Rehabilitation Global Needs

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Introduction

Rehabilitation is the care needed when a person is experiencing or is likely to experience limitations in everyday functioning due to aging or a health condition, including chronic diseases or disorders, injuries, or trauma. According to the World Health Organization (WHO), rehabilitation is defined as a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions interacting with their environment. Rehabilitation is is a critical health strategy to optimise everyday functioning and ensure the highest possible standard of health and well-being and can include exercise, balance training, home modification, sensory integration, community activities, mobility aids, prosthetics/orthotics and many other interventions. Rehabilitation interventions optimize well-being by addressing impairments, limitations, and restrictions in many areas (mobility, vision, and cognition) while considering personal and environmental factors.  The need for rehabilitation depends on timing, type of intervention that a rehabilitation provider selects, aetiology and severity of the person’s health condition, the prognosis, the way in which illness affects the person’s ability to function in the environment, as well as the individual’s identified personal goals. These services may be required  throughout their lifespan by persons with health conditions.

Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. In the 21st century rapid population ageing accompanied with a rise in chronic conditions, trauma/injury survival and non-communicable diseases (NCD) in conjunction with increasing global conflict, rapid urbanization and motorization are leading to a shift in health care needs.

Growing Demand for Rehabilitation Services

The rapid increase in numbers of people experiencing a decline in functioning seen worldwide is due to the changing health and demographic trends of the increasing prevalence of non-communicable diseases and population aging. Hence, rehabilitation needs will further increase in the years to come, which is a considerable challenge for health and social systems in addressing those needs.

Non-Communicable Diseases

Noncommunicable diseases (NCDs), also known as chronic diseases differ significantly from acute conditions and require a different approach to the disease's complexity and frequent requirements for continuing care. The World Health Organization estimates that 50% of the global disease burden is due to chronic illness.  Since chronic diseases are long-lasting, conditions do have compounding and sustained effects on the individual and broader society's social, physical, psychological, and economic levels. Chronic diseases cost billions of dollars in direct healthcare costs and also in productivity losses.

Aging Population

According to the world data published in 2013, life expectancy has increased globally from less than 30 years to over 72 years. After two centuries of progress, people can expect to live much more than twice as long as our ancestors, and this progress is seen in every world region, with people today can expect to live more than twice as long. According to WHO, the number of people over 60 years of age is predicted to double by 2050, with more people living with chronic diseases such as diabetes, stroke, and cancer.

Childhood Related Issues

Children constitute a significant and important portion of users of rehabilitation services. The potential benefits of rehabilitation services are not restricted to aging and adult populations. According to WHO, while the child mortality rates are declining, not all who survive thrive. Early interventions that optimize developmental outcomes for children with various health conditions (including neurological, congenital, and intellectual impairments), and injuries, can positively affect participation rates in education, community activities, and future capacity to work.

Other Health Conditions

The ongoing incidence of injury (such as burns), the occurrence of natural calamities (earthquakes/floods), disease outbreaks, human-induced hazards (conflict, terrorism, or industrial accidents) can create overwhelming rehabilitation needs due to injury or illness. They affect existing services and significantly impact the most vulnerable populations and the weakest health systems.

Socioeconomic Impact of Poverty

Poverty is closely associated with NCDs. Lack of access to health care and screening for conditions and also lack of disease-prevention efforts put people in low-income countries at higher risk of dying from non-communicable disease as well as infectious disease.

The non-communicable disease threatens progress towards the 2030 Agenda for Sustainable Development, which includes a target of reducing premature deaths from NCDs by one-third by 2030. Widespread availability of rehabilitation services is essential for health systems to be able to respond effectively to the needs of older populations. Numerous studies have concluded that community-based rehabilitation increases the safety and independence of older people, reduces the risk of falls, and decreases the need for hospital and nursing home admissions.

Resources

• Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global Estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Dec 1.

References