A Comparative Study of the Rehabilitation Services Systems for People With Disabilities

Objective: Providing desirable rehabilitation services to the people with disabilities has been always one of the most important concerns of the health system in the countries. Today, it is important for policymakers and health care providers recognize the different systems for providing rehabilitation services to people with disabilities. In this regard, it will be very useful to conduct comparative studies and use the experiences of successful countries. The purpose of this comparison-analytical study was to compare the systems for providing rehabilitation services to people with Materials & Methods: This comparative study was conducted about nine countries in 2020. In order to determine the comparison framework in this research, four dimensions of the functions of health systems were used based on the 2000 report of the World Health Organization and countries were compared in dimensions of stewardship, resource production, financing and service provision. Findings obtained from each country were presented separately in the comparative tables. The model used in this comparative study was based on Beredy model that contain four stages include description, interpretation, proximity, and comparison. In the present study, purposive sampling was used. The statistical population included rehabilitation systems in the world and the research examples were Iran, China, Turkey, India, USA, Mexico, Germany, England and South Africa. Criteria for entering the research according to the functional model of the World Health Organization were the availability of data and By geographical category, select at least one country from the Americas, Europe, Asia and Africa. Results: The findings showed that in Iran, the Welfare Organization was responsible for providing rehabilitation services for people with disabilities, while in other countries it was the Ministry of Health. Also, to compare resource production, two indicators of staff training and access to comprehensive national data were used. In all countries studied, the training of specialized human resources is done through the university system. Iran, India, and Mexico did not have full access to comprehensive national data, but the United States, Germany, China, South Africa, and Turkey provided the platform for planning and policy-making. Moreover, funding in Germany, the United States, China and Turkey is mostly provided through the insurance system, In the United Kingdom is mostly provided through the tax, but in Iran it is provided through subsidies from the public revenues and taxes. Finally, in addition to the private sector, rehabilitation services in the public sector in Iran was provided in an incoherent manner by various organizations, including the Ministry of Health and Medical Education, the Exceptional Education Organization, the Red Crescent, the State Welfare Organization, and the Martyrs and Veterans Affairs Foundation, while in other countries often provided these services through hospitals and the private sectors. Conclusion: Despite the numerous strengths in the system of providing rehabilitation services to the disabled in Iran, the integration of the rehabilitation sectors of various organizations within the Ministry of Health not only increases the coordination of inter-sectoral and intra-sectoral coordination, the coherence of management and unified policy, but also causes, leads to reduced costs, proper allocation of resources and increased financial resources in this sector. In addition, it leads to a reduction in overlapping tasks and responsibilities and prevention of duplication of work, training of specialized personnel based on the needs, and finally providing more desirable services. Therefore, it is necessary for policymakers and planners to review and reform the laws and processes in order to move towards the formation of a system for providing rehabilitation services to the disabled in Iran.