Rehabilitation in context (RiC) – a conceptual framework for the rehabilitation sector

Abstract

Purpose: Demand for and complexity of rehabilitation is rising globally, especially in low resource settings. The rehabilitation sector lacks a conceptual framework suited to reflect the dynamics of numerous elements influencing and defining it. This paper introduces the "Rehabilitation in Context" (RiC) framework, designed for the diversity and complexity of rehabilitation in a given context. Materials and methods: The framework was developed in an iterative process including literature and frameworks review, global consultation rounds wih stakeholders and is informed by systems thinking and lived experience. Results: The RiC framework consists of four components: Context, Systems, Population, and Services. "Context" delineates environmental, political, and cultural influences, impacting population health and service accessibility. "Systems" involve governmental, non-governmental, and international entities regulating rehabilitation. "Population" considers people in need, addressing objective and subjective factors. "Services" includes workforce, infrastructure, and outcomes. The framework recognizes bidirectional influences among components, emphasizing interconnectedness and multidimensionality. Conclusion: Looking at discrepancies in needs and supply, this framework considers the context in which rehabilitation is offered as a key element to understanding and strengthening the sector. The framework consolidates key features that underpin the complexity of rehabilitation and aims to systematically assess and strengthen the rehabilitation sector in diverse contexts