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Background: Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.

Methods: To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific).

Findings: Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34–2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235–392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588–636] and 83 million YLDs [62–106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68–1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed.

Interpretation: To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.

VOLUME 396, ISSUE 10267, P2006-2017, DECEMBER 19, 2020
https://doi.org/10.1016/S0140-6736(20)32340-0

The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

RAPID REVIEW VOLUME 395, ISSUE 10227, P912-920, MARCH 14, 2020

DOI:https://doi.org/10.1016/S0140-6736(20)30460-8

The issuing of a statement by the Interagency and Expert Group on Sustainable Development Goal (SDG) Indicators in Geneva, a group of leading UN agencies, civil society actors, and independent experts strongly supporting the Washington Group on Disability Statistics’ Short Set of Questions (WGSS) is noted and a short explanation of the questions is provided.

The Lancet Global Health VOLUME 5, ISSUE 7, PE649-E650, JULY 01, 2017

https://doi.org/10.1016/S2214-109X(17)30207-3

To determine current issues related to persons with intellectual disabilities, we undertook a global study, examining government action as reported to the CRPD Committee and gathering data from 667 disability experts and organisations from 88 countries regarding the extent to which low awareness of intellectual disability and stigma are continuing concerns, and what is being done to tackle these concerns

The Lancet, Global Health, Vol 4, Issue 5, PE294-E295, May 01, 2016

The implementation of national health insurance reforms designed to move towards universal health coverage by 9 low-income and lower-middle-income countries in Africa and Asia  is reported. Five countries at intermediate stages of reform (Ghana, Indonesia, the Philippines, Rwanda, and Vietnam) and four at earlier stages (India, Kenya, Mali, and Nigeria) are considered. These countries’ approaches to raising prepaid revenues, pooling risk, and purchasing services are described using the functions-of-health-systems framework. Their progress across three dimensions of coverage: who, what services, and what proportion of health costs is assessed using the coverage-box framework. Patterns in the structure of these countries’ reforms including use of tax revenues to subsidise target populations and steps towards broader risk pools are identified. Trends in progress towards universal coverage, including increasing enrolment in government health insurance and a movement towards expanded benefits packages are reported. Common, comparable indicators of progress towards universal coverage are needed.

Evidence shows that people with disabilities often rate their own quality of life much higher than others rate their quality of life: subjective satisfaction of disabled people is usually comparable to that of non disabled people. [...] physicians and other healthcare professionals need to accept that many people with disabilities, particularly where their health conditions are congenital or long term, do not necessarily perceive their disability as a problem or pathology.

The Lancet
Volume 374, Issue 9704, 28 November–4 December 2009, Pages 1815-1816

This article assesses "the contribution of physical, mental, and cognitive chronic diseases to disability, and the extent to which sociodemographic and health characteristics account for geographical variation in disability." Using cross sectional surveys of people aged over 65 in seven low and middle income countries, the findings highlight specific associations of chronic diseases to disability and overall that dementia, not blindness, is overwhelmingly the most important independent contributor to disability for elderly people in low and middle income countries. This resource is useful to people interested in the contribution of chronic diseases to disability in elderly people
The Lancet, Vol 374, Issue 97041
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"Mental health disorders represent a largely hidden, if not substantial proportion of the world's disease burden. They can often be neglected, especially in low and middle-income countries, many of which have no resources to tackle mental-health concerns. The Lancet Series on Global Mental Health draws together leading experts from the Institute of Psychiatry, Kings College London, UK, The London School of Hygiene and Tropical Medicine, UK, and, WHO to highlight the gaps in mental-health services worldwide, and to formulate a clear call to action"
The Lancet, Volume 370, Issue 9590