Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS).
<h4>Background and objective</h4>The need for rehabilitation is growing due to health and demographic trends, especially the rise of non-communicable diseases and the rapid ageing of the global population. However, the extent to which rehabilitation is integrated into health systems is m...
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297109&type=printable |
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| author | Pauline Kleinitz Carla Sabariego Gwynnyth Llewellyn Elsie Taloafiri Ariane Mangar Rabindra Baskota Kedar Marahatta Shiromi Maduwage Myo Hla Khin Vivian Wonanji George Sampa Ali Al-Rjoub Jaber Al-Daod Alarcos Cieza |
| author_facet | Pauline Kleinitz Carla Sabariego Gwynnyth Llewellyn Elsie Taloafiri Ariane Mangar Rabindra Baskota Kedar Marahatta Shiromi Maduwage Myo Hla Khin Vivian Wonanji George Sampa Ali Al-Rjoub Jaber Al-Daod Alarcos Cieza |
| author_sort | Pauline Kleinitz |
| collection | DOAJ |
| description | <h4>Background and objective</h4>The need for rehabilitation is growing due to health and demographic trends, especially the rise of non-communicable diseases and the rapid ageing of the global population. However, the extent to which rehabilitation is integrated into health systems is mostly unclear. Our objective is to describe and compare the nature and extent of integration of rehabilitation within health systems across nine middle-income countries using available Systematic Assessment of Rehabilitation Situation (STARS) reports.<h4>Methods</h4>Cross-country comparative study with variable-oriented design using available rehabilitation health system assessment reports from nine middle income countries.<h4>Findings</h4>The integration of rehabilitation into health systems is limited across countries. Governance and financing for rehabilitation are mostly established within health ministries but weakly so, while health information systems are characterized by no available data or data that is insufficient or not routinely generated. The overall numbers of rehabilitation workforce per capita are low, with frequent reports of workforce challenges. In most countries the availability of longer-stay, high-intensity rehabilitation is extremely low, the availability of rehabilitation in tertiary hospitals is modest and in government supported primary care its almost non-existent. Multiple concerns about rehabilitation quality arose but the lack of empirical data hinders formal appraisal.<h4>Conclusion</h4>The study sheds light on the limited integration of rehabilitation in health systems and common areas of difficulty and challenge across nine middle income countries. All countries were found to have a basis on which to strengthen rehabilitation and there were often multiple areas within each health system building block that required action in order to improve the situation. Findings can inform governments, regional and global agencies to support future efforts to strengthen rehabilitation. Additionally, our study demonstrates the value of STARS reports for health policy and systems research and can serve as a model for further comparative studies. |
| format | Article |
| id | doaj-art-8e7360bfa0fa4e899cfed3f1661695b2 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-8e7360bfa0fa4e899cfed3f1661695b22025-08-20T02:23:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01192e029710910.1371/journal.pone.0297109Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS).Pauline KleinitzCarla SabariegoGwynnyth LlewellynElsie TaloafiriAriane MangarRabindra BaskotaKedar MarahattaShiromi MaduwageMyo Hla KhinVivian WonanjiGeorge SampaAli Al-RjoubJaber Al-DaodAlarcos Cieza<h4>Background and objective</h4>The need for rehabilitation is growing due to health and demographic trends, especially the rise of non-communicable diseases and the rapid ageing of the global population. However, the extent to which rehabilitation is integrated into health systems is mostly unclear. Our objective is to describe and compare the nature and extent of integration of rehabilitation within health systems across nine middle-income countries using available Systematic Assessment of Rehabilitation Situation (STARS) reports.<h4>Methods</h4>Cross-country comparative study with variable-oriented design using available rehabilitation health system assessment reports from nine middle income countries.<h4>Findings</h4>The integration of rehabilitation into health systems is limited across countries. Governance and financing for rehabilitation are mostly established within health ministries but weakly so, while health information systems are characterized by no available data or data that is insufficient or not routinely generated. The overall numbers of rehabilitation workforce per capita are low, with frequent reports of workforce challenges. In most countries the availability of longer-stay, high-intensity rehabilitation is extremely low, the availability of rehabilitation in tertiary hospitals is modest and in government supported primary care its almost non-existent. Multiple concerns about rehabilitation quality arose but the lack of empirical data hinders formal appraisal.<h4>Conclusion</h4>The study sheds light on the limited integration of rehabilitation in health systems and common areas of difficulty and challenge across nine middle income countries. All countries were found to have a basis on which to strengthen rehabilitation and there were often multiple areas within each health system building block that required action in order to improve the situation. Findings can inform governments, regional and global agencies to support future efforts to strengthen rehabilitation. Additionally, our study demonstrates the value of STARS reports for health policy and systems research and can serve as a model for further comparative studies.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297109&type=printable |
| spellingShingle | Pauline Kleinitz Carla Sabariego Gwynnyth Llewellyn Elsie Taloafiri Ariane Mangar Rabindra Baskota Kedar Marahatta Shiromi Maduwage Myo Hla Khin Vivian Wonanji George Sampa Ali Al-Rjoub Jaber Al-Daod Alarcos Cieza Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). PLoS ONE |
| title | Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). |
| title_full | Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). |
| title_fullStr | Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). |
| title_full_unstemmed | Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). |
| title_short | Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO's Systematic Assessment of Rehabilitation Situation (STARS). |
| title_sort | integrating rehabilitation into health systems a comparative study of nine middle income countries using who s systematic assessment of rehabilitation situation stars |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297109&type=printable |
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