Comprehensive rehabilitation: a content analysis of Colombian legal framework to support the disabled population

Abstract

Background: The 72.7% of the population on disability status has no affiliation t1o health system, and about 78.2%of population registered i requires rehabilitation services; The Physiotherapy Services are demand by 21.9%, showing that there is a priority to improve bodily functions and functioning, and that other aspects such as mental and social are less taken into account (Moreno, Rubio, Angarita, 2011). The majority of the rehabilitation interventions, do not consider factors related with the integration of people into the environment (Gomez, Valencia, 2004). These rehabilitation services are first requested approximately for the elderly population at 36.2% and secondly by the population between 15 and 44 years of age (29.3%). There are other even more striking indicators, such as the fact over the 100% of individuals referred for rehabilitation services, just the 25% attend to the all process, being the economic factor the determinant of this desertion; 78.2% of who attend to the rehabilitation services, report not been recovered. (1) The World Health Organization is clear to state that the first step to improve the impact of rehabilitation services, is to incorporate the concept into local law and specific regulations for people with disabilities including national rehabilitation plans:, surveys show that the majority of the world countries do not have rehabilitation policies (42%) and have not been established clear guidelines for rehabilitation processes (40%) (WHO, 2011). Purpose: Analyze the comprehensive rehabilitation concept and its dialogue with the regulatory framework for disability support in Colombia. Methods: Qualitative study conducted through the content analysis method for the analysis of the normative framework of disability in Colombia. Results: It is evident the coexistence of different models of disability in Colombian legislation; from this perspective it was possible to categorize the concept of disability as described in the rules, having reviewed a total of 26 papers and 67 units of, in which, the authors could identify the Individual disability paradigm as the predominant in these rules. Similarly, six definitions of rehabilitationwere analyzed,with the latest set forth in Act 1618 of 2013, in which the relational paradigm emphasizes rights. It is emphasized that the individual model prevailing on the regulatory framework for disability support responses focused on the aspect of ability to function, aside the aspect of opportunity of choosing. Conclusion(s): It is conclude there is a need to propose and implement, in accordance with the real needs of people with disabilities, a national rehabilitation plan, and that existing rules should be consistent with the rights of persons with disabilities. Similarly, the rules for disability support in Colombia must be constantly evaluated from the perspective of extended disability frameworks, allowing to include aspects such as poverty and inequalities inherent in the Colombian context and those related with access, cultural perspective and actual financing mechanisms rehabilitation processes. Implications: Project results call for further analysis and development of regulatory consistency that supports the actions of the rehabilitation system and generated guidelines from which the scope and impact of decisions and interventions aimed at the population in disability is established.