ALERT – A New Way to Improve Financial Access to Rehabilitation Services

Posted by: on Dec 12, 2015 | No Comments

Handicap International has launched in 2015 a project to improve the access to physical and functional rehabilitation care for persons with disabilities in countries with low and middle income. This initiative originated in an initial question posed by the rehabilitation technical department at headquarter level: How to reduce the financial barriers in order to have access to functional rehabilitation services and to mobility aide in low and middle income countries?

A diagnostic tool in the economic system of physical and functional rehabilitation for low- and middle-income countries was developed. This tool covers four main areas: the provision to rehabilitation care, the cost of rehabilitation care charged to the user, the context of the social security and the capacity on the development of the country of concern. The development of this tool has received strong scientific support as Handicap International has collaborated with Alain Letourmy, Health economist and Research fellow at CNRS and at the “Centre d’Etudes et de Recherches sur le Développement International – CERDI” with the participation of several Master 2 students in Health Economics and International Development.

In July and August of 2015, this tool has been deployed on three continents, Africa, America and Asia, in three countries, Burkina Faso, Colombia and Laos and in three different languages, in French, Spanish and in English. Following these tests the tool was presented at an international seminar between 26 and 29 October in Madagascar in the presence of fifty participants, rehabilitation actors in their country (manager and rehabilitation services personnel representing the ministries of health, Handicap International teams etc.) Twenty nationalities of developing countries were present, such as Irak, Haïti, Senegal, Cambodia, Egypt as well as Mali. Two experts accompanied the debate and brought their experiences all throughout this seminar, Alain Letourmy, our research partner, and Oumar Ouattara, PhD Consultant in Public Health and Health Financing. An interview of the two experts is also available online here. The tool was welcomed with enthusiasm and strong demands were formulated during this seminar to deploy this tool in 2016 in their countries.

The challenge of such a diagnosis is to obtain robust and reliable data on the current situation of rehabilitation, according to the country’s context, with the perspective to implement advocacy with the civil society as well as well-reflected, feasible and evidenced based politics. This will lead to concrete projects aiming at improving financial access for person with disability to rehabilitation services.


“In Laos, 93% of the person with disability live below the poverty line; in Burkina Faso, health spending can cause a household to irremediable poverty if they accede 45$; in Laos, only 1% of the population live within 10 kilometers of a rehabilitation center while 63% of the population in Laos live more than 100km away from a center and this indicator rises to 80% in Burkina Faso.”

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This tool is part of the vision of the international community (Sustainable Development goals, Action Program in Addis-Abeba, the WHO Global Action plan on disability 2014-2021), and it has deepened the field of study. International institutions mention persons with disability (such as vulnerable persons) and promote universal access to primary health care (or basic) but no reference is made to the specific health care needs of people with disabilities, this is why we, as Handicap International, intervene. We offer a tool providing economic and non-economic data for the system; this is for the specific care, physical and functional rehabilitation, for persons with disability. Eventually, the data issued by the tool could assist in lobbying activities for the recognition in international texts for the legislation for the right to access to basic health care and rehabilitation services for persons with disabilities.

If you like more information on this please contact us at:

Listen here to our expert (in French)