With life expectancy on the rise throughout the Region of the Americas,1 people are experiencing greater levels of acute and chronic illnesses and sustaining injuries more than at any time in history.2 Many of these conditions may impact health and function, for which rehabilitation is the frontline health strategy. It is for this reason that rehabilitation has been termed the health strategy of the 21st century.2 Recent estimates suggest that around one in every three people has a need for rehabilitation at some point in the course of their illness or injury.3
In 2017, the World Health Organization (WHO) assembled a meeting of more than 200 rehabilitation experts from 46 different countries to discuss the state of rehabilitation throughout the world. This seminal event highlighted the global unmet need for rehabilitation and called for coordinated action and commitment amongst all stakeholders to raise the profile of rehabilitation as an integrated health strategy by 2030.4 While the “areas for action” within Rehabilitation 2030 call for systemic changes at sub-national, national, and global levels, we, as physical therapists, must also heed the “call” at the levels of our individual practice and service. We must view ourselves within the context of the rehabilitation community, which is part of the larger global health community, advocating for social justice and health equity all around the world.
The WHO defines Rehabilitation as “a set of interventions needed when a person is experiencing or is likely to experience limitations in everyday functioning due to aging or a health condition, including chronic diseases or disorders, injuries or traumas.”5 Rehabilitation 2030 puts an emphasis on rehabilitation for all, as a key component of universal health coverage, debunking the often perceived notion that rehabilitation is a service specifically for people with disabilities. Within the definition above, we can see that rehabilitation professionals, including physical therapists have an important role to play throughout the life course and across the entire continuum of care.
To achieve this, physical therapy (and other rehabilitation services) needs to be accessible in primary, secondary, and tertiary settings and working with people who have or are at risk of having highly prevalent and costly conditions including non-communicable diseases, communicable diseases, mental health concerns, and women's health, and are also working in emergency settings and on disaster preparedness and response teams.2,5,6 Physical therapy works not only in a restorative manner but consistently in prevention, wellness, and maintenance. Greater access to physical therapy and rehabilitation services would help “ensure healthy lives and promote well-being at all ages,” a United Nations goal for sustainable development (goal #3).7
Rehabilitation 2030 challenges us, as healthcare professionals, to take a systems approach to strengthen all facets of our sector, from human resources to quality practice; leadership and governance; to data and information to better integrate within the health system. But what exactly can we as individuals do?
A working group of rehabilitation professionals in medical facilities around the world met to discuss the role of the clinician in raising awareness of the need for rehabilitation within and among medical faculties, policy makers, civil society, and the private sector.8 They developed guiding principles that focus on provision concepts and data, information and public relations, and collaboration in projects and networking.8 To effectively implement these recommendations, we must identify and consider the systems around us and act. Some systems may be more apparent, such as the clinics, hospitals, and institutions in which we work. Others may be more subtle, such as the attitudes of society and other healthcare professions towards the rehabilitation sector.
We propose a number of steps that physical therapists, and all rehabilitation professionals, can take to begin to respond to the Rehabilitation 2030 Call for Action.
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Advocate and educate the public, the public health sector, and other key stakeholders on the importance of rehabilitation and the work of our professions during personal, professional, and social interactions.
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Consume, collect, and share data, evidence, and research to advance physical therapy on an individual, systems, and societal level.
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Enlarge the regional physical therapy workforce through high-quality educational opportunities.
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Support and engage with non-governmental and grass-roots organizations involved in strengthening physical therapy and rehabilitation services.
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Join, support, or establish national professional associations of physical therapists so that our voice and actions can be magnified.
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Engage with and support regional organizations such as the Pan American Health Organization and the South American region of World Physiotherapy.
With an aging population, an increase in non-fatal injuries, and an epidemiologic transition to higher incidence of non-communicable diseases,2 it is expected that the need for rehabilitation will increase throughout the Americas. Without scaling up rehabilitation services the unmet need will create greater health inequalities. Rehabilitation 2030 is a call to fulfill the basic human right to health and wellbeing and each one of us has a role to play.9
Rehabilitation is an investment that contributes to health, economic, and social development.4 However, to expand access and take it to all corners of the Region, we must think of Rehabilitation 2030 as a personal call and be the agents of change. The time to act is now: What is your role?