During the last few decades, the field of rehabilitation has experienced substantial
development, growth, and acceptance. Rehabilitation addresses the impact of a health
condition on a person’s everyday life by optimizing their functioning and
reducing their experience of disability. Rehabilitation expands the focus of health
beyond preventative and curative care to ensure people with a health condition can
remain as independent as possible and participate in education, work, and meaningful
life roles [1]. A definition of rehabilitation for
research purposes has been recently published [2].
Scientific and clinical research have generated a body of knowledge that strongly
supports the use of many rehabilitation interventions with positive outcomes in
various populations and health conditions.
We also have now a better understanding of the growing global need, demand, and
recognition of rehabilitation around the world. For example, it has been estimated
that 2.41 billion people in the world could benefit from rehabilitation services.
This means that at least one in every three persons in the world needs
rehabilitation at some point during the course of their disease or injury [3]. This figure has most likely increased because
of the COVID-19 pandemic. The need for rehabilitation increased by 63%
between 1990 and 2017 because of the aging population, the increasing prevalence of
noncommunicable health conditions, and the shifting epidemiological profile in most
countries [3]. Finally, according to the 2022
global report on health equity for persons with disabilities, approximately 1.3
billion people or 16% of the world’s population has moderate to
severe levels of disability associated with the underlying health conditions and
impairments [4]. Now more than ever before, it is
crucial that rehabilitation is available and accessible to populations globally
according to their needs. The important contribution of rehabilitation to the
functioning, including social and occupational participation and well-being of
populations worldwide, can no longer be denied or delayed. Rehabilitation is
critical for the attainment of the United Nations Sustainable Development Goal 3,
Ensure healthy lives and promote well-being for all at all ages [5].
Notwithstanding the foregoing arguments, there continues to be a high unmet need for
rehabilitation globally, with some low- and middle-income countries reporting unmet
needs up to 50% of those who could benefit from rehabilitation.
Rehabilitation services are not accessible to many people around the world [6]. Many of those in need do not have access
because of the failure, at least partially, to effectively plan for rehabilitation
services. Many nations and health systems have not implemented policy measures that
recognize rehabilitation as an essential component of universal health coverage
[7]
[8].
Health policy, planning, and decision making for rehabilitation often require more
local evidence to adequately plan, finance, implement, and monitor quality
rehabilitation services including infrastructure and workforce to make services
accessible to those in need [9].
The field of health policy and systems research (HPSR) seeks to understand and
improve how societies organize themselves in achieving collective health goals and
how different actors interact in the policy and implementation processes to
contribute to policy outcomes [10]
[11]. By nature, it is interdisciplinary, a blend of
medicine and health sciences, economics, sociology, anthropology, political science,
law sciences, public health, and epidemiology that together draw a comprehensive
picture of how health systems respond and adapt to health policies, and how health
policies can shape – and be shaped by – health systems and the
broader determinants of health. The importance of HPSR for rehabilitation has been
recently highlighted with robust data that needs to be considered and used by health
policy and systems community and leadership [12].
Health policy and systems research for rehabilitation generates the evidence needed
by policy makers to make appropriate decisions and to develop action plans to
enhance the capacity of the health system to serve the population in need of
rehabilitation services. For example, the evidence generated by HPSR helps (1)
establish priorities for rehabilitation service delivery, (2) evaluate outcomes of
various rehabilitation interventions in relation to the levels of care in the health
system, (3) identify specific benefits to society justifying those decisions, and
(4) strengthen health systems to increase access, quality, and provision of health
services for rehabilitation [13].
Supported by the recent resolution on ‘Strengthening rehabili- tation in
health systems’ that has been endorsed by the World Health Assembly for the
first time in the history of the World Health Organization, [14] it is time to leverage HPSR to support societal
health goals as they apply to rehabilitation.
In 2022, the World Health Organization Rehabilitation Program established the World
Rehabilitation Alliance (WRA) [15] to strengthen
networks and partnerships that advocate for the integration of rehabilitation into
health systems. The WRA is a World Health Organization – hosted global
network of stakeholders whose mission and mandate are to support the implementation
of the Rehabilitation 2030 Initiative [16] through
advocacy activities. The WRA focuses on promoting rehabilitation as an essential
health service that is integral to Universal Health Coverage and to the realization
of the United Nations Sustainable Development Goal 3. The work of the WRA is divided
into the following five workstreams: workforce, primary care, emergencies, external
relations, and research. The research workstream is dedicated to the generation and
routine use of HPSR evidence for planning and integrating rehabilitation into health
systems. The specific objectives of this workstream are to advocate for (1) the
demand and utilization of HPSR evidence for rehabilitation, (2) the widespread
generation of high-quality HPSR evidence for rehabilitation, and (3) the
publication, dissemination, and implementation of HPSR evidence for
rehabilitation.
In this context, the coauthors of this editorial on behalf of their respective
academic journals express their full support for the WRA mission in general and for
the specific objectives of the research workstream. In concrete terms, we commit
that our journals, as much as possible, will implement one or more of the following
actions: (1) invite researchers in the field of HPSR for rehabilitation to submit
their manuscripts to our Journals for peer review and possible publication, (2)
create a special journal section, series, or designation dedicated to HPSR for
rehabilitation, (3) appoint editorial board members with expertise in HPSR for
rehabilitation, and (4) disseminate research articles among funding agencies and
policymakers. These actions by our academic journals will help the WRA achieve its
goal of strengthening rehabilitation services for all.
