Health Systems for Rehabilitation - Critical Appraisal of the National Programme for Stroke in India.

Abstract

The organized provision of health services in India has been envisioned since 1946 by the recommendations from the Bhore committee. However, the policy and program strategies for the provision of good quality health care still lack effectiveness. Access to rehabilitation services for persons with disabilities continues to be a significant public health problem in India. This review intended to identify the barriers to integration and implementation of rehabilitation services within the national program for stroke in India. The methods involved the critical review and appraisal of the last five years of the published common review mission reports which report the performance of the entire health system and national program of the country. All relevant policy and program documents related to the national program for the prevention and control of cancer, diabetes, cardiovascular diseases, and stroke, were also reviewed. The World Health Organization, Rehabilitation 2030 recommendations were also cross-compared to summarize the findings from the critical review. The results revealed that rehabilitation was neglected within the conceptualization and implementation of the NPCDCS program. Let alone for the Stroke program, there was not any evidence-based description of the concept of disability management and rehabilitation within the NPCDCS program. The health system in its current form appears to be a non-inclusive system for disability-inclusive development. The priority is mainstreaming disability within the agenda for the health of the nation. If disability could be mainstreamed within the health agenda of India and in LMICs, universal health coverage and disability-inclusive development can certainly, be achieved.