The Issues And Challenges In The Rehabilitation Sector

Icon image collection of physiotherapy centre activities

Medical rehabilitation helps individuals with disabilities attain and then maintain optimal functioning of their body. It does so by reducing the impact of their health condition and teaching the person basic life-tasks like eating and walking.
Rehab focuses on increasing the existing capacity of individuals with handicaps. The therapy aims to maximise the functional ability of a person with the help of:

Medical care providers
Social workers
Education
And vocational measures

Even though rehabilitation can aid a person in regaining regular life, it is often the most neglected sector of healthcare. In particular, the disability policies set by the government.

What Issues Medical Rehabilitation Faces Around The World?

Physical medicine and rehabilitation are an excellent investment because it amplifies human capacity. Yet, a survey of countries, particularly developing nations, shows a massive gap between need and provision of rehabilitation.

A perfect example is a global survey conducted in 2005. The study aimed to find out how many countries implemented the UN Standard Rules on the Equalization of Opportunities for Persons with Disabilities. Of more than 100 nations, only 38% adopted the rehab policies. Moreover:
50% did not pass legislation on rehabilitation.
40% did not establish rehabilitation programmes.
Non-compliance with standards is the smallest challenge rehab faces. A bigger one is the limited access to assistive devices. For example, hearing aid distributors found that the current production level of hearing aids only meets 10% of the worldwide need. In developing countries, that number is reduced to 3%! Of all the people who require hearing aid in countries like India and Africa, only 3% get them.

Where there are rehab centres, they are limited to urban areas like Chennai. This centralisation and concentration of medical rehabilitation have left tier 2 and 3 cities with inadequate access to services.

Limited access to assistive devices leads to:
Deterioration in health
Restricted activity
Constraint on participation
Increased dependency
Reduced quality of life
Another issue rehabilitation is tackling, especially in places like India is the insufficient rehabilitation personnel with appropriate training and experience. Lack of proper physiatrists is a significant hurdle physical medicine and rehabilitation has to overcome.

One more issue that riddles rehabilitation services are legislation. Governments are taking no responsibility for people living with a disability. There is no implementation of policies, and there is a very weak strategic planning. Spending and coverage on rehabilitation and disability are also limited.

What Are the Policies For Rehabilitation In India?

The Indian Constitution applies to all citizens of the nation. It doesn’t define ‘disability.’ Furthermore, the Directive Principles of State Policy remarks that the State should deliver every possible help in case of:

Old age
Sickness
Disablement
Unemployment

To empower people with disabilities, the Government of India has enacted the following legislation over the years:

Indian Lunacy Act, 1912
Mental Health Act, 1987
Rehabilitation Council Of India Act, 1992
Persons With Disability Act, 1995
National Trust Act, 1999
Right To Education Act, 2010

The rights the act provides to those who need medical rehabilitation are:

Service by a qualified and trained rehab professional who have been registered by the Council.
Maintenance of a certain standard of professional conduct by the rehabilitation providers. If not met, then the professionals face disciplinary action and even removal from RCI.
Guarantee that all rehabilitation professionals are under the regulation of a statutory council, which comes under the preview of the central government.

In here, the focus remains on the Rehabilitation Council Of India Act. The legislation was put into practice to:

Regulate training policies
Standardise policies
And regulate programmes in the field of rehabilitation or person with disabilities

The act states that a rehabilitation practitioner should be qualified from an institute recognised by the RCI. Additionally, the practitioner should be registered with RCI. These rules are also applicable to special educators in the field of rehabilitation.

As one of the leading rehab centres in Chennai, we are intimately aware of the shortcomings of rehabilitation. Much needs to be done by the government to overcome the challenges the sector faces.

More investment and financing are required so that every person of the nation can get easy access to rehab facilities.
The supply and capacity of personnel need to be amplified. For this, education and training are a must; followed by recruitment and retention.

The delivery of rehabilitation services must be integrated with the current healthcare system. For example, by coordinating with a hospital in Chennai, we are able to deliver crucial help to dozens of patients each year. It ensures early intervention which leads to more recovered patients.

The last step required to make the lives of those who live with disability better is assistive technology. We have seen first-hand how our patients in Chennai lead happier lives with assistive aids. More local manufacturing, reduction in taxes and good follow-up can make a world of difference.