title: The Cross-Cultural Societal Response to SCI: Health and Related Systems.
abstract: The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative aligned with the World Health Organization's (WHO) Global Disability Action Plan. Based on the outcomes of this initiative, countries will be able to shape their health systems to better respond to the needs of persons with SCI. This paper describes and compares the macroeconomic situation and societal response to SCI across 27 countries from all 6 WHO regions that will participate in the LHS-SCI initiative.
  
  
  
  A concurrent mixed-methods study was conducted to identify key indicators that describe the situation of persons with SCI, the general societal response, the health and rehabilitation system, and the experience for a SCI person after discharge from inpatient rehabilitation.
  
  
  
  A strong correlation was found between the efficiency of a healthcare system and the amount a country invests in health. Higher availability of resources does not necessarily imply that unrestricted access to the healthcare system is warranted. Variations in the health systems were found for various domains of the health and rehabilitation systems.
  
  
  
  The evaluation and comparative analysis of the societal response to SCI raise the awareness of the need of more standardized data to identify current needs and gaps in the quality and access to SCI-specific health system.
authors.affiliation: From the Swiss Paraplegic Research, Guido A. Zäch Institute, Nottwil, Switzerland.
authors.forename: Diana
authors.initials: D
authors.lastname: Pacheco
authors.forename: Mirja H
authors.initials: MH
authors.lastname: Gross-Hemmi
mesh_terms: D003431:Cross-Cultural Comparison; D003695:Delivery of Health Care / Q000458:organization & administration*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D006305:Health Status Indicators; D006801:Humans; D011788:Quality of Life; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014944:World Health Organization