From Primary to Tertiary Care: Implementing the WHO Package of Interventions for Rehabilitation

Abstract

Rehabilitation is an essential component of health systems, yet access to comprehensive services remains highly inequitable, particularly in low- and middleincome countries (LMICs). To address the growing global burden of disability, the World Health Organization (WHO) introduced the Package of Interventions for Rehabilitation (PIR), a diagnosis-based framework outlining essential interventions, workforce competencies, and equipment needs across priority conditions. While comprehensive, the PIR does not prescribe models of care, raising important questions about implementation in resource-constrained settings. This mini-review examines how the PIR can be operationalized across primary, secondary, and tertiary levels of care through contextual adaptation, task sharing, and scalable workforce development. We suggest practical strategies for supporting early identification, continuity of care, and efficient resource utilization. A case example of amputation rehabilitation illustrates how PIR guidance can be translated into feasible service delivery and training models, demonstrating the PIR’s potential to strengthen rehabilitation systems and advance equitable access within universal health coverage.

Keywords: Physical and Rehabilitation Medicine, Health Services, Delivery of Health Care, Developing Countries, Health Workforce, Global Health