one of the main health strategies, is integrated in health systems. In light of the ageing population, the increase in chronic health conditions and higher survival rates after severe diseases and injury, the significance of rehabilitation as a response to increasing levels of disability worldwide is clear. Rehabilitation services, moreover, are not restricted to a minority of “people with disabilities”, but are for everyone in the population who can benefit from them.
This special issue deals with some aspects of the challenge of scaling-up rehabilitation in low- and middle-income countries. Part 1 provides general discussions of the nature and importance of rehabilitation as a health strategy, in light of demographic and epidemiological trends, strategies for strengthening rehabilitation at the national level, developing techniques for assessing rehabilitation services, and implementing clinical quality management for rehabilitation services. Part 2 provides examples of country-level initiatives and projects that can contribute to better implementation of rehabilitation services. Also in this part there are examples of the role of NGOs and, in particular, the International Society of Physical and Rehabilitation Medicine (ISPRM), in scaling up rehabilitation services.
Future steps to be taken are:
From the 1Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany, 2Department of Health Sciences and Health Policy, Faculty of Humanities and Social Sciences, University of Lucerne, Lucerne, 3Swiss Paraplegic Research (SPF), Switzerland, 4Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden, and 5Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA