370 F . Khan et al .
Table I . Summary of current health systems / resources for Disability and Physical Medicine and Rehabilitation in 4 |
low- and middle-income countries ( LMICs ) |
|
Madagascar |
Mongolia |
Pakistan |
Nigeria |
Population , mil Life expectancy at birth , years ( 2015 ) |
24.2 ( 2015 ) 65.5 |
3 ( 2015 ) 68.8 |
201.9 ( 2016 ) 66.4 |
182.2 ( 2015 ) 54.5 |
Economic statistics GDP per capita a : $ 390
( 2014 ); Total expenditure on health : 3 % of GPD HDI rank : 154
Human resources ( healthcare )
Health Services / Infrastructure
Skilled health professionals : 4.8 / 10,000 Physicians : 0.14 / 1,000 people ; In 2012 : 3,188 doctors , 4,858 nurses / midwives , PT < 1 / 10,000 people
3 hospital beds / 10,000 people ( 2010 ) Hospitals total density / 100,000 population : 0.47 ( 2013 )
GDP per capita a : $ 4,353 ( 2014 ); Total expenditure on health : 4.7 % of GPD HDI rank : 90
Skilled health professionals : 64.6 / 10,000 Physicians : 2.9 / 1,000 people ; In 2011 : 7,140 doctors , 10,143 nurses / midwives
3 hospital beds / 10,000 people ( 2010 ) Hospitals total density / 100,000 population : 2.5 ( 2013 )
Disability data |
PwD : ≈1.8 mil ( 2000 ) |
PwD : 108,000 |
|
Disability-prevalence : 7 – 8 %
Disability-prevalence :
|
( 2000 ) Mortality from NCDs b : 23.4 % |
3.9 % ( 2010 ) Mortality from NCDs b : 32.0 % |
Disability type Polio ; stroke ; leprosy ; congenital diseases ; malnutrition ; drug and alcohol consumption ; Alzheimer ’ s disease , cerebral palsy
Legislation of disability for Persons with disability
CBR
Research and evaluation
1998 law for equal rights to PwD , CRPD ratified : 2007 ; National Decade of Disabled Persons ( 2003 ), The Madagascar Action Plan 2007 – 2012
No National CBR programme , most funded by NGOs Recent research on orthoses for clubfoot ; no inter-country collaboration ; member of ISPRM
Physical : 29 % Mental / intellectual : 19 %, Visual : 15 %, hearing : 12 %, speech disability : 6 %
CRPD signature – no , ratification 2009 ; Law of Mongolia on Social Security of Persons with Disabilities 2005 ; National Program for Promoting Persons with Disabilities , 2006 – 2012
Government , NGO-funded CBR programmes
Currently on an upward trend in research in medical rehabilitation
GDP per capita a : $ 1,427 ( 2015 ); Total expenditure on health : 2.8 % of GPD HDI rank : 147
Skilled health professionals : 14.0 / 10,000 Physicians : 0.8 / 1,000 people In 2014 : 149,142 doctors , 111,857 nurses / midwives 6 / 10,000 people ; rehab physicians : 38 ( 25 military ), PT / OT < 1 / 10,000 people
GDP per capita a : $ 2,640 ( 2016 ); Total expenditure on health : 3.7 % of GPD HDI rank : 152 Skilled health professionals : 20.1 / 10,000 Physicians : 0.4 / 1,000 people ; In 2008 : 56,526 doctors , 224,943 nurses / midwives , PT < 2 / 10,000 people
6 beds / 10,000 people
Total 34,173 health Hospitals total density / 100,000 facilities ( 2011 ): population : 0.53 ( 2013 )
88 % primary , 12 % 989 public & 800 private secondary , 1 % tertiary hospitals , 596 rural health 22 healthcare centres , 4,910 health units at facilities / 100,000 basic primary healthcare level people ( 2010 ) 15 departments of rehabilitation medicine , 32 PT departments ( mainly in the army ) PwD : 3.3 mil Disability prevalence : 2.5 % ( 1998 ) Mortality from NCDs b : 20.5 %
Physical : 18.9 %, visual : 8.1 %, hearing : 7.4 %, Intellectual : 7.6 %, Mental : 6.4 %, multiple : 8.2 %, others 43.4 %
CRPD signature 2008 , ratification 2011 ; National Policy for PwD : 2002 ; National Plan of Action 2006 – 2025 ; the Disabled Persons ( Employment and Rehabilitation ) Ordinance 1981 ; Convention on Rights of the Child 1990 ; Convention on Elimination of all Forms of Discrimination against Women 1996 No National CBR programme , most funded by NGOs
Currently on an upward trend in research in medical rehabilitation ; member ISPRM
PwD : 3.3 mil Disability prevalence : 2.3 % ( 2016 ) Mortality from NCDs b : 19.6 % Visual , hearing & physical impairment ; intellectual & communication impairments
CRPD signature 2007 , ratification 2010 ; Nigerians with Disability Decree 1993 ; Lagos State Special People ’ s Law 2011 ; The Child Rights Act , 2003 ; National Social Welfare Policy 2012
No National CBR programme , most funded by NGOs Currently on an upward trend in research in medical rehabilitation
( Main sources : WHO World Health Statistics 2016 ; WHO Country Profile ; WHO Health Statistics 2011 ; WHO Disability and Rehabilitation Status 2004 ( 14 ); ESCAP 2012 , Statistical Yearbook for Asia and the Pacific 2014 , Umeh et al . African Disability Rights Yearbook 2013 ,
Wikipedia 2017 ). a GPD ( nominal ). b NCDs = cardiovascular disease ( CVD ), cancer , diabetes and chronic respiratory disease . c Skilled health professional density
2005 – 2013 , refers to : primarily nurses / midwives and physicians . CBR : community-based rehabilitation ; CRPD : Convention on the Rights of Persons with Disabilities ; GDP : gross domestic product ; GNI : gross national income ; HDI : Human Development Index ; ISPRM : International Society of Physical and Rehabilitation Medicine ; LMICs : Lowand Middle-Income Countries ; OT : occupational therapists ; mil : million ; NGO : non-governmental organization ; NCDs : non-communicable diseases ; P & O : prosthetics and orthotics ; PM & R : Physical Medicine and Rehabilitation ; PT : physiotherapists ; PwD : persons with disability ; SLTs : speech and language therapists ; WHO : World Health Organization .
that there are fewer than 2 PTs for 10,000 people . Despite the scarcity of rehabilitation resources ( infrastructure and human resources ), to date , there are limited systems to evaluate and / or build rehabilitation capacity ( personal communication with workshop participants ).
Based on the current World Bank Group ’ s classification to define income status of the countries ( gross national income ( GNI ) in 2015 ), except Madagascar ( categorized as a low-income country ; GNI per capita ≤ US $ 1,045 ), all 3 countries of interest ( Mongolia , Nigeria and www . medicaljournals . se / jrm