IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0297109.html
   My bibliography  Save this article

Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO’s Systematic Assessment of Rehabilitation Situation (STARS)

Author

Listed:
  • 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

Abstract

Background and objective: 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. Methods: Cross-country comparative study with variable-oriented design using available rehabilitation health system assessment reports from nine middle income countries. Findings: 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. Conclusion: 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.

Suggested Citation

  • Pauline Kleinitz & Carla Sabariego & Gwynnyth Llewellyn & Elsie Taloafiri & Ariane Mangar & Rabindra Baskota & Kedar Marahatta & Shiromi Maduwage & Myo Hla Khin & Vivian Wonanji & George Sampa & Ali A, 2024. "Integrating rehabilitation into health systems: A comparative study of nine middle-income countries using WHO’s Systematic Assessment of Rehabilitation Situation (STARS)," PLOS ONE, Public Library of Science, vol. 19(2), pages 1-37, February.
    • Handle: RePEc:plo:pone00:0297109
    DOI: 10.1371/journal.pone.0297109
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0297109
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297109&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0297109?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Marmor, Theodore & Wendt, Claus, 2012. "Conceptual frameworks for comparing healthcare politics and policy," Health Policy, Elsevier, vol. 107(1), pages 11-20.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Cacace, Mirella & Ettelt, Stefanie & Mays, Nicholas & Nolte, Ellen, 2013. "Assessing quality in cross-country comparisons of health systems and policies: Towards a set of generic quality criteria," Health Policy, Elsevier, vol. 112(1), pages 156-162.
    2. Simone M Schneider, 2020. "Beyond endogeneity in analyses of public opinion: Evaluations of healthcare by the foreign born across 24 European countries," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-20, June.
    3. Immergut, Ellen M. & Schneider, Simone M., 2020. "Is it unfair for the affluent to be able to purchase “better” healthcare? Existential standards and institutional norms in healthcare attitudes across 28 countries," Social Science & Medicine, Elsevier, vol. 267(C).
    4. Bonasia, Mariangela & Kounetas, Konstantinos & Oreste, Napolitano, 2020. "Assessment of regional productive performance of European health systems under a metatechnology framework," Economic Modelling, Elsevier, vol. 84(C), pages 234-248.
    5. Mackenbach, Johan P. & McKee, Martin, 2015. "Government, politics and health policy: A quantitative analysis of 30 European countries," Health Policy, Elsevier, vol. 119(10), pages 1298-1308.
    6. repec:jet:dpaper:dpaper391 is not listed on IDEAS
    7. Matthias Fischer & Harald Heinrichs, 2018. "Dimensions, Dialectic, Discourse. Three Political Perspectives on the Sustainability of the German Healthcare System," IJERPH, MDPI, vol. 15(7), pages 1-22, July.
    8. Yin, Jason Dean-Chen & He, Alex Jingwei, 2018. "Health insurance reforms in Singapore and Hong Kong: How the two ageing asian tigers respond to health financing challenges?," Health Policy, Elsevier, vol. 122(7), pages 693-697.
    9. Schneider, Simone M. & Popic, Tamara, 2018. "Cognitive determinants of healthcare evaluations – A comparison of Eastern and Western European countries," Health Policy, Elsevier, vol. 122(3), pages 269-278.
    10. Proksch, Dorian & Busch-Casler, Julia & Haberstroh, Marcus Max & Pinkwart, Andreas, 2019. "National health innovation systems: Clustering the OECD countries by innovative output in healthcare using a multi indicator approach," Research Policy, Elsevier, vol. 48(1), pages 169-179.
    11. Westra, Daan & Angeli, Federica & Carree, Martin & Ruwaard, Dirk, 2017. "Understanding competition between healthcare providers: Introducing an intermediary inter-organizational perspective," Health Policy, Elsevier, vol. 121(2), pages 149-157.
    12. Davis, Peter & Milne, Barry & Parker, Karl & Hider, Phil & Lay-Yee, Roy & Cumming, Jackie & Graham, Patrick, 2013. "Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions," Health Policy, Elsevier, vol. 112(1), pages 19-27.
    13. Embrett, Mark G. & Randall, G.E., 2014. "Social determinants of health and health equity policy research: Exploring the use, misuse, and nonuse of policy analysis theory," Social Science & Medicine, Elsevier, vol. 108(C), pages 147-155.
    14. Milena Vainieri & Guido Noto & Francesca Ferre & Laura C. Rosella, 2020. "A Performance Management System in Healthcare for All Seasons?," IJERPH, MDPI, vol. 17(15), pages 1-10, August.
    15. Matthias Fischer, 2016. "Welfare with or without Growth? Potential Lessons from the German Healthcare System," Sustainability, MDPI, vol. 8(11), pages 1-14, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0297109. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.