title: Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century.
abstract: People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the 'challenges and opportunities' for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce.
  
  
  
  The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome.
  
  
  
  The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas.
  
  
  
  Based on the results, we have prioritized the following 'Six Rehab-Workforce Challenges': (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and tele-service; (5) adapt policy options to different contexts (e.g. rural vs urban), even within a country; and (6) develop international solutions, within an interdependent world.
  
  
  
  Concrete examples of feasible local, global and research action toward meeting the Six Rehab-Workforce Challenges are provided. Altogether, these may help advance a policy and research agenda for ensuring that an adequate rehabilitation workforce can meet the current and future rehabilitation health needs.
authors.affiliation: Portuguese Ministry of Education, Aggregation of Schools of Escariz, 4540-320, Escariz, Portugal. jesus-ts@outlook.com.
authors.forename: Tiago S
authors.initials: TS
authors.lastname: Jesus
authors.affiliation: Doctor of Physical Therapy Division, Duke University Medical Center, Duke University, Box 104002, 27710, Durham, NC, United States of America.|Duke Global Health Institute, Duke University, Durham, NC, United States of America.
authors.forename: Michel D
authors.initials: MD
authors.lastname: Landry
authors.affiliation: Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008, Lisbon, Portugal.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dussault
authors.affiliation: Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008, Lisbon, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Fronteira
mesh_terms: D003906:Developing Countries; D006233:Persons with Disabilities / Q000534:rehabilitation*; D014943:Global Health; D000069576:Health Equity; D006282:Health Personnel; D006291:Health Policy; D006301:Health Services Needs and Demand; D066086:Health Services for Persons with Disabilities / Q000458:organization & administration; D006801:Humans; D007391:International Cooperation; D008507:Medically Underserved Area; D000072087:Occupational Therapists / Q000600:supply & distribution; D059825:Physical Therapists / Q000600:supply & distribution; D057766:Policy; D011203:Poverty; D019035:Rural Health Services; D012424:Rural Population; D000078329:Workforce
keywords: Global health; Health equity; Health services for persons with disabilities; Human rights; Rehabilitation; Workforce