In the 2030 Agenda for Sustainable Development, goal 3 aims to “ensure healthy lives and promote well-being for all at all ages” and calls for the achievement of universal health coverage (UHC). UHC is defined as “all people receiving the full spectrum of quality health services that meet their needs without being exposed to financial hardship in paying for the services”. Rehabilitation is among the essential health services to be included in UHC.
Rehabilitation service delivery can be provided over different levels of care, settings and models. Mostly, rehabilitation services are concentrated in secondary and tertiary levels of care providing both inpatient and outpatient care. These are often located at the district, regional and national levels and are typically provided in hospital and institutional settings including general hospitals, rehabilitation wards in general hospitals, specialized rehabilitation hospitals as well as nursing and respite homes. Rehabilitation services, however, also play a crucial role in the primary level of care which is usually the first point of contact for many people and serves as a link to specialized services. These primary care services are usually provided on an outpatient, outreach and home care basis in community settings including single or multi professional practices (office or clinic), homes, schools, and workplaces.
With the increasing need for rehabilitation worldwide and taking into account the limited financial resources, it is crucial to prioritize evidence-based and cost-effective interventions for the integration of rehabilitation in health systems. Successful rehabilitation service delivery also requires the availability of rehabilitation workforce, who are equipped with the competencies needed to deliver the interventions. In countries where rehabilitation is not available, or is limited, information on evidence-based and cost-effective interventions and the required workforce will help the planning and integration of rehabilitation in health systems.
WHO provides technical support to countries working to strengthen rehabilitation service delivery, and is developing resources to support countries in planning, budgeting and integrating evidence-based and cost-effective interventions into their health system.
The Package of interventions for rehabilitation is a resource that provides information on essential interventions for rehabilitation and related resource requirements for 20 health conditions. This resource aims to facilitate planning and budgeting the integration of rehabilitation in all service delivery platforms in health systems to achieve universal health coverage for rehabilitation and make it accessible to all people who are in need for it.
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The Package of interventions for rehabilitation (PIR) outlines the most essential interventions for rehabilitation for 20 health conditions, together with information on the required material resources and workforce that is usually skilled to deliver these interventions. As such, the PIR presents an indispensable resource for countries when planning for and budgeting the integration of rehabilitation services into their health systems. This report illustrates the use of the PIR in developing a first rehabilitation service package in Georgia. It demonstrates how the PIR was used to prioritize the target population for this service package, as well as how information on interventions for rehabilitation was used to define the service package, and how the costing of it was informed. Insights into the steps that were taken to implement the service package are also described. Together with the lessons learned from these processes, this report provides valuable information on how countries can use the PIR when developing a rehabilitation service package and the practical aspects to be considered during implementation.
The standards for rehabilitation services (SRS) will provide technical guidance to ministries of health, service planners and other users on (minimum) quality requirements, quality-improvement and assurance initiatives, and facility equipment to ensure the development and improvement of rehabilitation services, that are effective and efficient, people-centred and safe, and to which all people have timely and equitable access. The SRS will be applicable to rehabilitation services at all service delivery levels (from community to tertiary care levels), all settings (in-patient or out-patient; single service provider or specialized multidisciplinary teams) and for all rehabilitation areas (e.g. musculoskeletal, neurological, or cardiopulmonary rehabilitation). The SRS will have a specific focus on the needs in low- and middle resource countries.
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