Journal of Rehabilitation Medicine: Special Issue 50-4bokBW | Page 21

Strengthening health-related rehabilitation services at the national level
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Table II. Recommendations framework according of the chapter on rehabilitation of the World Report on Disability
(WRD)
No WRD chapter
1.
2.
3.
4.
5.
6.
7.
8.
9.
10. Disability – a
global picture
11.
12.
13.
14.
15.
16.
17.
18.
20.
21.
Recommendation area from the WRD
Recommendation Expected Implementation
for the country
outcomes projects
Adopt the ICF
Improve national disability statistics
Improve the comparability of data
Develop appropriate tools and fill the research gaps
General healthcare Policy and legislation
Financing and affordability
Service delivery
Human resources
Data and research
Rehabilitation
Policies and regulatory mechanisms
Other issues
Data collection
Financing
Human resources
Service delivery
Technology
Research and evidence-based practice
Terminology and translation of documents
Education and media campaigns
Stakeholder dialogue
Response to
specific country
needs
ICF: International Classification of Functioning, Disability and Health.
these experiences, which might also be regarded
as testing the underlying principles, the following
conclusions can be drawn:
• The overall concept is feasible and helpful for
developing NHDRPs.
• The development of NHDRPs is strongly de-
pendent on the political will in the country and
on support from national bodies, such as the
MOH and WHO country offices, as well as the
commitment of experts from the country.
• The methods of collecting information are fea-
sible and lead to a good picture of the situation.
In this context, using a standardized assessment
tool is very useful. The first draft under deve-
lopment has already provided a good basis of
information. It would be helpful to use a stan-
dardized questionnaire for situation analysis,
similar to the Ear and Hearing Care Situation
Analysis Tool (19).
• There is a lack of information about the pre-
valence of disability in Egypt and Ukraine and
the survey methods are inconsistent, resulting
in estimates of disability rates at odds with the
WRD figures. It is strongly recommended that
countries use an internationally accepted and
comparable method, such as the Model Disabi-
lity Survey (20). WHO headquarters in Geneva
should take a lead in performing these surveys.
It also would be helpful to perform international
scientific studies to evaluate the lived experience
of persons with specific health conditions (e.g.
by using the methodological approach of the
International Survey on Spinal Cord Injury
(InSCI; (21)).
• For the implementation of appropriate rehabili-
tation services, in addition to political will, the
working structure within and between ministries
is of major importance. There must be high-
level responsibility and a sound mechanism
for communication and coordination among
responsible bodies.
• Another important factor is the understanding
and conceptualization of disability. The WHO
definition of disability (9) is not yet incorpo-
rated everywhere, and terminology in national
languages, in some cases, may be a barrier to
a modern understanding of disability 2 . There is
a need for cultural and linguistic expertise to
clarify this issue; regional WHO offices may
play a major role in this.
• For RATs, it is crucial to talk to different stake-
holders, in particular to government and WHO
representations and to representatives of per-
sons with disabilities. It also crucial to involve
E.g. in Slavic countries disability is translated as “invalidity”, a
word that describes being “not (or less) valid” and thus refers to the
“old model” that disability is an attribute of a person and making
them less valid in contribution to society.
2
J Rehabil Med 50, 2018