Neurorehabilitation in Developing Countries: Challenges and the Way Forward

Neurological disorders affect one billion people worldwide and have significant disability-burden with longer-term functional and psychosocial issues that need comprehensive management, including rehabilitation. The prevalence of disability due to neurological conditions is escalating worldwide. These add to the economic burden for healthcare systems (particularly in lowresourced countries), where despite improved acute health care systems, health policies have not extended to include rehabilitation. Neurorehabilitation is interdisciplinary and cross-sectorial, requiring collaborative coordinated effort of diverse sectors, professions, patients and community. This article provides a narrative overview of literature on neurorehabilitation in developing countries and highlights some of the challenges in implementation of the World Health Organization’s Global Disability Action Plan (DAP), focusing on rehabilitation (Objective 2) within the context of neurological conditions. Several issues related to neurorehabilitation are discussed for a systematic approach to build horizontal health care systems that are sustainable and responsive; involvement of bilateral agencies using multi-sectorial approach, new partnerships, strategic collaboration; provision of technical assistance, research and development; and capacity-building for a strong interdisciplinary workforce. Other factors that need to be addressed include governance for strengthening health care systems through logistics, surveillance and service delivery; and adequate scaling. The DAP provides comprehensive summary actions to tackle global disability, including neurological disorder-related disability, and offers governments, policy-makers and other relevant stakeholders a blueprint for implementing recommendations of the World Disability Report and the Convention on the Rights of Persons with Disabilities, and facilitate social inclusion of persons with neurological conditions, in countries at all stages of development.