Strengthening Rehabilitation in Health system: Stakeholders’ perception of factors contributing to the adoption of World Health Organizations guide to strengthen rehabilitation in the Rwandan healthcare system
Authors: Musabyemariya Ines , (MSc. Amanuel Kidane Andegiorgish 
Published: July 2024

Background: Rwanda has achieved a significant improvement in the overall healthcare delivery. Although stakeholders’ perception of the adoption of the World Health Organization (WHO) guide to strengthen rehabilitation is crucial for improving healthcare delivery, however, little is known about strengthening the rehabilitation services in the Rwandan health systems following the WHO guide.
A cross-sectional qualitative study was conducted to interview several rehabilitation stakeholders representing institutions that played a role in implementing the WHO guide to strengthen Rehabilitation in Health system. A structured data collection questionnaire and interview guide were used. Questionnaire data were collected using a 5-point Likert Scale, and analyzed using SPSS version 21, while interviews were recorded,transcribed, coded , cathegorizes thematically analyzed.
A total of 180 stakeholders have filled the questionnaire, with 64% of them being males. The majority (43%) of the research participants were aged between 41-45 years. More than eight-tenth (83.3%) of the participants had a first degree and 10% had a master’s degree level of education.
Overall, 7 themes and 13 sub-teams emerged from the key informant's interviews of stakeholders. The increase need for rehabilitation services is highly perceived by all governmental and non-governmental organizations in Rwanda. Rwanda's successful adoption of the WHO guide to strengthen rehabilitation in its healthca system can be attributed to the country's commitment justified by existing policies, guidelines, and the robust disability movement and this could be an inspiring model for other countries to follow. Additionally, Rwanda's ambition to become a premier tourist destination in East Africa has played a pivotal role in driving the adoption of WHO guidelines. Along with emphasizing stakeholders' perspectives, the results have identified obstacles that may hinder the desired outcome of strengthening rehabilitation in the national health system, such as a shortage of skilled and specialized professionals in the field of rehabilitation services, lack of data on the needs of rehabilitation services in Rwanda, and lack of experts to oversee the implementation of the rehabilitation strategic plan. Moreover, lack of enough rehabilitation facilities, inadequate financial resources, geographical barriers, and a lack of a responsible person at the central level to supervise rehabilitation activities are some of the potential obstacles that may impede the effective implementation of strenthening rehabilitation in Rwanda s health system.
Conclusion Rehabilitation Sector in Rwanda is providing a valuable model for other Low and Middle-Income Countries seeking to improve their rehabilitation services. With the demand for such services on the rise, investment in human resources and retaining those who are in practice, equipment, and infrastructure is necessary to satisfy the population's needs. Moreover, appointing a rehabilitation professional to oversee the implementation ofrehabilitation activities is imperative. It is recommended to build on identified contributing factors for the future sustainability of the process. Addressing the discussed challenges is crucial to ensure the intended outcome of integrating rehabilitation into Rwanda's healthsystem.