Rehabilitation is a cornerstone of health care, aiming to improve functioning and reduce the impact of disability on daily life. Recent estimates indicate that approximately 2.6 billion people globally could benefit from rehabilitation services. However, access remains critically limited in many regions. Recognizing this challenge, the World Health Organization (WHO) launched the Rehabilitation 2030 initiative in February 2017, emphasizing the need to integrate rehabilitation into health systems. This commitment was further solidified in May 2023, when the 76th World Health Assembly unanimously adopted the first-ever resolution on rehabilitation: “Strengthening Rehabilitation in Health Systems”. The resolution highlights the urgent need for robust research to inform policy and systems development, particularly through Health Policy and Systems Research (HPSR).
In response, CochraneRehab, in collaboration with the WHO Rehabilitation Programme, has developed a protocol to produce four Cochrane Overviews of systematic reviews. These reviews focus on the four key pillars of HPSR, as outlined in the Cochrane Effective Practice and Organization of Care (EPOC) taxonomy:
- Delivery arrangements: Investigating how, when, and where rehabilitation services are organized and delivered and who delivers them.
- Financial arrangements: Exploring how funds are collected, insurance schemes, how services are purchased, and using targeted financial incentives or disincentives.
- Governance arrangements: Examining rules and processes that define authority, accountability, openness, participation, and coherence.
- Implementation strategies: Identifying interventions designed to bring about changes in healthcare organizations, the behavior of healthcare professionals, or healthcare recipients’ use of health services.
The protocol, approved by the Cochrane Central Editorial Service and recently published in the European Journal of Physical and Rehabilitation Medicine, offers the strategic roadmap for synthesizing evidence in these critical areas. The project’s results will assist policymakers and other stakeholders in developing strategies to address challenges and improve access, quality, and outcomes of rehabilitation services through research and evidence-based health policy development.
This collaboration marks a major milestone in strengthening rehabilitation’s role within health systems, aligning with global efforts to ensure equitable access to high-quality care for those in need. Stay tuned for updates!
The Thematic group units involved in the project are:
- Milan University (Milan, IT)
- Galeazzi Sant’Ambrogio Hospital (Milan, IT)
- CERC, Humanitas University (Milan, IT)
- Vanvitelli University (Naples, IT)
- Lucerne University (Lucerne, CH)
- IDRR, Ontario Tech University (Toronto, CA)
References:
Negrini S, Kiekens C, Del Furia MJ, Minozzi S, Ryan R, Arienti C, Parkhill A, Côte P, Gimigliano F, Sabariego C, Capodaglio P, Decary S, DE Groote W, Frontera WR, Mudau Q, Atkinson-Graham M, Bakaa N, Battel I, Butzbach OK, Cordani C, Engeda EH, Konstantinidis T, Iolascon G, Liguori S, Mior S, Moretti A, Paoletta M, Touhami D, Wong J, Duttine A. Evidence synthesis of health policy and systems research in rehabilitation: a protocol for Cochrane overviews of systematic reviews on delivery, governance, financial arrangements, and implementation strategies. Eur J Phys Rehabil Med. 2025 Jan 27. doi: 10.23736/S1973-9087.24.08833-6. Epub ahead of print. PMID: 39869129. PubMed link - Full-text link