Global trends in rehabilitation and current situation in ASEAN countries

Abstract

Along with the demographic transition toward an aging society and the epidemiological transition toward non-communicable diseases, rehabilitation needs have been globally increasing. Rehabilitation had historically been defined only for persons with disabilities, while it is currently defined that anyone may need it at some point in their lives. Furthermore, it is considered an essential service that should be included in the Universal Health Coverage (UHC).

Every third person in the world is estimated in a health condition that could be a beneficiary of rehabilitation, and the rehabilitation need will increase in the future as the population ages. However, many countries, particularly low- and middle-income countries, struggle to address even their current needs adequately. To address this situation, the WHO launched “Rehabilitation 2030” in 2017. It has undertaken various initiatives to promote health systems for rehabilitation.

Rehabilitation needs are also increasing in ASEAN countries. As in other regions, the highest estimated rehabilitation needs are due to musculoskeletal disorders. Moreover, the needs are estimated to be higher for older people in both the Western Pacific and Southeast Asia regions. Regarding the workforce in ASEAN countries, the gap in the number of therapists per 10,000 population was a maximum of 48 times for physiotherapists and 20 times for occupational therapists among countries. This is a crucial issue to be addressed.

An appropriate analysis of the current situation is essential to promote the system for rehabilitation in each country. The WHO has developed tools for the systematic assessment of rehabilitation situations. Studies have reported that using the tools enabled revealing issues such as inadequate service design for rehabilitation, inefficient referral systems, and a lack of appropriate mechanisms for managing and evaluating the quality of rehabilitation in a targeted country. Referring to these useful tools, establishing representative indicators that demonstrate the rehabilitation situation in each country, and integrating those indicators into assessments for related issues such as the UHC, healthy aging, and long-term care, could improve the system for rehabilitation.