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Global Rehabilitation Workforce, Policy and Innovation

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 July 2020) | Viewed by 16633

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Special Issue Editors

Prof. Michel D. Landry

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Guest Editor

Duke Global Health Institute, 310 Trent Drive, Durham, NC 27710 Map, Box 90519, Durham, NC 27708, USA
Interests: disability; rehabilitation; policy; incentives; global health; innovation

Dr. Tiago Silva Jesus

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Guest Editor

Global Health and Tropical Medicine & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, Lisbon 1349-008, Portugal
Interests: global health; rehabilitation; human resources for health; quality improvement; health policy and systems research

Prof. Helen Marie Hoenig

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Guest Editor

Rehabilitation Service, Durham VA Health Care System, 508 Fulton Street, Durham, NC 27705, USA
Interests: health policy and systems research; geriatric rehabilitation; spinal cord injury

Special Issue Information

Dear Colleagues,

Healthcare services, providers, and technologies are evolving globally, but they have not been able to keep pace with the alarming rise in rates of chronic conditions and disabilities. Rehabilitation providers and interventions have been shown to be able to bridge the supply and demand gap, yet there are numerous gaps that limit access to and quality of rehabilitation care. Toward closing those gaps, greater understanding of issues surrounding the rehabilitation workforce, policy, and service delivery innovations is urgently needed across the gradient of high, middle- and low-income countries.

This Special Issue welcomes empirical, review, and theoretical papers on the development, testing or implementation of innovative rehabilitation studies and solutions within the following broad fields: (1) planning, educating, managing, or regulating the rehabilitation workforce; (2) developing rehabilitation policies, plans and priorities, inclusively across sectors; (3) determining health systems’ capacity to meet rehabilitation needs, access, and coverage requirements; (4) developing rehabilitation infrastructures, governance, and funding schemas, and finally on (5) developing and evaluating service delivery innovations, such as the use of digital technologies, rehabilitation delivered in primary care, or implementing practice guidelines, referral pathways, or quality assurance programs. The examples are merely illustrative, and we welcome other categories that might fit into the context of rehabilitation workforce, policy, and service delivery innovations. Overall, innovations can target one or more key structures, or building blocks, for health systems to provide quality, accessible, affordable, and locally-acceptable rehabilitation services, across the care continuum.

Finally, we welcome papers addressing any country, region (e.g., rural areas), as well any political or economic context. Paper on cross-national developments, tools, and partnerships (e.g., international aid, South–South collaborations, reverse innovation) also are welcome, such as any other innovative, disruptive means to positively impact rehabilitation service provision worldwide.

Sincerely,

Prof. Michel D. Landry
Dr. Tiago Silva Jesus
Prof. Helen Marie Hoenig
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

rehabilitation
global health, workforce
health policy, health systems
governance
financing
service delivery
health information technologies
quality improvement
healthcare access, innovation

Published Papers (5 papers)

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Research

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12 pages, 323 KiB

Open AccessArticle

Rehabilitation Service Assessment and Workforce Capacity Building in Albania—A Civil Society Approach

by Boya Nugraha, Klejda Tani and Christoph Gutenbrunner

Int. J. Environ. Res. Public Health 2020, 17(19), 7300; https://doi.org/10.3390/ijerph17197300 - 6 Oct 2020

Cited by 4 | Viewed by 2364

Abstract

Background: Rehabilitation is an important health strategy. Due to the lack of rehabilitation professionals (e.g., no physical and rehabilitation medicine, occupational therapist, and others) and lack of rehabilitation services (e.g., no multi-profession rehabilitation services in hospital, no post-acute rehabilitation services, no community-based rehabilitation services), the need to strengthen rehabilitation in Albania was pronounced. Therefore, this project aimed at rehabilitation service assessment and workforce capacity building in Albania. Methods: The World Health Organization’s Template for Rehabilitation Information Collection was used to collect available data related to rehabilitation services. Additionally, two site visits to different rehabilitation centers including interviews with relevant stakeholders were performed. A stakeholders’ workshop to prioritize recommendations was also performed before finalizing the report. Results: In Albania, rehabilitation service delivery, rehabilitation workforces, and financing in rehabilitation need to be strengthened. Conclusions: The project achieved the intended objectives. Additionally progress has been occurring in the development and implementation of the Physical and Rehabilitation Medicine specialization at the University of Medicine, Tirana. Full article

(This article belongs to the Special Issue Global Rehabilitation Workforce, Policy and Innovation)

16 pages, 2279 KiB

Open AccessArticle

A Multi-Site Study of Traumatic Brain Injury in Mexico and Colombia: Longitudinal Mediational and Cross-Lagged Models of Family Dynamics, Coping, and Health-Related Quality of Life

by Annahir N. Cariello, Paul B. Perrin, Yaneth Rodríguez-Agudelo, Silvia Leonor Olivera Plaza, Maria Cristina Quijano-Martinez and Juan Carlos Arango-Lasprilla

Int. J. Environ. Res. Public Health 2020, 17(17), 6045; https://doi.org/10.3390/ijerph17176045 - 20 Aug 2020

Cited by 7 | Viewed by 3363

Abstract

Latin America has high rates of traumatic brain injury (TBI), yet reduced mental and physical health outcomes due to limited rehabilitation services. To understand the psychosocial adjustment process in TBI patients in Latin America, the incorporation of cultural values including family-based variables is imperative. The current study examined relations among healthy family dynamics, coping, and mental and physical health related quality of life (HRQL) among a sample of TBI patients across three sites and two countries over the first 4 months post-injury. A sample of 109 acute TBI patients from Mexico and Colombia were recruited, and a series of longitudinal mediation and cross-lag panel analyses were run. Mental and physical HRQL were positively associated with each other, as well as healthy family dynamics and coping. Coping partially mediated the effects of healthy family dynamics on both mental and physical HRQL. Family dynamics showed the strongest cross-lag relationships with coping going from 2 months to 4 months. Similarly, coping showed the strongest cross-lag relationships with both mental and physical HRQL going from baseline to 2 months. Results provide empirical support for the importance of a rehabilitation workforce that has been trained in and can effectively implement family-based interventions for individuals with TBI in Latin America. Full article

(This article belongs to the Special Issue Global Rehabilitation Workforce, Policy and Innovation)

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20 pages, 588 KiB

Open AccessArticle

Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study

by Tiago S. Jesus, Michel D. Landry, Helen Hoenig, Yi Zeng, Sureshkumar Kamalakannan, Raquel R. Britto, Nana Pogosova, Olga Sokolova, Karen Grimmer and Quinette A. Louw

Int. J. Environ. Res. Public Health 2020, 17(11), 4139; https://doi.org/10.3390/ijerph17114139 - 10 Jun 2020

Cited by 18 | Viewed by 3693

Abstract

Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r² = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources. Full article

(This article belongs to the Special Issue Global Rehabilitation Workforce, Policy and Innovation)

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17 pages, 2728 KiB

Open AccessArticle

Development of the Rehabilitation Health Policy, Systems, and Services Research Field: Quantitative Analyses of Publications over Time (1990–2017) and across Country Type

by Tiago S. Jesus, Helen Hoenig and Michel D. Landry

Int. J. Environ. Res. Public Health 2020, 17(3), 965; https://doi.org/10.3390/ijerph17030965 - 4 Feb 2020

Cited by 12 | Viewed by 2973

Abstract

Background: Health policy, systems and services research (HPSSR) is increasingly needed to enable better access to, and value of, rehabilitation services worldwide. We aim to quantify the growth of Rehabilitation HPSSR publications since 1990, compared to that of overall rehabilitation research and overall HPSSR. Methods: Quantitative, comparative analysis of publication trends using the PubMed database and its indexation system. Comprehensive search filters, based on Medical Subject Headings (MeSH), were built and calibrated to locate research articles with content on HPSSR and rehabilitation of physical impairments. Additional filters were used for locating research publications declaring funding support, publications in rehabilitation journals, and finally publications focused on high-income (HICs) or low- and middle-income countries (LMICs). The same approach was used for retrieving data on comparator fields—overall HPSSR and overall rehabilitation research. Linear regressions, with ANOVA, were used for analyzing yearly publication growths over the 28-year time frame. Results: Rehabilitation HPSSR publications in PubMed have grown significantly from 1990 to 2017 in the percentage of all rehabilitation research (from 11% to 18%) and all HPSSR (from 2.8% to 3.9%; both p < 0.001). The rate of Rehabilitation HPSSR published in rehabilitation journals did not change significantly over time (p = 0.47). The rates of publications with declared funding support increased significantly, but such growth did not differ significantly from that of the comparator fields. Finally, LMICs accounted for 9.3% of the country-focused rehabilitation HPSSR since 1990, but this percentage value increased significantly (p < 0.001) from 6% in 1990 to 13% in 2017. Conclusion: Rehabilitation HPSSR publications, i.e., those indexed in PubMed with related MeSH terms, have grown in both absolute and relative values. Rehabilitation HPSSR publications focused on LMICs also grew significantly since 1990, but still remained a tiny portion of the Rehabilitation HPSSR publications with country-specific MeSH terms. Full article

(This article belongs to the Special Issue Global Rehabilitation Workforce, Policy and Innovation)

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Review

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31 pages, 1499 KiB

Open AccessReview

Legal and Regulatory Approaches to Rehabilitation Planning: A Concise Overview of Current Laws and Policies Addressing Access to Rehabilitation in Five European Countries

by Aditi Garg, Dimitrios Skempes and Jerome Bickenbach

Int. J. Environ. Res. Public Health 2020, 17(12), 4363; https://doi.org/10.3390/ijerph17124363 - 18 Jun 2020

Cited by 7 | Viewed by 3734

Abstract

Background: The rising prevalence of disability due to noncommunicable diseases and the aging process in tandem with under-prioritization and underdevelopment of rehabilitation services remains a significant concern for European public health. Over recent years, health system responses to population health needs, including rehabilitation needs, have been increasingly acknowledging the power of law and formal written policies as strategic governance tools to improve population health outcomes. However, the contents and scope of enacted legislation and adopted policies concerning rehabilitation services in Europe has not been synthesized. This paper presents a concise overview of laws and policies addressing rehabilitation in five European countries. Methods: Publicly available laws, policies, and national action plans addressing rehabilitation issues of Sweden, Italy, Germany, the Netherlands and the United Kingdom were reviewed and descriptive documents analyzed. Actions found in national health policies were also evaluated for compliance with the key recommendations specified in the World Health Organization’s Rehabilitation 2030: Call for Action. Results: Across countries, legal and policy approaches to rehabilitation planning varied in scope and reach. While all countries entitle citizens to rehabilitation services, comprehensiveness of coverage varied. Health legislation of Germany and Netherlands recognizes access to rehabilitation as a human right for persons with disabilities, while Sweden and the United Kingdom acknowledge its importance in disability laws for achieving substantive equality for persons with disabilities. Regarding policies, in all countries but Italy, targeted universalism remains the predominant strategy governing rehabilitation services, as demonstrated by the lack of comprehensive, national action plans for rehabilitation addressing the general population. Nevertheless, references found in disease specific policies indicate a solid consensus that rehabilitation remains an integral component of the care continuum for those experiencing disability. Conclusion: Although a universal approach to rehabilitation coverage is institutionalized in national legislation of the countries examined, this approach is not expressed in formal policies. Targeted strategies aiming to ensure access to subpopulation groups with higher perceived needs for rehabilitation prevail, indicating a strong political will towards the reduction of health inequalities and the promotion of human rights of people experiencing disability. Results obtained from conducting this descriptive review provide the basis for future appraisals of the situation regarding rehabilitation service and policy development in Europe. Full article

(This article belongs to the Special Issue Global Rehabilitation Workforce, Policy and Innovation)

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