Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review.
Ohnmar Htwe, Brenda S Yuliawiratman, Abena Y Tannor and 5 others
PMID 38551518WHAT IT FOUND
Rehabilitation access in low- and middle-income countries was limited most often by cost, facilities and workforce.
Across 42 included papers, insurance, government or NGO funding, community-based programs and training were reported facilitators.
Key findings
01Financial barriers were reported in almost all papers as a primary obstacle to forming and accessing rehabilitation services in low- and middle-income countries.
02Facility, workforce, education and community-based program shortages were also reported barriers to rehabilitation service organization.
03Reported facilitators included insurance or government and NGO funding, community-based programs, and education or training programs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only English-language papers were included, and grey literature was excluded, so non-English and unpublished reports were not available to the review. From 150 full-text reports, 42 papers were selected, and the included papers were a mix of cross-sectional studies, qualitative studies, reviews, organizational or consortium studies, a clinical commentary and descriptive papers. The review reports themes from included papers rather than patient outcomes or tested service changes, so it does not show which barrier or facilitator caused a change in access. The papers cover many countries and service settings, so findings may not apply to any one local clinic, hospital or community program.
Declared interests
The authors declared no conflict of interest with any financial organization regarding the material. The review was conducted under the ISPRM-WHO Working Group for rehabilitation capacity building in low- and middle-income countries.
The easy way to misread this
Do not read the listed facilitators as proven ways to increase access. The review reports themes from 42 included papers. It does not provide evidence that any single facilitator improves rehabilitation access.