Joint statement: a call for rehabilitation in UHC


Saturday, Dec. 12, is Universal Health Coverage Day, or UHC for short. This year, Handicap International drafted a joint statement, signed by 19 other organizations active in rehabilitation, highlighting the vital need to not just define rehabilitation in the context of UHC, but to discuss rehabilitation and include rehabilitation within global health planning. The joint statement follows:

Universal Health Coverage (UHC) is vital to achieve a healthy population in the 21st Century. It seeks to foster equitable and sustainable access to health services; addresses emerging and longstanding challenges in health; ensures people don’t suffer financial hardship when seeking healthcare; and supports economic and development progress.

We, a group of actors working across the globe on rehabilitation services, are concerned that whilst rehabilitation is defined within UHC, it is rarely discussed and included within global health planning. Rehabilitation services, including assistive health technologies, are “a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments” . These services contribute to healthy, independent populations which can fully participate in society. On this UHC Day we want to ensure that these vital services for millions of people around the world are not forgotten:

Because our world is changing.

Today 15% of the world’s population lives with a form of disability.

In low and middle as well as in higher income countries, demographic trends show the health needs of populations are changing. People are living longer, into older age, but are also experiencing more non-life threatening health conditions. Non communicable diseases are not only causing a rise in the number of deaths but also impairments and disability. The epidemic of road crashes causes many more injuries than they do deaths. Conflicts, crises and natural disasters are the reason for many short or long term impairments. In addition improving survival rates for people amongst mothers, young children, people living with HIV and other infectious diseases may lead to rising incidences of comorbidities and disabilities.

Because our vision of health is changing.

Being healthy is a human right.

Health can no longer be seen as a mere reduction of mortality. Good health means enjoying maximal physical, mental and social well-being. Health, wellbeing and poverty are inextricably linked. Persons with disabilities, whom might have a higher incidence of health related complications, tend to be marginalised and excluded, face unique barriers to accessing health care, and are particularly at risk of catastrophic health expenditures. Societies cannot progress with economic development without ensuring access to quality, affordable, accessible, appropriate health services.

Universal Health Coverage is the means to address these changes.

“UHC is the single most powerful concept that public health has to offer.”

—Margaret Chan, Director-General, WHO

Several major health declarations have called upon UHC to build health systems and equity and the 2030 Agenda for Sustainable Development Goal #3.8 calls for UHC as a means to achieve health for all. We support this initiative and call upon the global community to support countries in achieving UHC. The definition of essential services currently includes rehabilitation. However it does not feature in any measures or tracer indicators.

Rehabilitation must be better included within the UHC agenda.

The demand for rehabilitation and assistive health technologies will be magnified in the coming years.

Evidence is showing a rise in the prevalence of disability. A greater emphasis on rehabilitation is called for within the WHO Disability Action Plan 2014-21, the World Report on Disability and the United Nations Convention on the Rights of Persons with Disabilities. Rehabilitation intervenes across the continuum of care, enabling greater health and functional outcomes. Access to rehabilitation professionals such as physiotherapists, occupational therapists, prosthetists/orthotists, speech therapists, as well as access to quality and affordable assistive products make a major difference in people’s health and wellbeing .

As professionals working on rehabilitation, we therefore call for those working on UHC to:

  • Establish and recognize rehabilitation and assistive health technologies as a crucial component of universal health coverage and elaboration of a list of Priority Assistive Products (APL);
  • Include indicators for rehabilitation and assistive health technologies within the basic package of essential health services covered under UHC;
  • Include persons with disabilities in innovative health financing solutions that aim to achieve UHC, as they often face institutional barriers to participation in such protection measures.