Disability and Capacity Building of Rehabilitation Health Workforce in Low and Middle Income Countries

摘要

Disability is a global public health issue. More thanone billion people currently experience disability,which equates to approximately 15% of the world’spopulation. Disability disproportionately affectsmarginalized, disadvantaged or at-risk populationssuch as women, older people, and people who arepoor. Children from poorer households, indigenouspopulations, and those in ethnic minority groupsare also at signifcantly higher risk of experiencingdisability. Lower income countries have a higherprevalence of disability than higher income countries.1There is strong evidence for a link between disabilityand poverty in low and middle income countries andan urgent need for further research and policy action tobreak the cycle.2 A cross pilot survey of rehabilitationhealth professionals from Pakistan, Morocco, Nigeriaand Malaysia captured assessment of clinical skillsrequired in rehabilitation. The fndings highlight coreskills and gaps in training, education, and availablefunding. The survey recommended that investment incapacity-building of rehabilitation health workforcewill allow professional skill development strategiesto meet particular needs described by participantsto deliver high-quality services.3 Bangladesh, a lowresource country in South Asia, launches rehabilitationmedicine service in some 50 years back, but a snailpace progress creates a sordid saga in this world’smost densely populated country. The structures ofprimary health care delivery systems in Bangladeshhave no provision of priority care for disabled andhave scarcity of skilled manpower to address thedisabled. In Bangladesh, like many other low andmiddle income countries (LMICs) there is a shortageof workers with appropriate rehabilitation skills,resulting in task-shifting practices. For rehabilitationservices in many LMICs, there are challenges withinoperational healthcare systems in terms of policy,funding structure/infrastructure, capacity, human andphysical resources, and technology.