New Contributor Series: Beatrice E.A. Sankah on Rehabilitation in Africa

Rehabilitation in Africa

Beatrice E.A Sankah, PhD


State of Rehabilitation in Africa

In simple terms, the World Health Organization (WHO) describes rehabilitation as helping a child, adult or older person become as independent as possible in everyday activities and enable their participation in education, work, recreation, and meaningful life roles. 

Global conversations on rehabilitation

The need for rehabilitation is highly unmet and globally, about 2.4 billion people are living with health conditions that could benefit from rehabilitation. Rehabilitation has been under-prioritized and under-resourced for many years in many countries across the globe (Cieza et al. 2020). It has and continues to be seen as (1) a backup strategy when preventive, promotive, or curative interventions fail, (2) a disability-specific service needed by a few people, or (3) a specialized service only affordable to some members of society. Many lower-middle-income regions including Africa share similar challenges with the rest of the world, however, these challenges are more pronounced as more than 50% of people within the region are experiencing inaccessible or underserviced rehabilitation services than they require (WHO). The above are ongoing global conversations that heralded the development of many global initiatives including these WHO initiatives: the Rehabilitation 2030 call to action to integrate rehabilitation into the health systems, the Package of interventions for rehabilitation to support the management of prevalent conditions with high need for rehabilitation, and the World Rehabilitation Alliance to foster the rehabilitation advocacy and ensure rehabilitation inclusion in many health systems globally.  

With our lenses on Africa, we ask 

  1. How Africa is driving the rehabilitation agenda. 
  2. What health conditions need rehabilitation the most within the region? 
  3. What rehabilitation interventions are available to ensure independent living and utmost participation in daily activities?

Within this blog, we discuss “How Africa is driving the rehabilitation agenda”. Subsequent blogs will address questions 2 and 3. 

State of Rehabilitation in Africa

Similar to the rest of the world, there is a growing need for rehabilitation within the region due to many factors including increasing injuries, the aging population, and disabilities resulting from non-communicable diseases such as stroke and low back pain (WHO Africa region). Compared to the global estimates (1 in 3 people), 1 in 5 people could benefit from rehabilitation within the African region and as of 2019, about 210 million Africans have experienced conditions that could also benefit from rehabilitation. The need for rehabilitation is high in Africa. However, in comparison to other world regions, Africa reported lower estimates regarding the prevalence of non-communicable diseases needing rehabilitation and number of years lived with disability (WHO Rehabilitation Need Estimator). For example, musculoskeletal diseases were the most prevalent condition reported among seven condition categories studied, however compared to other world regions, Africa recorded the lowest prevalence (see Figure 1). 

Despite the comparatively low prevalence (Figure 1), these conditions are still prevalent regardless and need to be explored in terms of clinical management, policy decision-making, advocacy on awareness creation, and research. Recommendations on rehabilitation interventions and their implementation within national healthcare systems are also warranted.


Figure 1: Prevalence of all conditions needing rehabilitation according to world regions.

The graph describes the seven prevalent conditions needing rehabilitation across six world regions. This graph was extracted from the WHO Rehabilitation Need Estimator on all condition categories, all ages, both sexes, and prevalent cases per 100k in 2019. K = Thousand. 


How is Africa driving the rehabilitation agenda?

Advancing Rehabilitation in Africa is work in progress. While there is still a lot to do, appreciable efforts are being taken by the WHO African regional office with other rehabilitation stakeholders to advance the Rehabilitation 2030 agenda within the region. In this regard, WHO Africa held its inaugural regional rehabilitation meeting in November 2023 to provide an overview and identify actions regarding the status of rehabilitation and assistive technology (AT) within health systems in Africa. The report of the meeting is available here however, key considerations from the report for effective rehabilitation in Africa include training and education, workforce development, research, and data collection at both national and regional levels. 


Accessibility, availability, and affordability of rehabilitation services vary within and between countries in the African region. However, for people receiving some form of rehabilitation currently, interventions being offered are (1) community-based rehabilitation, (2) provision of orthopedic devices and mobility aids, (3) training and capacity development of rehabilitation personnel and policy development on disability, and (4) capacity building among others (WHO African region). While these constitute some aspects of the recommendations within the WHO Package of interventions for rehabilitation, not all interventions have been explored as some countries are unaware of their existence. It is therefore paramount for countries within the region to explore how these recommended rehabilitation interventions among other WHO tools can be integrated and implemented.

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