A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries

Tess Bright, Sarah Wallace and Hannah Kuper
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Tess Bright: International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK
Sarah Wallace: International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK
Hannah Kuper: International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1 E7HT, UK

IJERPH, 2018, vol. 15, issue 10, 1-34

Abstract: Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMICs) is limited. A systematic review was conducted to examine this in depth. In February 2017, six databases were searched for studies measuring access to rehabilitation among people with disabilities in LMICs. Eligible measures of access to rehabilitation included: use of assistive devices, use of specialist health services, and adherence to treatment. Two reviewers independently screened titles, abstracts, and full texts. Data was extracted by one reviewer and checked by a second. Of 13,048 screened studies, 77 were eligible for inclusion. These covered a broad geographic area. 17% of studies measured access to hearing-specific services; 22% vision-specific; 31% physical impairment-specific; and 44% measured access to mental impairment-specific services. A further 35% measured access to services for any disability. A diverse range of measures of disability and access were used across studies making comparability difficult. However, there was some evidence that access to rehabilitation is low among people with disabilities. No clear patterns were seen in access by equity measures such as age, locality, socioeconomic status, or country income group due to the limited number of studies measuring these indicators, and the range of measures used. Access to rehabilitation services was highly variable and poorly measured within the studies in the review, but generally shown to be low. Far better metrics are needed, including through clinical assessment, before we have a true appreciation of the population level need for and coverage of these services.

Keywords: access; health care; rehabilitation; people with disabilities; low- and middle-income country; universal health coverage (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (15)

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