Global disability action plan 2014–2021 (GDAP): The way forward

Abstract

An estimated 80% of persons with disability (PwD) live in low- and middle-income countries (LMICs), with significant burden of disease and subsequent disability. The WHO Global Disability Action Plan 2014–2021 (GDAP), provides a list of specific actions and metrics for the empowerment of PwD, including strengthening/extending rehabilitation, assistive-technology, support services, and community-based rehabilitation. The aim of this study was to identify potential barriers for implementation of the GDAP in LMICs. The Flying Faculty rehabilitation team from the Royal Melbourne Hospital, Australia conducted intensive workshops at medical/academic institutions in LMICs for healthcare professionals from various local Physical Medicine and Rehabilitation (PM&R) facilities. A modified Delphi method identified challenges for future implementation to address gaps identified. Despite differences in the healthcare system and practices in LMICs, the challenges reported in four countries, at both macro (governmental/policy makers) and micro levels (community/social/individual) were similar. Common strategies were implemented to address challenges: limited knowledge of disability services, PM&R workforce, guidelines and accreditation standards; coordination amongst healthcare sectors; social issues; data and research; legislation and political commitment. Support of potential facilitators were: need for strong leadership; advocacy of disability-inclusive development; investment in infrastructure/human resources; coordination/partnerships in healthcare sector; and research. Disability care and rehabilitation is an emerging priority in LMICs to address the needs of people with disability. The GDAP framework provides guidance to facilitate access and strengthen PM&R services.