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A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries

Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMIC...

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Autores principales: Bright, Tess, Wallace, Sarah, Kuper, Hannah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210163/
https://www.ncbi.nlm.nih.gov/pubmed/30279358
http://dx.doi.org/10.3390/ijerph15102165
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author Bright, Tess
Wallace, Sarah
Kuper, Hannah
author_facet Bright, Tess
Wallace, Sarah
Kuper, Hannah
author_sort Bright, Tess
collection PubMed
description Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMICs) is limited. A systematic review was conducted to examine this in depth. In February 2017, six databases were searched for studies measuring access to rehabilitation among people with disabilities in LMICs. Eligible measures of access to rehabilitation included: use of assistive devices, use of specialist health services, and adherence to treatment. Two reviewers independently screened titles, abstracts, and full texts. Data was extracted by one reviewer and checked by a second. Of 13,048 screened studies, 77 were eligible for inclusion. These covered a broad geographic area. 17% of studies measured access to hearing-specific services; 22% vision-specific; 31% physical impairment-specific; and 44% measured access to mental impairment-specific services. A further 35% measured access to services for any disability. A diverse range of measures of disability and access were used across studies making comparability difficult. However, there was some evidence that access to rehabilitation is low among people with disabilities. No clear patterns were seen in access by equity measures such as age, locality, socioeconomic status, or country income group due to the limited number of studies measuring these indicators, and the range of measures used. Access to rehabilitation services was highly variable and poorly measured within the studies in the review, but generally shown to be low. Far better metrics are needed, including through clinical assessment, before we have a true appreciation of the population level need for and coverage of these services.
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spelling pubmed-62101632018-11-02 A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries Bright, Tess Wallace, Sarah Kuper, Hannah Int J Environ Res Public Health Review Rehabilitation seeks to optimize functioning of people with impairments and includes a range of specific health services—diagnosis, treatment, surgery, assistive devices, and therapy. Evidence on access to rehabilitation services for people with disabilities in low- and middle-income countries (LMICs) is limited. A systematic review was conducted to examine this in depth. In February 2017, six databases were searched for studies measuring access to rehabilitation among people with disabilities in LMICs. Eligible measures of access to rehabilitation included: use of assistive devices, use of specialist health services, and adherence to treatment. Two reviewers independently screened titles, abstracts, and full texts. Data was extracted by one reviewer and checked by a second. Of 13,048 screened studies, 77 were eligible for inclusion. These covered a broad geographic area. 17% of studies measured access to hearing-specific services; 22% vision-specific; 31% physical impairment-specific; and 44% measured access to mental impairment-specific services. A further 35% measured access to services for any disability. A diverse range of measures of disability and access were used across studies making comparability difficult. However, there was some evidence that access to rehabilitation is low among people with disabilities. No clear patterns were seen in access by equity measures such as age, locality, socioeconomic status, or country income group due to the limited number of studies measuring these indicators, and the range of measures used. Access to rehabilitation services was highly variable and poorly measured within the studies in the review, but generally shown to be low. Far better metrics are needed, including through clinical assessment, before we have a true appreciation of the population level need for and coverage of these services. MDPI 2018-10-02 2018-10 /pmc/articles/PMC6210163/ /pubmed/30279358 http://dx.doi.org/10.3390/ijerph15102165 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bright, Tess
Wallace, Sarah
Kuper, Hannah
A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title_full A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title_fullStr A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title_full_unstemmed A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title_short A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries
title_sort systematic review of access to rehabilitation for people with disabilities in low- and middle-income countries
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210163/
https://www.ncbi.nlm.nih.gov/pubmed/30279358
http://dx.doi.org/10.3390/ijerph15102165
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