Medical rehabilitation in Ghana M. J. TINNEY 1 , A. CHIODO 1 , A. HAIG 1 & E. WIREDU 2 1 University of Michigan Hospital, Department of Physical Medicine and Rehabilitation, Ann Arbor, Michigan, USA, and 2 The University of Ghana, Accra, Ghana Abstract Purpose. To explore the current system of medical rehabilitation services for persons with disabilities in a developing country (Ghana) and to identify future needs, opportunities, and barriers. Methods. Information was obtained through a literature review and through interviews with healthcare providers, disabled people’s organizations, educators, government officials, and consumers. Direct observations were made of Ghana’s capital city, Accra, and of a major tertiary medical center there, Korle Bu Teaching Hospital. Results. Ghana has virtually no medical rehabilitation and few laws to protect the disabled. There are no occupational therapists or physiatrists in the entire country, and only a handful of physical therapists, prosthetists, orthotists, and speech therapists. There are many barriers to the establishment of such services, including lack of funding, limited government support, cultural stigma of the disabled and poor utilization of existing resources. Conclusions. A national model for sustainable medical rehabilitation is needed in Ghana and likely in other similar countries. Keywords: Rehabilitation, Ghana Introduction In a world of more than 6 billion people, approxi- mately 600 million have some type of disability. Currently, 80% of the world’s disabled population lives in low-income countries [1]. Unfortunately, the World Health Organization (WHO) reports rehabi- litative services in the developing world reach only 1 – 2% of the disabled [2]. This lack of medical rehabilitation is evident in many countries. The reasons for the deficiency in medical rehabi- litation services are not intuitive. Unless it is assumed that a person with a disability will die as a result of the disability, the cost-effectiveness of rehabilitation to the disabled individual, to their family, and to their society seem obvious. Even the poorest countries have a sufficient population of middle class or wealthy persons to both require and support medical rehabilitation. Yet it is largely absent. In order to understand the reasons why medical rehabilitation has not become a part of many healthcare systems, it is necessary to look at historical, cultural, political, and economic factors. Unfortunately very little research has been under- taken in developing countries, where mobility and physical capabilities are so vital [3]. Few papers have been published stating the need for rehabilitation in developing countries, including Ghana [2,4,5]. While not all countries are the same, an in-depth look at this one country may provide some clues that may be useful to others. The current paper examines the situation in Ghana. Its goals are both to propose a model for sustainable medical rehabilitation in that country and to provide a benchmark for evaluation of rehabilita- tion systems in other countries. Methods A literature search was completed on MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, and PubMed to look at medical rehabi- litation care in developing countries. Contacts were made and interviews completed with healthcare Correspondence: Anthony Chiodo, University of Michigan Hospital, Department of Physical Medicine and Rehabilitation, 325E Eisenhower Parkway, Ann Arbor, Michigan, USA. Tel: þ1 734 936 7379. Fax: þ1 734 615 1770. E-mail: tchiodo@umich.edu Disability and Rehabilitation, June 2007; 29(11 – 12): 921 – 927 ISSN 0963-8288 print/ISSN 1464-5165 online ª 2007 Informa UK Ltd. DOI: 10.1080/09638280701240482 Disabil Rehabil Downloaded from informahealthcare.com by HINARI on 08/09/12 For personal use only.