Rehabilitation 2030: Health policy and systems research and occupational therapy

Louise Gustafsson

In a first for the Australian Occupational Therapy Journal, the final issue of the year includes an editorial that has been co-published together with approximately 30 (and increasing) journals. The editorial (Frontera et al., 2023) was developed by the Health Policy and Systems Research for Rehabilitation Group of the World Rehabilitation Alliance, World Health Organization. The World Rehabilitation Alliance is a global network whose mission is to advocate for the Rehabilitation 2030 initiative from the World Health Organization (https://www.who.int/ initiatives/rehabilitation-2030).

Rehabilitation 2030 recognises that there is an urgent need for changes within the global landscape to improve equity of access to rehabilitation. Indeed, there is a growing global need for rehabilitation to be recognised as critical for health and wellbeing and thus included within universal health coverage in many countries, but particularly low to middle income countries. This is essential if we are to achieve the United Nations Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages (United Nations, n.d).

The World Rehabilitation Alliance (https://www.who.int/initiatives/worldrehabilitation-alliance) includes five workstreams: Workforce, Primary Care, Emergencies, Research, and External Relations. Each workstream has developed specific activities in their area of focus united by the continuing failure to meet the global population needs for rehabilitation. The research workstream (https://www. who.int/initiatives/world-rehabilitationalliance/research) has a specific focus on the field of health policy and systems research – and the editorial represents one of the advocacy activities of this group.

What is health policy and systems research?

This is transdisciplinary research, which has a focus on addressing real world issues and situations to support the implementation of health policies and strengthen health systems. The four central elements are health systems, health system development or strengthening, health policy, and health policy analysis (Gilson, 2012). The fundamental concept is to bring together the two fields and understand how health systems and health policy interact to shape, or be shaped by, each other and how the society is organised around these in the delivery of healthcare. There is an urgent need for collaborative health policy and systems research, particularly in low to middle income countries, to support the inclusion of rehabilitation as universal health care and improve equity of access of rehabilitation.

The Australian Occupational Therapy Journal has committed to the advocacy activities of the health policy and systems research group of the World Rehabilitation Alliance. Consistent with this activity, a recent editorial (Aplin & Gustafsson, 2023) discussed equitable and appropriate access to assistive technology on a global and local level. The editorial and the work of others highlights how the health policy and system interaction can and does impact health services and outcomes. As one example, the editorial placed a spotlight on the current conflict between client choice, evidence-based solutions and what is considered reasonable and necessary within the organisations who manage the assistive technology provision. At the core of this issue is the operationalisation of a policy within a system with an increasing focus on economic efficiency (Steel, 2019). Although our experiences do not mirror the experiences of countries where rehabilitation is not included within universal healthcare, there is an increasing need for the profession to recognise, promote, and be involved in health policy and systems research. References