Alarcos Cieza, MSc, MPH, PhD

World Health Organization, Head Quarters , Geneva

Potential

3

Goal

Attainment by all

peoples of the

highest possible

standard of health

WHO Head Quarters , Geneva

Mortality

Causes of death in the Philippines 1990-2017

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA, 2019. Available from http://vizhub.healthdata.org/gbd-compare.

1990

2017from 44.9% to 69.3%

Communicable, maternal,

neonatal and nutritional

diseases

from 45.5% in 1990

to 22.9%

from 9.6% in to

7.7%

6

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA, 2019. Available from http://vizhub.healthdata.org/gbd-compare.

Rank of causes of death in the Philippines 1990-2017

Morbidity

9

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA, 2019. Available from http://vizhub.healthdata.org/gbd-compare.

Prevalence of health conditions in the Philippines 1990-2017

10

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA, 2019. Available from http://vizhub.healthdata.org/gbd-compare.

Prevalence of health conditions in the Philippines 1990-2017

Low back pain Osteoarthritis

Functioning

What is functioning?

Seeing

13

Communicating

14

Relationships

Hand and arm use

15

Eating

Work

16

Moving around

17

Why should we bother

about functioning?

Infectious

diseases

Ageing

NCD

Injuries

Increasing number of people

are living with

limitations in functioning

MORTALITY MORBIDITY FUNCTIONING

Infectious

diseases

Ageing

NCD

Injuries

0

500

1000

1500

0 10 20 30 40 50 60 70 80 90 100

Functioning score

Fre

qu

en

cy

No Mild Moderate Severe

Functioning Continuum in Philippines

0

No limitations

100

Extreme limitations

0 10 20 30 40 50 60 70 80 90 100

23

Goal

Attainment by all

peoples of the

highest possible

standard of health

WHO Head Quarters , Geneva

PROMOTION

PREVENTION

TREATMENT

REHABILITATION

Public Health

StrategiesObjective

Health

Morbidity and Mortality

Functioning

Mortality - Mortality

Recovery

Disease control

?

Potential

to have an impact at the

population at large

but ..

26

UNMET

NEED

There are significant unmet needs for rehabilitation across

all world regions, and in some countries more than 50% of

people who require rehabilitation services do not receive

them.Kamenov K, Mills JA, Chatterji S, Cieza A. Needs and unmet needs for rehabilitation services: a scoping review. Disabil Rehabil. 2019 May;41(10):1227-1237

What needs to happen?

Integration

29

Along the continuum of care

Acute Post-acute Long-term

Primary

Secondary

Tertiary

Community

Primary Health Care

31

Source: Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA, 2019. Available from http://vizhub.healthdata.org/gbd-compare.

Prevalence of health conditions in the Philippines 1990-2017

Low back pain Osteoarthritis

32

Going beyond capacity

Equity

Everyone who needs rehabilitation receives

quality services to optimize and maintain

their functioning in everyday life

• Provision of high-quality, essential

services for

– Health promotion,

– Prevention,

– Treatment,

– Rehabilitation and

– palliation

according to need

• Protection from financial hardship 34

Universal Health Coverage

Governanceand

leadership

Financing

Health information

system

Health workforce

Essential medicines

and AT Integrated

and equitable

rehabilitation

Strengthening the Health System

• Functioning

• Integration of rehabilitation at all levels of

the health systems

• UHC and health system strengthening

• Technical tools

• Agree on actions to strengthen health

systems for rehabilitation in countries

• Commitments to move the agenda forward36

Agenda

Alarcos Cieza, MSc, MPH, PhD

World Health Organization

Avenue Appia 20

1211 Geneva 27

Switzerland

Tel.: +41 22 791 1998

Fax: +41 22 791 4874

Email: ciezaa@who.int

Website: http://www.who.int/rehabilitation

37