Health-related rehabilitation services: assessing the global supply of and need for human resources

Abstract

Background: Human resources for rehabilitation are often a neglected component of health services strengthening and health workforce development. This may be partly related to weaknesses in the available research and evidence to inform advocacy and programmatic strategies. The objective of this study was to quantitatively describe the global situation in terms of supply of and need for human resources for health-related rehabilitation services, as a basis for strategy development of the workforce in physical and rehabilitation medicine.

Methods: Data for assessing supply of and need for rehabilitative personnel were extracted and analyzed from statistical databases maintained by the World Health Organization and other national and international health information sources. Standardized classifications were used to enhance cross-national comparability of findings.

Results: Large differences were found across countries and regions between assessed need for services requiring health workers associated to physical and rehabilitation medicine against estimated supply of health personnel skilled in rehabilitation services. Despite greater need, low- and middle-income countries tended to report less availability of skilled health personnel, although the strength of the supply-need relationship varied across geographical and economic country groupings.

Conclusion: The evidence base on human resources for health-related rehabilitation services remains fragmented, the result of limited availability and use of quality, comparable data and information within and across countries. This assessment offered the first global baseline, intended to catalyze further research that can be translated into evidence to support human resources for rehabilitation policy and practice.

Figure 1

Density of allied health workers associated to rehabilitation, 73 countries. Source: Global Atlas of the Health Workforce [19].

Figure 2

Percentage distribution of the medical workforce by practice area, 6 countries. Source: Canadian Institute for Health Information; Oficina Nacional de Estadísticas de Cuba; Alto Comissariado da Saude de Portugal; Statistics Korea; Sudan National Human Resources for Health Observatory; Syrian Central Bureau of Statistics [27-32].

Figure 3

Density of physiotherapists by data source, 33 countries. Source: Global Atlas of the Health Workforce; World Confederation for Physical Therapy [19,22]. Note: Countries included are Australia, Bahrain, Bangladesh, Bolivia, Brazil, Cameroon, Canada, Costa Rica, Egypt, Estonia, Finland, Ghana, Indonesia, Iran, Jordan, Kenya, Namibia, Nepal, New Zealand, Nigeria, Panama, Romania, Rwanda, South Africa, Sri Lanka, Swaziland, Tanzania, Thailand, Uganda, United Kingdom, USA, Zambia and Zimbabwe.

Figure 4

Attributable years of life lost versus density of health professionals associated to rehabilitation, 67 countries. Source: Global Atlas of the Health Workforce; GBD Disease and injury country estimates [19,23].

Figure 5

Attributable years of life lost versus density of rehabilitation health professionals, by region, 58 low- and middle-income countries. Source: Global Atlas of the Health Workforce; GBD Disease and injury country estimates [19,23]. Note: Country geographical classification based on WHO regions.

Figure 6

Attributable years of life lost versus density of rehabilitation health professionals, 9 high and upper-middle income countries. Source: Global Atlas of the Health Workforce; GBD Disease and injury country estimates [19,23]. Note: Country income classification based on World Bank criterion for classifying national economies.