What would 'upscaling' involve? A qualitative study of international variation in stroke rehabilitation.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Stroke* ; Stroke Rehabilitation*; Colombia ; Germany ; Ghana ; Humans ; Nepal ; New Zealand/epidemiology ; Pakistan ; Sierra Leone ; Turkey/epidemiology ; United Arab Emirates ; United Kingdom ; Vietnam

Background: Demand for stroke rehabilitation is expected to grow dramatically; with the estimated prevalence of stroke survivors rising to 70 million worldwide by 2030. The World Health Organization's (WHO) report - Rehabilitation 2030: A call for action - has introduced the objective of 'upscaling' rehabilitation globally to meet demand. This research explored what upscaling stroke rehabilitation might mean for health professionals from countries at different stages of economic development.
Methods: Qualitative descriptive study design using semi-structured interviews was employed. Purposively sampled, clinical leaders in stroke rehabilitation were recruited for interviews from low through to high-income countries.
Results: Twelve rehabilitation professionals (medicine, physical therapy, occupational therapy, and speech and language therapy) from high (United States of America, Germany, United Kingdom, United Arab Emirates, New Zealand), upper-middle (Colombia and Turkey), lower-middle (Vietnam, Pakistan, Ghana), and low-income countries (Nepal and Sierra Leone) were interviewed. Upscaling was seen as a necessity. Successful scaling up will require initiatives addressing: political governance and managerial leadership, increasing knowledge and awareness of the value of rehabilitation, financial support, workforce developments, physical space and infrastructure, and the development of community services and reintegration.
Conclusion: Although there have been many gains within the development of stroke rehabilitation internationally, further investment is required to ensure that this patient population group continues to receive the best quality services. For the WHO to be successful in implementing their objective to upscale rehabilitation, specific attention will need to be paid to political, professional, economic, and sociocultural issues at global and local levels.

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Keywords: Developing countries; Physical and rehabilitation medicine; Rehabilitation; Stroke rehabilitation; World Health Organization

Date Created: 20210430 Date Completed: 20210514 Latest Revision: 20240401

20240401

PMC8082958

10.1186/s12913-021-06293-8

33926440